Editorials of The Times

Taking Health Care From the Poor

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, New York Times
Taking Health Care From the Poor

When Ohio and Michigan expanded their Medicaid programs to broaden coverage, residents who became eligible found it easier to look for work, according to studies by the Ohio Department of Medicaid and the University of Michigan. That’s because having Medicaid gave them access to primary care doctors and prescription medicine that helped them live normal lives and get jobs.

That’s how you help people in the real world. The Trump administration said Thursday that it would get poor people to work by letting state governments deny them Medicaid if they don’t have a job.

The Centers for Medicare and Medicaid Services argues that this draconian step will encourage more Medicaid beneficiaries to get a job and thus “promote better mental, physical and emotional health.” There’s no evidence that this is true, and the data from Michigan and Ohio shows that it contradicts the truth. There is good reason to worry that fewer people will have a job in states that adopt this cruel policy.

Arkansas, Indiana, Kentucky and seven other states are seeking waivers from federal law to initiate the policy, and the agency says it is ready to grant them the waivers in the coming days if the states meet certain minimal conditions, like exempting people who are pregnant, disabled or caring for family members.

The new policy would be attempting to solve a problem that doesn’t exist. About two-thirds of Medicaid beneficiaries are seniors, disabled people or children. Of the remaining one-third, nearly 80 percent are in families with at least one working person and 60 percent have full- or part-time jobs, according to the Kaiser Family Foundation. This policy change is merely a bureaucratic obstacle to keep poor people from obtaining Medicaid. Eligibility for the program varies from state to state, but the national median income limit for a single person to qualify for Medicaid is $16,642 a year.

Republican lawmakers who have demonized the program as welfare for “able-bodied adults” have long sought to require Medicaid beneficiaries to work. Those lawmakers have been particularly angry about the expansion of Medicaid under the Affordable Care Act, which they have been trying to repeal since it was passed in 2010.

Taking Medicaid away from people who are out of work would damage some of the most vulnerable people in the country. Among them are residents of rural areas who are struggling with opioid addictions and, as a result, cannot hold down permanent jobs. It will also hurt people who, through no fault of their own, lose their jobs and are not able to quickly find another one because they live in a depressed area or because economic changes have made their skills less valuable. Then there are people with chronic conditions like diabetes who do not qualify for disability but are often unable to work.

“Even though sometimes I can get a job, you’ve got to understand — sometimes I can’t even walk,” Jimmy Brunson, a diabetic in Arkansas, told The Times last year.

It is not clear that the Trump administration can legally allow states to impose a work requirement. Experts say federal law allows the government to grant waivers only if they help to advance the aims of Medicaid, which is to provide medical care to low-income people. It strains credulity for the administration to argue that denying health insurance to people on the basis of their employment status meets that test. Public interest groups acting on behalf of Medicaid recipients are likely to challenge such waivers in court.

Maybe Americans shouldn’t be surprised that this administration wants to take health care away from the poor, given that it has spent so much time trying to wreck the ACA. But they should be angry.

Albany, Pass the Child Victims Act

If the #MeToo movement of the last few months has taught us anything, it’s that it is extremely painful and risky for victims of sexual harassment or assault — even those with power, money and connections — to speak out against their abusers. Now consider how much harder it must be for a child.

It should surprise no one that a vast majority of people who were sexually abused as children never report it. For those who do, it takes years, and often decades, to recognize what happened to them, realize it wasn’t their fault and tell someone. The trauma leads to higher rates of alcoholism and drug abuse, depression, suicide and other physical and psychological problems that cost millions or billions to treat — money that should be paid not by taxpayers, but by the offenders and the institutions that cover for them.

For these reasons, many states — including eight last year alone — have done the right thing and extended or eliminated statutes of limitations for the reporting of child sexual abuse. This has encouraged more victims to come forward and seek justice for abuse that was never properly addressed, if it was addressed at all.

New York, which has had no shortage of child sex-abuse scandals, should be on that list. In fact, it should be leading the nation on this issue. Instead it, along with Mississippi, Georgia, Alabama and Michigan, is one of the states with the least victim-friendly reporting laws in the country. New York requires most child sex-abuse victims to sue by the age of 23, 19 years before the average age at which such victims report their abuse.

Lawmakers have had the solution in their hands for more than a decade. The Child Victims Act would extend the statute of limitations to age 50 in civil cases, and to age 28 in criminal cases. It would also establish a one-year window in which anyone would be permitted to bring a lawsuit, even if the statute of limitations had already expired.

The bill enjoys widespread and bipartisan support in Albany — it passed the state Assembly once again in 2017, by a vote of 139-7 — and from Gov. Andrew Cuomo. And yet it keeps failing to become law.

Why? The Senate majority leader, John Flanagan, a Republican, has refused to let the bill come to the floor for a vote. The bill’s opponents, which include the Catholic Church, Orthodox Jewish groups and the Boy Scouts of America, are concerned primarily with the one-year window, which they believe would cause a wave of claims that could drive churches, schools and hospitals into bankruptcy. That hasn’t happened in other states, even those that opened the window for longer. In Minnesota, which created a three-year window for a population a little more than a quarter of New York’s, just under 1,000 civil claims have been filed.

But even if it did, we should be less concerned with protecting the bank accounts of institutions that might harbor sexual predators, and more concerned with bringing justice to the victims — whether their abusers are clergy members, teachers or, as in a majority of cases, a family member.

The Child Victims Act should have passed on its merits long ago. Since it hasn’t, Cuomo needs to step up and demonstrate the leadership he has shown on many other divisive issues in recent years, like same-sex marriage. If Cuomo includes the bill’s provisions in the 2018-19 state budget, which he is scheduled to present on Tuesday, he will make it extremely tough for Flanagan and other Republican leaders to say no to protecting New York’s most vulnerable victims.

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