Are Bevin’s new Medicaid rules ‘all about putting up roadblocks’ for poor people?
"He's just trying to set up roadblocks so he can trip people up and then knock them off Medicaid to save money. That's all there is to it," said Stewart, 62, a
"When you charge a premium, some people can't pay it, so off they go. When you make people file a report every month, some people aren't going to make the deadline, so off they go," Stewart said. "It's all about putting up roadblocks."
Stewart is one of 15 Kentucky Medicaid recipients who sued the Trump administration in federal court
While the controversy has focused on Bevin's work requirement, the lawsuit also draws attention to the new hurdles that Medicaid recipients will have to jump in order to keep their coverage. They include monthly premiums, initially from
Missing a payment or notification could trigger a six-month lockout on basic health coverage. Missing the enrollment window could mean waiting nine more months for the next opportunity.
The lawsuit, which was organized by three nonprofit groups, claims the waiver violates the 1965 law establishing Medicaid because it will result in the reduction of health care to poor people who need it. The Bevin administration estimates 95,000 people will lose their coverage over the next five years out of the more than 400,000 Kentuckians just above the poverty line who are currently enrolled in expanded Medicaid.
"Members may have health coverage temporarily suspended for not meeting the community engagement and employment initiative requirements, failing to pay required monthly premiums or failing to report a change in circumstances," the Bevin administration told the
Health policy experts say Kentuckians are likely to fall off the Medicaid rolls because of the paperwork obstacle course. Someone juggling a low-wage job, children and the usual turmoil associated with poverty is unlikely to have time for regular check-ins with Medicaid officials, even assuming they have reliable Internet access or transportation to a state office building in their community, the experts say.
"When you're considering assistance programs, the research shows that each time you require a point of contact between the state and the enrollee -- each time you require an active choice -- you lose people," said
"What's interesting is that even small premiums discourage enrollment," Dague said. "You would think the value of the program would outweigh the cost of paying
Other states have seen such results. In
The Bevin administration told the Herald-Leader this week that it will make the monthly check-ins "streamlined and automated," both for people using the web and those visiting a state office. It's assumed that about 80 percent of Medicaid recipients have a smart phone, said
"The premiums are not intended to be a barrier and will be in lieu of the co-payment system in the current Medicaid state plan," Meier said, referring to the fees, often
In
"By increasing personal involvement in health care decisions, members gain skills for long-term success and are empowered to take an active role in their day-to-day health care decisions," Meier said.
But
McComas is raising four children in an apartment in
McComas said she doesn't object to the work requirement; she has worked her entire life. But she fears losing Medicaid if she misses a payment or check-in. And she needs vision and dental coverage, she said, which means more time spent performing extra tasks, such as taking a "health-risk assessment," and then verifying the completion of those tasks with state officials so she has the proper credit awarded to her new special incentives account.
"It's aggravating to me. I feel like I'm being punished for doing the right thing," McComas said. "If they start sending me bills, then I'm going to have to juggle which other bill I won't be able to pay that month. Will it be my rent I'm going to short, or something else? Because I don't have extra money lying around."
Her co-plaintiff in the lawsuit,
At age 62, Stewart said, he resents being made to "jump through hoops" after a lifetime of work, but he figures he won't have to jump through them for long.
"I just have to make it to 65, and then I'm eligible for Medicare," Stewart said, standing outside his small apartment off
He laughed.
"That'll do me for a year or two. And then I'll find something else until I make it to 65. I'll find something. I'll make it," Stewart said. "I'll fare better than a lot of the clients I worked with -- people who were mentally ill, people who didn't graduate from high school. I've got no idea what they're going to do. There's nothing for them. You tell them to go out and get a job and pay a premium or else we'll take away your health care, and they'll just disappear into the streets."
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