Safety net programs, including Medicaid and the Children’s Health Insurance Program (CHIP), Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and Kentucky Transitional Assistance Program (K-TAP), play a critical role in making sure families struggling to make ends meet can have food to eat, cover basic family needs, and access critical supports and services needed to be healthy and thrive.
This is especially important as new evidence emerges about the critical role of economic and concrete supports in preventing child maltreatment, including lowering the chances of a substantiated abuse or neglect report for children who participate in SNAP or WIC and a decrease in child maltreatment investigations when children have continuous Medicaid or CHIP coverage. And for many families, recovering financially from the pandemic will extend well beyond the public health crisis, necessitating continued assistance.
As is the case in most omnibus pieces of legislation, House Bill 7 is a mixed bag. There are good elements for Kentucky kids, and there are also elements that are truly problematic for Kentucky families.
Among the good elements, the final version of HB 7 directs the General Assembly and Cabinet for Health and Family Services to:
- Establish a benefits cliff taskforce and directs the task force, in collaboration with the Interim Joint Committee on Health and Family Services, to study various facets of the safety net, including the feasibility and cost of continuing the 200% FPL for CCAP and creating a bridge insurance program
- Create a benefits cliff calculator for public benefits recipients to assess the impact life changes will have on their benefits
- Establish a transitional benefit for SNAP recipients transitioning off of K-TAP and create an online SNAP employment and training program
- Allow Medicaid to be used to provide substance use disorder treatment for incarcerated individuals
While there are some good elements to the bill, we still have several outstanding questions and concerns about HB 7:
- With no fiscal note, it is unclear how much implementation will cost the Cabinet for Health and Family Services and if they will have to hire additional staff. We are particularly concerned about the cost of creating a Community Engagement program for Medicaid recipients, as CHFS is already experiencing a workforce crisis and long wait times, and we are concerned that provisions will worsen this without additional funding.
- Former foster youth often need significant support as they transition into adulthood. The bill does not make exemptions for these at-risk young adults, and we are concerned with how former foster youth will be impacted by the provisions of this bill. Additionally, it is unclear how pregnant women with no other dependents will be impacted.
- We know that Kentucky families make a variety of arrangements to ensure children are well taken care of, such as informal kinship, which includes having outside adults move into or stay in the home to assist with caretaking. House Bill 7 instructs CHFS to request a waiver for the Able Body Adults Without Dependents (ABAWD) time limit exception for adults residing in the same house as someone younger than 18. Older siblings, grandparents, and cousins may be unemployed in order to dedicate themselves to taking care of the child, allowing the child’s parents to participate in school, work, or substance use treatment.
- Timely access to medical care is essential for Kentucky kids and their caregivers. Newly established rules around self attestation for Medicaid could result in a delay in access, particularly for kids who participate in K-CHIP but not SNAP. While Senate President Pro Tem Givens’ Floor Amendment vastly improved rules around self attestation, concerns remain for how this will impact access to care.
Throughout this process, we have been grateful to see several revisions to this legislation via the committee sub that show a willingness by House Speaker David Osborne and Speaker Pro Tem David Meade to listen to feedback from stakeholders and prioritize Kentucky’s kids and kinship caregivers. Additionally, we are grateful for Senator Givens’ Floor Amendment, which will further reduce unintended consequences. We are glad to see the following provisions included or removed from HB 7:
- Removes provisions that would have eliminated Broad-Based Categorical Eligibility for SNAP
- Reduces penalties for fraud and removes the chance of a permanent ban from supports
- Removes provisions that would have implemented work requirements for Medicaid recipients with no dependents
- Directs the legislature, CHFS, and third parties to study facets of the current safety net during the interim, such as the feasibility of placing multiple programs on a single EBT card and creating a bridge insurance program for low-income families
- Removes provisions that would have required parents to cooperate with child support enforcement to continue receiving benefits
- Gives CHFS more flexibility to waive work requirements during emergencies
- Removes provisions that would have required SNAP recipients to report changes within 10 days
- Allows CHFS to use self-attestation for Medicaid as a last resort and accept fluctuating income data
- Removes costly provisions that would have required CHFS to coordinate with Department of Corrections, the Administrative Office of the Courts, and the Department of Revenue.
In addition to HB 7, the General Assembly passed SJR 150, which effectively ended maximum allotments for SNAP benefits. Maximum allotments have allowed SNAP recipients to receive the maximum amount of SNAP benefits possible throughout the pandemic, providing crucial support for low-income families as they navigate school quarantine and higher grocery prices. With this passing, April will be the last month of maximum allotments, and May will see a $50 million reduction in SNAP benefits flowing into Kentucky. This will be particularly devastating in rural communities, where SNAP benefits increased economic output by 1.25% and the total number of jobs by 1.18%.
As the pandemic has proven, we all fall on hard times and a strong safety net is crucial to catching Kentucky kids and families. As we move into the interim, we hope the General Assembly will use the task forces created in HB 7 to identify where holes in this net exist, not make them larger.