New York, NY — "You helped Wall Street - now, how about the states?" That's essentially the message Governor David Paterson has delivered to Congress this week. He he testified before the powerful U.S. House Ways and Means Committee, recommending a stimulus package to help states meet their budget shortfalls.

Gwen O'Shea, president and CEO of the Health and Welfare Council of Long Island, agrees with Paterson. She believes New York has made all the budget cuts it can, including limiting many of the social programs that provide a safety net for families. She sees potential for a plan that would target states' infrastructure and health care needs, and would expand programs like the federal Supplemental Nutrition Assistance Program, more commonly known as Food Stamps.

"People don't save Food Stamps - they use them. About 90 percent of Food Stamp recipients use the money the same month they receive it. So, if we increase those allotments, we address the issue of hunger, and also stimulate the local economy."

O'Shea points out that, for every dollar invested, Food Stamp use returns $1.73 to the economy. Paterson testified that there are also plenty of infrastructure programs waiting to begin, all of which could help boost the state's lagging economy. What they lack, he says, is federal funding.

"We would have 40 shovel-ready programs for improving highways and bridges. We would have another 58 programs ready to go in the area of water projects."

Paterson has suggested that the stimulus plan include an increase of at least 5 percent in the Federal Medical Assistance Program; and that new federal block grants be issued, much like the ones Congress enacted to help the economy after the attacks of September 11. Not all governors agree with his proposals, however - some say an additional major expenditure would drive the nation deeper into debt.




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Last year's Medicaid expansion in South Dakota increased eligibility to another 51,000 adults but a new report showed among people across the state who qualify, only 39% are enrolled.

Groups likely to be uninsured include young adults and American Indian young adults. About half of those who are uninsured now qualify for Medicaid benefits.

Xanna Burg, director of South Dakota Kids Count, said low enrollment rates are, in part, due to timing. She explained the expansion was rolling out just as states were ending the federal requirement which kept everyone on Medicaid covered during the pandemic.

"I think having those happen in tandem hurt the ability to really do this significant outreach to eligible populations," Burg observed. "Because you're trying to deliver one message saying, 'We've expanded eligibility,' and then there's this other message that's saying, 'You need to, like, re-enroll.'"

Matt Althoff, secretary of social services, has said some people who were disenrolled are making more income and no longer qualify and this should be celebrated. The expansion actually increased the income level for households to qualify, from just over $14,000 a year for a family of four, to about $43,000.

Burg noted one challenge for enrollment is, the information helping to determine eligibility is housed under different programs in the state. She argued more communication could boost the numbers.

"Thinking about where programs can talk to each other, whether it's through SNAP or WIC or the Free and Reduced Price Lunch Program," Burg suggested. "Working across agencies to really identify these populations that might be eligible."

State officials said it could take up to two years to reach full enrollment.

Members of the U.S. House Work and Welfare Subcommittee came to Illinois this month to drum up support for work requirements for anyone seeking public assistance.

U.S. Rep. Darin LaHood, R-Peoria, and U.S. Rep. Danny Davis, D-Chicago, held a field hearing on what they called the "Dignity of Work," stressing the importance of employment as a solution to lift people out of poverty.

Nearly 12% of Illinois residents live below the federal poverty line - LaHood said at the hearing that teamwork is needed to help more of them find jobs.

"Whether it's through churches, nonprofits, private foundations or government programs," said LaHood, "when providing relief and assistance to those in need, we should be exploring every possibility to promote work as the surest pathway out of poverty."

But the Center on Budget and Policy Priorities points out that most working-age adults who receive assistance like Medicaid or SNAP are already working - their jobs don't pay enough to meet basic household expenses.

Others are dealing with child care or elder care, have health issues, or are between jobs and need assistance only temporarily.

Testimony at the hearing included multiple examples of people who were able to become self-sustaining with help from the federal programs.

Kristy Schofield, now the director of Homeless and Housing at Dream Center Peoria, said she was a single mother of two and living in her car before reaching out for help.

She said these programs are a godsend for someone who has lost hope.

"These programs give our guests an opportunity to work - and with that, accomplish and achieve," said Schofield, "thereby gaining that self-esteem and belief in themselves, and lowering the chance that they will live in poverty."

Congressman LaHood said, "Tying federal benefits to the expectation of work is not a punishment."

He cited an Axios-Ipsos poll out last year that found growing support for making people look for work if they want public assistance - including 80% of Republicans, 66% of Independents, and 49% of Democrats.

Missouri's Department of Social Services anticipates as many as 200,000 Missourians will lose their Medicaid benefits over the course of the next year, because their income has increased and they no longer qualify.

While the public health emergency was in effect, states could not remove anyone from their Medicaid rolls, but as the Medicaid "unwinding" has begun, the department is resuming annual renewals.

Kim Evans, director of the family support division for the Department of Social Services, encouraged everyone to be sure the state has their current contact information so they don't miss important forms and requests for information. They can do it in a number of ways.

"Individuals can go online and report that, at mydss.mo.gov, they can fax that to us, they can scan it to us," Evans outlined. "On our website we have a live chat, and somebody can report it to us that way also."

Evans pointed out there is also a resource center in every county for those who would like help in person. She explained the renewals will be processed the month the person originally qualified, beginning with June. The first round of annual renewal forms will be sent out the first week of May and must be returned by June 30.

Evans noted two circumstances will cause a person to receive a form.

"If we cannot verify the person's information, or the information we receive makes them totally ineligible for Medicaid, we will send an annual renewal form," Evans pointed out.

She stressed if people do not return their form on time, they risk a break in coverage. After the due date, they have 90 days to submit their information to have their case reopened.

Evans added the state is opening a new customer portal in early May, where all future forms and notices will be placed. She encouraged everyone to sign up once it is available.

"So they will be able to access this form that they'll be able to review, make changes," Evans explained. "Then they can submit that directly to the agency. That is really how we want everybody to complete their forms, because that populates the system."

Those who no longer qualify for Medicaid will be referred to the Marketplace to look for an insurance plan that works for them.


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