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Moises and Medicaid Part 2

Stanley Feld M.D.,FACP,MACE

I could not understand why Moises and his wife were rejected for Medicaid coverage. He did not qualify by the Medicaid rules in the state of Texas. I was not aware of the qualifying rules but thought $22,000 income per year would certainly qualify him for Medicaid. It was a difficult internet search. The rules are not transparent.

“What are the minimum qualifications?

Medicaid is available to qualifying Texans of all ages and abilities. There are separate programs for families and children and for people who are elderly or have a disability. In general, you must:
• Be a Texas resident.
• Be a U.S. citizen or a non-citizen in certain recognized categories.
• Meet certain resource and income limits, which vary by eligibility group.”

There is nothing in the statement that mentions specific income. The government wants price transparency but does not have it on its website.

“How do my assets, such as my home and bank accounts, and my income affect whether I can receive Medicaid?

The amount of assets and income you’re allowed depends on the category you apply under. Contact your local Eligibility office for more information. You’ll need to provide proof of income and assets when you apply. In most cases, a homestead is not counted as an asset.”

An applicant for Medicaid is at the mercy and judgment of the case worker. The case worker has concrete rules. There does not seem to be any exceptions or appeals.

“If I have a job, can I still qualify for long-term care Medicaid?

That depends on how much you earn at your job. Having a job may not disqualify you, but the amount of money you can earn and still be eligible for Medicaid is low.”

Where is the logic? An economist told me that Moises should know the rules of the game. His goal should be to have an income below the poverty level. Is this the American way? I was taught you were supposed to work hard, be creative and innovative, increase your income and live a better life.

Where is the promise of affordable healthcare? It seems to be simply rhetoric by politicians.
Something is wrong. Does anyone think universal healthcare with a single party payer system and its bureaucracy would solve the experience Moises had with Medicaid? I don’t.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
StanleyFeld M.D.,FACP,MACE

  • Kevin Gilbert

    Your last couple sentences leave me puzzled. I am not sure that a universal coverage system with a single payer is the best system, but it would certainly solve Moises’s problem – he wouldn’t be turned down for coverage due to a judgment call on income from the case worker.

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