Caught up in the rush

Arkansas public policymakers have long been suspicious of, and stingy toward, welfare recipients.

They place their focus on a fat man submerged in a lumpy sofa eating Cheetos and watching television reruns all day while living off the dole. I speak proverbially, though conceivably literally.

These policymakers—mostly rural and conservative—want that tub of lard up off his ample behind and put to work changing tires on a big rig—or something else similarly arduous.

In Arkansas, poverty is often treated more as accusation than condition.

So, late last week, a federal official initiated a conference call with Arkansas reporters to say that the feds appreciated the Arkansas vigor in purging tens of thousands off Medicaid in two months, but to suggest that Medicaid-purging is not the Indy 500 and that Arkansas conceivably could be throwing out some babies with those giant vats of bathwater suspected of containing that Cheeto-munching couch potato.

The issue is part of the effort to re-normalize after the pandemic. During covid, federal officials expanded Medicaid eligibility and put a moratorium on purges. Now the job is to wind Medicaid back to where it was.

The wind-back process began this spring. Arkansas has thrown off more than 100,000 people in two months—nation-leading in per-capita terms. More than half of those purges have been for not returning the renewal form or failing to fill it out fully.

In some defense of the state human-services agency, we should understand that it is operating under an Arkansas-specific timetable, a typical one, outlined in legislation passed during the recent right-wing extravaganza of a legislative session. It commanded that everyone no longer due Medicaid get taken off its rolls in six months.

It’s that same old policymaker disdain for the fat guy. Take away his health insurance and do it now, the legislation is saying.

The man calling in from the federal government last week said he appreciated the special circumstance of the Arkansas legislative timetable, but that the federal government, which pays a much higher share of Medicaid than the state, was advising the process should get done in a year.

And he said a few thousand children seemed to be among the purges, and that there is such an understandable national focus on making sure kids get health care— with programs such as ARKids First in Arkansas—that time should be taken to explore recourses.

He wasn’t accusing, he emphasized. He was just saying.

I have a note from a man saying he got included in the Medicaid expansion in Arkansas during covid but now lives out of state and has received repeated calls from Arkansas officials making sure he does not intend to try to renew. So that anecdote suggests there isn’t bureaucratic heartlessness at play— that maybe there’s simply too much legislatively mandated rush that is gathering up too many purges of people who can’t be reached at the same cell number they had the last couple of years.

I find interesting the assumption of a state-government spokesman that most likely those people not responding and therefore purged know that their income levels make them ineligible for what they got in special circumstances during the pandemic.

Maybe. Or maybe an equally plausible assumption is that a lot of poor people are transient and don’t receive notices, and are not savvy on matters in the news and official government communications, and do not know they’re on Medicaid, or off, unless they wind up at the emergency room.

The problem is simply the rush, and that’s probably the fat guy’s fault.