Arkansas Medicaid rule described as 'disastrous' | Arkansas Blog

Tuesday, November 20, 2018

Arkansas Medicaid rule described as 'disastrous'

Posted By on Tue, Nov 20, 2018 at 6:58 AM


Washington Post columnist Catherine Rampell today rips
Gov. Asa Hutchinson's scheme to require computerized reporting of work to qualify for Medicaid as 'disastrous" and illustrates with some personal examples. (Rampell also did a television segment for PBS NewsHour last night — the video above is strongly recommended.)

Hutchinson thinks it's working great, though more than 12,000 have lost coverage since June and thousands more are in the pipeline for loss of benefits. He cites, without offering evidence, his belief that the rule has moved many people into jobs.

Writes Rampell:

Consider Adrian McGonigal, who is challenging the policy in federal court.

McGonigal, like most non-disabled, nonelderly Medicaid recipients, had a job. Full time, too, at a chicken plant. The plant’s chemicals sometimes aggravated his COPD, a chronic lung disease, but his employer accommodated the condition by moving him from processing to shipping.

More important, McGonigal’s prescription medication — funded by the state’s Medicaid expansion, since his job didn’t come with health insurance — kept his symptoms in check.

McGonigal was unclear about what he needed to do to report his work hours, or if he had to report at all. The new policy applies only to Medicaid expansion enrollees, but even most people in that group don’t have to frequently check in with the state (because of age, disability, state already has work information on file, etc.). Like many I spoke with, McGonigal says he got confusing and sometimes conflicting information from the state’s Department of Human Services, which told him to report online. He doesn’t have a cellphone or computer, so he borrowed his sister-in-law’s smartphone.

“I thought that everything was good,” he told me in an interview for The Post and “PBS NewsHour.” “I thought it was just a one-time deal that you reported it, and then that was it.”

It wasn’t.

The state wanted him to report monthly . He learned this only when his pharmacy told him his insurance had been canceled. After that, he couldn’t afford his medication. His COPD flared up and he landed in the emergency room. And he missed lots of work.

“I tried to stick it out, and still go to work, but I just couldn’t do it,” he said. Ultimately, reluctantly, his supervisor let him go.

In other words: A policy intended to help people get jobs instead cost McGonigal his.

This was predictable. A Hamilton Project report found that the preponderance of evidence suggests Medicaid has little or positive effects on labor-force supply. For many families, safety-net services support work, rather than discourage it.

This is, as Rampell notes, on tops of the difficulties of being poor — changing addresses and phone numbers and homelessness have made it hard to keep those eligible informed. The unemployment rate is low, but rural dwellers don't have so many options. And, though you work, you can't guarantee your employee will provide enough hours to meet the insurance threshold.

There's more. It's equally depressing. Perhaps a federal judge will soon spare the working poor of Arkansas this cruel policy, with computerized enhancement to make it perversely cruel.

Want some fun? Pull out your iPhone (everyone has one, right?); log into your home WiFi (everybody has one right?); see if you can find the state website for signing up for Medicaid coverage and reporting your work activities. (No, I won't give you a clue on how to find it.) Give it a ride. Then ask your legislator to do the same. You might be surprised.

HAPPY DAY: DHS Director Cindy Gilespie, Gov. Hutchinson and Trump Medicaid boss Seema Vera proudly announce approval of the state's work rule for Medicaid eligibility. It's been disastrous, says a Washington Post columnist.
  • HAPPY DAY: DHS Director Cindy Gilespie, Gov. Hutchinson and Trump Medicaid boss Seema Vera proudly announce approval of the state's work rule for Medicaid eligibility. It's been disastrous, says a Washington Post columnist.

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