Un­safe pes­ti­cides

En­dan­gered species at risk

The Maui News - - FRONT PAGE - By ADAM BEAM

FRANKFORT, Ky. — Ken­tucky has be­come the first state to re­quire many of its Med­i­caid re­cip­i­ents to work to re­ceive cov­er­age, part of an un­prece­dented change to the na­tion’s largest health in­sur­ance pro­gram un­der the Trump ad­min­is­tra­tion.

The Cen­ters for Medi­care and Med­i­caid Ser­vices an­nounced the ap­proval on Fri­day. The change will re­quire adults be­tween the ages of 19 and 64 to com­plete 80 hours per month of “com­mu­nity en­gage­ment” to keep their cov­er­age. That in­cludes get­ting a job, go­ing to school, tak­ing a job train­ing course or com­mu­nity ser­vice.

It’s a big change for Ken­tucky, a state that just four years ago em­braced for­mer Pres­i­dent Barack Obama’s health care law un­der a pre­vi­ous Demo­cratic gov­er­nor who won praise for post­ing some of the largest in­sur­ance cov­er­age gains in the coun­try.

But Repub­li­can Gov. Matt Bevin said while more Ken­tuck­ians have in­sur­ance, it is not mak­ing them health­ier.

Ken­tucky, along with the rest of Ap­palachia, still falls be­hind the rest of the coun­try in 33 out of 41 pop­u­la­tion health indi­ca­tors, ac­cord­ing to a re­cent study. Bevin said he be­lieves his pro­gram, with its em­pha­sis on work and com­mu­nity ser­vice, will en­cour­age peo­ple to be health­ier.

“There is dig­nity as­so­ci­ated with earn­ing the value of some­thing that you re­ceive,” Bevin said. “The vast ma­jor­ity of men and women, able-bod­ied men and women . . . they want the dig­nity as­so­ci­ated with be­ing able to earn and have en­gage­ment.”

In its ap­pli­ca­tion to Wash­ing­ton, Bevin’s of­fice said it ex­pected the changes to save tax­pay­ers more than $300 mil­lion over the next five years. They said the new rules will ap­ply to about 350,000 Ken­tuck­ians, about half of whom al­ready have jobs. They es­ti­mated as many as 95,000 peo­ple could lose their Med­i­caid ben­e­fits, ei­ther be­cause they did not com­ply with the new rules or they lose their el­i­gi­bil­ity when they get jobs that pay too much money.

Demo­cratic U.S. Rep. John Yar­muth, who rep­re­sents Louisville, called the plan “dan­ger­ous and ir­re­spon­si­ble.”

“Thou­sands of Ken­tucky fam­i­lies will face fi­nan­cial ruin,” he said.

But there are many ex­emp­tions for the work re­quire­ments. The work re­quire­ments will not ap­ply to preg­nant women, full-time stu­dents, for­mer foster care youth, pri­mary care­givers of chil­dren and the el­derly and full-time stu­dents.

The work re­quire­ments — which start in July and will last five years — also do not ap­ply to any­one des­ig­nated “med­i­cally frail,” a broad term that in­cludes peo­ple suf­fer­ing from al­co­hol or drug ad­dic­tion in a state that has been among the hard­est hit by the opi­oid cri­sis.

“Why should an able-bod­ied work­ing-age man or woman with no de­pen­dents not be ex­pected to do some­thing in ex­change for that which they are be­ing pro­vided?” Bevin said. “I’m not wor­ried about it at all.”

Bree Pearsall is wor­ried. She and her hus­band, Ben Abell, are full-time farm­ers of about 200 acres just south of Louisville. Pearsall said they de­pend on Med­i­caid to cover their fam­ily, which in­cludes a 2-year-old and a new baby ex­pected next month.

Un­der the new pro­gram, Pearsall and her hus­band would have to let state of­fi­cials know each time their wages change. If they don’t, they could lose their in­sur­ance for up to six months as a penalty. Since the cou­ple is self-em­ployed, they don’t have a reg­u­lar pay­check, and their in­come changes dra­mat­i­cally through­out the year.

“I see those be­ing very big ob­sta­cles to main­tain­ing con­sis­tent cov­er­age,” she said. “I’m def­i­nitely anx­ious about it.”

The changes also re­quire peo­ple to pay up to $15 a month for their in­sur­ance. Ba­sic den­tal and vi­sion cov­er­age is elim­i­nated, but peo­ple can earn those ben­e­fits back through a re­wards pro­gram. That in­cludes do­ing things like get­ting an an­nual phys­i­cal, com­plet­ing a di­a­betes or weight management course or par­tic­i­pat­ing in an anti-smok­ing pro­gram.

Ad­vo­cates for the poor have said work re­quire­ments will be­come one more hoop for low-in­come peo­ple to jump through, and many could be de­nied needed cov­er­age be­cause of tech­ni­cal­i­ties and chal­leng­ing new pa­per­work. Law­suits are ex­pected as in­di­vid­ual states roll out work re­quire­ments.

Call­ing the Trump ad­min­is­tra­tion’s waivers “un­prece­dented,” two se­nior con­gres­sional Democrats who work on Med­i­caid is­sues asked the non­par­ti­san Gov­ern­ment Ac­count­abil­ity Of­fice to re­view the gov­ern­ment’s de­ci­sion-mak­ing process.

“It is crit­i­cal that key de­ci­sions re­gard­ing el­i­gi­bil­ity, cov­er­age, ben­e­fits, de­liv­ery sys­tem re­forms, fed­eral Med­i­caid spend­ing, and other im­por­tant as­pects of these demon­stra­tions are trans­par­ent, ac­count­able, and in line with con­gres­sional in­tent,” wrote Rep. Frank Pal­lone of New Jer­sey and Sen. Ron Wy­den of Ore­gon.

Se­nate Ma­jor­ity Leader Mitch McCon­nell praised the changes, call­ing it “com­mon­sense steps to en­gage pa­tients, im­prove health, and re­duce the bur­den on Ken­tucky tax­pay­ers.”

AP photo

The Na­tional Ma­rine Fish­eries Ser­vice is­sued its new bi­o­log­i­cal opin­ion on three organophos­phate pes­ti­cides — chlor­pyri­fos, di­azi­non and malathion — af­ter a years-long court fight by en­vi­ron­men­tal groups. EPA Ad­min­is­tra­tor Scott Pruitt re­versed an Oba­maera ef­fort in March, to bar the use of chlor­pyri­fos on fruits and veg­eta­bles af­ter peer-re­viewed aca­demic stud­ies found that even tiny lev­els of ex­po­sure could hin­der the de­vel­op­ment of chil­dren’s brains.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.