Following the lead of the Trump administration’s efforts to cut Medicaid and strip millions of Americans of their health coverage, lawmakers in Harrisburg are trying to rush through new work requirements for people who use Medicaid in an effort to make it harder for people to get and stay covered.
These requirements, which would force people to repeatedly prove either that they work more than 20 hours per week or that they suffer from a serious illness or a disability, or fall under other exempt categories, would cost taxpayers $3.4 billion over the next six years by creating new red tape. An estimated 85,000 would be stripped of their health coverage.
This is in the midst of the opioid epidemic ravaging Pennsylvania. In December, an analysis by the Centers for Disease Control and Prevention showed Pennsylvania to be the fourth hardest-hit state in the country.
In the year ending in September 2017, the number of drug overdose deaths in Pennsylvania was 5,443, an increase of 43.4 percent over the previous 12 months. In Philadelphia alone, about 1,200 people died of drug overdoses last year, up 34 percent from the previous year. Taking away people’s Medicaid coverage will make this problem worse; nationally, four in 10 non-elderly adults with an opioid addiction rely on Medicaid to get treatment .
I’m not just concerned about these new requirements because they’re bad policy. I’m worried for a very personal reason.
My son suffers from bipolar disease. It is debilitating, causing him extreme anxiety, fluctuating mood swings, and bouts of deep depression. Before Medicaid expansion, he was unable to get insurance. He earned too much at his retail minimum-wage job to qualify for Medicaid at the time.
Because of his inability to access care for his mental health, he turned to street drugs to self-medicate, to make himself feel somewhat normal, so he could get through the day. This is not an unusual approach for people with mental illness who cannot get the health care they desperately need. Sadly, it is one of the contributors to the current opioid addiction epidemic.
While he continued to self-medicate, he grew addicted to drugs, to the point that he overdosed on heroin twice. Each time they were thankfully able to revive him with Narcan. When he got coverage through Medicaid, he was able to get help through the mental health program at Crozer. He was in and out of the crisis center three times, but Medicaid paid for his treatment and his necessary medications.
I’m very worried about how the additional burden of filing extensive documentation to qualify for Medicaid would impact families like ours trying to get help for an opioid addiction. At the time when he was seeking treatment, an administrative delay or trouble finding the appropriate documentation of his mental illness could have been a matter of life or death for my son.
Today he is doing well, but he will need medication his entire life. He is only able to hold a part-time job and will never be able to work full-time because of his mental health. Thankfully, Medicaid keeps him healthy enough to continue to work and live a normal life.
Because he works retail, my son’s hours fluctuate, and if he has to continuously document his work hours and his mental health status to keep his Medicaid, I’m worried that he won’t be able to do so. As a result of his years of drug use, he tends to miss deadlines, and he might not stay on top of getting the required documentation from his doctors and getting it in to the Medicaid office on time. Even a lost pay stub could mean he’d lose his coverage for months at a time.
If these new requirements become law, my son will be one paperwork error away from losing his coverage and the medications he needs. If that happens, he will most certainly return to drugs, and the next time he overdoses, there may not be anyone there to save him.
Lawmakers should think carefully about the potentially devastating impact of these new requirements on our state and especially the toll it could take on those that need treatment for an opioid addiction.
Ruth Ann Davidson is a former medical coder and is currently a health-care activist. She has spent the last five years fighting for adequate care requirements from Medicaid.