New Orleans The big, bad, budget bill has many draconian features, most of which have to do with work requirements, which don’t go into effect until January 1, 2027, but coupled with more restrictions on SNAP or food stamps, states and the federal government are already mired in chaos. In many places, food stamp recipients have already seen their benefits cut, even though most of them are already working and meeting the 80-hour per month work requirement.
Today is not atypical. An almost double-digit bunch of emails poured into my inbox on food stamp problems. Missouri had to let grocery stores in that state know that they could still accept stamps for some drinks and other items that are on the restriction list. Walmart fully understands the billions it makes as the number one national seller of grocery goods to SNAP recipients and is now offering “bonus points” to families using food stamps to retain the business in Louisiana. Public libraries in Prince George’s County, Maryland are setting up free grocery shelves to supplement books for some their visitors who are among the 3.5 million people that have already lost or seen their benefits curtailed. This is just a sampling of the confusion at the top of the pyramid and the pain at the bottom.
The changes in Medicaid in Trump’s “take from the poor, give to the rich” bill are also giving states fits. Dr. Oz, the television doctor who now heads the Center for Medical Services, released an advisory on the new regulations being rolled out for compliance. Reading between the lines, it was obvious that HHS is getting pushback from states who are grappling with how to deal with this unfunded mandate requiring Medicaid recipients to recertify and prove their work or volunteer hours to receive benefits. His message indicated that CMS would depend on what they called “self-attestation” throughout all of next year, 2027, as the new work requirements come into effect. Back in the day, we used to call this self-certification in a simpler time, meaning essentially that it was a kind of honor system. Of course, there were warnings that in 2028, the hammer would come down and not being able to verify benefits would mean losing them.
This may be a break for some, but not for some forms of disabled beneficiaries who previously had been certified by their states or whose condition, backed by their doctors, gave them automatic access to Medicaid. The CMS rules seemed to require new certification by the states to fit the more stringent Medicaid rules now. Reading between the lines, some of the threats embedded in the rules about defining “frailty” seemed to be sending a message to the head of the New York City public health department and other more caring areas who had publicly been quoted trying to recruit doctors to help certify frailty for recipients. As part of the BRAVO coalition, we have already heard from various health-centered groups trying to understand how their clients and family members can comply with these rules. To say that some are already in a panic, doesn’t overstate the case.
We haven’t seen anything yet. The closer we get to the effective date for these punitive measures, the more pain and horror we’re going to see everywhere in the country. The worst irony I saw in my inbox today was a note that the USDA, which is administering these cuts, is putting out what they call an “interactive map” to let recipients whose benefits they have reduced or denied about where they can go this summer to find “feeding sites.’
Unbelievable. America, what a country?!?