“Are there no prisons? And the union workhouses — are they still in operation?” — Ebenezer Scrooge
In the 1990s Republicans achieved one of their goals when they put together the welfare reform package that was signed into law by President Clinton — a work requirement for welfare benefits. But so far they have not managed to institute a similar requirement for Medicaid under the Affordable Care Act, despite a strong interest in doing so. That may be about to change.
The Wall Street Journal is reporting that the Trump administration will allow states to modify their Medicaid programs to include a requirement that recipients have to work in order to receive benefits. HHS Secretary Tom Price and Centers for Medicare and Medicaid Services Administrator Seema Verma told governors in a letter that the administration is ready to work with them on granting waivers that would allow them to change how Medicaid is handled in their states. Lawmakers in several Republican-run states have been wanting to implement work requirements for Medicaid for several years.
Arkansas Governor Asa Hutchinson is one of the governors who thinks it’s just fine to force people to have to work in order to get healthcare. In 2015 Hutchinson told a reporter that
[Medicaid] is supposed to be an incentive and encouragement for people to work versus an incentive for people to just receive the government benefit and not be part of a working culture of Arkansas.
Of course, since Republicans are involved there’s some shiftiness afoot. There is an income cap for Medicaid recipients. That cap was increased under the Medicaid expansion provision of the Affordable Care Act. In Arkansas, Gov. Hutchinson wants to roll back the income cap to the federal poverty level, rather than keeping it at 138 percent of the poverty level as provided for under Medicaid expansion. The Arkansas Times says that will throw some 60,000 Arkansans from the Medicaid rolls, moving them to subsidized plans on the Obamacare marketplace; which, of course, the GOP in Washington is now actively trying to get rid of.
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A February 25 article in The New York Times tells the story of some of the Arkansans who could be hurt by Medicaid changes. Remember, these are the people who Republicans think should be exposed to the “dignity” of work, apparently even when you’re too sick to do much of anything.
Jimmy T. Brunson is one of those people. He suffers from painful neuropathy in his feet due to diabetes. He qualified for Medicaid under Obamacare, but says he would probably be kicked off if a work requirement is brought in. ““I’d probably be out. Even though sometimes I can get a job, you’ve got to understand — sometimes I can’t even walk,” he told the Times.
But it was Leonard Cuello, who works for the National Health Law Program, who summed up this plan the best:
Applying work requirements to health coverage gets it exactly backward.An individual needs to be healthy to work, and a work requirement may prevent them from getting the health care they need in order to be able to work.
Keep in mind that many of the people about to be screwed over by this change that is coming from the Trump administration were probably Trump voters — poor Southern whites who believed the great God-Emperor would create a paradise for them. Instead, he is about to let his party screw them over, again, big league.