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Thread: Arkansas’s Medicaid experiment has proved disastrous

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    Arkansas’s Medicaid experiment has proved disastrous

    states are supposed to be the "laboratory of democracy", so I wonder when the last successful conservative state policy actually was? maybe Massachusetts health care reform...ie Romneycare.

    ====

    https://www.washingtonpost.com/opini...d09_story.html

    Arkansas’s Medicaid experiment has proved disastrous

    By Catherine Rampell
    Columnist
    November 19 at 7:06 PM

    BENTONVILLE, ARK.

    This summer, Arkansas became the first state to require poor people to prove they’re employed to receive Medicaid.

    Critics say the state is trying to save money on the backs of the poor. That’s nonsense, Arkansas officials reply. They want to help the poor. Backed by the Trump administration, they are inspiring slackers and moochers to climb the economic ladder.

    Thirteen other states are pursuing similar policies. They’d do well to pause their plans. For many low-income families, the Arkansas experiment has already proved disastrous. More than 12,000 have been purged from the state Medicaid rolls since September — and not necessarily because they’re actually failing to work 80 hours a month, as the state requires.

    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.

    Opinion | Planned Medicaid changes could do extreme amounts of harm. Or not.
    Opinion writers Charles Lane, Molly Roberts, Jennifer Rubin and Dana Milbank debate the Trump administration's plan to make people work for their Medicaid. (The Washington Post)

    “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.

    There are other reasons programs such as Arkansas’s are unlikely to improve work outcomes.

    The lives of low-income Americans can be precarious. They may change addresses and phone numbers often — which explains why other Arkansans I interviewed, including at a Little Rock homeless shelter, said they learned about the work reporting system only after their insurance was already at risk.

    Arkansas’s overall unemployment rate is low. But in rural areas, jobs still can be few and far between. Many workers don’t have control over their hours, either.

    Consider another plaintiff, Anna Book, who is homeless. A restaurant dishwasher, Book just barely meets the state’s 80-hour monthly minimum. But if business is light, she might lose a shift.

    She has already fallen below the threshold once; after three strikes, she’ll be barred from Medicaid until the following January.

    Medicaid recipients can’t directly report over the phone, in person or by mail. Like McGonigal, Book doesn’t have a computer. She designated a pastor to log her work hours for her.

    The state made reporting online-only to avoid hiring more staff. (It also didn’t allocate any additional dollars to help enrollees find work.) Officials did this even though Arkansas has the lowest level of household Internet access in the country, and the online portal doesn’t work well on smartphones. Once, when I tried it, I got an error message saying my phone’s browser was “not compatible.” The next day, it was mysteriously compatible again.

    Most indefensibly, the website shuts down every single night between 9 p.m. and 7 a.m. for “scheduled maintenance.”

    No wonder 80 percent of those required to report work hours or exemptions each month are reporting nothing at all.

    I asked Cindy Gillespie, director of the state’s DHS, how confident she was that all — or even most — of the thousands of people kicked off Medicaid were not working and were insufficiently motivated to work. She said she’s confident anyone improperly removed from the rolls could easily get their situation reversed.

    McGonigal’s experience suggests otherwise.

    Last month, his legal-aid lawyers persuaded DHS to grant him a “good cause” exemption and a chance to re-enroll in Medicaid. But because of additional red tape, he still hasn’t gotten any of his medication. It’s been six weeks.

    Meanwhile, the chicken plant says he’s welcome back. But only, McGonigal says, when — and if — he’s healthy enough to work.
    There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that "My ignorance is just as good as your knowledge."- Isaac Asimov

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    Senior Contributor antimony's Avatar
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    Arkansas is a ruby red state. The good people of Arkansas had a chance to reject these policies this November. Instead, they doubled down. I don't see why anyone needs to be at all sympathetic to those affected by Republican led policies in places Arkansas. They chose their own fate.
    "Is God willing to prevent evil, but not able? Then he is not omnipotent. Is he able, but not willing? Then he is malevolent. Is he both able and willing? Then whence cometh evil? Is he neither able nor willing? Then why call him God?" ~ Epicurus

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    Arkansas is a ruby red state. The good people of Arkansas had a chance to reject these policies this November. Instead, they doubled down. I don't see why anyone needs to be at all sympathetic to those affected by Republican led policies in places Arkansas. They chose their own fate.
    i understand the partisan sentiment behind this but in this way madness lies: 1, you're not going to find many converts if your going in position is "if you didn't vote for my party, you can all go to hell," 2, they didn't -all- vote red-- as recently as 2012, the entire levers of government in Arkansas were controlled by Dems, 3, the point of progressive politics is to make government work for all Americans, not just progressives.

    reminds me of the blinkered conservative arguments to let California burn because that's what they voted for.
    There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that "My ignorance is just as good as your knowledge."- Isaac Asimov

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    Quote Originally Posted by antimony View Post
    Arkansas is a ruby red state. The good people of Arkansas had a chance to reject these policies this November. Instead, they doubled down. I don't see why anyone needs to be at all sympathetic to those affected by Republican led policies in places Arkansas. They chose their own fate.
    Antimony

    These are the three statewide ballot issues on the Arkansas in 2018. None address the Medicaid program. So if you mean the voters directly voted on it they did not. If you are saying they indirectly by reelecting Republicans, okay. But as has been shown in many of these Southern and Appalachian states, the populations have been voting against their own self interests recently because they believe the siren song of cutting taxes and MAGA.

    Arkansas Issue 2, Voter ID Amendment (2018)Approved
    Arkansas Issue 4, Casinos Authorized in Crittenden, Garland, Pope, and Jefferson Counties Initiative (2018)Approved
    Arkansas Issue 5, Minimum Wage Increase Initiative (2018)Approved


    How's that working out for ya?
    “Loyalty to country ALWAYS. Loyalty to government, when it deserves it.”
    Mark Twain

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    Senior Contributor antimony's Avatar
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    Quote Originally Posted by astralis View Post
    i understand the partisan sentiment behind this but in this way madness lies: 1, you're not going to find many converts if your going in position is "if you didn't vote for my party, you can all go to hell," 2, they didn't -all- vote red-- as recently as 2012, the entire levers of government in Arkansas were controlled by Dems, 3, the point of progressive politics is to make government work for all Americans, not just progressives.

    reminds me of the blinkered conservative arguments to let California burn because that's what they voted for.
    First of all, who says I am looking for converts?

    Second, it is not "if you didn't vote for my party, you can all go to hell,". It is more of you get what you vote for. Britons deserve whatever they get from Brexit. Indians deserve the mess of demonetization because they voted in the government that caused it. You are right that Arkansa used to be controlled by Dems, but the good people of Arkansas voted them out. They chose the candidates that campaigned for and implemented these policies, by a wide margin. How much did Hutchinson win by? These issues were known since September and still he won by a wide margin. Therefore, these policies have the support of a great majority in Arkansas. Therefore, they own it.

    Do you want an example from the Progressive side? Seattle has been electing Council members who have promulgated very stern measures from a landlord's perspective. Now if property owners and landlords start dumping their properties and go off elsewhere and the Seattle rental market slumps because of that, whose fault will it be?

    Finally, California's fires are also dictated by the state's geography and climate. I don't believe that conservatives are a natural phenomenon.
    Last edited by antimony; 21 Nov 18, at 16:28.
    "Is God willing to prevent evil, but not able? Then he is not omnipotent. Is he able, but not willing? Then he is malevolent. Is he both able and willing? Then whence cometh evil? Is he neither able nor willing? Then why call him God?" ~ Epicurus

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    Senior Contributor antimony's Avatar
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    Quote Originally Posted by Albany Rifles View Post
    Antimony

    These are the three statewide ballot issues on the Arkansas in 2018. None address the Medicaid program. So if you mean the voters directly voted on it they did not. If you are saying they indirectly by reelecting Republicans, okay. But as has been shown in many of these Southern and Appalachian states, the populations have been voting against their own self interests recently because they believe the siren song of cutting taxes and MAGA.

    Arkansas Issue 2, Voter ID Amendment (2018)Approved
    Arkansas Issue 4, Casinos Authorized in Crittenden, Garland, Pope, and Jefferson Counties Initiative (2018)Approved
    Arkansas Issue 5, Minimum Wage Increase Initiative (2018)Approved


    How's that working out for ya?
    These work requirements measures were implemented in the middle of this year. By September the probles were known. Yet Hutchinsn won by a wide margin and state turned even more red.

    Voting for a policy when you do not know its impact is one thing. Voting when the impact is known is quite another.
    "Is God willing to prevent evil, but not able? Then he is not omnipotent. Is he able, but not willing? Then he is malevolent. Is he both able and willing? Then whence cometh evil? Is he neither able nor willing? Then why call him God?" ~ Epicurus

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    Senior Contributor antimony's Avatar
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    For those within Arkansas and elsewhere still worried about the fallout from the Work requirements, do not fear.

    The hyper bi-partisan National Review bemoans that the "Left" is attacking the really quite nice requirements. "less than 15 percent are at risk of losing their benefits".
    https://www.nationalreview.com/corne...-under-attack/

    Meanwhile, the uber-balanced TownHall assures us that the work requirements are anything but onerous.
    https://townhall.com/columnists/nich...erous-n2512445

    So, what were we worried about again?
    "Is God willing to prevent evil, but not able? Then he is not omnipotent. Is he able, but not willing? Then he is malevolent. Is he both able and willing? Then whence cometh evil? Is he neither able nor willing? Then why call him God?" ~ Epicurus

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