Tulsa World echo ~ caring opinion from Sooner land: Thank you

Certainly, a lot of Bible loving Christians are living in Oklahoma. From this picture, the Oklahoma Governor Mary Fallin is among them.

So, how is it that those who adhere to the teachings of Jesus Christ, as he instructed from the Sermon on the Mount, must need an education about how to be generous towards one another, especially to our children.

Sixty-six percent of the people in Oklahoma’s Medicaid program are 18 or younger. That’s more than 530,000 people, according to the Oklahoma Health Care Authority.

Wayne Greene echo opinion*: Why aren't the people on Medicaid working? Because, for the most part, they're children

This echo opinion is among the columns and letters I have enjoyed finding in my random search of newspapers from all over the place. This one is a gem, published in Tulsa World, in Oklahoma.

OKLAHOMA ~ Gov. Mary Fallin has issued an executive order instructing the state’s Medicaid office to seek federal permission (MaineWriter ~ As a Christian, Governor Fallin should be leading the instructions about how to live by the Beatitudes!)

Several pieces of legislation aiming at the same idea are pending in the House and Senate.

On the face of it, the work requirement makes obvious sense. 

As a society, we want people to provide for themselves. The state can’t afford to carry the burden of supporting the medical costs of able-bodied people.

It also makes emotional sense. People will value health care that they work for and earn. They will understand its costs and value, and work hard to continue to have it. In short, we all believe to some extent that work gives value to the things workers purchase as the fruits of their labor.

As Fallin said in her executive order, “Work is a critical tool in attaining capability for independence.”

This all raises an interesting question: Why aren’t the people on Medicaid working?

Well, in Oklahoma, most of them aren’t working because they’re children. Sixty-six percent of the people in Oklahoma’s Medicaid program are 18 or younger. That’s more than 530,000 people, according to the Oklahoma Health Care Authority.

Another 159,000 Medicaid recipients — 20 percent — are not fit for work because they are aged, blind or disabled.

Fallin’s executive order provides for exemptions from the work requirement for children and people over age 64. She also would exempt people who aren’t physically or mentally fit to work, pregnant women, people caring for children under age 6, and those who fall in several other categories.

So, when we consider work requirements, we should keep in mind that in the best-case scenario, we are talking about less than 10 percent of the Medicaid population who are 18-65 and able to work.

That’s still over 74,000 people. Why aren’t they working?

The short answer is: A lot of them are working. Sadly, they work but earn so little that they are still eligible for Medicaid.

The Kaiser Family Foundation studied nearly 25 million working-age adults who are not receiving federal disability payments but who are enrolled in Medicaid. It found that most of them are working and that a very large majority — 80 percent — are in working households.

Nearly half of the working Medicaid adults are employed by small companies that are not required to provide health care coverage to employees. A lot of the people are only able to find or hold part-time work.

It may be hard for middle-class Tulsans to recognize, but you can work very hard in Oklahoma and still be desperately poor. For an able-bodied working-age Oklahoman to be eligible for Medicaid, they can’t earn more than 41 percent of the federal poverty level, which would equate to roughly $7,500 a year for a single mother of one.

The Kaiser study found that among the working-age Medicaid recipients who were not working, most had some major impediment preventing them from getting job, including illness or disability (36 percent), home or family care responsibilities (30 percent) or school (15 percent). Only 6 percent said they couldn’t find jobs.

As Carly Putnam of the Oklahoma Policy Institute recently pointed out to me, in Oklahoma we also have to figure in the effect of felony records preventing people from getting jobs. One in 12 Oklahomans have a felony conviction, thanks largely to our habit of treating substance abuse as a crime deserving prosecution instead of a disease deserving treatment.

Hypothetically, the policies of some states, including Oklahoma, could be discouraging adults on Medicaid from trying to find work. When Oklahoma rejected Affordable Care Act funding to expand Medicaid, it inadvertently created a health care gap between the state’s Medicaid eligibility cutoff (currently 41 percent of the federal poverty level) and the eligibility for federal subsidies for health care coverage through the “Obamacare” electronic marketplace, which starts at 100 percent of poverty.

In other words, if you’re at 40 percent of the poverty level, you’re eligible for Medicaid, but if you work harder and your income goes up to 42 percent of poverty, you lose you Medicaid but don’t earn enough to qualify for “Obamacare” until you get to 100 percent.

A bill proposed by state Sen. Josh Brecheen, R-Coalgate, and approved by the Senate last week would make that problem even worse. It would lower working-age adult eligibility for Medicaid to 20 percent of the poverty level (a little more than $4,100 a year for a single mother). If you believe that poor people would rather have Medicaid than work for their own health care, — and I don’t — then you should oppose Brecheen’s bill because it would discourage people from working. In fact, it would encourage people who are on Medicaid and working to quit their jobs so they could keep their health care coverage.

As Workforce Tulsa Executive Director Shelly Cadamy pointed out in a recent Tulsa World op/ed column, we know how to move people into the work force. We need to fund workforce development programs, quality child care and elder care, and solve transportation problems. We need to make substance abuse treatment available and remove licensing restrictions on the marketplace. Then we might also want to consider adequate funding of the state’s public schools, career tech schools, colleges and universities.

Denying Medicaid to the working poor isn’t going to force them to get jobs. They already have jobs, if they can get them. 

Taking away their Medicaid will only make them poorer, sicker and more desperate. (MaineWriter ~ "Blessed are the merciful....")

*Wayne is the editorial pages editor of the Tulsa World and a political columnist. A fourth-generation Oklahoman, he previously served as the World’s city editor for 13 years and as a reporter at the state Capitol of four years.