Kim Bellard
Thus, the house passed their “big and beautiful bill” with the narrowest profits. The bill is crucial to the massive savings of Medicaid, which Republicans will get some joy from over the past few years, but now they are cautiously explaining just to reduce “waste, fraud and abuse”, eventually realizing that many of Magma’s voters rely on Medicaid.
Much of these savings comes from proposed work requirements for Medicaid recipients, a Republican strategy the Biden administration has been rejecting. Speaker Mike Johnson is very vocal about their importance. People affected by work requirements insist on Facing the country:
If you can work and refuse to do so, you are cheating on the system. You are cheating on the system. And no one in the country believes that this is right. So there is a moral component to what we are doing. When you make young people work good for them, it’s good for their dignity, good for their self-worth, and good for the community they live in.
He firmly believes that there is no job, but too many, especially young people – “playing video games all day”. He and other Republicans want to return Medicaid to their original purpose: “It is for young people, singles, pregnant women, disabled people and older people,” Speaker John Som said. “But what's going on right now is that you have a lot of people, like young people, healthy workers, who are working Medicaid. They don't have jobs where possible.”
Generally, for most Medicaids that exist, Medicaid is not a real plan for the poor, but for certain types of poor, especially low-income pregnant women and children, and medical poverty. Obamacare uses the Supreme Court to allow states to decide whether to do so, but Obamacare has expanded its coverage to everyone, but ten states still don’t.
Indeed, it is a moral issue, not the kind that the speaker Johnson likes is about whether there is a moral imperative, especially the poor, especially the poor.
The problem with these Medicaid recipients who don't work is shibboleth. For example, the Kaiser Family Foundation found that “92% of Medicaid adults are working (64%), or are likely to be eligible for exemptions.” A 2023 CBO analysis has led to doubt that such job requirements will not have much impact on the number of Medicaid recipients for jobs. Job requirements are the solution to the problem.
What we know about job requirements from Arkansas and Georgia’s waiver programs is that they do reduce the number of Medicaid staff, but largely by making it harder to verify eligibility. The requirements are confusing, the process that the recipient/potential recipient must follow is cumbersome, and the mechanisms required to monitor them are expensive (or, according to your point of view, are profitable for some vendors).
It's not about getting healthy people to work, it's about “waste, fraud and abuse”; it's about making fewer people joining Medicaid.
The call for returning Medicaid to its original purpose seems very selfish. For example, Medicare initially did not cover people under the age of 65 for ESRD or disabled people. Social Security did not initially cover farm workers or self-employed workers, nor did it provide benefits to survivors of persons with disabilities or retirees (spouse and children). We can save a lot of money by returning these plans to their original purpose, but these plans are bridges that Republicans are not ready to cross.
If we think Medicaid is not a suitable program for many poor people, it is a fair discussion. Medicaid has more problems, low reimbursement rates in most states and lead to a lack of participation in health care providers. In fact, just by joining them in the ACA program can better serve many poor people.
Unfortunately, ACA is not designed for the poor, its premium subsidies and cost-sharing reduces Don't apply For those with income levels. It is assumed that all of these people will be covered by Medicaid expansion. Of course, low-income people can get an ACA plan, but it’s hard to see how they can afford premiums or pay a deductible/co-insurance amount to get the care they may receive.
Maybe those low-income video games play young people can find jobs, but their employers will most likely not provide health insurance, or even so, the required employee premium contributions will be unbearable, or they may try to get a more unbearable ACA plan. For better or worse, in complex systems, we have Medicaid as their best place.
The moral components of speaker Johnson and others, many of whom claim to be devout Christians, seem to be missing out, and in the world’s wealthiest countries, no one should not get the health care they should have for its cost. The United States has found the best way to achieve this – a very imperfect solution – is to keep more people covered by some form of health insurance. The ACA cuts nearly half of those who are uninsured, but that still leaves nearly 30 million people without coverage.
It is estimated that the Big and Beautiful Act will add more than 100 people to uninsured positions, but most but not all come from people who have lost Medicaid coverage. Oh, and this may also further weaken safety net hospitals and professionals, further exacerbating the impact.
So when you hear Republicans talking about “waste, fraud and abuse” in Medicaid, they mean that some people shouldn’t have access to health care (similar cuts mean some people shouldn’t eat). I was sad about it and didn’t even need to check the Bible to make sure it was morally wrong.
Whether those people are playing video games.
If they want to hunt down fraudulent bills, overtreatment, kickbacks, etc., yes, I'm all targeting these waste, fraud and abuse. But when the poor have fallen, kick the poor, no.
Kim is the former emarketing Exec of the main blues program, late editor and regret tinture.ionow regular THCB contributor
