We are consistently playing defense to protect social services that are so vital to many black families living in our region. Many of the families in our community rely on safety net programs, like SNAP (Supplemental Nutrition Assistance Program) and Medicaid, to get by, but every day in our state legislature those programs are at risk.
Medicaid now allows states to impose work requirements as a condition of eligibility, meaning able-bodied individuals ages 19-64 must provide documentation for 80 hours a month of work or other approved community engagement in order to receive Medicaid benefits. Work requirements are sold as a way to get individuals back to work, to lift them out of poverty so they no longer need these safety net programs.
However, we know that often doesn’t happen. A study on Temporary Aid for Needy Families (TANF) revealed that, despite increased earnings, people still aren’t able to earn enough to move out of poverty. Individuals on programs with work requirements remain poor, and we know that the jobs available are often lower paying with no benefits. We also know that requiring work as a new provision for Medicaid isn’t actually about helping people out of poverty – it is about cutting safety net programs and saving money for the state.
HB 183 and SB 76 add these requirements to the Missouri Medicaid program. When it comes down to it, this would impact around 3,000 people. While this may not seem significant, these bills, and so many others, are sending a message: basic rights are contingent on work. This opens the door to start chipping away at the safety net programs so vital to our communities, particularly St. Louis’ black communities.
Medicaid coverage actually helps individuals and families become financially stable, while work requirements do the opposite. This is a “pull yourself up by your bootstraps” tactic for vulnerable residents – who have no boots to strap!
This kind of legislation creates more barriers for low-income individuals and families to access health care, such as additional paperwork and pressures to find and maintain accessible work, which ultimately compounds the pressures they face. Health care contingent on work is just one prime example of the legislative attack on safety net programs. It takes all of us to push back against policies that harm our most vulnerable and replace them with policies that actually work.
Rose Anderson-Rice is chief program director at Generate Health, and helps oversee FLOURISH, the initiative working to eliminate racial disparities in infant mortality in St. Louis.
