‘Reform’ Backward Step

April 14, 2018 GMT

Words matter. There is a lot of talk these days, primarily from Republican lawmakers, about “welfare reform.” It’s a catchy phrase, and lawmakers pair it with evocative images: people dependent on government programs, trapped in a cycle of poverty, or unwilling to work. It’s time to leave rhetoric behind and discuss the implications for Pennsylvania’s budget and Pennsylvanians. When most people think of welfare, they probably think of cash assistance or Temporary Assistance to Needy Families: a monthly check to families in poverty to help them meet their basic needs. Today Pennsylvania spends less than .05 percent of state general funds on cash assistance and about 1 percent of Pennsylvanians receive this benefit. Parents are subject to employment and training requirements and there’s a five-year lifetime cap on benefits, with limited exceptions. The Supplemental Nutrition Assistance Program, previously known as food stamps, is a critical program to combat food insecurity, experienced by about 13.8 percent of Pennsylvanians. Research shows that providing SNAP benefits helps to improve high school graduation rates, adult earnings, and health outcomes, and reduces health care spending. SNAP benefits are federally funded, so changes to SNAP won’t make a dent in our state budget. That leaves Medicaid, the state and federal program that provides health coverage to low-income and disabled children, adults, and seniors, and covers 2.9 million Pennsylvanians. Medicaid is a critical safety net for all of us. Nearly two out of three Pennsylvanians in nursing homes are Medicaid recipients because Medicare doesn’t pay for long-term care.  In 2017, the federal government mounted a sustained attack on Medicaid under the guise of repealing the Affordable Care Act. I testified before Congress on the Graham-Cassidy proposal, which would have cut Pennsylvania’s Medicaid funding by $15-30 billion over 10 years. In the face of this devastating proposal, we learned that Medicaid is quite popular. Three-quarters of people have a favorable opinion of Medicaid, and only 12 percent of people want decreased spending on Medicaid. Americans made themselves heard, Congress backed down, and Medicaid has remained unscathed. Now, lawmakers again are gearing up to target Medicaid. Some lawmakers are eager to apply work requirements. I agree that we want as many people as possible to be employed. But stripping health coverage from individuals with chronic conditions, or who are battling addiction, is not going to help them find a job. It is much more likely to send them into a spiral of worsening health that ultimately will cost our society even more in medical costs and in lost productivity. The conversation should be about improving programs that help keep people healthy.  Healthy people are much more apt to look for work, enabling them to support themselves and their families.   Instead of punitive proposals, we should focus on how we break down barriers for people to get good-paying jobs. Those barriers may include access to child care, transportation, educational level, or a criminal record. I commit to working toward bipartisan solutions that support people as they seek and retain work, rather than punishing those who most need a helping hand.