Brownback to poor: "if you get sick, quit your job"
Brownback to Poor: “if you get sick, quit your job”
For the working poor, Governor Brownback’s decision to not expand Medicaid sends them a real clear message, “if you get sick, quit your job.” That’s the only way to qualify for health care coverage under KanCare, our version of Medicaid. Most Kansans agree that work is necessary for someone to make the most of their lives. Gov. Brownback has actually removed the incentives that would encourage Medicaid recipients to work. It’s stunningly poor policy-making.
With renewed calls for Congressman Paul Ryan to be named Speaker of the United States House of Representatives I found myself remembering some things he said about his vision for the way America structures her incentives. As the Republican Vice Presidential candidate Paul Ryan said “we don't want to turn the safety net into a hammock that lulls able-bodied people to lives of dependency and complacency, that drains them of their will and their incentive to make the most of their lives," and just this past July at the Aspen Ideas Festival he elaborated by saying “The highest marginal tax rate is a single mom making $25,000 a year, who is losing $0.80 to $0.90 on the dollar when she tries to take a leap of faith and go work.”.
What Representative Ryan was implicitly acknowledging is that sometimes, in our rush to accountability, we create perverse incentives for people. This resonates with me. Tending to our livestock in the fields behind our home near Dodge City, I learned from my father what many southwest Kansans tell their sons, “haste makes waste”. Sitting in guard towers along the front lines of the war on terror as a young man I feared what complacency could do to a tired soldier, and worse, what it could do to those who depended on him. Serving on my local Board of Education I have witnessed what local government can do when thoughtful incentives are implemented and what state government can do when the opposite occurs. Government has a mixed track record when it intervenes in people’s lives, but one thing we know for sure, the way it structures incentives matters.
Remarkably, Kansas Governor Sam Brownback seems to have forgotten this lesson when it comes to Medicaid Expansion. For all the bad parts of the Affordable Care Act – and there are plenty of them – there are a few good ones. And Medicaid Expansion is actually one of the good parts – or at least it should be for Kansans. It allows states to expand access to Medicaid to fill gaps in coverage, covers 100% of costs of expanding coverage, and will cover 90% for the foreseeable future. But instead of taking that opportunity, Governor Brownback wants us to believe that expanding Medicaid will create a new class of dependent Kansans and calls it “morally reprehensible”. The reality is that not expanding Medicaid will also likely have that effect.
Other than Medicare for seniors, there are now two ways that the government helps Americans afford increasingly unaffordable healthcare coverage: Medicaid and the Affordable Care Act. Receiving Medicaid today is very difficult in Kansas, because our state has one of the lowest thresholds for Medicaid eligibility in America. For a family of three to qualify in 2014, total household income needed to be less than $618 per month. Adults without dependent children don’t qualify at all, regardless of their income level.
To receive Premium Assistance Credits through the Affordable Care Act, an individual or family must have a minimum income of at least 138% of the poverty level. That translates into just over $2,200 per month in household income. That leaves a significant coverage gap for the working poor – a mother, for instance, who is trying to go back to school to better her family’s life, while working a minimum wage job.
The question here is pretty simple: Do we encourage people to keep their job if they get sick, or do we maintain a system of perverse incentives that forces workers to quit their jobs to get health insurance, and potentially drags them into a life of dependency and complacency? We all know the answer to this, but does Governor Brownback?
Aaron Estabrook is a Post 9/11 Combat Veteran and Vice President of the Manhattan-Ogden Board of Education and Founder of the Moderate Party of Kansas Movement