By skyforbes 
Reasonable requirement to encourage growth, or draconian measure sentencing people to their deaths?
I read an article about Kentucky’s new work requirements last week, and saw this week that my own state of Kansas is moving to implement something similar. So I’ve been thinking about it a lot lately.
Here’s the thing that has me debating with myself: if I were a good little liberal, I would immediately be opposed to any legislation that is designed to kick people off of Medicaid. However, the idea of requiring people receiving government assistance to work towards employment does not sound bad.
I believe that the existence of lazy unmotivated people who are on Medicaid because they choose not to work is greatly exaggerated. I believe the vast majority of Medicaid recipients would be earning enough to pay for their own insurance if they could. The article indicates that in Kentucky, 60 percent of Medicaid recipients had jobs, and the majority of those who did not had documented impediments to working.
I think finding ways to encourage and empower Medicaid recipients to get to a point where they didn’t have to rely on government assistance would be a good thing.
The problem is that I do not believe that is the actual intent of any of the proposed or already implemented legislation.
Here is a summary of Kentucky’s new rules as described by Reuters:
Kentucky’s waiver, submitted for federal approval in 2016, requires able-bodied adult recipients to participate in at least 80 hours a month of “employment activities,” including jobs training, education and community service.
The Kentucky program also imposes a premium on most Medicaid recipients based on income. Some who miss a payment or fail to re-enroll will be locked out for six months. The new rules will take effect in July, Kentucky state officials said.
First off, how do you define “able-bodied”? And who is in charge of making that determination? Do you think Kentucky will employ a bunch of counselors or specialists who will listen to each person’s story and make a determination on a case-by-case basis? Or do you think individuals will be required to fill out a confusing pile of paperwork and provide impossible-to-obtain proof of reasons they cannot work?
Second, 80 hours a month works out to about 20 hours a week, which is a steady half-time job. Not unreasonable in and of itself, but what kinds of jobs training, education, and community service qualify? What about people in areas where those opportunities are scarce, or those that don’t have access to transportation? And what if the jobs training and education come at a cost that they cannot afford?
Third, what about the premiums? How will they be determined? And how does charging the recipients help them move towards better financial stability?
Fourth, kicking recipients off for six months because they miss a payment or fail to re-enroll is excessively punitive, and does nothing to help the recipients get to a better place.
And finally, if the goal was really helping people earn enough to afford insurance, why wouldn’t it focus on Welfare recipients instead of Medicaid?
Here’s more from Reuters:
The rules apply to those between 19 and 64 years old. Certain groups are exempt, including former foster-care youth, pregnant women, primary caregivers of a dependent, full-time students, the disabled and the medically frail. The Trump administration also said states would have to make “reasonable modifications” for those battling opioid addiction and other substance-use disorders.
A reasonable list of exemptions. But again, how does the system determine if you belong to one of these groups, and who shoulders the burden of proof? I think it is fairly safe to assume that when in doubt, the system will say a person is able-bodied to work.
I feel this is another instance where we have to look at the letter of the law to determine the intent. And it seems pretty clear that the intent is to kick as many people possible off of Medicaid to save money.
Maybe if the legislation focused on the creation of new job coach positions within the state government, who were assigned a caseload of Medicaid recipients who in turn were required to meet with them on a regular basis, establish work goals, and show progress towards those goals, I would believe the intent was to empower more citizens to work.
But it doesn’t. And nothing this administration or legislature has done leads me to believe they give even a fleeting thought to improving life for the poor. They constantly complain about the Affordable Health Care Act and how much more money states and the federal government have had to spend on these “deadbeats” and never talk about any interest in improving the life of the poor.
Some will argue that it is not the government’s responsibility to “help those that won’t help themselves.” Some will say that those who can’t afford healthcare don’t deserve it.
And that is at the heart of many conservative versus liberal debates, really. Is the government simply there to protect us from war, put out fires, collect the trash, and leave the rest for the citizens to sort out? Or is government supposed to seek to ensure life, liberty, and the pursuit of happiness for all citizens?
I believe it should be the later, but I also believe the people in power have a decidedly different view.