| Deserving Poor
by Dr. Barbara DiPietro, Senior Director of Policy
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It’s a curious phrase—the deserving poor. The Cambridge dictionary defines the deserving poor as “people who are poor but have good qualities and are not responsible for having little money.” Naturally, this begs several questions: deserving according to whom? What are “good qualities?” And who is responsible for people “having little money?” Answers to these questions are increasingly being framed around employment status, and we are seeing more public policies at the federal and state level that require work in exchange for basic human needs like health care, housing, and food assistance. The values driving these questions—that people do not deserve help if they do not work—are increasingly becoming normalized in our policy discussions. This should concern us all. Certainly our American public policies have rarely viewed basic needs as human rights, but Congress, the Trump Administration, and—increasingly—Governors and state legislators are moving to further separate the “deserving” from the (presumably) “undeserving” by adding work requirements and other barriers to more public programs. Promoted using the rationale that people who are low-income should know “ the dignity of work,” these policies only perpetuate stigma, hardship, and poverty. Find out what’s happening in your state related to work requirements in Medicaid, SNAP, housing, and TANF. Continue to push back against harmful and inaccurate stereotypes by holding conversations with policymakers and elected officials, testifying at hearings, responding to public comment periods, writing letters to the editor, protesting, marching, and being active in any way possible. Push back against the growing view that some people deserve assistance and others do not. Human rights are about dignity, equity, and freedom—for everyone. We all deserve better.
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| Work Requirement Round-Up
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Health Care: Following guidance released from CMS earlier this year, states have been applying for Medicaid 1115 Waivers that include work requirements, lock-out periods, partial expansions, co-pays and premiums, and other provisions that will jeopardize insurance coverage and limit access to care. The National Health Care for the Homeless Council stands strongly opposed to these changes and encourages the HCH community to stand up against changes proposed in your state. Track the status of waivers in your state and submit comments if you’re in a state with an active proposal. Currently open for public comment: New Hampshire (due Sept. 2), and state comments for Oklahoma (due Sept. 3). Use our issue brief that outlines the problems with these waivers and refer to our comments on Kentucky’s waiver as a template you can replicate. What are 1115 Medicaid Waivers, you ask? See our Back to (Policy) Basics section to the right!
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Food: Throughout the summer, Congress has been debating the Farm Bill in conference committee, which will determine the future of the SNAP program (Supplemental Nutrition Assistance Program, also known as food stamps). The House version would cut SNAP and add work requirements for most “able-bodied” people, while the Senate version maintains the funding and program structure. In order to move forward, the House and the Senate must come to an agreement on a final bill. Contact your member of Congress and ask them to reject the measures included in the House bill and support the Senate version with this easy-to-use tool from our friends at the Food Research & Action Center, who are leading this effort.
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As we get closer to the end of the 115th Congress and mid-term elections, stay up to date on the latest in Medicaid, the federal budget, opioid legislation, and more to prepare for an advocacy-filled Fall! Medicaid battles continue: Advocates rejoiced this June when a federal court ruling halted the implementation of Kentucky’s Medicaid waiver. Yet, following this ruling, CMS opened a second comment period ( read our comments) hoping that further comments would allow the waiver to survive against the legal ruling. The administration is expected to announce a decision for Kentucky’s waiver, amongst other state waivers, in the coming weeks.
Positive Health and Housing Funding Bills Pass the Senate: The Senate finalized bills that fund housing and health programs, providing a win for advocates with robust funding for housing programs and increased funding for addiction treatment and the opioid crisis. Read an analysis of the Health Bill and the Housing Bill. The full Congress has until the end of September to pass a final package, and action is awaited in the House. The current numbers are mostly a win for health and housing advocates, with a $100 million increase for Health Centers and most other programs receiving flat funding or minor increases, as well as increased funding for substance abuse and addressing the opioid crisis. Follow our budget chart that lists spending levels for health and housing programs relevant to the HCH community. Congress Continues to Be "All-Talk" on Opioid legislation: As addiction kills up to 200 people a day in the U.S., Congress delays action on the countless bills sitting in both chambers. Majority Leader Mitch McConnell said the Senate will pick up work on opioid legislation after Labor Day. The HCH Community must continue to call for faster action on this critical issue: view our action agenda.
Housing Relief Bills: Senator Cory Booker (D-NJ) and Senator Kamala Harris (D-CA) have both introduced bills (read Booker’s bill and Harris’ bill) that will help alleviate the national housing crisis. While neither are expected to pass in the current Congress, they are an important starting point for a conversation about the federal response to homelessness. Learn more and Take Action on these bills with resources from our partners at the National Low Income Housing Coalition.
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| What We're Reading
• Rx for Health: A Place to Call Home ( Health Affairs). Check out this great article from our CEO Bobby Watts together with Kaiser Permanente SVP and Chief Community Health Officer Dr. Bechara Choucair!
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Back to (Policy) Basics
What is a 1115 Medicaid Waiver? Section 1115 of the Social Security Act gives states the ability to apply for a waiver to use their federal Medicaid money for purposes or “demonstration projects” that are not otherwise allowed within the Medicaid program. The changes must meet the Medicaid program’s objectives and are approved at the discretion of the Secretary of Health and Human Services (HHS). Learn more:
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