Cossy Hough, LCSW
'This piece appeared in Texas Perspectives, the Houston Chronicle and the Austin American Statesman. See last post for more discussion about work requirements and Texas Medicaid from Anna Stelter.
The Trump administration has recently asked federal agencies to strengthen and expand existing work requirements for low-income Americans who receive public assistance through programs such as Medicaid and food stamps (Supplemental Nutrition Assistance Program or SNAP). Federal agencies have 90 days to review their current systems and propose policy changes.
Helping and empowering Americans living in poverty to be independent from public benefits is a worthy but complex goal. However, this effort is based on a simplistic analysis of public assistance and will harm the most vulnerable among us.
The Trump administration has pointed to Kansas as a success story because after the state strengthened the Temporary Assistance for Needy Families work requirements in 2011, caseload levels dropped and recipients received benefits for shorter periods. However, a recent study shows that one year after exiting the TANF program, nearly two-thirds of former recipients in Kansas had either no earnings or earnings below 50 percent of the poverty line. Work requirements may be effective in reducing welfare rolls but are clearly not as effective in reducing poverty.
An assumption under the administration’s request is that employment is the most effective way out of poverty and into self-sufficiency for Americans receiving public assistance. But low-wage jobs often do not generate enough income for individuals to achieve these goals.
Another issue is the instability of the low-wage labor market. Individuals receiving public benefits often work in industries such as food services and construction, in which both employment and hours are instable. The lack of flexibility in low-income jobs also means that workers may lose their job if a family disruption or a temporary lack of transportation forces them to take even a short amount of time off.
Many parents in low-wage jobs can’t afford full-time childcare or even after-school child care, and therefore working full-time is not an option for them. Demand for affordable childcare outweighs the supply across the country. According to the Afterschool Alliance, 18.5 million more children would participate in after-school programs if they were available in their communities. And yet, federal funding to help low-income parents pay for these programshas been declining.
Health also plays a factor that the Trump administration isn’t considering. States generally waive work requirements to receive public benefits for individuals with disabilities. Determination of a disability through the Social Security Administration is commonly accepted, but the process can take from one to three years and the average rate of denial is 53 percent. Approval of a disability claim for someone who can work intermittently due to chronic illness is unlikely. This leaves many Americans in the vulnerable position of being unable to work full time and unable to be declared disabled by the federal government. Strengthening work requirements for this population of Americans would be disastrous, especially if more people with chronic illnesses lose their Medicaid coverage. Without Medicaid coverage, people with chronic illnesses who live in poverty may find themselves both unable to work full time and unable to address their health needs.
Ultimately, the timing for this effort from the Trump administration is misjudged and the assumption that additional work requirement will impact the poverty rate in any meaningful way is shortsighted. SNAP enrollment and spending has been declining and is projected to continue to decline for the foreseeable future. The majority of families receiving SNAP benefits already had a working family member within the past year. The majority of non-elderly adults who receive Medicaid also work, most averaging over 80 hours of work per month. The executive order appears to be another attempt of the Trump administration to save money to the detriment of the vulnerable, including the 70 percent of SNAP households with children and the high numbers of children enrolled in Medicaid.
What legislators ought to do is reduce barriers to steady employment such as lack of childcare. And work requirements as a condition of health care coverage through Medicaid should be removed from consideration entirely. The realistic solution to address poverty in the U.S. is multi-layered as the problem itself and deserves more than an overly simplistic and ineffective solution.
Will Francis, LMSW
Government Relations Director,
National Association of Social Workers,
Cossy Hough, LCSW
Clinical Assistant Professor, The University of Texas at Austin,
School of Social Work
Anna Stelter, LMSW, MPH
Health Policy Analyst
Texas Health Institute
Alison Mohr Boleware, MSSW
Mental Health Policy,