Living Large in Carson City: The “My Yacht is Bigger than Your Tiny Boat” Edition

 Image result for medicaid cartoons

When it comes to Trump and his administration, it’s easy to overlook an important news items among the mine field of political missteps these people so deftly make. Sure, his wacky endorsements (Judge Roy Moore), outrageous pronouncements (I would love to see a shutdown) and overall obtuseness (We wish him (Rob Porter) well . . . he did a good job) are attention grabbing and incendiary, but all too predictable with what has become the Trump reality.

It’s all and elaborate smoke and mirrors game calculated to take the public’s attention off the bread and butter issues under attack by Trump and his administrators on a daily basis. Take any major topic from climate change to the environment to tax laws to deregulation of Wall Street to countless other vitally important topics to the American electorate; all are under seige. His policies are literally destroying the fabric of what really makes America great.   

Here is a case in point:

After approving Medicaid work requirements, Trump’s HHS aims for lifetime coverage limits

February 05, 2018 06:58 PM

Say what?  “Life time coverage limits” should read “lifetime coverage ‘Caps'”. Tony Pugh wrote,

After allowing states to impose work requirements for Medicaid enrollees, the Trump administration is now pondering lifetime limits on adults’ access to coverage.

Capping health care benefits — like federal welfare benefits — would be a first for Medicaid, the joint state-and-federal health plan for low-income and disabled Americans.

If approved, the dramatic policy change would recast government-subsidized health coverage as temporary assistance by placing a limit on the number of months adults  have access to Medicaid benefits. 

Granted, there can be confusion about the difference between Medicaid and Medicare. Medicare is a federal program attached to Social Security and is available to all Americans over the age of 65 and some people with disabilities There are no income restrictions attached to Medicare. It has become the go to “base” insurance asset for most elderly Americans but limited in its coverage. Generally, most seniors have to carry a supplemental insurance policy to help cover out of pocket costs, but still, it is a life saver when it comes to insurance for the vast majority of Americans over the age of 65. 

Medicaid is different. Medicaid is a state and federally run program that targets low income individuals, children and the elderly to aid in medical and long-term care expenses. The federal government pays states up to 50 percent of of the states’ Medicaid costs. The program is on a sliding scale so that wealthier states receive less federal dollars as opposed to states with fewer dollars to contribute to the fund.  Unlike Medicare which is offered to all Americans, Medicaid has strict income requirements that individuals cannot exceed. Since not all states are created equal, and given the sliding scale used by the federal government, essentially, each state has its own unique Medicaid program. Red states have their rules; blue states have theirs. 

This is where it gets tricky and where the Trump administrations sees a window of opportunity by capping benefits. 

The move would continue the Trump administration’s push to inject conservative policies into the Medicaid program through the use of federal waivers, which allow states more flexibility to create policies designed to promote personal and financial responsibility among enrollees.

However, advocates say capping Medicaid benefits would amount to a massive breach of the nation’s social safety net designed to protect children, the elderly and the impoverished.

In January, the Trump administration approved waiver requests from Kentucky and Indiana to terminate Medicaid coverage for able-bodied enrollees who do not meet new program work requirements. Ten other states have asked to do the same.

Need it be stated that the vast majority of these petitioners are deep red states who supported Trump in the 2016 election. What is disturbing is the attempt to target “able-bodied enrollees” who fall outside the new requirements with no regard to their income or ability to pay for medical care on their own. Frankly, if a person is able-bodied and fit to work, they should if circumstances allow. However, the problem is who is defining what able-bodied means. These are states like Arkansas, Utah and Kansas, notoriously tight-fisted when it comes to monetary concerns and governance.

All of this smacks of a lack of empathy. Not to single out the above three states, but more to the overall Republican quasi Tea Party mentality that comes with small government. It is understandable to strive for fiscal responsibility and elimination of waste. All Americans think these are good ideas regardless of their political affiliation. But one has to wonder at what costs? Trimming the military budget to make it more efficient or reeling in out of hand spending is one thing, but on the backs of those less fortunate seems cruel and petty. 

In the scheme of things, this is not a monumental issue that is going to excite a huge amount of concern for most Americans. It is, however, indicative of the new Republican Party that is afoot in America under Trump’s leadership. America is losing an essential sense of equality that has been the guiding principle that has made this a great country. Historically, as Americans, the rule, as JFK was so fond of saying, was, “A rising tide lifts all the boats.”

No longer it seems in Trump’s America. 

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