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For example symptoms after hysterectomy purchase indometacin 50 mg online, seasonal workers may have a period of time each year when they are not working enough hours to meet a work requirement and as a result will churn on and off the program during that time of year symptoms acid reflux buy cheap indometacin 75mg online. Or medicine zolpidem buy indometacin 25 mg low price, some may have a reduction in their work hours at the last minute and therefore not meet the minimum numbers of hours needed to retain Medicaid bad medicine order generic indometacin online. Many low-wage jobs are subject to last-minute scheduling, meaning that workers do not have advance notice of how many hours they will be able to work. If you are constantly at the whim of random scheduling at your primary job, you will never know when you will be available to work at a second job. As people are disenrolled from Medicaid for not meeting work requirements, possibly because their hours get cut one week or they have primarily seasonal employment (like construction work), they will cycle back on Medicaid as their hours increase or the seasons change. People may be most likely to seek to re-enroll once they need healthcare and be less likely to receive preventive care if they are not continuously enrolled in Medicaid. Disenrollment and lock out would lead to worse health outcomes, higher costs Medicaid enrollees must meet the work requirement for four months out of every six-month period in order to maintain coverage. Enrollees who lose exempt or employment status and are no longer complaint with the requirement at least four months of the six-month period will have their benefits suspended. These benefits will remain suspended untul the Medicaid enrollee demonstrates compliance with the requirement for one month. Once suspended from Medicaid coverage, beneficiaries will likely become uninsured. Needed medical services and prescription drugs, including those needed to maintain positive health outcomes, may be deferred or skipped. Because people without health coverage are less likely to have regular care, they are more likely to be hospitalized for avoidable health problems and to experience declines in their overall health. This will only lead to poorer health outcomes and higher uncompensated costs for providers. In a 2003 analysis, researchers from the Urban Institute found that people who are uninsured for less than 6 months are less likely to have a usual source of care that is not an emergency room, more likely to lack confidence in their ability to get care and more likely to have unmet medical or prescription drug needs. A 2008 analysis of Medicaid enrollees in California found that interruptions in Medicaid coverage were associated with a higher risk of hospitalization for conditions such as heart failure, diabetes, and chronic obstructive disorders. In addition to the poorer health outcomes for patients, these avoidable hospitalizations are also costly for the state. Studies repeatedly show that the uninsured are less likely than the insured to get preventive care and services for major chronic conditions. Support services will be inadequate Child care is a significant barrier to employment for low-income parents. Many low-income jobs have variable hours from week to week and evening and weekend hours, creating additional challenges to finding affordable and safe child care. Finding affordable and safe child care for children is difficult and a barrier to employment. Requiring employment in order to maintain health care, but not providing adequate support services such as child care, sets a family up for a no-win situation. Even with the recent increase in federal child care funding, Tennessee does not have enough funding to ensure all eligible families can access child care assistance. Although Tennessee proposes to exempt individuals who are disabled or designated as physically or mentally unfit to work, in reality many people who are not able to work due to disability or unfitness are likely to not receive an exemption due to the complexity of paperwork. Additionally, those with disabilities may have a difficult time navigating the increased red tape and bureaucracy put in place to administer a work requirement, including proving they are exempt. The end result is that many people with disabilities will in fact be subject to the work requirement and be at risk of losing health coverage. The proposal does not provide any estimate of the number of people who are expected to become disenrolled from Medicaid. This lack of information is unacceptable and Tennessee should provide details about the anticipated change in enrollment in the state. Without this detail, it is impossible to fully understand the impact of the proposal.

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