Unable to destroy Medicaid by legislating it out of existence in Congress, the Trump administration is expected to shortly issue executive guidance designed to alter the 50-year-old program and sharply reduce the number of poor receiving benefits.
Fulfilling a longtime dream of conservatives, the revised guidelines will require Medicaid recipients to work, even though many are unable to work because they are crippled, sick, going to school fulltime or caregivers for those who are unable to take care of themselves, according to The Hill.
Charging that Trump is just trying to undermine the expansion of Medicaid under President Obama, Democrats and other advocates for the poor are preparing to file lawsuits to stop the Trump administration from making this change.
Trump is meeting with GOP leaders at Camp David *this weekend* to discuss using reconciliation for ACA repeal and Medicaid gutting, per @caitlinnowens
An action guide >> https://t.co/rswua5uvy9
— Topher Spiro (@TopherSpiro) January 5, 2018
Each state would have the option of seeking a waiver for permission to enforce the must-work rules, which the Obama administration fought for eight years.
Nine states have already applied and Kentucky is expected to be the first granted permission. In Kentucky alone, that is expected to result in about 100,000 fewer people being eligible for the medical assistance to the poor within the next five years.
There were about 9.8 million non-elderly people enrolled in Medicaid in 2016, according to the Kaiser Family Foundation, of whom 36 percent have an illness or are disabled, 30 percent are caring for a family member and 15 percent are attending a school.
Even those who want to work face obstacles to getting regular employment.
“Many Medicaid enrollees working part-time face impediments to finding full-time work,” reports Kaiser, adding that “many cite economic reasons such as an inability to find full-time work (10 percent) or slack business conditions (11 percent) as the reason they work part time versus full time.”
An analysis by the Georgetown Center for Children and Families indicates that a “significant number of people” would lose coverage simply due to red tape.
The Trump Administration, led by conservative activist Seema Verman, administrator of the Centers for Medicare and Medicaid Services (CMS), has been working on this plan for months but has been delayed, apparently, as the lawyers try to anticipate how to deal with the inevitable legal challenges.
The legal challenges are expected to argue that the work requirement is illegal under the current law and would require an act of Congress to change.
“The guidance is an attempt to put the administration’s preferred legal framing around the waiver approvals, in anticipation of likely legal challenges in the federal courts,” Eliot Fishman, a former high-level Medicaid official under President Obama told The Hill.
“Given that the legal standard is whether the waivers ‘promote the objective’s of the Medicaid program,” continues Fishman, “that the basic objective of the program to cover low-income people, and that these waivers will take coverage away from low-income people, they will have a tough legal case to make.”
If Trump is successful this will open the door to other state efforts to downgrade or cripple Medicaid. Wisconsin, for instance, wants the right to drug test all those who get benefits and drop any caught using illegal drugs.
This may also be the first stage of an all-out assault on Medicare and even Social Security as Republicans claim they need to make budget cuts in the wake of their tax legislation which funnels billions from working people and the middle class to the wealthy, increasing the national debt by over $1.5 trillion in the next few years.
During his campaign, Trump promised not to cut Medicare and Social Security but as he has shown, his past pledges are ultimately meaningless. This week, for instance, Trump’s Attorney General announced the federal government will go after medical marijuana users even though Trump had said repeatedly that would never happen.
Trump has repeatedly lied to the American people about a wide range of things so any pledge he once made to protect Social Security is clearly subject to his revision.
Trump Ensures Poor People On Medicaid Die Miserably & Broke In Disgusting Friday Move https://t.co/wG9dxV7lBu
— Bipartisan Report (@Bipartisanism) January 5, 2018
That would mean millions of elderly people and others who voted for him would be victims of his penchant to look them in the eye and lie.
While the rich are planning to buy yachts and giant corporations are handing out bonuses to employees from their tax savings, those who need help the most – the poor, elderly, disabled, students and others – are paying a heavy price for Trump making the rich richer.
Trump Administration Medicaid Administrator Seema Verma: We're rolling out work mandates to make it harder for ordinary Americans struggling to get health care. https://t.co/9tx6buKFXx
Trump Adminstration Secretary of the Treasury Steven Mnuchin and spouse: Let them eat cake. http://pic.twitter.com/ZGD19AvFre
— Adam Searing (@AdamSearing) January 5, 2018