>> Sreenivasan: FOR MORE, I

SPOKE RECENTLY WITH SARA

ROSENBAUM, A PROFESSOR OF HEALTH

LAW AND POLICY AT GEORGE

WASHINGTON UNIVERSITY MILKEN

INSTITUTE SCHOOL OF PUBLIC

HEALTH.

SARA ROSENBAUM, THANKS FOR

JOINING US.

SO, LET'S FIRST TALK ABOUT

KENTUCKY.

IT WAS POISED TO BE THE FIRST

STATE IN THE COUNTRY TO ADD WORK

REQUIREMENTS FOR SOME MEDICAID

RECIPIENTS, BUT JUST DAYS BEFORE

TAKING EFFECT, A JUDGE BLOCKED

THE NEW RULES.

WHY?

>> KENTUCKY'S PROPOSAL, LIKE THE

PROPOSALS IN OTHER STATES,

REALLY BOILED DOWN TO REMOVING

PEOPLE FROM MEDICAID.

THE STATE BY ITSELF PROJECTED A

15% DROP IN MEDICAID

BENEFICIARIES, AND WHAT THE

JUDGE SAID WAS, YOU HAVEN'T

SHOWN US HOW AN EXPERIMENT ON

THE POOR THAT REMOVES TENS OF

THOUSANDS OF PEOPLE FROM THE

MEDICAID PROGRAM FURTHERS THE

OBJECTIONS OF THE MEDICAID

PROGRAM, SO YOU HAVEN'T DONE

YOUR JOB UNDER THE LAW.

YOU HAVE TO GO BACK AND EXPLAIN

WHY REMOVING COVERAGE FROM

PEOPLE FURTHERS THE OBJECTIVES

OF MEDICAID.

>> Sreenivasan: ALL RIGHT,

LET'S TALK A LITTLE BIT ABOUT

THAT WORD, "EXPERIMENT."

ARE 50 STATES ALLOWED TO

BASICALLY HAVE 50 DIFFERENT

EXPERIMENTS ON WHAT COULD AND

WHAT COULD NOT WORK, AND IN THIS

CASE WHAT COULD AND WHAT COULD

NOT BE SUED TO STOP?

>> MEDICAID DOES NOT-- EXCEPT IN

ONE VERY PARTICULARIZED

CIRCUMSTANCE-- ALLOW A STATE TO

IMPOSE WORK REQUIREMENTS.

SO, IN ORDER TO CONDUCT A WORK

EXPERIMENT-- AND I USE THE WORD

"EXPERIMENT" QUITE LITERALLY

HERE-- THE FEDERAL GOVERNMENT

HAS TO TURN TO A DIFFERENT

PROVISION OF LAW, ONE THAT

ACTUALLY PREDATES MEDICAID

ITSELF.

AND SO, IN ORDER TO USE THIS

SPECIAL AUTHORITY WHICH HAS

BEEN AROUND FOR 55 YEARS NOW,

THE SECRETARY IS ESSENTIALLY NO

LONGER APPROVING A STATE PROGRAM

UNDER THE MEDICAID STATUTE.

HE'S APPROVING IT AS AN

EXPERIMENT.

>> Sreenivasan: THERE'S GOING

TO BE PEOPLE WHO LOOK AROUND AND

SAY, LOOK, WE HAVE HISTORICALLY

LOW UNEMPLOYMENT.

WHAT'S THE HARM IN ADDING WORK

REQUIREMENTS TO GETTING THIS

INCREDIBLE BENEFIT OF

HEALTHCARE?

>> IN FACT, THE UNEMPLOYMENT

RATES AS YOU POINT OUT ARE

HISTORICALLY LOW.

THE VAST MAJORITY OF POOR PEOPLE

WORK, LOOK FOR WORK.

THE NATURE OF LABOR IN A

LOW-WAGE MARKET, WHICH IS WHERE

LOW-INCOME ADULTS ARE,

OBVIOUSLY, IS THAT IT COMES IN

CYCLES.

YOU MAY GET MORE HOURS.

YOU MAY GET FEWER HOURS.

YOU MAY BE CALLED IN FOR A TIME

OR GET LAID OFF FOR A WHILE.

YOU MAY BE A SEASONAL WORKER.

AND SO, THERE'S A NORMAL

FLUCTUATING TO AND FRO, AND ANY

EFFORT THAT CAN BE MADE TO HELP

PEOPLE WHO ARE IN LOW-WAGE JOBS

WHO NEED SKILLS, TRAINING, WHO

NEED HELP FINDING WORK IS A

WONDERFUL THING, AND THE RESULTS

OF VOLUNTARY WORK PROGRAMS ARE

ACTUALLY QUITE STRONG.

WHAT IS A REAL HEAD SCRATCHER

HERE, FROM A POLICY POINT OF

VIEW, IS WHY YOU WOULD EVER

THREATEN PEOPLE'S HEALTH

INSURANCE COVERAGE OVER THIS

WHEN THERE IS NO EVIDENCE, IN

FACT, THAT MORE THAN THE

SMALLEST HANDFUL OF LOW-INCOME

PEOPLE JUST DON'T WORK AND DON'T

WANT TO WORK AND HAVE NO REASON

NOT TO WORK.

TO PUT AT RISK PEOPLE'S COVERAGE

SIMPLY BECAUSE THEY CAN'T REPORT

IN THEIR MONTHLY HOURS CLOCKED

AT WORK, WHEN, IN FACT, THERE'S

A TINY HANDFUL OF PEOPLE WHO,

YOU KNOW, ARE THE PROVERBIAL

NEEDLES IN THE HAYSTACK, IS I

THINK WHAT MAKES THE WHOLE

ENTERPRISE SO IRRATIONAL AND

FRANKLY SO INHUMANE.

>> Sreenivasan: ALL RIGHT,

SARA ROSENBAUM, A PROFESSOR OF

HEALTH, LAW AND POLICY AT

GEORGE WASHINGTON UNIVERSITY,

THANKS SO MUCH FOR JOINING US.

>> THANK YOU.