Thanksgiving is near, the winter holidays will follow quickly, and then off we go to another new year. Yet while time marches, millions of people are stuck in place when it comes to realizing financial stability, or worse, finding it harder to feed their families and pay medical bills this year than they did last.
Indeed, 2023 is shaping up to be a pivotal year for America’s safety net. The very programs that America relied upon to weather the COVID-19 pandemic are all undergoing change. Programs that provide healthcare, food assistance, internet connectivity and other basic needs all face major challenges, and the decisions we make will have real, human consequences. We know from our work that there is bipartisan interest among states across the country in modernizing these programs. We need commitment at the federal level, too, to help us strengthen our resilience in a post-pandemic world.
Medicaid is a good example. During the pandemic, programs swelled as annual re-enrollment policies were eliminated to meet America’s healthcare needs in a crisis. We were rewarded with an extraordinary achievement: our uninsured population dropped to an all-time low. Yet now, annual re-enrollment is being reinstated and an estimated 15 million people stand to lose health insurance as a result, even though almost half will remain eligible. Since April, more than 10 million people have already lost Medicaid. States are struggling mightily to assist the uninsured, but they need our help and support.
Another example is WIC, the Special Supplemental Nutrition Program for Women, Infants, and Children, which supports an estimated 6 million people with nutrition assistance. While WIC has received bipartisan funding support for more than 25 years, the program is now facing a funding shortfall because of rising food costs and higher-than-expected participation. Without additional funding to cover the gap, state agencies would need to create waiting lists, leaving about 600,000 young children and new parents without access to nutritious foods and healthcare service referrals that WIC provides.
There is also SNAP, the Supplemental Nutrition Assistance Program once known as food stamps. During the pandemic, access to SNAP was eased, enabling people to buy groceries in a time of need. At certain points, interview requirements were dropped if there was sufficient information to determine eligibilty. Benefit amounts focused on household size, reducing complexity and increasing the amount of money available to people. College students and working adults also benefited from simplified rules. However, the expansion of benefits and streamlining ended earlier this year, and since then the number of Americans experiencing food insecurity rose dramatically, according to a University of Pennsylvania study published in JAMA. If we are committed to ending poverty, making sure Americans have enough to eat is a good start.
"All of this uncertainty is against the backdrop of recent federal poverty statistics that showed 2022 as the largest one-year increase in poverty on record, with the number of children living in poverty doubling."
Healthcare and nutrition are not the only programs facing challenges. The Free Application for Federal Student Aid form, known as FAFSA, is being revamped and improved as required by legislation with strong bipartisan support. But the timing of the rollout just before the end of this year will give students less time to navigate the form and apply for financial aid.
The Affordable Connectivity Program helps low-income Americans pay for internet access, which is increasingly—and rightly—considered a basic need. But Congress must provide additional funding or it will run out in early 2024. Programs like these provide opportunity, and we must ensure that Americans have simple and dignified access in times of need.
All of this uncertainty is against the backdrop of recent federal poverty statistics that showed 2022 as the largest one-year increase in poverty on record, with the number of children living in poverty doubling.
Amid all the studies and statistics, it is easy to forget that this is about people. Take, for example, Thomas, a 48-year-old who worked as a maintenance technician and welder before experiencing homelessness. Thomas has received insurance through Medicaid since 2017, but was removed as part of this year’s re-enrollment effort. Yet Thomas was unaware of the change until he was unable to receive the blood pressure medication he uses to keep two brain aneurysms at bay—and was forced to cancel an important neurosurgery.
Thankfully, Thomas called a phone line run by Benefits Data Trust for assistance reapplying for Medicaid. Our benefits specialist also helped him apply for expedited food assistance, connected him with housing programs and referred him to the local Social Security office to apply for disability benefits. Together, these programs can get Thomas out of his truck and back to a life without fear that low income (or no income) will become a fatal condition.
But that can only happen if programs are modernized and access is smooth.
There are encouraging signs that improvements are being prioritized, including last week’s recognition from the White House through an executive order that government must better understand the promise – and manage the risks – of artificial intelligence in the public sector. Through the Aspen Institute Financial Security Program, BDT is participating in working groups of federal and state human services leaders who are coordinating with nonprofits and other partners to design solutions for the delivery of benefits.
The lesson of the pandemic is that when we streamline public benefit programs and strip away barriers, we help more Americans. More people who need it receive healthcare. More people eat. These things are not part of a blue or red agenda, they are an integral part of America’s promise. We must take care of our safety net programs if we expect them to take care of us.