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March 28, 2024 | Volume 28, No. 3 | Archives
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Cruel and Unusual Punishment
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| In This Issue:
- FY2024 Appropriations and FY2025 Budget Update
- Administration Announcements
- New Resource: Health Insurance at HCH Programs 2022
- A Closer Look: Cruel and Unusual Punishment
- Medicaid Unwinding
- Zooming in on Medicaid Across States
- Heartbreaking Record: Drug Overdoses Killed 108,000 People in 2022
- What We’re Reading (and Watching)
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FY2024 Budget: A deeply divided Congress finally passed all 12 FY2024 appropriation bills and averted multiple threats of government shutdowns. Congress passed the first set of FY24 spending bills on March 8 and, over the weekend, the House and Senate approved the second appropriations minibus funding the remaining six government departments, including Labor, Health and Human Services, Education, and Related Agencies. President Biden signed the $1.2 trillion funding package on Saturday closing a chaotic FY2024 Appropriations process, which keeps the government funded through Sept. 30, 2024. Thanks to Democrats, the FY2024 Appropriation package averted harmful abortion and anti-LGBTQ policy riders though there was plenty of controversy about inclusion of stringent border security policy, aid to Israel, and barring funding for the United Nations Relief and Work Agency (UNRWA). In what is shaping up to be a contested and turbulent election year, border security, immigration, and the administration’s position on Palestine will be contested issues.
Community Health Center mandatory funding passed in the March 8 appropriations minibus. Mandatory funding increased to $4.4 billion (up from from $3.9 billion in FY23) on an annualized basis through Dec. 31, 2024, over 15 months (FY24 through the first quarter of FY25). Community Health Center discretionary funding was enacted in the most recent second FY2024 Labor HHS appropriation bill at $1.8 billion through Sept. 30, 2024, preserving funding at FY23 levels. Hence, both funding streams are temporary and only extend to the end of the fiscal/calendar year. Stay tuned for additional advocacy needed to sustain funding for longer periods of time. Read our FY2024 Appropriations chart to see the funded grant programs that support the Health Care for the Homeless community.
FY2025 budget: The President outlined his priorities in his State of the Union address on March 7 and released his FY2025 Budget on March 11. President Biden’s Unity Agenda for the Nation fact sheet lays out President Biden’s priorities including fighting opioid addiction, tackling the youth mental health crisis, maternity care deserts, and gaps in access to primary care. His budget calls for expanding community health centers, and specifically increasing funding to HCH programs to increase street medicine and street outreach activities.
Find more details in our FY25 President Budget HCH Provisions fact sheet to learn about how the President’s FY2025 Budget supports programs important to the Health Care for the Homeless programs.
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Administration Announcements
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| New Resource: Health Insurance at HCH Programs, 2022
One of the most common barriers to accessing health care is a lack of health insurance, which pays for services. Our new health insurance fact sheet takes a comprehensive look at health insurance at HCH programs, and how state-level decisions regarding Medicaid expansion affect geographic and racial equity.
Importantly, this new brief calls for a range of advocacy actions:
- Expand Medicaid in all states
- Advance a national solution
- Ensure enrollment
- Engage policymakers
- Expand presumptive and continuous eligibility
- Share personal narratives
- Illustrate the advantages
- Fight policies that weaken Medicaid
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| Cruel and Unusual Punishment
By Barbara DiPietro, Senior Director of Policy
In Grants Pass, Ore., there is a law that bans camping in public — and the law defines a campsite as any place that has bedding like a sleeping bag or pillow. This means that, despite no housing and no shelter, folks living outside get tickets of up to $300 for sleeping outside.
Homeless folks in Grants Pass — like Gloria Johnson — are fighting back.
On Monday, April 22, the Supreme Court will determine whether the City of Grants Pass violated Gloria Johnson’s 8th Amendment right to be protected against “cruel and unusual punishment” when states criminalize the presence of human beings in public spaces. Their decision — expected to be issued at the end of June — will impact everyone living unsheltered (now and in the future) throughout the United States. At its core, this case will decide whether cities are allowed to punish people for things like sleeping outside with a pillow or blanket, even when there are no safe shelter options.
A finding in favor of Gloria Johnson will mean jurisdictions across the country will no longer be able to use jails or fines to punish people for simply existing in public spaces when they have nowhere else to go. However, a ruling in favor of Grants Pass will give cities and states permission to punish people who are forced to sleep outside, even when they have no other safe option. This is a big deal.
The folks who are advocating for Grants Pass are also those who promote criminalization and encampment bans as a public policy strategy. There are now statewide bans against camping in Florida and Tennessee, and — even more cruelly — a law in Kentucky is about to pass that allows killing people simply for being on private property. Organizations like the Cicero Institute are promoting model legislation in state legislatures across the country to not only criminalize homelessness, but also to redirect public funding away from housing and into internment camps and institutionalization.
Unlike those at Cicero, the HCH Community regularly sees the harms caused by the way most encampment sweeps are conducted, clearly understands how cruel and unusual it is to sweep/arrest poor people for being unhoused, and understands that housing is the only compassionate solution to homelessness. I think the HCH Community also understands how cruel and unusual it is to blame poor folks for the public policy choices made by elected officials that create homelessness faster than we can end it.
How to draw attention to and build power around this case:
Important advocacy point: Even if the Supreme Court says it is LEGAL to arrest someone for sleeping on the street, that doesn’t mean jurisdictions MUST or SHOULD take these actions. Let’s continue to advocate for permanent housing as a solution to homelessness, and push back against laws that shift systemic policy failures onto the shoulders of unhoused people.
The entire national homelessness advocacy community will continue reporting on this case. Watch for the Supreme Court decision to be issued by the end of June.
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| Medicaid Unwinding
As of the publication of this issue, over 18 million people have been disenrolled from Medicaid, and almost 40 million people had their Medicaid enrollment renewed. Across all states with available data, 70% of all people disenrolled had their coverage terminated for procedural reasons (not completing paperwork). In some states, like Florida, Medicaid call centers whose job is to help with renewals, high call times and call drops are making it exceedingly harder to renew or access Medicaid. CMS released resources about the Permissibility of Certain Practices During Medicaid and CHIP Renewals. This informational bulletin and slide deck address questions from states, partners, and stakeholders.
Zooming in on Medicaid Across States
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| Heartbreaking Record: Drug Overdoses Killed 108,000 People in 2022
The Centers for Disease Control and Prevention released the number of overdose deaths in 2022, showing a 1% increase from 2021. Rates decreased between 2021 and 2022 for people ages 15–34 and increased for those age 35 and older. Between 2021 and 2022, rates increased for all races and Hispanic-origin groups, except Native Hawaiian or Other Pacific Islander non-Hispanic and White non-Hispanic people. To combat the opioid crisis the President launched The White House Challenge to Save Lives from Overdose, a nationwide call to increase training on and access to life-saving opioid overdose reversal medications.
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| Join Other Advocates in Phoenix in May for Our Annual Conference
The annual National Health Care for the Homeless Conference & Policy Symposium is the country’s largest gathering of practitioners of homeless health care, advocates, people with lived experience of homelessness, and researchers about homelessness. The conference offers tremendous opportunity to learn, grow professionally, reconnect with colleagues, and make new connections with our community. Conference spots are filling quickly, so don't miss your chance to join us!
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What We're Reading (and Watching)
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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 or donating to support this work.
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