The Republican war on Medicaid and the American safety net for people in need that dates back to Lyndon Johnson’s Great Society continues.
After instituting new work rules for some Medicaid patients recently, and cutting funding in the proposed budget this week, the Trump administration is moving toward another policy change that would make the government-subsidized health coverage temporary assistance instead of something that would be available as long as it is needed.
The latest plan to save money at the expense of low-income Americans who dare to become ill will place a limit on the number of months or years that adults who qualify for the program have to access Medicaid benefits for the first time.
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Without an act of Congress, the change will be made by conservative politicians who rule the executive branch through the use of federal waivers that allow states to change the rules to save them money.
Of course, that is not how Republican backers would put it. They say that it gives states greater flexibility to create politics that promote personal and financial responsibility.
Advocates for people in need “say capping Medicaid benefits would amount to a massive breach of the nation’s social safety network designed to protect children, the elderly and the impoverished,” reports McClatchy News.
The conservatives claim that they do not want to destroy Medicaid but rather push it back to its roots when it was mainly there to serve pregnant women, children, the elderly, those with disabilities and others who have no other ability to access health care.
Under ObamaCare, Medicaid was expanded to include some adults, both married and single, who qualified because of their low income.
“Critics say Medicaid time limits will pose an enormous administrative burden by requiring states to track recipients’ employment, eligibility, and disability status,” reports McClatchy News. “It could also shave valuable coverage months from people with health problems that impede their ability to work.”
That means workers who qualify because of their low income but can’t get health insurance or coverage from their job could time out of the Medicaid coverage even if they still need the benefits.
It would mean they would lose coverage “as if it’s their fault that their job isn’t offering insurance,” Leonardo Cuello, director of health policy at the National Health Law Center told McClatchy. “And this would happen to thousands upon thousands of people across the country.”
Idea of Medicaid Time limits is based on a false assumption that workers will get health insurance from their employer. In 2017, just 14% of workers earning the lowest 10 percent of wages had employer-provided health insurance. https://t.co/aLi9pBND6w
— Anne Dunkelberg (@adunkcppp) February 8, 2018
How many people would be affected depends on how many states seek a waiver to institute the time limits. So far Arizona, Wisconsin, Kansas, Utah, and Maine have all indicated they want the new time limits.
Some see it as similar to limiting how long a person can get jobless benefits, food stamps or welfare assistance, but critics say it is quite different.
It could put a lot of sick people in a situation where their only alternative is to go to hospital emergency rooms for help, which is a much more costly form of treatment that in the end is still paid for by taxpayers.
“I think you have to be very thoughtful here in a way that’s quite different from cash assistance,” Gail Wilensky, a senior fellow at Project HOPE who ran the Medicaid program under President George H.W. Bush told McClatchy.
“It depends on what the safeguards and defaults are in a program like this,” added Wilensky. “Otherwise, it does not make a lot of sense and seems to be cruel and inappropriate.”
There is also a legal argument against injecting time limits into the Medicaid system. Under the original mandate by the Department of Health and Human services, waivers are to be done as experiments to see if it furthers the objectives of the program, meaning it improves health outcomes and access to providers – not just to save money.
“All of these policies that we are seeing are inconsistent with the objectives of Medicaid. They don’t seem to seem to have a legal basis and, as such, our stance is that they should not be approved. And we will work very hard with our partners to make that opinion well known,” said Suzanne Wikle, a senior policy analyst at the Center for Law and Social Policy.
Under President Obama, some of the states run by conservative Republicans like those named sought similar time limits and were rejected because they did not meet the objectives of the program and had nothing to do with improving patient care.
Under Trump, it seems a given they will be approved because it is all about money and saving taxpayers – especially the richest ones – from having to subsidize the sick, the needy and the poor.
"As a candidate, Trump repeatedly said he would never cut Medicare or Medicaid. Now he proposes cutting Medicare by $554 billion and Medicaid by around $250 billion."https://t.co/iB4UgwSdUW
— Rachel Maddow MSNBC (@maddow) February 13, 2018
These are more heartless, inhuman changes being pushed by the most cold-blooded and cheap administration in modern history, so this is not a surprise, just a disgrace.
The Trump budget is morally bankrupt and bad economic policy. It pays for his tax breaks for the rich and large corporations by slashing Medicaid by $1.3 trillion, cutting Medicare by $554 billion and slicing $10 billion from the Social Security Disability Insurance Program.
— Bernie Sanders (@SenSanders) February 12, 2018