Natasha McClendon worked about three days each week during the school year as a substitute teacher assistant for Chicago Public Schools. But she wasn’t able to land a job for the summer.
The 48-year-old Englewood mom worries her struggles to find work could cost her family the public health insurance and food assistance they need. That’s because her current hours may not be enough to satisfy new, more onerous work requirements in President Donald Trump’s sweeping tax and policy bill that won final approval by Congress Thursday.
“What do we do?” McClendon asked. “Will we actually be able to meet these requirements in order to continue [the] benefits?”
The new requirements for people like McClendon’s family, who are enrolled in Medicaid health insurance and receive Supplemental Nutrition Assistance Program, or SNAP, benefits, are expected to ripple across the economy as they roll out over the next few years. Community groups in particular will likely see an uptick in need as people look for help trying to hold on to their benefits, said Lindsay Allen, an assistant professor of emergency medicine at Northwestern University.
“As more people are losing benefits, demand is going to rise for things like food pantries and medical assistance funds and crisis housing services,” Allen said. “Those pantries and free clinics and even legal aid are going to be stretched very, very thinly.”
Illinois Democrats and experts have warned that the measure’s $1.2 trillion in cuts would cost more than 500,000 Illinoisans their health care coverage and put about 427,000 people at risk of losing food assistance.
Across the Chicago area, food pantries and advocacy groups are bracing for what lies ahead and scrambling to offer guidance for residents.
Safety net hospitals, which typically treat mostly low-income patients on Medicaid and people who don’t have health insurance, could see greater demand. But without Medicaid funding, they could face dire circumstances.
Food pantries brace for long lines
McClendon’s family is enrolled in the Medicaid public health insurance program, and she receives $906 a month from SNAP to feed herself, her husband, their 9- and 12-year-old daughters and an 18-year-old daughter headed to college in the fall. To stretch out the family’s budget, she visits St. Sabina Church’s food pantry on the South Side once a month.
She fears food pantries and other community resources will be squeezed by rising needs as new work requirements for both SNAP and Medicaid — as well as other cuts to those programs — take effect over the next few years.
“People like me, who have to rely on the food pantry — are they going to have enough food to supply the people that are going to be coming to their pantries for food when they run out of benefits?” McClendon asked.
The Greater Chicago Food Depository anticipates lines at food pantries will only get longer because of changes to SNAP and Medicaid, said Man-Yee Lee, the group’s spokesperson. Its network of 850 food pantries in Cook County served 2.4 million households last fiscal year, more than in the previous year and even more than during the pandemic, she said.
“We were never meant to solve hunger alone, and nor should we be expected to,” Lee said. “And it is exactly these safety net programs that Congress is proposing to cut that we need at this crucial time.”
At Nourishing Hope, which operates food pantries and other nutritional programs, more than 4,000 new people who were also enrolled in SNAP last year sought assistance from its food pantries, said Mitzi Baum, interim chief executive officer.
There’s already a three-to-four-week wait to receive support from a Nourishing Hope case worker, and that demand is expected to grow, as people will likely have to prove their eligibility for Medicaid more than once a year under the new bill, Baum said. But they don’t have funds to hire more case workers.
“We would definitely like to do that because we know the demand on social workers and organizations like ours is only going to increase when individuals need twice as much the support to prove their eligibility,” Baum said.
At the food depository, Lee said they are working to expand the retailers, manufacturers and farmers they work with to secure rescued food. They have also been pushing for more food donations and stepping up fundraising efforts, she said.
But Baum said that won’t be a long-term solution to filling the gap the federal government may leave.
On the Southwest Side, the Brighton Park Neighborhood Council has already seen a drop in the number of people it typically helps enroll for programs like SNAP. That’s because people living in households with immigrants without legal status fear it could put their immigrant relatives in danger, said Patrick Brosnan, the community group’s executive director.
That means households are getting by however they can, even as many already struggle because they lost breadwinners during the pandemic, Brosnan said.
That’s what happened to McClendon’s family. Her father, who had lived with her, died during the pandemic, making it harder to make ends meet.
“Some days I cry because I’m, like, at the point of [giving] up,” she said. “But then I said, ‘No, I have these babies to live for, so I can’t give up.’ I have to keep going. And I thought about my dad, because my dad was a go-getter.”
‘Death to safety net hospitals’
Access Living, a Chicago-based organization that provides services and helps people living with disabilities, has spent months trying to keep people informed about the various versions of Trump’s tax and domestic policy bill, said Sebastian Nalls, a policy analyst with the group.
“This process is confusing, and it is intentionally designed to be confusing to remove as many people off Medicaid as possible,” Nalls said.
For now, people on Medicaid should check their addresses with the program to ensure they receive mailed notices, he said. They should also check their “redetermination” date, or when they are scheduled to have their eligibility reassessed, Nalls said.
And while they don’t know exactly how soon a Medicaid work requirement would be implemented in Illinois for the first time, Nalls said those who work should start saving pay stubs just in case.
For those who lose Medicaid because of ineligibility or paperwork issues, there aren’t many other options.
“Folks are going to be relying heavily on safety net hospitals,” Nalls said. “That’s where it’s going to come down to where people will forgo going to the doctor, getting treatment, etc., until they absolutely have to and they need to go to the emergency room.”
But Tim Egan, president and chief executive office of Roseland Community Hospital, said cuts to Medicaid will equate to safety net hospitals facing a “firing squad.” About 75% of patients at Roseland are covered by Medicaid and their funding heavily relies on the program, he said.
In anticipation of Medicaid cuts, the hospital’s lab is already cutting back on certain tests to reduce costs, Egan said.
“This is cold-blooded murder,” he said. “This will mean death to safety net hospitals and our patients, plain and simple, death.”
Brosnan, of the Brighton Park Neighborhood Council, said his group will be waiting for guidance from the state before deciding what to tell residents who come to them for help.
“We’ll have to pick up the pieces,” Brosnan said. “And we’re going to have to re-create systems of care, and maybe in so doing, we’ll be able to create even more robust systems, because that’s what’s necessary.”