Kentucky Spending All Its Money Making Sure Nobody Gets Something For Free
Kentucky was the first state in the country to get approval to impose work requirements on recipients of Medicaid, a terrible idea that Donald Trump and the current crop of GOP ninnyhammers think is the best idea since pee tests and private prisons. And while Kentucky's work requirements were blocked by a federal judge shortly after they were rolled out, a report by financial analyst Fitch Ratings found adding the work requirements increased the state's administrative costs by 40 percent. Golly, a result that everyone saw coming, what a huge surprise!
You see, kids, you can't have a Poors Gotta Work program without making sure the poors are actually working, not to mention tracking who's required to work and who's not, who's in a job training program, who's volunteering, who's in school, and so on. Most important, you have to determine who you can throw off healthcare for not having a computer like poor people shouldn't, and how to get away with it, heh-heh-heh.
Lead researcher Eric Kim explained that getting a whole new poor-thumpin' bureaucracy off the ground actually costs something, you see:
In its biennial budget, Kentucky's Medicaid administration costs increased more than 40%, or $35 million, from the prior biennium to $116 million, which Fitch partially attributes to implementing Medicaid work requirements.
This may come as a surprise to those who assumed work requirements might just cut down on the number of unworthy poors through the magic of yelling "Get a job!" while stroking the embossed cover of your personal copy of Atlas Shrugged. Instead, you have to do computers and staff and number-crunchers, all of which make limited government bigger somehow. And yes, that's even if Kentucky somehow achieves its dream of scaring away or shunting off 95,000 enrollees over five years.
Direct costs for Medicaid work requirements could limit savings from enrollment declines. Work requirements require tracking systems that few, if any, states have. States developed systems in the 1990s to implement work requirements for welfare called the Temporary Assistance to Needy Families (TANF) but the scale of Medicaid is significantly larger now. TANF enrolled 2.4 million monthly during 2017. Medicaid enrolled 67.3 million in April 2018 alone.
And oopsies, even if work requirements force even more people off benefits, the savings from making them sicker won't make the costs of developing and operating those systems vanish. You can't police the poors without having systems and people in place to make sure you're only fucking them over in the government-approved ways. But it's a great way to allocate tax money on things other than providing healthcare, so it's popular.
It's not as if any of this can be much of a surprise to the people who've been pushing work requirements, the Get Tough On Poor People flavor of the moment. Most people getting Medicaid already work (or are children, or retired, or on disability), and nearly 80 percent are in a family where at least one person is working. Work requirements, like so many great ideas from small government conservatives who hate social engineering, are mostly a solution in need of a problem. Have to wonder if data systems manufacturers have been pushing for them.
It's almost as if these fuckers have learned nothing from the experiments with pee-testing welfare applicants, which mostly determined that testing labs made assloads of money while the testing programs found only a handful of bad evil drug abusers to throw off welfare.
Still, the dream of eliminating poverty by making life even harder for poor people is an attractive one, so we can hardly guess what scheme Rs will impose next. Maybe mandatory DNA testing of poors to make sure they aren't welfare lizard people come to steal our young for their reptilian overlords.
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Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.