Stephen Lendman

Medicaid is a jointly administered federal/state program, providing medical care for poor and low-income people.

The Health Insurance Association of America calls Medicaid a “government insurance program for persons of all ages whose income and resources are insufficient to pay for health care.”

Around 75 million Americans qualify. States have broad leeway in determining who’s eligible. They may participate or opt out of the program. None chose to go this route so far.

Under Obamacare, all US citizens and permanent residents with incomes up to $133% of the poverty line qualify for Medicaid - defined as $24,250 for a family of four in the continental US, somewhat higher for Alaska and Hawaii. Healthcare is a fundamental human right. Most nations have some form of universal care, America the only developed one without it.

The world’s richest country denies all its citizens a right millions can’t afford, most others way underinsured.

Medicaid is barebones healthcare at best, woefully inadequate in cases of serious diseases, illnesses or disability.

On Thursday, the Centers for Medicare & Medicaid Services (CMMS) released new guidelines, letting states deny Medicaid to eligible able-bodied residents without jobs, participation in work-related activities or “community engagement” - including job training or enrollment in school.

This represents a major disturbing change in the program since begun in 1965 - the federal government providing matching funds to states for medical care to eligible residents.

CMMS administrator Seema Verma issued a statement, saying “Medicaid needs to be more flexible so that states can best address the needs of this population.”

“Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries, and today’s announcement is a step in that direction.”

It’s a step in the wrong direction, assuring fewer needy people are covered, eroding a vital program, one of various steps to eventually eliminate it.

The federal government intends reneging on its responsibility to help pay for the great GOP tax cut heist - at the expense of social justice. Large cuts in Medicare, Medicaid, food stamps and other social programs are planned.

Republicans never wanted these programs in the first place. With executive branch and congressional control, they intending taking full advantage - prioritizing militarism, warmaking, corporate handouts and tax cuts for the rich, at the expense of eroding the nation’s vital safety net for its poor and least advantaged.

Verma is a right-wing extremist, a longtime advocate of requiring Medicaid recipients to work, uncaring about millions of Americans struggling daily to get by, many having to choose between paying rent or medical expenses, unable to afford both.

Reasons why Medicaid recipients don’t work are as follows, according to the Kaiser Family Foundation:

— 36% are ill or disabled;

— 30% are taking care of their home or family, including single mothers;

— 15% are in school, 9% retired, 6% seeking work, and 3% for other reasons.

Many Medicaid recipients have physical or emotional health problems short of meeting federal disability criteria. Some can’t meet their state’s work verification requirements.

According to Kaiser’s Program on Medicaid and the Uninsured associate director MaryBeth Musumeci, “(e)ligible people could end up losing coverage because the right documentation does not get sent to the right place.”

Ten states (Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin) already intend imposing work requirements for able-bodied Medicaid recipients, others likely to follow, perhaps all or most eventually.

Responsible health policy experts regard Medicare and Medicaid as essential programs not to be based on compliance with rules unrelated to them.

CMMS deputy administrator/director Brian Neale, saying “(p)roductive work and community engagement may improve health outcomes” sounds disturbingly like the Nazi concentration camp slogan: “Arbeit macht frei” - Work sets you free.

In the camps, it was free from their lives. Maybe GOP extremists have something similar in mind for the nation’s poor and disadvantaged.

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Stephen Lendman lives in Chicago. He can be reached at lendmanstephen@sbcglobal.net.

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