Small, but Huge

Charlie Pierce on Income Verification:

Take, for example, the tougher income-verification standards for the people seeking to qualify for subsidies under the Affordable Care Act. This is almost universally described as a "minor tweak" to the health-care law, usually by people that it never will affect. In real life terms, it opens up a whole universe of cruel, low-level political mischief similar to that being played out (again) with the Social Security disability payments. If standards can be tough, why can't they be tougher? And tougher still? Waste! Fraud! Abuse! (I can see the 60 Minutes report now.) People who get caught in this mill are going to have their lives made worse. They are going to be strangled with paperwork. This may be the price Democrats have to pay to get a deal, but let's not pretend that this is going to be minor to anyone who has to cope with it in their daily lives.

I have a friend who used to do trauma therapy for teens and their families in Lowell. The amount of paperwork these families, frequently immigrant, illiterate, and in crisis had to fill out was just staggering. She told me that she couldn't keep doing the work because she couldn't face forcing some sobbing woman to fill out and refill out hours of paperwork, neverending, kafkaesque, intrusive and demeaning paperwork that took the hours she could have spent treating them and turned them into a nightmare of bureaucratic indifference.