Women Just Can't Win: Medicaid Work Requirements and Inadequate Workplace Policies

From the desk of ... Katie Martin

 

This Blog Written and Provide by: The National Partnership’s Vice President for Health Policy, Katie Martin.

February 28, 2018 | Health Care

 

Here’s an idea for politicians who claim they want to help women and families become more financially secure: Don’t institute punishing work requirements in programs that are meant to help people achieve and maintain economic security. Instead, promote and protect access to affordable, quality health care and supportive workplace policies.

This appears to be a foreign concept for the Trump administration and congressional leadership. Last month, the Centers for Medicare & Medicaid Services (CMS) approved problematic work requirements in Kentucky and Indiana’s Medicaid programs. Trump followed suit with a 2019 budget that proposes work requirements for critical programs that lift women and families out of poverty and combat persistent inequality.

Medicaid work requirements are especially punitive for women, who must contend with workplaces that don’t reflect or support the complexity of their lives in order to meet stringent work requirements under Medicaid and maintain the health coverage they need.

Medicaid is a vital source of health coverage for millions of women: 17 percent of women in the United States are enrolled in Medicaid. Due to racism and other systemic barriers that have contributed to income inequality, women of color are disproportionately likely to be insured through Medicaid: 31 percent of Black women and 27 percent of Hispanic women aged 15–44 were enrolled in Medicaid in 2015, compared with 16 percent of white women. Medicaid pays for nearly half of all U.S. birthsand is the largest payer of publicly funded family planning services.

Most women who are enrolled in Medicaid (56 percent) already hold jobs. Many of those who do not are caring for family members, have a serious illness or disability or attend school. Still, nearly two-thirds of those at risk of losing Medicaid coverage because of work requirements are female.

It is already challenging for women with health conditions or who are caring for loved ones to work, and Medicaid work requirements will only make this harder. This is in part because far too few women have access to paid family and medical leave. In fact, fewer than 60 percent of workers have access to unpaid leave under the Family and Medical Leave Act (FMLA), leaving more than 40 percent without access to job protection when they need to take leave for medical reasons. This means, for example, that a woman not covered by the FMLA who is enrolled in Medicaid could lose her job if she takes time away from work to get cancer treatment, and then lose her health coverage due to Medicaid work requirements. Losing Medicaid could be a death sentence for this woman. At the very least, this would severely threaten her ability to get the care she needs and maintain her economic stability.

Medicaid work requirements could also block people with hourly and seasonal jobs from keeping their coverage. Women make up two-thirds of the nearly 23 million low-wage workers in the United States. Many low-wage workers have variable hours, and an inflexible Medicaid work requirement could cost them health coverage if their hours drop below a certain level.

Seven in 10 low-wage workers are unable to earn a single paid sick day. For these low-wage workers who are enrolled in Medicaid, a single sick day could mean losing their job and then their health care. Job loss due to lack of paid sick days is not uncommon. Overall, nearly one in four U.S. adults reports having lost a job or being told they would lose a job for taking time off due to illness or to care for a sick family member. In addition, women are more likely to be primary caregivers of children and older adults, making them particularly vulnerable if they need to take a sick day to care for a loved one.

Even if the United States adopted family friendly workplace policies, Medicaid work requirements would still be punitive, ineffective, administratively burdensome and entirely without justification. These requirements are about driving people off Medicaid, not empowering them or improving their lives. In fact, the states applying for waivers to implement work requirements even acknowledge estimated coverage losses in their applications.

Ultimately, states that choose to implement Medicaid work requirements will compound the harm women already experience from inadequate workplace policies, undermining women’s health, well-being and economic security. More states should instead expand Medicaid — without work requirements — and connect more women to the health care they need to get and stay healthy.

 

 

Gun Violence and the Mental Health Debate

Gun Violence and the Mental Health Debate

A Blog

Washington Premier Group

Once again the nation is torn over how to handle a tragic situation. Gun violence in America remains prevalent, in neighborhoods, domestic violence and most disturbingly - mass shootings of our children. Just since the start of 2018 there have been several instances in schools alone that killed over 20 people and injured even more[1]; but, instead of the country uniting and devising a plan, we instead find ourselves divided on the best course of action to take. While the political factions bicker with each other and make little to no improvement, the children across the country have taken it upon themselves to demand change – “out of the mouths of babes”.

On Wednesday, February 21, 2018, hundreds of students marched over 10 miles to Washington, DC in support of Parkland, Florida shooting victims marching on their own state capitol. These students, parents and teachers along with many others begged the questions of “How many deaths will it take? How many more mass shootings must there be before we fix the system?” Lawmakers in Congress continue to offer thoughts and prayers to families and victims, but they have failed to pass any legislation. In order to effectively implement policy that will prevent further school and mass shootings, Congress must come to an agreement on what needs to change.

The usual arguments are that the country needs stronger federal gun control laws like banning bump stocks and criminal background checks while the opposition comprised of 2nd amendment supporters argue that guns are not the problem and that the government cannot strip Americans of their right to bear arms. Another angle, however, that people often mention but rarely revisit is that the country lacks proper mental health care and treatment and that background checks that would prevent criminals from purchasing guns would not be able to properly screen for mental illnesses.

The President and several Republicans support the idea of requiring clearance from a mental health specialist before allowing someone to purchase a gun, but Democrats are quick to counter that the government should instead focus on gun control as the main issue, and not merely blame the mentally ill.  There is clearly a need to do address both issues.

Data on the number of mass shootings attributable to mental illness is difficult to find, so psychologists and gun control advocates struggle to back their views with statistical support. At a time where many are trying to end the stigma surrounding mental health, immediate reactions by the general population to assume shooters were ill and label them as “crazy” provides an argument to avoid addressing gun law reform. Sure, it is easy to say that nobody in their right mind would have the audacity to pull a gun on someone if unprovoked, let alone an entire school of young students, but many warn that automatically labeling all persons who conduct these heinous acts as mentally ill makes others living with mental illness afraid to seek help out of fear of judgement, or worse. Not every shooter suffers from Major Depressive Disorder, for example, and not every person with Major Depressive Disorder conducts a mass shooting. By connecting the two without proper statistics and education, we delay any chance of ending the stigma on mental health and any chance of passing policies that will diminish mass shootings.

When talking with a young adult who lives with Generalized Anxiety Disorder comorbid with other mental illnesses, I listened as she provided a take on these issues that seemingly encompassed all aspects under discussion[2]. The first question I asked her was whether or not she supports mental health screenings for people who want to purchase a gun, to which she immediately replied in agreement of such a measure. She went on to explain that not everyone is fit to have a gun, but that not all shootings should immediately be attributed to mental illness. Those without mental health challenges often fail to empathize with and understand those who struggle with them, frequently labeling these people as scary and violent instead of proposing policy initiatives that would fund more institutions and encourage our fellow citizens to seek help.

The big takeaways that Psychologists want society to embrace and that they have been trying to convey for decades is that those with mental illnesses are not a dangerous people because of their diagnoses. There are many violent people that do not have mental health struggles just as there are many who do have these struggles who are not violent. Instead of automatically associating gun violence with mental health, Psychologists and advocates believe that people need to be comfortable having conversations about mental health so that those with and without violent characteristics are comfortable seeking help and have it readily available.

By instilling background checks and mental health screenings before one can purchase a gun is a small step in the right direction and should not be considered over-burdensome on law-abiding gun owners. While many argue that these small precautionary measures would in principle become a slippery slope that could lead to limiting the Constitutional right, we are now at a tipping point, where those who have abused this right by their criminal act of taking the lives of more innocent school children for the rest of us not to do something about it.  

By: Ms. Sarah Vitellaro (WPG Staff Intern)

 

 

[1] http://www.washingtonexaminer.com/no-there-have-not-been-18-school-shootings-so-far-in-2018/article/2649183

[2] C. Douglass, personal communication, February 23, 2018.

FMLA 25th Anniversary Celebrated on Capitol Hill as Advocates Encourage Further Progress

Washington Premier Group represents Federally Employed Women (FEW), a proud coalition member of the National Partnership for Women and Families and supporter of the FMLA. The 25th anniversary of the FMLA was Monday, marked by a celebration on Capitol Hill and a tweet storm that left #FMLA trending for 7 hours! A roundtable discussion on Tuesday, February 26, 2018 allowed members of the House of Representatives to talk with leaders of the FMLA and paid family leave initiatives about how to progress this idea increasingly supported by both sides of the aisle. An important point brought up at Tuesday’s roundtable was the need to devise an economic presentation to provide businesses that easily displays the cost of implementing paid family leave. Many businesses step back from offering it because they fear losing money and employees. It was made clear, however, that the cost of hiring and training new employees outweighs the cost of offering an existing employee paid family leave. It was said yesterday that to hire and train a new employee costs 150% of a current employee’s salary, making it more cost effective to provide the existing employee with paid leave. Offering this benefit to employees also improves retention rate; for example, when Google increased their paid time off from 12 to 16 weeks, employee retention rate increased by 50%.

Another point brought up was that when conservative voters were presented with four options for family leave, an overwhelming majority favored the Family Act. They felt it was the most “Republican idea” because it exercised shared costs. With support coming from both Democrats and Republicans, speakers at the roundtable discussion believe that paid family leave is finally a question of when and how. 

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DSA Chair, Chief Exec Frances Pierce Among Philadelphia’s Most Admired CEOs

Frances Pierce, chairperson, president and CEO of Data Systems Analysts, has received recognition from the Philadelphia Business Journal as one of the 2017 Most Admired CEOs in Philadelphia.

The editorial board of the publication selected Pierce for the award, which aims to commend CEOs in areas such as innovation, financial activity, commitment to diversity in the workplace and contributions to the Greater Philadelphia region, DSA said.

The company noted Pierce helped restructure DSA in efforts to broaden its service offerings and market presence and was responsible for expanding operations to include eight regional offices.

DSA’s revenue rose to $168 million in 2017 from $9 million in 1991 and the number of employees increased from 100 to more than 400 during her time as president and CEO.

Pierce’s tenure included the designation of the company in the Inc 5000 Fastest Growing Companies list nine times.

The 2017 Most Admired CEOs awarding ceremony was held Dec. 7, 2017

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DACA: Framing the Policy Debate

          ·   DACA – Deferred Action for Childhood Arrivals

·  Approximately 690,000 young adults are protected under the DACA program[1]

·  To be eligible, applicants had to have been brought into the U.S. before age 16, had lived within the U.S. since June 15, 2007, and no older than 30 at the time which DHS enacted the policy in 2012[2]

·  Among the accepted applicants, Mexico is by far the greatest contributor, followed by El Salvador, Guatemala, and Honduras.[3]

·  Since the enactment of DACA, recipients have been able to obtain valid driver’s licenses, enroll in college, and legally secure jobs. Therefore, they pay income taxes.[4]

·  DACA recipients are not legal permanent residents nor do they have a path towards citizenship.

·  If Congress doesn’t produce legislation by March 6, as many as 983 undocumented people could lose their protected status every day—nearly 30,000 people per month.

·  The DHS stated it would process new DACA applications that were received by September 5, 2017, and renewal applications that were received by October 5, 2017. People who already have DACA and whose work permits would expire between Sept. 5, 2017, and March 5, 2018, were eligible to apply for a two-year renewal if they applied by October 5, 2017.[5]

·  Judge William Alsup, a judge of the U.S. District Court for the Northern District of California, ordered a preliminary injunction, which reallows DACA recipients to apply for renewal of their status. However, this action by Judge Alsup does not allow people to allow for DACA status if they do not already have DACA status.[6]

                                            DACA

 “Is it Time for Congress to Address Immigration?”

DACA, or Deferred Action for Childhood Arrivals, is a program originally enacted by the U.S. Department of Homeland Security under the Obama administration in 2012. Despite the contrasting opinions on each side of the political aisle, DACA contains many positive and negative qualities that make its continued enactment not the most optimal policy for the United States and its people. The program has allotted undocumented immigrants who have been living in the United States (for at least two decades) to obtain “deferred action” meaning they can live and work in the United States without fear of immediate deportation.[7] This allows almost a million people to work and to pay income taxes contributing to the government services and benefits we all expect. However, DACA recipients are not afforded many government services, which they contribute. For example, DACA recipients may not be awarded benefits such as Medicaid, private health insurance subsidized by the U.S. government (per Patient Protection and Affordable Care Act), or CHIP (Children’s Health Insurance Program).[8] By allowing DACA recipients to be known to the state, they are removed from the black market and possess economic security. Additionally, the program has allowed almost one thousand recipients to participate and serve in the U.S. military.[9] Furthermore, DACA recipients have enjoyed many benefits from the United States that would prove costly to ignore. Since entering the United States, DACA recipients have attended Americans schools, and some have even went on to postsecondary institutions. Educating a populace is incredulously expensive. The revocation of DACA would be a major drain on productivity. Another flaw of the program is the cost of applying for DACA. Per application, a potential recipient must pay a nonrefundable fee of $495 to DHS.[10] If his or her application is denied by DHS, there is no appeal. The individual must reapply and pay that fee again.[11] Aside from the economic side of this issue, the issue of morality and the sanctity of a family is also a significant portion of this debate. All recipients of DACA entered the United States at less than sixteen years of age.[12] They would not recognize and do not know their country of origin. Many DACA recipients also have family members in the United States who are U.S. citizens or have legal resident status. Many who are vehement supporters of DACA argue that the revocation of DACA would cause families to be torn apart. By allowing DACA recipients to be open about their status to the state, they can feel more comfortable accessing community services, contacting the police, and being more engaged in civic activities. However, a major flaw of DACA is the storage of information, and the management thereof. If someone, in good faith, applies for deferred action under the program, and are denied, the U.S. Department of Homeland Security knows exactly where and who that person is to begin deportation procedures.[13] Further, at any time, the deferred action may be revoked by the DHS.[14] While DACA does have its faults, it is better than no alternative policy.

 

[1] www.cnn.com/2017/09/04/politics/daca-dreamers-immigration-program/index.html

[2] www.cnn.com/2017/09/04/politics/daca-dreamers-immigration-program/index.html

[3] www.cnn.com/2017/09/04/politics/daca-dreamers-immigration-program/index.html

[4] www.cnn.com/2017/09/04/politics/daca-dreamers-immigration-program/index.html

[5] https://www.nilc.org/issues/daca/

[6] https://www.nilc.org/issues/daca/daca-preliminary-injunction-regents-v-dhs/

[7] http://www.cnn.com/2017/09/04/politics/daca-dreamers-immigration-program/index.html

[8] https://ccf.georgetown.edu/2014/04/11/for-daca-youth-health-insurance-is-only-a-dream/

[9] https://www.cbsnews.com/news/pentagon-says-daca-recipients-in-military-number-fewer-than-900/

[10] http://www.cnn.com/2017/09/04/politics/daca-dreamers-immigration-program/index.html

[12] https://www.uscis.gov/humanitarian/consideration-deferred-action-childhood-arrivals-daca

[13] https://www.immigrationequality.org/get-legal-help/our-legal-resources/path-to-status-in-the-u-s/daca-deferred-action-for-childhood-arrivals/#.WmX4-0xFzIU

[14]https://www.immigrationequality.org/get-legal-help/our-legal-resources/path-to-status-in-the-u-s/daca-deferred-action-for-childhood-arrivals/#.WmX4-0xFzIU

The Recent Government Shutdown- What Happened?

At midnight on Friday, January 23, the United States government shut down for the first time since 2013. Two days later, on Sunday, the Senate passed a bill to end the shutdown, and President Trump signed it soon after. The bill allows government funding to continue through February 8th, 2018, (which is fast approaching).  The Majority Leader will be held accountable if he does not bring immigration legislation to the Senate floor.  The Senate Democrats put pressure on the Republicans before the shutdown to try to force a vote on a bill that would prevent the deportation of Deferred Action for Childhood Arrivals (DACA) recipients.  In short, if these issues are not resolved by February 8th, the government could shut down again.  

Democrats were hesitant to sign the bill because it gives Republicans another opportunity to avoid or delay any legislation on immigration. Although liberals made it clear that they would only agree to reopen the government if conservatives agreed to vote on legislation, a promise is different from actually carrying out the action. It will, therefore, be interesting to see if Congress holds a vote before this new deadline, or if we see another shutdown.  Albeit short, the two days that the government was closed had an affect on Washington and those normally paid by the government, however.

A provision of the U.S. Constitution allows lawmakers to still get paid their salaries despite the federal government being shutdown due to their lack of ability to reach an agreement, but it does not provide the same for members of the military. Many members of Congress elected not to receive pay during the shutdown or donated their pay to charity. Others proposed legislation to prevent Congressional members from getting paid and to ensure that servicemen and women continue to receive pay and benefits.  These actions displayed by both sides of the aisle, while commendable, hint at the need for policy allowing those who protect our country to still receive a paycheck when members of Congress fail to pass a budget to keep the government open.  Aside from the military, the shutdown also affected federal contractors.

Federal contractors, or the people and groups who perform duties under a federal department or agency, were also impacted by the government shutdown. Lockheed Martin, for example, expected a “result in costly schedule delays and breaks in production that w[ould] increase overall program costs and interrupt the delivery of critical equipment to [their] customers” (http://www.defenseone.com/business/2018/01/why-shutdown-didnt-much-affect-defense-firms/145390/).  Other federal defense contractors refused to confirm or deny any effect the shutdown may have had on their firms, but Lockheed Martin admitted a negative impact across their locations.

Although this government shutdown did not last very long, it could have a longer impact on whether the immigration issue gets resolved.

 

Spring 2018 Interns

            WPG would like to extend a warm welcome to our three interns this semester! Sarah Vitellaro, a junior at Stonehill College in Massachusetts, will serve as the Intern Coordinator and Administrative Assistant. She brings to WPG her prior experience as an intern at the Massachusetts State House and as a volunteer on local campaigns. In the future she hopes to combine her Psychology Major, Healthcare Administration Minor, and passion for public policy in a medical setting. Shane Palmer, a junior at George Mason University, is a MTA Event Coordinator and Research Intern for WPG. He has experience as a member of the Board of Directors for an emerging 501(c)(3) nonprofit LGBT+ community center, and he hopes to become a policy analyst at a think tank. Ebenezer Bulcha, a junior triple-major at Dartmouth College, is also a MTA Event Coordinator, as well as the Social Media Intern for WPG. He possesses many valuable skills including an extensive background in policy research, analysis of economic and sociological trends, and mass-data analysis. He intends to pursue a JD/MBA post-graduation and to practice corporate and patent law.

            We are very excited to have you all on board as you apply your skills and acquire new ones through your work with research, writing, and events. We look forward to helping you along your educational journeys and hope you take advantage of every opportunity you are given to showcase your unique talents and passions. Once again welcome to Washington, D.C., and welcome to WPG!

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Thank You And Farewell to WPG's Fall 2017 Interns

WPG would like to extend a sincere thank you to all of our talented interns from the Fall 2017 semester. You all worked extremely hard to complete each assigned task in a timely and professional manner, and you consistently went above and beyond to ensure the organization and its clients had the tools necessary for success. It was a pleasure having you in the office and at our various events, and we enjoyed getting to know each of you. Please enjoy these pictures from some of our events as a final thank you for your contributions this past fall. WPG wishes you nothing but the best in your future endeavors

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Family and Medical Leave Act (FMLA) Celebrates 25th Anniversary with New Video Wall

On February 5, The National Partnership for Women & Families will celebrate the 25th anniversary of the Family and Medical Leave Act (FMLA). It’s been used more than 200 million times, and each use is a story that is personal, poignant and powerful.

It’s an important day for the National Partnership because they drafted and led the fight for this historic legislation, and they were there in the Rose Garden when President Clinton signed the bill into law.

Today, they’re leading the fight for a national paid leave program, and they are using this occasion to invite activists and partners across the country to share their stories on the new Support Paid Leave video wall.

That’s where you come in.

Please take a minute and use our simple video testimonial tool to share a few words about what #paidleavemeans to you. Only your first name will be visible to the public, and you can easily share the video with your friends when you're done.

Helpful tips: Please hold your phone sideways/horizontally when recording the video and be sure to mention your first name, city and state at the beginning.

Please be part of the FMLA celebration and help us advance paid leave by sharing your story today!

Learn more about how to record your paid leave testimonial here

Thanks!