The bad, the good and the outlier

by Tom Sullivan

Eli Wallach in The Good, the Bad and the Ugly (1966).
Georgia Gov. Brian Kemp in 2018 campaign commercial.

Catherine Rampell delivers some good news otherwise buried in a torrent of bad for the Trump administration.

First, to summarize the bad.

Witness after witness before House investigators confirm in their testimony that Donald Trump, Trump’s personal lawyer Rudy Giluliani and their associates attempted to use the presidency for personal, political gain. The revelations have turned his spinning defenders into dervishes. It will only get worse for Trump (and harder for his lackeys to spin) when public hearings begin next week.

Politico reports:

In the assessment of the five diplomats at the center of the impeachment inquiry, Giuliani was everywhere. He was texting with State Department officials and directing U.S. foreign policy, all seemingly at the behest of the president. He was Trump’s free-wheeling emissary seeking to push a foreign government to, in effect, publicly tar Joe Biden.

House investigators have stitched together a uniquely Trumpian narrative — one of retribution against perceived enemies, defiance of diplomatic norms and a pervasive fear that Russia would benefit from the disarray, all to help Trump fend off his top 2020 rival.

Donald Trump has turned the executive branch into an ongoing criminal enterprise like his others. House investigations underway will determine whether Congress will shut down this one the way the state of New York shut down the fraudulent Trump Foundation. New York Attorney General Letitia James announced Thursday Trump must pay $2 million in damages “for improperly using charitable assets to intervene in the 2016 presidential primaries and further his own political interests.” The money will go to nonprofit organizations in the state.

In “19 paragraphs of factual admissions,” Trump and the Foundation admitted multiple acts of self-dealing in court filings while claiming in public James “is deliberately mischaracterizing this settlement for political purposes.” And why isn’t she investigating the Clinton Foundation, huh?!

Expect past Trumpian behavior to be prologue.

Now, for the good news. Medicaid work requirements designed to kick poor and sick Americans out of Medicaid coverage are beginning to crumble, writes Rampell:

I’m referring to Medicaid work requirements, policies that kick low-income people off their insurance if they don’t register sufficient work hours. Until recently, it looked as if these programs were on an unstoppable march, with two dozen states pursuing them.

But with the state elections in Kentucky and Virginia this week, plus policy rollbacks recently announced in other states, things are starting to change.

Medicaid work requirements might sound reasonable enough. Ostensibly, they’re about helping poor people move up in the world, or at least making sure they’re not taking advantage of taxpayer largesse. If you buy the premise that poor people choose to be poor because poverty is just too darn comfortable, maybe taking away their access to insulin or inhalers is just the kick in the rear they need to go out and get a job.

Turns out that’s not how it works. Data from the Kaiser Family Foundation finds most recipients are already working. Most of those who aren’t are in school, care-giving or ill. Or else lack the child care, skills, or clean criminal records needed to hold down a job.

But it is no surprise to find that to dislodge a few suspected, undeserving deadbeats, “small-government” conservatives are willing to spend more than $250 million in Kentucky alone. And they don’t mind if this evil rain falls on the just as well as the unjust:

In Arkansas — the first state to actually implement these requirements — more than 18,000 people lost their health insurance over the course of a few months. Many of these Arkansans actually met the work requirements, or were legally exempted from them. Yet they were still purged from the insurance rolls, due to onerous and confusing reporting requirements.

Consider one such person whom I profiled last year, Adrian McGonigal. He was employed at a chicken plant and thought he had sufficiently documented his hours. He lost his Medicaid coverage anyway, leaving him unable to get the prescriptions he needed to manage his chronic obstructive pulmonary disease (COPD). He landed in the hospital multiple times and eventually lost his job.

Rampell cites a New England Journal of Medicine study that found work requirements shrank insurance rolls but did not increase employment. Oh, work requirements may also be illegal, but in this administration, that’s probably by design.

Even so, states are figuring out this “sticks” approach is costing them. They are shelving work requirements:

In fact, just last month, two more states — Arizona and Indiana — announced that they were pausing programs that had already been approved by the Trump administration.

Then on Tuesday, Democratic electoral victories in Kentucky and Virginia raised expectations that these states will soon rescind their states’ policies as well. This would mimic a similar reversal from Maine earlier this year, when a Democrat replaced a far-right Republican as governor.

The progress isn’t universal. Georgia Gov. Brian Kemp (R) recently unveiled his own work requirements proposal — expected legal, administrative and human costs be damned.

For now, Georgia appears to be as much an outlier as Kemp. Authoritarians gonna authoritarian.

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