New Orleans       The new rules for Medicaid recipients mandated in Trump’s Big Bad Budget Bill go into full effect on January 1, 2027, including the 80-hour work or volunteer requirement.  Many states are already in the process of changing the rules and enrollment procedures, because in addition to the rule changes the federal government and states are attempting to reduce the beneficiaries through “paper cuts” or bureaucratic hurdles meant to block applications and renewals.

Louisiana is one of the states that has embraced such draconian policies with tragic enthusiasm.  One of our ACORN colleagues has acted as a volunteer and advocate in trying to assist friends and others in applying or continuing to retain benefits.  Recently, he shared a report from the trenches of his efforts which was shocking in manifesting the incompetence and deliberateness of the state in its attack on the rights of eligible recipients.

On cases, he was helping, he shared the following problems and takeaways:

• The Louisiana Medicaid document upload Captcha proving you are not a bot has been “broken” for months. You have to mail or email documents to the state. When emailed there is no confirmation except that “a ticket has been opened,” and those cases are still pending.
• There are deliberate design issues that prevent people re-registering. For example, the document upload page is nested back in a menu in the document tab. There is a small font on the home page saying this is where you upload documents, but you have to click the top tab once in there to find the document upload page, if you’re lucky.

My colleague reporting these issues is one of the people that we all go to when we have computer issues, so he qualifies at the least as very tech-savvy, which distinguishes him from the average person in Louisiana, and likely the usual benefit applicant or recipient.  To understand the context, Louisiana has a severe digital divide, so designing the Medicaid documents in obtuse ways by the state is clearly deliberate.  Researchers have found that “Approximately 1.7 million Louisiana residents, over one-third of the state’s population, lack access to high-speed, reliable internet, with around 20% of households having no broadband subscription at all. Roughly 400,000 to 500,000 households lack high-speed internet. About 64% of unconnected Louisianans cite cost as the primary barrier, with roughly 7 in 10 unable to afford broadband priced at $60 or less. Rural, northeast Louisiana, among the state’s poorest areas and specific parishes like Claiborne (51% access) and Webster (61% access) have the lowest adoption rates.  Approximately 460,000 adults aged 18–64 lack basic computer skills.”

Let’s say an applicant makes it through the maze somehow, here’s what happens next in our brother’s experience:

• Once documents were submitted most people just get dropped, even if they qualify financially.
• There is no link on the portal to appeal the rejection, so you have to search for Louisiana Medicaid appeal. It gives you this really funky page that does not look official at all and is “conveniently” down all the time: http://www.adminlaw.state.la.us/HH.html
• There is also this page that works, but you really have to just trust it is the page you are looking for, because it does not have any documentation, doesn’t look to official, and has no links from the Louisiana Department of Health directs that you here: https://laserfiche.adminlaw.state.la.us/Forms/hSgLX
• If you do appeal, your benefits are extended during the appeal process. Once you appeal, sometimes the case is dropped, probably because you appealed.
• In other cases, some actually get a court date, which might require some kind of advocate or possibly even a lawyer, if you qualify for legal services at 200% of poverty. Many will fall before they can climb this mountain.

What a miserable and horrific experience for a desperate family just trying to access government benefits that they need and are eligible to receive.  It just seems unconscionable.

Our colleague has his own theory based on months of experience with this system:

It doesn’t seem like the Louisiana Department of Health has the resources to defend all these rejections and is just throwing all this red tape, technique issues, and design flaws into the pipeline to deny the applicant.

Indeed, and in tens of thousands of cases, this is likely to work simply by discouraging the applicant, regardless of their eligibility.  This is exactly the stated goal of Trump and his administration.  Don’t overtly cut the benefits, just throw up roadblocks to block recipients from the entitlements, so that tax cuts for the rich can be funded.

What a country!  Where does the plight of people come up on the list of priorities? Is this the America we want?