More than 70 million Americans Health insurance owned by low-income or disabled people is called Medicaid by the state and federal governments. The main qualification at the moment is that you must be below a certain income level. But there is an idea that is very popular among Republicans - all of them should return Need work.

Republicans A bill was proposed to establish national work requirements, States have a lot of flexibility to add their own rules. Arkansas and 12 other states During the first Trump administration, there was a green light to add these job requirements, but in just a few months the court stopped these plans.

Now, Trump is back in the White House, with states including Arkansas, Ohio and Arizona recovering efforts, involving some Medicaid patients and advocates.

Patients worry about losing health care

Nummer Neal, 31, relies on a lot of medications to keep her healthy. Arkansas resident suffers from lupus, an automatic immune disease that causes joint pain, leaving her vulnerable to frequent illnesses.

"Someone will catch a cold, and it will turn into flu for me or pneumonia, or pneumonia, I've had 11 covid times," Neil said.

Thanks to Arkansas Medicaid, Neal was able to afford her essential doctor visits and medications.

But in December, when Neal went to pick up the prescription to control pain and inflammation, the pharmacist told her that she no longer has insurance coverage and that she owed more than $1,000.

“I was really worried,” Neil recalled, leaving the pharmacy empty-handed. “If I don’t have steroids to relieve this inflammation, the pain I’m in is almost unbearable.”

It turns out that the situation is a paperwork error, but creates a two-month nightmare for Neil. She said she ended up delaying paying rent to cover some of the medications.

Neal does work as a manager at Pizza Restaurant, but she earns enough to get Medicaid. She was worried that if she was very ill, she might have to stop working - losing Medicaid coverage.

That's because in January, Arkansas Governor Sarah Huckabee Sanders Announced plan To reclaim the demands the state attempted to make under the first Trump administration.

New advice from Arkansas

According to current regulations, if you are an adult In Arkansas, you can qualify for Medicaid for $20,000 or less per year. The suggested rule will add another test - you have to work.

"Most Arkansas are trying to pay for their health insurance, but many of these healthy adults simply don't work and get it for free," Sanders said.

In a statement, she said the country is spending More than 200,000 Medicaid is $2.2 billion An estimated 40% of healthy adults are unable to work properly.

This time the country's plan is to provide those State-funded help find a job And, only if they refuse, please suspend their Medicaid coverage. This is with Their attempt in 2018if people do not report that they work 80 hours a month, they will automatically lose their health insurance.

“Once this work demands begin, we will achieve our goals, even if Arkansas is far from government dependence on the road and the path to prosperity,” Sanders said in announcing the plan.

However, several studies have shown that 90% of qualified adults nationwide Because they have a disability, are in school or are caring for, are already working, or are not required.

Arkansas can now get a contract from the federal government one day. Ohio and Arizona are awaiting the same approval. Several other states, including South Carolina, Idaho and Iowa, are also negotiating to increase their own rules of work.

Lessons from Arkansas' first attempt

Seven years ago, Arkansas was in the first Trump administration, one-third of eligible adults may approximately 18,000 people lost coverage in less than a year. Many are working, but No complex monthly reporting work followed. Resolving these mistakes and helping people recover coverage legal aid for Arkansas attorney Trevor Hawkins.

“It’s my whole day and I’m able to help them get back to coverage,” Hawkins said.

However, many others have not resumed Medicaid. Just one One in 10 people who lose coverage The second year.

2019, federal judge Stopped state plansruled that this is illegal and does not target the core purpose of Medicaid providing health insurance to low-income individuals.

From Harvard School of Public Health It was also found that the rules did not lead to more work.

“It’s a bad investment,” Hawkins said of the job requirements plan.

To implement these working rules, states must also create new tracking and reporting systems Expensive to set up and run.

“Just another way to cut Medicaid”

Those who support job requirements believe that the policy will help low-income individuals escape poverty by inspiring them to find jobs.

but Gideon Lukenssenior fellows from the Center for Budget and Policy Focus believe that these job requirements are just strategies to reduce Medicaid enrollment.

this Congressional Budget Office It is estimated that over $100 billion in job requirements imposed nationwide over the next decade - by excluding more Medicaid personnel, the government does not have to pay for its medications and care.

"When you lose coverage, yes, you're giving less, but you're also having great difficulties," Luckens said.

State with limited Medicaid Compared to states without insurance, coverage is twice as high as states that expand Medicaid coverage.

Currently, states are the countries that require approval for these job changes, but if the House Republicans propose state work requirements are passed, Urban Institute and Robert Wood Johnson Foundation It is estimated that up to 5 million people may lose coverage.