After reading a story about a fix to the Affordable Care Act, I’m reminded of this scene from Office Space (OK, I know that’s not the scene, but a reasonable facsimile that won’t get me sued). In the scene, the two efficiency experts named Bob find that Initech has been paying Milton Wadhams for years without him being an actual employee. “Due to a glitch in the payroll department, he was still getting paychecks,” says one of the Bobs. “So, we went ahead and fixed the glitch.”
They won’t tell Milton that he’s been fired, they just make it so that he won’t receive a paycheck anymore, and everything else will “work itself out naturally,” thereby avoiding confrontation.
That’s what came to mind when I read about this.
Memo to President Barack Obama and the debt negotiators: You can save $13 billion by fixing a glitch in the new health care law.
(Sen. Mike) Enzi introduced legislation Monday to fix a glitch that would have allowed some middle-class early retirees to get health insurance at virtually no cost by qualifying for Medicaid coverage meant for the poor. Democratic Sen. Ben Nelson of Nebraska introduced a similar bill, signaling the fix could have bipartisan support.
The problem came to light recently, an obscure provision of the complex health care law that changed the current practice of counting Social Security benefits as income for deciding who can get Medicaid [...]
An early retiree drawing Social Security would have paid much less for the same policy than a neighbor of the same age, similar medical history, earning the same total income from work.
So basically, due to a drafting error, middle-class early retirees would have become eligible for Medicaid, because their Social Security benefits wouldn’t have counted as income for these purposes. According to CBO, this would mean that 500,000 to 1 million people would still be able to get insurance coverage, but not at such cheap rates.
Because we all know that the worst thing that could possibly happen is if people got cheap health insurance.
So Congress is going about fixing the glitch. And for the purposes of avoiding confrontation, I’m sure they won’t bother to recognize how fixing the glitch will hurt these people.
Some lawmakers want to change the law to ensure that Medicaid remains a program for the poor, but several advocates say simply counting Social Security benefits as revenue would hurt people with disabilities. Some 1.8 million people receive Social Security disability benefits but aren’t eligible for Medicare, and the law in its current form would allow many of them to get onto Medicaid.
“I worry about a fix that could be painful to people who have major healthcare problems,” said Ron Pollack, executive director of Families USA.
This affects people with disabilities in a waiting period for Medicare that would be blocked from Medicaid as well. Medicaid allows them to access long-term care services they must have.
The Obama Administration says they want to come up with a proposal that protects people with disabilities from becoming the Milton Wadhams of this glitch-fixing scheme. I don’t think Mike Enzi and Ben Nelson have such sensitivity.
This also speaks to the unintended consequences of trimming universal care programs, which with the Gang of Six and other grand bargain proposals will soon become very salient.