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Colin Kaepernick Photo Credit: FB

How do we differentiate who we are from what we are? Do titles really define who we are or what we think about people? Do we not care about who they are as a person; their morals, values, and stances?

We are asked as children what we want to be when we grow up, which is often answered by a title – a police officer, teacher, a professional athlete. We don’t get asked who we want to be, or what we want to be known for.

We often assign respect and obedience to certain titles without thinking the expectations we have of someone who holds it. Some may exceed expectations, and others may not be close to meeting them. But, what do we do when we learn who they are as a person and not the title they hold?

A professional football player kneeled during the national anthem because police officers were not meeting the expectations society has relayed on them. But rather than join his efforts in holding them accountable for their deadly actions, he lost his job for getting involved in something that isn’t part of his job description.

Collin Kaepernick’s job is to be a quarterback and not protest injustices which is what some of his critics say. He showed us who he is as a person, what he stands for, and what he believes in. In return, he is villainized and no longer is he considered a good football player, but has been rebranded as a troublemaker. Is that fair?

Power and privilege are two concepts that most people strive to obtain, but some may never achieve it. These two things are primarily held in the hands of white men in America. Minorities lack the social status to have powerful messages heard and understood by White America which often leads to relying on our white counterparts to understand our situation in order for something to get done.

Collin Kaepernick had a platform at his disposal which was the NFL. He used his stage in hopes of giving a voice to an issue troubling his community because this was something “white America” isn’t experiencing, nor could they understand the lived fear people of color have of the police.

Because this was something the majority did not understand, Kaepernick’s behavior was too radical for unaffected to be willing to listen and pay attention to the real issue, police brutality. Kneeling during the flag and national anthem was not about disrespecting the flag or national anthem. His kneeling was to bring attention to an epidemic faced by a particular group of Americans.

When we often hold positions of power, we expect others to listen to us and conform to our desires. When something is not presented how we like it, we are less likely to value that person and what they believe.

One of the core values of the social work profession is the dignity and worth of the person. Acknowledging the reality that not everyone will be affected the same. The willingness to listen to others when they’re trying to tell their story can go as far as saving someone’s life.

If the reasoning for Kaepernick’s kneeling had been met with empathy when he shared why he was kneeling, the issue of police brutality would have remained the center of the issue instead of NFL players being called “sons of bitches” by the President of the United States because he doesn’t like them kneeling.

If the people in power, the NFL stakeholders, the President of the United States, and other officials who can hold law enforcement accountable, cared as much about issues like police brutality as they did about football players kneeling, American lives could literally be saved.

Unfortunately, when minorities with no standing and power in America try to bring awareness to social issues where minorities are also the victims, no one seems willing to listen or do anything about it.

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Michelle Fernandez is an MSW student at the University of Houston. She began studying social work as a way to fulfill her personal goal and to pay it forward as others have helped her. After Michelle completes her master's, she plans to become a licensed professional social worker and practice in the macro setting.

          
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News

To Stop Fake News, Social Media Firms Need Our Help

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Misinformation is as old as communication itself. In television’s glory days, self-styled psychic Uri Geller fooled viewers for years before being outed as a fraud. Centuries earlier, in the adolescence of print media, British con artist William Chaloner circulated pamphlets attacking the national mint.

But never has misinformation spread so widely, readily, and willfully as it has in the age of social media. And never have so many different actors been culpable in creating that reality.

Take the dreadful Parkland, Florida, school shooting earlier this year. While Twitter and Facebook afforded students and their families access to potentially life-saving information sooner than other media, their algorithms also amplified right-wing conspiracy theories claiming student survivors were “crisis actors.” Although multiple print and digital media outlets quickly debunked the theory, the damage had already been done.

Often unwittingly, everyday Americans are caught in the crossfire of politically charged misinformation. Understandably, they’ve come to rely on social media to stay in touch. How else could a 50-something dad circle back with an elementary school friend who moved away decades prior? But they’ve also been shepherded into echo chambers by algorithms that prioritize clicks over truth — echo chambers that the majority of Americans, according to Pew Research, expect to get worse over the coming decade.

Certainly, it would be easy to point the finger at social media companies alone. But these platforms are neither the first nor the only perpetrators. Tribalism, a vacuum of government policy, and, yes, the very business model of social media firms have all played a part in this problem.

Inside the Social Media Machine

Compared to its media ancestors, social media is the perfect vector for spreading misinformation. The first of its three problematic attributes is its decentralized architecture, punctuated by highly influential nodes. Each nodular individual or company attracts like-minded media consumers, magnifying its influence on a given topic, regardless of the node’s expertise or truthfulness.

Although decentralization delivers media that’s maximally applicable to the user and prevents a single authority from controlling the narrative, it’s also dangerous. Misinformation spreads like wildfire in such a forum, where competence and truth matter less than the emotional payload of what’s being discussed.

Furthermore, social media makes it easy to link or break ties with connections, enabling users to self-select informational inputs. Over time, users can and do shut out information they dislike or don’t believe, distorting their own reality according to what’s “true” within their information bubbles. Because they’ve insulated themselves from uncomfortable ideas, the shock value of those ideas increases and drives users to respond with vitriol rather than reason.

The final systemic flaw of social media? Just follow the money — and, more specifically, the clicks. Clicks are literal currency for social media companies. Information that provides immediate gratification is good for business, and outrage-triggering content offers it like nothing else. Until that incentive structure shifts, social media’s echo chambers are likely here to stay.

Does that mean society is doomed to a truthless future? Not necessarily. But to rectify the situation, social media users, government entities, and social media platforms themselves must all be willing to alter their behaviors.

A 3-Pronged Defense Against Misinformation

For better or worse, social media users must be the first line of defense against the spread of half-truths and outright falsehoods. In short, they must be responsible informational bartenders. If a bartender serves an intoxicated person who later kills someone with her car on the way home, the bartender is at least morally culpable for fueling the tragedy.

Each time a social media user takes an action, such as retweeting a 280-character rant, he serves that information up to someone else. If he doesn’t critically consider content before sharing it, he’s putting someone else at risk — this time, with added social proof behind it, a cue to trust the information.

Fortunately, critical consumption of media is something everyone is capable of. Reading content entirely before sharing it, asking whether the content is coming from a reputable source, and searching for corroborating evidence from another source are easy and powerful guardrails against misinformation.

Couldn’t government entities also act as guardrails, playing the referee of truth? They certainly could try, but appointing a singular authority to separate fact from fiction invites an opportunity to propagandize. Facts are rarely black-and-white, and government officials are often all too happy to dole out “alternative facts” that advance their own narratives.

Instead, the role of governments (if any) must be to set policies that encourage all media companies, traditional and social, to build models that encourage deliberative engagement over clicks. About six in 10 American media consumers scan only the headline of news content before moving on. Something as simple as having share buttons placed in or at the bottom of content rather than directly on social platforms would at least force readers to open the source content before sharing it with others.

And what would social media companies think of such a policy? Obviously, they’re beholden to shareholders and market realities, just like other companies. Under their present model, they’re going to fight tooth and nail against any regulation that could cut into clicks and shares.

But there are certainly other business models that they could adopt. For example, switching to a subscription-based forum would weed out bots and give users more ownership over the media community they’re paying to be a part of. Such a system would also provide a revenue buffer to experiment with less emotionally charged, higher-quality content.

Incentivizing longer engagement with media through gamification, such as a system of points or social rewards, could be an effective compromise. Medium is exploring this path with a reader-assessed content quality metric called “claps.” Whether Medium’s approach becomes a viable long-term revenue model or not remains to be seen, however.

In today’s hyperpoliticized media environment, it can be difficult to remember social media’s original purpose: to inform and bring people together. Although social media has connected friends and families in some contexts, it’s driven wedges between others, sometimes to the point of job termination, social isolation, and even suicide.

If social media is ever to achieve its stated goal, we must start by fighting misinformation. And winning the war on misinformation will require all of us — people, companies, and governments and liberals, conservatives, and independents — to choose truth over comfort both on social media and off.

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LGBTQ

Delaware Legislature Sends Anti-“Conversion Therapy” Bill to Gov. Carney’s Desk

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Today, the Human Rights Campaign (HRC), the nation’s largest lesbian, gay, bisexual, transgender and queer (LGBTQ) civil rights organization, hailed the Delaware General Assembly’s passage of Senate Bill (SB) 65, legislation protecting LGBTQ youth in the state from the dangerous and discredited practice known as “conversion therapy.”

The legislation was sponsored by State Senator Harris McDowell and State Representative Debra Heffernan, and Governor John Carney is expected to sign it into law. Once signed, Delaware will join 13 other states and Washington, D.C. with laws or regulations protecting LGBTQ youth from the harmful practice.

“For young people across Delaware, this legislation provides vital and potentially lifesaving protections from the damaging, dangerous and discredited practice known as ‘conversion therapy,’” said HRC National Press Secretary Sarah McBride, a Delawarean. “While Delaware has made historic progress on LGBTQ equality, we can and must do more to protect LGBTQ youth from rejection, stigma, and harm. SB 65 is a critical and significant step in that direction. We thank the Delaware General Assembly for their support of this vital legislation and we look forward to Governor Carney signing it into law.”

“We thank those members of the General Assembly who voted to protect LGBTQ children against the dangerous and harmful practice of conversion therapy, and especially prime sponsors Senator Harris McDowell and Representative Debra Heffernan and their legislative aides for their leadership,” said Equality Delaware’s Mark Purpura. “We look forward to Governor Carney signing the bill into law promptly.  We are also thankful to have had the opportunity to work together again with the HumanRights Campaign on this important issue. We need to keep the momentum going across the country to end this despicable practice once and for all.”

There is no credible evidence that conversion therapy can change a person’s sexual orientation or gender identity or expression. To the contrary, research has clearly shown that these practices pose devastating health risks for LGBTQ young people such as depression, decreased self-esteem, substance abuse, homelessness, and even suicidal behavior. The harmful practice is condemned by every major medical and mental health organization, including the American Psychiatric Association, American Psychological Association, and American Medical Association.

Connecticut, California, Nevada, New Jersey, the District of Columbia, Oregon, Illinois, Vermont, New York, New Mexico, Rhode Island, Washington, Maryland, and Hawaii all have laws or regulations protecting youth from this abusive practice. A growing number of municipalities have also enacted similar protections, including cities and counties in Ohio, Pennsylvania, Washington, Florida, New York, Arizona, and Wisconsin. In addition, lawmakers in New Hampshire recently passed similar legislation which currently awaits the governor’s signature.

According to a recent report by the Williams Institute at UCLA School of Law, an estimated 20,000 LGBTQ minors in states without protections will be subjected to conversion therapy by a licensed healthcare professional if state lawmakers fail to act.

HRC has partnered with the National Center for Lesbian Rights (NCLR) and state equality groups across the nation to pass state legislation ending conversion therapy. More information on the lies and dangers of efforts to change sexual orientation or gender identity can be found here.

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Health

Little Difference Between Gun Owners, Non-Gun Owners on Key Gun Policies, Survey Finds

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A new national public opinion survey from the Johns Hopkins Bloomberg School of Public Health finds widespread agreement among gun owners and non-gun owners in their support for policies that restrict or regulate firearms.

The survey measured support for 24 different gun policies and found minimal gaps in support between gun owners and non-gun owners for 15, or 63 percent, of the policies. For 23 of the 24 policies examined, the majority of respondents supported gun restrictions or regulations, including requiring a background check on every gun sale (universal background check) and prohibiting a person subject to a temporary domestic violence restraining order from having a gun for the duration of the order.

The survey was fielded in January 2017 and is the third National Survey of Gun Policy conducted by the Johns Hopkins Center for Gun Policy and Research. Researchers used National Opinion Research Center’s AmeriSpeaks online panel designed to be representative of the U.S. population. The study sample included 2,124 adults (602 gun owners, 1,522 non-gun owners) ages 18 years and older.

The findings will be published online in the American Journal of Public Health at 4 P.M. EDT on May 17, 2018.

In 2016 in the U.S., firearms were responsible for more than 38,000 deaths and over 116,000 nonfatal gunshot wounds treated in hospitals. The U.S. continues to debate measures at both the state and federal levels that seek to address gun violence.

The policies with the highest overall public support and minimal support, by gun ownership status included: universal background checks (85.3 percent gun owners, 88.7 percent non-gun owners support), license suspension for gun dealers who cannot account for 20 or more guns in their inventory (82.1 percent gun owners , 85.7 percent non-gun owners support), higher safety training standards for concealed-carry permit holders (83 percent gun owners, 85.3 percent non-gun owners support), improved reporting of records related to mental illness for background checks (83.9 percent gun owners, 83.5 percent non-gun owners support), gun prohibitions for people subject to temporary domestic violence restraining orders (76.9 percent of gun owners, 82.3 percent non-gun owners support), and gun violence restraining orders, which are commonly referred to as extreme risk protection orders or Red Flag laws  (74.6 percent of gun owners and 80.3 percent non-gun owners support).

“Policies with high overall support among both gun owners and non-gun owners may be the most feasible to enact, and some have strong evidence to support their ability to reduce gun violence,” says lead author Colleen Barry, PhD, MPP, Fred and Julie Soper Professor and Chair of the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. “Widespread claims that a chasm separates gun owners from non-gun owners in their support for gun safety policies distracts attention from many areas of genuine agreement—areas that can lead to policy solutions and result in the prevention of gun violence.”

The survey also found several points of disagreement between gun owners and non-gun owners. Nine of the 24 policies examined had greater than 10-point support-gaps. However, more than half of gun owners still favor several of these policies to restrict or regulate guns. These include: requiring that a person lock up guns in the home when not in use to prevent access by youth (58 percent of gun owners and 78.9 percent of non-gun owners support), allowing information about which particular gun dealers sell the most guns that are then used in crimes to be available to the police and public (62.9 percent of gun owners and 73.4 percent of non-gun owners support), requiring a person to obtain a license from local law enforcement before buying a gun (63.1 percent of gun owners and 81.3 percent of non-gun owners support), and allowing cities to sue gun dealers when there is evidence that the dealer’s practices allow criminals to obtain guns (66.7 percent of gun owners and 77.9 percent of non-gun owners support).

Two survey questions on concealed carry were new in the 2017 survey. Results show that 25.1 percent of respondents (42.6 percent of gun owners, 19.3 percent of non-gun owners) believe a person who can legally carry a gun should be allowed to bring that gun onto K-12 school grounds, and 84.7 percent of respondents (83 percent of gun owners, 85.3 percent of non-gun owners) believe that a person who can legally carry a concealed gun should be required to pass a test demonstrating they can safely handle the gun in common situations they may encounter.

“There is data supporting the efficacy of many of the policies with wide support among both gun owners and those who don’t own guns,” says study co-author Daniel Webster, ScD, MPH, director of the Johns Hopkins Center for Gun Policy and Research. “Relatively few states have these laws in place. This signals an opportunity for policy makers to enact policies which are both evidence-based and widely supported.”

“Public Support for Gun Violence Prevention Policies among Gun Owners and Non-Gun Owners in 2017” was written by Colleen L. Barry, PhD, MPP, Daniel W. Webster, ScD, MPH, Elizabeth Stone, BMus, Cassandra K. Crifasi, PhD, MPH, Jon S. Vernick, JD, MPH, and Emma E. McGinty, PhD, MS. All researchers with the exception of Elizabeth Stone are with the Johns Hopkins Center for Gun Policy and Research. Ms. Stone is with the Division of General Internal Medicine, Johns Hopkins School of Medicine.

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Child Welfare

100 Former Foster Youth Visit Members of Congress to Advocate for Child Welfare Reform

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Before the foster youth shadows met their Members of Congress, they gathered as a group for training with the FosterClub. Photo Credit: Congressional Foster Youth Caucus

Each May, the Congressional Caucus on Foster Youth introduces a resolution to recognize May as National Foster Care Month. Last year the resolution was cosponsored by more than 130 Members of Congress. In addition to re-introducing this important resolution to call attention and raise awareness about this issue, the Congressional Caucus on Foster Youth will be hosting a range of events in May, including a panel on May 23rd to discuss kinship placement and navigator programs which will also be streamed on Facebook Live.

The National Foster Youth Institute (NFYI, www.nfyi.org) is gearing up once again to bring over 100 current and former foster youth, selected from a nationwide pool of applicants to Washington D.C. for a week of leadership training sessions, workshops on activism, and legislative meetings, culminating in an opportunity to spend a day “shadowing” their individual Congress members. Shadow Day attendees, some as young as 18, have all spent time in the foster care system and will share their experiences, while advocating for reforms in the child welfare system, both in their district and nationwide.

NFYI creates the Shadow Day Program each year, in partnership with the Congressional Caucus on Foster Youth, providing a forum for members of Congress to discuss and develop policy recommendations which strengthen the child welfare system and improve the overall well-being of youth and families. Co-chaired by Rep. Karen Bass (D-CA), Rep. Tom Marino (R-PA), Rep. Brenda Lawrence (D-MI), Rep. Diane Black (R-TN), and Rep. Jim Langevin (D-RI), the bipartisan Congressional Caucus on Foster Youth brings together over 100 Members of Congress to discuss the challenges facing all foster youth and develop bipartisan policy initiatives.

NFYI’s Shadow Day Program has trained a corps of foster youth alumni across the nation who have developed chapters in their home districts and partnered with local leaders and organizations to educate policymakers to addresses chronic problems within the national, state, and local child welfare systems.

Rep. Karen Bass (D-CA, 37th), during Shadow Day 2017, stated that government essentially becomes “the parents” when it puts children in foster care, and then “washes our hands of them” once they turn 18.

“Any time a foster youth falls through the cracks, then the government is really responsible because when we remove children from their parents, we — meaning the government — become the parents, we are responsible for them,” Bass said on the House floor. “So, we’re working on legislation to improve that.”

No one knows more about the pitfalls of our nation’s child welfare system than those who grew up in it. These young people are coming to D.C. to share their stories both – their challenges with abuse, trafficking, overmedication, or homelessness – and their successes with mentorship, adoption, family reunification, community activism and independent living. The goal is to help Congress understand how to improve the child welfare system.

“National Foster Care Month is a month to honor the successes and challenges of the more than 400,000 foster youth across the country and to acknowledge the tireless efforts of those who work to improve outcomes for children in the child welfare system. Making sure that all children have a permanent and loving home is not a Democrat or Republican issue—it should be an American priority. This May, we come together to celebrate the experiences of the youth who are in, or have been in, the child welfare system and raise awareness about their needs.” – Bipartisan Congressional Caucus on Foster Youth

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Politics

Is The Fair Housing Act Failing?

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Denied. It’s a word that some people hear more than others. Specifically, when it comes to housing opportunities. The Fair Housing Act of 1968 was supposed to equalize the housing market for a variety of diverse populations, regardless of race, color, national origin, religion, sex, familial status, and disability (Fair Housing Act).

Fifty years ago this month, the Fair Housing Act came into existence. So it’s only fair to ask, is it working? Is there less housing discrimination that when the Fair Housing Act was passed five decades ago?

As with most socio-political questions, the answer is not a simple yes or no. According to a 2012 report released by the Department of Housing and Urban Development (HUD), while more obvious forms of housing discrimination (such as refusal to show a unit to a person of a racial minority) have declined, more subtle forms of discrimination persist.

The study specifically identified that African Americans, Hispanics, and Asians were told about and shown fewer units than Whites. This is a difficult practice to catch. However, HUD and various fair housing groups have used secret shoppers and complaint hotlines, among other methods, to obtain evidence of housing discrimination of this kind with some success.

A study by Reveal that came out this month identified that this trend is still occurring heavily when it comes to lending and homeownership data, with African Americans being denied home mortgages at a much steeper rate than White borrowers.

While banking institutions insist this disparity is due to neutral factors such as credit scores, fair housing researchers have shown the existing lending model relies heavily on the traditional credit score which has disparate and/or disproportional impact on racial minorities.

As the study by Reveal shows, traditional credit scores don’t take certain kinds of financial history, such as paying rent and utilities, into account. Therefore, someone could pay rent and utilities on time for 20 years and not have a sufficient credit score to receive a mortgage from a financial institution. The system is designed where one must first have assets in order to acquire the credit to get assets, a prime example of privilege.

These reports primarily focused on obtaining housing. What about discrimination when it comes to evictions from persons already housed? Much less research has been done on this aspect of fair housing. An article produced by Harvard Civil Rights-Civil Liberties Law Review discussed how previous studies have only gone so far as to prove correlations between higher rates of evictions and some fair housing protected classes.

Households with a higher percentage of children in the Milwaukie neighborhood being studied exhibited a higher eviction rate than households with fewer children. This could indicate fair housing violations occurring based on familial status and dynamics. However, more research is needed to determine the validity of this claim by examining the “eviction warranting behaviors” of landlords.

For example, are households with children are more likely to break aspects of a lease such as paying the rent on time? These questions require further research to truly understand if there is an underlying fair housing concern particularly in the instance of no-cause evictions which are much more difficult to evaluate.

Take Away

One positive of the passage of the Fair Housing Act is that it created tools by which persons could advocate for themselves or others. It opened a form of recourse that those experiencing housing discrimination could take against housing providers that do not follow Fair Housing Law. Amidst all the work to be done to improve the impacts of the Fair Housing Act, there are some simple ways the general public can increase the prevalence of fair housing practices.

Know the federal Fair Housing Act and how it works, specifically in your state. Some states have additional protected classes above and beyond those listed in the Federal Fair Housing Law. You can start learning at the National Fair Housing Alliance

Use this knowledge to advocate for the fair housing rights of yourself and others, especially if you work with vulnerable populations who are likely to experience housing discrimination. For example, fair housing law can demonstrate how to correctly use reasonable accommodations to achieve successful housing placement and retention for persons with disabling conditions who would otherwise be unable to access and enjoy housing.

Hold those who make decisions about housing accountable by reporting known housing discrimination for investigation at HUD Housing Discrimination Complaint Form

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Health

Why Work Requirements Will Not Improve Medicaid

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One out of every five low-income Americans depends on Medicaid, the national insurance program for the poor jointly run by federal and state governments. Medicaid provides insurance coverage for a broad array of health services from pregnancy care and childhood immunizations to emergency hospitalizations. As the practice of health care has developed, states have applied for waivers under Medicaid’s “Section 1115” program to test new ways of delivering prenatal care, coordinated care for children, and specialized medical treatment for cancer patients.

But in 2018 the Trump administration signaled a major shift in the Medicaid waiver policy. Section 1115 waivers are now being used allow states to require people applying for Medicaid to work or engage in unpaid “community engagement” as a condition of eligibility. Currently, such work requirements for Medicaid are under consideration in twenty states.

Are work requirements for Medicaid a good idea – comparable to the kinds of improvements states have tried under waivers in the past? Medical and social scientific research actually suggests that imposing work requirements is unlikely to improve health outcomes. Even more worrisome, for the three-fifths of Medicaid beneficiaries who are already employed, administrative work requirements are likely to impose barriers to accessing needed healthcare. Because the new work requirements do not further Medicaid’s goal of providing healthcare coverage, they may well violate established Medicaid law.

My research reinforces prior findings that Medicaid work requirements will not make anyone healthier. These rules will create confusing bureaucratic red tape and prevent low-income Americans from getting the care they need. Millions of low-income Americans will pay the price for this attempt by the Trump administration to misapply federal law.

The History of Medicaid

Established in 1965, Medicaid provides health insurance coverage to the elderly, individuals with disabilities, and low-income families. The law as written was meant “to furnish medical assistance” to individuals “whose income and resources are insufficient to meet the costs of necessary medical services.” People who benefit from Medicaid are far less likely than their peers to forego necessary medical care, and a growing body of research shows that Medicaid coverage is associated with lower rates of mortality and increases in access to care and self-reported improvements in health.

Over the years, many improvements in the Medicaid program started at the state level. Under Section 1115, the Secretary of Health and Human Services can allow states to waive certain requirements to experiment with policies that are “likely to assist in promoting the objectives” of the Medicaid Act.

Beginning in the 1990s, states like Minnesota, New York, and New Jersey used waivers to expand coverage to new populations of low-income Americans, control program costs, and improve the quality of care. Nevertheless, because Section 1115 waivers are supposed to promote the objectives of the original Medicaid law, federal officials prior to the Trump administration were reluctant to approve state modifications that would deny potential beneficiaries necessary access to medical care.

Work Requirements Mean More Bureaucracy and Less Health Care

Breaking with tradition, in 2018, the Trump administration advised states that it would approve Section 1115 waivers that required individuals to participate in “employment-related activities,” including paid employment or job training as well as unpaid volunteer work or community service. As of April, nearly 20 states are in the process of developing such waiver applications and the Centers for Medicare and Medicaid Services has already approved such waivers in Kentucky, Indiana, and Arkansas.

The results are likely to undercut Medicaid’s basic goals. Although three out of every five able-bodied Medicaid beneficiaries already work or participate in community engagement, new work requirements will create costly and confusing bureaucracy for millions of low-income Americans who will have to periodically recertify their work status with multiple state agencies. People suffering from intense poverty tend to struggle more than others with such burdens. Predictably, many will fail to meet the new paperwork requirements and fall out of the system, even though they still need health insurance. Not only will this outcome directly undermine the basic purpose of Medicaid, applying the new rules will consume time and resources administrators could devote to helping beneficiaries.

Busting the Myth that “Employment Leads to Better Health”  

Policymakers and civic leaders should push back against false Trump administration claims that existing research bolsters the case for new Medicaid work requirements:

  • Trump officials claim that a 2016 study showed that employment is associated with better health outcomes – but the researchers actually noted that unemployment rates “were not significantly associated with life expectancy… in the bottom income quartile.”
  • Officials say that a 2014 study published in Occupational and Environmental Medicine establishes a “protective effect of employment on depression and general mental health.” But those researchers said that they cannot establish a causal link because “positive health effects of employment can be affected by the fact that healthier people are more likely to get and stay in employment.”

Indeed, research supports the opposite of Trump administration claims. Instead of employment automatically improving health, better health actually improves people’s employment prospects. A research summary in Medical Care Research and Review finds that improved health would increase earnings by 15 to 20 percent. Some studies suggest that low-income jobs lead to higher rates of mortality and other bad health outcomes.

A recent Health Affairs report found that participants in a Florida welfare experiment whose benefits were conditioned on workforce participation had a 16 percent higher mortality rate than comparable recipients not subject to work stipulations.

Medicaid was designed as a program to improve the health of poor Americans – and available evidence suggests that it should continue to serve this core purpose – rather than being turned into a cudgel to deny care or force people into bad jobs.

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