Mostly because he's an obscenely rich libertarian motherfucker who thinks that people who were not born rich don't deserve to live.
More specifically:
Now,
before you get all “ARE THEY GONNA MAKE NURSING HOME RESIDENTS WORK IN
COAL MINES,” the letter is quite clear that states can only throw
people off healthcare for not working if they’re “non-elderly,
non-pregnant adult Medicaid beneficiaries who are eligible for Medicaid
on a basis other than disability.” So relax! Sending Meemaw to the coal
mines is Phase III, and won’t even be considered until CHIP reauthorization is made conditional on the repeal of child labor laws.
SNIP
And
if most people currently getting Medicaid are already working, or seem
to have a good reason not to be working (which may win them an exemption
from the work requirement), then why the hell is a work requirement needed in
the first goddamn place? That’s simple: You gotta tighten the screws on
poor people, because no matter what the reality is, Republicans just know life
in poverty is an endless funtimes parade of free stuff. The goal here
is to add more barriers to people living the high life on Medicaid, and
the result will be fewer people getting the medical care that really can improve their job prospects.
Emma Sandoe is, as always on this subject, excellent:
Eight
in 10 Medicaid beneficiaries of working age already live in working
families. Recent analysis by the Kaiser Family Foundation has found that
the most Medicaid beneficiaries who are not working are sick or
disabled (but do not meet the rigid definitions of disability outlined
by the Social Security Administration), or they are taking care of their
family who may be elderly, sick or children that need care. Many more
are in school or are retired.
These
people have valid reasons for not working and taking away their health
insurance will likely make their health worse or worsen the health of
the people that they are caring for. The administration has created a
solution to a problem that does not exist.
This
policy will make it more difficult for people who are eligible for
Medicaid and are working in low-wage jobs to be enrolled in the program.
Navigating the complexities of health insurance bureaucracy is
difficult for anyone. This policy adds another layer of complexity to
the system. Now, beneficiaries will have to take additional steps when
applying for coverage, as well as monitor and ensure their state
government is accurately recording their information to receive the
benefits they are already eligible for. Think how the country would
respond if Medicare beneficiaries had to regularly prove that they were
aging to keep their Medicare cards.
In
reality, IT systems don’t always work, mail gets lost and people
working two to three jobs to get by and still making little money may
not have the time to correct the paperwork. Healthy people who want to
get preventative health care will drop out of Medicaid because the
additional burden is too high. These people may miss cancer screenings
and diagnosis of chronic conditions.
The
purpose of any insurance is to protect against financial devastation.
Rigorous and recent research shows that Medicaid coverage not only
improves a beneficiary’s health, it protects low-income people against
bankruptcy and financial loss. These important protections have reduced
extreme poverty and allowed many people opportunities to get out of
poverty.
The
administration has tried to make this policy more palatable by making
exceptions for people who volunteer or have a severe disability. But
this policy is so heavily pushed by the administration and Republican
states because they think it will reduce the number of people on
Medicaid. When we’ve tied work to other government run programs, it does
little to increase work. In fact, we’ve seen the opposite: that access
to health care can make it easier for people to find jobs. We’ve seen
that when people don’t have access to needed medications it is harder
for them to find jobs.
The
point about how adding further conditions creates bureaucratic
impediments that inevitably cause even eligible people to lose their
insurance is particularly important.
"Simply vile" pretty much covers it.
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