Now, you don't hear it very much in the corporate media, but the budget bill that the Republicans passed through the House and Senate and Donald Trump signed that set the table for this tax legislation - this tax scam that is being worked out between Republicans in the House, Republicans in the Senate and the billionaires who own them all - includes a trillion dollar cut to Medicaid and a half a trillion dollar cut to Medicare.
So how do you get people to stop using Medicaid and Medicare if you're going to cut the funding for it? You can't just start saying to doctors, 'sorry we're only going to pay you 20% of what we used to pay you, or 80%, or whatever it may be.' I mean, you could, but you might as well not have a system. So what do you do?
Well, the Republicans have got an answer to that, too. You just you have to admit these guys, they're slick. They put a lot of thought into this stuff.
They want to make sure that the donor class is not paying for your health care if you happen to be working for $7.50 an hour someplace and are making so little even though you're working full-time that you qualify for Medicaid.
They want to make sure that you can no longer get that Medicaid because Medicaid is paid for out of the federal coffers and federal coffers are replenished in part by taxes from billionaires and big corporations.
And billionaires and big corporations, they want to keep all that money in Bermuda. They don't want that money messing around here.
So, how do we get people to stop using Medicaid? Because we're going to cut a trillion dollars - a thousand billion dollars - out of Medicaid, so how do we get people to stop using it?
Again, this is all predicated on the foundational notion that Republicans have that health care is not a right, it is a privilege. It's a privilege that you must earn, and you earn it by becoming wealthy, because that's the only metric that is important.
Being a good person - not important.
Being a decent parent - not important.
Being a good son or daughter - not important.
Being wealthy - oh yeah, that gets the GOP going.
So you've got the Centers for Medicare and Medicaid Services - it's called CMS - the part of HHS that administers Medicare and Medicaid. And the woman in charge of this, her name is Seema Verma. And last week she made a rather shocking - in fact it's been called "twisted" and "absolutely awful" by health care experts - a shocking statement.
This from Common Dreams by Jessica Corbett, staff writer. The headline: "In 'Twisted' Push, Trump Admin Encourages States to Impose Work Requirements for Medicaid."
Now, keep in mind, the vast majority of people on Medicaid fall into three categories:
- they are people working usually full-time for very low pay - they're making so little that they qualify for Medicaid - so they're already working;
- they are elderly people who are in nursing homes and rather than their children and grandchildren paying for their nursing care, Medicaid pays for it. The Republicans would much rather that these middle-class families who have some wealth - they still own houses, you know - there's money here we can extract from these people;
- and then you've got children and single moms - and that's that a large cohort of children.
So this is who's getting Medicaid right now, and this is who Seema Verma says should now have to fulfill the work requirement before they get Medicaid.
"Verma vowed to fast-track approvals of states' proposals for amending how they implement Medicaid and denounced the Obama administration's rejection of work requirements for Medicaid recipients, promising to "approve proposals that promote community engagement activities."
Presumably these are red states' proposals.
Now what the hell does "proposals that promote community engagement activities" mean? She says, "working, volunteering, going to school, or obtaining job training." In other words, you have to earn your health.
Remember I said Republicans don't think health care is a right, it's a privilege.
"According to a Kaiser Family Foundation (KFF) analysis published in February, among able-bodied individuals who were under the age of 65 and enrolled in Medicaid in 2015, 59 percent were working, and 78 percent were in families with at least one worker.
Despite these figures, eight states - Arizona, Arkansas, Indiana, Kentucky, New Hampshire, Maine, Utah, and Wisconsin - have submitted requests for permission to require able-bodied Medicaid enrollees to work or complete community service, Kaiser Health News reported. To make changes, states submit waivers for existing requirements to the Health and Human Services Department (HHS), which includes CMS."
If you live one of these states you might want to have a quick conversation with your state senator or your state representative or your state assembly person or whatever it is in your particular state.
Now I might be wrong, but I believe every single one of those states is entirely or largely controlled by Republicans. And what the states have submitted these waivers to do is four major things:
- base the eligibility on drug screening - you've got to pee in a cup if you want to have health care;
- impose premiums on people with incomes below the poverty line, so even if you're poor you're going to have to start paying for your Medicaid;
- impose a time limit on how long people can be enrolled in Medicaid. "oh, that factory the left your West Virginia town that hasn't come back, there's no more work but tough luck, you weren't born rich, you've been on Medicaid for two years you can't have it any more";
- and refuse coverage to people who don't submit renewal paperwork on time or don't report employment or income changes within 10 days.
So under these new rules that the Trump administration is proposing, if you get a raise and you fail to notify the Medicaid people, you've committed a crime. You're now engaged in Medicaid fraud. You can go to jail if you don't tell them within 10 days of your raise or any other change in your employment status.
Now, odds are, they won't send you to jail, they'll simply say, "you're no longer eligible for Medicaid. You can't have it. Ever. Sorry. Tough luck."
And this is part of the strategy that the Republican Party is using to be able to get enough people off Medicaid that a trillion dollars over a decade - a hundred billion dollars a year - a trillion dollar cut to Medicaid won't be noticed. Because people aren't eligible for the benefit anyway. Because "oh, last year you must have smoked a joint of pot", or "oh, last month you actually got a 10 cent an hour raise and you didn't notify us, you're no longer eligible for Medicaid".
I mean, this is craziness, and this is part of this war on working people that the Republican Party declared in 1981 with the election of Reagan Ronald Reagan. When he was sworn in January 20th 1981 and first thing he did was bust up the Professional Air Traffic Controllers Organization" - the PATCO union.
And that war on working people continues to this day.