Saturday, January 13, 2018

Kentucky's Medicaid Cuts

Kentucky became the first U.S. state to impose restrictions on Medicaid recipients that require them to be in work or doing jobs training.  Able-bodied adult recipients are to participate in at least 80 hours a month of “employment activities,” including jobs training, education and community service.

The Kentucky program also imposes a premium on most Medicaid recipients based on income. Some who miss a payment or fail to re-enroll will be locked out for six months.

The rules apply to those between 19 and 64 years old. Certain groups are exempt, including former foster-care youth, pregnant women, primary caregivers of a dependent, full-time students, the disabled and the medically frail. The Trump administration also said states would have to make “reasonable modifications” for those battling opioid addiction and other substance-use disorders.

Health advocacy groups blasted the new regulations, saying it would make it tougher for the most vulnerable Americans to have access to healthcare. Among adult Medicaid recipients aged 18 to 64, 60 percent already have jobs, according to the Kaiser Family Foundation health policy research group. Most adult Medicaid recipients who do not work reported major impediments as the reason, according to Kaiser.

At least nine additional states, mostly Republican-led, have proposed similar changes to Medicaid: Arizona, Arkansas, Indiana, Kansas, Maine, New Hampshire, North Carolina, Utah and Wisconsin.

Kentucky citizens need to be reminded of the out-of-state corporate plutocrats and their homegrown enablers make Kentucky one of the most unequal as well as most unhealthy states. Independent studies of economic and physical well-being consistently rank Kentucky as one of the poorest and unhealthiest states. Kentuckians are literally dying of inequality. Kentucky is among the top three states in industrial air pollution; one in 10 here suffer from asthma, and “we’re No. 1” in lung cancer and death from lower respiratory diseases. The state makes the top 10 in breast, colorectal and cervical cancers, diseases driven by smoking, obesity and lack of screening. Deaths from drug abuse in West Virginia and Kentucky routinely make the top two; and more prescriptions are written for opioids than there are residents. 
Inequality, high poverty and ill health are closely connected. In 2016 Kentucky’s 18.5 percent poverty rate was one of the highest in the nation. Almost a third (30.8 percent) of African-Americans and just over one in four children living in poverty. Kentucky ranks second in the rate of abused children, double the national average. Kentucky has the highest rate of homeless students, from families broken by deaths, divorce, prison, and in 2012-13 the highest percentage of children with incarcerated parents.
Inequality breeds decline and physical and mental sickness in people and groups. It also breeds a politics of rage and despair.

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