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Last May, Kimberly Thompson, a warehouse worker in Columbus, Ohio, had a hysterectomy. The operation left her unable to do physical work and so Thompson, a warehouse worker, applied for Medicaid, welfare and food stamps while she recovered. But the surgery led to an infection, and the infection led to her organs shutting down. She spent a month in a medically-induced coma.
What happened next, as reported in a searing piece by NBC's Seth Freed Wessler, was a cascade of bureaucratic tragedies that would almost be funny if they weren't destroying a real woman's life. Her welfare and food stamps were terminated "because she had failed to complete the mandatory work and training requirement for receipt of government assistance." When she called Ohio's Department of Jobs and Family Services to tell them she was in the hospital, a worker there informed her she had two days to get to the county office and verify her hospitalization.
Let's stop for a minute there. Thompson had just woken up in the hospital after a monthlong coma. She had had seven toes amputated, and was suffering from some cognitive problems. And she was told she had to somehow make it to the county office in two days or she would lose her benefits.
She didn't make it to the county office, of course. And she lost her benefits.
Thompson lived in a trailer with her daughter. Without the job and without the benefits, she lost her trailer, and, now using a colostomy bag, was forced to stay on the couches of different relatives. Her daughter went to live with her father.
That last bit is important — and leads to the cruel, mindless conclusion of Thompson's case. Thompson went to the Legal Aid Society of Columbus to appeal the termination of her benefits. The state ruled for her, and even made back-payments. She's now receiving food stamps again. But it's no longer clear that she's eligible for welfare. Why? Because her daughter doesn't live with her anymore. And why doesn't her daughter live with her anymore? Because Thompson lost their home after the state terminated her benefits because she was in a medically-induced coma.
"It seems crazy," Thompson told NBC. "If I'd had that money after the coma, if I'd had it all along, I could have had a place for me and my daughter, but now because she doesn't live with me it's impossible to get us back together until I can get work again. I don't know when that will be."
Wessler's piece, which goes into much more detail on the way stringent work requirements and archaic systems led to Thompson's nightmare, is worth reading in full. It brought to mind a story Vox published recently, by Andrea Louise Campbell, on how Medi-Cal, California's version of Medicaid, is forcing her brother's family to stay poor in order to afford the care needed by his wife, who was in a car accident that left her a quadriplegic.
"This is how things will be indefinitely," writes Campbell. "In order to get poor people's health insurance, Dave and Marcella must stay poor, forever." They are limited to $3,150 in assets. They can't save for retirement or use tax-free accounts to put away money for their son's college education. For them, getting richer means being bankrupted by health-care costs.
Any program that makes fine distinctions between the deserving and the undeserving will sometimes make mistakes. Those mistakes can be corrected, and if they occur too often, the fix can be written into the rules. The problem here is that there isn't just one program. There is an almost endless array of them, and that makes the rules of any one hard to understand — and even harder to fix.
As Campbell writes, "Medi-Cal is a collection of more than 100 programs, each with its own income methodology and rules." Thompson's problems came because of the way the particular rules and computer systems being used by three programs in Ohio collided to destroy her life. These programs are often too small for any one of them to make the same mistake too many times and too understaffed to be able to respond quickly or effectively to individual cases. And, for the most part, these programs are mostly used by people journalists rarely know, or meet, so there's little political pressure or media outcry over their failings.
It's enough to make you support a universal basic income.