Republican debt ceiling plans could see most vulnerable Americans lose aid

<span>Photograph: Anadolu Agency/Getty Images</span>

Photograph: Anadolu Agency/Getty Images

As debt ceiling negotiations come down to the wire with the 1 June deadline looming, some Republican leaders seem determined to use critical safety net programs – specifically, Medicaid and Snap – as a bargaining chip, and millions of America’s most vulnerable families may pay the price.

Cuts and restrictions to these essential programs, which offer healthcare and food assistance, will cause further hardship to families who are already struggling – and who in many cases can’t afford the basic essentials like food and shelter. The Republican fixation on appending work requirements to these benefits are also ineffective: data shows these policies are not needed and don’t produce any substantial solutions. Some critics say they also force people to find jobs that don’t actually lead to economic mobility, prolonging their need for federal assistance.

Related: Low-income Americans face a ‘hunger cliff’ as Snap benefits are cut

“Most Americans with health coverage through Medicaid are already working if they are able to,” Senator Ron Wyden, chairman of the Senate finance committee, said in a recent statement. He also noted that “the track record shows work reporting requirements are a bureaucratic nightmare for Americans”.

If Democrats make these concessions to the GOP, the cuts would also be one more blow to vulnerable people this year, many of whom just recently experienced slashed benefits when emergency Snap benefits ended along with the public health emergency for Covid-19 in May. At the same time, grocery prices are soaring: The US Department of Agriculture estimates all food prices are predicted to increase 6.5% in 2023, on top of the jumps in cost we’ve already seen over the past year or so.

Maine resident Hazel Willow, single mother to a four year old, recently left an abusive relationship and says these programs provide the essential support she desperately needs to survive and heal.

“The way I’m best able to provide for my child, to make sure I’m living my highest good as myself, a mother, a citizen and human in society, is to heal and recover with whatever ability I have in my body that day,” Willow said. “To do that safely and successfully, I need the societal safety net of Snap, Tanf, Wic, and others.”

Willow notes that – like everyone else she knows who relies on these programs – she would love to be more self-sufficient, and wishes she had more options that would provide her with more financial breathing room and agency over her own life.

“A life in which you live or die by your access to these programs is not an easy one. In my new world – where almost everyone is on most of these same programs – I have yet to meet someone who has an easy day, who is happy and safe with the way their life is and feels content to simply exist on these benefits.”

Paco Vélez, president and chief executive of Feeding South Florida, said there are more than a million people struggling with food insecurity in his region and worries that more restrictions will make the situation even more dire.

“The proposed work restrictions expand the minimum 20 hour per week work requirement from ages 18 to 49 to include ages 50 to 55,” said Vélez. “Many times, individuals that are unable to work fall through the cracks and have a hard time filing for an exemption or navigating the process to obtain disability, although their health is at risk, or they are unable to perform in a job they used to be able to do.”

“My Snap benefits run out by the second week of the month and that is already shopping for whatever I can find on sale,” says Lilia Jorge Perez, 51, of Hollywood, Florida, who relies on Feeding South Florida. “I want to buy more healthy foods like vegetables, fruits, chicken or fish but that would take most of my benefits.”

Perez came to the US from Cuba last year and has been struggling to find work because she is still waiting for her work permit. She was recently cut off from Medicaid and cash assistance and is grateful to be receiving Snap benefits.

“It is already difficult to find work and even worse for those over 50 with little to no education and who don’t speak English,” says Perez. “I know people shouldn’t have to rely only on the government to provide for themselves, but if we are already facing the possibility of homelessness from the raise in rent, and people are going without food because of the prices, how can the politicians make it worse during such a difficult time in the United States?”

Work restrictions often create obstacles for people accessing benefits, while also putting additional strain on staff and resources that are already stretched thin in such programs. Many families are required to navigate a notoriously complicated and time-consuming process in order to submit documentation proving they are meeting the requirements.

Related: ‘Horrible timing’: pandemic food relief ends as inflation sends families scrambling

And many communities – especially those in high-poverty areas – lack the resources to help residents who are facing food insecurity.

“The families we serve may not have access to a computer, miss the required phone interview, or have notices mailed to a former address,” said Vélez. “Expanding the age for work requirements will force more folks to jump through these hoops to access food – a necessity.”

Meanwhile, the cuts could deprive millions of Americans access to healthcare at a time when Covid continues to have significant impacts. The pandemic emergency status may have officially ended earlier in May, but tens of thousands of Americans are still getting sick with the virus or dealing with the lingering symptoms of long-term Covid.

A mandatory national Medicaid recertification process involving all program enrollees – known as an “unwinding” – has already begun as states resume the annual eligibility verification procedures that had been on hold during the pandemic. KFF estimates that between 5.3 million and 14.2 million people will lose Medicaid coverage just through that process alone.

States that saw some of the largest Medicaid enrollment surges during the pandemic – such as California, New York and Florida – are also likely to be among those with the largest number of people who lose coverage during this unwinding process. That means many people living in those states will soon be left uninsured – particularly in states like Florida, which didn’t adopt the Medicaid expansion, meaning fewer people meet the criteria for eligibility.

Adding work requirements and other barriers to coverage will compound the healthcare access crisis – and place significant strain on community resources including emergency rooms (where uninsured patients will seek care if they have no other option).

The US Department of Health and Human Services (HHS) says the red tape created by the Republicans’ proposed work restrictions would jeopardize the health coverage and access to care of 21 million Americans.

Kimberley Causey-Gomez, commissioner of the Virgin Islands Department of Human Services, notes that more than 40% of the territory’s population relies on Medicaid, and she worries that many of them may be at risk of losing coverage (and the access to healthcare) should work requirements become a reality.

Meanwhile, in Maine, Willow thinks the wealthy, including lawmakers and administrators who create and oversee these policies, don’t appreciate the consequences their actions have for people who rely on these programs – people who play an important role in our communities and society.

“The people who make your coffee, cut your hair or bag your groceries. The staff at the gas stations and restaurants you frequent,” she said.“Your life is supported by these programs whether you see them or not.”

This article was supported by the Economic Hardship Reporting Project

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