Stop trying to repackage the worst parts of AHCA
Repackaging an idea that was bad at the national level and hawking it as a state mandate doesn’t do anything to relieve the objectionable nature of the proposal.
So it is with two bills proposed by state Rep. Seth Grove, R-York. The legislation would impose work requirements and a lifetime eligibility limit on people in Pennsylvania’s Medicaid program, and create a state-level administrative post to oversee the mandates.
And yes, the ideas — which are, coincidentally, key components of the U.S. House’s widely-derided American Health Care Act — are just as ridiculous and counterproductive as they sound.
Grove’s bills are unlikely to become law with Gov. Tom Wolf in office, and that’s a good thing. No other state imposes a work requirement on Medicaid, and none place time limits on the program either. There are plenty of areas in which Pennsylvania should choose to lead the way, but this isn’t one of them.
It’s a callous and short-sighted move that would add another level of bureaucracy and administrative cost to our already-dysfunctional state government and likely create more economic hardship for the most vulnerable among us.
The time limit — an arbitrary five year maximum for Medicaid eligibility — is particularly egregious and flies in the face of basic health care best practices: continuous care, which keeps people healthier and long-term costs down, is the entire point.
Grove’s misguided Medicaid work requirement is no better. What problem, exactly, is the proposal supposed to solve? Most people receiving Medicaid who can work, already do.
According to the 2015 National Health Interview Survey, half (48 percent) of all Medicaid expansion beneficiaries are either permanently disabled or have serious physical or mental limitations that preclude them from often physically demanding, low-wage jobs.
Of those who are “able-bodied,” only 13 percent are not working, in school or seeking work — and 75 percent of those say they’re not working because they are either caring for a family member or have experienced a problem like being laid off.
In fact, Medicaid by itself likely does more to support and promote work than any federal or state requirement. A 2016 study of Medicaid expansion in Ohio found that 52 percent of employed workers said Medicaid made it easier for them to keep their jobs, and 75 percent of unemployed workers said Medicaid made it easier for them to look for work.
If Pennsylvania Republicans want to encourage the poor and partially disabled to join the workforce, perhaps they should focus on responding to sharp economic and health concerns in rural communities, where nearly 70 percent of residents say jobs are hard to find, according to a national poll by the Pew Research Center.
That makes far more sense than trying to implement one of the most ill-conceived, unpopular and backward pieces of the AHCA as a state-level mandate.
