Federal Budget Targets SNAP, Medicaid, ACA, Housing

By Josette Keelor, News contributor

The Trump administration has proposed $763 billion in budget cuts over the next 10 years.

These cuts would repeal the Affordable Care Act and eliminate the Medicaid expansion, as well as greatly change how the Supplemental Nutrition Assistance Program (SNAP) functions and set up work requirements for many who receive government subsidies — all programs that affect the people social workers strive to help.

For now, these are all what-ifs, because luckily for those who rely on supplemental government assistance, the U.S. House of Representatives has so far rejected the fiscal year 2019 budget, and Congress has rejected the House’s first attempt at a farm bill.

The president’s budget each year covers all government-sponsored programs, and each administration then needs approval from Congress to fund the budget. But social work experts don’t see that approval happening this summer leading up to the September budget deadline.

If, for example, Congress wanted to change Medicaid right now, they would have to pass a budget resolution, which social worker Deborah Weinstein said they won’t do.

Anything the administration tries to pass would need 60 votes in the Senate, “and they don’t have 60 votes to make these kinds of restrictions in the Medicaid program,” said Weinstein, executive director of the Coalition on Human Needs in Washington, D.C.

While Weinstein isn’t concerned about President Trump’s budget passing in its present form, she said more work needs to be done to preserve programs important to social workers and the people they serve.

“We need to be alert to the various ways (legislators are) trying” to make cuts, she said. “They’re looking for these backdoor ways. That is what the work requirements would do.”

Those looking to make cuts to programs are working on appropriations bills and other pieces of legislation — in particular, the farm bill, which affects agriculture programs and includes proposals to change SNAP.

Supplemental Nutrition Programs

If any aspect of the Trump administration’s budget passes, Americans who currently rely on government subsidies for themselves or loved ones stand to lose in various ways, with some of the largest impacts hitting hard in health care, housing assistance and supplemental food programs.

All three safety net programs are extremely important in the lives of low-income people and are extremely slashed in the Trump budget, Weinstein said.

Currently, SNAP provides an average of $125 per month to each of 42.2 million Americans, according to the Coalition on Human Needs. Trump wants to cut that assistance by more than $15 billion.

“The farm bill just was defeated in the House,” Weinstein said, but was likely up for another vote in June. (At press time, this had not happened.)

Through the president’s budget in February and the House’s recent farm bill, HR2, we’ve seen efforts by the administration and Congress to weaken SNAP, said Lauren Badger, government relations associate for the Food Research and Action Center.

SNAP is the nation’s most effective anti-hunger program, she said, with 84 percent of all benefits going to households with children, seniors or people with disabilities.

The program reaches more than 40 million people and in 2016 helped bring 3.6 million out of poverty, Badger said.

“It’s also a critically important anti-poverty program,” she said. Therefore, any efforts to weaken it would increase incidence of poverty.

“SNAP is a very effective program. It works exactly as it’s intended,” she said.

But that doesn’t mean it’s as effective as it could be. The $125 average allocation per person boils down to about $1.40 per meal, which Badger said isn’t enough.

“Most benefits run out by the end of the month,” she said. “So, people are forced to make difficult choices.”

Among those choices are whether to buy food or pay rent, and how they’ll buy other necessities.

“It also impacts local economies,” she said.

HR2 does little to alleviate those concerns, Badger said. It would take food off the table for more than 2 million people.

The president’s budget, too, would make “gigantic cuts to SNAP,” Weinstein said — about 33 percent, or more than $213 billion over 10 years.

Part of those changes would be replacing about 40 percent of cash allocations through SNAP debit cards with boxes of food.

“They would be nonperishable items, very costly to do that,” Weinstein said.

She said the U.S. Food and Drug Administration estimates it could save money on this initiative by paying less for the food items that would fill those boxes.

“But you can be sure, number one, that it goes against the knowledge that we now have that fresh fruits and vegetables will be more nutritious for people,” Weinstein said.

These proposals would also impact individuals who are on special diets or who have food sensitivities, and also could increase the time and cost burden on localities tasked with staffing local programs and traveling great distances to deliver food to people who live far from town.

“All of those things are tremendous problems,” Weinstein said.

Since Congress rejected the bill, she said there’s no effort to incorporate such policies into the farm bill.

A greater issue she sees to the future of SNAP and other programs is the administration’s interest in imposing work requirements on those who receive government assistance.

“The Congressional Budget Office estimates that more than 2 million will lose SNAP assistance because of these work requirements,” Weinstein said.

Current law requires those receiving benefits to work until the age of 50, but the president’s proposals would extend that age requirement to 62.

Those without dependent children and those who are poor enough to qualify would only receive three months of benefits over the course of three years unless they meet the work requirements. This restriction stops when they turn 50.

People who have been out of the labor force for a while and can’t find adequate work quickly enough would be among those the proposal affects the most.

The version of the farm bill just defeated stipulates work requirements of at least 20 hours a week, increasing to 25 or so in a few years, Weinstein said.

It also requires monthly documentation of that work and would apply requirements to families with children younger than 6. Under current law, exclusions exist for families with children younger than 12.

The farm bill also would extend work requirements to the age of 60, but doesn’t have the distinction of the three months, Weinstein said.

“In a way, it’s worse than the three months,” she said. A violation would mean no SNAP benefits for up to a year or longer.

While the work requirement plan might seem like a good idea on the outside, it has a lot of problems in implementation.

Everyone wants people to be able to work, Weinstein said. “That sounds fair to people at first blush.”

But finding work might not be so easy for lower-skilled laborers or those who live in places where jobs are scarce.

Even those who do have jobs might not have employers willing to give them more hours. Or they might work jobs that require them to be on call, which would interfere with their ability to take on a second job.

“That’s the reality of a lot of today’s labor market,” Weinstein said. “People who want to work a lot more hours can’t.”

Furthermore, Badger said many who receive SNAP benefits do work, defying misconceptions many people have about program participants abusing their benefits or refusing to work when they can.

Most people receiving SNAP benefits are low-income children and seniors. And most SNAP beneficiaries who can work, do work, she said.

The farm bill as it is would cut eligibility for working families, which in turn would impact all other aspects of beneficiaries’ lives.

SNAP participants already pay a higher percentage of their income for rent and child care than many other Americans do. Changing SNAP eligibility would also affect their access to other programs, such as free or reduced school meals for children.

If HR2 passes, 265,000 low-income children would lose their school meals, Badger said.

The bill, she said, is setting up an unproven workforce program.

“Taking away someone’s food benefits is just a really bad approach to this,” she said.

For Weinstein, the decision to support the farm bill or the president’s budget comes down to the motivation backing them. Is the government trying to get more people to work, or trying to reduce their own caseloads overseeing those who receive benefits?

“So, these are kind of themes that we are going to see applied wherever we can do it, and we just have to recognize them for what they are. They are ways of getting people off of the caseloads,” she said. “They are not ways to help people.”

All congressional Democrats voted against the farm bill, plus 10 moderate Republicans and others who wanted to force a vote on a restrictive immigration bill, Weinstein said.

“The administration is casting about for various ways of restricting people’s eligibility for benefits,” she said. Congress didn’t go along with the food box, but “they are interested in the work requirements.”

Health Care Funding

On health care for low-income Americans, Trump’s budget calls for cutting federal Medicaid funding substantially over the coming decade.

Repeal of the Affordable Care Act has been a longstanding platform for the president, and it’s included in his budget along with eliminating plans for a government-subsidized Medicaid expansion.

“It would also turn Medicaid into a block grant,” Weinstein said. “It gives states the option to take the money as a block grant.”

She sees that as problematic because of the limited nature of grant money. Right now, Medicaid is an open-ended program, so if there’s an increase in eligibility populations in any state, those people will be included in the program, with state and federal governments each paying their own share.

Even if the economy takes a hit, Weinstein said, the program responds. But block grants would allow states to take a fixed amount in Medicaid funding.

“And if states figure out a way to deny people assistance, they can keep that money,” she said.

Another proposed budget option is to impose a per capita cap on Medicaid funding. If more people apply and are eligible, the amount will grow on a per person fixed amount. But, “it won’t respond to the actual medical costs that are incurred.”

Medicaid participants would get a fixed amount, Weinstein said.

While Congress has not taken any action to approve such changes, Weinstein said the administration is approving waiver requests from states on its own, and more waivers are being sought.

“Can this be legal?” Weinstein recalled a South Dakota resident asking in a recent email.

“And some don’t think it is,” Weinstein explained. The administration is being sued over it, she said.

Proposals also include work requirements similar to those proposed for SNAP, which Weinstein said will negatively affect participants. “They simply won’t be able to follow the rules.”

Housing Assistance

Housing, too, is an area where the president has proposed program cuts, Weinstein said.

“He would have cut the various kinds of subsidized housing programs by about 14 percent.”

For example, she said cutting the rental vouchers housing choice program would have resulted in 200,000 households not getting vouchers to help offset the cost of housing.

“Congress is not likely to be that bad,” she said. But she also doesn’t think the U.S. Department of Housing and Urban Development bill is enough to cover all existing vouchers.

Therefore, passage of the bill might still see close to 200,000 households losing benefits.

Unfortunately, she said, there are efforts to reduce or not adequately fund the amount of money for vouchers.

The HUD bill would triple the minimum rent recipients would have to pay to receive government assistance. And here, too, plans for future funding would require work requirements.

“There are kindred spirits in Congress looking to realize some of the goals of the Trump budget,” she said.

These initiatives spell dire outcomes for many lower income families, but Weinstein hasn’t lost hope.

“There’s another side of this story,” she said. Last fall, Congress passed a two-year spending deal that covered fiscal 2018-19.

“It did some great things and the president signed it,” she said. “So, this is interesting.”

There are caps restricting the amount of money that’s been spent on the annually appropriated program, which includes funding for housing, job training, education, some child care funding and other child welfare, among other programs.

“There they really rejected the harsh cuts that the president wanted to make,” Weinstein said. And Democrats worked hard to increase funding in areas, she added.

“But ultimately these things passed with bipartisan support,” she said. Child care funding, for example, nearly doubled. “It’s just a huge win.”

Hope for the Future

David Rosen, community officer on regulatory affairs for the Clean Budget Coalition — of which NASW is a member — said his organization advocates for a clean budget, meaning language in the budget is free of “poison pill riders” that detract from the budget’s ability to make a positive impact on Americans’ lives.

Poison pill riders are measures that have nothing to do with the budget, Rosen said. His organization wants the budget to go through “the regular order, and that we end up with a clean process and clean budget at the end of the day.”

“We haven’t managed to keep out every single rider over the last three budget cycles,” he added. But they’ve managed to keep well over 95 percent of riders out of the final budget each time.

There are a handful that keep coming back each year, he said. “For the most part we have been incredibly successful.”

For Weinstein, too, bipartisanship is key in finding measures that benefit the most people and help prevent harmful or unrelated initiatives being shoehorned into the budget.

“There’s been a tremendous advocacy to fight this and it has paid off in that in the past the farm bill has been bipartisan,” Weinstein said.

“But the inclusion of these harsh work requirements with the work of advocates across the country has led to all the Democrats opposing them, and as I say, a moderate number of Republicans opposing them as well.”

On the Senate side, she said, it’s more bipartisan. “We get the impression that it won’t have these kinds of harsh requirements.”

So, what can social workers and other Americans do? Stay vigilant, fight for what’s right and share personal stories of how SNAP and other programs have helped your loved ones.

Americans benefit when bills are bipartisan and lawmakers listen to each other, Rosen said.

“When we stand together united and say no, it’s a much stronger message and it’s much easier for lawmakers trying to do the right thing to get behind,” he said.

Weinstein agreed: “Keep fighting, because even in the most unexpected places, we can make real progress.”

The annual funding deadline is at the end of September, and though Rosen said no one knows what’s going to happen yet, he said there’s still time to enact positive change.

“Call your members of Congress in both chambers,” he said. “Tell them: Keep the poison pill riders off of the spending bills.”