Acceptance of the New Normal | HEALTHY @ HOME

Acceptance of the New Normal | HEALTHY @ HOME

Acceptance of the New Normal | HEALTHY @ HOME

As we enter the holiday season it’s important to recognize the changes that have taken place in 2020, and are shaping the way families are gathering for celebrations.  

Laura Cochling of Changing Perceptions Therapy walks us through healthy ways to accept our new normal. 

To learn more about the Healthy @ Home series and see additional videos click here

We are driven by a belief – supported by experience and research- that people from all walks of life are more likely to flourish if they have an intact, healthy family and strong relationships.

 

To learn more about how the Healthy Families Initiative is active in the community, click here

How Can You Measure Welfare Program Success? Part 2

How Can You Measure Welfare Program Success? Part 2

How Can You Measure Welfare Program Success?

Part 2

By Erik Randolph

My last blog explained dependency metrics and how they measure the success of welfare programs. However, these metrics are not the complete answer.

By also following people after they leave the system, we can gain a fuller picture of success.

This technique is common for job training programs. In fact, it is a requirement for state and local agencies receiving federal funding per the Workforce Innovation and Opportunity Act, where agencies routinely measure the status and income of persons up to a year after  exiting the job training program. 

Follow-the-person metrics can be used for welfare programs as well, as Kansas and Maine already  demonstrate. 

 

Background on Food Stamp Work Requirements

 When the U.S. economy was recovering from the Great Recession, the states of Kansas and Maine led the nation in reinstating the federal work requirement for “Able-Bodied Adults Without Dependents” (ABAWDs).   

The news media generally criticized the governments of Kansas and Maine for reinstating the rule, claiming it was cruel to push ABAWDs off food assistance. Kansas and Maine responded with follow-the-person data. 

Shortly thereafter in 2015—while Barack Obama was still president—the federal Food and Nutrition Service urged all other states to follow the federal law by reinstating the ABAWD rule. However, most states were hesitant to do so, and they continued seeking waivers and exemptions from enforcing it.

Federal law has two work requirements for the food stamp program. There is the general work requirement for persons ages 19 through 59 with notable exceptions, such as being in school half-time, physically or mentally unfit for employment, or caring for a child under six years of age or an incapacitated person. Under the general work requirement, the recipient must register for work or otherwise have good cause if they are not working at least 30 hours per week or enrolled in a job-training or workfare program. 

The second work requirement is specific to ABAWDs. This rule applies to persons ages 18 through 49, unless they are already exempt from the general work requirement or if they are responsible for a child under 18 years of age, or pregnant. Non-exempt ABAWDs cannot receive benefits for more than three months in a 36-month period unless they work for an average of 20 hours per week on a monthly basis or they participate in an approved “employment and training” program. 

States may, and routinely do, waive the ABAWD rule in areas within their state with unemployment over 10 percent, and they have the discretion to exempt up to 15% of persons from the requirement. 

During the Great Recession, Congress suspended the ABAWD rule until September 20, 2010, but many states continued waiving the requirement well into 2017. 

 

Kansas and Maine Break New Ground 

Under the administration of Governor Sam Brownback, Kansas restored the ABAWD rule in October 2013. The Kansas Department for Children and Families, with the help of the state’s Department of Labor, followed the wages of individuals exiting the food stamp program. Departments of labor typically administer unemployment insurance programs that collect wage data. 

According to a report by the Foundation for Government Accountability, Kansas had 28,144 ABAWDs on food stamps in October 2013. One year later, in October 2014, there were 9,193. The following October, the number dropped to 7,601.

The drop in enrollment among this population may be alarming if one assumes these individuals were worse off, as many in the news media did. However, the follow-the-person data showed otherwise. On average, the annual wages of these individuals rose above the poverty line, from $6,703 in December 2013 to $13,304 in the fourth quarter of 2014. 

 

Maine had a similar experience.

No longer requesting an ABAWD waiver in 2014, the Maine Departments of Labor and Health & Human Services cooperated in following the wages of the 6,866 who did not comply with the reinstatement of the work requirement and exited the program. The Governor’s Office of Policy and Management under the political leadership of Governor Paul LePage analyzed the wage data. Its report showed total wages for this group more than doubled from the third quarter of 2014 to the fourth quarter in 2015. On average, quarterly wages increased from $1,984 to $3,514, also raising the wages of many ABAWDs above the poverty level. 

 

 

What Follow-the-Person Metrics Could Mean for Georgia and Other States

Unfortunately, both Kansas and Maine abandoned the follow-the-person data collection—not for policy reasons related to the effectiveness of the metrics but because of changes in political leadership.

Nevertheless, the states demonstrated that follow-the-person metrics can be applied to welfare programs in addition to job training programs. There is no good reason why Georgia and other states could not also implement follow-the-person metrics for welfare programs by having their welfare agencies cooperate with their departments of labor.

Additionally, states are not limited to using department of labor wage data. They could also initiate surveys to collect more detailed data on the well-being of individuals after exiting a program. 

Do you think it would be good for Georgia to begin using dependency and follow-the-person metrics to measure the success of welfare programs? Let us know in the comments below.

 

Erik Randolph is Director of Research at the Georgia Center for Opportunity. This blog reflects his opinion and not necessarily that of the Georgia Center for Opportunity.

DISINCENTIVES FOR WORK AND MARRIAGE IN GEORGIA’S WELFARE SYSTEM

Based on the most recent 2015 data, this report provides an in-depth look at the welfare cliffs across the state of Georgia. A computer model was created to demonstrate how welfare programs, alone or in combination with other programs, create multiple welfare cliffs for recipients that punish work. In addition to covering a dozen programs – more than any previous model – the tool used to produce the following report allows users to see how the welfare cliff affects individuals and families with very specific characteristics, including the age and sex of the parent, number of children, age of children, income, and other variables. Welfare reform conversations often lack a complete understanding of just how means-tested programs actually inflict harm on some of the neediest within our state’s communities.

Helping Children Adjust to Holidays During the Pandemic

Helping Children Adjust to Holidays During the Pandemic

Helping Children Adjust to Holidays During the Pandemic

 

 

 

By Guest Blogger Jen Johnson 

 

 

 

We have a unique opportunity to introduce this social skill this year due to the financial impacts of the pandemic.

 

Have you ever shown up to a party or wedding and felt under or over dressed? Have you turned up at a friend’s house for game night and realized your partner forgot to tell you it was potluck and you’re empty-handed? What about when you’ve gone to a restaurant and realized after arriving that there’s a dress code or that you need to tip and you didn’t bring cash? Think about a time where you’ve been embarrassed or frustrated because you didn’t meet an expectation you didn’t know about beforehand? 

What happened?

How did it feel?

What would you have preferred happened?

All of these experiences of discomfort could have been avoided if you had known the expectations in advance, right?

Setting expectations is an integral part of helping children meet expectations and manage their feelings.

This year families will be experiencing holidays in different ways due to the pandemic. Many families will not be seeing grandparents or extended family due to the risk of exposure to Covid-19. Events that have often anchored the holidays in the minds of children may be cancelled (e.g., Santa at the mall, holiday parties, community gatherings, religious services, parades). 

Children have experienced changes in major routines since the beginning of 2020. Many of these changes have happened so quickly that children did not have the chance to emotionally adjust. For example, schools closed quite suddenly in the Spring and decisions about virtual/hybrid/face to face learning have been made by the month and sometimes down to the week in some school districts. 

Fortunately, the holidays don’t have to be experienced that way. We, as caregivers, are in charge of our holiday plans. They don’t depend on the government, the school district, or any organization. We can decide now what the holidays will look like and begin setting expectations with children in advance.

I want to discuss two different aspects of setting expectations: topics that may need to be considered and discussed, and language you can use to communicate with children. 

These are some areas you may need to consider setting expectations:

Family Gatherings

Will you attend? Will you wear masks? Will there be social distancing? Will certain family members not be in attendance due to their decisions about their health? Children need to know in advance what to expect at family gatherings this holiday season. Don’t wait until you’re on the way to the gathering in the car to set expectations. Start talking about it now! Bring it up several times before the actual holiday arrives and allow children to share their thoughts and feelings. It might sound something like this:

“I want to talk to you about Thanksgiving this year. Usually we go to Grandma’s house and all your aunts and uncles and cousins come and we eat and play games. Do you remember when we did that last year?” Asking if they remember is important depending on the age. If they don’t remember, then the change this year may not be a big deal to them. If they do, it may be a bit more challenging. “This year is going to be  different, kind of like how school is different right now.” (Insert your plans and expectations. I’ll share my family plans.) This year we are all going to make food at our own houses and then we are going to Zoom with all of our aunts and uncles and cousins. We are still going to play games, except we will be online together instead of in person. I’m feeling sad we won’t see our family, but I’m excited about the new games.” (You’ve just modeled how to share emotions.) “What feelings are you having about this?” (wait) “What questions do you have?” (Use this instead of “Do you have questions?”)

Traditional Holiday Events

What are the events your family attends every year during the holidays? My family loves to go to the Fantasy of Lights in my hometown of Wichita Falls, Texas. We gather at Grandma’s house for dinner so she feels cozy and included since Grandpa passed a few years ago. Christmas Eve services are almost always on the books, and since my son was born we’ve started celebrating Christmas morning at my parents’ house. To kick off the holiday season, we almost always go to the Dallas Symphony Orchestra’s holiday show and have a family cookie baking night.

It is quite likely that none of these events will happen this year.

Grandma is elderly. Mom is a survivor of lung cancer and a lobectomy. My son is considered high risk, so crowding into a church building isn’t a risk we are willing to take. The pandemic has drastically changed how we will engage in holiday events this year. 

Just as you talked about family gatherings and how those will look different, talk about how events surrounding the holiday will look different this year. Think of ways you can substitute those events with safe ones. For example, we plan to stream a musical holiday show instead of going in person. We might even get all dressed up! We will likely have our own cookie baking night at home and gather virtually with Grandma and our parents. If my son was older, the conversation might sound like this:

“I want to talk to you about our (insert holiday) traditions. You might have to explain that “traditions are things we do every year around the holidays” and give an example. What (insert holiday) traditions can you think of that you’re looking forward to this year? Allow your child time to talk about what they’re looking forward to. Focus on the events they are excited about and determine whether those are safe events. If they aren’t you might say something like, “I really like to go to the music show too. This year instead of going to Dallas for the show, we’re going to watch it at home on TV. I’m feeling disappointed that we won’t get to see Santa come out at the Christmas show, but I’m excited that we can still watch on TV because we can have snacks while we watch!” You’ve just modeled how to share emotions. “What feelings are you having about this?” (wait) What questions do you have?” (Use this instead of “Do you have questions?”) 

Gifts

The financial impacts of the pandemic have been significant for many families. Your family may have traditions related to gift-giving that may need to look different this year. And that’s okay! It’s important to prepare children for this difference. I am NOT saying we need to explain financial difficulties to children. Finances are an adult issue, and children should feel as safe and secure as possible. However, it is possible to set expectations around gift-giving without referencing finances.

As caregivers, we have two options: Pretend like everything is going to happen as normal and then manage the disappointment and hurt feelings on that special holiday.

or (and preferably)

Tell children in advance that gift-giving is going to be different this year so we can get all those thoughts and feelings processed before the holiday. It doesn’t mean there won’t be thoughts and feelings on the holiday, but they will most likely be less intense if there has been regular discussion and processing prior to the holiday. There is no benefit to not telling a child they won’t be getting a pony or the newest gaming system. The benefit of communicating the truth is that it helps them adjust their expectations so they are better able to enjoy the gift they DO receive. It might sound like this:

“I saw that you wrote your gift wish list. I want to look at it together and talk about what’s on it. Your wish list looks so fun. I see that you put ______ on your list. I am not (or Santa is not) going to be able to get that gift for you this year. But can you think of something fun we could do? Maybe we could have a special chocolate chip pancake breakfast and watch Christmas movies? (*Insert things you could do together.) How are you feeling about that? What questions do you have?”

*Go hiking or biking. Do a craft with supplies from your local dollar store. Drive around at night with closed mugs of hot chocolate and do a scavenger hunt of different yard decorations. 

A few days later, circle back to the discussion again and take the opportunity to teach your child how to receive a gift that isn’t exactly what they wanted.

We’ve all had the experience of opening up a gift to discover we’ve received something we just don’t care for. As adults, we don’t throw tantrums or point out that we don’t like it because we’ve learned social skills related to this experience. Our children can learn this skill one of three ways.

1) They observe someone else, usually another child, express they don’t like something, observe the negative reactions of the adults, and promise themselves they’ll never do that.

2) They themselves express that they don’t like something, experience the negative shaming reaction of adults, and promise themselves they’ll never do that again.

or (and preferably)

3) They are pre-taught to show appreciation for every gift and the consequences of what happens when you don’t (i.e. people get their feelings hurt and it makes them sad). Discussion and role plays that allow children to practice are helpful when teaching this skill. When they are pre-taught the skill, they are more likely to meet expectations because you’ve set them up in advance. This doesn’t mean they won’t feel disappointed or sad or even  that they will master the skill this holiday, but we have a unique opportunity to introduce this social skill this year due to the financial impacts of the pandemic.

We have a unique opportunity to introduce this social skill this year due to the financial impacts of the pandemic.

Holidays this year are certainly going to be different. It is 100% okay to grieve the loss of the connections and fun that will be missed, and we should walk with children through those experiences and emotions. As caregivers, we have the opportunity to model how to process the emotions and mold the experience our children have during the holidays this year.

This post can be found in its original form here.

Jen Johnson  is the founder of The Child Safety Collaborative and a PhD Candidate in the Department of Educational Psychology at the University of North Texas. Jen worked in public education for almost a decade before moving into the private sector to address child abuse and maltreatment through The Child Safety Collaborative. Her research is focused around accommodating safety curriculums for children with disabilities.

 

 

STRONGER FAMILIES CREATE THRIVING COMMUNITIES

 

During this time of uncertainty, we know the potential for anxiety and stress in homes is high. That’s why we are putting together resources to help families come together during this time of crisis and adapt to the rapidly changing pandemic environment.

 To learn more about the Healthy Families Initiative at GCO click here

A family sitting on the floor together

How Can You Measure Welfare Program Success? Part 1

How Can You Measure Welfare Program Success? Part 1

How Can You Measure Welfare Program Success?

Part 1

By Erik Randolph

If you want to know how well welfare programs work, ask welfare agency administrators how they measure success. This was suggested by Randy Hicks, President and CEO of the Georgia Center for Opportunity (GCO), years ago. Almost invariably these administrators will answer that they measure success by how many people they serve. When the total number of people they serve goes up, the programs are more successful. Or are they?

To the contrary, program participation does not measure success. Furthermore, the chances are that welfare agency administrators lack the metrics to tell us how successful the programs truly are.

Program participation can measure demand for the program, or it might indicate the number of people in need. In these cases, program participation is useful information. But does it actually measure success? 

The more important goal of welfare programs is to help people overcome their financial difficulties and escape poverty. This enables them to live more fulfilling lives. Public policy should not encourage them to languish on assistance for years on end but rather help them improve their circumstances until they no longer need assistance, or their reliance on assistance becomes lessened. Welfare agencies generally lack metrics to effectively measure this important goal.

Which revises our original question slightly: How can you measure success?

Dependency Metrics

One potential way to measure success is to use dependency metrics that evaluate the percent of the population who are dependent on major welfare programs. This is partially done at the federal level but not at all at the state level.

In 1994, Congress passed the Welfare Indicators Act. It focuses on food stamps, Temporary Assistance for Needy Families (TANF) cash grants, and Supplemental Security Income (SSI). Every year, the U.S. Secretary of Health and Human Services is required to file a report with Congress showing dependency on those three welfare programs.

The most recent report was released in 2018. The pie chart below comes from page eight of that report, showing for the year 2015 the percentages of the national population according to their proportion of their total income dependent on the value of food stamps, TANF cash grants, and SSI. The higher the proportion of an individual’s income that comes from these three assistance programs, the worse off the person probably is. For example, if the value of food stamps constitutes more than 50 percent of an individual’s income, that person cannot be well off financially. In comparison, when food stamps constitute 25 percent to 50 percent of an individual’s income, it means the person has more additional income and is better off than when food stamps comprise more than 50 percent  of total income. And having less than 25 percent of total income coming from food stamps is better than having 25 percent to 50 percent of total income on food stamps.

Georgia has the ability to generate dependency metrics through the Georgia Gateway, including TANF cash grants, food stamps, medical assistance, and two other programs. These are means-tested programs, meaning the Department of Human Services has not only participation numbers but also income information of the applicants and recipients. The Department could relatively easily have its I.T. crew write scripts to spit out reports periodically showing the number of individuals and families by dependency on their income on those programs captured through the Gateway. Coupled with Census data, the Department could produce periodic reports showing how dependency changes over time and further break down the data by demographic groups. 

Furthermore, because every individual has a unique identifier, the I.T. crew could produce additional scripts to follow people over time. This would allow for more sophisticated analytics showing the financial progress of people and families in the system. 

Dependency metrics are not perfect. They do not capture persons who would be eligible for the program but do not participate. However, the number of these individuals are regularly estimated and could be presented as additional information in the analysis. 

Ideally, it would be best if the dependency metrics captured all assistance programs. Currently, this is not possible.

Assistance Programs Breakdown

Exactly How Many Programs Do People Benefit From? 

Often people qualify for multiple assistance programs. Their children might be on Medicaid and receiving free school lunches. At the same time, the household may be receiving food stamps. Additionally, if the parent or parents work, they may be receiving the Earned Income Tax Credit (EITC) and Additional Child Tax Credit. We just listed five programs that welfare families typically receive. 

And there are more programs. If the family has young children under five, they could receive food packages from the Women, Infants, and Children (WIC) program. Additionally, the family may be receiving childcare assistance, Section 8 rental assistance, and/or energy assistance.

Now you might think that we have a dataset somewhere telling us the total number of welfare programs families are benefiting from. If you assumed that we do, you would be wrong. No such dataset exists.

The reason? First, the welfare system is disjointed. There is no single agency or dataset that can tell us the total number of programs people are on. Even Georgia’s award winning Gateway, which is one of the better integrated eligibility systems in the country, cannot tell you. While the Gateway can tell us about food stamps, Medicaid, WIC, TANF, and subsidized childcare services, it is missing the refundable tax credits, free school lunches breakfasts, Section 8 rental assistance, and other welfare programs not listed. 

Second, statistical sources do not include all welfare programs in their questionnaires and have other limitations, such as serious time lags. For example, the American Community Survey asks about food stamps, Medicaid, and Supplemental Security Income but practically none of the other programs, making a statistical inference for the complete picture impossible. 

The Survey of Income and Program Participation gets us closer, giving us childcare assistance, WIC, energy assistance, and public housing, among others. However, it is still missing the refundable tax credits, including the EITC which is one of the big three welfare programs. Worse, SIPP is structured for longitudinal studies that makes the survey totally impractical for monitoring program participation on a regular and timely basis.

Adopting Dependency Metrics in Georgia

Dependency metrics would improve our ability to measure success, and state leaders should consider implementing them in Georgia. 

Georgia would do a better job than the federal government with dependency metrics. The Gateway houses the data for critical programs, enabling Georgia to produce monthly estimates, more timely estimates, and for more programs. In contrast, the Feds apparently cannot meet its obligation in producing annual reports, provides only national data for only three programs, and there are significant time lags. The most recent Federal report came out on May 4, 2018, with 2015 and some 2016 data.

Once implemented at the state level, dependency metrics will improve over time. If and when further integration, consolidation, and streamlining of eligibility systems occur, as recommended by GCO, dependency metrics will become more complete and more useful.

However, they are not the sole answer. There is another way to measure success that would complement well dependency metrics. This will be the topic of my next blog.

In the meantime, do you have ideas on how we can measure success in welfare programs? We would love to hear them. Be sure to put them down in the comments below.

Erik Randolph is Director of Research at the Georgia Center for Opportunity. This blog reflects his opinion and not necessarily that of the Georgia Center for Opportunity.

DISINCENTIVES FOR WORK AND MARRIAGE IN GEORGIA’S WELFARE SYSTEM

Based on the most recent 2015 data, this report provides an in-depth look at the welfare cliffs across the state of Georgia. A computer model was created to demonstrate how welfare programs, alone or in combination with other programs, create multiple welfare cliffs for recipients that punish work. In addition to covering a dozen programs – more than any previous model – the tool used to produce the following report allows users to see how the welfare cliff affects individuals and families with very specific characteristics, including the age and sex of the parent, number of children, age of children, income, and other variables. Welfare reform conversations often lack a complete understanding of just how means-tested programs actually inflict harm on some of the neediest within our state’s communities.

Health Care Waiver Approvals Are Good News

Health Care Waiver Approvals Are Good News

Health Care Waiver Approvals Are Good News

By Erik Randolph

Amidst the noise of the presidential election, the mainstream news media missed a major announcement the prior Sunday that promises to positively impact the lives of many Georgians.

 

The announcement could signal a turning point in the near future, giving hope to many Georgians suffering from the unintended consequences of the Affordable Care Act (ACA) since its implementation seven years ago.

 

Georgia has taken advantage of Section 1332, which is possibly the best provision in the ACA. It allows states to better design a system of providing health insurance coverage by applying to the federal government to waive burdensome requirements of the law itself and some other federal regulations.

 

Last year, the state legislature gave Governor Brian Kemp the authority to seek waivers from the federal government, and the governor has done just that. Without much fanfare, Georgia’s Section 1332 waiver request, as amended, was finally approved on Sunday. This approval complements Georgia’s other approved waiver request on Medicaid that received widespread press coverage and was announced during a joint press conference on October 15th with the governor and Seema Verma, administrator of the federal Centers for Medicare & Medicaid Services. 

 

First, let’s review just some of the mess the federal law created.

 

The Price Sticker Shockwave

 

The Affordable Care Act has not lived up to its name, as demonstrated by spiking health insurance costs, especially in the individual markets.

 

Once the law went into effect and the new premiums took hold in the individual markets, there was a price sticker shockwave that rolled across the country. The Manhattan Institute for Policy Research calculated price increases varying from 64.5% for a 40-year-old female to a 178.8% increase for a 27-year-old male. 

 

Our own analysis estimated premiums increased 17 times faster than the general inflation rate from 2014 to 2019. On average, Georgians suffered average price increases of 70.7% for Bronze plans, 77.3% for Silver plans, and 70.4% for Gold plans.

 

The chart below shows one result of our research. We estimated that the median annual price for a pre-ACA insurance plan for a family of four in Georgia was $5,386 in January 2013. For 2019, the median prices for a family of four rose to $17,550 for a bronze plan, $18,644 for a silver plan, $23,065 for a gold plan, and $26,081 for a platinum plan.

 

 

 

ACAHIX

Moreover, because of the unaffordability of the premiums, many who had insurance coverage prior to the ACA found themselves uninsured. As pointed out in the governor’s Section 1332 waiver application, 129,000 Georgians dropped out of the marketplace from 2016 to 2019, a staggering decline of 22%.

A major culprit for the price spikes and loss of coverage is the ACA itself. Many insurance policies in effect prior to the law became immediately ACA noncompliant because the law redefined what constituted a policy and mandated changes to how insurers calculate premiums. This was exacerbated by how the federal bureaucracy initially implemented the law. The political promise of “if you like your plan, you can keep your plan” turned out to be untrue. 

The impact was not just on the individual markets. Employer-based plans also experienced major price increases, but this and other unintended consequences are a topic for another day.

Hope with Reinsurance and Better Access

The first part of the approved Georgia plan will begin in 2022, which naturally brings up the question: why must we wait so long? The short answer is because we’re dealing with government bureaucracies.

Despite the slowness, the Reinsurance Program will pass through federal funding from anticipated savings from the Premium Tax Credit, expected to be $285 million in Plan Year 2022, matched with state funds from either general revenue or a state user fee to reinsure insurers to bring down the cost of premiums. The reinsurance kicks in only for insurance claims above preset thresholds up to predetermined caps. It also varies based on three regions in the state intended to bring down more quickly the cost of premiums in those regions hurt worse from the premium increases since implementation of the ACA. The reinsurance only pays for a portion of the cost above those thresholds, up to the caps, to make sure insurers have a stake in the game to keep costs down.

Governor Kemp’s approved application estimates the Reinsurance Program will, on average, increase individual market enrollment by 0.4% and lower premiums by 10.2% in the first year, which are hopefully just conservative estimates considering the damage done to the market by the ACA. The Reinsurance Program targets individuals and families between 100% and 400% of the federal poverty level (FPL), who account for 57% of Georgia’s uninsured population.

 

pie chart GA's uninsured

The second part of the plan—that will begin with a delayed implementation in 2023 over concerns of the impact of COVID-19 and to ensure a smooth transition—is the Georgia Access Model addressing a major complaint about the ACA. The law makes Georgians go through the Federal Facilitated Exchange (FFE) to buy insurance on the individual markets. Government’s overreach includes requiring individuals to prove to bureaucrats that they endured a qualifying life event before they are allowed to buy health insurance during any time outside the government’s mandated enrollment period. 

To be run by the state instead of the federal government, the Georgia Access Model will still allow an online exchange as before, but, importantly, it frees individuals from the mandate of going through the exchange, allowing them to shop through multiple channels, including private distribution channels, brokers, and agents. It promises to return health insurance shopping to the way functioning markets work. 

Georgia is expected to run the new exchange more efficiently. Today, FFE is separate from the Georgia Gateway that handles Medicaid. Georgia will link the two together, which brings up the approved Medicaid waiver.

Helping the Poor with Pathways to Coverage

In addition to the Section 1332 waiver, the federal government also approved a Section 1115 waiver, allowing modifications to the Medicaid program. This waiver addresses adults under 100% FPL, which is 28% of the uninsured. The remaining uninsured are children under 100% FPL who already qualify for Medicaid, and families over 400% who will benefit from the lower premiums. 

Here the Georgia state legislature and Governor Kemp need to be commended for not falling into the Medicaid expansion trap. What they succeeded in doing is getting the federal government to allow Georgia to transform the program into one that makes more sense.

One big problem with Medicaid is that it traps people in poverty. There are welfare cliffs and marriage penalties associated with it. Another big problem is that the health outcomes are among the worst of any health care system in the nation. The states that expanded Medicaid have subjugated more individuals to these negatives.

Instead, Pathways to Coverage establishes a demonstration project to help adults up to 100% of the federal poverty level. Private market practices will be introduced, including incentivizing healthy behavior and creating member reward accounts. The goal is to create a pathway to help persons transition to higher quality private coverage, consistent with other welfare policy goals of not having adults languish below the poverty line by helping them move out of poverty.

The Long Run

Ultimately, implementation of these approved plans will determine their success. Therefore, the state administration needs to be vigilant and continue working on improving.

Considering constraints placed on the states by the federal government, it is probably the best deal Georgia could have received. But, as officials in the Kemp administration recognize, these waivers are not the complete solution. More needs to be done.

What we would like to see is a more aggressive agenda to adopt our vision of establishing a true risk equalization system that can deliver universal coverage with the highest quality of care only possible through leveraging the free-enterprise system. Switzerland has already shown the way, and you can read more about our vision and the Swiss system here.

If you had personal experience with the FFE, escalating health insurance costs, lost your coverage, or other thoughts on the best solutions, we are interested in your story and thoughts. Be sure to post your experience in the comments below.

*Erik Randolph is Director of Research at the Georgia Center for Opportunity. This blog reflects his opinion and not necessarily that of the Georgia Center for Opportunity.

GCO welcomes Jace Brooks as Director of the Gwinnett Workforce Initiative

GCO welcomes Jace Brooks as Director of the Gwinnett Workforce Initiative

GCO welcomes Jace Brooks as Director of the

Gwinnett Workforce Initiative

March 2020 changed everything for Jace Brooks, as it did for so many Americans.

As a member of the Gwinnett County Board of Commissioners, Jace had worked for years to bring together nonprofits with government resources in the human-services area. All of these efforts went into overdrive when the first case of COVID-19 arrived in Gwinnett County. 

 

The global pandemic was no longer an abstract concept in the news—it was in our backyards impacting our neighbors. In a matter of months, Gwinnett County’s remarkable 2.4 percent unemployment rate spiked to 12.5 percent. Tens of thousands of residents were out of work, many of them homeless.

That’s when the Georgia Center for Opportunity (GCO) approached Jace about joining the team as a contractor to aid workforce development efforts in Gwinnett County. Initially, Jace worked to assemble a handful of service providers, nonprofits, schools, and employers to help the county’s struggling workers find stable work again. Those partnerships blossomed to over 25 organizations, companies, and schools, including Goodwill, Families First, Georgia Gwinnett College, the Gwinnett Chamber of Commerce, the public library system, Impact46, and the Community Foundation for Northeast Georgia.

 

The need hasn’t let up. In fact, it’s only growing, even as Gwinnett County rebounds from the economic shocks experienced in the spring. That is why GCO decided to bring on Jace full-time as our new Director of the Gwinnett Workforce Initiative.

“I have a deep love for Gwinnett County and the entire Atlanta metro region,” Jace says. “That’s been fostered through my service on the Suwanee City Council, the board of commissioners, and through volunteer time at my family’s church, Gwinnett Church. There are so many people struggling out there. I think of the single mom with a couple of kids, just looking for a place to stay or a meal. Through our partners, we can get her connected to all the right resources and move her from crisis to career. That is work so full of meaning, and I couldn’t be more excited to be on board with GCO.”

The Gwinnett Workforce Initiative is part of GCO’s broader effort to link underserved communities with the resources they need to thrive. It’s called Hiring Well, Doing Good (HWDG). This effort is based on the belief that a stable job is key to human flourishing. But it takes a concerted effort to come alongside struggling people to give them the resources, support, and training needed to succeed. And that help best comes from a bottom-up approach through our neighborhoods and communities, not top-down from government.