This morning I was contacted on Twitter by a woman in Louisville, Kentucky who appears to be in pretty dire straits:
On 7/1/18, in Ky, my Medicaid/ ACA will be canceled. I may still need a brain shunt, LP #8, RXs, PT, etc. I was informed that my PCP could write a letter stating I was "Medically Fragile" but even then the provider has final say. Like fox guarding hen house. Please help me/DM
I am a disabled attorney living with my 76-year-old mother who takes care of me. In 2011, I was bitten by a tick and was infected with Ehrlichiosis Chaffeensis and Rickettsia. A week later, I contracted Coxsackie B4 virus. Because I was kept on antibiotics for 19 years, I had no immune system to fight these illnesses.
As I noted last month, the Republican-controlled Michigan State Senate is planning on jumping on board the pointless, wasteful, cruel "work requirement" bandwagon which is all the rage among the GOP types these days.
Sure enough, they're planning on ramming it through within the next week: The Michigan Senate’s Competitiveness Committee is expected to hold a hearing on SB 897, a bill that would impose a work requirement on over 670,000 adult Michiganders with Medicaid health coverage...or nearly 7% of the state population.
The committee chair and the bill’s sponsor, Senator Mike Shirkey (SD-16) is planning on pushing the committee vote through ASAP and then kicking it over to the full state Senate right away.
Gov. Gary Herbert signed a measure Tuesday to give more than 70,000 needy Utahns access to government health coverage, ending years of failed attempts on Capitol Hill to expand Medicaid in the state.
But whether House Bill 472 ever takes effect still remains uncertain. Under President Obama’s signature Affordable Care Act (ACA), the Utah law needs approval by the federal Centers for Medicare and Medicaid Services (CMS), which has sent mixed signals on whether it will fully sign off.
Even if CMS does approve HB472, it will likely be about a year — even on an aggressive schedule — before the state can begin enrolling people for coverage. Meanwhile, a competing Utah citizens initiative that would expand Medicaid coverage more widely than HB472 also continues to gather signatures for a spot on November’s ballot.
UPDATE 4/11/18: I posted this piece about a month ago; I don't have any specifics, but I have reason to believe that the Michigan state legislature could be moving on this any day now. If you live in Michigan, CALL YOUR STATE SENATOR OR REPRESNTATIVE AND TELL THEM *NOT* TO IMPOSE WORK REQUIREMENTS ON "HEALTHY MICHIGAN" ENROLLEES!
State Senate introduces bill to add work requirements to Medicaid
The bill would require able-bodied adults to work or be in school for 30 hours a week in order to receive Medicaid.
Some lawmakers in Lansing want people to work to get Medicaid. The Senate introduced a bill Thursday. It would add work requirements to the Medical Assistance Program, or Medicaid.
...If passed, able-bodied adults would be required to work or continue school for 30 hours per week as a condition of receiving medical assistance.
Nearly three years ago, there was a big report about a bunch of Republican Governors of states which hadn't expanded Medicaid under the Affordable Care Act who claimed that they were willing to do so, but only if a work requirement was part of the deal:
In nearly a dozen Republican-dominated states, either the governor or conservative legislators are seeking to add work requirements to Obamacare Medicaid expansion, much like an earlier generation pushed for welfare to work.
The move presents a politically acceptable way for conservative states to accept the billions of federal dollars available under Obamacare, bringing health care coverage to millions of low-income people. But to the Obama administration, a work requirement is a non-starter, an unacceptable ideological shift in the 50-year-old Medicaid program and a break with the Affordable Care Act’s mission of expanding health care coverage to all Americans. The Health and Human Services Department has rejected all requests by states to tie Medicaid to work.
Last November, along with voting to keep a Democrat in the Governor's office, Virginia voters also swept a huge wave of Democrats into office in the state legislature. They didn’t quite take a majority, but they came within a single vote of getting a 50-50 tie in the state Assembly. Instead, they have a two-vote shortfall (51-49), matching the same two-vote shortfall (21-19) in the state Senate.
A prominent Republican state legislator from southwest Virginia announced his support Thursday for expanding Medicaid, an about-face that could make it easier for other rural conservatives to get on board after four years of steadfast opposition.
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, sir...it'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)...no sir, I sure don't.
Indiana Adds Work Requirement To Medicaid, Will Block Coverage If Paperwork Is Late
PHIL GALEWITZ
Indiana on Friday became the second state to win federal approval to add a work requirement for adult Medicaid recipients who gained coverage under the Affordable Care Act. A less debated provision in the state's new plan could lead to tens of thousands of people losing coverage if they fail to complete paperwork documenting their eligibility for the program.
The federal approval was announced by Health and Human Services Secretary Alex Azar in Indianapolis.
Medicaid participants who fail to promptly submit paperwork showing they still qualify for the program will be locked out of enrollment for three months, according to updated rules.
Gov. Matt Bevin has issued an executive order that would strip Medicaid coverage from nearly half a million Kentuckians should his proposed overhaul of the federal-state health plan be struck down in court.
No one has filed a legal challenge to Bevin's changes to Kentucky's Medicaid program that federal authorities approved Friday.
But several advocacy groups have said some of the changes — such as requiring some "able-bodied" adults to work or volunteer at least 20 hours a week — likely will be challenged in court because they violate federal law that establishes Medicaid purely as a health program and does not authorize work requirements.
With the big news this week about CMS giving work requirements the green light and Kentucky immediately jumping all over it, I decided to look up a few data points from some expansion states which don't include a work requirement for the heck of it:
As of January 8th, 2018, Michigan had 669,362 adults enrolled in the "Healthy Michigan" program (aka, ACA Medicaid expansion), or over 6.7% of the total population.
Men make up slightly more enrollees than women (51% to 49%)
Enrollees are spread fairly evenly by age brackets (19-24, 25-34, 35-44, 45-54 and 55-64)
Around 80% of MI expansion enrollees earn less than 100% of the federal poverty line; the other 20% earn between 100-138% FPL.
