Health insurance for about 600,000 Americans hangs in the balance as part of last-minute negotiations to raise the US debt ceiling.
House Republicans are pushing to include enhanced job requirements for federal care recipients — now called Temporary Assistance for Families in Need — the Supplemental Nutrition Assistance Program (SNAP) and Medicaid as part of a debt ceiling deal with the White House.
We can’t spend more money next year. We have to spend less than we spent the previous year. It’s pretty easy, said Speaker Kevin McCarthy (R-Calif.) Friday.
Under the GOP proposal, 600,000 Americans — mostly low- and middle-income workers able to work and ages 19 to 56 — would lose their Medicare after being kicked out of federal Medicaid funding, according to a Congressional Budget Office analysis from April.
That would save the government $109 billion over the next decade, the Central Bank of Oman estimates, and is just a fraction of the $32 trillion in federal debt that Republican- and Democratic-led administrations have accumulated.
The White House had repeatedly brushed off raising the debt ceiling as non-negotiable before giving in to Republican demands for talks before the June 1 potential run out of money.
There’s a good chance that people who are about to lose their Medicaid coverage, Social Care, or SNAP benefits won’t know they’ve been kicked out of these federal programs until it’s too late.
Arkansas approved Medicaid’s work requirement in 2017, resulting in tens of thousands of people missing coverage. Arkansas legal aid attorney Trevor Hawkins has set out to survey his state to let people know their lives are about to change.
The Hill told people he met on the road they had no idea what was to come.
“Most people didn’t realize these business requirements were a thing until they started getting notices of problems,” he said. “They got signs of non-compliance, but that’s just because they didn’t know it.”
“I’ve traveled virtually the entire state, talking to people at bookstores, gas stations, barbershops — you name it. I’m posting flyers all over the state,” he said. “It’s been a really tough time for me personally, just kind of seeing how it affects people, doing everything I can to try and spread the word.”
Trida Robinson, an Arkansas worker who nearly lost her health insurance because of the Employment Requirements Act and ended up suing the state, said she would have died if she lost her coverage because she had a tumor she needed to have removed that was related to anemia.
“I would have died. The tumor was causing me to bleed, and it was making my blood count really low,” Hale said in an interview. “If I had lost my insurance at that time, how would I be able to go to the doctor to even know what was going on with me? Those appointments were only $300 and $400.”
Officially about 18,000 people have been cut off from their health insurance by Arkansas’ job requirements, Hawkins said, but that number is likely much higher because of the selective way the state actually tracks numbers.
However many people end up losing coverage in Arkansas, the total adds up to a fraction of the number of people who will lose coverage nationally.
While Republicans and some Democrats have defended the work requirements as obligating people receiving state benefits to work for higher levels of pay, research from the Harvard T.H. Chan School of Public Health shows that in practice, the requirements in Arkansas did not promote employment.
“Awareness of work requirements did not increase employment over the eighteen-month follow-up,” the researchers concluded, adding that “awareness of work requirements remained poor, with more than 70 percent of Arkan residents unsure whether the policy was in place.”
Many researchers view the proposed law merely as a mechanism by which people are excluded from government programs rather than as a way to encourage people to earn a wage.
As such, the requirements should not be viewed as a “work requirement” so much as a “paper work requirement,” as they say.
“If the goal is to get people who can work into work, the way it’s done is saying, ‘Prove it.'” That’s very different from checking them out, said Katherine Ann Edwards, an economist and public policy analyst, in an interview with The Hill. Using the excellent administrative data that state governments already have.
“It puts the burden of proof on them, and one of the consequences that we know this will have is that a lot of people will miss out on the benefits,” Edwards said.
This could be a good outcome if the onerous paperwork requiring Medicaid recipients to find a high-income job would then make them ineligible for the program.
“But this is a very rosy picture and we don’t have any evidence to support it,” Edwards said. “Instead, it results in people missing out on benefits.”
The GOP legislation passed in the House “prioritizes the use of existing databases or other verification procedures whenever possible” over officially reported business requirements, but experts say such language has little chance of being realized in practice.
“Outside of a massive effort to organize federal databases to be able to talk to each other, job requirements will continue to function as they have in the past,” said Matt Darling, an employment policy fellow at the Niskanen Center in Washington. tank.
The work requirement, Darling said, is “a program that fails to get people into work while dropping people from Medicaid if they don’t fill out the paperwork.”
Republican targeting of Social Care and National Health Insurance programs comes on the heels of massive tax cut packages passed during the past two Republican administrations that have added significantly to the US deficit.
After the repeal of the Child Tax Credit in 2022, which lifted millions of American children out of poverty, policy analysts repeatedly point to a lack of political consequences for targeting programs geared toward poor and low-income Americans.
“The poverty rate has basically remained unchanged over the past 40 years, so I don’t know if that’s possible [targeting the poor] It is necessarily a bad political strategy,” Edwards said.
“It’s not like I can say there are a lot of bad political outcomes for people who don’t help the poor. We do that all the time.”
Despite the regular argument that defaulting on US debt would lead to economic disaster, the Biden administration has not seriously pursued any legal solutions.
As progressive Democratic lawmakers urge Biden to sidestep Republican demands to cut programs that help low-income Americans, the White House has so far been stuck in negotiations with House Republicans.
These alternatives include proposals for additional coinage for the express purpose of eliminating or reducing the level of US debt below the current maximum level.
Biden has expressed his willingness to invoke the Fourteenth Amendment to the Constitution, but US courts and global financial markets may not accept such alternative solutions.
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