If Scott Walker has his way, poor people in Wisconsin will have to undergo drug testing, one way or another.
Last week, the Republican governor forged ahead with a plan to require testing for some recipients of the state’s Supplemental Nutrition Assistance Program, commonly referred to as food stamps. That measure would come on top of another proposal to test Wisconsin’s Medicaid enrollees, which is pending federal approval, as well as a law already on the books requiring drug screening and testing for non-custodial parents receiving Temporary Assistance for Needy Families funds. If both of Walker’s proposals pass federal scrutiny, it’ll mean all three of the major welfare programs in the state will have drug-testing components.
The move to add drug testing to SNAP is another gambit in Walker’s ongoing effort to overhaul welfare, which has included a host of reforms over the past three years. The change would affect recipients who participate in its Employment and Training Program. Through ETP, able-bodied, childless adults already have to meet work requirements in order to qualify for food stamps. Under the proposed regulation, those who test positive would be required to undergo treatment—on the state’s dime, if they can’t afford it—or face losing their benefits. The Walker administration has also sought to add work requirements and a time limit on benefits to Wisconsin’s Medicaid program, and it wants to extend the SNAP work requirements to parents.
It’s far from certain whether the latest reforms from Walker will pass federal muster. Under former President Barack Obama’s administration, Walker’s requests to implement drug testing in SNAP were denied or held up by the Department of Agriculture under the rationale that they constituted an additional eligibility barrier that Wisconsin wasn’t entitled to impose. While the state disagreed with that assessment, the argument wasn’t a new one: The Centers for Medicare and Medicaid Services, part of the Health and Human Services Department, has also traditionally denied waiver requests from states to implement work requirements and drug testing for Medicaid.
Walker may see an opening, though, under the Trump administration. Early in her tenure, CMS Administrator Seema Verma wrote a letter signaling that the agency would accept work requirements in Medicaid waivers, like the one currently being considered for Wisconsin. She also announced last month that it “will approve proposals that promote community-engagement activities,” which typically include work, job training, or community service. According to Kaiser Health News, health-care advocates expect this move from Verma presages the agency’s support for further conservative reforms affecting Medicaid eligibility, such as drug testing.
The USDA has also signaled that it is willing to consider conservative reforms to SNAP, after a federal court threw out Walker’s suit against the department over his original drug-testing proposal in 2016. Shortly after Walker sent his SNAP drug-testing regulation to the state legislature for review last week, the USDA issued a press release stressing “how important it is for states to be given flexibility to achieve the desired goal of self-sufficiency for people.” In both messaging and timing, the USDA’s release seemed to offer a direct reassurance to Walker: The terms “self-sufficiency” and “workforce development,” both of which the department included in its notice, were used heavily by Walker in his promotion of drug testing and in his welfare overhaul generally.
With the federal government sending encouraging messages on welfare reform, it’s worth considering what those changes would mean for Wisconsin’s low-income citizens. Walker has defended his SNAP drug-testing plan by arguing that “people battling substance-use disorders will be able to get the help they need to get healthy and get back into the workforce.” But it’s unlikely the rule would actually work that way. According to ThinkProgress, results from Wisconsin’s limited rollout of drug testing in TANF showed that “in 2016, at least 1.6 times as many people were denied benefits for failing to follow through on a drug test as those who tested positive.”
That’s not the only potential consequence. In the welfare drug-testing schemes that are out there, states bear high costs for drug tests that rarely come up positive, and the chilling effect on enrollment is much greater than the number of people who end up receiving treatment. Put another way, people who do need drug treatment the most will be the least likely to follow through with screening, and thus will be those most likely to lose benefits. Drug testing also places yet another burden on low-income people who aren’t drug users, but have trouble finding time or transportation to complete the tests.
It’s hard to believe that the net effect of these provisions—likely a decrease in statewide enrollment in welfare programs—is an unforeseen one for Walker’s administration. The governor has trafficked in the dog-whistle stigmatization of welfare recipients as lazy, saying in a formal address advocating for drug testing that “we firmly believe public assistance should be a trampoline, not a hammock.” His insistence on this plan to encourage more “people who are drug free” ignores the fact that there are ways to accomplish the worthwhile goal of treating substance abuse that don’t involve potentially taking away food stamps.
Walker’s welfare plan could accomplish that goal by simply treating people—by offering low-cost or no-cost rehabilitation and support services to people on welfare programs, or by offering optional screening. But that’s not what Walker’s plan does, and mandatory screening will almost certainly further stigmatize a program where people of color are overrepresented.
Additionally, work requirements—which show little evidence of actually increasing workforce participation in TANF—could serve the purpose of further severing people with drug issues from necessary support. Medicaid is already the largest provider of substance-abuse and mental-health services in the country, and it’s hard to reason that restricting access to the program via work requirements and drug tests will treat more people.
That these welfare reforms are nearing approval as Walker is in the middle of fighting an opioid crisis is particularly ironic. A 2016 report from a special state task force found that in 2013, more Wisconsin residents died from drug overdoses than from either motor-vehicle accidents or firearm homicides. It also found that overdose deaths in the state more than tripled from 2003 to 2014. While those numbers don’t place Wisconsin near the top of the heap of states managing massive spikes of opioid-related deaths, they are extraordinary all the same. And so is the state’s prescription for bringing them down: The task force recommended the very drug-screening program that Walker is so close to implementing now.
As the Wisconsin experiment goes, so goes the rest of the country. Walker’s welfare proposals have been road maps for other states, and his SNAP plan is the first such proposal before the USDA. Other states have been eager to similarly implement drug-testing and work requirements on their welfare programs, and 18 proposed or created rules to that effect in 2015. The Obama administration was a major roadblock to the realization of those laws, but according to Politico, the Trump administration could soon echo CMS’s and USDA’s overtures with an executive order mandating a full review of all federal welfare programs. And GOP legislators have indicated that sweeping welfare reform is the next major item on their agenda.
To predict the effects of those hypothetical federal changes, perhaps it would help to examine the analyses and objections made by concerned citizens during the comment-making period of the drug-testing rule for SNAP in Wisconsin. “Commenters state that the proposed rules further complicate an already complicated application process and will turn eligible individuals away from applying [to the state’s SNAP program] FoodShare, increasing hunger in Wisconsin,” the report reads. “Others argue that if FSET participants must be drug tested then so should every government official and anyone else receiving tax dollars in any other form.”