Governor Tom Corbett’s past due Medicaid expansion proposal, “Healthy Pennsylvania” demonstrates why the Pennsylvania Governor is considered one of the least popular governors in US history, even as he decides to run for reelection. It also demonstrates some of the most fundamental faults in the GOP’s current philosophy. What the Corbett’s proposal does is solidify a thorough lack of comprehension when it comes to economic and behavioral incentives while it reinforces the perception that Republicans do not care about or understand the poor.
Taking a close look at Corbett’s proposal, Medicaid recipients making as little as 479 dollars a month would have to pay a premium of thirteen dollars a month. The intent is to make people recognize the services they utilize come at a cost, thus the premium is supposed to be a way of training the poor to more actively seek ways of paying for their expenses. Although thirteen dollars a month, or two percent of an individual’s incomes, sounds more than generous, it is important to realize at this income level, or even at several times this income level, people are existing in a state of financial distress where they must forgo basic needs in order to survive.
Just as most drowning victims are not focused on their retirement, the impoverished struggling to meet even their most basic needs of the day are not focused on long-term and intermittent potential costs like those from health issues. Certainly, people should be focused on their health, but an inability to utility healthcare makes the effort largely pointless, even disparaging. Someone making 479 dollars a month, unless he is in school and borrowing to cover expenses, probably cannot afford the gas to go to the doctors, let alone the cost of a premium. Consequently, any intended financial incentives serves solely as punitive measures.
Corbett and other Republicans leaders supposedly rejected Medicaid expansion, because they regard the program as unsustainable. Given the small price tag of the premiums, charging individuals a premium and denying the health insurance when they inevitably miss a payment does nothing except make Medicaid ineffective. In reality, the constant cancellation and reinstatement of policies will probably make the program harder to manage. More importantly, Medicaid is not supposed to be a low cost public option as it is a healthcare program for the impoverished, thus it is not supposed to bring in revenue nor is it supposed to be a self-sustaining program.
That said, the reason the Affordable Care Act funds the expansion of Medicaid is to address the broader costs of individuals who are forced to neglect their healthcare needs, because their employers do not provide benefits or their employers do not pay them enough so they can purchase private health insurance. The Federal government is essentially giving Pennsylvania money to spend on preventive care in order to save money on emergency care and preventative diseases. Certainly, the Obama Administration should be open to novel ways of more efficiently using tax payer dollars, if doing so does not undermine healthcare, but it must reject any provisions that undermine the coverage afforded to Medicaid recipients.
Furthermore, Republicans love the idea of a “usage fees,” yet our economic future is built on our ability to save, invest, and spend on savings in future, e.g. vacations, emergency situation, retirement etc. As such, people must be able to displace their costs if they cannot afford the burden of those expenses and their efforts to solidify their socioeconomic standing at the same time. When it comes to buying a house, people more often than not get loans. If they cannot, they cannot enjoy the benefits and savings associated with owning a house while society will never enjoy the future purchasing and investment power these individuals would have built up.
That said, it is also important to remember few people can afford to build the roads and bridges they use every day; therefore, all taxpayers fund infrastructure that they may never use. Displacing costs onto to society gives the economically weak room to grow. The lesson here is that overburdening the poor will prevent them from ever stabilizing and advancing their finances to a point they can eliminate wasteful expenses and climb the socioeconomic ladder. Any lessons the poor may learn from paying “their share” will be learned if they ever have a chance to earn enough to pay their fair share. Henceforth, political leaders should focus on economic development, so people have a chance to improve their financial situations.
In the spirit of advancement, Corbett does, however, want anyone working under 20 hours a week to engage in twelve employment search activities a month or lose their coverage. In reality, this provision would probably affect a minimal number of individuals. If there is an effect, more people looking for work will translate into greater competition, especially for those at the minimum wage level in need of multiple incomes, thereby, undermining the leverage of workers in terms of starting wages and wage increases. For the poor, this will likely do nothing for those looking to earn more by switching jobs while those out of work for too long will still be just as unlikely to be hired.
Meanwhile, it is important to remember job seekers are not job creators. Obviously, employees do not decide how many hours their employer(s) will allow them to work, how much pay they will earn, unless they have leverage to charge more for their labor as someone like Corbett does, and if they receive healthcare benefits. In fact, jobs only exist when there is demand for labor, i.e. businesses have customers. Consequently, this Republican view that you can incentivize workers to “find work” is only valid if there is work to be found, though who gets that work is more dependent upon employers and consumers. As such, Corbett and other GOP leaders should focus their efforts on economic development and solving the long-term economic issues of our States and Country.
Moreover, instead of burdening the Medicaid system with verification tasks, Corbett should focus on improving Pennsylvania’s economy and its job search program PA Career Links, so the people can find a living wage job instead of a chance at a handful of minimum wage jobs. On the flip side, Medicaid should be focused on connecting recipients with doctors and efficiency. Republicans like Corbett are so bent on punishing people for being poor and proving the solution to poverty is for the poor to stop being lazy that they would rather overcomplicate a government program by creating costs and hurdles with no real gains to show for it than end the need for Medicaid by helping create living wage jobs.