Molly Adams
Despite a grassroots push for universal healthcare, seven states have adopted work requirements for Medicare coverage.
The Medicare-for-All movement may be gaining steam, but so is it’s evil counterpoint: the Medicaid for None movement.
It doesn’t formally go by that name, of course. It cloaks itself as a noble and long-overdue campaign to make lazy welfare moochers go out and get a job by imposing work requirements as a condition for Medicaid eligibility.
“...people who should remain eligible are losing coverage.”
Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, says the purpose of work requirements is to “help lift individuals out of the shadows of opportunity and into its light.”
Before the squatter currently occupying the White House took over, the Centers for Medicare and Medicaid Services never gave a state government permission to impose Medicaid work requirements. But now, seven states have the green light.
Arkansas was the only state that enforced those work requirements in 2018. And guess what happened? In the six months of 2018 where the work requirements were in place, 18,164 people were dropped from Medicaid in Arkansas for failure to comply. But the thing is, in Arkansas, Medicaid enrollees ages nineteen to forty-nine must not only engage in work or other qualifying activity for at least 80 hours a month, they also must prove it by submitting documentation to the state each month online. A telephone reporting option was added in December.
Failure to comply for any three months in a calendar year can (and obviously will) get you kicked off of the Medicaid rolls. And you can’t even apply for reinstatement until January 1 of the following year. Only 1,452 of those dropped for noncompliance were reinstated this year.
People with disabilities can be exempt from the Arkansas work requirements. But if you receive a disability exemption, you must reapply for it every two months or, again risk losing your Medicaid coverage.
How many people who were working or should have been exempt were dropped from Medicaid anyway because they weren’t fully aware of, or couldn’t keep up with, all the reporting requirements (not to mention good old human error)? Probably a lot.
An analysis of Arkansas Medicaid work requirement conducted by the Center on Budget and Policy Priorities finds, “Far more Arkansans are losing Medicaid coverage than are in the presumed target group of people not working and ineligible for exemptions, which means people who should remain eligible are losing coverage.”
The report also says, “People coping with serious mental illness or physical impairments may face difficulties obtaining physician testimony, medical records, or other documents required to qualify for exemptions. Mental illness often affects the cognitive functions needed to navigate complex bureaucratic systems, making it hard for someone to qualify and often leading them to give up and drop out of the process.”
But the report concludes that what’s going on in Arkansas is a failure because of these “unintended consequences.”
It is sure wrong about that. The Medicaid for None movement has succeeded in purging a whole bunch of people from the Medicaid roles in Arkansas, with a whole bunch more to come.
Those are precisely the intended consequences.