WASHINGTON ― The Republican Obamacare repeal bill that passed in the House on Thursday contains a little-noticed provision that would kick lottery winners off Medicaid.
Though there’s little reason to think lottery winners are sapping Medicaid, the logic of the measure is that anyone with significant winnings should be able to take care of himself without help from the government’s health insurance program for the poor. But groups that follow gambling policy say lottery winners might especially need that help.
Keith Whyte, director of the National Council on Problem Gambling, said people with gambling disorders are likely to play the lottery, and if they win they’re likely to lose the money in a short time.
“So a problem gambler who wins the lottery then loses her access to care, even though they will blow through those winnings, leaving them broke and with nowhere to get help,” Whyte told HuffPost.
Another part of the American Health Care Act that could affect gambling addicts is a provision that potentially allows states to disregard Obamacare’s “essential health benefits” standards, which require insurers to cover a range of benefits in any plans sold in state marketplaces.
The standard includes treatments for mental health and substance abuse disorders, which could include gambling disorders, though state laws vary considerably. (Gambling disorders have only recently been listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.)
“We would be concerned with any paring back of essential health benefits that eliminates ‘gambling disorders,’” Whyte’s group said in a letter to congressional leaders that was also signed by gambling industry associations.
Whyte said lawmakers haven’t been receptive to his group’s concerns. A spokesperson for Rep. Fred Upton (R-Mich.), who sponsored the gambling provision, did not immediately respond to a request for comment.
People with high incomes are ineligible for Medicaid, but Republicans said current law only makes lottery winners ineligible in the single month in which they received their jackpots. The legislation, which was inspired by local news reports, would require Medicaid to count lump-sum payments over the course of many months.
The measure is a part of other Republican efforts targeting alleged malfeasance by welfare recipients, such as efforts to drug test people on food stamps. Some House Democrats have previously said this campaign is little more than a distraction.
Though Republicans rushed to pass their health care bill after cobbling it together with an ad hoc series of deals, they honed the lottery provision for years, making several adjustments in response to input from experts outside of Congress. It’s one of the only parts of the bill that actually got a hearing this year.
The House bill stands little chance of making it through the Senate.
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