This Is My Shocked Face #2: Report confirms Medicaid work requirements serve no purpose other than to screw poor people
In other words, only about 10% (at most) of those still in the Medicaid Gap could even remotely 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."
Georgetown University Health Policy Institute, February 2019:
Last week, the state of Arkansas released its latest round of data on implementation of its Medicaid work reporting requirement – the first in the country to be implemented. As readers of SayAhhh! know, over 18,000 lost coverage in 2018 as a result of not complying with the new reporting rules. And the policy is clearly failing to achieve its purported goal – incentivizing work – with less than 1% of those subject to the new policy newly reporting work or community engagement activities.
As it races to revamp Medicaid by allowing work requirements for the first time, the Trump administration is failing to enforce federal rules directing states to assess the impact of the change on low-income patients who rely on the half-century-old safety net program, a Times analysis shows.
None of the eight states that the administration has cleared to implement a Medicaid work requirement has in place a plan to track whether Medicaid enrollees find jobs or improve their health, two goals often touted by administration health officials.
...Critics say the administration and the states appear to be systematically ignoring or weakening the requirement for independent analysis, perhaps because they fear the results.
New work requirements for people in Michigan's Medicaid expansion group could cause as many as 183,000 people to lose their coverage.
Anywhere between 9 and 27 percent of the approximately 680,000 people enrolled in the Michigan Healthy Plan - or 61,000 to 183,000 recipients - could be kicked of the rolls.
That's up to three times what was estimated by the House Fiscal Agency when the work requirement bill was passed last year. The work requirements are scheduled to take effect on January 1, 2020.
These findings are from a recent study by Manatt Health, a national consulting firm and division of the legal and consulting firm of Manatt, Phelps and Phillips.
The first major study on the nation’s first Medicaid work requirements finds that people fell off of the Medicaid rolls but didn’t seem to find more work.
Since Arkansas implemented the nation’s first Medicaid work requirements last year, a new study published in the New England Journal of Medicine has found, Medicaid enrollment has fallen for working-age adults, the uninsured rate has been rising, and there has been little discernible effect on employment.
The research appears to confirm some of the warnings from Medicaid advocates who opposed the Trump administration’s approval of work requirements in Arkansas and other states. People are losing Medicaid coverage, often as a result of confusion rather than failure to meet the work requirements, but they aren’t finding jobs and getting insurance that way. They are simply becoming uninsured.
...The uninsured rate for the same population increased from 10.5 percent in 2016 to 14.5 percent in 2018. Employment declined among this group over the same time frame, from 42.4 percent to 38.9 percent, though that was true for all cohorts. But for Medicaid coverage and the uninsured rate, the population targeted by Arkansas’ work requirement saw significantly more deterioration than other age groups and people in other states.
...Policy experts have argued from the start that work requirements were contrary to Medicaid’s purpose of providing health coverage to low-income Americans and that most people who are on Medicaid and can work already do work.
They had also warned that irregular hours and burdensome reporting requirements, rather than failing to work, were more likely to lead to people losing coverage. That was the case with McGonigal.
As Adam Serwer so aptly put it last year, The Cruelty Is The Point.