No Health Care for You! Prodded by Team Trump, states are requiring people to work for their Medicaid.

AuthorThomhave, Kalena

Charles Gresham held various jobs in the food industry and construction, but was routinely let go because he would have seizures on the job. Due to his health, the thirty-seven-year-old resident of Harrison, Arkansas, needed work with a flexible schedule, which is almost impossible to find in the low-wage labor market.

Arkansas's Medicaid expansion program helped Gresham get the care he needed. But then he started receiving confusing and complex letters from the Arkansas Department of Human Services, telling him he needed to report work hours in order to keep his benefits. As a result, according to a lawsuit filed last November, he began to have "more anxiety attacks than normal" as he worried that his medical coverage would be discontinued, with potentially fatal consequences. Another plaintiff in the lawsuit, twenty-six-year-old Russell Cook of Little Rock, worked seasonally as a landscaper. But, due in part to an extended rainy season, the job fell short of providing the requisite eighty hours per month under the states new Medicaid work requirement. "The loss of health insurance could be catastrophic for Mr. Cook, as he is presently living on the streets, where deteriorating health can have especially severe consequences," the lawsuit states.

A third plaintiff, forty-two-year-old Treda Robinson of Searcy, Arkansas, has anemia that causes "fatigue, weakness, and heavy menstrual bleeding," according to the lawsuit. She began receiving Medicaid in 2014 but had to quit her job for medical reasons in 2015. Her condition required serious surgery, most notably having a massive tumor removed, putting her Medicaid in doubt. Though her documented disabilities should satisfy the requirement, Robinson was told that her ill health did not exempt her. If she was non-compliant for three months, she would be removed from Medicaid entirely.

The lawsuit, with a total of nine named plaintiffs, accuses the Trump Administration of "bypass [ing] the legislative process and act [ing] unilaterally to fundamentally transform Medicaid, the cornerstone of the social safety net." Arkansas began requiring work for health care in June 2018, threatening Medicaid for thousands. The plaintiffs were represented by Legal Aid of Arkansas, the Southern Poverty Law Center, and the National Health Law Program.

In March of this year, the plaintiffs succeeded; a federal judge struck down the requirement and it was immediately halted. That means the work requirement is gone, at least for now. But during the nine months that it was policy, more than 18,000 low-income people lost their health insurance. Most have not gotten it back.

Many of these individuals are entitled to reinstatement, but don't know how to make this happen. Perhaps they have no idea how they lost their health coverage. Perhaps they've decided that the stress of reapplying just isn't worth it, and they'll go to the emergency room when a health problem escalates. Nonprofits that could help them have no idea who they are.

Advocates for people in need say the experience of these Arkansans should be a warning sign to other states that, with a green light from the Trump Administration, are planning to institute new work requirements for Medicaid recipients. Republicans in these states see these rules as a way to cut costs and promote "self-sufficiency." But critics see them as politically motivated efforts to milk resentment against people who receive any form of government assistance other than handouts to the rich.

President Donald Trump's Department of Health and Human...

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