Mixed Bag But Still Trending Down
Up and down, but generally down…
The Missouri Department of Social Services has released the Monthly Management Report for July 2023 for the Family Support Division and the Missouri HealthNet Division. [ www.dss.mo/re ]
Alas, no surprises. The number of Missourians getting Temporary Assistance climbed by 88 people (0.8%) from June while those getting food stamps dropped by about a thousand (0.1%). The total enrolled in MO HealthNet – aka Medicaid – was down by 19,409 (1.3%) as the state prunes the Medicaid rolls with a bulldozer.
Now, media reports about those losing coverage have noted higher numbers. Both the media reports and the July report are correct: as people get cut others come on board for the first time. To me the bigger issue is what the numbers should be. I still maintain that Missouri ought to have at least 100,000 more people on food stamps, 250,000 more on Medicaid and at least 40,000 more on Temporary Assistance. The bureaucrats planted a number of deadly mine fields between the programs and the public. This is deliberate policy. It works.
We’ll come back to that.
Here’s some food stamp trivia…Based on the July report who benefits from stamps in Missouri?
Children Disabled Elderly Adults
267,239 90,168 83,950 213,379
41% 14% 13% 33%
[I know, it’s rounding.]
Remember, SNAP has always been designed to assist working poor families. Looking at other data and it becomes apparent that the number of single, non-working adults without care-needing dependents (‘bums’ targeted for “work requirements”) is very, very small. Food stamps help make it possible for fast food workers, janitors, school bus drivers and other lower-paid workers with families to survive.
July Missouri Benefits
2023 2013
Temporary Assistance
Children 9,713 61,844
Adults 2,713 31,460
Total 12,426 93,304
Benefits $1,204,123 $8,294,531
Per Family $ 229.36 $ 228.72
Per Day $ 7.40 $ 7.38
Food Stamps (SNAP)
Participants 654,736 918,776
Benefits $126,264,774 $117,34,371
Per Person $ 192.85 $ 127.72
Per Meal $ 2.07 $ 1.37
Medicaid
Enrolled 1,497,282 866,383
Covered 1,550,057 969,825
Payments $1,282,663,151 $659,675,017
Per Patient $ 827.49 $ 680.20
Managed Care 1,254,193 553,852
Premium $ 377.49 $ 180.60
A Few Words About DSS Staffing
July 1st marked the beginning of Fiscal Year 2024 for the State of Missouri. Per the department’s website, they have “5,800+” employees.
Sounds impressive, except for reality:
- Not that many years ago – when the total number of cases handled was lower – DSS had 7,000+ workers; and,
- As fast as folks are pulling their ripcords, I think 5,800 is a serious over statement.
Remember, even with this year’s pay raises, Missouri state worker pay remains pretty close to the bottom of every list. (Some say we’re still 51st of the 50 states and D.C.) The jobs are hard and complex. On top of that, much of the work must still be processed in 1970’s computer language, and, questionable actions to put the burden of completing complicated paperwork on clients keeps punishing those who are eligible and needy.
Again, 5,800 people sounds like a large workforce. However, let’s also look at the number of cases they handled in July…
Temporary Assistance 5,250 Families
Food Stamps 325,926 Households
MO HealthNet 1,510,082 Patients
(650,000 estimated cases)
That’s at least 980,000 files, or, about 170 per employee. And, each files requires substantial effort to keep it current.
That’s especially true in Medicaid. A family of three – mom, dad and son – can easily have three Medicaid files. Mom could be in the pregnant/child bearing women category, dad in expanded Medicaid and little Jimmy in the special program for kids. Each of those categories has special rules and different income guidelines.
As we see with the impossible effort to update eligibility of everyone on Medicaid in the next year, that’s a lot of work. In the old days with more workers and fewer cases DSS couldn’t keep up. This year? They are doomed. Expect a lot of press reports on eligible people “falling through the cracks,” on medical providers complaining about patients losing care and all that. It’s the Missouri Wat.
Glenn Koenen