Technology versus the Poor

Technology_management_LG_FOCNew Orleans    With herculean efforts along with extensive field work and mega expenditures of dollars and political capital, www.healthcare.gov works better now to the degree that about 2 million people weathered the storm to sign up under the new Affordable Care Act with millions more expected hopefully before March 31st.  I use the words “works better” carefully though since there’s not a day still where the hollers don’t ring through our offices about the website failing.

Meanwhile, I wonder about the lessons we’re really learning.  Tennessee for example just announced that they were moving to a web-only application system for everyone for TennCare, their version of the health insurance system.  I have to wonder what papers they are reading and whose interests they are hoping to serve by such a change in face of widely disparate internet access and the complex problems and challenges posed by these new systems.

Recently, I reminded everyone about the huge problems presented by the Bush Administration’s rollout of the drug expansion benefit under Medicare Plan D and its complexity and challenged enrollment and the lessons not learned by the Obama administration.  Georgetown law professor, David Super, in a Times op-ed piece does an even better and more comprehensive job in documenting the trail of tears for lower income families trying to get through the maze.

Just as disaster-relief agencies keep track of hurricanes, floods and earthquakes, students of anti-poverty programs remember a litany of automation and contracting meltdowns — some of them prolonged, even epic. Florida, 1992-93. Michigan, 1998-99. Colorado, 1998-2002. Texas, 2006-7. Indiana, 2007-9. The Colorado Benefits Management System is particularly memorable: When first implemented, it reportedly refused food stamps to anyone who did not have a driver’s license from Guam.  But finding parallels to the HealthCare.gov meltdown requires no memory at all. Just as HealthCare.gov was filling the headlines, a contractor for the Georgia Department of Human Services was neglecting to send renewal notices to the homes of some 66,000 food stamp recipients and about half that number of Medicaid beneficiaries. On Nov. 1, the state’s computer system…automatically terminated benefits to all those affected for failure to cooperate with reviews they had never been told were underway. In December, a Massachusetts contractor sent thousands of people, many of whom were elderly or had disabilities, new electronic food stamp benefit cards and immediately deactivated their old cards — without waiting to see if the new ones had arrived in the mail. Many had not. In mid-October, a contractor’s glitch made food stamps inaccessible to recipients in 17 states. The White House showed impressive alacrity in fixing HealthCare.gov. But its response to technology failures affecting low-income people has been far more sluggish.

This would all seem embarrassing, if the frequency of occurrences didn’t seem so inevitable and perhaps even deliberate.  There are so many better ways to do this, I have to wonder who is being fooled by these slipshod efforts that are punishing the poor while worshiping the holy grail of new technology while neither assuring access or ability to use it.

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