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Wednesday, November 14, 2018

If only we were better at means testing

You know what might make a problem like this go away?  See if you can guess.
Legislative Auditor Daryl Purpera's office found problems with the agency's infrequent use of wage data from the state labor department to determine eligibility.

The report says since Gov. John Bel Edwards expanded the state's Medicaid program in July 2016, the department has relied on Medicaid recipients to self-report changes in their paychecks in the 12-month period between the initial application for Medicaid and coverage renewal.

Auditors suggested more frequent checks using available state wage data should be used to ensure Medicaid recipients aren't earning more than allowed to qualify. Pennsylvania, Wisconsin and other states do quarterly reviews to check eligibility against income data, the report says.

The report also found errors in the work done by health department caseworkers. In addition, auditors said the agency didn't double-check income information when federal officials determined people who applied for individual marketplace insurance coverage through the Affordable Care Act were instead deemed eligible for the Medicaid expansion program. Those federal officials don't have access to state wage data, the report says.

"Without a sufficient process to determine recipient eligibility, LDH cannot ensure that Medicaid dollars are spent appropriately," Purpera wrote to legislative leaders in the audit.
Imagine if we could just give people health care without a convoluted process for determining whether or not they are eligible. What if... everybody was eligible?  That's crazy talk, though, right?
Universal social programs are based on the principle, as single-payer health care advocate Dr Quentin Young would later put it, of “Everybody in, nobody out.” The goal is to establish a sense of mutual accountability and mutual benefit across society. The method is to enshrine cooperation and solidarity in the institutions by which the state distributes public resources.
Oh hey speaking of crazy talk, Senator Kennedy also has some comments.




John knows that Medicaid operates through private health providers, right? I mean, apart from the contracting and means testing role of the health department, we're very much in the "private sector" already. 

Anyway none of that is his point.  His point is, John is still seriously considering running for Governor next year. We should have his decision in a week or so.

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