As Congress plans their legislative goals for the year, we’ve heard certain elected leaders mention that they want to achieve “welfare reform” in 2018. While the term may sound harmless, in reality it acts as a vehicle for elected officials to strip benefits from those who rely on government programs like the Supplemental Nutrition Assistance Program (SNAP) and Medicaid.
This process of “welfare reform” has already started, with the Centers for Medicare & Medicaid Services (CMS) recently allowing states to implement work requirements for Medicaid. So far 10 states have submitted proposals to implement these work requirements, and Kentucky is the only state to implement the new requirements so far. Traditionally these proposals have been denied because they’re inconsistent with the purpose of Medicaid, which is to provide health care to low income people.
SNAP and Medicaid are crucial components in helping millions of American individuals and families maintain a decent standard of living. SNAP helps low-income families put food on the table, and Medicaid provides health coverage to specific categories of low-income adults and children. Without programs like these, millions of people would have to make impossible decisions between feeding their families or going to see a doctor.
SNAP Already Has Work Requirements
Historically, Medicaid has not had any sort of work requirements, whereas SNAP does. Because of this, the proposed work requirements for Medicaid are structured similarly to SNAP. This means that able bodied individuals between 19 and 64 years old would likely have to work 20 hours per week, although some states are considering volunteer work and/or community service instead of paid labor. Potential exemptions could include:
- People with disabilities and/or who are medically frail
- Pregnant women
- Caregivers for kids under the age of 6
- Dependents with disabilities
- Students enrolled at least half-time
- Those who are deemed physically or mentally unfit for employment
- People in substance abuse treatment or rehabilitation
These requirements and exemptions would vary depending on the state. In addition to work requirements, Maine and Wisconsin have also proposed to establish time limits for Medicaid benefits similar to the limits found in SNAP.
Unlike Medicaid, SNAP already has work requirements and time limits in place. Able bodied adults without dependents must be engaged in work related activities for 20 hours per week in order to receive benefits for more than 3 months and less than 3 years. Exemptions include people who are:
- Disabled
- Caring for disabled family members or children under the age of 6
- Currently in rehabilitation
- Enrolled in school, training, or higher education at least half time
If a recipient doesn’t meet the work requirement, then they lose their SNAP benefits with increasing penalties for each successive failure to meet the requirement.
Work requirements and time limits have a negative effect:
- Under current law, 68% of SNAP recipients are already exempt, and 13% of recipients are already working.
- Among those who currently receive Medicaid benefits and are not already working, 81% are either ill, disabled, going to school, or taking care of their home or family member(s).
- Those with high health care needs won’t get relief. Certain individuals with high health care costs but who don’t qualify for an exemption could lose their benefits. One example can be seen in TANF, where recipients with disabilities and poor health are more likely to lose their benefits.
Work requirements target an already vulnerable population, and fail to help people move out of poverty:
- Work requirements don’t help people get better jobs. One assessment found that the majority of people subject to work requirements remained below the poverty line, while others found themselves in even deeper poverty.
- Those who are already working could get cut off. People who find work may be unable to report how many hours they’ve worked due to temporary employment, which means they could fall below the threshold needed to receive benefits. This problem is particularly prevalent among Medicaid recipients, as those who found stable employment in states with a work requirement ranged from 22.1% to 40.8%.
- Work requirements fail to take into account other issues with finding a job. Many of those who benefit from Medicaid belong to a racial or ethnic minority, have low education levels, and/or have a criminal record, making it fundamentally harder to find and maintain gainful employment.
Congressional leaders have repeatedly mentioned that this version of “welfare reform” will be their top priority for 2018. We need you to tell your members of Congress that work requirements don’t work, and that these recent efforts will only prevent benefits from going to those who need them the most. Our prophetic voice requires us to speak out for fairness and justice. Denying benefits from those who need them the most is immoral, and we cannot stand by while others are prevented from getting the help they need.
Please, write your representatives and tell them to reject work requirements for Medicaid.
