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Author: Monika Lee

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‘Worse Than People Can Imagine’: Medicaid ‘Unwinding’ Breeds Chaos in States

In California, staffing shortages at county agencies that administer Medi-Cal, the state’s Medicaid program, are making it more difficult for people to renew their coverage.

In Missouri and Florida, callers waited on hold for more than two hours on hotlines to renew their Medicaid coverage.

In Tennessee, the parents of a disabled man who had been on Medicaid for three decades fought with the state this summer to keep him enrolled as he lay dying from pneumonia in a hospital.

Seven months into what was predicted to be the biggest upheaval in the 58-year history of the government health insurance program for people with low incomes and disabilities, states have reviewed the eligibility of more than 28 million people and terminated coverage for over 10 million of them. Millions more are expected to lose Medicaid in the coming months.

The unprecedented enrollment drop comes after federal protections ended this spring that had prohibited states from removing people from Medicaid during the three pandemic years. Since March 2020, enrollment in Medicaid and the related Children’s Health Insurance Program had surged by more than 22 million to reach 94 million people.

The process of reviewing all recipients’ eligibility has been anything but smooth for many Medicaid enrollees. Some are losing coverage without understanding why. Some are struggling to prove they’re still eligible. Recipients and patient advocates say Medicaid officials sent mandatory renewal forms to outdated addresses, miscalculated income levels, and offered clumsy translations of the documents. Attempting to process the cases of tens of millions of people at the same time also has exacerbated long-standing weaknesses in the bureaucratic system. Some suspect particular states have used the confusing system to discourage enrollment.

“It’s not just bad, but worse than people can imagine,” said Camille Richoux, health policy director for the nonprofit Arkansas Advocates for Children and Families. “This unwinding has not been about determining who is eligible by all possible means, but how we can kick people off by all possible means.”

To be sure, some of the Medicaid recipients who signed on to the program when the U.S. unemployment rate soared amid covid-19 lockdowns have since gotten health insurance through new jobs as unemployment dropped back to pre-pandemic lows.

And some of the disenrolled are signing up for Affordable Care Act marketplace plans. Centene CEO Sarah London, for example, told investors on Oct. 24 that the health care giant expected as many as 2.4 million of its 15 million Medicaid managed care members to lose coverage from the unwinding, but more than 1 million customers had joined its exchange plans since the same time last year.

Still, it’s anyone’s guess how many former Medicaid beneficiaries remain uninsured. States don’t track what happens to everyone after they’re disenrolled. And the final tallies likely won’t be known until 2025, after the unwinding finishes by next summer and federal officials survey Americans’ insurance status.

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Garden Party 2023 Reflections

Western Center’s Garden Party 2023 was a night for the ages. We gathered in community, indoor and outdoor, and virtually, on October 19th to celebrate social justice and anti-poverty trailblazers at the Ebell of Los Angeles. Our annual fundraiser contributes to our own work while giving us the space to shower glitter on colleagues and partners in this fight for a more just world.

Over 300 friends, colleagues, mentors, activists, and more gathered for this beautiful, heartfelt night. Crystal Crawford, Western Center’s Executive Director, opened the night by bringing our attention to the 60 anniversary of the March on Washington and the 60th anniversary of the 16th Street Baptist Church bombing that killed 4 little Black girls in Birmingham. While highlighting the connection between these historic social justice moments and the founding of Western Center, she celebrated the progress that has been made with completion of the long-awaited final report of the California Reparations Task Force this year.

In addition to the spirit of celebration in the air in recognition of Western Center’s 56 years of legal and legislative victories, the night was also heavy with grief as we mourned innocent lives lost in Israel and Palestine. Honoree Gina Belafonte powerfully drew a throughline from colonization to slavery to the abject terror and violence happening in Israel and Gaza.

It’s a stark reminder of the people we’ve lost along the way for justice, for desegregation, for voting rights, for a right to live with dignity and respect. So many are not here with us today, but we can celebrate them, say their names, and honor them in our own fights.

Our emcee, Chike Robinson, highlighted several Western Center victories and drew our attention to the jump in poverty, the largest single year jump, due to the refusal of policymakers to continue lifesaving programs like eviction assistance, the child tax credit, and more.

But those paying attention knew this would happen. Ending poverty takes all of us, and it takes direct and meaningful action, not the status quo.

We were privileged to honor four individuals and one firm this year, all of whom have been amazing partners in this work.

Harry Belafonte and Gina Belafonte received our Inaugural Derrick Bell Award 

Harry Belafonte was more than a musician, actor, activist, and philanthropist. He was a force. He was a freedom fighter. He was an anti-apartheid warrior. He was a movement mentor extraordinaire. He encouraged and challenged generations of artists of color to stretch the ways they moved within the industry and their communities.

Gina Belafonte is an award-winning Producer, Director, Actress, Educator, Prison Abolitionist, and Freedom Activist. She has been using art as a tool for over 25 years to communicate messages of hope and civic engagement.

Derrick Bell was a distinguished legal scholar, prolific writer, and tireless champion for equality. His work inspired the development of critical race theory, a body of legal scholarship that explores how racism is embedded in laws and legal institutions. Professor Bell was a co-founder and past Executive Director of Western Center.

Covington & Burling, LLP  received the Max Gillam Pro Bono Award 

Covington & Burling, LLP did 1,500 plus hours of extraordinary pro bono work in Alliance of Californians for Community Empowerment (ACCE) Action v. the California Department of Housing and Community Development (HCD). Covington worked alongside Western Center and our partners to hold the state accountable for multiple systemic failures in distributing Emergency Rental Assistance Program funds intended to keep people housed during the pandemic. 

The Max Gillam Pro Bono Award memorializes preeminent litigator Max Gillam, who served as pro bono counsel when Western Center faced an attack aimed at shutting our doors and ending federal support for legal services providers

Eva Paterson, Civil Rights Activist & Social Justice Champion received the Earl Johnson Equal Justice Award

Eva Paterson is a civil rights champion and litigator with more than four decades of experience. Paterson co-founded the Equal Justice Society, a legal organization transforming the nation’s consciousness on race through law, social science, and the arts and served as its President from 2000 through August 31, 2022.

The Earl Johnson Equal Justice Award is named after and presented by Justice Earl Johnson (ret.), Scholar in Residence at Western Center on Law and Poverty, who served as an Associate Justice of the Court of Appeal, Second Appellate District, from 1982 to 2007. Both Justice Johnson and Eva Paterson are graduates of Northwestern and both made history when they served as Student Body President.

Yolanda Arias, Managing Attorney, Legal Aid Foundation of LA received the Mary Burdick Advocate’s Award 

Yolanda Arias, Managing Attorney at the Legal Aid Foundation of Los Angeles, was selected unanimously by Western Center attorneys to receive this honor. This award recognizes Yolanda’s extensive work as a litigator, trainer, and mentor in the field of public benefits, medical debt, foster care, and immigration.

Mary Burdick joined Western Center as a staff attorney in 1975, later serving as co-Senior Counsel, and ultimately, Executive Director. During her tenure, Mary argued two of the three U.S. Supreme Court cases ever argued by Western Center attorneys, Cabell v. Chavez-Salido, 454 U.S. 432 (1982), and Pierce v. Underwood, 487 U.S. 552 (1988). 

Throughout the night we listened to music by DJ T-Kay (Dublab) who blessed us with worldwide diasporic sounds including Brasilian jazz, African funk, and Latin soul.

And we ended the amazing night with singer and philanthropist Aloe Blacc performing “Someday We’ll All be Free” in a moving special musical tribute to Harry Belafonte. 

A special thanks to the Western Center Development Team as well as their partners – the Ebell of Los Angeles, Carol Kono-Noble, First Option Entertainment, Designs by Her, Fotospark, Pablo Aguilar photography, and House of Printing for working tirelessly to make Garden Party 2023 a success.

We look forward to seeing many of you at future events and webinars, and we’ll see you next year for Garden Party 2024.

CalFresh and other public aid in Sacramento County move to new system

If you get help from Sacramento County to pay for food, health care or housing — and almost half of all residents receive some kind of public assistance — you likely have visited MyBenefits CalWIN to apply for, renew or manage your benefits.

Well, that access point changes this week.

On Monday, the MyBenefits CalWIN site, mybenefitscalwin.org, began redirecting thousands of users to a brand new online portal, BenefitsCAL.com, where they will be directed to create new accounts and link to the personal information already in their files.

“We do have a large percentage of our customers who utilize our online services with our current system,” said Roselee Ramirez, manager of the human services division in the county’s Department of Human Assistance.

Ramirez said the team has been meeting with community-based organizations and advocates to encourage users to create new accounts.

“We want to make sure all our customers are aware of that, so we can help them with getting up on the new online system,” Ramirez said.

BenefitsCal has gone through several years of testing and includes updates that take advantage of 21st century technology, like using cell phones to scan and upload documents, said consumer advocate David Kane of the Western Center on Law & Poverty.

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‘Substantial remodel’ — a legal loophole to evict tenants in LA

Erica Rede never thought the installation of some new appliances could lead to an eviction.

Rede says she’d always paid her rent on time, and had been living in her South Pasadena apartment, with her son (a recent South Pas High grad), for seven years when her building was purchased by a new landlord. Soon after that, a vacant neighboring unit got new flooring, new heating and cooling, a washer and dryer, and a dishwasher. But rather than hope her apartment would soon gain these amenities, Rede worried.

Then, in July 2022 during the countywide Covid eviction moratorium, Rede received an eviction notice, saying “the basis for the termination is that the Premises [sic] will be substantially remodeled” — her fear was coming true.

Rede’s story is all too common across LA County: Through a loophole in the state’s Tenant Protection Act of 2019 (TPA), landlords can push tenants out to facilitate a “substantial remodel” — though what exactly constitutes “substantial” has always been fuzzy.

In response to street vendor lawsuit, City Council members acknowledge the need to bring L.A.’s street vending ordinance into legal compliance, but the proposal still falls short.

In response to street vendor lawsuit, City Council members acknowledge the need to bring L.A.’s street vending ordinance into legal compliance, but the proposal still falls short.

Los Angeles – On Friday, October 20, 2023, a motion was introduced in Los Angeles City Council calling for the City’s Sidewalk Vending Ordinance to be amended in order to comply with state law. Currently, the City’s Sidewalk Vending Ordinance excludes sidewalk vendors from 9 City areas representing some of the most popular pedestrian areas of the City, including the Hollywood Walk of Fame. The motion proposes City officials create new vending rules for Hollywood Boulevard and the Hollywood Bowl, to be crafted in consultation with the vending community.

The No Vending Zones in the City’s Sidewalk Vending Ordinance, along with several other restrictive regulations, are currently the subject of a lawsuit filed in December 2022 by sidewalk vendors and sidewalk vendor advocates. The judge overseeing this lawsuit made an early ruling indicating that he found little justification for Los Angeles’ regulations under state law. Trial is set for February 2024.

We share the general goals described in this motion –  to create a lawful and successful sidewalk vending program that balances legitimate safety considerations with economic inclusion. In fact, street vendors have long been proposing these exact ideas, and have advocated tirelessly for inclusive and transparent policies that would allow these small businesses to operate with dignity and safety. So while it should not have required our lawsuit to motivate these actions, we appreciate the support of the council members authoring this motion, as well as this express acknowledgement that the City must bring its ordinance into legal compliance.

But this motion does not actually propose to eliminate the unlawful No Vending Zones, and it risks repeating the process that resulted in the illegal restrictions in the first place. The motion does not immediately end the City’s unjust exclusion of vendors from entire neighborhoods, nor does it address the deep financial, emotional, and psychological harms experienced by vendors from years of draconian enforcement of these unlawful and exclusionary policies. The motion does not address the illegal citation practices of the Bureau of Street Services (StreetsLA) over the past four years, or provide redress to vending businesses that have been harmed by StreetsLA’s retaliatory actions. The motion does not address the other regulations we challenge in our lawsuit, including the unnecessary and potentially illegal buffer zones around swap meets and schools. Ultimately, the motion may lead to an unnecessary patchwork of confusing policies, still not aligned with state law.

Vendors cannot afford to continue to rack up thousands of dollars in illegitimate fines while a motion works its way through multiple committees and politicized discussions. Half-measure steps in the right direction will not resolve the litigation. Therefore, our lawsuit will proceed until the foundational legal issues underlying our case are resolved. And we will vigorously oppose any effort to use this motion, and its protracted timeline,  as justification for delaying full resolution of our legal claims. We continue to welcome a conversation with the City that centers the voices and experiences of vendors, but we are not deterred from pursuing our strong legal claims and we are confident that we will prevail in court if necessary.

 

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Community Power Collective: Community Power Collective builds power with low-income workers and tenants through transformative organizing to win economic justice, community control of land and housing, and to propagate systems of cooperation in Boyle Heights and the greater LA region.

East LA Community Corporation: ELACC is a Boyle Heights-based community development corporation that uses an equitable development model to engage residents traditionally left out of decision-making processes. In addition to affordable housing, they provide financial capability services through their Community Wealth department, which supports sidewalk vendors with free tax preparation, financial coaching, Technical Assistance, and social loans. ELACC is co-founder of the Los Angeles Street Vendor Campaign (LASVC) and has worked with micro-entrepreneurs for over a decade.

Inclusive Action for the City: Inclusive Action for the City (IAC) is a Community Development Financial Institution and nonprofit organization based in Los Angeles whose mission is to bring people together to build strong local economies that uplift low-income urban communities through advocacy and transformative economic development initiatives. IAC serves the community through policy advocacy, research, consulting services, business coaching, and a lending program, among other efforts. IAC is a co-founder of the Los Angeles Street Vendor Campaign and has worked with street vendors and other small business owners for more than 10 years.

Public Counsel: Founded in 1970, Public Counsel is the nation’s largest provider of pro bono legal services, utilizing an innovative legal model to promote justice, hope, and opportunity in lower-income and communities of color in Los Angeles and across the nation. Through groundbreaking civil rights litigation, community building, advocacy, and policy change, as well as wide-ranging direct legal services that annually help thousands of people experiencing poverty, Public Counsel has fought to secure equal justice and opportunity for all for more than 50 years.

Western Center on Law & Poverty: Fights in courts, cities, counties, and in the Capitol to secure housing, health care, and a strong safety net for Californians with low incomes, through the lens of economic and racial justice. For more information, visit www.wclp.org.

Inequality Insights

Millions of low-income households will continue receiving Supplemental Nutrition Assistance Program benefits through November and December, even if there is a federal government shutdown, U.S. Department of Agriculture officials said this week.

More than 2.9 million California households receive federal food assistance through CalFresh, CalMatters’ Justo Robles reports. Twenty percent of Californians are food insecure — meaning they lack reliable access to healthy food.

Jacqueline Benitez is one of them. She earns about $1,300 a month working part-time as a preschool teacher in Los Angeles County. The 22-year-old also is a junior at California State University, Long Beach.

Monthly rent for her Bellflower apartment recently jumped $200, she said, not leaving much for food. Now more than ever, Benitez said, her $88 monthly CalFresh benefit is essential. Eating properly helps her focus while studying and working with children.

“With $88 I try to buy things that will last, like rice, pasta, popcorn chicken,” she said.

“Without CalFresh benefits, I would be eating half a burger and leave the rest of it for tomorrow.”

In prior threats of federal shutdowns, welfare benefits were guaranteed only through September, the end of the government’s fiscal year. A federal shutdown would risk more than 40 million people’s access to food and nutrition assistance programs nationwide.

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Marin City fathers find relief in debt reduction plan

Tino Wilson, a Black man and business owner from Larkspur, has been buried by child support payments for decades.

With three children: Julian, 31; Tino Jr., 19; and Malachi, 14; Wilson, 50, owed about $70,000 in child support to the state.

“It’s hard to get out from under it, but I had to try to do it,” Wilson said.

This year, the Phoenix Project, a Marin City-based advocacy and aid group, and the county Department of Child Support Services stepped into help, assisting Wilson with reducing his debt by about $30,000 and setting up a regular and more manageable payment plan.

“I felt stuck and couldn’t get anywhere,” he said. “But they are very, very helpful and they are working fast with me. There’s a whole lot of people like me getting help.”

The state’s debt reduction program aims to assist parents like Wilson, who have past-due child support payments owed to the government, called arrears. The money is owed if the children received public assistance or were in foster care when child support payments were not being made.

Federal law requires that the state be reimbursed for expending taxpayer dollars for supporting the children.

The problem, said Felecia Gaston, director of the Phoenix Project, is that these arrears become so staggering that working adults, especially Black men in Marin City, are unable to get out from under them. The debt owned to the state compounds at an interest rate of 10% a year, often causing the payments to be even further out of reach.

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California Abdicating Duties on Housing People Who are Unhoused

With more than 170,000 people experiencing homelessness in California, most of whom are Black and Brown,  many government actors are seeking clarification on their ability to sweep unhoused people out of public view. More pointedly, these government actors, after several losses in lower courts, are asking for a blessing from the highest court to remove unhoused people from the street without any guarantees of building or investing in either enough shelter or enough housing for those who need it.

The epidemic of houselessness is ever present –  touching every area of our state, and now every area of our legislative and legal systems. The historic reach of the problem is now forcing our big blue state to stretch. How we choose to do so is the question. At present, our cities and counties are reaching past the courts, perceiving them not as arbiters of facts or interpreters of the legal boundaries of enforcement, but rather as obstacles. Treating the lower courts as a scapegoat in their lackluster efforts to address this crisis, several counties and cities have asked for Supreme Court intervention. The goal is to overturn a series of decisions that protect the civil rights of the unhoused in Johnson v. Grants Pass.

In 2018, the U.S. Court of Appeals for the Ninth Circuit ruled in Martin v. Boise that cities cannot enforce anti-camping ordinances against unhoused people without shelter beds available for them. The Boise decision rests on the undisputed fact that human beings need sleep in order to sustain life, and a City’s failure to provide a sheltered place to rest or sleep, paired with the active criminalization of sleeping outdoors, is inhumane under the 8th Amendment. 

Johnson v. Grants Pass is the Ninth Circuit’s recent ruling that modestly expands Boise to include administrative enforcement of anti-camping ordinances and prohibitions on using blankets and pillows to sleep. And the Coalition on Homelessness and several unhoused individuals sued the City of San Francisco over their violation of Boise and other policies on the books for destroying encampments without offering shelter to residents.

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LA County supervisors want to erase $2.6 billion in residents medical debt

Billions of dollars of medical debt owed by nearly a million Los Angeles County residents could be purchased by the county and retired, according to a proposal set in motion on Tuesday, Oct. 3.

The L.A. County Board of Supervisors voted 5-0 to explore a plan to purchase $2.6 billion in medical bills owed by people throughout the county for pennies on the dollar. If implemented, the action would relieve families of what can become a lifetime burden and often prevents them from seeking medical care.

“Medical debt can contribute to food insecurity and housing instability,” said Fourth District Supervisor and board chair Janice Hahn, co-author of the motion along with Second District Supervisor Holly Mitchell. “Once someone has medical debt it becomes a barrier to assessing their healthcare.”

Hahn said the motion is a way to address medical debt experienced by up to a million county residents. The process would cost the county only a fraction of the amount owed to buy the debt, then retire it, the county reported.

Here’s how it would work:

When people accumulate debt from unpaid medical bills, eventually hospitals and medical establishments sell the debt to for-profit collection agencies. If not paid, these agencies often win judgments in court that can result in liens on payroll and properties against the patients.

Los Angeles County intends to intervene by buying out the residents’ debt for pennies on the dollar.

The proposal could wipe out billions of dollars in medical debt at a cost to the county of only millions, Hahn explained. The potential cost to the county would be $24 million to retire $2 billion in medical debt spread over the next two to three years, according to the county Department of Public Health (DPH).

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Time for Change: Rethinking SSI’s Asset Limits

Time for Change: Rethinking SSI’s Asset Limits

The Supplemental Security Income (SSI) program was created to provide financial support to low-income individuals with disabilities. While the program aims to offer a safety net for disabled folks with low income, one often-overlooked aspect is the impact of asset limits on SSI recipients. These limits force recipients to live on the edge of economic insecurity, preventing them from saving and achieving financial independence. It is time to significantly raise or eliminate the asset limit, like we have for programs like SNAP and Medi-Cal.

Today, the federal monthly SSI benefit is $914 for individuals and $1,371 for couples. As a means tested program, SSI considers all income and resources an individual has or has access to. Several factors can reduce the already modest benefit amount including other sources of income like Social Security, pensions, child support, or living with someone who provides support. 

Current asset limits require individual recipients to have less than $2,000 in assets and couples have less than $3,000. Some assets include cash, bank accounts, stocks, land, life insurance, vehicles, and anything that can be liquidated in a short amount of time. Even retirement accounts that have penalties for withdrawing funds are included. Unfortunately, these asset limits vary for individuals and couples, putting couples with disabilities at a disadvantage. To be equitable, couples should have a $4,000 resource limit. Instead, the limit is capped at $3,000 –a $1,000 penalty. This discourages couples from marrying and economically penalizes them for doing so. Certainly, the Social Security Administration (SSA) should follow a consistent resource limit so individuals and couples can be on the same level.

The asset limit issue stems from values set in an economy from five decades ago in1974. If these limits were to be adjusted for inflation, they would be around $12,378 for individuals and $18,507 for couples. Crunching the numbers, this shows a significant difference of $10,000 to $15,000 in assets, that present price levels are six times higher than in 1974, and that the 1974 dollar has lost significant purchasing power over the years, making these limits increasingly inadequate. 

Restricting savings to $2,000 and $3,000 hinders a recipient’s ability to achieve self-sufficiency and leaves them vulnerable to unexpected expenses from health crises, appliance breakdowns, or economic recession, which disproportionately affect recipients, making it that much harder to recover. As exemplified with Nicholas Hemachandra, an SSI recipient with autism, he has to cut back on hours and spend most of his earnings to avoid losing his benefits. Ray, Nicholas’ dad, hopes for a day when his son can have his own apartment when he is no longer around. However, with the $2,000 limit, it “stops him from (buying) pretty much anything (Hyatt)”. These limits create unnecessary uncertainty for parents like Ray and many others. Coupled with inflation, they further strain recipients that are struggling to keep up with rising grocery prices and housing costs. Raising these limits would encourage saving, reduce the need to exhaust savings before meeting basic needs, and encourage recipients who can, to work. 

Another issue with the outdated limit is its tendency to disrupt benefits and services, causing “churn.” On average, “70,000 beneficiaries have their benefits suspended annually”(CBPP) due to excess resources. Beneficiaries who exceed the limit not only lose benefits, but for many, more importantly, access to Medicaid. SSI eligibility automatically qualifies them for Medicaid. No senior or person with disabilities should ever have to miss essential medications or lose access to lifesaving services because of savings.

Furthermore, raising the limit would simplify the system and reduce administrative costs. Every year 40,000 beneficiaries have their coverage terminated forcing them to go through the hassle of reapplying. The Center on Budget Priorities and Policies states that SSI administration consumes 35% of SSA’s costs, even though it serves fewer recipients than SSDI (Social Security Disability Insurance), which costs 19%. 

Another finding to highlight from CBPP’s article is increasing limits has limited fiscal impact. Raising them to $10,000 and $20,000 for couples only boosts participation to 3%, while $100,000 results in a 5% increase. Surprisingly, removing the resource limit entirely results in a 6% expansion, just 1% more than the $100k threshold. This is because individuals applying for SSI typically have minimal savings, especially recipients with disabilities who have limited earnings.

Scaling resource limits to $10,000 and $20,000 wouldn’t significantly increase costs. In fact, the Center on Budget Priorities and Policy has projected an $8 billion increase over ten years, representing about 1% of program costs over that period. 

These proposed policy changes have the potential to alleviate SSA financial strain and, more importantly, empower this vulnerable population towards economic independence. While they may not drastically increase in program participation, they can help uplift recipients to a better state of economic well being and independence. Additionally, it’s important that we push for more dialogue in the policy space and look into other programs such as SNAP and TANF with more flexible asset limits.

Furthermore, it’s worth noting this September, the SSI Savings Penalty Elimination Act was introduced in Congress which aims to update SSI’s asset limits. Western Center supports this bill and will be advocating for its passage.

In conclusion, SSI’s resource limits have far-reaching consequences, forcing recipients on the edge of poverty, hindering financial security, and causing benefit interruptions. Updating these limits is vital for promoting self-sufficiency and ensuring a more effective, equitable system.