In Focus: Supplemental Nutrition Assistance Program (SNAP)
Sep 18, 2017 | PERMALINK »
Medicaid Once Again Under Attack
By Jessica Gehr
With just two weeks left before the end of the federal fiscal year, Senate Republicans are once again trying to “repeal and replace” the Affordable Care Act (ACA), leaving millions without coverage. This time Senators Bill Cassidy (R-LA) and Lindsey Graham (R-SC) have proposed a bill that fundamentally alters the Medicaid program. It turns the ACA’s enhanced match for the Medicaid expansion population into a fixed block grant and converts the existing Medicaid entitlement into a per capita cap, a mechanism under which states would receive a set amount of money per enrollee from the federal government to administer the program. It also block grants the financial assistance that helps workers and families buy private insurance through the ACA and undermines protections for people with pre-existing health conditions. As hard as it is to imagine, this bill goes further and cuts Medicaid deeper than previous proposals, posing serious risks to low-income children, parents, young adults, seniors, and individuals with disabilities.
The proposed financing changes to Medicaid are a significant cost shift to states. States would receive between 35 and nearly 60 percent less funding for Medicaid in 2026 than under current law. This would cause states to reduce benefits (such as prescription coverage), create waiting lists for care, and raid other parts of their budgets such as postsecondary education funding to help fill the void of federal Medicaid dollars. To make matters worse, the bill’s block grant funding for the Medicaid expansion population would entirely disappear after 2026. Beginning in 2027, the Cassidy-Graham bill would be nearly identical to the repeal-without-replace bill estimated by the nonpartisan Congressional Budget Office (CBO) to leave 32 million more people uninsured.
The Cassidy-Graham bill also includes a provision found in previous House and Senate repeal-and-replace bills that would allow states to require Medicaid recipients to work to receive health coverage unless they are pregnant, seniors, determined disabled by the state, or single parents of young children or children with disabilities. Work requirement policies are inconsistent with the realities of today’s low-wage jobs, which are characterized by changing, unpredictable schedules, lack of paid leave for personal or family health needs, and no health insurance. A work requirement provision would cause workers to lose the health care coverage they depend on through Medicaid to stay healthy so they can find and keep work.
This last-ditch partisan effort to repeal and replace the Affordable Care Act is being driven by the legislative mechanism expiring at the end of this month that allows Republicans to pass the bill with a simple majority. That is why the Senate is rushing this legislation through without hearings, a CBO score, or public debate. Rather than rushing to push a partisan bill that has not yet been reviewed by the CBO, Republicans and Democrats should come together to reauthorize the Children’s Health Insurance Program, stabilize the ACA’s Marketplace and work to help people afford the coverage they need.
Sep 12, 2017 | PERMALINK »
SNAP Provides a Lifeline for Millions Each Year
In 2016, the Supplemental Nutrition Assistance Program (SNAP) lifted 3.6 million people out of poverty, according to newly released data from the U.S. Census Bureau. This is one of many measures of SNAPs effectiveness as an anti-poverty program. The program fed over 42 million people in FY 2017.
SNAP provides a monthly allotment, $142 per person on average, for households to purchase food for themselves and their families. While SNAP is one of our most efficient and effective tools for combating poverty and hunger in the U.S., there is room to grow and strengthen the program. Over 44 million people still lived in poverty in 2016, according to the “supplemental poverty measure,” which takes into account taxes, transfers, and work and medical expenses. Moreover, 15.6 million households were food insecure, meaning that they had difficulty at some time during the year providing enough food for all their members due to a lack of resources.
In recent years, states have made progress streamlining administration of public programs, including SNAP, to remove barriers for eligible individuals and families. At the national level, we have many opportunities to strengthen and expand this critical part of the safety net.
The Closing the Meal Gap Act of 2017, introduced by Representative Alma Adams (D-NC), would strengthen SNAP in several ways. The bill would standardize and simplify the calculation of medical deductions and shelter expenses, provide exemptions from the 3-month time limit for workers who were not offered an opportunity to participate in the state’s Employment & Training program, and update the method used to calculate the amount of benefits to take into account the time pressures on low-income families.
SNAP is a lifeline for millions of individuals and families in America. Today’s Census data proves that SNAP effectively lifts people out of poverty. However, we still have work to do, as highlighted by the millions of households who struggle to put food on the table. By investing in SNAP and strengthening the program, we can lift many more out of poverty and ensure nobody goes hungry in the America.
Sep 12, 2017 | PERMALINK »
Work Support Strategies: Measures of Progress
Public programs, like the Supplemental Nutrition Assistance Program (SNAP) and Medicaid, provide critical support to millions of Americans who struggle to make ends meet due to low wages and lack of steady hours or work. However, too many families still face significant challenges accessing the supports they need. Application processes are often complex, burdensome, and time consuming for both applicants and the staff of social services offices. To address these issues six states took on the challenge of reforming technology, policy, and business processes through the foundation-supported Work Support Strategies (WSS) initiative.
Each of the WSS states used data to inform and assess state efforts. Two new reports from the Urban Institute detail the data that guided the states’ efforts and provide an update to important metrics for tracking the initiative’s effects. The first report examines changes in the number of people who were jointly eligible for both SNAP and Medicaid/Children’s Health Insurance Program (CHIP) in each state. As expected, the proportion of adults eligible for both SNAP and Medicaid increased significantly between 2013 and 2015 in states that adopted the Medicaid expansion available through the Affordable Care Act, while the number stagnated or declined in non-expansion states. This report also analyzes the rates of people participating in both the nutrition and health care programs in three WSS states—Illinois, South Carolina, and Idaho. South Carolina saw significant increases for both adults and children while Idaho, which already had very high rates of joint participation, saw little change. Illinois, which expanded Medicaid, saw declines in the share of people jointly eligible for both programs who were enrolled, even though the number increased sharply. The 50-state joint eligibility data provided in this report allows other states to calculate their own joint participation rates.
The second report from the Urban Institute highlights how WSS states used information about the client experience to improve program access and participation. Investigators used client surveys to assess people's experiences about interactions with staff, the clarity of the information they received, the speed of receiving benefits, and other factors. These surveys helped social service offices target their efforts to deliver benefits faster, simplify processes, and improve the overall experience of their clients.
The WSS initiative highlights the importance of thinking about both the collection and use of data from multiple dimensions. Data can be used not only to develop targets and for accountability but also to support learning and transparency. The WSS states used data as a key part of their reforms by continually testing assumptions, seeking feedback, and adapting along the way. Tracking data on client satisfaction and on joint participation sends an important message about the need to put clients at the center of the eligibility process to support hard-working people in their efforts to gain economic security.