How work requirements for social security programs impact people in need

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• MEGAN THOMPSON:

  In a rural pocket of Maine, east of Augusta, 50-year-old Tim Keefe lives in a spartan 2-room trailer without a bathroom or even any running water. A Navy veteran, he's single and has two grown daughters.

• TIM KEEFE:

  We don't need too much refrigeration this time of year.

• MEGAN THOMPSON:

  His only income is about $200 dollars a month in food stamps.

• TIM KEEFE:

  You have to kind of figure out what you're going to need for each day and what you can get away with. You're not eating like a king, but you're eating. So that's the important part.

• MEGAN THOMPSON:

  But not too long ago, things were even more difficult for Keefe. He was working at a manufacturing plant when he suffered a wrist injury that required multiple surgeries. He lost his job, and then his home.

• TIM KEEFE:

  In here, this is where I spent last winter.

• MEGAN THOMPSON:

  For a time, Keefe lived in a small tent, warmed by an electric heater.

• TIM KEEFE:

  You're basically stuck in the tent when it's really cold. It's just, ah, it's survival.

• MEGAN THOMPSON:

  Adding to the hardship, Keefe had no access to food stamps.That's because beginning in 2014, if you were under 50 and you weren't caring for children, Maine started enforcing a three month time limit on food stamps, unless you were working 20 hours a week, volunteering, or in a job training program. Keefe could do none of those things with his injured wrist and he was under 50.

• TIM KEEFE:

  You wake up in the morning you're a caveman you've got to go find food you got to gather you gotta hunt, you know? And I tell you when you're when you haven't eaten in a few days your morals are out the window, you know, hitchhiking to the supermarket and robbing the supermarket for food became an option, a viable option.

• MEGAN THOMPSON:

  Keefe estimates he lost 40 pounds during the 10 months he went without food benefits. Then, he turned 50 last May, and became eligible again for food stamps, also known as the Supplemental Nutrition Assistance Program, or SNAP.

• TIM KEEFE:

  I've gained it all back. I mean the SNAP program is a lifeline it really is.

• MARY MAYHEW:

  It is not in the best interest of anyone to just simply hand out a check.

• MEGAN THOMPSON:

  Mary Mayhew was the Commissioner of Maine's Department of Health and Human Services from 2011 to 2017 under Republican governor Paul LePage. She says the state was ripe for reform when she took over administration of its safety net programs.

• MARY MAYHEW:

  The department had truly lost sight of its core mission. The work underway was focused on trying to be all things to all people. Success was defined by the number of people coming onto welfare, rather than the number of individuals who were on that pathway to self-sufficiency and independence.

• MEGAN THOMPSON:

  Under Mayhew, Maine looked at the wage records of nearly 7,000 adults without dependents, people like Tim Keefe, in the one year after food stamp benefits were cut off.

• MARY MAYHEW:

  Individuals left food stamps went back to work and their incomes increased by over 114 percent. They were earning more than the federal poverty level. Exactly the goal that we certainly hoped for as we incentivized and prioritized work.

• MEGAN THOMPSON:

  And the Trump administration has taken notice. Citing Maine's changes to its SNAP program, in April, President Trump signed an executive order directing federal agencies to strengthen and introduce work requirements.

  Mayhew, meanwhile, has left her position at Health and Human Services to run for governor in the Republican primary. She has also consulted with the Trump administration about Maine's experience with work requirements.

• MARY MAYHEW:

  I'm incredibly proud that Maine is seen as a model.

• CHRIS HASTEDT:

  Maine is not a model, it's a cautionary tale.

• MEGAN THOMPSON:

  Chris Hastedt is the Public Policy Director for Maine Equal Justice Partners, an advocacy group representing low income Mainers.

• HASTEDT:

  Things are not going in a good direction. And for the for those who argue that these so-called reforms are effective and we're helping to raise families out of poverty and improve their ability to support their families. It's just not happened.

• MEGAN THOMPSON:

  Hastedt notes that the same study on food stamp changes in Maine touted by Mayhew and the Trump administration, is not all positive.

• CHRIS HASTEDT:

  Two-thirds of people that had been terminated still did not have employment. That's about the same that had didn't have employment at the beginning of the year. But now at the end of the year they had neither wages nor food assistance.

• MEGAN THOMPSON:

  She says forcing people to work ignores the barriers often faced by many low-income people.

• HASTEDT:

  Jobs aren't available or the hours aren't available or transportation isn't available or childcare isn't available. But none of those factors are considered in these inflexible policies that say you either work 20 hours a week or you don't get food.

• MEGAN THOMPSON:

  Hastedt also points to federal data showing that since 2011, Maine has seen food insecurity, which measures access to food, increase by nearly 9 percent, while the national level has declined by about 11 percent.

• CHRIS HASTEDT:

  This is just part of this ideological march toward a policy that is not going to be effective and it's only going to create more hardship for people who are impacted by it. That's what we've seen here in Maine and that's what we would expect to see from a similar policy in Medicaid.

• MEGAN THOMPSON:

  Medicaid, which provides healthcare for low-income Americans, is jointly administered by states and the federal government. Last year, maine asked the federal government to add work requirements to Maine's Medicaid program.

  Ricker Hamilton is the state's current commissioner of Health and Human Services, which oversees Medicaid in Maine. He supports adding work requirements to the program, which is known as MaineCare.

• RICKER HAMILTON:

  We didn't have these tools for the people so they only had the welfare benefit, they only had MaineCare services, so they were kind of stuck. And I think by helping people who are able and want to work, it's enhancing the program and improving the program.

• MEGAN THOMPSON:

  The state wants to make Mainecare more like its SNAP program. Among other changes, it wants to require able-bodied adults, including those with children over the age of 5, to work at least 20 hours a week, volunteer, or be in job training. Maine is one of seven states with pending requests for similar measures. Kentucky, Indiana, and Arkansas have already had work requirements for Medicaid approved by the Trump administration. Hamilton says the state's economy is healthy, and has jobs available.

• RICKER HAMILTON:

  This is a golden opportunity that hasn't existed in a very long time and I think it's time for us to step bravely as opposed to fret, wring our hands, and shake our heads, and say, "what if?" We need to take that step forward.

• MEGAN THOMPSON:

  Hamilton points to the state's experience with yet another social safety net program: the original "welfare to work" program promoted by President Bill Clinton in the 1990's.

  It's called Temporary Assistance for Needy Families, or TANF.

  In Maine, to qualify for TANF a recipient must have low or no income and be caring for a child. In order to help those recipients get jobs, the state provides not only cash assistance, but also subsidized transportation and childcare. As well as personalized support and job search classes.

• TEACHER:

  I presume everyone in here has a resume.

• MEGAN THOMPSON:

  Classes like this one near Augusta are mandatory for most recipients, and Maine enforces a firm 5-year time limit for receiving TANF benefits.

  28-year-old Michelle Young received a little less than $300 a month in TANF cash assistance, off and on, for almost 14 months before and after giving birth to her daughter.

• MICHELLE YOUNG:

  I hadn't worked in years. So your confidence is down a little bit and it's really it's embarrassing to have to ask for help. It's embarrassing to have to receive TANF.

• MEGAN THOMPSON:

  Young got a job as an administrative assistant working with a nonprofit that helps TANF recipients. She credits the support she received, and the requirement to find employment, with helping her get and keep a job.

• MICHELLE YOUNG:

  You know the accountability, I needed it.

• MEGAN THOMPSON:

  Maine is now launching a pilot program for 500 households to offer similar work supports to SNAP recipients.

• DR. RENEE FAY-LEBLANC:

  It might be good to get you set up with a pulmonologist now that you have MaineCare.

• MEGAN THOMPSON:

  Doctor renee fay-leblanc is the chief medical officer at greater portland health, where about 35 percent of its nearly 11,000 patients are on mainecare

• DR. RENEE FAY-LEBLANC:

  Mainecare is important for people to be able to get to the place where they can work, provide for their families.

• MEGAN THOMPSON:

  Maine estimates that eligibility for MaineCare will decline as a result of the new work requirements. Dr. Fay-LeBlanc says the consequences for losing access to MaineCare can be life and death.

• RENEE FAY-LEBLANC:

  I had a patient who did not have MaineCare. He was having a lot of symptoms that hadn't been explained yet or diagnosed and yet he refused to go to the hospital because he didn't want to rack up more medical debt. And that patient died last year. And I firmly believe that if he had had access to Mainecare and could have gotten his medications and real thorough workup for the symptoms that he was experiencing, he wouldn't have died.

• MARY MAYHEW:

  Maine today is considered today an absolute national leader…

• MEGAN THOMPSON:

  Mary Mayhew has made the changes she oversaw in Maine's social safety net programs a pillar of her campaign for governor.

• MEGAN THOMPSON:

  She says asking able-bodied recipients of SNAP benefits or MaineCare to work is not about shrinking the programs or punishing those who need help.

• MARY MAYHEW:

  This is not about saving money or being punitive it is about recognizing that work and employment restores human dignity. I am far more concerned about the tendency of these programs to cast a wide net and trap people than I am that someone is going to fall through the cracks.

• MEGAN THOMPSON:

  Tim Keefe says he fell through the cracks once after getting injured. His wrist is now strong enough for him to work, but has struggled to find a job.

• TIM KEEFE:

  They say is you know a lot of open jobs and people really looking for work in this day and age but I pounded the pavement for nine months and I can't get hired. I just I've never had such a problem getting hired before in my life.

• MEGAN THOMPSON:

  Using money from a workman's comp settlement, Keefe purchased some land. And he's hoping to build a small house using found timber. And for now, he still gets SNAP benefits.

• MEGAN THOMPSON:

  But last month, Republicans in Congress proposed raising the work requirement and job training age from 49 to 59 for SNAP recipients as part of the farm bill. Meaning Keefe – as a 50 year old – could again lose access to food aid.

• TIM KEEFE:

  There has to be some vehicle for poor people to eat. You can't just starve em,' you can't do that.

• MEGAN THOMPSON:

  The House of Representatives is expected to debate and vote on the 2018 farm bill before the end of the month.