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CousinIT

(9,247 posts)
Fri Jan 12, 2018, 09:57 PM Jan 2018

Kentucky became the first state today to require Medicaid beneficiaries to work or lose care




BREAKING: Kentucky became the first state today to require Medicaid beneficiaries to work or lose access to care. They are also requiring very poor people to pay premiums or lose coverage— for extended periods. The plan is for a national model. Here’s quick highlights.1/

Let’s start here in reviewing the new program.

There’s a “literacy” provision.

If you don’t work enough hours and lose coverage, you can get to see a doctor again if you can pass a state literacy course about health or money. 😕2/

There is also a 6 month lock out provision— meaning you can’t apply for coverage again for six months if you are removed for not registering annually or if you have a kid or get married and don’t report it.

For “certain populations.” 3/

But the good news is you get to report this information using KY’s already overloaded Medicaid call centers.

Can’t see that being a problem. 4/

If you don’t pay your new premiums, you lose coverage & then have a period where you can’t enroll.

This will likely be what ends a lot of access. Many families can’t afford school lunch as it is. Or have checking accounts. Or have access to state offices. I could go on... 5/

Sorry part timers. If your hours drop under 30/week, you lose coverage. Unless you add another 20 hours of job training, you’re cut off. 5/

And the KY governor believes this will be a national model.

@StephArmour1 has full play by play of his press conference remarks.6/

KY Gov. Bevin says the Medicaid work requirements and other changes approved in state "will soon become the standard and the norm in the United States of America."

There’s rarely been a more apt reflection. Literacy tests, state monitoring, tied up bureaucracy, locking poor people out if they can’t pay. /end
27 replies = new reply since forum marked as read
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Kentucky became the first state today to require Medicaid beneficiaries to work or lose care (Original Post) CousinIT Jan 2018 OP
Backfire big time Iliyah Jan 2018 #1
LOL, Rich Cons Fucking Poor Con Trump Supporters... Grassy Knoll Jan 2018 #2
and fucking poor non Trump supporters alike standingtall Jan 2018 #4
This is even worse than I thought it would be standingtall Jan 2018 #3
That does not match with the discussion on NPR last night - Ms. Toad Jan 2018 #15
Will impact more than 3 percent of medicaid recipients standingtall Jan 2018 #20
The starting point is that 60% of all able-bodied recipients already work. Ms. Toad Jan 2018 #23
The final product of this has not been crafted so it is not standingtall Jan 2018 #24
Remember - Republicans believe that everyone on Medicaid is a deadbeat. Ms. Toad Jan 2018 #25
Republicans are the very definition of deadbeats. dchill Jan 2018 #26
:) n/t Ms. Toad Jan 2018 #27
That's conservatism at work! Hurting the most vulnerable. IluvPitties Jan 2018 #5
Are they going to make them work the coal mines? Yo_Mama_Been_Loggin Jan 2018 #6
What about those who are too infirm Cha Jan 2018 #7
They will not be able to impose work requirements on people already on standingtall Jan 2018 #9
Well good.. they're not messing with Cha Jan 2018 #14
I dont actually know what the age limit will be standingtall Jan 2018 #16
thank you for that, standingtall Cha Jan 2018 #17
The repugs would just as soon see them die. Ferrets are Cool Jan 2018 #11
Yeah they would.. and I hope those Cha Jan 2018 #18
*Right wing Dump voters* from Kentucky. roamer65 Jan 2018 #8
you would think they would go to Illinois first sense it is closer to Ky standingtall Jan 2018 #10
MI has been a destination in the past. roamer65 Jan 2018 #12
. WhiskeyGrinder Jan 2018 #13
Fuck Bevin and kacekwl Jan 2018 #19
Any waivers for people too sick to work? dflprincess Jan 2018 #21
They will have to go to their doctors and beg him or her to fill out an exemption form. standingtall Jan 2018 #22

standingtall

(2,785 posts)
4. and fucking poor non Trump supporters alike
Fri Jan 12, 2018, 10:09 PM
Jan 2018

Not every poor person in Ky supported Trump or Bevin. Neither Trump or Bevin carried Louisville or Lexington Kentucky's 2 largest cities which have poor people on medicaid in them.

Ms. Toad

(34,075 posts)
15. That does not match with the discussion on NPR last night -
Fri Jan 12, 2018, 10:44 PM
Jan 2018

which expected Ky to be the first state today - since its application was written over the past few months to be intended to comply with the guidelines.

The experts expected the guidelines to hold up to court challenges. I don't believe these would. So I'm suspicious that about the accuracy of this report.

Here is something that sounds closer:

Kentucky’s waiver, submitted for federal approval in 2016, requires able-bodied adult recipients to participate in at least 80 hours a month of “employment activities,” including jobs training, education and community service.

The rules apply to those between 19 and 64 years old. Certain groups are exempt, including former foster-care youth, pregnant women, primary caregivers of a dependent, full-time students, the disabled and the medically frail.

The Kentucky program also imposes a premium on most Medicaid recipients based on income. Some who miss a payment or fail to re-enroll will be locked out for six months.


Not supporting the plan - but it is important to be accurated. As crafted, the work requirement is actually only expected to impact about 3% of Medicaid recipients (based on my recollection from the NPR report). The NPR report didn't discuss (or discussed before or after I tuned in) premium payments or enrollment gaps. I am curious to see what those requirements are.

standingtall

(2,785 posts)
20. Will impact more than 3 percent of medicaid recipients
Sat Jan 13, 2018, 12:18 AM
Jan 2018

it just will and no way it doesn't. There are realities that need to be dealt with. First off medically frail people not on SSI or SSDI will need their doctors to fill out an exemption form. Often times doctors don't like to fill out those forms to begin with or they charge for them or fill them out incorrectly. Those forms expire anyway. Now imagine people with chronic conditions without cures who are not on SSI or SSDI having to proof and reproof working is a hardship for them over and over again it will lead to lapses in coverage. And just where is a caregiver of a sick person suppose to go to get an exemption for themselves? Somehow I don't think a letter from the person the caregiver is taking care of will suffice as proof for a state agency. When Matt Bevin proposed this 2 years ago he floated making medicaid recipients pay a premium as well as taking dental and visual insurance away from smokers. So that's properly where the reports on premiums comes from.

Ms. Toad

(34,075 posts)
23. The starting point is that 60% of all able-bodied recipients already work.
Sat Jan 13, 2018, 12:38 AM
Jan 2018
A study by the Kaiser Family Foundation found that about 60 percent of "able-bodied" Medicaid beneficiaries already work. And a third of those who don't have jobs say it's because they are ill or disabled.


A third of the 40% of "able bodied" individuals (i.e.not considered for assistance are disabled under the less rigorous standards ofthe ADA (which this program must meet). So we're down to 24% of the "able bodied population. I couldnt find recent numbers, but in 2013, 18% of Medicaid recipients were children or disabled. Now we're down to 19% of the "able-bodied" population, before you deduct the other exemptions (caring for a parent, caring for a disabled child, etc.) (The article I found today didn't have the level of detail of the report last night - so I'm having to backtrack through their work to estimate.

I'm not saying it is an easy process (I have a child who falls in this category, and the forms for accommodations at school are pretty much the same in concept, if not execution, to these exemption. I've written more than I care to admit for the doctor to sign). I'm not saying it is an appropriate process.

But it does impact far fewer that the "sky is falling" response suggests - and we need to be accurate or we lose the credibility we need to move Congress toward the programs people need to survive.

standingtall

(2,785 posts)
24. The final product of this has not been crafted so it is not
Sat Jan 13, 2018, 12:50 AM
Jan 2018

possible to be entirely accurate, but I firmly believe the number of people affected by this will be alot higher that 3%.In any case people not on SSI-SSDI with health issues will need an exemption from their doctors. Just because someone has an impairment that meets the ADA does not mean a state agency will except that as proof. A doctor will actually have to fill out a form saying so and so cannot work. If only 3% were affected by this I doubt republicans would fool with it. From the article in the Hill Matt Bevin estimated this would effect 95,000 close to 1/3 of Kentucky's medicaid population. If they do this they will not stop there the next thing they will try is to kick a significant portion of people off the disability rolls.

Ms. Toad

(34,075 posts)
25. Remember - Republicans believe that everyone on Medicaid is a deadbeat.
Sat Jan 13, 2018, 10:49 AM
Jan 2018

So they believe that this will kick freeloaders off of Medicaid because they're only on Medicaid because it's a free ride. They think they are crafting it for the 90% or above who are just too lazy to get off of their bums (and if you force them to work, the state's obligation to pay for their medical care will vanish).

That's why it is important to use more neutral numbers and the actual waiver, instead of those of a self-serving Republican governor.

The problems you suggest are real - those ought to to be the focus (as well as numbers that can reasonably be supported by the data). We should not be using Republican propaganda, or broad generalizations when even the not-terribly-accurate sources the tweets were taken from qualify the impact (some, as to the lock-out provision, for example).

dchill

(38,505 posts)
26. Republicans are the very definition of deadbeats.
Sat Jan 13, 2018, 10:57 AM
Jan 2018

On the government dole and not producing anything of value to the people they're supposed to be representing. 80 hours a month of work-related activity would be a huge uptick for these drones.

standingtall

(2,785 posts)
9. They will not be able to impose work requirements on people already on
Fri Jan 12, 2018, 10:26 PM
Jan 2018

SSDI or SSI obviously. People over 50 will probably be okay although they might have to pay a premium to keep their medicaid. Who will really get hurt by this is people under 50 with illnesses that make working a hardship who are not on SSDI or SSI.

Cha

(297,317 posts)
14. Well good.. they're not messing with
Fri Jan 12, 2018, 10:41 PM
Jan 2018

people on SSI.

I would have thought the age limit would be up until 62 or 67 to make them work for their Medicaid.

"Who will really get hurt by this is people under 50 with illnesses that make working a hardship who are not on SSDI or SSI."

I know.. that really sucks. I hope they find some recourse because they can't work if they're sick and they can't get help if they don't have Medicaid.

standingtall

(2,785 posts)
16. I dont actually know what the age limit will be
Fri Jan 12, 2018, 10:46 PM
Jan 2018

I was only guessing. Kentcky's age limit for snap benefits for work requirements is under 50. I was just guessing this would be along similar lines. Possible it could be older. The only reason their not messing with people on SSI is they know there is no way that would hold up in court. Hopefully this will not hold up in court either.

roamer65

(36,745 posts)
8. *Right wing Dump voters* from Kentucky.
Fri Jan 12, 2018, 10:24 PM
Jan 2018

Do not move to Michigan to get Medicaid. You are not welcome here. Stay the fuck in KY.

kacekwl

(7,017 posts)
19. Fuck Bevin and
Fri Jan 12, 2018, 11:12 PM
Jan 2018

Fuck Mc Connell. Why your at it fuck all these slimy repukes who would know work unless they can do it on their knees.

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