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Federal judge blocks Arkansas and Kentucky Medicaid work requirements

Monday, April 1st, 2019

A federal judge struck down Medicaid work requirements in Arkansas and Kentucky on Wednesday, temporarily blocking one of the Trump administration’s most consequential health policies.

U.S. District Judge James Boasberg ruled that the federal government did not properly justify the need for the work requirements given the number of people who would lose health coverage.

This is the second time Boasberg blocked Kentucky’s Medicaid work requirements. In June 2018, he said the administration didn’t adequately consider the significant coverage loss if Medicaid eligibility was conditioned on reported work. In response, Kentucky officials resubmitted a nearly identical waiver.

Boasberg ultimately agreed with advocacy groups that sued on behalf of Medicaid enrollees, and ruled that the state and federal administration had not done enough to differentiate between the two waivers.

“The Court cannot concur that the Medicaid Act leaves the Secretary so unconstrained, nor that the states are so armed to refashion the program Congress designed in any way they choose,” wrote Boasberg in his Kentucky decisionWednesday. “As a consequence, once again finding the reapproval was both contrary to the Act and arbitrary and capricious, the Court will vacate it and remand to HHS for further review.”

The judge cited coverage loss in Arkansas as further proof.

Over 18,000 low-income Arkansans lost health coverage last year because they didn’t meet the work and reporting requirements. Of these 18,164 residents, only 8 percent have reapplied and regained coverage in 2019. Thousands more were on track to lose coverage this year if they didn’t report hours for three consecutive months. Kentucky’s revised work requirements were supposed to be implemented April 1.

Boasberg called Arkansas’ waiver “arbitrary and capricious because it did not address — despite receiving substantial comments on the matter — whether and how the project would implicate the ‘core’ objective of Medicaid: the provision of medical coverage to the needy.”

Advocacy groups that sued on behalf of Medicaid beneficiaries were pleased with the decision.

“Medicaid is federal and state program designed to provide health care, it is not and never has been a program intended to encourage work,” Jane Perkins, legal director of the National Health Law Program, said in a statement. “The law is about providing health care services to low-income individuals and families and underserved populations. It is nonsensical and illegal to add obstacles to Medicaid for large groups of individuals who are already working or full-time health care providers for family members or suffering chronic health matters that prevent them from work.”

Advocacy groups are also suing the Trump administration for approving Medicaid work requirements in New Hampshire.

This article was originally published at ThinkProgress on March 27, 2019. Reprinted with permission. 

About the Author: Amanda Gomez covers health policy. She previously worked at the PBS NewsHour.

The Anti-Job-Creation Party Wants Welfare Recipients To Work

Wednesday, June 8th, 2016

Isaiah J. PooleHouse Speaker Paul Ryan ended up overshadowing his own efforts Tuesday to highlight the Republican Party’s proposals for overhauling aid programs for low-income people by telling reporters that he was still planning to endorse and vote for a presidential candidate that had earlier uttered what he called “the textbook definition of a racist comment.”

The Speaker of the House shredding his moral credibility – in the heart of one of Washington D.C.’s historic African-American communities, no less – to remain loyal to Republican presidential candidate Donald Trump was indeed far more worthy of media attention than the ostensible purpose of his crossing the Anacostia River, which was to use a church-based substance abuse treatment center as a backdrop for his effort to rebrand the Party of the 1 Percent as the party that cares the most about the poor.

Nonetheless, the package of proposals that Ryan began unveiling this week, under the branding of “A Better Way,” should not be ignored, even though many of their tenets will be familiar to people who have followed what passes for anti-poverty policy in the conservative movement. What Ryan hopes is that at least Senate and House candidates will use the “Better Way” proposals to give the impression that the Republican Party is more than the “Party of No” and a party that thinks the solution to every economic problem is a tax cut for the wealthy.

People who are interested in a detailed rebuttal of the “Better Way” anti-poverty proposals should refer to the Center for Budget and Policy Priorities, which has posted a series of commentaries on Ryan’s plan.

Much of the analysis is around the ways Ryan and his Republican allies try to avoid the fundamental truth contained in a statement issued Tuesday by Deborah Weinstein of the Coalition for Human Needs: “It costs money to give people the tools to escape poverty” – and Republicans just don’t want to spend that money. Weinstein notes that this year, under Ryan’s leadership, House Republicans proposed cutting low-income programs “by $3.7 trillion over 10 years, mostly in health care, but also cutting [Supplemental Nutritional Assistance Program benefits, commonly known as food stamps] by $150 billion (a 30 percent cut between 2021-2026), and cutting Pell Grants and other low-income education programs.”

There is another familiar theme that will jump out if you look at Ryan’s plan: the insistence that “our welfare system should encourage work-capable welfare recipients to work or prepare for work in exchange for benefits.”

The principle that every person who wants to work should have a job is one that progressives and conservatives could unite around – if conservatives believed that government had a role to play in helping to create the jobs that they are so adamant that people take in lieu of being “dependent on government.”

But there is nothing in the 35-page report on poverty programs and the Republican alternative that speaks to actual job creation. There is a lot of righteous hectoring about how people receiving government assistance – whether it’s the now-rare cash assistance, SNAP benefits, or housing aid. But the section of Washington Ryan chose as the setting for his news conference has an unemployment rate of 12 percent, more than two-and-a-half times the national average.

What the people in the community don’t need is to be lectured about the value of work. They need jobs. And this is where the Republican rhetoric does not match reality, since the Republican Party has dramatically cut spending on every economic development program that would support job creation, ranging from badly needed infrastructure investment to the kinds of economic development programs that enabled communities to improve themselves without the destructive, zero-sum game of gentrification.

Ryan and his party also does not believe that the federal minimum wage should eventually be raised to $15 an hour, so that people who work and raise a family can actually rise above poverty through their wages. It is the double-whammy that renders all of Ryan’s posturing about “a better way” to deal with poverty just that – election-year posturing. It’s just like his attacks on Donald Trump’s “textbook” racism – designed to project an air of moral probity to cover immoral actions.

This blog originally appeared at OurFuture.org on June 7, 2016. Reprinted with permission.

Isaiah J. Poole worked at Campaign for America’s Future. He attended Pennsylvania State University and lives inWashington, DC.

Dozens Of Walmart Workers Walk Out On Strike In Miami

Tuesday, October 22nd, 2013

Bryce Covert

In the latest labor action against Walmart, dozens of workers reportedly walked out on the job on Friday to go on strike. Workers demanded higher wages and better hours, and one worker told Salon that he estimated 80 people took part in the action.

The strike came after protests in 15 different cities in September against the country’s largest private employer. But while those included rallies and pickets in protest of alleged firings of striking workers, they did not include workers who were on strike. Friday’s action was the first work stoppage since June. While past actions were organized by OUR Walmart and supported by unions, this appeared to be independently organized.

Workers have alleged that they are routinely disciplined and fired for trying to organize for better hours and wages. In August, 10 current and former workers were arrested at a rally outside the company’s headquarters. Labor groups allege that five workers were fired after strikes in June while others were suspended or disciplined. The company has admitted that it threatens thatvacation time or other benefits could disappear when workers ask about the right to unionize.

Walmart, for its part, told the Huffington Post that employees don’t get full schedules because they aren’t available all the time and has denied that it is a minimum wage employer. It has previously said of the protests that “the opinions being expressed aren’t representative of the vast majority of the people who work for us.”

A recent survey found that over half of Walmart locations are only hiring temporary workers, not full-time positions. Meanwhile, while the company claims full-time workers make $12.78 an hour on average, another report saysthe average worker makes $8.81, 28 percent of the pay at other large retailers. Its workers make so little that they have to rely on public benefits to get by, with workers at a single location consuming around $1 million worth in food stamps, Medicaid, and other programs. The company has also stood staunchly against living wage bills in multiple cities, with the latest victory in Washington, DC, where after it threatened to pull plans to open stores Mayor Vince Gray (D)vetoed a bill.

Yet the store’s sales have recently suffered, in part from widespread customer dissatisfaction with its inability to keep shelves stocked, likely thanks to not hiring enough full-time workers. Other stores follow a different model, with Costco paying workers $21.96 an hour and seeing profits rise 19 percent in the first quarter of the year. WinCo, a small Idaho-based grocery store chain, beats Walmart’s prices while paying more than $11 an hour and offering generous benefits.

Perpetually low wages aren’t unique to the retail sector, and they have also sparked widespread protests and strikes in the fast food industry, which have spread to nearly 60 cities.

This article was originally printed in ThinkProgress on October 21, 2013.  Reprinted with permission.

About the Author: Bryce Covert is the Economic Policy Editor for ThinkProgress. She was previously editor of the Roosevelt Institute’s Next New Deal blog and a senior communications officer. She is also a contributor for The Nation and was previously a contributor for ForbesWoman.

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