Kentucky: Congrats, jackholes! You're about to waste $374 million to make poor people feel bad about themselves!


From the Cabinet Meeting scene in the comedy "Dave":

DAVE: Now the Commerce Department..,

SECRETARY OF COMMERCE (sitting erect): Yes, Mr. President?

DAVE (from a card): You're spending forty-seven million dollars on an ad campaign to... (reading) 'Boost consumer confidence in the American auto industry.'

SECRETARY OF COMMERCE: Um...yes,'s designed to bolster individual confidence in a previous domestic automotive purchase.

DAVE: So we're spending forty-seven million dollars so someone can feel better about a car they've already bought?

SECRETARY OF COMMERCE: Yes, sir, but I wouldn't characterize it that way...

DAVE (indignant): Well I'm sure that's really important, but I don't want to tell some eight- year-old kid he's got to sleep in the street because we want people to feel better about their cars. (beat) Do you want to tell him that?

SECRETARY OF COMMERCE (quietly): No sir...(looks at TV cameras) sir, I sure don't.

OK, Sherman, set the Wayback Machine to nearly three years ago, when I wrote the following:

In other words, only about 10% (at most) of those still in the Medicaid Gap appear to match the GOP's cliche of a "lazy, good-for-nothing layabout" type who's able-bodied, has no serious extenuating circumstances and so forth. The "get off your ass and work!" requirements appear to be nearly as big a waste of time and resources as the infamous "drug testing for welfare recipients" bandwagon which a bunch of states jumped on board over the past few years.

As for the other requirements (co-pays/premiums), this is kind of the same sort of logic which recently led a GOP state Senator to come to the brilliant conclusion that slashing the Medicaid budget in half would free up money for other stuff! Why yes, of course it would. Just as requiring people on Medicaid to pay a chunk of the cost of their treatment would, as demonstrated by the Montana example above, save money as well...because 36% of those eligible would never enroll in the program in the first place! BRILLIANT!!

For that matter, guess what else would "save money" for the state? Killing all of the people in the Medicaid Gap! Then you wouldn't have to deal with them at all!

Basically, Republicans have gone from saying "screw the poor" to "OK, you can see a doctor but only if you dance for me first."

Cut to three years later:

Bevin's Medicaid changes actually mean Kentucky will pay more to provide health care

Within Gov. Matt Bevin's complex plan to reshape the state Medicaid program to cut costs and hold people accountable is this fact that may surprise some Kentuckians:

Under Bevin's plan, it actually will cost Kentucky more to provide health coverage to people affected by the Medicaid changes than if the state did nothing.

Cost savings come from the assumption that nearly 100,000 people will drop out of Medicaid by the end of the five-year project recently approved by the federal government. For those who remain, the monthly cost of care increases faster than it would have had the state made no changes, according to the administration's projections.

"You're spending more money to cover fewer people," said Dustin Pugel, a policy analyst for the Kentucky Center for Economic Policy in Berea and a critic of the Bevin plan. "I'm not crazy about the idea of us spending more money to cover fewer people."

Meanwhile, Kentucky plans to spend close to $374 million over the next two years — most of it in federal money — to launch the plan starting July 1.

It has added $186 million to the current budget and proposes $187 million in the next budget year starting July 1 for administrative costs, most of the money associated with the Medicaid changes. Part of the administrative costs added to this year's budget would go toward creating a Medicaid computer system required by the federal government.

The mind boggles.