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Medicaid is a state program providing some low-income American citizens with low-cost or even free health coverage. The categories of the population usually eligible for Medicaid include the elderly, people with disabilities, some families and children, and pregnant women. Although the coverage differs from state to state, it allows the people below a certain income level to feel secure and receive care in case of necessity. However, a new initiative of Trump’s administration introduces Medicaid work requirements which are already supported in 10 states throughout the country (Goldstein, 2018). Although they are positioned as a positive change, many vulnerable population categories are under the risk of staying unprotected.
The fact that work requirements are to be imposed to be eligible for Medicaid is disturbing a great part of the American population. Some people refused to believe it was true, but the letter prepared by Medicaid directors left no doubt that changes are real. The letter provides states with an opportunity to reduce Medicaid benefits to some citizens who were previously eligible for this state program. Medicaid coverage is expected to be available for those people who “have a job, are in school, are a caregiver or volunteer, or participate in other approved forms of “community engagement” (Goldstein, 2018, para. 2). At present, ten states are ready to implement the innovation immediately after federal permission.
The suggested change in Medicaid coverage eligibility requirements means the following. States will have to restructure their Medicaid programs “to force individuals who would otherwise be eligible for Medicaid to work” (Chen, 2018, para. 2). A person is expected to work for about 20 hours a week to stay eligible for coverage and have a guarantee of medical care in case of necessity. Another disturbing issue is that the federal Centers for Medicare and Medicaid Services (CMS) provides states with significant flexibility in the ways and conditions of the implementation of the new requirements (Gleckman, 2018). It means that people cannot be sure if they are eligible for Medicaid until all conditions are settled and announced officially.
Value of Change
Imposing a work requirement on citizens in order to be eligible for and receive Medicaid benefits is an important issue that causes many arguments both in political and social spheres. On the one hand, it is expected to stimulate people who want to receive Medicare coverage and related benefits. On the other hand, it would leave a great part of vulnerable populations unprotected, and without the necessary access to healthcare services.
Anti-poverty and healthcare advocates claim that the planned changes are cruel and lack rationality. They support their claims with facts that at present, eligible Medicaid recipients already have a job except for people with disabilities and the elderly (Chen, 2018). The category of low-income citizens who are not employed, in most cases, cannot get work due to their poor health. Thus, the suggested change would be an endless circle for them because they are unemployed due to their illness or disability and cannot receive help since they are unemployed (Chen, 2018).
Cause and Effect
One of the reasons causing the existing problem is the desire of the government to stimulate the unemployed population to find a job. The idea is supported by the Conservatives who struggle to “shrink the welfare state” (Chen, 2018, para. 4). One of the expected changes is the reduction of enrollment to Medicaid on the national level, which is likely to save costs but would deprive impoverished people of important medical services (Chen, 2018)
However, many people acknowledge the absurd character of forcing the poor to work in order to get health care which is a granted right of every citizen. Still, the poor are not the only category of the population that can suffer from the change. Other vulnerable populations, for example, transgender individuals, frequently have problems with finding a job. Thus, the unemployment level of transgender people is three times higher than the average throughout the country (Johnson, 2018).
One of the reasons for this situation is employment discrimination. Thus, the new eligibility criteria for Medicaid would make this vulnerable population even more unprotected. On the whole, the unsure benefit of increasing the population prosperity through forcing them to work is “far more likely to dehumanize trans people and prevent Americans from accessing necessary medical care” (Johnson, 2018, para. 11). Finally, the innovations in Medicaid programs would deprive of medical care the people who are looking for a better place of employment or the disabled who still have to prove their status.
It is evident that the policy should not be widely implemented in the condition it is in now. Even taking into consideration the probable positive effects of the changes in Medicaid requirements, there was no research about the number of people who would suffer from the change. Thus, this change process should be well-prepared and have a deep theoretical ground as well as statistical analysis to support it. Also, there should be a plan of care for people who are temporarily not eligible for Medicaid to provide their right for the healthcare of necessary quality. Until possible negative consequences are not investigated, the change in Medicaid eligibility criteria should not be implemented.
After the planned changes in Medicaid requirements were announced, the mass media have presented many real-life examples of people who can become victims of this change. Thus, The New York Times outlines the cases of elderly or disabled people who are worried about the coming changes (Goodnough, 2017). For example, Christopher Caveney, aged 38, a citizen of Blytheville, lost some benefits because he was not working the necessary 20 hours a week (Goodnough, 2017).
At present, he has his Medicaid coverage but could have lost it while he was recovering from spine surgery. Now, he managed to find a part-time job as a security guard, but his income is still low. Mr. Caveney states that he believes that “most people want to work,” but he knows “a lot of people work when it’s not necessarily in their health’s best interest” (Goodnough, 2017, para. 26). This example is one of the many cases of people whose employment does not depend on their desire to find a job.
On the whole, changes in Medicare requirements are a complicated issue. They may have some hypothetical benefits, but before they are achieved, more people will suffer from the lack of health care availability. Thus, I do not support the implementation of this change because it is not beneficial for many vulnerable groups and the major purpose of Medicaid is to protect these people, providing them with the necessary care.
Chen, M. (2018). The Medicaid work requirements could make it Impossible to qualify for Medicaid in most states. The Nation. Web.
Gleckman. H. (2018). What Medicaid’s work requirement means for seniors, people with disabilities, and their caregivers. Forbes. Web.
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Goldstein, A. (2018). Trump administration opens door to states imposing Medicaid work requirements. The Washington Post. Web.
Goodnough, A. (2017). The adults a Medicaid work requirement would leave behind. The New York Times. Web.
Johnson, C.J. (2018). Medicaid work requirements are yet another burden for trans workers. The New York Times. Web.