No. of Recommendations: 22
The "millions thrown off of healthcare" will be people who can work but choose not to.
That's certainly wrong. And possibly very wrong.
There are a lot of people who benefit from Medicaid who are not physically disabled, but lack the ability to regularly work. For example, if you head down to your local homeless shelter, you will find a non-trivial number of people who could not go out and get employed even if they wanted to. They lack suitable clothing, they lack suitable hygiene, they lack transportation, they lack a home address for paperwork, they lack any kind of job history. They may be presently addicted to substances that make them utterly unsuitable for work. They may have physical or mental issues that do not rise to the level of disability (or which they can't afford to have diagnosed by a medical professional as constituting a disability), but which make them unsuitable for work. Etc. Plenty of other people who suffer from the same lack of social or physical capital (especially in rural areas) who are simply not capable of getting to a job and performing it regularly.
There are also a lot of people that have familial situations that make them unable to go to work - they are caregivers for the elderly, other disabled household members, or for children that are not legally their dependents. The <65-year-old grandmother who is watching her daughter's children every day so the daughter can go to work (but can't afford child care) is not a "can work but choose not to" person, but they'll get booted off Medicaid just the same. And of course there are the many, many people who end up getting thrown off healthcare because they fail to properly navigate the bureaucratic labyrinth necessary to document all of this, especially those who have to string together odd jobs or self-employment.
There's no way that many of these people can start working. They would require a massive influx of resources to get them in a position where they could do that.
The reason that some rural GOP members are upset at the proposal is that they know a non-trivial number of their constituents fall into these categories - they're currently on Medicaid but aren't going to be able to meet the requirements. Which means that the rural hospitals and medical community that currently treat these folks are going to end up their finances blown to shreds when they get thrown off the program - not only do they lose the revenue, but many of these folks will still need to be treated anyway. And because so many of these people can't work - not choose not to but can't - there's nothing that the state can do to get them working.
