Sunday, December 3, 2023

Ky. ranks low in benefits for the poor; health secretary says he reminds legislators of the impact programs have on communities

Health Secretary Eric Friedlander

Update, Dec. 4: This story has been updated with additional information from state Health and Family Services Secretary Eric Friedlander's office. One number has been corrected.

By Melissa Patrick
Kentucky Health News

In a national webinar on safety-net programs, state Health and Family Services Secretary Eric Friedlander said he would mention the state's low ranking in assistance to needy families in his discussions with legislators who will soon write the state budget. 

The webinar was held Nov. 28 by the Brookings Institution, a leading think tank that does in-depth, nonpartisan research to improve policy and governance at local, national and global levels.

The webinar opened with an introduction to Brookings' new tool, State Safety Net Interactive, showing the evolution of safety-net benefits over 21 years for a hypothetical sample of non-disabled, non-immigrant, single-mother families if they had full access to major safety-net programs, based on each state's rules.

Screenshot of Brookings Institution interactive map
The interactive tool shows that in 2022, Kentucky ranked 49th in cash and food assistance for this theoretical family, providing $4,810 in assistance. That was lower than any state but Arkansas and Mississippi. Adjusted for the cost of living in each state, Kentucky ranked 44th.

Friedlander told the webinar audience that he looked forward to using this interactive tool in his policy discussions with the state's lawmakers: "I appreciate getting the additional data and support from the tool that Brookings is rolling out today and I think it will be helpful in my discussions with the General Assembly."

Friedlander said it's important to recognize that Kentucky has a "blue governor" and a "very red General Assembly" and that there are often differing narratives when it comes to safety-net benefits and policy.  

He said that when it comes to safety-net programs, his cabinet tries to recognize that whatever happens to an individual in any community impacts everyone in the community, and he tries to convey this to policymakers. One example he used is the Supplemental Nutrition Assistance Program, formerly food stamps.

"I've taken an approach with the General Assembly, which is, if it weren't for SNAP, we wouldn't have the amount of grocers that we have across the state. If it wasn't for Medicaid, we wouldn't have a health-care system at all. If it wasn't for child-care support, we wouldn't have child care," he said. "So I also take it from an angle of the economic support to communities . . . but what happens to communities when we're able to provide support for these individuals in their communities."

Kentucky increases benefits to the most needy families

Friedlander said his cabinet recently increased Temporary Assistance for Needy Families, a federal program that provides cash assistance to families with children and very low incomes.

In a follow-up email, Friedlnader spokeswoman Susan Dunlap said Kentucky's TANF program is called the Kentucky Transitional Assistance Program and stressed that the interactive Brookings tool does not yet reflect the changes made to Kentucky's program. 

"The funding level changed earlier this year, and adjustments do not yet show up in the interactive tool, which reflects data through 2022," Dunlap said in an email. "The tool, soon, should reflect the change in income eligibility level."

Dunlap said the benefit and income eligibility levels for this program had not changed since at least 1995, when the one and two-person household income categories were last increased, and the last increase for larger households was even earlier. 

She offered this example: "Accounting for inflation having risen 92 percent between 1995 and 2022, the maximum benefit level for a household of three would have been $503 had it just kept up with inflation. The current benefit reflected in the interactive tool is $262 for a household of that size. The recent increase in funding doubles the benefit level to $524 for a household of three – just above the inflation-adjusted equivalent for 1995."

Dunlap added that the income eligibility limit has been frozen for the past 27 years. "Had it kept up with inflation, it would have been $1,870 per month last year," she wrote. "The current limit for a household of this size reflected in the interactive tool is just $974 per month." 

Friedlander said Kentucky had not changed TANF in 20 27 years and that the recent changes increased payments and reduced some administrative barriers. When legislators asked why, the cabinet showed them the economic impact of SNAP, TANF and Medicaid for each county, beyond the numbers for individuals.

"And it actually made an impact," Friedlander said, adding later, "There are these dependence narratives that are out there, and I don't believe that they're backed up by evidence. But we have to be able to show the evidence that this is not the case within the Cabinet for Health and Family Services." 

He said it is possible to work across partisan lines "as long as we are being honest and evidence-based about what's happening." He added that such talks generally take place "off-stage" and require "relationship building." 

Friedlander pointed to the state's efforts to use the Kynect website to reduce the administrative burden of safety-net programs. "We have an integrated eligibility system, meaning you can go and you can sign up for different programs -- TANF, SNAP, Medicaid, child care -- under one umbrella."

Friedlander said Kentucky discovered this system could work really well during the pandemic. He said other lessons from the pandemic include learning that CHFS could be "nimble" and "can make changes quickly" and can deliver services in a different, but often "more effective and efficient way."

"As of December 2023, there were approximately 12,514 families participating in the KTAP program, made up of approximately 6,242 adults and 21,534 children. Since 2016 alone, the total number of Kentuckians receiving KTAP had fallen by 54 percent," according to the CHFS.

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