Big Beautiful Bill

Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:There are many people who receive Medicaid that are able to work. However they don't have the education or job skills to command a position that will come with health insurance as a benefit. And then others choose not to work. Still others are too young to work, too old to work or too disabled to work.

I work with the poor as a case manager and live in this world day-in and day-out.


My understanding is that 65+, 19 and below and disabled are NOT required to work in the new bill.

The problem isn’t work per se. The problem is that working 20 hrs a week 50 weeks a year or so at $25/hr is going to disqualify a lot of people in HCOL areas because they’ll go over the income.


Is it for all 65+? I know some immigrants who became citizens after 65 plus & are getting medicaid benefits. How is this fair? They have not paid anything in taxes & will continue to get medicaid.


Bingo! What this reveals is really people have been receiving Medicaid who should never have been getting taxpayer funded benefits. And these hospitals are crying because they can't pay their c-suites $100 million in salaries. Even “not for profit” hospitals pay ridiculous salaries. The for-profit nursing homes exploiting taxpayers and old people are also crying right now.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Why will the medicaid provisions hurt rural hospitals? Is it because there are no jobs for the able-bodied to do, thus they cannot meet the work requirements? Or is it that illegal alien farm workers / factory workers are on Medicaid in these rural areas?


Because their patients will no longer have any way to pay for care.


What specific provisions of the bill would make their patients ineligible for Medicaid?


Read the bill. The GOP is installing new barriers to receive monies.


I have - able-bodied must work and no illegals. What else am I missing?


The 85 year old widow with dementia is supposed to work? Please explain.


Stop your whining, pick up that walker and get your geriatric bones back down to the sweatshop, grandma!
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Why will the medicaid provisions hurt rural hospitals? Is it because there are no jobs for the able-bodied to do, thus they cannot meet the work requirements? Or is it that illegal alien farm workers / factory workers are on Medicaid in these rural areas?


Because their patients will no longer have any way to pay for care.


What specific provisions of the bill would make their patients ineligible for Medicaid?


Read the bill. The GOP is installing new barriers to receive monies.


I have - able-bodied must work and no illegals. What else am I missing?


The administrative requirements are so burdensome that even people eligible for the program may not be able to enroll. That’s a feature, not a bug. Republicans don’t want people to use Medicaid or food stamps, even if they are eligible.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Why will the medicaid provisions hurt rural hospitals? Is it because there are no jobs for the able-bodied to do, thus they cannot meet the work requirements? Or is it that illegal alien farm workers / factory workers are on Medicaid in these rural areas?


Because their patients will no longer have any way to pay for care.


What specific provisions of the bill would make their patients ineligible for Medicaid?


Read the bill. The GOP is installing new barriers to receive monies.


I have - able-bodied must work and no illegals. What else am I missing?


The administrative requirements are so burdensome that even people eligible for the program may not be able to enroll. That’s a feature, not a bug. Republicans don’t want people to use Medicaid or food stamps, even if they are eligible.


What administrative requirements are too burdensome?
Anonymous
Anonymous wrote:Why will the medicaid provisions hurt rural hospitals? Is it because there are no jobs for the able-bodied to do, thus they cannot meet the work requirements? Or is it that illegal alien farm workers / factory workers are on Medicaid in these rural areas?


The vast majority of people on Medicaid already work. Nearly all are American citizens or legal residents (some states cover illegal residents with their own funds not federal).

These are paperwork requirements not work requirements. The places that have tried it have failed.

It creates a lot more bureaucracy and people end up getting kicked off by accident or giving up. Rural communities rely on Medicaid even more than non rural.

https://www.nytimes.com/2025/06/28/upshot/republicans-medicaid-work-requirement

Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Why will the medicaid provisions hurt rural hospitals? Is it because there are no jobs for the able-bodied to do, thus they cannot meet the work requirements? Or is it that illegal alien farm workers / factory workers are on Medicaid in these rural areas?


Because their patients will no longer have any way to pay for care.


What specific provisions of the bill would make their patients ineligible for Medicaid?


Read the bill. The GOP is installing new barriers to receive monies.


I have - able-bodied must work and no illegals. What else am I missing?


The administrative requirements are so burdensome that even people eligible for the program may not be able to enroll. That’s a feature, not a bug. Republicans don’t want people to use Medicaid or food stamps, even if they are eligible.


Yes. That's a way to trim the cost of Medicaid, SS and Medicare. Make it so difficult to use that many qualified people won't be using it.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Why will the medicaid provisions hurt rural hospitals? Is it because there are no jobs for the able-bodied to do, thus they cannot meet the work requirements? Or is it that illegal alien farm workers / factory workers are on Medicaid in these rural areas?


Because their patients will no longer have any way to pay for care.


What specific provisions of the bill would make their patients ineligible for Medicaid?


Read the bill. The GOP is installing new barriers to receive monies.


I have - able-bodied must work and no illegals. What else am I missing?


The administrative requirements are so burdensome that even people eligible for the program may not be able to enroll. That’s a feature, not a bug. Republicans don’t want people to use Medicaid or food stamps, even if they are eligible.


What administrative requirements are too burdensome?


It’s been repeatedly abandoned and deemed a failure in states where they have tried it. Websites don’t work, people can’t get hold of staff to correct problems, compliance trickier with things like gig work or other jobs with variable hours, people with “non-permanent” disabilities (like down syndrome) have to routinely prove they have a non-permanent disability with all of the paperwork and doctor visits that entails and so on.

The point is to wear people down and give up on Medicaid. Not to get them to work.

Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Why will the medicaid provisions hurt rural hospitals? Is it because there are no jobs for the able-bodied to do, thus they cannot meet the work requirements? Or is it that illegal alien farm workers / factory workers are on Medicaid in these rural areas?


Because their patients will no longer have any way to pay for care.


What specific provisions of the bill would make their patients ineligible for Medicaid?


Read the bill. The GOP is installing new barriers to receive monies.


I have - able-bodied must work and no illegals. What else am I missing?


The administrative requirements are so burdensome that even people eligible for the program may not be able to enroll. That’s a feature, not a bug. Republicans don’t want people to use Medicaid or food stamps, even if they are eligible.


Yes. That's a way to trim the cost of Medicaid, SS and Medicare. Make it so difficult to use that many qualified people won't be using it.


So these beneficiaries who were competent and capable enough to enroll are not competent or capable enough to maintain enrollment? Or, maybe, the current lax standards for enrollment led to fraud?
Anonymous
There is no proof of widespread fraud in these programs. It is a GOP canard.
Anonymous
Anonymous wrote:There is no proof of widespread fraud in these programs. It is a GOP canard.


Then Medicaid recipients are clearly capable of taking on the new administrative requirements.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Why will the medicaid provisions hurt rural hospitals? Is it because there are no jobs for the able-bodied to do, thus they cannot meet the work requirements? Or is it that illegal alien farm workers / factory workers are on Medicaid in these rural areas?


Because their patients will no longer have any way to pay for care.


What specific provisions of the bill would make their patients ineligible for Medicaid?


Read the bill. The GOP is installing new barriers to receive monies.


I have - able-bodied must work and no illegals. What else am I missing?


The administrative requirements are so burdensome that even people eligible for the program may not be able to enroll. That’s a feature, not a bug. Republicans don’t want people to use Medicaid or food stamps, even if they are eligible.


Yes. That's a way to trim the cost of Medicaid, SS and Medicare. Make it so difficult to use that many qualified people won't be using it.


So these beneficiaries who were competent and capable enough to enroll are not competent or capable enough to maintain enrollment? Or, maybe, the current lax standards for enrollment led to fraud?


From NYT article:

The two states that have actually put in work requirements show some of the hurdles that others could face.

When Arkansas started a work requirement in 2018, state officials worked hard to educate the public — mailing letters, sending emails, placing phone calls, briefing medical providers, posting on social media sites, distributing fliers. Still, around the time the program began, only about half of eligible people knew whether the work requirement applied to them. The website used to document work hours was not designed for smartphones and was routinely taken offline at night for maintenance.

Almost none of the people who were required to report work hours under the system did so in the first months of the program, and 17,000 people lost coverage before the program was stopped by a federal judge.

Georgia expanded Medicaid coverage in 2023 for low-income people who could prove they were working. But the state’s sign-up system is often glitchy. Documents that seem to upload sometimes don’t, or they are reviewed so late that a person trying to sign up has already missed a deadline, according to Cynthia Gibson, a managing attorney at the Georgia Legal Services Program, who has helped some Georgians appeal their denials. Only around 7,400 people have enrolled so far; the state expected around 100,000.
Anonymous
Anonymous wrote:
Anonymous wrote:There is no proof of widespread fraud in these programs. It is a GOP canard.


Then Medicaid recipients are clearly capable of taking on the new administrative requirements.


The same number of staff will be chasing paperwork and dealing with issues related to work requirements. That slows processing down for every legitimate Medicaid recipient too. This is why it has repeatedly failed where it has been tried.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Why will the medicaid provisions hurt rural hospitals? Is it because there are no jobs for the able-bodied to do, thus they cannot meet the work requirements? Or is it that illegal alien farm workers / factory workers are on Medicaid in these rural areas?


Because their patients will no longer have any way to pay for care.


What specific provisions of the bill would make their patients ineligible for Medicaid?


Read the bill. The GOP is installing new barriers to receive monies.


I have - able-bodied must work and no illegals. What else am I missing?


The administrative requirements are so burdensome that even people eligible for the program may not be able to enroll. That’s a feature, not a bug. Republicans don’t want people to use Medicaid or food stamps, even if they are eligible.


Yes. That's a way to trim the cost of Medicaid, SS and Medicare. Make it so difficult to use that many qualified people won't be using it.


So these beneficiaries who were competent and capable enough to enroll are not competent or capable enough to maintain enrollment? Or, maybe, the current lax standards for enrollment led to fraud?


From NYT article:

The two states that have actually put in work requirements show some of the hurdles that others could face.

When Arkansas started a work requirement in 2018, state officials worked hard to educate the public — mailing letters, sending emails, placing phone calls, briefing medical providers, posting on social media sites, distributing fliers. Still, around the time the program began, only about half of eligible people knew whether the work requirement applied to them. The website used to document work hours was not designed for smartphones and was routinely taken offline at night for maintenance.

Almost none of the people who were required to report work hours under the system did so in the first months of the program, and 17,000 people lost coverage before the program was stopped by a federal judge.

Georgia expanded Medicaid coverage in 2023 for low-income people who could prove they were working. But the state’s sign-up system is often glitchy. Documents that seem to upload sometimes don’t, or they are reviewed so late that a person trying to sign up has already missed a deadline, according to Cynthia Gibson, a managing attorney at the Georgia Legal Services Program, who has helped some Georgians appeal their denials. Only around 7,400 people have enrolled so far; the state expected around 100,000.


Or maybe they could not prove they were working. Occam’s razor.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:There is no proof of widespread fraud in these programs. It is a GOP canard.


Then Medicaid recipients are clearly capable of taking on the new administrative requirements.


The same number of staff will be chasing paperwork and dealing with issues related to work requirements. That slows processing down for every legitimate Medicaid recipient too. This is why it has repeatedly failed where it has been tried.


It won’t be the same number of staff because DOGE.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Why will the medicaid provisions hurt rural hospitals? Is it because there are no jobs for the able-bodied to do, thus they cannot meet the work requirements? Or is it that illegal alien farm workers / factory workers are on Medicaid in these rural areas?


Because their patients will no longer have any way to pay for care.


What specific provisions of the bill would make their patients ineligible for Medicaid?


Read the bill. The GOP is installing new barriers to receive monies.


I have - able-bodied must work and no illegals. What else am I missing?


The administrative requirements are so burdensome that even people eligible for the program may not be able to enroll. That’s a feature, not a bug. Republicans don’t want people to use Medicaid or food stamps, even if they are eligible.


Yes. That's a way to trim the cost of Medicaid, SS and Medicare. Make it so difficult to use that many qualified people won't be using it.


So these beneficiaries who were competent and capable enough to enroll are not competent or capable enough to maintain enrollment? Or, maybe, the current lax standards for enrollment led to fraud?


From NYT article:

The two states that have actually put in work requirements show some of the hurdles that others could face.

When Arkansas started a work requirement in 2018, state officials worked hard to educate the public — mailing letters, sending emails, placing phone calls, briefing medical providers, posting on social media sites, distributing fliers. Still, around the time the program began, only about half of eligible people knew whether the work requirement applied to them. The website used to document work hours was not designed for smartphones and was routinely taken offline at night for maintenance.

Almost none of the people who were required to report work hours under the system did so in the first months of the program, and 17,000 people lost coverage before the program was stopped by a federal judge.

Georgia expanded Medicaid coverage in 2023 for low-income people who could prove they were working. But the state’s sign-up system is often glitchy. Documents that seem to upload sometimes don’t, or they are reviewed so late that a person trying to sign up has already missed a deadline, according to Cynthia Gibson, a managing attorney at the Georgia Legal Services Program, who has helped some Georgians appeal their denials. Only around 7,400 people have enrolled so far; the state expected around 100,000.


Or maybe they could not prove they were working. Occam’s razor.


It has repeatedly failed. It creates more bureaucracy and ends up covering fewer people - even people who would otherwise be exempt from complying. Got it - you don’t like Medicaid. Kicking legitimate people off is a feature not a bug.

The handful of states that have already attempted work requirements in Medicaid spent tens of millions of dollars. Kentucky spent $250 million in 2018 on its program, before a court stopped it. But the Senate version of the bill allots only $200 million for the entire country.

States would also need to hire more workers to check time sheets, doctors’ notes and other documents as well as make application decisions. And they would need to staff call centers with employees who could answer questions from confused beneficiaries.

That may sap resources from other parts of Medicaid and could lead to more errors and longer waits for pregnant women and people with disabilities attempting to sign up. In eight states, more than a third of applications already take more than 45 days to process.


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