Join us on Monday evening:  Big Tent Organizing Rally: Sink the Reconciliation Bill – a virtual event, 7:30 p.m. ET. Lots of co-sponsoring organizations, including CHN. Click on the image to RSVP.

President Trump and his allies in Congress seem to think average people are awash in excess – too many pencils!  SNAP nutrition benefits that are too generous! Medicaid and Affordable Care Act coverage that’s too easy to get! 

President Trump, fresh from pasting golden doodads around the Oval Office, told Americans who’ll have to cope with higher prices from his tariffs that 5 pencils are quite sufficient.  And House committees charged with coming up with ways to pay for four trillion dollars in tax breaks for the wealthy and corporations have mapped out sacrifices that millions of people will have to make, in less food, less health care, and less income. 

All those trillions in tax breaks did not include continuing higher premium subsidies for people with low incomes purchasing Affordable Care Act health insurance.  Letting the current increased subsidy expire will mean about 5 million people will go without health insurance, according to the Congressional Budget Office (CBO).  The House Republican proposals to cut Medicaid are expected to result in another 8.6 million people losing Medicaid, for a total of about 13.7 million denied health coverage if these proposals are enacted, according to a CBO letter responding to questions from House Energy and Commerce Committee Democrats. 

The House Committee on Agriculture has also released its proposals to cut the Supplemental Nutrition Assistance Program (SNAP) by about $300 billion over a decade ($230 billion over 9 years).  So far, it’s not easy to estimate how many people will lose SNAP altogether, but the proposals are designed to end benefits for many, and to reduce benefits for many more.  The Committee would subject many more to paperwork requirements to demonstrate that they are working or that they are exempt from the required hours of work or training. The new proposal would extend the age range subject to these requirements from the current 18-54 to 18-64.  People with children 7 and up would newly be subject to the work documentation requirement. There is no requirement that child care be provided.  If people cannot document that they are complying or that they are exempt, they will be time-limited off SNAP for three years after only three months of assistance. 

The House Agriculture bill makes more and unprecedented cuts in SNAP, for the first time requiring states to pay a proportion of SNAP benefits, and to double states’ share of SNAP administrative costs.  States will have to pay a minimum of 5 percent of SNAP benefit costs, but their payments will rise if error rates in the state are higher.  Over the past two decades, every state except South Dakota had at least one year with error rates exceeding 6 percent, which would mean their required SNAP share would rise to at least 15 percent.  If states could not meet these new cost requirements, federal SNAP payments would decline.  That will mean a reduction in benefits to all receiving SNAP and/or restrictions in eligibility so that some people are excluded altogether.  It’s worth noting that error rates are mostly as a result of inadvertent mistakes, and include both overpayments and underpayments.  States will continue to have to pay penalties for these errors, in addition to facing the new match requirements.  If states do not make these new payments, the federal funding for the state will also decline, adding up to a sharp reduction, leading states to use red tape strategies to disqualify more people.  Other provisions limit adjustments the federal government can make to reflect the most up-to-date estimates for the cost of at least a minimally healthy food budget. Now, the average SNAP payment per person per day  is about $6.  That could decline, and then rise only minimally with inflation.

There are a host of reasons why people with low incomes will lose both SNAP and Medicaid, including those with children and those with disabilities.  In the case of SNAP, the increased payments demanded of states will lead to reduced benefits.  In Medicaid, co-payments of $35 for medical services will cause some people to forego services.  For both programs, work and eligibility reporting requirements will cause millions of people to lose benefits, despite their continued eligibility.  This is not mere speculation.  When states embarked on redetermining eligibility for Medicaid after the end of the pandemic emergency, the majority of denials were done for bureaucratic reasons – not because there was an actual determination of ineligibility.  People who were eligible but did not speak English well had an especially difficult time navigating the system. In Florida, for example, Medicaid call wait times for non-English speakers were far longer; in fact, 45 percent of Spanish language calls were disconnected before reaching a person to talk to, compared to only 5 percent of such disconnections for English speakers, according to research conducted by UnidosUS.  People fail to get renewed, because they don’t receive mailed notices or fail to produce the documentation that they are indeed disabled or otherwise eligible.  A study reported in the Journal of the American Medical Association (JAMA) found that people in Connecticut who were denied SNAP because of failure to comply with work reporting requirements were likely to have a disability, including substance use disorders, and were unlikely to work more once their benefits were denied. 

I watched the debate about the Medicaid cuts in the House Energy and Commerce Committee as it continued all night long on May 13-14.  The proponents refused to concede that anyone eligible would lose Medicaid. They insisted that only people who were wrongly receiving Medicaid coverage would be denied.  They held up the self-satisfied banner of the “dignity of work;” it would be good for people to be forced to get “off the couch.”  There is ample evidence that the people subject to these requirements do work, but their health or their children’s, or the insecurities of the job market or lack of child care, make their work unstable, so they may not meet the requirements.  Or they really would be exempt from the requirements, but they face multiple roadblocks to proving their continuing eligibility. 

There’s a lot more in these bills that will take the basics away from people with modest incomes.  As we knew from the start, you can’t cut a trillion dollars from health care and nutrition aid without hurting people and the communities they live in. 

The House seems headed, as soon as next week, to pass a package that forces many losses of basic needs on millions of people while ramping up even more tax breaks for the wealthy and corporations.  We have to stand in the way – we have to hold elected officials accountable.   

This isn’t a done deal.  If you agree that 5 pencils, less food, less health care, and less income is not the economic justice we require, keep up the fight with us. There are opportunities to jam things in all the next legislative steps, including the Senate.  We’re not done fighting; we’re not done telling the truth.