Rationing insulin. Skipping meals

IAMI – Elsa Romero eyes the $3.38 vanilla pound cake. A tiny bite could save her life. She's not sure she can afford it.
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Romero, 57, looks around the discount grocery in her Liberty City neighborhood, the cacophony of Spanish and Haitian Creole voices competing for her attention as she tries to do the math.

There's $90 in her bank account, and her next paycheck arrives in 10 days. As a janitor making minimum wage, she can't afford $110 for her weekly insulin, but a forkful of the dessert whenever her blood sugar drops could keep her out of the emergency room.

That cake – cheap and full of empty calories and sugar that could exacerbate her diabetes in the long run – is a short-term necessity, she decides.

Romero's predicament is dire and tragic and common. Across the USA, 58.3 million people work for less than $15 an hour. What hope they held out for relief in the form of a boosted hourly pay was dashed when Republicans and some Democrats had a $15 minimum wage removed from President Joe Biden's $1.9 trillion COVID-19 aid package. For people such as Romero, life continues to be a daily struggle.

With the cake in her basket, Romero moves to the hot bar. She picks up a quart of beef broth and a side of mashed potatoes, her only other food for the next few days.

She gets in line at the checkout counter.

"$11.24," the cashier says, ringing her up.

"Un momentico," she replies. One moment, please.

Romero pulls out a scrunched $10 bill and a couple of singles. When the clerk hands her the change, Romero puts it in the tip jar.

"There's always someone that needs it more," she says.

Elsa Romero purchases a vanilla poundcake, fruit and milk at a discount grocer March 16 in Miami. For Romero, 57, the cake is a cheap alternative to her expensive insulin.
Elsa Romero purchases a vanilla poundcake, fruit and milk at a discount grocer March 16 in Miami. For Romero, 57, the cake is a cheap alternative to her expensive insulin.
SAUL MARTINEZ FOR USA TODAY
Working two jobs to barely pay the bills
Working two jobs to barely pay the bills
Most voters – Republicans and Democrats – support raising the federal minimum wage, which has remained at $7.25 since 2009. Even before the COVID-19 pandemic, many Americans said soaring housing and food prices threatened their ability to pay for everyday expenses.

"There's no place in the United States where you can get a one-bedroom apartment for $7.25 an hour and still have enough to buy food and the absolute necessities," former U.S. Labor Secretary Robert Reich tells USA TODAY in a phone interview.

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Former U.S. Labor Secretary Robert Reich
There’s no place in the United States where you can get a one-bedroom apartment for $7.25 an hour and still have enough to buy food and the absolute necessities.
Biden said he wants Congress to pass a federal minimum wage increase, but there's no deal in sight. Experts say people such as Romero often must make difficult decisions to sustain themselves.