♪ ♪
[CHEERS AND APPLAUSE]
John: WELCOME, WELCOME,
WELCOME TO "LAST WEEK TONIGHT!"
I'M JOHN OLIVER.
THANK YOU SO MUCH FOR JOINING
US.
IT HAS BEEN A BUSY WEEK.
THE WHITE HOUSE HOSTED THE PRIME
MINISTER OF JAPAN, OJ SIMPSON
DIED-- MAY HIS MEMORY BE A
BLESSING.
AND SOUTH KOREA HELD
PARLIAMENTARY ELECTIONS.
AND IF YOU'VE NEVER SEEN SOUTH
KOREAN ELECTION COVERAGE BEFORE,
THEY GO ALL OUT WITH THE
GRAPHICS.
ONLY 300 SEATS ARE AVAILABLE
ON THE TRAIN, AND ONLY ONE SEAT
IS AVAILABLE FOR GYEONGGI HANAM
GAP.
DEMOCRATIC PARTY CHU MI-AE
VERSUS PEOPLE'S POWER LEE YONG.
CANDIDATE LEE YONG IS CURRENTLY
IN FIRST PLACE WITH 71.4% OF THE
VOTE.
WILL AHN CHEOL-SOO'S RUN
CONTINUE?
CANDIDATE LEE KWANG-JAE ENTERS
THE RACE IN SEONGNAM BUNDANG
GAP.
AHN CHEOL-SOO, PEOPLE'S POWER,
CURRENTLY IN FIRST PLACE WITH
62%.
John: WOW, THIS MAY BE THE
FIRST TIME I'M GOING TO SAY THIS
AND ACTUALLY MEAN IT, BUT COOL!
THEY USED CANDIDATES IN SOUTH
KOREA'S PARLIAMENTARY ELECTIONS
TO RECREATE THE CLIMAX OF
"MISSION IMPOSSIBLE: DEAD
RECKONING PART ONE," AND THEY
WENT ALL OUT.
THEY EVEN HAD A CANDIDATE
PARACHUTING DOWN TOWARDS THE
TRAIN AND KICKING IN THROUGH A
WINDOW, AND OTHERS FLYING AROUND
WITH JET PACKS, WHILE STILL
OTHER THEMED COVERAGE HAD
CANDIDATES COLLECTING BALLOTS IN
BUCKETS ON THEIR HEADS, ALL
WHILE A GIANT FACELESS BEAR WENT
SURFING AND ROAMED THE
COUNTRYSIDE, BEFORE LOOMING
BEHIND TWO PRESENTERS,
PRESUMABLY FIGURING OUT WHICH
ONE TO EAT FIRST.
THAT IS MAGNIFICENT.
AND WHAT DO WE GET INSTEAD?
STEVE KORNACKI WITH HIS SLEEVES
ROLLED UP TOUCHING A SCREEN?
WE'RE DOING THIS WRONG!
WE'RE DOING ALL OF THIS WRONG!
AND WHILE I'D LOVE TO TALK ABOUT
SOUTH KOREAN ELECTION GRAPHICS
ALL NIGHT, SADLY, WE HAVE TO
TURN TO ARIZONA.
BECAUSE THIS WEEK, IT DID THIS.
THE ARIZONA SUPREME COURT
RULED TODAY THAT A NEAR TOTAL
ABORTION BAN ON THE BOOKS IN
ARIZONA SINCE THE CIVIL WAR IS
ENFORCEABLE.
UNDER THE LONG-DORMANT 1864 LAW,
ABORTION IS A FELONY.
PERFORMING OR ASSISTING A WOMAN
WITH HAVING ONE IS PUNISHABLE BY
IMPRISONMENT.
John: YEAH, ALL OF THAT IS
HORRIFYING, INCLUDING THE FACT
THAT ANY KIND OF MEDICAL
PROCEDURE IS BEING DICTATED BY A
LAW FROM THE 1800S-- AN ERA
WHEN DOCTORS PRESCRIBED, AND
THIS IS TRUE, CHLOROFORM FOR
ASTHMA, COCAINE FOR HAY FEVER,
AND TOBACCO SMOKE ENEMAS FOR
CHOLERA.
AND BY THE WAY, NO, THANK YOU.
I'LL JUST GO AHEAD AND DIE FROM
THE CHOLERA IF IT'S ALL THE SAME
TO YOU.
THE POINT IS, IT WAS CLEARLY A
DIFFERENT ERA BACK THEN-- AS A
CNN ANCHOR TRIED, UNNECESSARILY,
TO EXPLAIN TO ONE OF HIS GUESTS.
YOU'RE A REPUBLICAN
STRATEGIST, DO YOU REALLY WANT
STATES GOING BACK TO CIVIL
WAR-ERA LAWS ON REPRODUCTIVE
FREEDOM?
I MEAN, WOMEN DIDN'T HAVE THE
RIGHT TO VOTE AT THAT POINT.
THIS SOUNDS LIKE KRYPTONITE.
THIS SOUNDS TOXIC FOR
REPUBLICANS ACROSS THE COUNTRY.
JIM, I DON'T WANT STATES
GOING BACK TO PRE-CIVIL WAR ON
ANY ISSUE, FOR OBVIOUS REASONS
HERE, RIGHT?
POINT TAKEN.
John: YEAH, I HOPE THE
POINT'S TAKEN!
I LOVE THE CLUELESSNESS OF
LOOKING AT A BLACK MAN AND
SAYING THAT THE 1860S WERE BAD
BECAUSE "WOMEN DIDN'T HAVE THE
RIGHT TO VOTE."
TRUE, BUT ALSO: MAYBE NOT THE
WORST THING PEOPLE DIDN'T HAVE
THE RIGHT TO DO BACK THEN.
IT'S WORTH TAKING A MOMENT ON
JUST HOW ARCANE THIS LAW REALLY
IS.
IT WAS WRITTEN AS PART OF THE
FIRST SET OF LAWS FOR THE
ARIZONA TERRITORY, WHICH ALSO
LEGALIZED CONSENSUAL SEX WITH A
10-YEAR-OLD, AND SPELLED OUT
THE CRIME OF "EXCUSABLE
HOMICIDE," WHICH INCLUDE
SITUATIONS LIKE WHEN DEATH
OCCURS WHILE "A PARENT IS
MODERATELY CORRECTING HIS
CHILD."
SO JUST TO RECAP 19TH
CENTURY ARIZONA LAW: ABORT A
FETUS?
FELONY.
SLEEP WITH A FIFTH-GRADER?
FINE.
MURDER YOUR CHILD FOR PISSING
YOU OFF?
THAT'S OKAY, AS LONG AS YOU'RE
MODERATE AND DON'T MAKE IT INTO
A WHOLE THING.
NOW, IT'S UNCLEAR EXACTLY WHEN
ARIZONA'S ABORTION BAN WILL GO
INTO EFFECT.
WHAT IS CLEAR IS THAT THIS IS
NOT SOMETHING THE MAJORITY OF
ARIZONA CITIZENS WANTS, AS POLLS
TWO YEARS AGO SHOWED 62% OF
VOTERS THERE BACKED MAKING
ABORTION LEGAL.
AND THE CURRENT RISING ANGER IS
WHY MANY REPUBLICANS ARE NOW
FRANTICALLY TRYING TO DISTANCE
THEMSELVES FROM THIS LAW,
INCLUDING KARI LAKE-- CURRENT
SENATE CANDIDATE AND
POSSESSOR OF BIG "LOCAL REAL
ESTATE AGENT" ENERGY.
SHE SAID THIS WEEK THAT SHE
OPPOSED THE RULING.
AND I GUESS THAT WOULD CARRY
SOME WEIGHT, JUST AS LONG AS SHE
HADN'T DONE AN INTERVIEW IN
WHICH SHE SUPPORTED THAT LAW,
EVEN SPECIFICALLY CITING ITS
NUMBER.
I'M INCREDIBLY THRILLED THAT
WE ARE GOING TO HAVE A GREAT LAW
THAT'S ALREADY ON THE BOOKS.
I BELIEVE IT'S ARS 13-3603, SO
IT WILL PROHIBIT ABORTION IN
ARIZONA EXCEPT TO SAVE THE LIFE
OF A MOTHER.
John: LOOK, IF YOU'RE GONNA
BACKTRACK ON SOMETHING, AT LEAST
DOUBLE CHECK YOU HAVEN'T SAID
THE EXACT OPPOSITE INTO A
MICROPHONE FOR SOMETHING CALLED
"THE CONSERVATIVE CIRCUS."
WHICH I KNOW SOUNDS LIKE
SOMETHING MSNBC WOULD TRY TO
USE AS A SICK BURN FOR TRUMP'S
MOTORCADE OR WHATEVER, BUT IT'S
ACTUALLY JUST SOME GUY'S
PODCAST.
BUT IT'S GOING TO BE HARD FOR
STATE REPUBLICANS TO DISTANCE
THEMSELVES FROM ALL THIS.
BECAUSE JUST BEFORE ROE WAS
STRUCK DOWN, THE STATE
LEGISLATURE ACTUALLY PASSED A
BILL WHICH EXPLICITLY AFFIRMED
THE VALIDITY OF THE 1864 BAN.
SO THEY KNEW THAT AS SOON AS ROE
WAS OVERTURNED, THAT BAN WAS
LIKELY TO BECOME LAW.
AND YET, A STATE SENATOR WHO
VOTED FOR THAT BILL, SHAWNNA
BOLICK, WAS QUICK TO CALL FOR A
REPEAL OF THE ABORTION BAN.
WHICH WOULD ALREADY BE HARD TO
TAKE, BEFORE YOU LEARN THAT HER
HUSBAND IS ACTUALLY ONE OF THE
STATE SUPREME COURT JUSTICES WHO
VOTED TO REVIVE IT.
AND WHILE IT'S NOT STRICTLY
RELEVANT, YOU SHOULD KNOW HE
ALSO ONCE DID THIS.
AN ARIZONA SUPREME COURT
JUSTICE ACCUSED OF RACISM AFTER
AN OLD VIDEO SURFACES ON SOCIAL
MEDIA.
IN THE CLIP, JUSTICE CLINT
BOLICK IS SEEN SINGING TO A
CROWD WEARING A WIG WITH
DREADLOCKS AND CALLING HIMSELF
"RASTA CLINT."
AND I DON'T LIKE TYRANNY.
SO I FIGHT FOR FREEDOM, FREEDOM,
FREEDOM, ALL THE LONG DAY.
John: OKAY.
HARD TO HEAR "FREEDOM
FREEDOM FREEDOM" FROM THAT MAN
IN ANY CIRCUMSTANCES, BUT
ESPECIALLY THIS ONE.
NOW, HE JUSTIFIED THAT BY SAYING
"I AM A FAN OF REGGAE MUSIC."
SOMETHING NOT ON DISPLAY THERE.
WITH HIS INJURED ARM, HE LOOKS
LESS LIKE A REGGAE MUSICIAN AND
MORE LIKE HE'S STARRING IN A
RACIST COMMUNITY THEATER
PRODUCTION OF "DEAR EVAN
HANSEN."
BUT SHAWNNA BOLICK ISN'T THE
ONLY LAWMAKER BACKPEDALING,
ANOTHER STATE SENATOR WHO VOTED
FOR THAT BILL, T.J. SHOPE,
JUSTIFIED HIS VOTE THIS
WEEK LIKE THIS.
I DON'T KNOW THAT ANY OF US
REALLY ACTUALLY BELIEVED THAT
ROE V. WADE WAS GOING TO BE
OVERTURNED.
SO IT WAS DEFINITELY MORE OF A
THEORETICAL, I GUESS, THAN AN
ACTUAL.
SO YOU VOTE, YOU VOTE A CERTAIN
WAY.
I HAVE NO REGRETS.
YOU VOTE A CERTAIN WAY BASED ON
THE INFORMATION THAT YOU HAVE AT
THE TIME.
John: YEAH, BUT YOU HAD ALL
THE INFORMATION AT THE TIME.
THE LAW WAS LITERALLY PASSED IN
ANTICIPATION OF THE OVERTURN OF
ROE.
SO THAT IS BULLSHIT.
BUT I GET THAT HE'S IN A
QUANDARY, THERE.
IMAGINE HAVING A PROBLEM THAT
STARTED OUT AS THEORETICAL AND
SUDDENLY BECAME ACTUAL, EVEN IF
YOU DIDN'T REALLY WANT IT TO.
THAT COULD COMPLETELY FUCK UP
YOUR WHOLE LIFE, COULDN'T IT?
IF ONLY THERE WERE SOME OBVIOUS
PARALLEL WE COULD USE TO
ILLUSTRATE HOW FRUSTRATING THAT
WOULD BE!
THIS ARIZONA DECISION IS SO
TOXIC, EVEN DONALD TRUMP THIS
WEEK KNEW ENOUGH TO TRY AND
CONDEMN IT.
DID ARIZONA GO TOO FAR?
YEAH, THEY DID.
AND THAT'LL BE STRAIGHTENED OUT.
AS YOU KNOW IT'S ALL ABOUT
STATE'S RIGHTS.
IT'LL BE STRAIGHTENED OUT.
I'M SURE THAT THE GOVERNOR AND
EVERYBODY ELSE ARE GOING BRING
IT BACK TO REASON AND THAT'LL BE
TAKEN CARE OF VERY QUICKLY.
John: OKAY, THERE'S A LOT TO
HATE THERE, FROM BLAMING ARIZONA
FOR A MESS HE LARGELY CREATED TO
INVOKING "STATE'S RIGHTS," A
PHRASE FAMOUSLY ASSOCIATED WITH
PEACEFUL COMPROMISE.
BUT DESPITE TRUMP'S REASSURANCES
THERE, THE ARIZONA LEGISLATURE
HAD THE CHANCE TO REPEAL THE BAN
ON THURSDAY MORNING, AND THEY
CHOSE TO ADJOURN WITHOUT TAKING
ANY ACTION.
AND THAT'S THE THING--
REPUBLICANS OWN THIS.
THEY GOT WHAT THEY WANTED,
OVERTURNED ROE V. WADE, AND NOW
THEY HAVE TO DEAL WITH THE
CONSEQUENCES OF THAT.
WHICH HOPEFULLY WILL BE
RIGHTFULLY FURIOUS CONSTITUENTS
TURNING THEM OUT OF OFFICE.
BECAUSE EVERYONE WE'VE MENTIONED
TONIGHT IS ON THE BALLOT IN
NOVEMBER-- EVEN "RASTA CLINT"
AND ARIZONA IS LIKELY TO ALSO
HAVE A REFERENDUM ON ABORTION
RIGHTS THEN, TOO.
SO ARIZONANS HAVE JUST SEVEN
MONTHS TO ENSURE THEIR VOICES
GET HEARD.
AND BY THE WAY, CABLE NEWS?
THAT MEANS YOU ALSO HAVE SEVEN
MONTHS TO MAKE SURE THAT, COME
ELECTION TIME, YOUR GRAPHICS ARE
UP TO THE TASK.
BECAUSE THE BAR HAS BEEN RAISED.
AND NOW, THIS.
Announcer: AND NOW,
PEOPLE ON TV ARE KIND OF BEING
DICKS TO CICADAS.
IT'S THE RETURN OF SOME VERY
OLD CREEPY-CRAWLY NOISY INSECTS.
THE MASSIVE INVASION OF THESE
GUYS.
CICADAS.
IT'S THAT TIME.
NO!
YOUR THOUGHTS?
THE CICADAS.
THEY ARE ANNOYING.
IT'S BECAUSE THEY'RE ANNOYING,
THEY ARE ALLOWED THE ARTIST
BECAUSE THEY ARE DISGUSTING TO
LOOK AT.
THOSE THINGS GROSSED ME OUT.
I HATE THE NOISE THEY MAKE.
GET THAT OFF THE SCREEN.
THEY ARE REALLY UGLY LOOKING.
SIX LEGGETT WING TO HORRORS
YEAH, THEY'RE KIND OF GROSS.
THEY STINK TO HIGH HEAVEN.
THEY'LL DIE AND DISAPPEAR
AGAIN FOR ANOTHER 13 YEARS.
THEY'RE ANNOYING, DISGUSTING
TO LOOK AT.
BEADY-EYED.
SPEAKER REALLY UGLY
REALLY UGLY.
♪ ♪
[LAUGHTER]
John: MOVING ON.
OUR MAIN STORY TONIGHT CONCERNS
HEALTHCARE.
THE INDUSTRY THAT'S DONE
BASICALLY NO INNOVATING IN THE
PAST FIFTY YEARS WHEN IT COMES
TO BIG ROLLS OF PAPER YOU PLOP
YOUR BARE ASS ON.
SPECIFICALLY, WE'RE GOING TO
TALK ABOUT MEDICAID-- THE
PUBLIC INSURANCE PROGRAM THAT
PROVIDES HEALTH COVERAGE TO
PEOPLE WITH LOW INCOMES.
IT IS MASSIVE, REPRESENTING $1
OUT OF EVERY $6 SPENT ON HEALTH
CARE IN THE U.S. AND AS OF LAST
YEAR, AT LEAST, IT COVERED MORE
THAN 90 MILLION PEOPLE.
AND THE REASON I PUT THAT IN THE
PAST TENSE IS, THANKS TO
SOMETHING CALLED "THE MEDICAID
UNWINDING," THAT NUMBER HAS BEEN
PLUMMETING, AND FAST.
HUNDREDS OF THOUSANDS OF
AMERICANS ARE FINDING OUT THEY
MAY BE WITHOUT ALL IMPORTANT
MEDICAID COVERAGE.
IT'S A PROCESS THEY'RE
CALLING "MEDICAID UNWINDING."
THEY BASICALLY SAID, HEY,
SORRY, YOU DON'T HAVE INSURANCE.
WE TOOK YOU OFF THE BOOKS.
THEY DIDN'T EVEN TELL ME THAT
I WAS DROPPED.
WE HAVE PEOPLE THAT WE HAVE
SERVED FOR 15 TO 20 YEARS, AND
SUDDENLY THEY'RE DROPPED OFF
MEDICAID.
John: IT'S TRUE!
PEOPLE HAVE BEEN GETTING KICKED
OFF MEDICAID, SOMETIMES WITH NO
NOTICE.
IN THE LAST YEAR, NET ENROLLMENT
HAS DROPPED BY OVER 11 MILLION
INDIVIDUALS, INCLUDING NEARLY
FIVE MILLION CHILDREN.
AND JUST FOR ONCE, COULD THE
GOVERNMENT BLINDSIDE PEOPLE WITH
SOMETHING BENEFICIAL?
OR EVEN JUST FUN?
LIKE IF ONE DAY CONGRESS
ANNOUNCED THEY'D BE ADDING SHREK
TO MOUNT RUSHMORE?
THAT'D BE SOMETHING!
HE'D FIT IN SO NATURALLY, YOU
MAY NOT EVEN HAVE NOTICED, HE'S
IN THERE!
THERE HE IS!
AND THAT'S BETTER!
MT. RUSHMORE'S BETTER WITH SHREK
ON IT!
AND THE THING IS, ALL THIS WAS,
TO SOME EXTENT, BY DESIGN.
THE UNWINDING HAS ITS ORIGINS
DURING THE PANDEMIC.
BECAUSE WHEN COVID STARTED, ONE
EARLY RELIEF BILL HAD A
REQUIREMENT THAT STATES COULDN'T
KICK PEOPLE OFF MEDICAID.
WHICH WAS A GOOD IDEA, GIVEN
THERE WAS A GIANT, GLOBAL PUBLIC
HEALTH EMERGENCY AND MILLIONS OF
PEOPLE WERE LOSING WORK AND
GETTING SICK.
BUT AT THE END OF LAST MARCH,
THAT POLICY EXPIRED, AND FOR THE
FIRST TIME IN THREE YEARS,
STATES STARTED CHECKING PEOPLE'S
MEDICAID ELIGIBILITY AGAIN.
SOME STATES, LIKE GEORGIA, EVEN
TRIED PUT OUT PSA'S LIKE THIS
ONE, TO ALERT PEOPLE TO THE
CHANGES THAT WERE COMING.
HEY!
DID YOU KNOW THAT THERE MAY BE
SOME BIG CHANGES COMING TO YOUR
MEDICAID COVERAGE?
YOU'RE A TALKING PEACH.
SURE AM!
BUT THAT'S NOT IMPORTANT RIGHT
NOW.
WHAT'S IMPORTANT IS THAT YOU
- VISIT StayCovered. - GA.gov
AND UPDATE YOUR CONTACT
INFORMATION.
WHY?
WELL, THE FEDERAL PUBLIC
HEALTH EMERGENCY MAY BE ENDING
SOON, SO IT'S IMPORTANT THAT YOU
VERIFY AND UPDATE YOUR MEDICAID
ACCOUNT.
THANK YOU, MR. PEACHY.
OH, NO, THAT'S MY BROTHER.
I'M GEORGE.
John: IT'S EXCELLENT.
IT'S ALL GOOD, BUT MY FAVORITE
PART IS THE SHOPPER SAYING,
"YOU'RE A TALKING PEACH" AND IT
RESPONDING, "SURE AM, BUT THAT'S
NOT IMPORTANT RIGHT NOW."
UH, DISAGREE, TALKING PEACH!
YOU'RE A PIECE OF FRUIT THAT CAN
TALK.
THAT IS MAYBE THE MOST
SIGNIFICANT EVENT IN THE HISTORY
OF HUMANITY OR FRUIT.
IF THAT WERE TO HAPPEN, EVERY
GOVERNMENT WOULD HAVE TO RETHINK
THEIR FARMING POLICIES
IMMEDIATELY.
THE U.N. WOULD HOLD AN EMERGENCY
ASSEMBLY REGARDING THE "TALKING
PEACH" ISSUE.
AND HOW COULD ANYONE EVER BE
COMFORTABLE EATING FRUIT AGAIN,
KNOWING THAT AT ANY MOMENT, IT
COULD SUDDENLY GO, "OWWW!
STOP IT, YOU'RE HURTING ME!"
UNFORTUNATELY, DESPITE
MAGNIFICENT PSA'S LIKE THAT, NOT
EVERYONE HEARD ABOUT THE
MEDICAID UNWINDING, OR KNEW
EXACTLY WHAT THEY HAD TO DO TO
KEEP THEIR HEALTHCARE.
AND WHAT THAT'S MEANT IS THAT A
PROCESS THAT WAS THEORETICALLY
JUST ABOUT REMOVING PEOPLE WHO
NO LONGER QUALIFIED, HAS IN MANY
STATES TURNED INTO AN
ADMINISTRATIVE CLUSTERFUCK.
BECAUSE 69% OF THOSE WHO LOST
COVERAGE HAD IT TERMINATED FOR
PROCEDURAL REASONS, LIKE MISSING
PAPERWORK-- WITH THAT NUMBER
CLIMBING AS HIGH AS 93% IN
STATES LIKE NEVADA AND NEW
MEXICO.
THAT MEANS THE OVERWHELMING
MAJORITY WEREN'T NECESSARILY
INELIGIBLE.
THEY MIGHT'VE BEEN-- THEIR
CIRCUMSTANCES MIGHT'VE CHANGED.
BUT MOST LOST COVERAGE BECAUSE,
FOR ONE REASON OR ANOTHER, THEY
OR THEIR PARENT OR GUARDIAN
NEVER COMPLETED THE RENEWAL
PROCESS.
AND FOR MANY, THAT WASN'T THEIR
FAULT, BUT THE STATE'S.
TAKE THIS FLORIDA FAMILY, WHO
RECEIVED ZERO NOTICE THEY HAD TO
DO ANYTHING TO MAINTAIN THEIR
MEDICAID COVERAGE-- THEN
SUDDENLY FOUND THEY'D LOST IT,
AT THE WORST POSSIBLE TIME.
THE PAST 24 HOURS HAVE BEEN A
NIGHTMARE FOR LIZ ADAMS.
IN THAT TIME, SHE FOUND OUT HER
TWO KIDS WERE DROPPED FROM
MEDICAID.
THE NEWS ALSO CAME A DAY BEFORE
HER 7-YEAR-OLD SON, BRIAN, WAS
SET TO HAVE A BIOPSY PROCEDURE.
HE'S CURRENTLY IN REMISSION FOR
LEUKEMIA.
I'M MAD.
I AM MAD.
I DO NOT UNDERSTAND HOW THEY CAN
DO THIS TO A CHILD.
ADAMS TELLS US SHE NEVER GOT
A LETTER, A CALL, OR ANY OTHER
FORM OF COMMUNICATION FROM DCF.
NO ONE ELSE I CAN TALK TO,
NOT EVEN THE DOCTOR'S OFFICES
CAN DO ANYTHING.
THEY'RE LIKE WE CAN TELL THEM
THAT IT'S ABSOLUTELY NECESSARY
THAT HE NEEDS MEDICAL TREATMENT,
BUT WE CAN'T MAKE THEM GIVE YOU
YOUR INSURANCE BACK.
John: THAT IS TERRIBLE.
BECAUSE ANYONE COULD TELL YOU
THAT KID NEEDS MEDICAL
TREATMENT.
I COULD TELL YOU.
A MAGIC 8-BALL COULD TELL YOU.
THAT OCTOPUS THAT USED TO
PREDICT SOCCER MATCHES COULD
TELL YOU.
IF YOU PUT OUT TWO PIECES OF
FOOD, EACH LABELED WITH AN
OPTION OF WHAT TO DO, IT'D
IGNORE THEM BOTH AND WRITE IN
THE SAND, "WHAT THE FUCK IS
WRONG WITH YOU?
GIVE THE KID MEDICAID, YOU
MONSTERS."
BUT THE THING IS, EVERYTHING
ABOUT THE CURRENT UNWINDING IS
EMBLEMATIC OF MUCH LARGER ISSUES
WITH HOW WE'VE ALWAYS
ADMINISTERED MEDICAID.
SO GIVEN THAT, TONIGHT, LET'S
TALK ABOUT MEDICAID IN GENERAL.
IT WAS FIRST ENACTED IN 1965 AS
PART OF THE SAME LAW THAT
CREATED MEDICARE, THE PROGRAM
PROVIDING HEALTHCARE TO THE
ELDERLY.
AND FROM THE START, IT WAS SET
UP VERY DIFFERENTLY.
BECAUSE WHILE MEDICARE'S A
PURELY FEDERAL PROGRAM, OPEN
PRIMARILY TO AMERICANS 65 AND
OLDER, MEDICAID IS A PARTNERSHIP
BETWEEN THE FEDERAL GOVERNMENT
AND STATES, WHERE THE FEDERAL
GOVERNMENT CONTRIBUTES AT LEAST
$1 IN MATCHING FUNDS FOR EVERY
$1 A STATE SPENDS.
AND WHILE THERE ARE SOME FEDERAL
REQUIREMENTS STATES MUST MEET,
THEY GET A LOT OF LEEWAY IN
DECIDING HOW TO RUN THEIR
PROGRAMS.
AND WHEN DONE WELL, THE SERVICES
THEY PROVIDE CAN BE
TRANSFORMATIVE-- FOR INSTANCE,
MEDICAID CAN PAY FOR PEOPLE WITH
DISABILITIES TO HAVE HOME HEALTH
WORKERS COME AND HELP WITH
MOBILITY AND DAILY LIVING.
WHICH IS HUGE-- AS THIS
ACTIVIST POINTED OUT A FEW YEARS
AGO, WHEN CUTS TO MEDICAID
SPENDING WERE BEING FLOATED.
MEDICAID PAID FOR MY SHOWER
TODAY, MADE IT SO I WAS ABLE TO
EAT BREAKFAST, HELPED ME PUT ON
MY CLOTHES.
I BREATHE BECAUSE OF MEDICAID,
MY VENTILATOR.
I MOVE THROUGH THE WORLD BECAUSE
OF A WHEELCHAIR FUNDED BY
MEDICAID.
MEDICAID TOUCHES EVERYTHING IN
MY LIFE.
IT MAKES EVERYTHING POSSIBLE.
John: EXACTLY, WHEN MEDICAID
WORKS, IT CAN BE AMAZING.
UNFORTUNATELY, IT OFTEN DOESN'T
WORK THAT WAY, WHICH YOU CAN
PROBABLY GUESS BY THE FACT WE'RE
TALKING ABOUT IT NOW.
IF THIS SHOW WAS SUPPOSED TO
MAKE YOU FEEL GOOD, IT WOULDN'T
BE HOSTED BY ME, IT'D BE HOSTED
BY STANLEY TUCCI.
CAN YOU IMAGINE?
YOU'D BE WATCHING AN IMPOSSIBLY
HORNY 30 MINUTE DEEP DIVE ON
NEGRONIS.
THAT'S A BETTER SHOW.
I WISH THIS WERE THAT SHOW.
YOU WISH THIS WERE THAT SHOW.
BUT IT JUST ISN'T.
THE THING IS, NOT ALL STATES
OFFER CARE LIKE THAT, OR MAKE IT
EASY TO GET.
BUT THERE'S ACTUALLY AN EVEN
BIGGER PROBLEM HERE, WHICH THAT
IN GENERAL, EVEN FOR THOSE WHO
QUALIFY FOR MEDICAID, IT CAN BE
INCREDIBLY DIFFICULT TO ACCESS.
AND THE PROBLEMS BEGIN WITH
BASIC ADMINISTRATIVE FUCKUPS--
LIKE WHAT HAPPENED TO THIS
1-YEAR-OLD IN FLORIDA.
RAVEN RECEIVED A MEDICAID
HEALTH INSURANCE CARD, WHICH, BY
THE WAY, HAS HER CORRECT DATE OF
BIRTH ON IT.
BUT THE STATE KEPT REJECTING IT
WHEN HER DOCTOR TRIED TO RUN IT
ON GROUNDS SHE'S NOT YET BORN.
SHE IS NOT BORN.
SHE IS 13-MONTHS-OLD, ALIVE, BUT
SHE IS NOT BORN.
SHE IS STILL APPARENTLY A FETUS
IN MY WOMB.
SO, I JUST PRAY SHE DOESN'T GET
HURT OR DOESN'T GET SEVERELY
SICK BECAUSE I'M-- I'M OUT OF
LUCK.
THEY'VE GOT COPIES OF HER BIRTH
CERTIFICATE, HER SOCIAL SECURITY
CARD, EVERYTHING TO PROVE SHE
WAS BORN, INCLUDING BEING
PHYSICALLY THERE.
John: WOW.
THAT FAMILY ACTUALLY WENT $2,000
INTO DEBT PAYING FOR ROUTINE
CARE FOR THEIR CHILD, WHILE THE
STATE TRIED TO FIGURE OUT IF SHE
EXISTED OR NOT.
WHICH IS RIDICULOUS.
IF YOU WANT TO KNOW IF SOMEONE
WAS BORN, HERE'S A QUICK TRICK:
JUST ASK, "WERE YOU BORN?"
IF THEY SAY "YES," THEY WERE
BORN.
IF THEY SAY "NO," THEY WERE
BORN.
AND IF THEY JUST STARE BLANKLY
AT YOU, THEY WERE BORN.
I'VE MADE THIS INTO A DECISION
TREE, BUT IT DOESN'T FEEL LIKE
IT SHOULD HAVE BEEN NECESSARY.
FOR YEARS, PEOPLE TRYING TO
ACCESS MEDICAID IN THEIR STATE
HAVE HAD TO NAVIGATE THROUGH
POORLY DESIGNED WEBSITES, LONG
WAIT TIMES, AND COMPLEX FORMS
AND NOTICES.
AND THOSE BURDENS HAVE A REAL
EFFECT.
EVEN BEFORE THE CHAOS OF THE
UNWINDING, IN 2022, ABOUT A
QUARTER-- A QUARTER-- OF
UNINSURED PEOPLE ELIGIBLE FOR
MEDICAID WERE NOT ENROLLED IN
IT, OFTEN DUE TO ENROLLMENT
BARRIERS.
AND THE THING ABOUT MEDICAID IS,
YOU DON'T JUST HAVE TO GO
THROUGH THAT CIRCUS ONCE.
YOU HAVE TO RENEW YOUR COVERAGE
EVERY YEAR, WHICH CAN BE
INCREDIBLY ONEROUS.
AT ONE POINT TENNESSEE WAS
SENDING FAMILIES WHO WANTED TO
RENEW THEIR MEDICAID A
QUESTIONNAIRE THAT COULD BE AS
LONG AS 47 PAGES, AND THE STATE
COULD BE CARELESS ABOUT DOING
THAT, AS ONE FAMILY LOST
COVERAGE AFTER THEIR RENEWAL
PACKET WAS MAILED TO A HORSE
PASTURE.
BECAUSE HORSES AREN'T
ELIGIBLE FOR MEDICAID.
THEY GET HEALTHCARE THROUGH A
DIFFERENT PROGRAM, CALLED THE
GLUE FACTORY.
AND LOOK, GLITCHES CAN OCCUR IN
ANY SYSTEM.
AND THEY CAN HAPPEN MORE OFTEN
IN GOVERNMENT PROGRAMS, WHICH
TEND TO BE UNDERFUNDED,
UNDERSTAFFED, AND OPERATING ON
ANCIENT TECHNOLOGY.
AND I'M NOT TRYING TO RAIN SHIT
DOWN ON HONEST GOVERNMENT
EMPLOYEES WHO HAVE TO PROCESS AN
ENDLESS BARRAGE OF PAPERWORK.
I HAVE TOTAL SYMPATHY FOR HOW
DEMANDING THOSE JOBS ARE.
IN FACT, THERE'S EXACTLY ONE
GROUP OF GOVERNMENT EMPLOYEES
IT'S OKAY TO MAKE FUN OF FOR
SOMETHING THAT'S NOT THEIR
FAULT, AND THAT'S SECRET SERVICE
AGENTS, FOR THE FACT THEY'RE
CONSTANTLY BEING BITTEN BY THE
PRESIDENT'S DOG.
I'M SORRY, I HOPE THEY'RE ALL
FINE, BUT I'M STILL GONNA LAUGH
EVERY TIME I THINK ABOUT IT.
BUT THERE ARE TIMES WHEN IT
FEELS LIKE THE OBSTACLES TO
GETTING MEDICAID HAVE BEEN PUT
THERE DELIBERATELY, SO STATES
CAN KEEP THOSE THEY SEE AS
"UNDESERVING" OFF THE ROLLS.
BECAUSE STATES GET A LOT OF
DISCRETION IN DECIDING WHO IS,
AND ISN'T, ELIGIBLE FOR
BENEFITS.
AND IN SOME, THEY KEEP THE BAR
TO QUALIFY TROUBLINGLY HIGH, ALL
WHILE ADOPTING A DEEPLY
MORALIZING TONE.
TAKE WHAT HAPPENED WHEN THE
TRUMP ADMINISTRATION GAVE SOME
STATES PERMISSION TO IMPLEMENT
WORK REQUIREMENTS AS A CONDITION
OF MEDICAID ELIGIBILITY.
SOME WERE EAGER TO PUT THOSE
INTO PLACE, LIKE THIS STATE REP
IN KENTUCKY.
WHY DO YOU THINK THE WORK
REQUIREMENTS ARE GOING TO WORK?
IT'S AN INCENTIVE.
I THINK THAT THERE IS DIGNITY IN
WORK.
IT'S SOMETHING THAT IS ABOUT
THE-- THE HUMAN PERSON.
SO OFTEN I SAY THAT OUR--
OUR-- SOMETIMES OUR CHARITY
BECOMES TOXIC TO PEOPLE.
IN OUR WANTING TO HELP THEM,
SOMETIMES WE'VE-- WE'VE HURT
THEM.
John: OKAY, PUTTING ASIDE
THAT CALLING ACCESS TO BASIC
HEALTHCARE "CHARITY" IS
IMMEDIATELY INFURIATING.
"IT'S SOMETHING THAT'S ABOUT THE
HUMAN PERSON?"
ARE YOU SURE THAT'S A SENTENCE?
IT SOUNDS MORE LIKE SOMETHING A
DRUNK ALIEN WOULD SAY WHILE
TRYING TO DESCRIBE A DAVID
FOSTER WALLACE BOOK.
"IT'S SOMETHING THAT IS ABOUT
THE HUMAN PERSON.
YOU KNOW, THE HUMANOIDS, AND
THEIR PERSON FEELINGS."
BUT IT'S WORTH NOTING THAT THE
MAJORITY OF ADULTS ON
MEDICAID-- ABOUT 63%-- ARE
ALREADY WORKING FULL OR
PART-TIME.
THOSE WHO AREN'T, ARE GENERALLY
IN SCHOOL OR MIGHT HAVE A
DISABILITY PREVENTING THEM FROM
WORKING, ONLY LEAVING A SMALL
PERCENTAGE OF THE POPULATION TO
WHOM THE POLICIES COULD EVEN
APPLY.
NOW, FORTUNATELY, KENTUCKY
DIDN'T END UP IMPLEMENTING A
WORK REQUIREMENT.
BUT UNFORTUNATELY, ARKANSAS
DID.
AND IT DIDN'T GO GREAT.
FOR A START, SIMPLY COMPLYING
WITH IT WAS A HASSLE.
BENEFICIARIES HAD TO REPORT
THEIR WORK ACTIVITIES ON A
GLITCH-PLAGUED WEB PORTAL, AND
SIX MONTHS IN, 18,000 ARKANSANS
HAD BEEN STRIPPED OF MEDICAID
AND LOCKED OUT OF REAPPLICATION
UNTIL THE FOLLOWING YEAR.
AND FOR SOME OF THOSE PEOPLE--
WHO, AGAIN, WERE ALREADY WORKING
LOSING ACCESS TO HEALTHCARE
COMPLETELY UPENDED THEIR LIVES.
LIKE THIS MAN, WHO HAD A JOB AT
A CHICKEN PLANT.
ADRIAN MCGONIGAL'S LIFE IS
COMING UNDONE.
HE BECAME ONE OF THE PEOPLE THAT
THE STATE HAS BOOTED FROM THE
MEDICAID ROLLS IN THE LAST THREE
MONTHS.
HE DISCOVERED THIS ONLY WHEN HE
WENT TO FILL PRESCRIPTIONS AT
THIS DRUG STORE, AND THE
PHARMACIST TOLD HIM, "SORRY,
YOUR COVERAGE HAS BEEN
CANCELED."
AND THAT IT WAS GOING TO BE
LIKE $340 FOR ONE OF THE
MEDICATIONS, AND LIKE $80 FOR
THE OTHER ONE.
SO, HE LEFT EMPTY-HANDED.
THIS WAS A BIG DEAL, BECAUSE
McGONIGAL HAS SEVERE COPD, A
CHRONIC LUNG DISEASE THAT MAKES
IT DIFFICULT TO BREATHE.
WITHOUT HIS MEDS, HE LANDED IN
THE HOSPITAL MULTIPLE TIMES AND
MISSED A LOT OF WORK.
HIS SUPERVISOR TRIED TO
ACCOMMODATE HIM, BUT HE WASN'T
HEALTHY ENOUGH TO PERFORM HIS
JOB.
SO HE LOST IT.
John: YEAH, THE WORK
REQUIREMENT FOR MEDICAID CAUSED
SOMEONE WHO WAS ALREADY ON
MEDICAID AND WORKING, TO LOSE
BOTH MEDICAID AND THEIR WORK.
WHICH HAS TO BE THE MOST
UPSETTING THING THAT'S EVER
HAPPENED IN A CHICKEN PROCESSING
PLANT, APART FROM ALL THE OTHER
THINGS THAT HAPPEN IN THERE ON
PURPOSE.
AND WHILE ARKANSAS DITCHED THAT
WORK REQUIREMENT AFTER LESS THAN
A YEAR, GEORGIA HAS ONE RIGHT
AND IT'S PROVING JUST AS STUPID
AND JUST AS UPSETTING.
AND THAT'S THE THING, SO MUCH OF
THE TALK AROUND MEDICAID SEEMS
TO CENTER ON THE FEAR THAT
SOMEONE, SOMEWHERE, MIGHT BE
"GAMING THE SYSTEM."
YOU HEAR IT ALL THE TIME.
THE PEOPLE IN MY DISTRICT
THAT WORK HARD, THAT STRUGGLE TO
PAY THEIR HEALTH CARE, THEY'RE
VERY FRUSTRATED WHEN THEY SEE
SOMEONE THEY KNOW IN THEIR SMALL
TOWN, WHERE EVERYBODY KNOWS
EVERYBODY, THEY SEE SOMEONE
THAT'S NOT WORKING.
WHY SHOULD SOMEBODY HAVE TO
GO TO WORK EVERY DAY AND PAY
TAXES TO PROVIDE SOMETHING TO
SOMEONE WHO COULD DO THE SAME
THING BUT CHOOSES NOT TO?
I DON'T THINK IT'S
UNREASONABLE TO SAY THAT
ABLE-BODIED PEOPLE WHO ARE
WORKING AGE, WHO ARE NOT
DISABLED, WHO ARE NOT SENIORS
SHOULD HAVE TO GO TO WORK IF
THEY WANT SOMEONE ELSE TO PAY
FOR THEIR HEALTHCARE.
John: LOOK, IT GOES WITHOUT
SAYING THAT I DISAGREE WITH MATT
GAETZ ON A LOT OF ISSUES: HIS
STANCE ON IMMIGRATION, HIS
STANCE ON GUN CONTROL, HIS
STANCE ON HANGING AROUND WITH
TEENAGE GIRLS-- WE DON'T SEE
EYE TO EYE ON MOST THINGS.
BUT ON THIS, I PARTICULARLY
DISAGREE.
BECAUSE STATES ALREADY
AGGRESSIVELY MONITOR MEDICAID
ELIGIBILITY-- AND SOME OF THEIR
EFFORTS CAN BE DERANGED.
TAKE TENNESSEE.
THEIR STATE INSPECTOR GENERAL
HAS A "MEDICAID FRAUD UNIT" THAT
POSTS THE NAMES AND PHOTOS OF
PEOPLE IT ARRESTS ON A
GOVERNMENT WEBSITE AND SOCIAL
MEDIA, WITH SOME ENDING UP ON A
"MOST-WANTED" LIST.
THIS WOMAN WAS CHARGED WITH A
FELONY FOR SUPPOSEDLY RECEIVING
TENNESSEE BENEFITS WHILE LIVING
IN MISSISSIPPI.
AND WOUND UP HAVING TO PAY
$2,000 TO BOND OUT OF JAIL AND
EVEN MORE TO HIRE AN ATTORNEY,
ALL JUST TO SHOW THAT SHE'D NOT
IN FACT COMMITTED "MEDICAID
FRAUD"-- HER DRIVER'S LICENSE
JUST HAD AN OUTDATED MISSISSIPPI
ADDRESS.
SO HER ONLY REAL "CRIME" WAS NOT
WANTING TO STAND IN LINE AT THE
DMV FOR EIGHT HOURS.
THE HEAD OF THAT TENNESSEE UNIT
EVEN ACKNOWLEDGED IT COSTS FAR
MORE TO RUN THE FRAUD UNIT THAN
THE OFFICE WILL EVER RECOUP FROM
PEOPLE ON MEDICAID, WHO ARE
USUALLY LOW INCOME.
BECAUSE THE TOTAL WOULD AMOUNT
TO LESS THAN $900,000" COMPARED
TO THE OFFICE'S BUDGET OF $6.4
MILLION A YEAR.
AND LOOK, I'M NOT AN ACCOUNTANT
DESPITE HAVING RESTING "BUDGET
ANALYST" FACE.
BUT EVEN I KNOW THAT MAKES NO
FINANCIAL SENSE.
AND LOOK, I'M NOT SAYING
MEDICAID FRAUD DOESN'T EXIST--
IT DOES.
BUT FOR THE MOST PART, THE
COSTLIEST FRAUD ISN'T BEING
COMMITTED BY PATIENTS GETTING
CARE THEY MAY NOT TECHNICALLY BE
ELIGIBLE FOR.
IT'S PROVIDERS DOING SHIT LIKE
THIS.
A HUSBAND AND WIFE LIVING A
FAIRY TALE LIFESTYLE PAID FOR BY
ALL OF US.
OVER A 3 TO 4 YEAR, THEY WERE
TRUE JET SETTERS IN THEIR
PRIVATE $900,000 PLANE.
THE HARRON'S RAN TWO HEALTH
SERVICES IN NORTH CAROLINA.
THEY BILLED THE STATE'S MEDICAID
SYSTEM AT LEAST $17 MILLION.
MOST, IF NOT ALL, OF THE
PATIENTS THEY CLAIMED TO HELP
WERE ALREADY DEAD, THEIR NAMES
GLEANED FROM OBITUARIES AND
CROSS-CHECKED WITH THE MEDICAID
DATABASE.
John: THAT'S OBVIOUSLY
REPREHENSIBLE, BUT IF I COULD
JUST GIVE ONE QUICK NOTE TO THAT
NEWS STATION: EVERYONE KNOWS
WHAT DEAD PEOPLE ARE.
YOU DON'T HAVE TO SHOW B-ROLL OF
A CEMETERY FOR US TO UNDERSTAND
THE CONCEPT OF DEATH.
JUST LIKE WHEN YOU SAID THE
HARRONS RAN TWO HEALTH SERVICES,
YOU DIDN'T NEED TO SHOW STOCK
FOOTAGE OF A DOCTOR WRITING
SOMETHING DOWN ON A NOTEPAD.
BUT INTERESTINGLY, YOU DIDN'T DO
IT ALL THE TIME.
LIKE, WHEN YOU SAID THE PHRASE
"$17 MILLION DOLLARS," YOU
DIDN'T FEEL THE NEED TO SHOW
THIS STOCK FOOTAGE OF CASH
SLOWLY FALLING OUT OF THE AIR.
WHY NOT?
HOW ELSE WILL YOUR VIEWERS
UNDERSTAND WHAT MONEY IS?
AS IF ALL THAT WEREN'T BAD
ENOUGH, THAT GUY LIKED TO POST
HIS BUSINESS AFFIRMATIONS
ONLINE, INCLUDING "NEVER OUTLIVE
YOUR USEFULNESS", "DOING BIG
THINGS REQUIRES ONE NOT TO BE
STUCK ON THE LITTLE THINGS", AND
"I'M NOT DOING A BUSINESS THAT'S
NEW, I'M DOING A NEW WAY OF
DOING BUSINESS"-- A QUOTE HE
LOVED SO MUCH, HE POSTED IT A
SECOND TIME A MONTH LATER, BUT
IN RED TEXT INSTEAD OF YELLOW.
AND I'LL ADMIT-- IT DIDN'T
REALLY RESONATE WHEN I READ THE
YELLOW-TEXT-OVER-DARK-GREEN-BACK
GROUND VERSION, BUT ONCE I SAW
THE "RED"-TEXT-OVER-"NEON"-GREEN
ONE, I WAS LIKE...WOW, THAT'S SO
TRUE.
THAT'S TOTALLY WHAT HE'S DOING.
BUT THAT'S BY NO MEANS THE ONLY
CASE OF MEDICAID PROVIDERS
DEFRAUDING THE GOVERNMENT.
IN ARIZONA THERE WAS A GROUP OF
FAKE REHAB CENTERS THAT, FOR
YEARS, CLAIMED FRAUDULENT
REIMBURSEMENTS FOR PATIENTS WHO
WERE EITHER GETTING SERVICES
THEY DIDN'T NEED, OR NOT GETTING
THEM AT ALL-- REPORTEDLY TAKING
IN MORE THAN $2 BILLION FROM THE
STATE.
AND SOME OF THEIR SUBMISSIONS
REALLY SHOULD'VE RAISED RED
FLAGS, LIKE A BILL FOR ALCOHOL
REHABILITATION FOR A 4-YEAR-OLD.
WHICH IS A LITTLE DIFFICULT TO
BELIEVE.
IF TODDLER ALCOHOLISM WERE AN
ACTUAL PROBLEM IN THIS COUNTRY,
YOU'D HAVE DEFINITELY SEEN A TLC
SERIES ABOUT IT.
AND WHILE, IN BOTH OF THOSE
CASES, THE PROVIDERS WERE
EVENTUALLY CAUGHT, IT TOOK YEARS
FOR THAT TO HAPPEN.
AGAIN AND AGAIN, THE PRIORITY
SEEMS TO BE MAKING SURE NO
INDIVIDUAL GETS A PENNY MORE
HEALTH CARE THAN THEY "DESERVE,"
EVEN AS STATES ARE WEIRDLY
BLITHE ABOUT MUCH BIGGER AMOUNTS
OF MONEY FLOWING OUT THE DOOR TO
LARGE ORGANIZATIONS.
AND SPEAKING OF LARGE
ORGANIZATIONS THERE'S ONE LAST,
MASSIVE FLAW WITH OUR MEDICAID
SYSTEM.
AND IT HAS TO DO WITH MANAGED
CARE ORGANIZATIONS, OR MCO'S.
THESE ARE PRIVATE COMPANIES
STATES CONTRACT TO DELIVER AND
PAY FOR HEALTHCARE.
CURRENTLY, 72% OF MEDICAID
BENEFICIARIES ARE ENROLLED IN A
PLAN CARE OVERSEEN BY AN MCO.
AND IT'S BIG BUSINESS.
THE FIVE BIGGEST MCO'S ARE ON
THE FORTUNE 500, INCLUDING
CENTENE, WHICH HAS LONG BEEN A
FAVORITE OF THIS GUY.
CENTENE, YEAH, A HEALTHCARE
PLAN PROVIDER FOR GOVERNMENT
SPONSORED PROGRAMS LIKE
MEDICARE, MEDICAID.
THIS ONE'S A LONGTIME CRAMER
FAVORITE, IT'S BEEN OUT OF
FAVOR, BUT MICHAEL NEIDORF TELLS
SUCH A COMPELLING STORY.
MICHAEL NEIDORF, CENTENE,
WHAT A HORSE THAT THING IS.
YOU HAVE IMPRESSED ME OVER
THE YEARS AS SOMEONE WHO IS
REALLY OUT FOR THE CONSUMER TO
GET THE BEST HEALTH CARE.
YOU HAVE MICHAEL NEIDORF ON
ALL THE TIME.
NO, CENTENE.
I THINK THAT MICHAEL NEIDORFF
IS AMAZING.
BY THE WAY, HE LOOKS GREAT
FOR 77.
HE GOT, HE'S AMAZING AND HE'S
JUST ALSO A FANTASTIC CHARITABLE
MAN.
John: OKAY, YOU ALREADY KNEW
THAT CRAMER'S WRONG ABOUT THE
COMPANY, BUT BEFORE WE EVEN GET
TO THAT, I'LL POINT OUT THAT THE
GUY THEY JUST SAID LOOKED "GREAT
FOR 77" WAS ACTUALLY 79 AND--
MORE IMPORTANTLY-- DIED JUST
FOUR MONTHS LATER.
IT SEEMS ANY OPTIMISTIC
PREDICTION THAT JIM CRAMER'S
INVOLVED WITH IS ENOUGH TO KILL
A BUSINESS OR EVEN A PERSON.
SEEING HIM COMPLIMENT YOU ON TV
IS THE CLOSEST THING WE HAVE TO
WATCHING THE TAPE FROM
"THE RING" IN REAL LIFE.
AS FOR CENTENE ITSELF, THERE ARE
SERIOUS QUESTIONS ABOUT HOW IT'S
MADE SOME OF ITS MONEY.
IN 2021, AFTER OHIO SUED IT FOR
OVERBILLING MEDICAID, IT
SETTLED, AND PAID THE STATE $88
MILLION.
IN FACT, IT WENT ON TO SETTLE
SIMILAR ALLEGATIONS IN AT LEAST
19 STATES, FOR NEARLY $1
BILLION.
AND I WOULD ARGUE IF YOU'VE HAD
TO DO THAT, YOU MAY NOT DESERVE
TO EXIST AS A COMPANY ANYMORE,
LET ALONE HAVE WALL STREET'S
THIRSTIEST BUSINESS BOY GO
"HUBBA HUBBA AWOOGA" OVER YOUR
STOCK PRICE.
AND LOOK, FINANCIAL DAMAGE IS
ONE THING.
BUT THE MOST INFURIATING THING
ABOUT MCO'S IS THAT-- AS WITH
SO MANY PLAYERS IN OUR
FOR-PROFIT HEALTHCARE SYSTEM--
THEY'RE INCENTIVIZED TO CUT
COSTS AT THE EXPENSE OF
NECESSARY CARE.
BECAUSE MCO'S GET PAID A SET
MONTHLY AMOUNT PER PERSON--
MEANING THEY GET A FIXED RATE.
SO THEIR PROFIT IS WHATEVER THEY
DON'T SPEND ON PATIENTS.
AND YOU CAN PROBABLY SEE WHERE
THIS IS GOING.
IN STATE AFTER STATE, THERE'VE
BEEN HEARTBREAKING STORIES OF
MCO'S PRIORITIZING COST SAVINGS
OVER PATIENTS.
THERE'VE BEEN HEADLINES ABOUT IT
IN FLORIDA, HEADLINES IN TEXAS,
AND HEADLINES IN IOWA.
AND JUST TO FOCUS ON IOWA, IT
TRANSITIONED TO USING MCO'S TO
RUN ITS MEDICAID PROGRAM IN
2016, AND IN JUST ITS FIRST
THREE YEARS, THERE WAS A NEARLY
900% INCREASE IN MEMBERS BEING
ILLEGALLY DENIED SERVICES OR
CARE.
AND SOME OF THE COST-CUTTING WAS
ABSOLUTELY ENRAGING-- LIKE WHAT
HAPPENED WITH LOUIS FACENDA, WHO
HAS CEREBRAL PALSY AND WAS
LIVING WITH HIS MOTHER.
HE NEEDS A LOT OF CARE, WHICH
PRIOR TO THE SWITCH-OVER WAS
PROVIDED BY MEDICAID.
BUT ONCE AN MCO GOT INVOLVED, HE
LOST A LOT OF WHAT HE'D BEEN
GETTING, STARTING WITH HIS
MEDICATIONS.
IT WAS A NIGHTMARE.
IT WAS-- IT WAS LITERALLY A
NIGHTMARE.
WHAT AM I GONNA DO?
I CAN'T AFFORD ALL THAT
MEDICATION.
ALSO CUT WERE HIS DAILY NURSE
VISITS.
SO, FOR SIX WEEKS, LOUIS WENT
WITHOUT THE IN-HOME BATHING AND
DIAPER CHANGING HE HAD HAD FOR
YEARS.
HE WASN'T GETTING CHANGED
LIKE HE WOULD NORMALLY GET
CHANGED TWO OR THREE TIMES OR
MORE A DAY.
IT WASN'T JUST THE SERVICES,
IT WAS THE MENTAL PART OF HIS--
HIS STATE OF MIND, NOT
UNDERSTANDING WHY ALL THIS WAS
HAPPENING.
John: LOOK, THAT'S OBVIOUSLY
MADDENING.
AND IT DOESN'T GET ANY BETTER
WHEN YOU HEAR A DOCTOR AT
AMERIHEALTH, THE MCO THAT TOOK
OVER IN IOWA, EXPLAINING, IN A
HEARING ABOUT A SIMILAR PATIENT,
JUST WHAT THE CORPORATE THINKING
WAS ABOUT THE NECESSITY OF
KEEPING PEOPLE CLEAN.
PEOPLE HAVE BOWEL MOVEMENTS
EVERY DAY WHERE THEY DON'T
COMPLETELY CLEAN THEMSELVES, AND
WE DON'T FUSS OVER TOO MUCH.
PEOPLE ARE ALLOWED TO BE DIRTY.
YOU KNOW, I WOULD ALLOW HIM TO
BE A LITTLE DIRTY FOR A COUPLE
OF DAYS.
John: LOOK, I'LL BE HONEST,
WHEN I FIRST HEARD THAT, I
THOUGHT, "THAT HAS TO BE TAKEN
OUT OF CONTEXT.
THERE'S NO WAY A DOCTOR-- A
LICENSED PHYSICIAN-- WOULD
TESTIFY, IN A HEARING, THAT HE
THINKS IT'S OKAY IF PEOPLE SIT
IN THEIR OWN SHIT FOR DAYS."
SO WE GOT THE FULL HEARING, AND
I'M NOT GOING TO PLAY IT FOR
YOU, I'M JUST GOING TO TELL YOU
HE SAID IT, HE MEANT IT, AND
IT MADE ME WANT TO PUNCH A HOLE
IN THE WALL.
AND JUST WATCH WHAT HAPPENS WHEN
LOUIS AND HIS MOM WERE TOLD
ABOUT WHAT THAT DOCTOR JUST
SAID.
WHAT WOULD YOU SAY TO HIM IF
HE WAS HERE?
I WOULD SPIT IN HIS FACE, TO
BE HONEST.
YEAH.
RIGHT, LOUIS, YOU LIKE TO BE
CLEAN.
I THINK IT'S HORRIBLE.
I DON'T HAVE WORDS FOR THAT.
John: YEAH, I'M STRUGGLING
FOR WORDS, TOO.
I WILL SAY, LOUIS KIND OF NAILED
IT BY BLOWING THAT RASPBERRY--
AND I DID APPRECIATE THAT
REPORTER DOING A FULL "JIM FROM
THE OFFICE" LOOK TO CAMERA AND
NODDING.
BUT IF I ABSOLUTELY HAD TO PUT
IT TO WORDS, I'D SAY "FUCK THAT
DOCTOR WITH A RUSTY CANOE, I
HOPE HE GETS TETANUS OF THE
BALLS."
AND IF HE HAS A PROBLEM WITH MY
LANGUAGE THERE, I'D SAY, I'M
ALLOWED TO BE DIRTY.
PEOPLE ARE ALLOWED TO BE A
LITTLE DIRTY SOMETIMES.
APPARENTLY THAT'S DOCTOR'S
FUCKING ORDERS.
AND WHILE LEGALLY, I HAVE TO
TELL YOU, AMERIHEALTH WANTS ME
TO TELL YOU LOUIS DID GET THAT
SERVICE RESTORED, I'LL POINT
OUT: IT WAS ONLY "AFTER" HIS
STORY MADE THE NEWS.
LOOK, THE REALITY OF MEDICAID IS
THAT TOO OFTEN, IT'S HARD TO
GET, EASY TO LOSE, AND NOT A
PRIORITY FOR THE GOVERNMENT, OR
THE COMPANIES WE HIRE TO RUN IT.
SO WHAT CAN WE DO?
WELL, AS I'VE SAID BEFORE-- I
PERSONALLY THINK THE BIG
SOLUTION HERE IS TO ADOPT A
UNIVERSAL HEALTHCARE MODEL.
BUT IN THE MEANTIME, I'D ARGUE
BOTH THE CURRENT UNWINDING, AND
MEDICAID PROGRAMS IN GENERAL,
NEED TO BE RUN WITH
SIGNIFICANTLY MORE CARE AND
EFFICIENCY.
AND THERE ARE WAYS TO DO THAT.
FOR INSTANCE, WHEN IT COMES TO
DETERMINING ELIGIBILITY, MAYBE
RATHER THAN SENDING 47-PAGE
FORMS TO HORSES, STATES COULD
INSTEAD RELY ON INFORMATION THEY
ALREADY HAVE IN THEIR DATABASES.
THAT SEEMS LIKE IT WOULD MAKE
BIT MORE SENSE.
MICHIGAN'S ACTUALLY A GOOD
EXAMPLE HERE.
IT WORKED WITH A DESIGN
NONPROFIT TO RETOOL ITS
APPLICATION AND RENEWAL
PROCESSES FOR ALL PUBLIC
BENEFITS, AND THE RESULT WAS
THAT 95% OF RENEWALS WERE
SUBMITTED ON TIME, WITH A 60%
DROP IN USER ERRORS.
ON THE FEDERAL END, CONGRESS
COULD ENSURE THAT THE AGENCY
THAT ADMINISTERS MEDICAID HAS
THE RESOURCES IT NEEDS TO
OVERSEE STATE COMPLIANCE.
AND FINALLY, WHEN IT COMES TO
MCO'S, IF THEY'RE GOING TO
CONTINUE PLAYING A ROLE HERE,
THERE CLEARLY HAS TO BE WAY MORE
OVERSIGHT.
WITH PERFORMANCE REVIEWS BEING
THOROUGH AND PUBLIC, ESPECIALLY
WHEN IT COMES TO THINGS LIKE
DENIALS OF CARE.
AND UNTIL SUCH TIME AS WE DO ALL
THAT, THE VERY LEAST WE CAN DO
IS MAKE MEDICAID PSA'S THAT
ACTUALLY PREPARE PEOPLE FOR THE
REALITIES OF OUR CURRENT MESS OF
A SYSTEM.
♪ ♪
HEY, DID YOU KNOW YOU MIGHT
BE ELIGIBLE FOR MEDICAID?
YOU'RE A TALKING PEACH.
SURE M, BUT THAT'S NOT
IMPORTANT RIGHT NOW.
WHAT YOU MEAN, AND ALL
PEACHES ALWAYS TALK?
SURE WE COULD, BUT DON'T
FOCUS ON THAT BECAUSE I WANT TO
TALK TO YOU ABOUT MEDICAID.
IS ANYBODY ELSE SEEING THIS
TALKING PEACH?
THE PROBLEM IS DIFFERENT TO
PENDING ON WHERE YOU LIVE.
THE GOOD NEWS IS IN ALL STATES
GENERALLY LOW INCOME CHILDREN,
WOMEN, AND FAMILY ARE ELIGIBLE
FOR MEDICAID P.R. >> ARE THERE
GOING TO BE A BUNCH OF LOOPHOLES
OR SOMETHING?
YOU HAVE NO IDEA.
HE'S RIGHT, TAKE MY STATE
TAXES.
OH, MY GOD, THERE IS YOU.
WHAT IS NOTHING?
I'M A SWEET POTATO.
LET'S SAY YOU'RE A SINGLE MOM
WITH TWO KIDS.
IF YOU ARE MAKING OVER $344 A
MONTH, YOU'RE NOT ELIGIBLE FOR
MEDICAID AT ALL.
IT'S TRUE AND THEN GEORGIA IF
YOU DON'T HAVE KIDS, YOU BETTER
BE WORKING.
OTHERWISE YOU CAN'T GET
MEDICAID.
HEY, GOOD FOR YOU, YOU'RE NOT
RUNNING A CHARITY OVER THERE.
THERE IS DIGNITY WORK.
IT'S SOMETHING ABOUT THE HUMAN
PERSON.
HEY, Y'ALL, I'M FROM
LOUISIANA.
WHAT'S UP WITH THIS ONE'S
EYES?
YEAH, THIS ONE HAS WRONG EYES
EYES.
WE CHECK YOUR FINANCES EVERY
THREE MONTHS TO MAKE SURE YOU
HAVEN'T GOTTEN SOME OVERTIME OR
PICKED UP WORK.
GETS ONE, AND IN WYOMING, YOU CAN
QUALIFY FOR MEDICAID AT ALL!
NO MATTER WHAT YOUR INCOME IS!
THERE IS LITERALLY NO WAY TO
QUALIFY FOR IT!
OH, MY LORD, IS NOT TRUE?
OUT OF WORK AND MAKING MONEY?
YES?
THAT'S MESSED UP.
I AGREE WITH THE COCONUT,
THAT IS SUPER FUCKED UP.
COME OVER HERE, BUDDY, STAND
OVER ON THIS SIDE AWAY FROM THE
PRODUCE.
DON'T WORRY, HIS MEDICAID
COVERAGE WON'T BE CUT.
UNLESS YOU DON'T FILL OUT THE
PROPER PAPERWORK BUT MAYBE IF
YOU DO.
THERE'S A GLITCH IN THE SYSTEM
LIKE I DON'T KNOW, MAILING YOUR
FORM TO A HORSE PASTURE.
IT'S HAPPENED, Y'ALL!
HOW DID YOUR KID WAS REALLY
BORN ANYWAY?
EXCUSE ME?
IF THE KID WAS NOT BORN HE
DOESN'T GET MEDICAID.
PROVE HE WAS BORN!
[CHANTING "PROVE HE WAS BORN"]
PROVE HE WAS BORN!
I DON'T HAVE TO PROVE
ANYTHING TO YOU!
YOUR VEGETABLES!
THE CHILD IS THE PROOF!
LISTEN, I KNOW IT'S ALL
COMPLICATED SO FEEL FREE TO GIVE
YOUR STATE MEDICAID OFFICE A
CALL IF YOU HAVE ANY QUESTIONS.
BE PATIENT THOUGH, AND FOR
THE IT TAKES MORE THAN AN HOUR
TO GET A LIVE PERSON ON THE
PHONE.
NO WAY, DUDE!
[SPEAKING NON-ENGLISH LANGUAGE]
I DON'T SPEAK SPANISH.
HE SAID THERE'S AN 80% CHANCE
YOUR CALL WILL BE DISCONNECTED
BY ACCIDENT.
ONCE EVEN THE POINT OF CALLING
THEN?
BECAUSE IT'S A FUN THING TO
DO.
I AGREE.
OKAY, WE'RE LEAVING NOW,
THANK YOU MR. PEACH.
MR. BEACHY IS MY BROTHER.
AND YOU AND HIM LAST WEEK.
AND NOW WE ARE GOING TO EAT YOU!
OH, SHIT.
[SCREAMING]
John: THAT IS OUR SHOW, THANK
YOU SO MUCH FOR WATCHING!
WE'LL SEE YOU NEXT WEEK.
GOOD NIGHT!
EXCEEDS ME, HELLO, CAN YOU
HELP ME?
CAN YOU REMOVE THIS HUSK FROM MY
EYE?
IS HANGING DOWN.
IT'S HANGING OVER.
PLEASE.
I'D LIKE TO SEE IN BOTH EYES.
POR FAVOR.
I DON'T HAVE HANDS.
GRACIAS.
THANK YOU FOR DOING THAT.