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The Trump administration’s war on health care

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Nick Bagley has a good column enumerating Republicans lies on healthcare and their consequences. The Trump-approved Medicaid work requirements are particularly egregious:

Work requirements poll well: If you’re getting benefits on the government’s dime, shouldn’t you be expected to pull your own weight? But they are a policy nightmare. Fully 60 percent of those who are subject to work requirements already work. Of those who don’t, the overwhelming majority are in school, disabled or caring for dependents. There just aren’t that many people on Medicaid who can work but have chosen not to.

That’s why work requirements can’t stimulate much new employment. Every Medicaid beneficiary who’s subject to the requirements, however, has to jump through the bureaucratic hoops of attesting to their work status. Desperately poor people who lack the bandwidth or the wherewithal to comply will lose health coverage because they can’t manage the paperwork.

Experience in Arkansas bears the point out. More than 18,000 people, or nearly one in four Medicaid beneficiaries subject to work requirements, lost coverage in the first seven months of the program. A careful study in the New England Journal of Medicine found that “lack of awareness and confusion about the reporting requirements were common.” Employment rates didn’t budge.

Losing Medicaid isn’t a pathway out of poverty. It’s a pathway to destitution. A randomized trial out of Oregon, for example, shows that getting Medicaid eliminated catastrophic medical bills and cut in half the rates of people who had to borrow money or skip other bills to pay for health care. Recent research also shows that Medicaid sharply reduces evictions.

The cruelty is the point.

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