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Medicaid Work Requirements Perpetuate A 'Vicious Cycle' Of Poverty

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George "Big G" Dagracia, who is homeless, solicits from passersby under light snow in Boston, Monday, March 21, 2016.
Michael Dwyer/AP
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It’s the faces that get to me. The resigned faces of the women lined up waiting to be served at the Pine Street Inn. On any given night, the shelter is a temporary home for these homeless women — a place to sleep and eat a good meal. Members of my sorority, Delta Sigma Theta, Inc., have volunteered here for more than 20 years. On our once-a-month Saturdays, we donate the meal: we design the menu, cook the dishes, and serve the food to the residents. And we always make enough for hearty portions and second servings. Last Saturday night, 93 women lined up for meatloaf, mashed potatoes with gravy and peas. Standing there handing out the plates, I looked into the faces of these women and was humbled and grateful because I know, “But for the grace of God, go I.”

There has never been a time in my life when I haven’t known people who are poor. My sister and I are just a couple of generations removed from family members who either eked out a meager living or subsisted on whatever they could put together. Trips to my parents’ rural hometowns in Louisiana and Mississippi were sharp reminders of the difference between their childhoods and ours. And we were not rich or even well-off. Both my parents worked hard so we would want for nothing. My dad would always tell my sister and me, “Your mother and I will give you all of what you need, and some of what you want.” I knew firsthand that a lot of people did not have that option.

Maybe that is why I do not harbor anger or resentment against people who are poor. I don’t believe that these are people who are trying to scam the system or take something from me and mine. I’ve truly struggled to understand why there are so many others who do feel that way.

And I am sure that it is this misplaced resentment which motivated the Trump administration to change the state's rules for recipients of Medicaid, the health insurance program for low-income Americans. States can now require Medicaid recipients to work or lose their benefits. Many of the 70 million Medicaid recipients are already working, already caring for disabled children, already enrolled in school. At a time when middle-class Americans are declaring medical bankruptcy in record numbers, it should be obvious why government health insurance is a literal lifeline for those who are poor.

Massachusetts Gov. Charlie Baker has rejected the Medicaid work requirement option. But other states are moving ahead, with critics saying the rules change will likely end up in court. Supporters of the Medicaid work requirements insist working actually has great health benefits. They point that out, even though the new proposal prevents states from paying for the job training, transportation or childcare many would need in order to work. A new definition of a vicious cycle.

The women at the Pine Street Inn never fail to return to the serving line to express their gratitude after eating their meals. Our leave taking is accompanied by a heartfelt chorus of, “Thank you ladies, it was delicious!” or simply, “Thank you for coming.” But for the grace of God, go I.

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