Arkansas Playing Gotcha with the Poor to Cut Them Off of Medicaid

New Orleans  In a sordid and shameful episode a few weeks ago Arkansas Governor Asa Hutchinson pridefully announced that the state had managed to bar 4300 people from health care support through Medicaid because of its new work requirement policies.  Seema Verma the head of the federal Center for Medical Services (CMS) who had approved this draconian attack on the poor played clueless cheerleader.

As more information come forward the real evil that underlies this shame emerges.  Let’s look at the facts.

Arkansas began the experiment by exempting two-thirds of the eligible recipients from having to report work hours, knowing this was going to be a problem.  30,000 people were then required to report.  16,000 didn’t report any qualifying activities to the state, either work, training or volunteer time.  In fact, according to the New York Times, “only 1200 about 2% of those eligible for the requirement, told the state they had done enough of the required activities in August, according to state figures.”  That’s pickle-poor!  It screams to a state failure not a people failure, and it foretells thousands more that will be denied coverage.

State officials tried to cover their rear ends, claiming they had done everything possible:  mailings, calls, and even putting out fliers some places where Medicaid patients congregate.  Even more ridiculously they touted the fact that they send emails and posted on social media sites.  Who are they trying to fool?  Arkansas ranks 48th among all of the states in the US in terms of connectivity and 30% of the population is underserved.  230,000 people in Arkansas don’t have any wired internet providers available where they live.  Who wants to guess whether embedded in these sorry statistics lie most of these lower income Medicaid recipients?

Shockingly, the Times then quoted Amy Webb, the chief communications and engagement officer for the Arkansas Department of Human Services saying, “If there’s something we are not doing to reach people, if someone will tell us how to do that, we will do it.”  Yeah, really?  She doesn’t mention that the state legislature forbade any use of media to increase enrollment under the Affordable Care Act.  Nowhere do they claim they were on the television or radio airwaves.  As the manager of KABF, a 100,000-watt noncommercial smack dab in the middle of the state with more than 50,000 listeners per week, more than half of them lower income, I can absolutely tell you we never received a public service announcement from them, much less any support for a real information promotion of the program.

Every other indication is one of abysmal failure.  The state conceded even when they had email address, only 20 to 30% opened the email.  Call centers said many didn’t answer their phones.  A professor from New York visited three counties in August and interviewed 18 people and 12 were unaware that work requirements even existed.  Other experts noted that an incentive system, even a punitive one trying to get more people into the workforce, won’t work if people don’t know about it.  Duh!

Adding injury to injury, all of the work hours are required to be submitted through the internet.  That’s the same internet thing that hundreds of thousands of Arkansans are not able to access, and even with access are not necessarily all-pro at using the state’s clunky website.

State officials in Arkansas need to start some truth telling.  These so-called work requirements are nothing of the kind.  This a pure and simple way to push eligible people off of Medicaid.  Hopefully a coming court hearing will stop this hypocrisy.

In the meantime, this is a scandal that none of us should be able to stomach.

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Please enjoy Johnny Guitar from Twisted Wheel.

Thanks to KABF.

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The Healthcare Fixes Unfixed, Divide and Conquer on Display

Sofia    There’s no national healthcare in Bulgaria from what I learned in recent discussions, so this is a country where Americans can come to die and feel at home.  Think about that for a minute.  Living costs are relatively low.  Healthcare costs are relatively high.  Is this the world we want?  Perhaps so, because we seem headed for that situation, like it or not, ready or not.

Reading the morning papers on-line and getting past the Trump twitter tirades, the endless Russian hacking stories, and the usual grist for the mill, it was hard to miss a story in the Times that reminded us that no matter what small joy we may have harbored at the failure of the Republican Congress, the Trump project of starving the Affordable Care Act to death is making good solid progress around the land.  Worse for America, but probably great news in the West Wing of the White House is that it is yielding an even more politically beneficial result for the Trumpsters and the right wingnuts:  it’s dividing America even more.

I’ve ranted about the problems of lower waged workers suffering from the Obamacare loopholes and compromises that called them “covered” by the minimum standards of a healthcare plan if they were working for 50+ employee companies when their employers were allowed to say they were offering qualified plans with such absurd $4000 to $6000 deductibles and 9% of monthly income payments that literally NO ONE in many lower waged companies with hundreds of workers were electing coverage since it would suck up a huge portion of their checks when they were making $10 to $15 per hour.  More cynically, they were also barred because they were ostensibly covered by their employers from receiving any of the subsidies or shared cost assistance from the Obamacare marketplaces, so unless their states had expanded Medicaid, they were caught in the gap.   Nothing was sorted out in these years perhaps due to gridlock in Congress and perhaps because who really cares about low wage workers anyway?

Now in the Trump attack on the lower middle class, his starving of Affordable Care is leading, as predicted to soaring price and deductible increases on sketchy plans, almost identical to those faced by lower waged workers.  Families are seeing 50% or more increases in some states, and deductibles running up to $6000 before they are able to get benefits.  Now middle-income families are in the same boat as lower waged service workers where the cost of having insurance is creating a huge, sucking hole in their paychecks.

The shameful difference is that too many, if the Times’ report is to be believed, are not blaming Trump, the Republican Congress, gridlock, or anyone else.  They are blaming lower income families and – painful irony alert – lower waged workers.  Despite the fact that many families in both of these population segments are working their asses off at any and all jobs they can muster, this is now fueling support for even more draconian work requirements for the poor and lower income families access food stamps or even Medicaid benefits.

If that isn’t a master Machiavellian stroke approaching pure evil, what is?  Pretending Trump and his people are corrupt clowns may be satisfying to some, but as the Affordable Care fight shows, we’re in a death match now, and, friends, don’t fool yourself that we’re winning.

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