Ohio Statehouse Credit: Pixabay
By Joni Halpern
Dear Ohio,
Once again, I write to you because you are the bellwether election state. In that sense, you are a critical part of the vetting process for presidential candidates.
In my last letter, I confided how bewildered I was that you had chosen a president so unlike my friends, Don and Ilene, who both grew up in Canton, Ohio. Everyone who knew these folks looked up to them, and some of us even tried to be more like them. They were people who invested their whole lives in the premise that everyone deserves to be treated with compassion, fairness and respect.
The house my friend Ilene grew up in still stands on 24th Street in Canton. Her father built it pretty much with his own hands. She remembered it as a place of love and understanding where she felt cherished. She said he was the kind of man who made her want to be good in his eyes. She remembered how he explained to her that quite often, it wasn’t the fault of his clients that they couldn’t pay their bills. Times were tough back then, and even spare change was hard to come by in some households.
You know, dear Ohio, when you don’t live in a state and you just meet people who once lived there, you have a tendency to think that everyone in that state is like the people you know. So, for a long time now, I have thought most Ohioans were like Don and Ilene – examples of compassion, understanding, respect and decency. I still cling to that belief.
But I noticed in the paper the other day that the president has figured out a way to dump people off the rolls of Medicaid, the federally supported health insurance program for the poor. He will now allow states to impose work requirements as a condition of receiving Medicaid. And two of the states racing to get federal permission to implement such a plan are Ohio and its neighbor, Kentucky.
That brings to mind a little story about my friend Ilene. We used to work in the same office. One day, back in 2005, she was listening to a conference call we were having with California state officials who were trying to figure out how they were going to help then-Gov. Arnold Schwarzenegger cut the state budget. Gov. Schwarzenegger was no champion of the poor. In fact, he was pretty shrewd, realizing that the poor do not donate to campaigns. They usually do not walk precincts or man phone banks. Often, they are so busy surviving and so filled with despair, they do not vote. Therefore, they can be made to bear most of the burden of government budget cutbacks with little or no consequences for politicians. But the governor did not want his fingerprints on the bloody knife, so he asked his henchpersons in the public benefits bureaucracies to find ways to produce the cuts so he could reach his target budget numbers.
Trouble was that by 2005, the state welfare program was already down to bare bones, having dumped more than half of all welfare recipients off the rolls since 1996, even though almost all of those who left welfare were still poor or deeply poor (at least halfway below the federal poverty threshold). But state officials said they knew how to cut more.
In our conference call, they explained that cutting more cases would mean millions in savings for the Governor’s budget. All they needed to do was impose one more obstacle. They would require one more face-to-face meeting that every parent on welfare had to have annually with a caseworker. One such meeting was already required. But now there would be two. (This was in addition to innumerable written monthly reporting requirements submitted under penalty of perjury, with proper verifications attached.)
State officials explained that one more meeting would result in termination of an additional 5 percent of all cases statewide. Hence, the savings. How would these terminations happen? Well, said the official on the call, some people would not receive the mailed meeting notice. Some people would be unable to attend, because they might be ill or working, or they might have to care for a disabled family member. Some people would be so upset by the paperwork requirements they would just give up and quit welfare. And some would not be able to find child care or transportation to the attend the meeting. Minimum 5 percent caseload reduction pretty much guaranteed.
Of course, it didn’t matter that these families would be even poorer. They were simply collateral damage in the face of larger societal goals. And, if moral authority was wanting, perhaps we can rationalize that they should have worked harder, done better in school, or avoided other detriments that resulted in their impoverishment.
Ilene said the whole thing was inhuman, and that back in Ohio, people wouldn’t think that was right. But maybe Ilene was wrong. Maybe the Ohio that gave birth to her values no longer exists.
Perhaps, dear Ohio, you are not aware that most people who receive Medicaid already work. Of the remainder, most are children or disabled. Some others tend to families while someone else in the household works. Thus, it is not to promote work that your state will impose these requirements. Instead, it is because proving compliance with work requirements will offer thousands of opportunities to close cases. Lost your pay stubs? Caseworker says she didn’t get them? You worked 79 hours instead of 80? You forgot to send them in? Too bad. Your Medicaid case is closed.
Now, dear Ohio, you can now look forward to thousands more Ohioans not having health care. What worked for the bureaucrats in California in 2005 to reduce welfare caseloads will also work to reduce your Medicaid rolls. People who leave Medicaid will still need health care, of course. But you won’t realize it until there’s a communicable disease racing through your community, like we’ve had with hepatitis A here in San Diego.
Congratulations to the Buckeye State. You have become what you dislike. You have become California. And wouldn’t you know? You have done so at a time when we are trying to become more like Ilene’s Ohio.
Bye for now. I’ll write soon, even if I don’t hear from you first.
Joni Halpern
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Wonderful piece and story Joni.
Your information is helpful to us because we have relatives who are on Medicaid.
Better warn them even though most of the time they don’t listen.
Awesome letter Joni! We appreciate you and keep up the good work.