Slow down, feds tell the mad Medicaid purgers

The federal Centers for Medicare and Medicaid Services told the state last Friday – a week ago today — that it had to stop terminating Medicaid recipients after giving them only 10 days’ notice to object to the state’s admittedly malfunctioning income verification system.

The Hutchinson administration, always keenly interested in the political appearance, insisted on formal written notification – something it could show right-wing legislators to demonstrate that the big bad Obama government was making the state extend this heinous due process to poor people.

Wheels moved slowly, as federal bureaucratic wheels are wont.

CMS apparently wanted to frame a nice-sounding rather than scolding letter because it appreciates that Gov. Asa Hutchinson, rare among Republican governors, intends to try to salvage the private option form of Medicaid expansion.

The final email notification came at the end of the week, and the Hutchinson administration put out a news release this morning saying that, golly, gee whiz, the state has decided to start giving 30 days after new “guidance” from the feds.

That’s euphemistic political speech for: The federal government has told Arkansas to stop being in such an all-fired hurry to achieve its apparent adrenaline rush from taking health insurance from poor people.

There are four persisting issues:

One – The feds apparently are not going to enforce this 30-day policy retroactively and the state has no intention on its own to do that. So the 58,000 or so already thrown off, many no doubt incorrectly, are still out of luck.

Two – Lawsuits are being prepared arguing that the income verification process was unfair and that the notice system was unfair. One will seek class-action status. An argument that due process of law was not followed would seem by my unlicensed legal eye to be made stronger by the disparate treatment given the first batch of notices as compared to the second batch after the federal government said essentially that the first batch was done improperly.

Three – None of this will matter much in the end, some administration officials think, because – 10 days or 30 – a ton of these people are over the income level and will be struck. If so, so be it.

Four – The potential political complication is that Hutchinson is now on record wanting to save the private option but only with  “flexibility” for the state granted by a federal waiver, and now CMS has given the state a little dose of inflexibility.

But it’s two different things – an arbitrary state initiative that is a catastrophe and gets called out by the feds, and a waiver, meaning a written contract, by which the federal government would formally agree in advance to conservatizing principles the state would apply to its private option.

You know, at some point you have to quit coddling the extreme right. You have to take the pacifiers out of the mouths of the troglodytes. You have to take your chances with the smart and correct policy.

Note: I’ll flesh this out and perhaps get really worked for a column Tuesday. Sunday’s is on the right wing’s obsession with Hillary Clinton.




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