The Reality of Work Requirements for Medicaid
HTML-код
- Опубликовано: 2 авг 2024
- We’ve spent the last few weeks talking work requirements for safety net programs, and it’s all been leading up to this: work requirements for Medicaid. By looking at the EITC and TANF, we learned some things. Can these lessons inform decisions about whether and how to implement work requirements for Medicaid? If so, how?
That’s the topic of this week’s Healthcare Triage.
Resources used in the making of this video:
Medicaid and Work Requirements: New Guidance, State Waiver Details and Key Issues: goo.gl/HvHieG
Updated: Who Could Be Affected by Kentucky’s Medicaid Work Requirements, and What Do We Know about Them?: goo.gl/ENZNXv
Kentucky Medicaid Work Requirements: What Are the Coverage Risks for Working Enrollees?: goo.gl/vSZ8wn
Kentucky Medically Frail Provider Attestation: goo.gl/GM4Gme
The Value of Introducing Work Requirements to Medicaid: goo.gl/c56oLs
Medicaid Enrollees and Work Requirements: Lessons From the TANF Experience: goo.gl/J8NsCP
Commentary: As Predicted, Eligible Arkansas Medicaid Beneficiaries Struggling to Meet Rigid Work Requirements: goo.gl/y416CD
A First Glance At Medicaid Work Requirements In Arkansas: More Than One-Quarter Did Not Meet Requirement: goo.gl/qBA543
One Big Problem With Medicaid Work Requirement: People Are Unaware It Exists: goo.gl/yzr3Du
More than 4,300 Arkansas residents lose Medicaid under work requirements: goo.gl/Xoxzrq
What Research Tells Us about Work Requirements: goo.gl/yDtzZ2
Opportunities to Promote Work and Community Engagement Among Medicaid Beneficiaries: goo.gl/ECw3TZ
Work Requirements in Social Safety Net Programs: goo.gl/dQS2L4
***
Aaron has a book out now! It’s called The Bad Food Bible: How and Why to Eat Sinfully. You can order a copy now!!!
Amazon - amzn.to/2hGvhKw
Barnes & Noble - www.barnesandnoble.com/w/the-...
Indiebound - www.indiebound.org/book/978054...
iBooks - itunes.apple.com/us/book?isbn=...
Google - books.google.com/books?vid=ISB...
Kobo - www.kobobooks.com/search/searc...
Any local bookstore you might frequent. You can ask for the book by name or ISBN 978-0544952560
John Green -- Executive Producer
Stan Muller -- Director, Producer
Aaron Carroll -- Writer
Mark Olsen - Graphics
Meredith Danko - Social Media
/ aaronecarroll
/ crashcoursestan
/ johngreen
/ olsenvideo
And the housekeeping:
1) You can support Healthcare Triage on Patreon: vid.io/xqXr Every little bit helps make the show better!
2) Check out our Facebook page: goo.gl/LnOq5z
3) We still have merchandise available at www.hctmerch.com
It's a lot easier to work and to find work when you're not sick...
Lisa Varble Why should they be cut off?
If you can't afford to be sick, then don't get sick. You can't expect us to pay for your lack of personal responsibility.
/s, because some people genuinely think like this.
What do you mean by sick? Cold, flu, other common illness or chronic sickness causing inability to work. If former, suck it up. If latter, apply for disability and make your case. Those disabled were not part of the population discussed.
What I see as a problem is people not wanting to take the first job they can for some superfluous reason. Take the job and if you don't like it keep searching. I'm not saying it will be easy. No one said it would be.
@@radamh Requiring people to report to work even when they are sick with common illnesses is bad for the economy and bad for those people and their coworkers. Going to work sick extends the time it takes to recover and during that extended time productivity suffers. Going to work sick also spreads disease. The flu may be common, but it is something that should be taken seriously. Forcing people to go to work sick or risk losing their health insurance can literally kill other people.
@@Marco_Onyxheart I really hate those people. I was disabled at birth and while I get more social security than most (it comes from my parents work record and they often worked three jobs so we could survive), it's still far below the poverty line and likely won't change. Yet I have to deal with those idiots judging me for something that happened in the WOMB.
The point of the work requirement is to stop people from receiving benefits. It isn't to ensure that people are covered.
That seems to be the bigger picture
We need to work to ensure that everyone is covered medically.
@@kaninma7237 the point of the law is that if they aren't working they don't get benefits. It's a cost control measure that for the most part does little to control costs (which is what this video is about). The point of cost control measures is to try to kick people off state sponsored insurance to reduce the amount of money the state is responsible for paying directly. Indirectly, these individuals end up getting sick and because they weren't covered and cannot pay, we as individuals end up carrying the cost through inflated medical treatment prices. The state then gets to brag about how great of a job it has done controlling costs and thus isn't charging you as a taxpayer, but in actuality you not only end up paying that tiny bit the state is saying it saved but you also get to reap the joy of spending significantly more on your own treatment. Thus the net effect is more money from you, less money from the state, and a couple thousand people whose lives were unnecessarily put in limbo for political reasons.
We need to make healthcare premiums and deductibles more affordable. Obamacare lowered premiums and kind of hurt deductibles if not enough people signed up though.
The administration costs for Kentucky went up by 40% ... basically eliminating any savings... and that was before it even came into effect or the court case that blocked it
In North Dakota I was denied multiple times for temporary Medicaid and disability during cancer treatments. I've learned it's the state's protocol to deny any and all cases two or three times without even looking at them.
Can't thumbs up that; it's too close to the sad truth.
Just as a suggestion that might help you, try asking for the hospital to grant you financial aid. I know each of those chemo treatments cost at least 5000.00 USD each, and I took 4 off those (Adriamycin/cytoxin) every 2 weeks. Then I took Taxol every week for 8 weeks. Not to mention 12 weeks of radiation 5 days a week. I'm glad I did the course, but it cost out the rear end!
You might also ask who the manufacturer is and contract then to see if they will donate some of the treatments. When my daughter was sick, Astra-Zenica donated the medications she needed. Praying for your recovery.
There's also the issue of whatever government employee or committee that reviews the work exception just deciding they don't want you to get it, regardless of the evidence, & simply deny the applicant again & again despite multiple doctors explicitly saying the applicant cannot work. There's no consequence for government employee incompetence or acting out of spite, ideologically driven or otherwise.
What's the point of a safety net if it doesn't catch the worst offs
Exactly. If you pay into Medicaid/Medicare, you should get it automatically. I think welfare should pay more taxes to get Medicaid and Medicare free. We have to pay the taxes for them, not us basically. Especially able welfare who do not work by choice, which is wrong.
@@ethanweeter2732 Most everyone pays into Medicaid by various federal and state taxes. Many have paid into Medicare and will never benefit from that.
Means testing is the greatest burden to the government. We could streamline by having Medicare for all and have a healthier population and lower cost.
Having Medicare for all does not make the population magically healthier. It simply allows people who continue to make poor choices in diet, exercise, and habit to avoid the costs.
@@radamhthis is like the argument for abstenance only being the only way of not incentivizing unwanted pregnancies but amplified to much worse because of far less habits outside of the responsible parties control, (say genetic diseases, people that get injured through largely no fault of their own and more) If you want the population to be healthier you do things like invest in health infrastructure. (say removal of farm subsidies to meat, inclusion of programs to get people to exercise, and more)
@@radamh Many insurance programs incentivize healthy habits through premium reductions etc... but you have to HAVE insurance to be subject to those programs. Medicaid is primarily used to help those with disabilities. But with expansions or a fully socialized system, getting a doctors voucher saying you meet healthy lifestyle goals to say get a tax deduction could do wonders to improve public health. As we already know these sort of incentivized programs work.
@@radamh Suppose you are correct, that having health care doesn't necessarily mean having better health. I don't agree with you, there is empirical evidence that agrees with me. But let's just say... If your goal is to decrease health care costs, the best way to do that is to insure that people are covered under a health care system. What do people who are uninsured do? They go to the hospital, which IS the most expensive option. Then they put the burden of the health care on the hospital system and the tax payers. They go to the hospital for something minor, like a cough or something major like their arm gets torn off. Either way it's a hospital visit instead of having a Primary Care Physician, which is less expensive. Even if they don't take care of themselves and continue to have bad habits. Uninsured people will have regular physicians they'll be able to see to have conversations with, be able to ask questions, maybe start healthier habits through education and so on, but mainly it will be cheaper for all of us if the uninsured stop using hospitals for non-emergency issues.
Love your content - thank you so much!!
People working in coal mines have been locked into poverty and have no alternatives but to live in poverty or leave Kentucky altogether, something that few are able to do.
This does not stop at metropolitan areas like Louisville which has its own population of poor people. I have 2 degrees, can't get work, and can't get help to do so (denied by Vocational Rehab: overqualified). We need real help, real jobs, real income, real transportation-work requirements include "reliable transportation" (read: a car) and won't consider the bus system reliable transportation. And that means we need a better public transportation system.
We need so much infrastructure, and that's a nice buzz word to kick around, but even that is only given lip service, and the training for it doesn't guarantee a job (I've had this training), not even in union halls.
Work requirements bug the hell out of me. I'm below the poverty line and always will be due to my disability, which also makes me excempt from them, but trust me, NO ONE chooses this life. NO ONE, not even the laziest slib would look at the chice between medicine, heat, food or rent every month and think that's an ideal lulife. Even the most basic min. wage job makes more than I do and as we've seen, that's often not enough ir eben avaible (my atea is just now coming out of the recession job wise).
Social programs should NOT have arbritrary requirements that hurt people more than they help.
Ah; Kentucky. 3 years ago I flew over on my way to a social service conference in Incineration. I was looking down at what appeared to be very large smoke plumes. I was informed that they were from coal fired power plants and that Kentucky had almost no environmental protection laws and seemed able to ignore Federal rules. Way to go Mitch McConnell
This is a simplistic view. Thank you NOT for thinking of us Kentuckians as stupid local yokels whose women are barefoot and pregnant. Those people working in coal mines have been locked into poverty and have no alternatives but to live in poverty or leave Kentucky altogether, something that few are able to do.
This does not stop at metropolitan areas like Louisville which has its own population of poor people. I have 2 degrees, can't get work, and can't get help to do so (denied by Vocational Rehab: overqualified). We need real help, real jobs, real income, real transportation (work requirements include "reliable transportation" (read: a car) and won't consider the bus system reliable transportation. And that means we need a better public transportation system.
We need so much infrastructure, and that's a nice buzz word to kick around, but even that is only given lip service, and the training doesn't guarantee a job, not even in union halls.
@@ginnyjollykidd average coal miner starting off makes 48k a year. That does not sound like poverty to me and I make 22k a year and live a productive life.
Less anecdotal evidence. More statistics please.
@@davidgoodwin4148
How much did you get paid to troll?
So how do vacations factor in with work requirements? Even low income people need a break sometimes. One weeklong trip equals loss of coverage?
And, what if you're sick and couldn't work your 20 hours that week? Is your coverage lost? So many unknowns.
💙
Work requirements made me lose my Medicaid coverage
People want to work. Training is not necessary for a person who has a University degree or more like I have. I have been denied help by Vocational Rehabilitation because I was OVERQUALIFIED for their services to HELP ME GET WORK!
I am DISABLED NOT HELPLESS! Why can I not get help finding employment? I do not have a car, either, and should I work, about half of that would go to buying a car. What happens if I lose a job? I'd be saddled with a car I couldn't pay for and any payments left on it.
TANF, SNAP, CHIP, Medicaid and so on are all BAND - AIDS. No one seems to want to do the hard work of making it possible for people to prosper. Is it too much to ask for a company to employ smart people who don't have a car?
People who can't work have trouble WORKING on paperwork. Source: Self.
@jfsfrnd It means that the paperwork requirement to sign up for special programs etc. isn't easy when you have trouble working for periods of time.
It's really quite simple. In today's neoliberal society, a dystopian future is within sight. If people refuse to work, then our society is prepared to let them die. Think about that. And keep in mind that working is not just supporting oneself: an employee is an asset that some corporation will use to increase profits. If a person is not capable of increasing some shareholder's wealth, then they deserve to die---that is the message this sends.
Requiring ANYTHING, aside from very basic registration of people to get health care is absurd. The social costs of leaving people without health care are unnecessary waste, and morally indefensible. THAT WHICH IS NECESSARY TO LIFE AND HEALTH IS NOT A PRIVILEGE, IT IS A RIGHT! If you are arguing that people should be allowed to get sick or die just because they are poor, then you have no argument that a human being with a soul should be willing to make.
You reasoning are so mangina & betamale
@@Chiyenworkout Eat dirt, troll.
@@kitthornton2336 Moral and altruism argument is mangina illogical argument. If you want to male healthcare affordable, in logical way. End Fda import drugs, end sugar subsidy and not allow illegal alien to use medicaid
@@Chiyenworkout " mangina"
Eat dirt. troll.
One person has suggested that Healthcare is part of the pursuit of happiness, which is one of those inalienable rights mentioned in the Declaration of Independence.
i have never in my life heard someone use the word "foci"
Intro music STILL super quiet
I'm okay with that. Most have it disproportionately loud, which is much worse/actually physically uncomfortable.
Work requirements for Medicaid is a good way to drive up suicide rates in people with depression and other serious mental illnesses which are already undertreated by Medicaid.
Who will be held responsible for those deaths?
work and health are not options for everyone... the assumption that people who don't work are lazy not sick... is stupid
when you are sick. chances are you are going to lose your job.... if you have menial job, unskilled and overaged, good luck...
the point of having healthcare is for you to be healthy to work... not the other way around
HEALTH CARE :
Europe vs America
WHATS IN IT FOR THE GOVERNMENTs and THE PATIENTS and why EUROPE WINS
European system costs 11% of GDP against 19% in the USA
EU HEALTH CARE IS ALL INCLUDED
THE USA NOT & WHY SO COMPLICATED???
USA life expectancy is 42th in the world on the world ratings.
WHATS IN IT FOR THE EU PATIENT?
If you pay taxes, as an individual, and contribute to the central government “POT” (the community POT of money).
You are covered for all treatment, hospital costs, surgery, drugs, implants, chemo, post op therapies, cost of prescribed drugs, specialist and normal GP doctors bills, specialist bills etc etc.
(There are some small exceptions.)
You dont have to look at the small print of coverage.
Its all included, pocket your credit card.. you dont need it.
You dont have to pay in advance
NO Paperwork
The system is rated as better than the American system as nobody is excluded and the system covers 99% of all patient needs.
THE EUROPEAN SYSTEM:
HOW IT WORKS:
All european health systems are government run and are simple systems .
It is a central, run by the govenment covering all healthcare needs for the population and is non profit , universal, and also internationally recognised between all EU countries.
The EU underlying system is through fiscal residency of a person, (ie you pay into the employment tax system of the country you live and into health system, if you are registered or unemployed you are covered)
Simply put, each person pays into the THE GOVENMENT POT as a % of individual pay packet contributions where you are employed
Importantly even if you are unemployed, but registered, you control illegal immigration. Illegals get no benefits, unless humanitarian emergency.
Importantly you are still covered. you as a patient get equal rights and coverage across Europe.
The EU system is state run, and covers everyone, from birth to death and costs half of the USA system.
Therefore in the USA a % of the health cost is based on profit to be paid out in dividends.
Additionallly not all people in the USA are covered, (approximately 15%)
Its a Bum deal for Americans. It costs 8-9% of GDP more than Europe
HOW IT IS MANAGED:
In America USA, the health system is profit run for the most part and privately handled. Patient care is secondary to profit for 50% of coverage.
The European state (country) is the employer of all health staff, doctors, nurses, etc.
Central government then covers the hospitals costs through a system which keeps the hospitals covered for the expenses of each patient.
If we compare the EU to the USA structure in terms of cost to GDP, Europe average 11% of GDP to the USA 20% of GDP, (2019) with the EU at 99% coverage and with improved life expectancy rate, compared to the USA.
Central Government in each country collects the money through the taxes you pay as a citizen, and redistributes it (generally) to regions ,hospitals, and doctors etc which then distributes the funds to the health system used by the patient.
The Government also allows the private sector to operate under the public system, to build hospitals, run them privately.
Each country allows this in different rules, like Germany/UK/France etc. They are then licence them to operate by the government.
But importantly, the patient who pays to the state contributions through his salary, has equal rights to access all hospitals.
10-15 % of the EU health system is private
If you wish to pay an additional supplement to the state system, you are allowed to do this into to the private scheme on top of your mandatory state payments so you get private health care coverage.
But you cannot opt out of the central system or add to it.
Most of people dont have the means or desire to pay private insurance policies. So the state system is better for them.
WHATS THE BENEFIT
Basically the EU system covers 99% of people and costs the half of the USA system.
In addition to this, with the EU system, if you pay contributions to the health system in the UK or France, you can have full medical care in other countries , Germany, Italy, Hungary or any other of the 27 states etc.
If you lose your job, you will still be covered. you just pay less to the system as unemployment reimbusement to you is less, so you pay less, but the more you earn at work, the more you contribute to the central system. Its based on % of earnings.
These European systems are based on the old and original UK system, The National Health Service, abbreviated to NHS, was launched by the then Minister of Health in Attlee's post-war government, Aneurin Bevan, at the Park Hospital in Manchester. Aneurin Bevan, Minister of Health, on the first day of the National Health Service, 5 July 1948 at Park Hospital, Davyhulme, near Manchester.
THE REAL ISSUE
1. EU Health is non political, non profit, more efficient and cheaper that the USA system,
2. BETTER in many ways, as the patient is first, and health has no “profit COST”.
3. It reduces the cost to the Government. (11% against the USA 20% per year GDP)
4. Its not fragmented. Its coverage is national, and for all.
5. If you are REGISTERED as a TAX payer, you have no problems.
6. If you are clandestine, then you get some emergency humanitarian services only.
Thus the authorities know who you are and send you home after.
Thanks for the comments!!!!
THERES NO WEASON!
anyone who tells you that there is an easy answer is lying or ignorant. beware of people with easy answers.
The problem isn't lack of information. The problem is bad faith negotiation & open malice towards the very idea that we could solve these problems by working together, or towards the idea that 'those people' will get something for nothing, or towards the idea that anything, *anything* that 'triggers the libs' is obviously the right thing to do. The problem is that a lot of healthy people think sick people are a burden on society that we'd be better off discarding, or that health care is a concern of other people and they shouldn't have to pay any money if they didn't get sick themselves. That's the status quo of modern conservative ideology.
Trogdor Burninator we can hope it happens to them some day
Cold-hearted ill-informed people, who may generalize from a single data point or two in their experience, are out for vengeance against those they see as cheaters. These intellectually lazy people, often GOP supporters, many of them Christian, don't care about their fellows. The oligarchs take advantage of this, along with the fact that the ill-informed think these programs make up a huge portion of the budget, to pass requirements like this. At the same time, the oligarchs walk away with an extra 1.5 trillion over the next ten years. The US is not a good country.
But what about all the people in eastern Kentucky who are choosing to be on meth? Or dropping out of high school despite being told that that's a dumb choice? These factors make it difficult for them to find a job, but they chose that lifestyle.
What's your point? They are bad people who aren't going to change, so we should punish them by denying them healthcare. These folk have been with us since the beginning of mankind.
How about instead of creating an expensive complicated system to make sure poor people don't get assistance we give cash to those who need it? Cut out all the administrative crap & do the simple right thing
why do we assume it's a good to force people to work anyway. literally who tf cares. I want everyone to have healthcare.
How bout citizenship Requirements for Medicaid? (preventing illegal aliens to use ER would reduce healthcare cost)
Art of street work out In the U.K. this was discussed and one of the arguments is that the time and work taken to work out who is eligible or not actually exceeds the costs of health care given.
@@MiniDress360 result?
There already are citizenship requirements for Medicaid. And, really?? You want to watch people bleed to death on a hospital's doorstep because they don't have a green card? That would make you feel good?
@@steveh46 I am nationalist, i don't care for globalist moral standard, that made by UN. American social program are belong to American, not illegal aliens.
@@Chiyenworkout You'd be shocked at what happens in other countries. If you show up at a hospital needing care, they don't ask whether you are a tourist or an illegal immigrant or a citizen. You're a human being, you get needed care.
You don't let little considerations like humanity or morality get in the way of your ideals though. So you're just a bad person no matter what you call yourself.
Being poor is supposed to suck. It is supposed to be so bad that people are willing to change their entire lives to avoid it. Just the threat of possibly being poor in the future should be enough to make 30 year old white women, who don't have their retirement set aside, drink plain coffee in the fall. It is supposed to be worse than working a job you abject despise for your entire life. Every single thing you do in life has to be paid for by someone, and that someone is supposed to be you.
Yet other countries seem to do a better job at reducing poverty but don't do it by making poor people's lives totally miserable.
Stop helping with unwed mother keep having babies get job the taxes payers pay for them not right.
Yeah. Why don't we talk about how medicaid takes up almost 22% of most states budgets, money that would be better spent on improving economic conditions or just staying in working peoples wallets. If you defered gratification and saved money while working then you could pay for insurance and therefore doctors bills when/if you got hurt. Not to mention most jobs provide medical coverage to people hurt while on the job. More over if you just hit a hard spot in life, it has been shown that churchs provied more than enough to cover you in your time of need.
Medicaid is a program that improves economic conditions. That is the entire point. A huge amount of people on benefits don't have the earnings to save.
www.ohchr.org/EN/ABOUTUS/Pages/DiscriminationReligionOrBelief.aspx because religion isn't an answer to charity. serious there are so many problems with this.
@@SanvelloSerapiega Medicaid is a social welfare program and like all social welfare programs it deprives those able to defer gratifaction from prividing larger economic gains while sustaining thoes who can't. ruclips.net/video/XooUY4p4RaY/видео.html
@@SanvelloSerapiega And as of right now religious Americans give the most out of anyone in terms of donating to the needy. www.forbes.com/2008/12/24/america-philanthropy-income-oped-cx_ee_1226eaves.html
Churches? Seriously? They are allowed to discriminate. I know for a fact that a major church organization here in St. Louis that helps the homeless discriminates LGBT persons. The churches argument is simply an empty argument for selfish libertarians.
@@tophers3756 I know. It's amazing what a free market is like. You can deside where your money goes. You are also saying that ALL churches will discriminate which is simply not true and certainly does not give way to the government stealing money from working people to mandate "equality".