Clock ticks as feds threaten to remove work requirement from Georgia’s partial Medicaid expansion | CENTER SQUARE

by Corey Burres | Feb 22, 2021

Clock ticks as feds threaten to remove work requirement from Georgia’s partial Medicaid expansion | CENTER SQUARE

The federal Centers for Medicare & Medicaid Services (CMS) could decide in a matter of weeks whether it will remove the work or activity requirement in Georgia’s partial Medicaid expansion plan.

The CMS said the plan, which was approved by former President Donald Trump’s administration in October, does not “promote the objectives of the Medicaid program” and would be impossible to accomplish because of the COVID-19 pandemic…

In a statement released Friday, the nonprofit Georgia Center for Opportunity (GCO) said CMS’ decision could lead to court battles, leaving the thousands of Georgians who stand to get coverage under the program in a lurch.

“Instead of using our resources and time to bicker before the courts, we should apply them to seek out the best ways to improve people’s lives,” said Erik Randolph, GCO’s director of research. “[Georgia Pathways] is based on the idea of helping adults escape poverty, plain and simple. It will propel them into situations where they have better opportunities and more resources for health coverage, such as through affordable individual markets or employed-based coverage.”

Read the full article here

Let’s Take Politics Out of Healthcare

by Erik Randolph | Feb 19, 2021

Let’s Take Politics Out of Healthcare

The federal government’s surprise move against Georgia

In a raw political move, the Centers for Medicaid & Medicare Services (CMS) removed the approval of Georgia’s Pathways to Coverage, labeling the program as “pending.”

Despite the fact that the COVID-19 vaccine rollout is consuming the resources and attention of the Governor’s office and the Department of Community Health, CMS gave Georgia only 30 days to respond before the federal government might eviscerate the program. In its February 12 letter, CMS targeted the program’s work or other community engagement components and also threatened “review” of other provisions of the program.

This move by the new administration in Washington, D.C., appears to be unprecedented. Finally secured last fall, the approval was part of an administrative process, which included time for public comments, that took years to develop.

Pathways to Coverage serves non-disabled adults below the poverty line. It is a critical component of Georgia’s plan to reduce the number of uninsured and make healthcare coverage more affordable, without sacrificing quality of care or causing other serious drawbacks associated with a traditional Medicaid expansion. It is based on the idea of not keeping these adults below the poverty line but moving them above it.

The Success Sequence provides an outline of how to reverse the cycle of poverty in our communities. GCO uses this as a framework for much of our work.

Let’s focus on helping people instead

Pathways to Coverage is really about helping people. Readers might want to check out my prior blog on this program as well as some of our published research on fixing the healthcare system.

The so-called Affordable Care Act (ACA) has caused havoc for Georgians when it comes to healthcare coverage and costs. The rate of healthcare price increases did not abate but accelerated. As we reported before, our own data analysis confirmed other research by showing that for individual markets, “Georgians suffered average price increases of 70.7% for Bronze plans, 77.3% for Silver plans, and 70.4% for Gold plans” over five years.

We also found that prior to the ACA, the median cost for a health insurance plan on the individual market for a family of four was $5,386 per year. But within six years, the cost varied from $17,550 to $26,081, depending on the level of the plan.

The bulk of Georgia’s uninsured problem lies not below the poverty line, but above it. Therefore, Pathways to Coverage necessarily links to Georgia’s Reinsurance Program designed to drive down costs in the individual markets. The test of the demonstration project will be to see how well Georgia can move people out of poverty into situations where they have better opportunities and more resources for health coverage, such as coverage through affordable individual markets or, better yet, employer-based coverage.

America has one of the world’s best and most innovative healthcare systems, if you have insurance to afford it. By far, employer-based and private insurance provides the best coverage. Medicaid has among the worst healthcare outcomes, can trap families in poverty (as we and others have demonstrated), and can be an obstacle in moving to the much-better private coverage. Incentivizing people to improve their circumstances is an important strategy that this demonstration project hopes to prove.

The Spirit of the Law

The new administration in Washington might feel like they are doing the right thing by attempting to strongarm states like Georgia into Medicaid expansion. However, this action raises concerns.

First, the question of whether the federal government can mandate states to expand Medicaid was already settled in the negative by a seven-to-two U.S. Supreme Court ruling. Second, removing a critical component of this demonstration project will not likely accomplish expansion but, if followed through, will compromise the effectiveness of the project. Third, it goes against the whole purpose of demonstration projects.

Pathways to Coverage is an approved—and hopefully remains so—Section 1115 waiver to Medicaid rules, which is found in the Social Security Act. In enacting this section of the law, Congress acknowledged that a one-size-fits-all approach dictated by the federal government is not always the best way to solve our public policy challenges.

Congress acknowledged this principle again when it enacted Section 1332 of the Affordable Care Act that allows states to come up with alternative plans in coordination with Section 1115 waivers. Georgia took advantage of both these provisions of law in developing its healthcare strategy.

Finally, demonstration projects allow states to experiment with what works best. Without experimentation, we hinder our ability to discover better ways to run public programs for the benefit of people.

What’s next

The best overall resolution would be for CMS to reinstate the approval and allow the demonstration to move forward. CMS will monitor the project, of course, but it must let it play out to see if the project will demonstrate a better way. Georgia has a vested interest in making it work. If not, Georgia could choose to modify or abandon the project. Besides, the federal government will have the opportunity to review the results when the waiver comes up for renewal.

Failure to reinstate the approval will likely result in a legal struggle before the courts. Who knows how long such a legal process will take? Instead of using our resources and time to bicker before the courts, we should apply them to seek out the best ways to improve people’s lives.

*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.

New federal budget report boosts $15-an-hour minimum wage | GEORGIA RECORDER

by Corey Burres | Feb 9, 2021

New federal budget report boosts $15-an-hour minimum wage | GEORGIA RECORDER

The nonpartisan Congressional Budget Office in a report Monday found a gradual increase to a $15 federal minimum wage by 2025 would reduce poverty, add $54 billion to the deficit over a decade and increase pay for millions of low-income workers.

The report could help Democrats make a strong case for including a gradual federal minimum wage increase in the $1.9 trillion relief package put forth by the Biden administration…

“Workers need immediate help, but doubling the federal minimum wage when Georgia small businesses are closing left and right is not the right answer,” said Buzz Brockway, the Georgia Center for Opportunity’s director of public policy and a former Republican state lawmaker from Gwinnett County.

Read the full article here

The Pandemic Doubles the Food Stamp Program Part 2

by Erik Randolph | Dec 8, 2020

The Pandemic Doubles the Food Stamp Program

Part 2

By Erik Randolph

It has been said that haste makes waste. Apparently, this saying also applies to legislation.

Back in March with the pandemic looming, Congress quickly passed major legislation to address the pain of the pandemic. It was well known at the time that the quickness by which the pandemic legislation became law would lead to mistakes and inefficiencies. Here is just one of them.

The Food Stamp Cliff

My last blog highlighted the new food stamps rule created by Congress to address the pandemic. I hinted at how it made welfare cliffs worse.

Welfare cliffs, also known as benefits cliffs, show up whenever a loss in benefits exceeds an increase in earnings. These cliffs are disincentives for earning more money and can show up in tax and welfare programs individually or in combination.

When it comes to the food stamp program, our research shows that normally these cliffs are fickle. Whether a cliff occurs for a family depends on several factors. In some cases, such as when there is an elderly or disabled member of the household, there are no welfare cliffs. However, if the household has no member who is disabled or elderly and especially receives the maximum deductions and allowances, there can be significant cliffs.

Now with the pandemic food stamp program, all households have cliffs—and they are steeper than ever before.

The table below shows the cliffs for households up to six6 persons when no member of the household is disabled or elderly. The benefit amounts stay the same no matter what income a household receives. Therefore, any household over the gross income limit—even just one dollar over the limit—would lose the entire benefit no matter what level of income it had prior to its income exceeding the limit.

Households with an elderly or a disabled member also have cliffs of the same magnitude. However, the gross income level when they hit the cliffs varies depending on the net income calculations, but in every case, these levels would be greater than the gross income limits listed in the table.

From March 2020 to August 2020, these cliffs were immaterial because the Georgia Division of Family and Children Services (DFCS) received permission from the Federal government to extend eligibility certification for six months. In practice, this meant that those households no longer qualifying for benefits were allowed to stay in the program.

However, DFCS began processing renewals again in September, and now households gaining in earnings can find themselves faced with the cliffs at the magnitudes displayed in the table.

What was Congress thinking?

The food stamp changes were part of the Families First Coronavirus Response Act (P.L. 116-127), which had overwhelming bipartisan support. With the legislation, Congress intended to ensure the physical and financial security of families.

One concern was access to food. Congress wanted to make more food available through the food stamp program. Fair enough.

However, changing the rule so that every household participating in the program gets the maximum allowable benefit was crude and blunt. It guaranteed steep welfare cliffs across the board. A single-parent household with one child earning $1,868 a month would lose $374 in monthly benefits if the parent received just one dollar more in income.

The action also favored wealthier participants. A four-person household with $2,839 in monthly income gets $680, which is exactly the same amount received by a four-person household with no income despite being more vulnerable.

Four Person Household Food Stamp Benefits

Congress did not have to be so crude and blunt in its approach. Just as easily, Congress could have simply increased the maximum allotment. This action would have spread out the extra funding across all incomes more evenly among the participants.

Congress could have also been more daring by simultaneously increasing the gross income limit, making any potential cliffs less severe.

The dilemma

Perhaps Congress chose not to consider these two easy alternatives because key members believed it would be too difficult to roll back the enhanced benefits once the pandemic is finally over.

There is probably some truth to this fear. However, we do not escape the political difficulty. My next blog will focus on the coming food stamp crisis.

If you have experience with the food stamp cliff, we would like to hear from you. Be sure to 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.

DOWNLOAD WHITE PAPER

DOWNLOAD EXECUTIVE SUMMARY

VISIT WELFARECLIFF.ORG

The Pandemic Doubles the Food Stamp Program Part 1

by Erik Randolph | Dec 6, 2020

The Pandemic Doubles the Food Stamp Program

Part 1

By Erik Randolph

The monthly spending for food stamp benefits in Georgia nearly doubled since before the start of the pandemic. Surprisingly, only 45.3 percent of the increased spending is due to increased participation. The remaining 54.7 percent is due to enhanced benefits.

Congress Makes a New Food Stamp Rule

On March 18th, the U.S. Senate passed H.R. 6201 that the U.S. House of Representative passed just four days prior. President Donald J. Trump signed the bill that same day, making the Families First Coronavirus Response Act (P.L. 116-127) the second federal law to address the looming pandemic.

The food stamp provisions in the law suspended work and work-training requirements and allowed states to request waivers to give recipients the maximum allotment for the Supplemental Nutrition Assistance Program (SNAP), the official name of the food stamp program.

Along with all other states, Georgia requested and received a pandemic-SNAP waiver—P-SNAP for short. P-SNAP lasts as long as there is a declared health emergency by the Secretary of Health and Human Services, and the waivers are renewed on a monthly basis.

Here is what it means in practice: Currently, all households of the same size receive the exact same food stamp allotment. An eligible single mom with one child receives $374 a month in food stamp benefits, the same amount as every other eligible two-person household in Georgia, no matter what income the household earns. It does not matter if the single mom has no income or makes $22,400 annually, which is just below the gross income limit. She still receives $374 each month in benefits.

Likewise, an eligible four-person household currently receives $680 each month no matter if the household has no income or $34,000 in income, which is also just below the gross income limit.

During normal times, DFCS calculates net income of the household by subtracting several deductions and allowances from a household’s gross income. Then, to determine the amount of the benefit, DFCS subtracts 30 percent of the calculated net income from the maximum allotment.

Benefits and Costs

The number of Georgia households participating in the food stamp program was 626,808 in February 2020. As of September, that total was 905,949 households—a 44.5 percent increase. The number of persons participating increased from 1,342,624 to 1,862,486 for a 38.7 percent increase.

The regular issuance of food stamp benefits followed the increase in household participation. It increased from $163,247,601 to $236,170,166—a 44.7 percent increase. Although the average fluctuated as much as $10.58 on a month-to-month basis, the average household benefit was $260.44 in February compared to $260.69 in September, which are almost identical.

However, P-SNAP enhanced the size of the payments to the participants. When combined with the regular issuance, the total benefits in September were $324,169,118 for a 98.6 percent increase, increasing the average household benefit to $357.82. Note that these numbers do not include $100,385,379 for free and reduced price school lunches in September that were funneled through the Electronic Benefit Transfer cards that are used to issue the food stamp benefits.

Was this the Best Way to Do it?

Note that Congress did not allow the states to expand the number of participants beyond the normal eligibility criteria for the program. The P-SNAP benefits of $581,085,040 spent since March were spent on those who would have normally qualified for the benefits.

Consequently, the households who benefited the most from the extra funding were those households with the higher incomes just under the eligibility limits. My next blog will show in greater detail how P-SNAP caused the welfare cliff to jump in magnitude.

In the meantime, if you have an opinion on whether this was a fair way to allocate extra funding for food stamps, be sure to let us know in the comments below.

Check Out Part 2

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.

Op-Ed: We don’t need to rely on elections to do good in our communities

by Corey Burres | Dec 4, 2020

Op-Ed: We don’t need to rely on elections to do good in our communities

This election season has been the most rancorous of our lifetimes. Is anyone surprised? We’ve come to expect the unexpected in 2020, a year that has seen searing social strife, suffering and pain through the COVID-19 pandemic. Our political and social fabric is badly damaged.

But in the midst of a chaotic political season and the suffering of so many, I’m reminded of this simple truth: the most impactful changes occur in our homes, neighborhoods, and communities. It is a model we live our lives by each and every day at my organization, the Georgia Center for Opportunity. We know the role of government is important, but it is in our communities where lives are formed and, when things go badly, where lives are transformed. And it’s there that neighbors, businesses, communities of faith, schools and nonprofits can come together in local unified action.

Politics and policy do matter, but ultimately they are not the main driving force that moves the needle when it comes to people’s lives. That must come from you and me, rolling up sleeves and working alongside others who may or may not have voted like we did, but who share a belief that everyone deserves the opportunity to achieve a better life, regardless of their race, the circumstances of birth, or past mistakes.

I’m thinking of women like Latesha Jackson, a Columbus native and single mother of four. She struggled for years in poverty, cycling between periods of unemployment and low-paying jobs in the service sector before a local cooperative of nonprofits, businesses, and schools known as Hiring Well, Doing Good helped put her on the path to a four-year degree.

My mind also goes to men like Kevin Johnson, a convicted felon who was looking for a second chance after paying his debt to society and spending years behind bars. He found it with Columbus Water Works, a company that has as a core value the need to give second chances. Kevin is now employed there and has hope for a better future.

My challenge to my fellow Georgians is this: what steps can we take today to begin impacting our neighbors for good and healing our national wounds? Don’t think about what government should or shouldn’t do. Think about what you can do. Because in the end, no one needs to wait for election results or government action in order to serve their communities. And no one needs to let election results keep them from doing good on behalf of others.

The road won’t be easy. It will take hard work. It’s far easier to stay in our silos and echo chambers, harshly judging our political enemies. But the far better path is one of service, care and compassion that restores human dignity and empowers everyone to live up to their potential.

As we live through the coming days, weeks, and months, let’s let our lives match the high standard set by Georgia’s earliest founders, who took on these timeless words as their motto: not for self, but for others.

Full Article First Appeared in The Center Square