| The Hypocrisy of Work Requirements by Dr. Barbara DiPietro, Senior Director of Policy
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The drumbeat of phrases sounds all-too-familiar: “the dignity of work,” “achieving independence through work,” “creating the opportunity to work,” and other sentiments. We’ve now got 15 states with Medicaid work requirements already approved or up for approval at HHS—with Wyoming, West Virginia, and Alaska battling it out in their state legislatures to be next in line (and no doubt more states behind them). It’s actually shocking how quickly states are rushing to adopt a cumbersome, ineffective, and immoral policy—presumably to encourage people to work. These are challenging times when we need strong advocacy efforts. We need everyone in the HCH community to organize, protest, write letters, testify, show up at public hearings, and challenge our elected officials at every turn. Meanwhile, show your support for big solutions like the new Medicare for All bill and the Green New Deal resolution (more on those below). Let’s put our values into action!
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| Take Action on... Health Care
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Following guidance released by CMS early last year, states have been adding harmful provisions to their Medicaid program that limit access to care--such as work requirements, lock-out periods, partial expansions, co-pays and premiums. Currently, eight states are awaiting federal approval for work requirements (AL, MS, OH, OK, SD, TN, UT, VA), seven states have received approval for them (AZ, AR, IN, KY, MI, NH, WI), and two states have already moved forward to implement them (AR, IN). As the first state to implement work requirements, Arkansas already has seen over 18,000 people lose Medicaid coverage. The National HCH Council is strongly opposed to any changes in health care that limit care and encourages you to speak out! Keep track of Medicaid waivers using Kaiser Health’s Tracker, be vigilant and active in your state’s Medicaid proposals, use our latest comment letter on the Tennessee waiver as a template to submit comments in your own state, and refer to our issue brief and statement on work requirements to learn more about what they mean for the HCH community.
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This month the Trump Administration released a proposed rule that would add work requirements to the Supplement Nutrition Assistance Program (SNAP/Food Stamps). This rule would decimate food assistance for many people who do not meet the employment criteria and those who are unable to sufficiently document their work hours each week. This rule is likely to increase hunger and poverty for over 700,000 people. The public 60-day comment period ends on April 2nd, and we encourage individuals and organizations in the HCH community to submit comments. Find more information, a sample letter, and an easy-to-use submission form on the Food Research and Action Center’s website. Keep an eye out for the Council’s comments, which we will share in the coming weeks.
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The long-awaited budget agreement increases funding for housing: In December, the President and Congress failed to pass multiple spending bills for 2019, including the budgets for the Department of Housing and Urban Development and the Department of Agriculture, which led to the longest government shutdown in history and disastrous consequences for many people living in poverty. Eventually, the President signed a budget into law that included an overall 10 percent increase in HUD programs and mostly flat funding for USDA programs. Learn more about the budget agreement, and see funding levels for programs we care about on our updated budget chart. State leaders reject the results of Medicaid ballot initiatives: Medicaid expansion passed via a ballot initiative in three conservative states: Utah, Idaho, and Nebraska. Amongst much protest, the Utah legislature passed a bill that would allow for a lesser, partial expansion of Medicaid with work requirements. Utah leaders plan to move forward when they receive approval from the administration. Nebraska doesn’t fall far behind in their efforts to stymie the will of the people.
A damaging Family Planning rule is finalized: The Trump Administration finalized a “gag rule” on Title X funding, which provides funding for family planning and preventive services to 4 million low-income people each year. The National HCH Council and many of our partners stand strongly opposed to this rule. To brush up on the rule, learn what it means for providers and read our comment letter on the proposal. Consumer rights organizations plan to challenge this rule in the courts, so stay tuned for more information on this issue.
A new and improved Medicare for All bill is released: On Wednesday, Rep. Jayapal (D-WA) released a new Medicare for All bill with a record 106 co-sponsors (learn more about what’s in the bill). The National HCH Council will continue our decades-long fight for health care for all via a single-payer solution and be vocal about how a Medicare for All plan works to end homelessness. Keep an eye out for more materials and ways to be engaged in the coming months.
An exciting road map outlined in the Green New Deal: Sen. Ed Markey (D-MA) and Rep. Alexandria Ocasio-Cortez (D-NY) introduced a resolution that lays out big solutions to our nation’s toughest problems. It includes everything from climate change to education to housing and health care. Stay tuned for more information on this plan.
A federal case against safe injection sites begins: As opioid-related deaths continue to rise around the country, some U.S. cities are working to open supervised injection sites. This month, federal prosecutors took action and challenged the nation’s first supervised injection site in Philadelphia. The results of this case will set a precedent for other cities with similar programs and may prevent the development of harm reduction programs to address the opioid crisis.
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| "Many of us agree that work has innate value and encourages self-sufficiency and personal fulfillment. Government-administered work requirements, though, don’t encourage these outcomes as much as penalize people who don’t fill out and mail back monthly paperwork. When the number of folks who find employment is swamped by the number of working people who lose coverage because of paperwork mistakes, this is a decidedly bad policy choice." — Brian Haile
Chief Executive Officer
Neighborhood Health (Nashville, TN)
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| Teacher Advocacy Inspiration: This week teachers are striking in Oakland, CA, and they are a part of a growing wave of strikes around the country brought about by low wages, rising housing costs, and unsuitable classroom sizes. While the end results vary (most recent strikes have brought modest pay increases), it is an impressive example of how a local movement can lead to a nationwide phenomenon and increased awareness. Learn more about the teacher strike in Oakland and the history and strategy behind striking as an effective form of advocacy.
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| Local HCH Advocacy Advocacy needs to be supported through research! Check out a new article in the American Journal of Public Health, a study on quality of life for formally homeless individuals in supportive housing, conducted within Healthcare for the Homeless – Houston’s program. The authors include leadership and staff at Healthcare for the Homeless – Houston. Congrats HCH-H!
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“Good news, Beth! You’ve earned almost enough work-credit points for your pain killer!”
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This publication and all HCH advocacy are funded by dues from Organizational Members of the Council and by private donations. Consider joining the Council to support this work.
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