Several state officials told The Health 202 that one of their greatest hurdles to getting these pilot programs off the ground is coordinating the new benefits with existing social services that might not be used to working with Medicaid, such as the Supplemental Nutrition Assistance Program, also known as SNAP.
CLASP
The Center for Law and Social Policy
On May 11, 2023 Indi Dutta-Gupta testified before the House Budget Committee on protecting American families from attempts to hold hostage policies that support them.
This testimony first explains at a high level why many people in the United States rely on specific federal programs to achieve economic security and access economic opportunity and how federal policies—in particular—effectively meet many of these needs. Next, the testimony explains why the deep cuts mandated under the McCarthy debt ceiling bill would undermine the nation’s well-being, including through counterproductive cuts to child care, workforce development, and postsecondary education. The testimony then explains why revenues must be a major part of the answer to concerns about deficits and debt. It concludes by highlighting the dangers of failing to raise our arbitrary threshold on the amount of outstanding obligations we allow ourselves to pay and urging Congress to act swiftly to avoid this self-inflicted wound to our prosperity.
By Suzanne Wikle
Congressional Republicans and Arkansas administrators have both recently revived the idea of so-called work requirements for Medicaid. The two proposals are contradictory in their approach, yet both are wrong. President Biden has rightfully pledged to not take away people’s health care or increase poverty as part of the debt ceiling negotiations. The administration must hold this line and reject any new work requirements for Medicaid, or increased work requirements for the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF).
We’ve known for decades that work requirements in SNAP and TANF primarily serve to limit people’s access to programs. They don’t equip people with tools or employment that allow them to leave poverty. In 2018, not surprisingly, we learned that work requirements in Medicaid produce the same results.
In 2018 Arkansas became the first state to implement work requirements in Medicaid, under a waiver approved by the Trump Administration. As a result, 18,000 people lost Medicaid coverage and there was no significant increase in employment. Federal courts eventually blocked this waiver as inconsistent with the intent of the Medicaid program.
Un-deterred by the data, Republicans in the U.S. House of Representatives are doubling down on this bad idea in the debt ceiling debate. They’re putting forward a proposal that would force all states to impose work requirements — requiring people to navigate a paperwork maze to prove they are in compliance of working enough or exempt from the requirement, and losing coverage if they don’t.
It would put coverage at risk for 10 to 21 million people.
The approach reiterates the false and paternalistic narrative that people experiencing poverty do not want to work, so they must be forced or incentivized to do so. It’s part of the deeply racist history of work requirements.
Speaker McCarthy’s caucus is pursuing the same onerous and punitive type of work requirements that ultimately do nothing to help people get ahead in life while simultaneously cutting people off essential safety-net programs. Proposals to implement or “strengthen” work requirements are veiled attempts to cut programs and limit people’s access to health care, nutrition support, and limited cash assistance.
Ironically, Arkansas now acknowledges that their previous approach of onerous and punitive reporting requirements was not productive. In their latest proposal, the state says, “While the intent (of the work requirement) was to encourage beneficiaries to engage in their communities and the workforce to achieve economic growth and eventual independence from government dependency, the monthly reporting of engagement hours was burdensome”.
Arkansas is now proposing to provide many people enrolled in Medicaid with “success coaches” to help them address Health Related Social Needs (HRSN) and increase their income above the Medicaid eligibility threshold. Helping people with a resume won’t ensure they have access to affordable child care, affordable housing, and a living wage that allows them to meet their needs.
A more productive approach would be to eliminate red tape and ensure that every Arkansan eligible for Medicaid can enroll—and stay enrolled. We know that Medicaid enrollment supports employment and decreases family financial stress. The U.S. Centers for Medicare and Medicaid Services (CMS) should reject the work-related components of Arkansas’ latest waiver.
Given all the evidence that work requirements don’t work, it’s reasonable to wonder why they are consistently raised, usually by leaders who ideologically oppose safety-net programs. One reason is that they know voters will reject straightforward proposals to cut or eliminate Medicaid. Recent election cycles have shown that voters don’t think politicians should take away peoples’ health care and state ballot initiatives have highlighted Medicaid’s popularity.
President Biden is right to draw a line in the debt ceiling debate, opposing any domestic spending cuts that will lead to people losing their health care or more living in poverty.
The House-passed debt ceiling bill now threatens all three programs with new or increased work requirements. Senate Democrats must help the White House hold this line. Further legitimizing work requirements as a reasonable policy is a slippery slope for continued attacks and cuts on programs.
Dear Friends,
We recently marked three years since the start of the pandemic. During this extraordinary time, we have learned lessons, shared experiences, tested solutions, and revealed realities about the state of our economy, never-ending racial and gender inequities, a democracy under constant siege, and basic human fatigue. Throughout it all, CLASP has remained nimble and responsive, advancing public policy that meets human needs and upholds human dignity. At the end of the day, what we seek is impact.
We want impact that is tangible. Impact that is transformative and durable. Impact that guides our efforts at every level. For every challenge we seek to address, we want to create short- and long-term impact for the tens of millions of children and families with low incomes, working people, youth and young adults, immigrants, and communities of color across the nation.
We hold the truths that we need dramatic and fundamental changes and that people who are suffering lack the luxury of waiting for the perfect solution. We develop and support effective compromises that make our eventual goals more achievable and resist those that undermine the world we are working to create. And we never lose sight of that ultimate vision as we build the knowledge and support necessary to win victories along the way.
2022 was a year of major changes for CLASP—from the transition of long-time executive director, Olivia Golden, to the beginning of my tenure as CLASP’s new president and executive director. Ushering in a new chapter, CLASP began a journey of realigning our vision and purpose, building on more than 50 years of impact at the local, state, and national levels. We are strengthening that impact by deepening our Hill presence and our partnerships to center people, equity, and our democracy in major policy proposals.
We recognize that our struggles are interconnected and that solutions are often crosscutting. This means creating policy solutions that build systems and structures to advance equity and make our democracy more responsive to people who are marginalized and excluded. For our solutions to work, we must deepen our engagement with individuals who have lived experiences with the challenges we address as strategic thought partners and experts. For people to trust us, we must provide valuable research, analysis, and evidence.
We remain ever grateful to our extended family of partners, collaborators, and funders. Your investments—financial and otherwise—have helped CLASP navigate times of uncertainty, opportunity, and threats. As we look ahead, impact will be our North Star, guiding our internal and external strategies, advocacy priorities, and collaborations.
In solidarity,
Indivar “Indi” Dutta-Gupta
President and Executive Director
Support CLASP to continue more of this work in 2022 and beyond with a monthly or one-time gift that will help kids and families with low incomes become economically secure.
The following statement can be attributed to Indivar Dutta-Gupta, president and executive director, Center for Law and Social Policy (CLASP)
Washington, D.C., April 26, 2023, 8:00 p.m.—The debt ceiling bill introduced by Speaker of the House Kevin McCarthy and passed today on a narrow margin by the U.S. House of Representatives allows out-of-touch extremists in Congress to hold our economy hostage to their demands to slash domestic spending and cruelly limit access to public benefits that strengthen our nation. The bill would set indefensibly low, rigid, and arbitrary caps on appropriations, allowing no adjustments for inflation or population growth and no ability to respond to emerging needs, such as a recession—which the bill and legislative strategy would make more likely—a national security crisis, or the next pandemic.
As funding falls behind the costs of meeting our nation’s needs each year, the bill’s cuts would grow over time. The cuts, which would be deep if spread across all discretionary programs, would be unprecedented if limited just to domestic discretionary programs other than veterans’ care. The legislation slashes everything including programs that support economic success such as child care, school meals, job training, and housing assistance as well as core public functions such as transportation and food safety.
The bill also limits access to benefits and health coverage that help secure a basic foundation for families to access opportunity and thrive—including the Supplemental Nutrition Assistance Program (SNAP), Medicaid, and Temporary Assistance to Needy Families (TANF)—for those who can’t prove they are working or exempt. We know from extensive evidence that such requirements are ineffective in promoting work. In fact, many people lose benefits even though they are working, or should qualify for an exemption, but fail to keep up with the paperwork requirements. Because TANF operates through block grants to states, the TANF provisions would not even save the federal government money. These requirements are solutions in search of a problem. They are based on stereotypes that people with low incomes do not wish to work; these narratives are demonstrably grounded in racism and will disproportionately harm those who are already the most excluded and marginalized by racism’s pervasive effects. Yet these requirements harm everyone and disrespect the unpaid caregiving and other work that supports our society. Conditioning supports and services that help meet our most fundamental needs on formal employment has no place in a just and prosperous society.
And other provisions in the bill, which purports to reduce the federal deficit, would actually increase it by making it harder for the federal government to collect the taxes that wealthy individuals and corporations are legally required to pay. This contrast makes clear the true priorities of the bill’s supporters.
This legislation is not a serious attempt to avoid the disastrous effects of defaulting on our debt, but an ideological wish list that would also wreck our economy. CLASP urges the House of Representatives to move forward quickly with a serious and clean bill to avoid the risk of default, which threatens to destabilize the financial markets even before we reach the “x date” when the debt ceiling prevents the nation from paying our bills.
CLASP appreciates HUD’s commitment to restoring the Affirmatively Furthering Fair Housing (AFFH) regulation and fulfilling its statutory obligation. The Biden Administration has expressed an intention to advance “equity for all, including people of color and others who have been historically underserved, marginalized, and adversely affected by persistent poverty and inequality.” This goal demands a comprehensive, community-oriented AFFH regulation. We commend HUD for proposing a rule that:
- Acknowledges the importance of integrating community input throughout the fair housing planning process.
- Provides technical assistance for program participants.
- Establishes a standard procedure for the public and HUD to enforce Equity Plan compliance.
- Equips community members with information and tools needed to hold program participants accountable.
These components must remain and continue to be prioritized in the final rule. In this comment, we recommend improvements to the proposed rule that strengthen the likelihood that meetings and other interactions with people directly impacted by fair housing issues will produce robust community engagement. CLASP is concerned that the community engagement requirements within the proposed rule prioritize convenience for program participants over quality of engagement. While we understand HUD’s attempts to reduce the burden on program participants through flexibilities like allowing for overlap between planning processes, excessive leniency will erode any distinction that the rule tries to make between community engagement and citizen or resident participation. Convenience cannot be the first priority. Community engagement involves significant preparation, but it should not be viewed as another administrative burden. Adopting the improvements outlined in this comment would ensure that the final rule prioritizes robust community engagement over convenience for program participants. We also suggest training, sub-regulatory guidance, and other materials that HUD should provide to program participants to support them in implementing parts of the rule related to community engagement.
By Ashley Burnside
This year, Congress has a big opportunity to promote positive policies in the Supplemental Nutrition Assistance Program (SNAP) through the Farm Bill reauthorization. But some policymakers have threatened to implement policies that would make SNAP food benefits harder to access for certain groups, including the disabled community.
SNAP, which provides monthly food benefits to individuals and families with low incomes, is one of our nation’s most effective anti-hunger public programs. SNAP is an important benefit for people with disabilities. Ten percent of the program’s non-elderly recipients identify as having a disability, and disabled people are more likely to face food insecurity. But SNAP can be hard to access for disabled people, and a time limit further restricts access for recipients known as “able-bodied adults without dependents”—or ABAWDs.
Under current law, ABAWDs can only access SNAP for three months in a three-year period unless they are working for at least 80 hours per month. Lawmakers have created exceptions for areas with high unemployment rates and where time limit waivers are in place. SNAP benefits are cut off after three months even if recipients are still experiencing food insecurity and face barriers to obtaining employment. Lawmakers have proposed expanding the population that would fall under the ABAWD category and who would therefore need to meet this work requirement.
The ABAWD acronym implies that only able-bodied adults must meet the work requirement or face a time limit. But people with disabilities can also be negatively impacted by this policy because it can be challenging for them to prove they have a qualifying disability that prevents them from working and meeting the SNAP work requirement.
SNAP policy requires recipients to be “physically or mentally unfit for employment” to qualify for an exemption from the time limit. The federal regulatory language for being “unfit” requires states to exempt people who:
1. receive public or private disability benefits;
2. are perceived as obviously “unfit” for employment by the program caseworker at the state agency; or
3. have documentation from a qualifying medical professional stating they are “unfit” for employment.
Each of these criteria can be challenging for people with disabilities to meet for the following reasons:
1. Applying for and receiving disability benefits, such as Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), is a long and cumbersome process. The application to receive disability benefits can take many months and can require a lawyer. In addition, the Social Security Administration is understaffed and underfunded, causing delays and customer service hiccups. Even if someone is considered ‘disabled enough’ to qualify for disability benefits, they may not be able to make it through the challenging application process to ultimately receive them.
2. A person may not be deemed ‘disabled enough’ to qualify for an exemption from the SNAP work requirement and time limit, depending on a caseworker’s perceptions, stereotypes, and awareness of disabilities and chronic illnesses. Caseworkers may be biased by their lack of understanding of disabilities and how they function. This is especially true if the person has an invisible disability, like chronic pain or autism spectrum disorder, which is harder for others to observe. The caseworker’s perceptions may also be biased based on the recipient’s other identities, including race and gender. For example, caseworkers may minimize a Black applicant’s reported pain more than someone who is white due to their internal biases.
3. Accessing medical documentation proving your disability for an exemption from SNAP time limits can be challenging. Securing medical documentation of your disability requires numerous health appointments, access to transportation, and health insurance. If you have a chronic illness, like Long COVID, it can be harder to secure a diagnosis from a medical provider and may require getting an appointment at a specialty clinic, which may have a months’ long waitlist. In addition, people with invisible disabilities and illnesses may face bias from medical providers who don’t believe their reported symptoms of pain. Research shows that women and people of color are more likely to face bias and skepticism from medical providers.
Disabled people risk losing food assistance when lawmakers enforce time limits or work requirements, even when exemptions are included for people with disabilities. Work requirements don’t work and will not lead to better economic opportunities or help eradicate food insecurity. Lawmakers should eliminate work requirements and time limits from SNAP—not expand the population that would be affected by them.
Note: this blog was updated on 5/9/2023 to reflect the reintroduction of the EATS Act.
By Ashley Burnside and Barbie Izquierdo
The Supplemental Nutrition Assistance Program (SNAP) provides monthly food benefits to individuals facing food insecurity. The program lifts households out of poverty and effectively connects people to food. But SNAP’s burdensome work requirements make it hard to access for certain populations, like college students. The Farm Bill reauthorization provides an opportunity to make SNAP easier to access for college students by lifting these requirements.
Many college students face food insecurity and financial hardship, made worse by the COVID-19 pandemic. This is especially true for students of color. In 2018, the Hope Center for College, Community, and Justice found that nearly half of Black students and 42 percent of Latinx students experienced food insecurity at four-year institutions, compared to only 30 percent of white students. In 2018, the Government Accountability Office reported that 29 percent of undergraduate students live in households with incomes below 130 percent of the federal poverty line and have at least one risk factor for food insecurity. Too often, lawmakers assume that all students receive financial support from their parents and therefore don’t need food benefits. These misconceptions have shaped SNAP policy for decades.
Hunger affects college students across the country, and many colleges have taken notice. Campuses are meeting this need through programs developed by students with lived experience, schools acknowledging the issue and providing resources, or students witnessing their peers experience food insecurity. Colleges have created tools like food pantries, meal-sharing programs, and soup kitchens where students can come together and eat in a safe space. Some of these programs are supported by Swipe Out Hunger, which is a nonprofit that reduces college student hunger by partnering with more than 550 colleges to promote on-campus solutions and policy changes. Some colleges qualify for federal grants or receive donations. But our future leaders need permanent and sustainable solutions like access to SNAP so they don’t have to choose between their education and eating. Colleges can’t tackle this issue alone; policymakers also need to step in.
Work requirement rules make it harder for SNAP to support college students. College students must work at least 20 hours per week to access SNAP, unless they meet a qualifying exemption. Working 20 hours per week while maintaining a course load is burdensome. The documentation requirements and other administrative burdens to maintain SNAP eligibility further hinder access to benefits. In addition, students are often unaware they’re eligible for SNAP, even if they meet the strict eligibility requirements, because of the confusing language about SNAP eligibility and stigma. Introduced earlier this year in the U.S. House of Representatives, the Opportunity to Address College Hunger Act would require colleges to notify students who participate in work-study that they may qualify for SNAP.
During the COVID-19 pandemic, lawmakers temporarily eased access to SNAP for college students by exempting additional populations of students from the 20-hour-per-week work requirement. Under the temporary policy change, students who are eligible for federal- or state-funded work-study and/or who have zero expected family contributions during the academic year didn’t have to meet the work requirement to access SNAP. However, this policy will expire in spring 2023.
The Farm Bill reauthorization should automatically exempt college students from SNAP’s work requirements. Representative Gomez will be reintroducing the Enhance Access to SNAP (EATS) Act this Wednesday, May 10th. This act would permanently remove the student work requirement. This is one of many recommendations we have for how the Farm Bill can advance access and equity in the SNAP program.
Please fill out the following form to have your organization formally endorse the EATS Act of 2023.
(EXCERPT)
- “This isn’t about substituting one for the other,” said Suzanne Wikle, a senior policy analyst at the Center for Law and Social Policy. “It’s really thinking about how we are using all of our resources collectively to best support people who aren’t able to meet their basic needs or are in a health crisis.”
Read the full article here.
By Ashley Burnside
The Farm Bill reauthorization provides an opportunity to improve the Supplemental Nutrition Assistance Program (SNAP) program to make it more equitable and anti-racist. One provision Congress should address in the upcoming legislation is SNAP’s hot foods ban. With very limited exceptions, SNAP recipients are not allowed to use their benefits to purchase prepared or hot meals. This policy is paternalistic, inconvenient, and ableist.
Cooking and eating are essential for daily living. These tasks can also take a lot of time, energy, and stress—especially if you are disabled. Disabled people are at least twice as likely to face food insecurity. And one in five SNAP households include a non-elderly disabled adult. Removing the hot meals ban in SNAP would help ensure that disabled people who may have difficulty preparing food due to their health condition can nourish themselves and their families.
I’ll talk about my own disability to provide an example of how cooking can be more difficult for someone who has a disability, and how ending the hot meals ban could help. I have mild cerebral palsy, a physical disability that causes spasticity in my muscles and very mild muscle paralysis on the right side of my body. Cerebral palsy looks different for each person who has it, and the same goes for all disabilities. For me, I experience pain when I stand for long periods of time, like when I am cooking, for example.
A common way to talk about expending energy in the disability/chronic illness community is the “spoon theory.” This theory proposes that every daily activity that uses physical and mental energy is the equivalent of a spoon, and a disabled person may only have so many ‘spoons’ per day they can use before they are depleted of their energy and in pain.
Tasks that able-bodied people take for granted, like cooking, can take up many spoons of energy for a disabled person. For me, cooking a meal can result in pain and fatigue, and it can use a few of my spoons, depending on the day. That leaves me with fewer spoons for the other necessities of daily life.
Let’s consider if I was making a chicken salad. Cutting the vegetables for the base of the salad requires precise maneuvering of a sharp knife, which is hard for me. And it can easily lead to a finger injury if I’m not careful. Cooking chicken requires standing for an extended period, bending to take the meat in and out of the oven to roast it, and then washing pans at the sink. It gets exhausting, and by the end, my legs are inflamed, and I am tired—and that is just for one meal.
Thankfully, workarounds can make cooking a bit easier for disabled folks like me, and it comes down to what groceries we buy. For example, I could buy a pre-cooked rotisserie chicken, which is available at many grocery stores and is sometimes cheaper than a raw chicken. This would prevent me from having to navigate bending and carrying heavy dishes in and out of the oven, using time and energy to cook the raw meat, and standing at the sink to then wash the heavy pots and pans.
But if I were using SNAP benefits to buy my groceries, I wouldn’t be able to buy a prepared chicken because of the hot foods ban. This means that I’d have to use more personal energy to cook, because I wouldn’t be allowed to purchase prepared meals.
The hot foods ban limits the options of SNAP recipients, requiring people to spend more time and energy cooking meals they could otherwise purchase already prepared were it not for the ban. This is also harmful because SNAP recipients know what food is right for them and their families, and the program should provide autonomy so recipients can decide what groceries they want to purchase. This policy also harms single parents, who might be short on time to prepare a meal for their kids after working a full day. And the hot foods ban may negatively affect older people, who also may face pain and fatigue when cooking; unhoused people, who may not have reliable access to a stove; and anyone else who doesn’t have time for cooking.
In the upcoming Farm Bill reauthorization, Congress should remove the hot foods ban in the SNAP program so more people can easily access various food options. This will benefit disabled people and numerous other populations. And this would promote equity in the SNAP program and access to food.
Get more content like this and more on the Farm Bill in 2023:
By Dashel Lewis
Hardly anyone likes paying taxes, but almost everyone likes the things that taxes pay for: everything from clean air and drinking water to food that is safe to roads and highways that get us from point A to B. Taxes also help pay for retirement and economic security programs like Social Security and Medicare that we all rely on as well as benefit programs for people with low incomes.
The government depends on annual tax revenues to help pay for these and countless other essential domestic programs, which cost trillions of dollars to maintain. For decades, tax revenues have not fully covered what the federal government spends, and the difference between those two numbers is the annual budget deficit. The sum of deficits over time is the national debt, which is money borrowed by the federal government through the issuance of bonds or other Treasury securities. Right now, the annual U.S. budget deficit is $723 billion, and our national debt is $31.6 trillion.
House Republicans are calling for drastic and harmful budget cuts to critical programs across the government to reduce deficits sharply. They are also threatening to refuse to raise the debt ceiling—which caps the amount the United States can borrow–so the government can pay its bills. Defaulting on our debt would have devastating economic consequences for the global economy, including massive unemployment and recession. However, these short-sighted options overlook the possibility of changing our tax code to boost government revenues, which can reduce the deficit and make the tax code more equitable.
Current pillars of our tax system like mortgage interest deduction, the lenient treatment of investments, and the tax-free status of wealth transfer vastly favor the intergenerationally rich. A more equitable system would remove the advantages that keep wealth accumulated at the top and improve IRS enforcement to minimize evasion by wealthy individuals, families, and corporations. Remarkably, recent IRS data shows that people in poverty face higher rates of audits than wealthier Americans.
President Biden’s FY24 budget proposal calls for significant reforms to the current code, including increasing the corporate tax rate to 28 percent and raising the top individual income tax rate to 39.6 percent. Adjusting those key base rates, in addition to closing existing loopholes that permit excessive tax evasion, would reduce the deficit and ensure a strong revenue base for securing and expanding social programs. Crucially, these reforms would take meaningful steps toward making our tax system an equitable reflection of where wealth is held in society.
Republicans would like to continue and build upon the 2017 Tax Cuts and Jobs Act (TCJA), commonly known as the Trump Tax Cuts, which gave significant breaks to wealthy individuals and corporations, hollowing out a key revenue base for domestic programs including social supports. Many of those tax breaks are up for renewal in 2025. Those who express grave concern about the deficit also support extending these giveaways. It’s critical that policymakers let the TCJA tax cuts lapse and reverse what has been a tool for wealth transfer for the already well-off.
At its core, our tax code must be progressive and focused on reducing poverty and inequality. We’ve seen how the tax system can be used to advance equity and combat poverty. Tax-based policies like the Child Tax Credit and Earned Income Tax Credit have provided economic lifelines to tens of millions of U.S. families. Simple steps like making the pandemic-era expanded CTC permanent and extending EITC eligibility to young adults without children and mixed immigration status families would significantly reduce poverty and bring the United States more in line with other rich nations more in line with other rich nations.
The programs and policies relied on by people who are the most vulnerable are undergirded by—and often directly involve—our tax system and the revenue it provides. Going forward, policymakers should make the IRS more effective both as a system for gathering the resources we need to combat poverty and a tool for distributing support.