The Big Beautiful Bill
Yesterday’s headline read “Dr. Oz says people will receive Medicaid if they ‘can prove that they matter.’”
I read the article. The doctor’s quote was taken a bit out of context. He was referring to the new Medicaid work requirement in Trump’s “big, beautiful bill.” In other words, if you work, you’ve proven you matter.
I guess if you don’t work, you don’t matter?
Porno
Work can be a little like pornography. It is hard to define, but you know it when you experience it. Even better if you get paid for it.
Work vs. Employment
Almost all human beings work every day.
Even a newborn baby works. Just think how hard it was to figure out what everyone was saying to you when language was still totally new. I could never even distinguish the syllables when I was still in the womb, so I never got a head start. What about you?
You don’t remember any of that, do you.
For the first year and a half of our lives, we are struggling to capture meaning from sounds and conduct at the same time we are advancing from rolling over, to crawling on four limbs, to walking on two legs. I don’t remember doing it, but I am pretty sure it was a lot of work.
But Dr. Oz wasn’t talking about work when he said work. He was talking about employment.
To matter in the world of Oz and Trump, you must be employed. That is, you must (1) have a boss who tells you what to do and (2) perform a service that renders a profit to your boss. Any other activity that requires effort, coordination, and skill is merely recreational.
None of that will keep you on Medicaid no matter how poor you may be.
That is if Congress passes Trump’s big, beautiful bill.
Thirty-Seven Percent
The headline got me thinking. What percentage of the people currently on Medicaid are children?
The number is 37 out of 100.
What percentage of Medicaid recipients are seniors (over 65)?
The number is 23 out of 100.
[Full disclosure: I am a senior but not on Medicaid. I qualify for Medicare but do not use it as I live in another country.]
Perhaps there is a clause in the big, beautiful bill that exempts children and seniors from the employment requirement?
I hope so.
Are Thirty-Six Percent Able-Bodied Adults?
According to the Foundation for Government Accountability (FGA), the percentage of able-bodied adults who are not seniors and who receive Medicaid is 35.9.
But first a note about the FGA. It is a conservative think tank. Among one of its priorities is promoting legislation to repeal child labor laws. I thought you might like to know about that about the FGA.
Given the source, I was skeptical about the FGA’s figure of thirty-six percent. So, I asked Google a different question and got another source, the Milbank Memorial Fund (MMF).
The MMF is a healthcare journal established in 1923.
The MMF says that only 15.8% of Medicaid recipients are able-bodied persons between the ages of 18 and 64. In other words, fewer than half the number offered by the FGA.
Here’s a link to the MMF article: Who’s Affected by Medicaid Work Requirements? It’s Not Who You Think | Milbank Memorial Fund
In addition, of the 15.8%, four out of five are women. Their median income is zero. Yup. ZERO.
The majority of these women were recently in the American workforce but left it to take care of their families.
I don’t know about you, but I am inclined to give all of these women a break. I am pretty sure they have enough to worry about without having to fill out more government forms to prove they are poor and needed at home.
So, if the MMF has got this right (based on data from the US Census Bureau), 3% of Medicaid recipients are able-bodied males between the ages of 18 and 64. As roughly seventy-two million people currently receive Medicaid, that works out to roughly two million able-bodied men aged 18 to 64.
I couldn’t find a figure for the average income of this group. But under current law, no able-bodied individual may receive Medicaid if his or her income is above $15,650. So, the average income of able-bodied men on Medicaid is going to be less than that, but maybe more than zero.
Three Percent
Two million able-bodied American men are on Medicaid.
In the mind of Dr. Oz, they don’t matter unless, of course, they are employed. All of the Republicans in the House of Representatives think the same thing.
Now it seems likely that some of the able-bodied men currently getting Medicaid are employed. I haven’t found any reliable numbers on that question. But even if they are employed, they aren’t killing it, are they? They’re scraping by on something less than $1,300/month.
Once upon a time, that would have been plenty (my dad retired in 1979 with a salary of $700/month). But it is not enough today. Not in America.
Do we wish to define any of these American men as human beings who do not matter because they are unemployed? If their number is only one million? Will that be okay? If their number is one hundred thousand? One hundred? Ten? One?
Well, at least they are still human beings, right? Not “thugs, criminals, scumbags, and degenerates.”
Unless they are immigrants or perhaps Democrats.
President Lincoln
A portrait of President Lincoln hangs in my office. It was first purchased in Sacramento, California in 1872. For many years, it hung in a schoolroom in my hometown. My oldest brother’s first-grade teacher gave it to my mother shortly after I was born. My mother gave it to me when I graduated from law school.
I cherish it. It reminds me that America once had a president who appealed to the better angels of our nature. A Republican president.
President Lincoln pleaded with a divided nation not to become enemies. Whatever his faults, he guided the nation toward freedom.
Admittedly, the reconciliation has been fraught with trials and tribulations—our post-Civil War relationships reconstructed in fits and stops. It has been a lot of work, and the job is far from done.
We’re not making progress in our work when we deny the value of two million impoverished American men. We are lost. When we deny the value of ten million American women because they have zero income and left employment to provide care for their families, we have imprisoned ourselves in darkness.
There but for fortune…
Portrait of an American President