OPINION

JOHN BRUMMETT: Arkansas meanness

Leonardo Cuello, policy director for the National Health Law Program in Washington that has sued over Arkansas' work requirement for Medicaid expansion, was assuring me the other day that trying to get Medicaid recipients into jobs is a good thing.

"Let's think about what you and I would do if we got together and talked about how to remove the impediments to work for people on Medicaid," he began.

Cuello proceeded to say that child care is a problem and that better child-care facilities would be needed, and that transportation is a problem and that some means of helping people get to work would be needed, and that a better job database tied to local markets would be needed.

What Arkansas is doing, Cuello said, is "doubly stupid," because (1) it contemplates none of that in simply requiring recipients to click a computer to say they're working or looking for work, and (2) it jerks insurance covering what is the main reason many people don't or can't work, which is bad health.


Yes, in Arkansas, the controlling conservative Republican focus is punitive--mean, I call it--rather than logically opportunity-based. Negative rather than positive, that is.

All conservatives want to talk about is some lazy no-account man swallowed up in a sofa watching TV all day while hardworking taxpayers provide his insurance for the bad health he is cramming into his mouth one welfare tortilla chip at a time.

All you're doing by jerking his health insurance for not clicking a computer for three months --whether he works or looks for work or not--is forcing the hospital to absorb the costs of care for his heart attack or stroke, and, eventually, pass those costs on to insurance carriers, meaning all of us the next year in premiums.

A punishment-based work program like the one Arkansas leads the nation in starting--one that emphasizes the miscreant and builds a policy around that negative focus--is like saying that, since there are drunken drivers on the highways, no one can drive unless he goes online every month and clicks a box that he has remained sober.

All you've done is insult everyone and stimulate computer activity. If you've kept one drunk off the road, you're lucky and have done it in spite of yourself.

The National Health Law Program spearheaded the lawsuit that led a federal judge in the District of Columbia to strike down Kentucky's first-in-the-nation work requirement before it could get started.

Cuello's group pointed out that federal law defines Medicaid as extending health care to the needy. The law further allows for waivers for experiments to enhance that service.

The lawsuit contended, victoriously, that requiring people to work or simply lose insurance did not enhance health coverage to the needy or amount to a worthy experiment in that direction.

Now the National Health Law Program has turned its attention to Arkansas, coming along with the first such requirement to be put into operation.

Already, more than 4,000 people have lost health insurance in Arkansas for failure to computer-click, and more will lose insurance month to month.

All the state knows about that is that those people didn't click their computers three months in a row. Have they died? Become wealthy? Found work? Moved to another state? Who the heck knows? What Arkansas officials know--and like--is that the rolls are reduced, and the state's matching costs are lower.

Four other states are coming along with work requirements and another dozen or so are threatening. Cuello and the National Health Law Program see the issue as the Trump administration's attempt to use waivers to change Medicaid fundamentally red state-by-red state without changing the law.

When I observed that the Trump administration presumably would change the wording of the Medicaid law through a bill in Congress if it could, Cuello responded, "There's no hypothetical to it." He pointed out that the Trump administration tried that very legislation last year and failed.

Poor Arkansan citizens are simply pawns played early in the game.

The Kentucky pawn has been captured already and the Arkansas one is probably soon to be.

The first thing the Trump Justice Department did in the Arkansas case was ask the D.C. judge who had ruled against Kentucky and then drawn the Arkansas suit to disqualify himself in the Arkansas case. He declined, presumably on the basis that being right the first time hardly rendered him unfit the second time.

Now a schedule for briefs and oral arguments has been set in the Arkansas case and a ruling by the judge seems likely sometime in the spring.

I'm betting against my home state's current political leadership and against meanness, by which I repeat myself.

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John Brummett, whose column appears regularly in the Arkansas Democrat-Gazette, is a member of the Arkansas Writers' Hall of Fame. Email him at [email protected]. Read his @johnbrummett Twitter feed.

Editorial on 10/04/2018

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