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Tuesday, March 5, 2013

If Arkansas goes for "private option," why would Medicaid need more means testing?

Posted by on Tue, Mar 5, 2013 at 4:09 PM

Bruce Westerman image
  • Rep. Bruce Westerman

When Republican lawmakers are out trumpeting the new alternative to Medicaid expansion, they're always quick to note that they want changes to the existing Medicaid program too. One big one is more means testing — extra steps to verify the income levels of recipients to make sure they qualify.

In his interview with Roby Brock last weekend, Rep. John Burris pushed for "reforms to our current system," specifically arguing that "absolutely we could do a better job of means testing and verifying that people receiving benefits are eligible for the benefits they're receiving."

The issue for Republicans is that right now, if you're a parent in Arkansas, you're not eligible for Medicaid if you make less than 17 percent of the federal poverty level. For a family of two, if you make more than $2600, you get kicked off the roles. For a family of four, the line is $4,000. These eligibility rates for the Medicaid program would stay the same if the state expands via the exchange.

A source of great stress and consternation for Republicans is: What if, say, a single mother with three kids making $5,000 a year sneaks on to the Medicaid rolls? They really, really don't want this to ever happen, which is why they advocate for more means testing for Medicaid.

Snark aside, I have a simple question. If Arkansas says yes to the new coverage plan, the plan Burris pitches in that interview with Brock, why would low-income folks try to sneak on to the Medicaid rolls when they could get free private insurance? Remember, Burris argues that these plans are going to be significantly better for recipients. Both he and Sen. Jonathan Dismang believe that folks would much rather be on a private plan. Maybe I'm missing a nuance here. But even if you think more aggressive means testing is a good idea, it's rendered completely irrelevant by the "private option" approach. If Republicans are right that the private plans will be better, the issue wouldn't be folks sneaking into Medicaid. The game-the-system scenario would be very poor parents saying they were above 17 percent FPL when they were actually below, the Welfare Queen fantasy in reverse.

I asked Rep. Bruce Westerman, a leader of his party's Waste Wing, ever vigilant against Waste! Fraud! Abuse! If there are free-premium private plans, why in the world would someone present themselves as poorer than they are to get on Medicaid? Why would we need more means testing for the Medicaid program?

"That seems to make sense, that logic," Westerman said.

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