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You are here: Home / Anderson On Health Insurance / Out of work in a pandemic, why care about Medicaid?

Out of work in a pandemic, why care about Medicaid?

by David Anderson|  July 28, 20208:05 am| 31 Comments

This post is in: Anderson On Health Insurance, COVID-19

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Jeff Stein highlights one section of the Senate Republican initial offer for the next round of COVID-19 disaster relief.  This section proposes to shift the current flat and guaranteed $600 a week federally funded supplemental payment to first a $200 per week payment and then a means tested program that serves as a 70% wage replacement stream. So that would be a massive income cut for many people who are laid off, furloughed or looking for work and not finding any. But that is not what I want to highlight.

 

Here it is: GOP plan on unemployment insurance, confirming our reporting this morning

Cuts $600/week benefit to $200/week — in October, replace $200/week w/ 70% replacement of lost wages

States can request a waiver if cannot make the switch pic.twitter.com/uAQnIRH3WP

— Jeff Stein (@JStein_WaPo) July 27, 2020

The sentence: “Starting in October, the additional payment would count as income when determining eligibiliy for federal low-income programs…” can be quickly translated as a method to significantly decrease Medicaid enrollment.

Under current law, income for Medicaid eligibility is determined on a monthly basis. Someone who has a good six months and made $100,000 before losing their job and earning nothing in month 7 can qualify for Medicaid on the basis of their income in month 7.

State funded unemployment insurance counts as income for Medicaid purposes. However, under the CARES Act, federally funded unemployment insurance income, of both the $600/week bump and pandemic unemployment insurance that covers many 1099 workers, does not count as income for Medicaid qualification purposes. It is quite plausible for someone to report both 0% Federal Poverty Level (FPL) and 250% FPL monthly income for different programs. Tens of thousands of individuals and families are receiving enough money to keep their head above water (or even occassionally get rid of some lead weights that has kept the water going into their mouths as they try to float) while qualifying for Medicaid. This is especially notable in states that have not expanded Medicaid. For instance,North Carolina’s Medicaid program will cover adult caregivers/guardians/parents of kids if the adult earns less than 44% FPL. Numerous families who have had all earners laid off or furloughed now qualify for North Carolina Medicaid even if they are not in deep poverty due to federal support. Many families who fall into the Medicaid gap at first glance are not in the gap because their federally funded unemployment benefits don’t count against them for Medicaid purposes.

Requiring all unemployment insurance payments to count as income for Medicaid purposes means many families will be experiencing the shock of job loss, the pain of significant income loss and the loss of any plausible source of affordable and decent insurance under this proposal.

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Reader Interactions

31Comments

  1. 1.

    Nora

    July 28, 2020 at 8:23 am

    They just never stop, do they? Even in the middle of a pandemic, when people are already suffering so much, they just can’t resist tightening the screws just a little more. Evidently just for the sadistic fun of it.

  2. 2.

    MomSense

    July 28, 2020 at 8:25 am

    The Republicans are fucking sociopaths.

  3. 3.

    cmorenc

    July 28, 2020 at 8:34 am

    Whittling down Medicaid, Medicare, and Social Security to the vanishing point has been a longstanding dream of GOP conservatives ever since 1964 and 1935 respectively.  They understand it’s not legislatively nor electorally feasible to do so in one big fell swoop, but they still figure that with repeated small cuts, they can eventually whittle them away to the point they are no longer viable, and con the public into seeing them only as residual programs to help poor people, not regular citizens.

  4. 4.

    Spanky

    July 28, 2020 at 8:43 am

    They won’t stop until we stop resisting.

     

    NEVER STOP.

  5. 5.

    artem1s

    July 28, 2020 at 8:59 am

    States can request a waiver if cannot make the switch

    and then there is this.  $200 will be permanent for the states that refuse to switch.  There will be repeated voter referendums that are repeatedly repealed by R-Governors – just like with ADA. The real crash is coming.  And the governors know they are facing bankruptcy without federal relief.  I have my doubts that Dolt45 will even lift a finger to help the true R-Cult45 believers come November.  And the Governors know it.

  6. 6.

    Nora

    July 28, 2020 at 9:12 am

    @cmorenc: Sort of like abortion, then, huh?

  7. 7.

    Chief Oshkosh

    July 28, 2020 at 9:16 am

    Every elected Democrat should respond to every question from the press today, no matter what the question is, with:

    The Republican plan means many families will be experiencing the shock of job loss, the pain of significant income loss and the loss of any plausible source of affordable and decent insurance, all at the same time and during a pandemic.

  8. 8.

    dnfree

    July 28, 2020 at 9:16 am

    Wow. Sneaky. And mean.

  9. 9.

    Michael Cain

    July 28, 2020 at 9:20 am

    Ah, one of my particular complaints from my days as a budget analyst for my state’s legislature: the constantly growing set of federal rules for calculating eligibility and benefit levels for public assistance programs.  There are no federal agencies that have to be concerned that Congress has created a 16th type of income, that counts for some programs and not for others, because the feds don’t actually administer the programs.  But every one of the 50 states plus DC have to modify their intake software (and if they’re doing things right, add test cases and perform full regression testing) in order to accommodate it.

    I was the stuckee for things software on the budget staff.  I hated having to sit in front of the Joint Budget Committee and say, “Mr. Chair, I’m here to review item #13 on today’s agenda, a $3.5M increase in software development expenses to bring the state’s system into compliance with federal eligibility changes…”

  10. 10.

    jonas

    July 28, 2020 at 9:23 am

    Needlessly cause pain and suffering for vulnerable people in a crisis? Sounds like a piece of Republican legislation to me!

  11. 11.

    OzarkHillbilly

    July 28, 2020 at 9:23 am

    My youngest is among the laid off. He already isn’t eligible for Medicaid (in Louisiana). And just for bonus, now appears to be developing a hernia.

    Good times.

  12. 12.

    David Anderson

    July 28, 2020 at 9:32 am

    @OzarkHillbilly:  Ouch, my sympathies to your youngest.

    Have him apply for Medicaid anyways.  Qualifying income in Louisiana is 138% FPL on a monthly basis.    Federally funded UI does not count for Medicaid.  There is no downside to applying.

     

    If he either does not apply for Medicaid or gets rejected, he still has a special enrollment period on the Exchange.  If he knows he needs surgery, it may make sense to spend more in premium to get a lower Out of Pocket Maximum for the next 5 months and then switching back down to the cheapest plan possible.

     

    If you need help; e-mail me.

  13. 13.

    Lacuna Synechdoche

    July 28, 2020 at 9:36 am

    David Anderson @ Top:

    Requiring all unemployment insurance payments to count as income for Medicaid purposes means many families will be experiencing the shock of job loss, the pain of significant income loss and the loss of any plausible source of affordable and decent insurance under this proposal.

    What is with the GOP obsession/fetish for cutting health insurance to the neediest people during a pandemic? I mean, I know Republicans are evil, but this is cartoon villain level bullshit. It’s like they literally get off thinking up new ways to make unemployed, poor, and/or lower middle class people suffer.

  14. 14.

    Emma from FL

    July 28, 2020 at 9:40 am

    I have come to the conclusion that they are evil, in the old traditional sense of the word. There’s no sophisticated explanation for it. Just pure evil.

  15. 15.

    BruceFromOhio

    July 28, 2020 at 9:42 am

    As noted elsewhere, the cruelty is the point. To understand any republican action, need look no farther than who does it hurt the most.

  16. 16.

    terraformer

    July 28, 2020 at 9:54 am

    Absolute horrors of human beings, the lot of them.

  17. 17.

    PenAndKey

    July 28, 2020 at 9:56 am

    All of this, and they still managed to also include something like $29B in defense funding (on top of the current defense bill), with $7B alone being for weapons platform purchases. Just… wow. It’s like watching the entire senate propose a bill that’s nothing but a giant poison pill filled with smaller poison pills all the way down.

  18. 18.

    OzarkHillbilly

    July 28, 2020 at 10:03 am

    @David Anderson: He already did apply for Medicaid. I was wondering about the Fed UI’s impact. I really don’t understand how he could have got turned down. The only thing I could think of was he was making good money before he got laid off and they plugged that into the equation too.

    Thanx for the reminder about the special enrollment period on the Exchange. I totally brain farted on that. I’ll give him a nudge when we talk this week.

     

    ETA: “If you need help; e-mail me.”

    As my wife says, I’m beyond help, but I’ll keep the offer in mind, Thanx again

  19. 19.

    Spanky

    July 28, 2020 at 10:23 am

    @Lacuna Synechdoche: Quite simple. The neediest are untermenschen to Republicans, and are to be used until useless, then thrown away. And I’m afraid there’s not a smidge of hyperbole in my explanation.

  20. 20.

    laura

    July 28, 2020 at 10:24 am

    Wouldn’t it be easier for the GOP to notify the newly laid off  and suddenly without health care to report for their soylent greening on date and time certain with the possiblity of a meal and brief video of beautiful things before tipping into the processors?

    Fucking nihilist fucks.

  21. 21.

    Yutsano

    July 28, 2020 at 10:33 am

    They know one of the reasons they got pantsed in the last election was partially due to healthcare right? And they want to keep trying to fuck with it? I mean sure go ahead it’s not like word isn’t going to get around that you tried to do that AGAIN or nothing.

    I honestly want to get one of them to defend this provision on camera. Just one. Then let that clip be used in a thousand ads across the country. They might just lose about everywhere.

  22. 22.

    Joe Falco

    July 28, 2020 at 10:34 am

    It’s like almost every part of the HEALS Act is specifically designed to be the opposite of what the word “heals” is supposed to mean.

  23. 23.

    Hoodie

    July 28, 2020 at 10:37 am

    @Nora: You have to understand that these guys start from the proposition that it’s all their (actually, their donors’) money and they’re being generous by letting you have some of it.  They can’t admit that you might have some moral claim on it, so it’s critical to make sure the largesse is delivered in a way that puts you in your proper subordinate moral position, i.e., you haven’t “earned” that money.  Of course, that becomes even more absurd in a situation like a pandemic, where people’s agency to earn things can be severely constrained.  But, bigger picture, they can’t (or don’t want to) grasp the concept that the country has a pool of resources to which people may have moral claims based on various factors, only one of which is winning some mythical tournament of merit that entitles you to those resources.

  24. 24.

    laura

    July 28, 2020 at 10:39 am

    @Joe Falco: try reframing it as a boot heel smashing the face of everyone not a white male billionaire republican from now till the end of time.

  25. 25.

    hells littlest angel

    July 28, 2020 at 10:49 am

    I can’t imagine what it’s like to wake up every morning with the resolve to be an even shittier human being today than you were yesterday.

  26. 26.

    David Anderson

    July 28, 2020 at 10:53 am

    @OzarkHillbilly: That is my bet, that the Louisiana application used his current month income which includes significant wage income to get him over 138% FPL.  Re-apply in August when his reportable income is significantly lower.

  27. 27.

    Nettoyeur

    July 28, 2020 at 12:16 pm

    The sheer cruelty seems to be a feature rather than a bug. Trump is the open embodiment of long standing GOP and Southern views. As Melania put it succinctly on her jacket, “I don’t care, do you?”

  28. 28.

    Brachiator

    July 28, 2020 at 1:32 pm

    The sentence: “Starting in October, the additional payment would count as income when determining eligibiliy for federal low-income programs…” can be quickly translated as a method to significantly decrease Medicaid enrollment.

    Wow. Thanks for pointing this out. This kind of thing is entirely consistent with the GOP disdain for poor people.

    They never stop.

  29. 29.

    leeleeFL

    July 28, 2020 at 2:02 pm

    I am never, ever, surprised by anything done by this Administration.  They are, invariably, the worst they can possibly be.  I must say though, Mnuchin does it with that face that begs to be slapped with a dead fish.  Or with Jared Kushner’s flaccid equipment…..I can’t decide.

  30. 30.

    OzarkHillbilly

    July 28, 2020 at 2:27 pm

    @David Anderson: I’ll tell him, thanx.

  31. 31.

    Ruckus

    July 28, 2020 at 4:08 pm

    @Lacuna Synechdoche:

    There is no actual logic involved in their lack of thought and responsibility. It is simply conservative dogma, screw everyone other than the masters of the universe, which is those who have managed to steal enough to look successful, because they are the only people deserving of the stature of citizens. And the only people who can gain that status look like they have never been tainted by an honest days labor, nor have any skin color darker than white chalk, nor get more than 15 minutes of sun. A month.

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