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Answer to Fun with debunking the right: photo ID s for Medicaid

by Eric Ferguson on February 3, 2012

What’s wrong with this story, that requiring a photo ID for voting is no inconvenience because it’s required for Medicaid already?

There are two right answers, one that is spot-on, and one that is technically correct, but only sort of, IMHO.

The really right, spot-on answer is “People without photo IDs have been denied Medicaid”. From the Washington Independent:

A controversial federal law designed to keep illegal immigrants out of Medicaid is still ensnaring U.S. citizens 18 months after it took effect. It has prevented tens of thousands of eligible U.S. citizens from enrolling in the program, according to Medicaid officials representing at least a dozen states.

But as for the discrepancies among the different ethnicities, Allison had a different theory, originated by Virginia officials. Latinos, he said, are accustomed to requests for their citizenship documents, and therefore have them ready. Low-income African-Americans and whites, on the other hand, may have rarely been asked for those documents, and, as a result, have difficulty producing them. In no case does that mean that these people are not eligible citizens, he added.

“You can only imagine,” Allison said, “that this policy didn’t hit its target.”

    This program is denying service to many more citizens who should be eligible than it is denying illegal immigrants [the formatting problem is in the article, and appears to have been a quote]

Iowa health officials echoed Allison’s criticisms. “This program is denying service to many more citizens who should be eligible than it is denying illegal immigrants,” said Roger Munns, a spokesman for Iowa’s Dept. of Human Services. “It’s quite clear that we’ve got people coming to our door who are, in fact, citizens. But they simply can’t locate their documents.”

From a study for Kansas on the effect of requiring photo ID for Medicaid:  

Research finds that:
Survey of Medicaid Beneficiaries
• If required to do so, 64.2% of Medicaid beneficiaries would need to purchase one of the
three state-approved forms of identification.
• An average of 1.8 IDs would need to be purchased per household.
• A Kansas Driver’s License and State ID cost between $16 and $22. A passport costs
between $82 and $97.
• Medicaid beneficiaries estimate that they can spend between $5 and $8 for one ID.
• Tuesdays and Saturdays are the best days for most Medicaid beneficiaries to purchase
an ID. The best times are between 10AM and Noon and 2PM to 4PM.
• Slightly more than 85% of the beneficiaries needing a new ID “strongly agree,” “mostly
agree,” or “somewhat agree” with a statement suggesting that they would experience
financial hardship if required to purchase a photo ID.
• Slightly more than three-quarters (75.7%) “strongly agree,” “mostly agree,” or “somewhat
agree” that they would need financial assistance to purchase an ID.
• Regarding the statement “requiring Medicaid beneficiaries to show a photo ID is a good
idea,” 37.5% of the respondents needing IDs “strongly agree.” More than 20% do “not
agree” with the statement.

Full study here.

So people eligible for Medicaid were turned away for lack of a photo ID, and cost seems to have been the biggest obstacle to getting the required documentation.

An interesting bit from the Washington Independent article:

But not all states have seen drops in Medicaid enrollment as a result of the new guidelines. Health officials in Minnesota, for example, said that when the rules were installed they took aggressive steps, like retrieving birth records from other states. As a result, there has been no tangible effect on participation, they said.

So if a state is determined to get the necessary documents to eligible people, it can be done. Maybe with expense and difficulty, but it’s doable. Yet what do we see in the states requiring photo IDs to vote? They put up obstacles to getting IDs rather than making them more available, let alone “free”. That speaks volumes about the real goal. That might explain conservative complaints that Rhode Island’s law is too liberal, since the Democratic-passed photo ID law allows those without ID to cast a provisional ballot, and then the signature on the ballot envelope will be compared to the voter registration record. If the signatures match, the vote counts. That’s in addition to student IDs being accepted, which conservatives hate. Even the ID requirement is phased in, with non-photo Id accepted this year and photos required in 2014.

The answer I said was technically right but I don’t like it is “Voting is in the constitution, Medicaid isn’t”. Access to health care isn’t an enumerated right, but it sure seems covered by the 9th Amendment, “The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.” Obviously conservatives don’t think access to health care is a right, or they have a funny way of showing it, but us more civilized sorts do think so. That’s why I don’t like the “voting is a constitutional right” argument in this instance — it implies access to health care isn’t a right.

What about the other answers? Hopefully it’s clear “Medicaid doesn’t require photo IDs” is just plain wrong. “Medicaid makes the IDs” is wrong because the photo ID is required in order to get the Medicaid ID. “ID machines can double as X-rays” is just wrong. I think. Now that I think about, are we sure they just take our photo? Are we really….sure?

And that, ladies and gentlemen, is your moment of paranoia for the day.

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