Bringing Down the Barriers to Enrollment in Federal Programs

Constance Etheridge went to the Department of Social Services office in South Carolina for a simple reason: she and her children were hungry and they needed food. Constance was told to go away – a flagrant violation of federal law that not only guarantees the right to apply for food stamps, but in situations like hers, the right to apply for emergency food stamps. Nicole Prado, pregnant and without health insurance, applied for Medicaid in Montana and was turned away. She was told there was a “waiting list.” That too was a violation of federal laws. State practices like these are common, and that culture of lawlessness explains the pervasive underenrollment in public programs like food stamps, child care, Medicaid and CHIP.

Testing for Barriers

The National Campaign for Jobs and Income Support, a new national coalition of grassroots groups, and the Northwest Federation of Community Organizations have jointly launched a project to address this underenrollment problem. Using an approach modeled on fair housing testing, grassroots groups identify low-income families eligible for these programs, send them in to apply, and document any barriers that prevent them from getting the benefits for which they are eligible.

Testers are recruited from the organization’s low-income membership base through door-knocking, and also through outreach at food pantries and other agencies. Potential testers are invited to participate in a campaign to win benefits for their families and to change unjust policies. The testing approach offers a great entry point – delivering concrete benefits for people who need them – for getting people involved. At the same time it creates a base and develops leadership that can fight for policy change. People are fired up and moved to seek systemic change when they understand that what happened to them is not an isolated case, but part of a pattern of bad behavior by state agencies.

The testing projects have revealed barriers to enrollment ranging from the onerous to the outrageous – long application forms, burdensome documentation requirements, no translation services, inaccessible offices, short office hours, harassment, discrimination and intimidation. These results have gotten wide press coverage in six states and in national media. But they were just the first step in a campaign to actually tear down those barriers.

Using the Test Results

As with the testing process, those affected by these lawless practices are playing a central role in the campaigns to change them. The local/regional organizations working on the campaign have provided their testers and other low-income families with opportunities to receive media training, plan and host community meetings, chair meetings, run actions and educate other low-income people on issues. These new leaders not only get training, but also develop their leadership skills through action followed by reflection and evaluation. For example, people originally recruited to be testers have led actions and directed negotiating sessions with state bureaucrats, and then evaluated their own performance and critiqued the events. This approach is now being taken national. A month after her experience in South Carolina, Etheridge and others like her were meeting with the head of the food stamps program and the head of the civil rights division at the Department of Health and Human Services in Washington, DC through National Campaign member South Carolina Fair Share.

These new leaders have won stunning victories. In Idaho, the campaign by the Idaho Community Action Network to change enrollment procedures tripled enrollment of kids in the Medicaid program. Idaho – which arguably has the most punitive welfare system in the nation – now leads the western states in CHIP enrollment. In Arkansas, a testing report and campaign by Arkansas ACORN helped to push the federal government to block a proposal by the Governor to trash the Medicaid program. The groups are now meeting with federal agencies to seek a national crackdown on bad behavior by states.

New Leadership is Key

A key to the success of these campaigns has been the development of grassroots leadership, especially the affected people themselves. These leaders provided incontrovertible evidence of a systemic failure – the inability of real people to get the benefits that most Americans think are readily available to help lift families out of poverty. There is plenty of data out there about underenrollment, but the press and politicians finally sat up and took notice when confronted with real stories and real people.

As important as the policy changes has been the leadership development itself. Many of these folks had never had the opportunity to have a say about the programs that affect them every day. They had simply accepted the ills of the system because they felt powerless. Their participation in these campaigns has given them confidence in themselves. They’re going to be setting an agenda for public policy change for a long time to come – in the states and in Washington, DC.

 

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