Medicaid recipients find $1 premiums too confusing to pay

Imagine if you were poor and you got Medicaid, heavily subsidized by the taxpayer, but you had to pay between $1 and $15 a month in premiums.  Wouldn't that be confusing?  For many people, it is so confusing that they don't understand how to pay and end up being kicked off Medicaid.

While the work requirement is unprecedented in the history of Medicaid, Mr. Wagner and others say they're just as concerned about other new rules that will be confusing and hard to follow.  For example, many adults who don't pay their small premiums can be locked out of Medicaid for six months, unless they complete a financial or health literacy course.  Others will lose access to dental and vision care.

Critics of the plan point to Indiana, which dropped about 25,000 adults from its Medicaid program from 2015 through 2017 for failing to pay premiums there.

Some also find the new work requirements some states have imposed troubling:

I'm wanting to go back to work, but if I was told, 'You have to go back,' I do think that would step up my anxiety,"  Ms. Penney said. "Volunteering would be less pressure, but you would still want to be consistent and reliable."

She expects she will find a way to pay the new premiums she'll owe under the plan – $4 a month – but predicts [that] it will mean going without other necessities at times.

"I was at the store yesterday, looking in my wallet and going, 'Do I have enough money for dog food?'" she said.  "The thought of taking on even one more expense feels overwhelming."

Imagine having to eat dog food to pay $4 a month in premiums!  Or, alternatively, imagine working a minimum wage job for 20 minutes, long enough to earn $4.  Some people would rather eat dog food.  But Ms. Penny is fighting back!

[S]he's a plaintiff in a lawsuit filed last month to stop Kentucky's new requirements from taking effect.

Ms. Penny says she is too "mentally ill" to work, but she is not too mentally ill to file a lawsuit.  I wonder if they sell dog food laced with Prozac!  That would certainly help her cut costs!

The article goes on to worry about the complication of the work requirements and the bureaucracy and cumbersome record keeping that would be required to comply with it.  You know that a government program is really worthy, really fundamentally important, when liberals start complaining about the cost of complying with it.

What do you think?  Do you think a bill for $1 for medical care is confusing for people with an entitlement mentality?  What could be done to make it simpler for them?

Ed Straker is the senior writer at

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