The Transparent Cynicism of Medicaid Work Requirements

Little Rock    Every spring soon or later I sit down for an annual cup of coffee with Ernie Dumas, former editorial writer for the Arkansas Gazette and currently still an op-ed columnist for the weekly Arkansas Times, but mainly an old friend from “back in the day” where we mark the ways our paths have crossed for decades and continue to do so.  There is an order to our conversations.  First, we usually comment on how “bad” it has become.  Then we talk about how we continue in our various ways to pound our heads against the wall, no matter what we just said in the first instance.

I brought up a squib I had seen in the local paper that morning about the new work requirements that the conservative Republican governor of Arkansas had mandated for Medicaid recipients in the state.  Dumas mentioned that he had just written a piece about just how Catch-22 bizarre these new rules were in the last issue of the Arkansas Times.  He jumped up and found one in the coffeehouse still, and I promised I would read it later.

Lordie!  If anything, Dumas might have soft pedaled how draconian these new, first-in-the-nation Medicaid work requirements really are.  It’s one thing to talk about Scrooging up the requirements and pretending that there are a bunch of scofflaws trying to dodge paying labor in order to be provided by the government.  This is the ideological myth of the “able-bodied” that tries to fog over the fact that the overwhelming majority of Medicaid recipients are children, the infirm or incapacitated, or older people caught in poverty before they qualify for Social Security.  The Arkansas plan is not about being tough and doing a search-and-save mission to find the able-bodied and require them to provide 80 hours per month of some kind of labor or volunteer work in order to maintain qualifications for Medicaid, although ostensibly that’s the actual requirement.  No, the Arkansas plan is clearly only about one thing only:  forcing people off of Medicaid.

Here’s the real story in Dumas’ own words:

“Governor Hutchinson will institute big cuts in medical insurance for poor adults this spring my making Medicaid enrollees get on their laptops every two months and prove they are working at least 80 hours a month….If they can’t do that they lose their health care for the year.  Wait:  They probably don’t have computers or email accounts, would have a clue about how to use them or to build the evidence needed to keep their insurance, and may not live someplace with easy broadband coverage.  The state’s answer:  This will give them the energy to join the digital society.”

According to Public Integrity’s study Arkansas ranked 49th in the country for the lowest level of internet subscriptions and the worst digital divide for the poor in the country.  Even arch conservative Arkansas Senator Tom Cotton and the current head of the FCC have pointed out the deficiencies in internet access particularly in rural Arkansas.

Cynically, Arkansas politicians will go to war on the poor by claiming they are helping them join the modern technological world.  This is a mandate to work coupled with an unfunded mandate to buy a computer and pay for wireless.

This one is easy.  It’s not about rewarding work.  It’s about punishing the poor for their poverty.


Please enjoy Land of Greed by Miss Emily featuring Gord Sinclair & Rob Baker.

Thanks to KABF.


Humpty Dumpty Health Care

Paris   Nothing like a couple of weeks on the road, three countries, a half-dozen or so cities, and the siren song of home, heat, and humidity all sounds better and better. Of course there’s no escaping the headlines or the occasional questions from random people from all walks of life about what thoughts we might have on Trump. As excited as people around the world were about Obama as president, they are mystified by Trump. They are not alone.

The Republican Senate’s efforts to not just repeal-and-replace Obamacare, but to cap entitlements for Medicaid and pretty much kick the teeth out of the poor, elderly, disabled, and others seems to have alienated a couple of senators, while others wanted a chance to run up and kick harder and go for the kill. The New York Times reported that Senator Portman from Ohio has been a huge problem behind-the-scenes for the Republican majority leader and his efforts to pull together the votes. Seems he was concerned about what might happen to 700,000 people in Ohio that had gained coverage under the Affordable Care Act. Wow! That’s a good question for a lot of politicians from a lot of states it would seem. Turns out that when you push Humpty Dumpty off the wall, it really is hard to put the pieces back again.

And, in fact as the votes collapsed on the latest Senate version, there was an even greater implosion on the latest Trump twitter tantrum urging just repeal and deal a couple of years down the road. Seems immediately three Republican women in the Senate from West Virginia, Maine, and Alaska said the equivalent of “what are you pulling my leg,” saying that it would be reckless and irresponsible to simply repeal and blow the Act up.

Many of the Republican governors with shorter terms and quicker elections who are forced to be closer to their constituents also got their back up on these draconian cuts and caps in Nevada, Ohio, and elsewhere. They have earned some thanks as well.

I wish there were a lesson learned on the order of “don’t mess with entitlements,” but we know better. Like a bad dream, they’ll be back with more mischief and other attempts, and one way or another, they will have to do something now, we might hope, to fix some of the pieces of Obamacare that are broken.

Will they reach out to Democrats? Do they really have a choice?

Maybe this will be a twist on the old story, that if you break it, you own it. In this case, the message to the Senate might be, if you can’t break it, then do your job, and fix it.