Tag Archives: Opioid crisis

Incentives? What’s good for Geese and Ganders: Medicaid Work Requirements

We can rest assured the Nevada Policy Research Institute (aka Koch Bros) will be staunchly defending the notion that poor or working Nevadans are so debauched that any form of financial support will cause them to head for the couch and the TV remote, witness their position on work requirements for Medicaid recipients:

“Medicaid is supposed to provide a safety net for those who are unable to help themselves — an admirable goal,” said NPRI policy analyst Daniel Honchariw. “Unfortunately, as the system currently works, it actually encourages many able-bodied adults to stay out of the workforce. As a result, the program isn’t just draining public finances, it’s eroding the self-sufficiency of those it’s purportedly supposed to be trying to help.”  [h/t Nevada Independent]

Dear Lord, I’d hate draining away anyone’s “self sufficiency.”  However, I’m not prone to illusions about innumerable people who for reasons beyond comprehension prefer “getting welfare” to having a job.  But Wait!  Nationally, 42% of those non-SSI, non-elderly with Medicaid health insurance are working full time, another 18% are working at part time jobs.  14% are not working because they are ill or disabled.  12% are caregivers for someone who is ill or disabled.  6% of the enrollees are in school, and 7% give other reasons for not being able to work. [KFF] So, let’s be rid of the Medicaid as Welfare motif — it’s not welfare, it’s a health insurance program.  Further, 60% of the recipients are working full or part time.  So, what are the income requirements for Nevadans in the Medicaid insurance program?

“In addition to the basic Medicaid requirements, petitioners must qualify by earnings. What are the income requirements for Medicaid in Nevada? Nevada Medicaid eligibility requirements pertaining to income are structured around the federal poverty level (FPL). This financial marker of determining Medicaid benefits eligibility considers the size of the family and larger households will have higher income limits. Medicaid can provide health care coverage to households with income up to 138 percent of the FPL. However, children younger than 19 years of age with incomes up to 205 percent of the FPL will also be eligible for medical coverage.” (emphasis added)

Now we come to the Income Trap phase of the argument.  We can’t, dare not, increase the minimum wage from a paltry $7.25 per hour, argue the Conservatives, because to do so would “cost jobs.”  However, if one takes out the plastic brains, punches in the numbers for a person working 40 hours per week at a minimum wage job the conclusion displayed in the little calculator window will be below the 138% FPL line.  Here’s a thought: If the Republicans are bent on removing working people from the Medicaid rolls, how about raising the minimum wage to a living wage?  And, now we continue on to the Geese and Gander finale.

We’ve just survived the enaction of the Republican Tax Cut, Tax-Scam, in which it was argued that if middle and working class Americans would shoulder the burden of supporting the federal government and allow the corporations and hedge fund managers to “keep more of their hard earned money,” then our prosperity will soar, the economy will boom and those hard-working wealth management titans will work even harder at their investment strategies.  So, pay them more and they will work harder, and make their money work harder.  Funny, this principle never seems to apply to working people who drive trucks, serve food, repair fuel injection systems, build houses, landscape properties, clean hotel rooms, sell merchandise, type memos, file records, stock shelves,… you get the idea.

Thus, what is sauce for the Geese (those hard working wealth management, upper 1% of the income earners, etc.) i.e. more benefits and breaks from the government is toxic bilge water for the other 99% Ganders, who if given even the least disincentive in the form of affordable health care will shed their uniforms and work clothes, head for the nearest couch and dissipate into a mere shadow of their former selves as their “self sufficiency” is drained by the system.

Perhaps we should call this out for what it is — yet another attempt to reduce the number of people eligible for assistance with their health care expenses because rich people don’t want to pay for it.  Because they imagine some otherwise healthy soul taking advantage of their fellows merely because the are “unworthy.”  If this sounds selfish, it’s because it is, essentially, a fundamentally selfish argument.  The saddest part of the entire issue is that the Geese having quacked for years about Welfare Queens (non-existent) and Unworthy Lazy Bums have convinced numerous Ganders of the horrors of expending any funds in support of those less fortunate.   There is one last point illustrative of the moral deficiency of the conservative argument.

Opioids.  Remember those 7% who gave other reasons for not working?  Some of them have been laid off from jobs and are seeking new employment, and some others are finding it difficult to secure employment because of opioid addiction.  Just for the record, Medicaid covers about 4 in 10 non-elderly adults with opioid addiction.  13.9% are white non-Hispanic; 6.6% are Black, and another 4.6% are Hispanic.  13.7% are males, 7.3% are females.  [KFF]  If we want to address opioid addiction in this country then we need to be taking care of those who are seeking help with this scourge, and not lecturing them about the wonders of the free market system and healthy lifestyles.

We could use a few less lectures on the Great American Rugged Individual and a few more mentions of our collective responsibility to care for our fellow citizens as we would wish to be cared for by them.

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