Fill worksheet

38 I AUTOMATING INEQ!!AUTY

during times of economic crisis. Poor and working-c lass people

resist restrictions of their rights, dismantle discriminatory in sti­

tutions, and join together for survival and mutual aid. But ti me

and again they face middle-class backlash. Social assistan ce is re­

cast as charity, mutual aid is reconstructed as dependency, and

new techniques to turn back the progress of the poor prolifera te .

A well-funded, widely supported, and wildly successful counter-

movement to deny basic human rights to poor and working-clas s

people has grown steadily since the 1970s. The movement man u­

factures and circulates misleading stories about the poor: t hat

they are an undeserving, fraudulent, dependent, and immo ral

minority. Conservative critics of the welfare state continue to ru n -

a very effective propaganda campaign to convince Americans t hat __

-

the working class and the poor must battle each other in a z ero-_

sum game over limited resources. More quietly, program

ministrators and data scientists push high-tech tools

promise to help more people, more humanely, while un_,,,.,_,.,,

efficiency, identifying fraud, and containing costs. The

poorhouse is framed as a way to rationalize and streamline

fits, but the real goal is what it has always been: to profile, vuJ«� --,- -

and punish the poor.

2

AUTOMATING HIGIBIUTY IN

THE HEARTLAND

A little white donkey is chewing on a fencepost where we turn coward the Stipes house on a narrow utility road paralleling the train tracks in Tipton, Indiana. Michael "Dan" Skinner, 65-year-old ex-newspaper man and my guide to central Indiana, heaves his mom's 19-year-old sedan across the tracks and imo the Stipes family's driveway a mile or so later. Their big white house is marooned in a sea of cornfields, but on this sunny day

.-. in March 2015, the stalks are cut back low and softened by snow •-•· melting to mud. Kim and Kevin Stipes joke that they've had to \ grow tall children: come July, the smaller ones disappear into the \ corn. I'm here to talk to Kim and Kevin about their daughter So­ /phie, who lost her Medicaid benefits during Indiana's experiment \with welfare eligibility automation. \ In 2012, I delivered a lecture at Indiana University Blooming­ ••••- ton about how new data-based technologies were impacting pub­ \ lie services. When I was finished, a well-dressed man raised his hand and asked the question that would launch this book. "You know," he asked, "what's going on here in Indiana, right?" I looked at

40 I AUTOMAUN_G INE~ALITY

him blankly and shook my head, He gave me a quick synopsis:

a $L3 billion contract to privatize and automate the state's

welfare eligibility processes, thousands losing benefits, a high-

profile breach-of-contract case for the Indiana Supreme Court,

He handed me his card, In gold letters it identified him as Matt Pierce, Democratic member of the Indiana House of Represen-

tatives. Two and a half years later, the welfare automation story brought

me to the home of Sophie Stipes, a lively, sunny, stubborn girl

with dark brown hair, wide chocolate eyes, and the deep brow

characteristic of people with cerebral palsy, Shortly after she was

born in 2002, she was diagnosed with failure to thrive, global de-

velopmental delays, and periventricular leukomalacia, a white-

matter brain injury that affects newborns and fernses, She was

also diagnosed with lp36 deletion syndrome, which is believed to

affect between l in 5,000 and 1 in 10,000 newborns, She has sig-

nificant hearing loss in both ears, Kim and Kevin were told that

she might never sit up, walk, or speak, For her first two years, all

she did was lie on her back She barely moved, Her parents contacted representatives of First Steps, a pro-

gram of the Indiana Division of Disability and Rehabilitative

Services that helps young children with developmental delays,

Through the program, Sophie received therapy and nutrition ser-

vices, and her family received counseling and support, Most

important: she had a gastronomy tube implanted to deliver nutri-

tion directly to her stomach; for the first two years of her life, she

had not been eating very much at alL Shortly afi:er they started

feeding her directly through the G-tube, Sophie began to sit up,

At the time of my 2015 visit, Sophie is 13, She gets around on

her own and goes to schooL She knows all the letters of the al-

phabec Though doctors originally told Kim that it wouldn't

do any good to sign to her, Sophie understands 300 or 400 words

in the family's pidgin sign language and communicates with her

AUTOMATING ELIGIEIUTY IN TH.E HEARTLAND I 41

parents and friends, Sophie has been at school all day, so she is

relaxing in her room watching Elmo's World, wearing orange-

and-pink-striped pajamas, Kim Stipes introduces us, and we wave

hello at each other,

I ask Kim to tell Sophie that I like her pink TV, and she laughs,

signing the message, "Kudos to Sophie," says her mom, a blond

with faded blue eyes, a gold thumb ring, and the slide-on Croes

worn by folks who spend a lot of time on their feet, "If other kids worked half as hard, they'd all be geniuses making millions,

That's how hard Sophie has worked,"

The Stipeses aren't strangers to hard work In a greenhouse

made of metal tubes and plastic sheeting, Kevin cultivates heir-

loom tomatoes, broccoli, lettuce, peppers, green beans, squash, and

even peaches, They can and freeze produce to use throughout the

winter, But 2008 was a rough year, Kevin lost his job, and with it,

the family's health insurance, He and Kim were trying to support

seven kids on what they could make selling auto parts on rhe inter-

net, Their son Max had recently been diagnosed with type I diabe-

tes, And Sophie had been very sick, throwing up all the time,

Without Medicaid Sophie's care would have been financially

overwhelming, Her formula was incredibly expensive, She needed

specialized diapers for older children with developmental delays,

It cost $1,700 every time Sophie had a G-tube implanted, The

cost of her care exceeded $6,000 a month,

Trouble really started in late 2007, when Kim applied for the

Healthy Indiana Plan, which provides catastrophic health insur-

ance for low-income adults, Though five of their children were

covered by Medicaid, she and Kevin had no health insurance, Im-

mediately afi:er Kim started the application process, four members

of the household became ill, Kim knew that she would not be able

to fill out all the required paperwork while caring for them,

So she went to her local Family and Social Services Adminis-

tration (FSSA) office in Tipton, spoke to a caseworker, and asked

42 \ AUTOMATING INEQ.::!ALITY

to have the application put on hold. The Tipton caseworker

told her that, because of recent changes at FSSA, application

decisions were no longer made at the local level. She would have

to speak with a call center operator in Marion, 40 miles away.

Kim called the Marion office and was told that her application

"would be taken care of." Neither the Tipton caseworker nor the

Marion call center operator told Kim that she had to sign pa-

perwork declaring that she was stopping the application pro-

cess. Nor did they tell her that her failed attempt to get health

insurance for herself and her husband might impact her children's

coverage. Then, rhe family received a letter from the FSSA. It was ad-

dressed to six-year-old Sophie, and it informed her that she would

be kicked off Medicaid in less than a month because she had

"failed to cooperate" in establishing her eligibility for the pro-

gram. The notice somehow managed to be both terrifyingly brief

and densely bureaucratic. Ir read:

Mailing Date: 3/26/08

Dear SOPHIE STIPES 1

MA D 01 (MI] Your MEDICAID beilefits will be discontinued

effective APRIL 30, 2008 due to the following

reason(s}:

-FAILURE TO COOPERATE IN ESTABLISHING ELIGI-

BILITY -FAILURE TO COOPERATE IN VERIFYING INCOME

SUPPORTING LAW(S) OR REGULATION(S) :

470IAC2,l-l-2

Iffiportant : If you believe you may be eligi-

ble for Medicaid benefits under another cat-

egory and have more information about your

AUTOlvIATING ELIGIBILITY IN THE HEARTLAND I 43

case, please contact us at the number listed

at the top of this notice within ten days (13

days if this notice is received by mail) of

the date of this notice.

. The nouce arrived on April 5, 2008. It had been ten days since

it was mailed. The family had three days lefi: to contact FSSA

and correct the mistake.

Kim sprang into action, composing a lengthy letter that

explained her situation and faxing it to the Marion office on Sun-

day, April 6. In it, she stressed that Medicaid kept Sophie alive,

that she had no other insurance, and that her medical supplies

alone cost thousands of dollars a month. Sophie's medicines were

due to run out in five days. Kim phoned the call center in Marion

and was told that Sophie was being cut off because Kim had failed

to sign the paperwork declaring that she was stopping her earlier

applications for the Healthy Indiana Plan. Kim protested that no

one had ever told her about the paperwork.

But it was too late.

According to the state oflndiana, the Stipes family had failed

to cooperate with the eligibility determination process and, under

state law, the punishment was total denial of medical benefits.

The sanction would impact both Kim and Kevin, who were try-

mg to get health insurance for themselves, and Sophie would be

demed the Medicaid she was already receiving. When Kim asked

why their other children were not being cut off, she was informed

that they were. She should expect four more letters.

. The Stipes family contacted Dan Skinner, who was spending

his retirement as a volunteer with United Senior Action, working

on behalf of elderly Hoosiers. In early 2007, United Senior Ac-

tion started getting calls from individuals and organizations all

over central Indiana: the shelves at food pantries were empty and 1,,

I I

44 I AUTOMATING INE~LITY

the United Way was overrun by requem for emergency medical

help. Skinner began an independent investigation in Howard

County, visiting the mayor's office, the area agency on aging,

Catholic social services, the senior center, and Mental Health

America. He found that people were losing their benefits for

"failure to cooperate" in alarming numbers. Sophie's case stood out to him as particularly appalling. "She

was six years old, and she was recovering. She learned how to sign.

She was starting to walk!" Skinner said. "She was starting to be

able to eat a little bit, and they said when she could rake 3,000

calories, they would take the feeding tube out. She was right at

that stage, and her Medicaid was cut off for failure to cooperate."

By the time the Stipes family reached him, Skinner remembered,

they were in a desperate situation and needed immediate action.

Dan called John Cardwell, founder and director of The Gen-

erations Project, an organization dedicared to addressing long-

term health-care issues in the state oflndiana. The two gathered

their colleagues from the AARP and the Alliance for Retired

Americans, lobbied their contacts, worked the media, and called

an emergency press conference. Dan took Sophie and her parents

to the Indianapolis State House in a van. "She had a little dress

on," Kim Stipes remembers. "She was not a happy camper then.

Her little life was rough." They walked into the governor's office

with Sophie in her wheelchair and "TV cameras in tow," said

Skinner. "They didn't expect that." At one point, Governor Mitch Daniels walked right by the

group. "He did have an opportunity, quite frankly, to walk right

over to us," Skinner recalled. "He just walked by. Mitch Roob

[Secretary of the FSSA] was with him. They just stared at us and

kept on going." Kevin Stipes yelled across the room to Daniels,

inviting him to come talk with his family. But the governor and

FSSA secretary failed to acknowledge them. "They get to that

AUTOMATING ELIGIBILITY 1N TH.E HEARTLAND I 45

position they don't want to deal with chat stuff They want lay-

ers," Kevin theorized later, "They want people in between." The

group asked for Lawren Mills, Governor Daniels' policy direc-

tor for human services, who agreed to meet with them. The next

day at four o'clock in the afternoon, Sophie had her Medicaid back.

Sophie's family was not alone. In 2006, Republican governor

Mitch Daniels instituted a welfare reform program that relied on

multinational corporations to streamline benefits applications,

privatize casework, and identify fraud. Daniels had long been a foe

of public assistance. In 1987, while serving as President Ronald

Reagan's assistant for Political and Intergovernmental Affairs, he

had been a high-profile supporter of a failed attempt to eliminate

AFDC. Nearly 20 years later, he tried to eliminate TANF in Indi-

ana. But this time he did it through high-tech tools, not policy- making.

Governor Daniels famously applied a Yellow Pages test to

government services. If a product or service is listed in the Yellow Pages, he insisted, the government shouldn't provide it. So it was

not surprising when, shortly after his election in 2004, Daniels

began an aggressive campaign to privatize many of the state's

public services, including the Indiana Toll Road, the Bureau of

Motor Vehicles, and the state's public assistance programs.

Daniels appointed Mitch Roob as FSSA secretary. In The Indianapolis Stat, Daniels praised Raab, then a vice president at

Affiliated Computer Services (ACS), as being" deeply committed

to_ the interests of the least fortunate among us and equally com-

mitted to getting the most service from every tax dollar." As their

first order of business, Roob and his boss commissioned an audit

of what Daniels called in a 2007 South Bend Tribune editorial

"the monstrous bureaucracy known as the Family and Social

46 I AUTOMATING INEQYALITY

Service Administration." As agency's audit report was released

in June 2005, two FSSA employees were arrested and charged

with theft, welfare fraud, and a panoply of other offenses. One of

the employees was accused of collaborating with church leaders

of the Greater Faith Missionary Baptist Church in Indianapolis

to collect $62,497 in food stamps and other welfare benefits

by creating dummy accounts for herself and fellow church

parishioners. Between them, the two caseworkers had 45 years of

experience at the FSSA. Daniels seized the political moment, In public speeches, press

releases, and reports, the governor repeatedly characterized Indi-

ana's welfare system as "irretrievably broken," wasteful, fraudu-

lent, and "America's worst welfare system." Citing the system's

high error rate and poor customer service, Mitch Roob criss-

crossed the state arguing that the system was broken beyond

the ability of state employees to fix. In early 2006, the Daniels administration released a request for proposal (RFP) to out-

source and automate eligibility processes for T ANF, food

stamps, and Medicaid. In the request, the state set very clear goals: reduce fraud, curtail spending, and move clients off the

welfare rolls. "The State is aware that poor policy and operations have con-

tributed to a culture of welfare dependency among some of its cli-

ents," the RFP read. "Respondent will help address this issue by

agreeing to use welfare eligibility and other programs to help cli- ents reduce dependency on welfare assistance and transition into a

paid work setting." While the state provided no incentives or sup-

port for matching applicants to available jobs, the RFP suggested

that the FSSA would be willing to provide extra financial incen-

tives for finding and denying ineligible cases. The state offered to

"pay the Respondent for superior performance," for example, if

the company can "reduce ineligible cases" by identifying "client

misrepresentations."

AUTOMATING ELIGIBILITY .iiN THE HEARTLAND I 47

At the time, the Indiana FSSA was helping about a million

people access health care, social services, mental health counsel-

ing, and other forms of support. The 2006 agency was sizable: it

had a budget of $6.55 billion and a staff of approximately 6,500.

But it was much smaller than it had been 15 years earlier. In 1991,

the Indiana General Assembly consolidated the departments of

Mental Health, Public Welfare, and Human Services, and out-

sourced many of its functions. By the time of the automation, the

FSSA had halved its public workforce and was spending 92 percent

of its budget buying setvices from outside vendors.

Everyone-advocares, applicants, administrators, and legisla-

tors alike-agreed that the existing system faced serious chal-

lenges, FSSA offices were using an extremely out-of-date system

called the Indiana Client Eligibility System (ICES) for daily ad-

minisrrative functions such as calculating eligibiliry and verify-

ing income. Customer service was uneven at best. A 2005 survey

found that applicants faced a slow intake process, a telephone sys-

tem that rarely worked, and caseworkers who were difficult to

reach. A US. Department of Agriculture (USDA) smdy found

that food stamp applicants made up to four visits to county of

fices before receiving program benefits. Overstretched staff

couldn't handle demand or keep up with towering piles of paper case files. 1

The Daniels administration insisted that moving away from

face-to-face casework and toward electronic communication

would make offices more organized and more efficient. Even bet-

ter, they argued, moving paper shuflling and data collection to a

private contractor would free remaining state caseworkers to

work more closely with clients. Daniels and Roob built a compel- lmg case. And people listened.

However, many ofDaniels's other assertions about the failures

of FSSA have been contested, His claim that Indiana's welfare

system was the worst in the country, for example, was based only

48 \ AUTOMATING INEQ!:!AUTY

on the state's record for moving Hoosiers off welfare. It is true that Indiana reduced the number of people on public assistance

more slowly than other states in the decade after the 1996 welfare reforms. But Indiana had seen a significant drop in the welfare

rolls years earlier. In the three years between the installation of ICES and the implementation of federal welfare reform, Indi-

ana's caseload fell 23 percent. As Daniels began his term, only a

tiny proportion of poor Hoosiers-38 percent-were receiving

benefits from TANF, and only 74 percent of qualified individu-

als were receiving food stamps. Despite the administration's insis-

tence that eligibility errors were spiraling out of control, the FSSA

reported food stamp error rates consistent with national averages.

The positive error rate-which measures those who receive bene- fits for which they are not actually eligible-was 4.4 percent. The

negative error rate-which describes those who apply for benefits

and are incorrectly denied them-was 1.5 percent. Only two bids were submitted for the contract, one from

Accenture LLC and the other from a coalition of companies

called the Hoosier Coalition for Self-Sufficiency. The coalition

was led by IBM and ACS, Roob's former employer. Accenture

dropped out of the bidding process. On December 27, 2006,

after holding a single public hearing on the topic, the governor

signed a ten-year, $1.16 billion contract with the IBM/ACS

coalition. In a press release celebrating the plan, Daniels announced,

"Today, we act to clean up welfare waste, and to provide Indiana's

neediest people a better chance to escape welfare for the world of

work and dignity. We will make America's worst welfare system

better for the people it serves, a much fairer deal for taxpayers,

and for its own employees."2 According to the Daniels adminis-

tration, the modernization project would improve access to

services for needy, elderly, and disabled people while saving taxc

AUTOMATING .EHGrn1uTY IN THE HEARTLAND I 49

payers' money. It would do this by automating welfare eligibility processes: substituting online applications for face-to-face inter-

actions, building centralized call centers throughout the state,

and "transitioning" 1,500 state employees to private telephone call centers run by ACS.

Daniels lauded his privatization plan and the automated

system in the 2007 South Bend Tribune editorial. "Today's wel-

fare system ... is totally indefensible," he wrote. "For Hoosier

taxpayers, reform means enormous savings: a half billion dollars

over the next 10 years, and that's only on the administrative side.

When today's high rates of errors and fraud are brought down,

savings will probably exceed $1 billion."3 By March, 70 percent of the FSSA workforce had moved to positions with private con-

tractors. In October the Indiana automation project rolled om

to 12 pilot counties in north central Indiana.

In the first nine weeks of the pilot, 143,899 people called the toll-

free number and 2,858 applied online. System failures were

immediate. "The telephone appointment system was a disaster,"

remembered_Jamie Andree of Indiana Legal Services, an organ-

1zat10n providing legal assistance to low-income Hoosiers. "An

interview would be scheduled from 10 to 12 in the morning.

People would have to find a phone, sit by it, and wait to be called.

Then the call wouldn't come, or they'd call at II:45 saying [the

mterv1ew] 1s being rescheduled for tomorrow."

Applicants who had taken time off work were often unable to

wait by the phone the next day for a new appointment. Others

received notices that required them to participate in phone inter-

views scheduled for dares that had already passed. According to a

2010 USDA report, a food stamp (called the Supplemental Nutri-

tion Assistance Program, or SNAP, after 2008) recipient added the

call center number to her cell phone plan's "friends and family"

i:J

so I AUTOMATING INEQ.gALITY

because she spent so much time on phone with them. Ap-

plicants who failed to successfully complete their phone intervkw

were terminated for failing to cooperate in eligibility determma-

tion. Says Andree, "It was a terrible, terrible, terrible system."

Private call center workers were not adequately trained to deal

with the severity of challenges faced by callers, nor were they pro-

vided with sufficient information about applicable regulations.

Advocates report call center operators bursting into tears on

the phone. "The first person I called under modernization, I re-

member it vividly," reported Terry West, a patient advocate with

15 years' experience in central Indiana. "She was young, and· · ,

did not have any experience whatsoever. ... There was a problem,

a denial of a case. I talked to this young lady for about an hour. I

kept citing [ the appropriate regulations]. After about a half an

hour, she just started crying. She said, 'I don't know what I'm

doing.' That's exactly what she told me. I said, 'Look, it's okay. I

was a caseworker. I'm reading right out of your policy manual

what has to be done.' She just cried." Millions of copies of drivers' licenses, social security cards,

and other supporting documents were faxed to a centralized

document processing center in Grant County; so many of them

disappeared that advocates started calling it "the black hole in

Marion." Each month the number of verification documents that

vanished-were not attached properly ro digital case files in a pro-

cess called "indexing" -rose exponentially. According to court

documents, in December 2007 just over 11,000 documents were

unindexed. By February 2009, nearly 283,000 documents had

disappeared, an increase of 2,473 percent. The rise in technical errors far outpaced increased system use. The consequences are

staggering if you consider chat any single missing document could

cause an applicant robe denied benefits. Performance metrics designed to speed eligibility determina-

tions created perverse incentives for call center workers to close

AUTOMATING ELIGIBILITY IN nm HEARTLAND I 51

cases prematurely. Timeliness could be improved by denying ap-

plications and then advising applicants ro reapply, which required

that they wait an additional 30 or 60 days for a new determination.

Some administrative snafus were simple mistakes, integration

problems, and technical glitches. But many errors were the result

of inflexible rules that interpreted any deviation from the newly

rigid application process, no matter how inconsequential or inad- vertent, as an active refusal to cooperate.

The automation's impacts were devastating for poor and

working-class Hoosiers. Between 2006 and 2008, the state ofln-

diana denied more than a million applications for food stamps,

Medicaid, and cash benefits, a 54 percent increase compared to the three years prior to automation.

Michelle "Shelli" Birden, a soft-spoken and serious young woman

from Kokomo, lost her benefits during the automation experi-

ment. Shelli was diagnosed with epilepsy at six months of age;

by the time she reached adulthood, she was suffering as many as

five grand ma! seizures a day. Despite having surgery to implant a

vagus nerve stimulator-something like a pacemaker for the

brain-she was still, in her own words, "violently ill" when the

modernization hit. In late April 2008 she received a recertifica-

tion notice from the FSSA. She faxed her response, a pile of forms,

and other documentation eight days later. On June 25, Shelli re-

ceived a letter dated June 12 informing her that her Medicaid

benefits would be discontinued in five days for "failure to cooper- ate m establishing eligibility."

The failure to cooperate notice had originally been sent to an

outdated address, which delayed its delivery. Now Shelli, in a

panic, phoned the call center. An ACS worker told her to try to

correct her application online. When that failed, she and her

boyfriend Jeff Stewart phoned the call center several more times,

trying to identify the problem. "I started reading her letters to

52 I AUTOMATING INEQ:g.ALITY

figure our what to do, and where to go, and who to call," Jeff re-

membered, "but you couldn't get anywhere on the phone. It was

like you were talking to a computer instead of a person:" . On July 11, call center operators connected Shelli with one

of the few remaining state caseworkers in Marion, who told her

that she had neglected to sign a required form but did not tell

her which one. By this point, she was starting to run out of

her anticonvulsant medications. She would have to find a free source for her drugs, which cost close to $800 a month, or risk

violent seizures, panic attacks, dizziness, insomnia, blurred vi-

sion, and an increased risk of death from going off them cold

turkey. . Shelli contacted the United Way, which ptovided her with a

few days of emergency medication. The staff also advised her to

immediately file an appeal of the "failure to cooperate" determi-

nation. She reached out to the Marion office again, on July 14,

and asked to lodge an appeal. But she was informed that the 30-

day deadline to contest the June 12 decision had passed. It was too late to appeal the FSSA'.s decision. She'd have to reapply.

A new determination would take 45 days. She had three days

of medication left.

The governor and the FSSA promised that an autom~ted eligibil-

ity system would offer increased client control, a fairer applica-

tion process, and more timely decisions. The problem with the

existing caseworker-centered system, as they saw it, was twofold.

First, caseworkers spent more time manually processing papers

and collecting data than "using their social work expertise to help

clients." Second, rhe outdated data system allowed caseworkers to

collude with outside co-conspirators to illegally obtain benefits

and defraud taxpayers. The old system involved caseworkers_ de-

veloping one-on-one relationships with individuals and families

and following cases through to completion. The new system was

AUTOMATING ELIGIBILITY rn THE HEARTLAND I 53

"self-serve," technology-focused, and presented call center

ers with a list of tasks to complete rather than a docker of families

to serve. No one worker had oversight of a case from beginning to

end; when clients called the 1-800 number, they always spoke to a

new worker. Because the Daniels administration saw relation-

ships between caseworkers and clients as invitations to fraud, the system was designed to sever those links.

The FSSA packed up all its existing records and moved them

to a central storage facility in Indianapolis. These paper records

were set aside in case the state needed them for appeal hearings,

but were not scanned into the modernized system. All current

recipients of TANF, food stamps/SNAP, and Medicaid were re-

quired to turn in all their supporting documentation again, no

matter how long they had been receiving benefits. "All of the doc-

uments that identified the members of the household-birth cer-

tificates and that sort of thing-were in the local office until the

modernization. And then they were gone," remembered Jamie

Andree. "It was as if they had never existed. So one of the things that happened with modernization is that people [were] asked to

turn in [obscure] stuff, like the tide to a vehicle that they hadn't

owned smce 1988. They were being asked to turn in things that the agency already had."

When clients did manage to find decades-old documents, de-

lays between the document center receiving paperwork and the

contractors processing it were consistently interpreted as the fault

of the applicant. Chris Holly, a Medicaid attorney in Blooming-

ton, estimated that 95 percent of the Medicaid applications he

handled during the automation resulted in eligibility determina-

tion errors. According to Holly, all the errors were generated by

the state and its contractors, not his clients. "We knew we had

submitted everything by the deadline," he said in December of

2014, "and we were still getting denials for failure to cooperate" I l . t wou d take three or four days for documentation to get

ii ii I' ,,'

54 j AUTOMATING INEQ:gALITY

Th Id deny it on the d b ,, h never waited. ey wou processe , ut t ey . d . f l et denied, they assume [d

di' ] r even before. An 1 peop e g , . ea me , o . , . Th 'II accept that they re JUSt

the system knows what its domg. ey

ineligible and give up." h . their health insurance 1 · t foug t to retam

Still, many app ,can s f idable odds. Like Shelli, they or food assistance against these orm c t out a single error in

. d · t yingto rerre became tenacious etecnves, r f es Failure to cooper-

!. . · gdozens o pag · complex app ,canons runnm . l d that some- cc d 1· l uuidance They s1mp Y state

ate notices orrere itt e " . . . h t speciiftcally was . h . h n apphcanon, not W a

thing was not ng twit a . d ·lleoible? Was . sing lost unsigne , or l ,r

wrong. Was a document mis , , , "Failure to . h FSSA or the contractor.

it the fault of the chent, t e h ' ,, · d Glenn Cardwell, a re- h t've p rase, note cooperate was t e opera ' l' . in Vigo County,

k d administrator now ,vmg tired casewor er an . , . bl m and not the city, ,not the "because then it was the clients pro e

contractor." . k s or omissions in an ap- Under the previous system, m1sta e . equiring case-

bl and nme-consummg, r plication were trou esome d cuments like birth workers and clients to collaborate tofsecfure ome social security

d . l ts proo o mco , certificates, me ,ca repor , d . t'on they had some- . ''B fi mo ern1za 1 ,

cards, and rental receipts.. e ore . d this notice. What do I 11 d 'Listen I receive one to ca up an say, ' . R "And the an-

d , ,, 11 d ACLU attorney Gavm ose.

need to al reca e . . ht now I'll make sure 'R . d wn to me fax it over ng ·

swer was un it o , f h' , ,, Before the auroma- . Iii d 'II take care o t is.

it gets m your e an we ,, h d been a last-ditch punishment tion, "failure to cooperate a . h . ly re•used to par-

d . few clients w o acuve J' caseworkers use agamst a Aft the automation, the

. h 1· 'b'l'ty process. er ticipate m t e e ,g1 ' ! h !fare rolls, no phrase became a chain saw that clearcut t e we

matter the collateral damage.

lk. bout what she remembers as Shelli Birden was wary of ta mg a. . . of her life. Ulric one of the most confusing and ternfymg times

AUTOMATING ELIGIB1UTY IN THE HEARTLAND I 55

mately she discovered the signature she had missed. "I had

to go back through my papers," she said. "l always copied my pa- pers. l missed one question, and boom, they shut me off." When we spoke in 2015, she remembered feeling completely alone in

a life-threatening situation. "They didn't give us enough infor-

mation," she said. "They didn't send us in with our social work-

ers anymore. They made us do it on our own."

But Shelli, as smart and tenacious as she is, didn't do it entirely

on her own. She received help from advocate Dan Skinner, whose

contacts with FSSA staff fast-tracked solutions. Her boyfriend

took on navigating the debacle like it was a second job. She re-

ceived help from the United Way, which provided advice and

support. Birden was reinstated to Medicaid on July 17. She re- ceived her medication in time to save her life. Seven years later,

with her health stabilized, Shelli was holding a job at Wal-Marc.

'Tm doing really good," she said. 'Tm actually able to get back to

work, and I feel like my life matters."

But many orhers were not so lucky. "As attorneys, we had ac-

cess ro people that could fix things," noted Chris Holly. "But

average well-meaning people that needed help? They were the

ones that suffered the most." Jane Porter Gresham, a retired

caseworker with nearly 30 years' experience at FSSA, agreed.

"The most vulnerable of our population-the parents of children

who didn't have food to eat, who needed medical treatment, and

the disabled who were not able to speak for themselves-were

the ones who iook it on the chin, took it in the gut, and in the heart."

Lindsay Kidwell of Windfall also lost public benefits during the

modernization experiment. Six months after giving birth to her

first child, Maddox, in December 2008, Lindsay was informed

that she was due to recertify for food stamps/SNAP and Hoosier

Healthwise, Indiana's Medicaid program for low-income parents,

56 \ AUTOMATING 1NEQEAL1TY

and children. She participated in a phone inter- pregnant women, k . n Marion, who

. December 10 with a call center wor er 1 h view on d d rovide Among t e told her what documentation she nee e to P . J k Wil-

b for her partner, ac documents requested were pay stu s h Buck-

d b t $400 a week before taxes at t e l' who ma e a ou h' ,ams, d Lounge Lindsay faxed everyt mg except horn Restaurant an . D b 19 because h stubs to the document center on ecem er '

J t ekpay 'd by bank check and didn't have any stubs. His boss at ac got pa1 fi d h w to sup-

lled the document center to n out o t~e Bucl17~i~~aaes. Following their directions, she wrote out a P y proo o "d d faxed them to the document list of paychecks an amounts an

center on December 23. . d d' al biH informing her

Januar 2 Lindsay receive a me lC On y ' b d . d d that she would be re- M d' 'dh d een en1e, an

that her e 1ca1 a f k t ror her recent postnatal l f · $246 out o poc e r, sponsib e or paymg d grocery shopping on

Wh h went out to o some check-up4 h e~~; card-the debit-like card holding her food January , er . J ar 15 she received

/SNAP benefits-was denied. On anu y ' stamp a letter from FSSA.

Mailing Date: 1/13/09

Dear LINDSAY K KIDWELL,

FSOl (XD) D STAMPS dated DECEM-

Your application for FOO

BER 10, 2008 has been denied.

not eligible because: You are To COOPERATE IN VERIFYING INCOME -FAILURE

SUPPORTING LAW(S) OR REGULATION(S)

7CFR273.2(d)

MA C 01 (MI) HEALTHWISE benefits will be Your HOOSIER

AUTOMATING ELIGIBILITY IN THE HEARTLAND I 57

discontinued effective JANUARY 31, 2009 due to

the following reason(s):

-FAILURE TO COOPERATE IN VERIFYING INCOME

SUPPORTING LAW(S) OR REGULATION(S) : 470IAC2.

1-1-2

A week later, well within the 13-daywindow to submit the "miss-

ing" documents, Lindsay went to her local Tipton County FSSA

office, submitting a more complete listing of wages and photo- copies of Jack's last three paychecks.

Lindsay had the wage report and canceled paychecks stamped

"Received" and asked for a copy. She watched the employee scan

her paperwork into the system and took a copy of the "Scan Suc-

cessful" notice confirming it was received by the document cen-

ter. She also filed an appeal of the earlier "failure to cooperate"

determinations. If she began a fair hearing process, her food stamps/SNAP and Medicaid would be reinstated until an ad-

ministrative law judge ruled whether or not the decision to termi- nate her benefits was correct.

The Tipton County worker told Lindsay that she should file a

new application for benefits rather than an appeal. It would be

faster and easier, she insisted. Lindsay refused. She didn't want to

reapply; she wanted to appeal what she saw as an incorrect FSSA decision.

Three weeks later she received a phone call from a young man

who informed her that she would receive a notice in the mail

soon-a hearing on her Medicaid case had been scheduled. Then

he advised her to drop her appeal. He was looking in the com-

puter, he said, and because Lindsay had never submitted payroll

information for Jack, she would lose her case. But Lindsay had

copies of his payroll information stamped "Received." She had

the canceled checks and the scan confirmation. Ir must be some

58 \ AUTOMATING lNE~ALITY

kind of mistake, she insisted. It didn't matter. Lindsay recalls that the man on the phone simply said, "I found no documentation of

recent payroll information in the computer. The judge will simply

look in the computer, see this, and deny you."

One of the great victories of the welfare rights movement of the

1960s and '70s was the redefinition of welfare benefits as the per-

sonal property of the recipient, rather than as charity that can be

bestowed or denied on a whim. Activists successfully challenged

inequitable access to public assistance by appealing decisions and

demanding access to administrative law procedures known as fair

hearings. In 1968, eight individuals denied due process in New York

launched a class action lawsnit chat led to a Snpreme Court deci-

sion in Goldberg v. Kelly. This landmark case found that all wel· fare recipients h.ave a right to an evidentiary hearing-a proc_ess

that includes timely and adequate notice, disclosure of opposmg

evidence, an impartial decision-maker, cross-examination of wit-

nesses, and the right to retain legal representation-before their

benefits can be terminated. By successfully reframing public benefits as property rather

than charity, the welfare rights movement established that public

assistance recipients must be provided due process under the

Fourteenth Amendment of the Constitution. The case hinged on

the understanding, expressed by Justice William Brennan, that

abrupt termination of aid deprives poor people of both their

means of survival and their ability to mount an adequate chal-

lenge to government decisions. "From its founding, the Nation's

basic commitment has been to foster the dignity and well-bemg

of all persons within its borders," Brennan wrote. "Public assis-

tance, then, is not mere charity, but a means to 'promote the gen-

eral Welfare, and secure the Blessings of Liberty to ourselves and

P . ,,,4

our ostenty.

AUTOMATING ELlGIBIUTY IN THE HEARTLAND 1 59

. 'Il;e far-reaching and fundamenral changes introduced by In- diana s automated system put it on an inevitable collision course

with the poor's right to due process guaranteed by Goldberg. A class action lawsuit, Perdue v. Murphy, was filed by Gavin Rose and Jacquelyn Bowie Suess, staff artorneys from the ACLU of

Indiana, on behalf of more than a dozen individuals in north

central Indiana who had lost their Medicaid, food stamps/

SNAP, or TANF assistance for failure to cooperate. The case

explicitly challenged the loss of due process under the automated system.

The ACLU alleged chat notices were incomplete, "failure to

cooperate" was being used too broadly, and the new caseworkerless

system denied the disabled equal access to public programs. They

also claimed that the last resort of wrongly denied applicants-a

fair heanng-was made increasingly difficult to access. Call cen-

ter workers defaulted to the decisions of the automated system

over the administrative law process, discouraging appeals in favor

of reapplication, and failed to notify applicants of their rights.

Applicants felt that they had nowhere to turn for redress.

Ali:er successes for the ACLU in lower courts, Perdue v. Mur- phy eventually went to che Indiana Supreme Court, which found that the state's" failure to cooperate" notices were unconstitutional

and did not provide adequate due process protections. But, re·

versing a lower court's decision, Indiana's highest court held

that the ',;ate does have a right to deny applicants for "failure to cooperate because at some point "failing" and "refusing" to coop-

erate converge. The case forced the FSSA to create more complete

and specific notices, but did little to return the individualized at-

tention of caseworkers to the Indiana eligibility process, or to

stop the use of"failure to cooperate" to clearcut the rolls.

"The judge will simply look in the computer ... and deny you,"

the call center operator said to Lindsay Kidwell in February 2009.

60 \ AUTOMATING INE~ALITY

The words were a nightmare. Despire rhe fact that she had

stamped proof that she submitted all the appropriate payroll mfor- mation, Lindsay wavered. Should she cancel her appeal? If she lost, she'd be responsible for repaying all the benefits she received while

waiting for a decision-months of medical and food bills. Even though Lindsay knew she was in the right, there was no

guarantee she would win the case. A loss would mean more debt for her young family. She asked the man on the phone if she could

talk to an advisor before deciding whether or not to contmue her

appeal. He said, "No. I need an answer now. Are you going or

not?" Gathering her courage, she re-affirmed that she wanted a

fair hearing. He hung up on her. Lindsay remembered that the appeal hearing was ~retry

straightforward. "I went to my appeal," she said in 2017. ,:'ey

said basically that rhey messed up. I didn't owe them money. Her family met all of the eligibility requirements of the program;

their Hoosier Healrhwise and food stamp benefits were officially

reinstated. But her experience with the FSSA still haunts her today. Her

family was self-supporting for nearly a decade after the eligibility

automation. Then she went through a divorce. When I spoke with her in 2017, she knew she was probably eligible for help from

FSSA. 'Tm going through a tough time," she said. 'Tm a singk mom. I work full rime, but it doesn't always cut it." Her expen-

ence during the automation makes Lindsay hesitant to apply for

benefits again. "They make it so difficult. Ifl applied now I could

probably get it, but that experience with being dented · · · I ,mean,

I cried. I did everything that they asked me to do. I don t even

know if it's worth the stress."

Applicants for TANF, food stamps/SNAP, and Medicaid were

not the only Hoosiers impacted by the shift to automated

AUTOMATING ELIGIBILJTY IN THE HEARTLAND j 61

decision-making. That's why I traveled to Fort Wayne in

March 2015 to talk to caseworkers about their experience with the Indiana experiment.

Fort Wayne, the second-largest city in Indiana, is in the northeast, 18 miles west of Ohio and 50 miles south of Michigan.

General Electric and International Harvester had factories there

that closed or scaled their workforces back significantly during

the 1970s and 1980s. Driving to my first appointment of the after- noon, I pass the local headquarters of the National Association of

Letter Carriers; George's International Market with its incredible selection of house-made salsas and bottled hot sauces; and Uncle

Lou's Steel Mill Tavern, which sports a sign in the window that

reads "Honk if you like beer." I cross the railroad tracks and the

St. Marys River, swollen from recent Hooding, into a neighbor- hood of modest two-story houses.

Jane Porter Gresham welcomes me into her tidy white home, where we sit on a blue velveteen couch in het front parlor.

Gresham's wooden cross contrasts sharply with her matching bluet-shirt and cardigan set. Gresham worked for the FSSA for

26 years, from 1985 to 2011, when she retired in the wake of the

automation. Even four years later, rage and frustration Ricker

across her round face as we speak. "People who are [at FSSA] for the first time, you can see it in their eyes-fear. Fear of what I'm

going to do. People say to me, 'I never thought I'd have to be

here.' They're not trying to cheat the system; they don't know

where else to turn. Our responsibility as public employees is to

make certain that people who are eligible get the benefits they're entitled to."

With decades of experience and seniority, Gresham managed to hold on to her state job when the automation rolled out to Al-

len County. But under the new system, she no longer carried a

caseload. Rather, she responded to tasks that were assigned by the

new WorkRow Management System (WFMS). Tasks bounced

62 \ AUTOMATING INE~ALITY

between 1,500 new ACS employees and 682 remaining state em-

ployees, now known as "state eligibility consultants." The governor promised that no state workers would lose their

jobs due to the automation and that salaries would stay the same

or rise. But the reality of the new ACS positions created a wave

of retirements and resignations. After reapplying for jobs they al-

ready held, sometimes for decades, and submitting to criminal

background checks and drug tests, workers found their positions moved from their home county office to a regional call center,

They were offered moving bonuses if their new job was more than

50 miles from their current work site, but many declined to up-

root their lives for the insecure new positions. Under the eligibility automation, no single employee "owned"

or oversaw a case; staff were responsible for responding to tasks

that dropped into their queue in the WFMS, Cases were not

handled in the county where applicants lived. Now, any employee

could take any call from any county using the new system, even

if they knew nothing about the caller's local context, "We got

calls from all over the state," says Gresham, "I had never heard of Floyds Knobs [in southeastern Indiana] until we started that pro-

cess! I had no idea of services that were available in that area," Reducing casework to a task-based system is dehumanizing,

she suggests, for both worker and client, "Ifl wanted to work in a factory, I would have worked in a factory. , , , You were expected

to produce, and you couldn't do that if you listened to the client's story," The majority of clients Gresham saw during her long career

were traumatized-by flood or fire, illness or accident, domestic

violence or extended unemployment. "People who have gone through a trauma want some hope that it's going to get better,

That somebody's paying attention, that they're not in this alone,"

she says, "That's what I think we did [before the automation], We listened to what they had to say and acted on it so that things

could get better."

AUTOMATING ELIGIBILITY IN THE HEARTLAND I 63

"W'I e oecame slaves to the task system," said Fred Gilbert o year FSSA employee . J" , , a ~o-h . . spena tz.n.ng in refugee assistance "L'k ot er private call center, it's 'just the facts' B t , I e any is very complicated, That's the , b f , u the welfare system wade through the mess," JO o caseworkers, to help people

ThegovernorandtheIBM/'"CS al', , , n co monpromi d · 1 dec1s1ons, more efficient use of resources and b tt se more time y vice B t k ' e er customer ser-

1 , u casewor ers experienced cascading technical fail

exp osron of errors that slo d , ures, an poorly trained private wor;:rs :;hr;r;,1s:::e~h3;!'plicbaltions,a hnd created on t h . pro ems t ey ACS ·k o t e remaming public employees. Mistakes made by

wm ers were referred to state worke fi , an omsized workload on the handf l fl rs or correction, piling remained, u O ong-terrn employees that

By summer 2009, there was a back! f and 6 500 J og O nearly 32,000 cases ' peop e were waiting for ap l h .

to their month! pea eanngs. According y management reports th FSSA

incredibl hi h £ d ' e was reporting B y g oo stamp eligibility error rates to the USDA

etween 2006 and 2008 h b' · 1 d f ' t e com med error rate more than t , Pe ' rom 5.9 percent to 19 4 M n-

h

, , percent, ost of that growth , t e negative error rate: 12 2 P f h was m , ercent o t ose ap I , f, f, d stamps were being incorrectly denied The t t ' f ymg or oo for food st d , . ' s a es ong wait times

penalties f:::h:~~~:~ttracted notice and threats of financial

sic The pressure to keep timeliness numbers high to fulfill the ba- reqmremenrs of the contract combined , h backlo f I ' wit an ever-growing

habitu:I :d cases£ ed to mass application denials and the now- vice rom call center workers to "·us ,,

Gilbert reflected "Th I b b J t reapply, Fred send something ;n e rufeshecame rittle, If[applicants] didn't

, one o t lfty docum , the case for failure to comply y; ;dnt~, you simply closed to help somebody," , , , , ou cou n t go out of your way

oom, ane orter Gresham turns ren . , necnve. Back in her living r J p

64 I AUTOMATING INE~ALITY

he streer· If you want "It didn't take long for word to get out on t b, h

, to the office [in person] ecause t ey your benefits on nme, go ,, h "We were

have to give you a face-to-~:e :~~;i;~:~~:, ~ase ~:::~ing every- inundated with people w d W didn't save b d d

We didn't save space an rent, e 0 y own, , , , d,,

k W were inundated at the en , wor ers, , , , e d h wn health be- G resham saw great workers burn out, an er o Id 't

11 , 1 w There cou n d , t "Morale was at an a -time o , gan to etenora e. ' e an camaraderie. It was just you be reassurance, there couldn t b y d h d I realized this

" , f 11 "Towar s t e en ' out there, she says wist u y, , h'

1 one of the last

was affecting my health, my relations ips, was

holdouts,"

d l · ng class families When failed by FSSA, Indiana's poor an wor G h- h F ed

! and eac ot er. ac 1· d on local governments, vo unteers, , re ie l , , f help recalcitrant state with lines of desperate peop e wamng or ' k Hoosiers

ncies and dismissive private call center wor ers, .

;:: ht back One of the centers of their resistance was M~nte,

lnl:ana, the largest city in the automation experiments rst

pilot area, h h "Middletown, USN' pro- Following State Route 32 t roug , Th ban-

vides a drive-by tour of the city's recent ind::~:~~:::he t::n as doned million-square-foot BorgWarner,pla 1 d 5 000 people

Y ou arrive from the west. In the 1950s, it emp oye 1 ' d , 2009

F d k but 1t c ose m , assembling transmissions for or true s, sphalt , h 11 by an enormous a

Two miles later on your ng t, you ro de the fa- field site of the old General Motors plant, Wodrkers ma, , n for

' M , M-22 "Rock Crusher" four-spee transmissio mous unc1e 1 d · 2006 h le cars of the 1960s there, but the plant c ose m .

t e muse h , b board in the Center When I visited Muncie in 2015, t e JO ,r d ly a

T ' office ouere on Township of Delaware County rustee s d' food

· · , gardener custo ian, handful of employment opportunities, '

service, Pepsi delivery,

AUTOMATING ELIGIBILITY IN THE HEARTLAND I 65

The state of Indiana is broken up into l,008 six-square-mile

townships, each with a local government office funded by prop-

erty taxes and run by a township board and an elected trustee,

Though each township office works a little differently, one of their

primary responsibilities is to manage local poverty relief Almost

immediately afi:er its rollout in October 2007, the failures of the

automated system overwhelmed the Delaware County Trustee's

office, "People were devastated," Lead Case Coordinator Kim

Murphy said, "I mean they were just lost, Lost, lost, lost," Al-

ready suffering through the rash of plant closures, Muncie fami-

lies were now getting kicked off food stamps, cash assistance, and

Medicaid, "They were confused, and they didn't know where to

turn," said Marilyn "Kay" Walker, Center Township trustee, "There

was no case management, no personal connection, no communi-

cation among agencies, It was just the biggest mess,"

According to the lvluncie Star Press, by February 2008, the

number of households receiving food stamps in Delaware County

dropped 7.47 percent, though the number of households receiving

food assistance had climbed 4 percent in Indiana overalL Calls to

the LifeStream 211 telephone hotline requesting information

about food pantries doubled, The Second Harvest Food Bank of

East Central Indiana faced severe shortages, The municipal grave-

yard complained it had not been paid for thousands of dollars worth of funerals for poor and indigent people,

The public was encouraged to apply for services through the new online syStem; but low-income families in Muncie, as else-

where, did not have regular access to the internet. The majority of

applicants had to rely on a community partner such as a local li-

brary, food pantry, or health clinic to access the online applica-

tion, The FSSA aggressively recruited community organizations

to support the new system by becoming part of a Voluntary Com- munity Assistance Network (V-CAN),

Asked to use her office's existing computers and staff to help

66 j AUTOMATING INEQ~ALITY

Muncie citizens submit applications for public assistance, Walker

resisted, "When it came out that this is what they were going to

do, I was like, 'Excuse me, but, hell! You are not!' They were try-

ing to get all these other organizations involved to do their work," she remembered, "We're already overloaded," Walker made her

office available to people who needed to fax documents and par-

ticipate in phone appointments, and her staff went out of their

way to help applicants, but she drew the line at becoming a V- CAN partner. "I didn't think it was our responsibility to start

doing FSSA'.s work" Public libraries were particularly hard-hit by the automation

project. "We had lines of desperate people waiting for help," said

Muncie Public Library director Ginny Nilles, now retired, V-CAN

partners received little to no compensation, training, or oversight

to do what amounted to volunteer casework Librarians trained

community volunteers to help patrons submit welfare applica-

tions, but the library was quickly overwhelmed, The situation

worsened when budget cuts required reducing hours and laying

off staff. Library staff and volunteers did a great job, said Nilles, but

there were serious issues, "Confidentiality is very important to li- brarians, The forms ask very personal questions, If they couldn't use the computer, it was incumbent on us to read the questions

out loud and get the answers: social security numbers, mental and

physical health, Volunteers are great, but if you pay someone to

do a job, it's their responsibility, It's about accountability,"

"Local agencies were victimized," said John Cardwell from

the Generations Project, who worked closely with local non-

profits throughout the automation, "They were being dumped

on, serving thousands of people they shouldn't have been serving,

scrambling ro help people get their benefits restored, They knew

these people, They weren't going to leave them without medical

care or food,"

AUTOMATING EUGIBIUTY IN THE HEARTLAND I 67

Faced with system failmes, increasing need, and little help

from the state, public assistance recipients, community organ-

izations, and trustee's offices began to organize, A group called

Concerned Hoosiers set up a website where FSSA and ACS

workers could share their experiences with the modernized

system, The Indiana Home Care Task Force held press confer-

ences on the automation experiment's impacts and drafted

model legislation to reverse damage, A subcommittee of ser-

vice providers, advocates, and welfare recipients calling them-

selves the Committee on Welfare Privatization Issues provided

emergency interventions for recipients facing benefits termi-

nation, organized press tours highlighting impacts on Hoosier

families, and launched campaigns to increase pressure on

policy-makers to stop the auromarion rollout and terminate

the IBM/ACS contract, With typical Hoosier humor, their ac-

ronym, COWPI, made it clear what they thought about the new system.

Town Hall meetings on the welfare modernization spread

across the state, Anderson was first in April 2008 then M · , unc1e, Bloomington, Terre Haute, Kokomo, One of the most successful

was the Muncie People's Town Hall meeting, held on May 13,

2008, Walker and Murphy proved to be shrewd organizers,

They printed flyers for the meeting and delivered them to so-

cial service agencies, convenience stores, and libraries, They

convmced the Dollar Tree to put a flyer in every customer's bag,

They scheduled the meeting to coincide with a free food distri-

bution by the Second Harvest Food Bank, They invited local

lawmakers, including State Senator Sue Errington, State Sena-

tor Tim Lanane, and State Representative Dennis Tyler, who

listened to hours of testimony from impacted constituents,

They invited Mitch Roob, who at first demurred, As the town

hall date approached, he changed his mind and asked Walker to

make space for a small army of caseworkers, eight computers,

68 I AUTOMATING INE~ALITY

and a photocopier, rn help attendees solve their eligibility prob-

lems on-site. More than 500 people attended. A room-spanning line of

public assistance recipients testified about unanswered phones,

lost documents, and benefits denied capriciously. Melinda Jones

of Muncie, the mother of a ten-month-old with cancer, was

fighting to keep her Medicaid and food stamps. "I have to beg

and borrow from my family to give my daughter her food," she

said, "and I think it's utterly ridiculous that we do our children

like this." Christina King, a diabetic and working mother of three, lost

her Medicaid during the modernization. She was unable to afford

insulin for seven months and her blood sugar was out of control,

putting her at risk of stroke or coma. "What good does it do when

my seven-year-old walks in and I physically cannot get out ofbed?"

she asked. "I spent two days in the ICU because I have no medi-

cine. My kidneys are now at risk. My eyes are at risk. But I get up

every day and I go to work, because I think it's important for me

to show my kids, 'Don't be dependent on the system.' I need a

hand up, not a handout. I'm raising three kids by myself. I am try-

ing to show my kids, 'Don't be like me-do better.'" Deaf, blind, disabled, and mentally ill clients were particu-

larly hard-hit. 'Tm deaf. How can I do a telephone interview?"

asked Dionna McGairk through a sign-language interpreter. "I

tell [ call-center operators] to use my relay service. They don't

understand what relay service is." When operators told her she

needed to get help to apply for public services, she responded:

"No-I can answer my questions myself. You are discriminating

against the deaf." The day after the Muncie Town Hall meeting, State Represen-

tative Dennis Tyler sent a letter to his colleagues in the Indiana

House of Representatives requesting a summer General Assem-

bly meeting to address ongoing problems with the automated sys-

AUTOMATING ELIGIBILITY KN THE HEARTLAND j 69

tern. "The state of Indiana isn't doing its job," he said to Joe

Cermak of NewsLink Indiana. "You don't want to think this sys- tem is put in place to fail these people, bur what can you think when it's failing this bad?" A few days later, on May 19, rhe IBM/

ACS coalition, receiving a "go ahead" order from the FSSA,

rolled out the automated system to 20 more counties in northeast-

ern and southwestern Indiana.

The modernized system had now reached 59 of 92 Indiana

counties, and was serving 430,000 social services clients, a bit less

than half of the state's caseload. On May 30, a severe weather

system-including tornadoes, torrential rain, and high winds-

battered the state, causing widespread flooding. The IBM/ ACS

coalition pulled employees away from regular operations to pitch

in for the flood effort, easing the way to emergency benefits for

thousands but worsening the already significant backlog for regu-

lar public assistance applicants.

At a Bloomington Town Hall meeting a few weeks later,

State Senator Vi Simpson and State Representatives Peggy Welch

and Matt Pierce listened to clienr testimony and grilled Zach

Main, director of the Division of Family Resources at FSSA and

Mitch Roob's right-hand man. Participants in the forum raised

similar concerns to those in Muncie: telephone lines were

always busy, Help Center offices had multi-day waits, failure to

cooperate notices were arbitrary and unclear, V-CAN partners

were not trained or supported. Main, visibly frustrated, re-

sponded to criticism of the new system. 'Tm nor here today to

argue, to defend," he said. Tm certainly not here to tell you that

everything is perfect with the system. What I will tell you is

that we're working very hard .... When Governor Daniels came

into office, Indiana was first in the nation in child deaths and

last in the nation in welfare-to-work. We had a system that was

undeniably broken, and the resulrs speak for themselves on that."

70 I AUTOMATING INE~ALITY

He faced a skeptical, even incredulous, room. If the results spoke for themselves, what were they saying, exactly? Simpson

and Welch, who had been responding to constituent complaints

for three months, weren't buying it. They pressed him with ques-

tions about the ambiguity of failure to cooperate notices, inade-

quate caseworker support, lack ofFSSA accountability to its own

processes, and failure to levy penalties against IBM and ACS for

poor performance. Peggy Welch shot back, 'Tm sorry Zach, but what we've heard

over and over again is about this telephone interview time, that

they tell you, 'We're going to call between 2 and 4 and you better

be there,' and rhe call doesn't come through. They call at 8 o'clock

the next morning and then say 'failure to cooperate.' That's a real

problem." Simpson added, "People don't know what it means

when they get 'failure to cooperate' on a denial notice. In the old days, they used to be able to call their caseworker and find out what piece of paper they were missing, or what signature line they for-

got to sign, or whatever the problem was. Now they don't have

anyone to call." The press was printing poignant human interest stories

emerging from the modernization: a nun denied Medicaid,

desperately ill patients spending their final months fighting to

get their health care back, food banks picked clean. Ollice

Holden, regional administrator of the Food and Nutrition Ser-

vice, which administers food stamps for the USDA, wrote a let-

ter to Secretary Roob requesting that the FSSA delay further

implementation. The federal government was concerned over long

determination wait times. The governor faced increasingly vocal challenges from state

legislators. "I asked for a point of personal privilege on the House

floor," said Matt Pierce, a Democrat. "I said, 'This is a train wreck

and everybody ought to know. This thing is hurting people.

We've really got to fix it.'" The governor attacked complaints as

AUTOMATING ELIGIBILITY V.N THE HEARTLAND I 71

partisan sniping. me tell you what," Daniels fired in

an interview with the Evansville Courier & Press, "[Legislators] are hearing complaints from people who made money off the

past system. That's where the complaints are principally coming from." 5

But Daniels' contention that the only people harmed by the auto-

mation experiment were welfare chiselers proved unsustainable

when members of his own party began to attack the project. ln

October 2008, State Representative Suzanne Crouch and Stare

Senator Vaneta Becker, both Republicans, drafted legislation that

would halt the expansion of the new eligibility system until the

Select Joint Commission on Medicaid Oversight could perform a

thorough review. At the close of the year, Daniels announced that

he was moving his friend and colleague, Mitch Roob, out of the

FSSA and making him the state's secretary of commerce and

CEO of the Indiana Economic Development Corporation. He

appointed Anne Waltermann Murphy, Roob's chief of staff, co

lead the troubled agency.

Within three months of taking control, Murphy demanded

that IBM submit a corrective action plan to improve 36 different

service deficiencies, including excessive wait times, lost docu-

ments, inaccurate data, interview scheduling problems, slow ap-

plication processing, and incorrect instructions to clients.

IBM argued that nothing in their contract required that they

respond to a corrective action plan, but agreed to evaluate exist-

ing operations and suggest areas for system improvement. Ac-

cording to Ken Kusmer of the News and Tribune, IBM released a 362-page plan to fix problems, including "inaccurate and incom-

plete data gathering" and "incorrect communications to clients"

in late July.6 Secretary Murphy encouraged two longtime welfare

officials, Richard Adams and Roger Zimmerman, to come up

with a "Plan B" in case IBM was unable or unwilling to make

72 \ AUTOMATING INE~ALITY

these changes. According to Adams' testimony in Perdue v. Mur- phy, the two sketched out a "hybrid system" that would bring back some aspects of the pre-automated FSSA process on a napkin

ovet lunch. Daniels continued to defend the automation experiment, in-

sisting that Indiana would not back down from high-tech welfare

teform and that "over time this issue will resolve itself." But the

political winds had changed. Daniels was now the subject of spec-

ulation about a presidential run, and the failed automation was

embarrassing to the state and to his administration. In Octo-

ber 2009, with his eye on a national audience, the governor did

something unexpected. He admitted that the experiment had

failed and canceled the contract with IBM, calling the project a

"flawed concept that simply did not work out in practice."

In May 2010, Indiana sued IBM for $437 million, claiming breach

of contract. The state claimed that the automation experiment

led to faulty benefit denials that harmed needy Hoosiers, and de-

manded that the company pay back the nearly half-billion dollars

they had received for running the modernization plus damages

for lawsuits, federal penalties, and state employee overtime. IBM

countersued for about $100 million for the server, hardware, au-

tomated processes, and software that the state was still using to

determine benefit eligibility. IBM won the suit, and was awarded

more than $52 million. "Neither party deserves to win this case," wrote Marion Supe-

rior Court Judge David Dreyer in his judgment in favor of IBM.

"This story represents a 'perfect storm' of misguided government

policy and overzealous corporate ambition. Overall, both parties

are to blame and Indiana's taxpayers are left as apparent losers ... ,

There is nothing in this case, or the Court's power, ... [to] remedy the lost taxpayer money or personal suffering of needy

Hoosiers."

AUTOMATING ELIGIBILITY IN TH.E HEARTLAND I 73

In its suit against IBM, the state charged that the company had misrepresented its ability to modernize complicated social

service programs and failed to meet the performance standards

contained in the contract. Automated counties lagged behind

"as-is" counties in almost every area of performance: timeliness,

backlogs, data integrity, determination errors, and number of ap- peals requested.

The state even accused IBM of jury-rigging its processes to

make its performance look better. "A major cause of the dramatic

rise in appeals in the Modernized counties," the private attorneys

hired to represent the state argued, "was that the IBM Coalition

workers were so far behind in processing applications that they

would often recommend denial of an application to make their

timeliness numbers look better, but then would tell the applicant to

appeal the decision. While the appeal was pending, the Coalition

workers would actually process the application and benefits would

be granted before the hearing date." According to the suit, "for

the three-year period, IBM was achieving higher-than-projected

profit margins at the same time that its modernized system was floundering."

IBM argued on the contrary: the state had consistently praised

their efforts. In May 2008, Secretary Roob reported to the Gen-

eral Assembly that, "We are serving more people statewide and in

a timelier manner than we ever have before." 7 In December 2008

Governor Daniels stated that the new system "was far better rhan

what preceded it." IBM admitted that there were problems with

managing overload in the new system. But the company claimed

the problems that arose were due to factors beyond its control.

The Great Recession, the new Healthy Indiana P~ogram, and the

2008 floods had pushed application levels beyond what either party had imagined.

Judge Dreyer saw incompetence and negligence on both sides. He noted that the state invited IBM to keep working on the

74 I AUTOMATING lNE~ALITY

project even as they rolled our the hybrid system, which was

based on IBM's tools, software, and skills, But since the Senate

had stripped the FSSA budget "bare" in early 2009, there was no

money to pay for change orders or modifications to the con-

tract, Secretary Murphy wrote in an email to her colleagues that

IBM would "not commit ro moving forward at no cost, , , ,

[T]hey want more money! We don't have money now and we

won't have money for the remainder of [State Fiscal Year] '10,

What a mess," 8 When IBM refused to do more work without more

pay, the stare simply cut out the middle man, terminating their

contract while keeping their equipment, processes, and subcon-

tractors in place.

The state and IBM both blamed forces out of their control for

the plan's collapse. But in reality the coalition delivered exactly

what Indiana officials had asked for: smaller welfare rolls, what-

ever the cost.

In the lawsuit, both the state and IBM avoided talking much

about the impact of the failed automation experiment on rhe

people oflndiana, The state knew from the beginning that what

it was doing posed enormous risks for public assistance recipients

and their families, The state identified "several areas of potentially

significant risk" with the automated system, but "concluded that

'the status quo is not acceptable"' and moved forward with the

plan anyway,9

The goals of the project were consistent throughout the auto-

mation experiment: maximize efficiency and eliminate fraud by

shifting to a task-based system and severing caseworker-co-client

bonds, They were clearly reflected in contract metrics: response

time in the call centers was a key performance indicator; determi-

nation accuracy was not, Efficiency and savings were built into

the contract; transparency and due process were not,

Judge Dreyer found that the problem with the automation ex-

AUTOMATING ELIGrnILITY m THE HEARTLAND I 75

periment was not contractor negligence, 'There was no material

breach of the Indiana/IBM contract, "The heart of the contract

remained intact throughout the project," he concluded in his find-

ings, "although sometimes beating irregularly," The state achieved

its goal of containing the cost of social service programs, The con-

tractor, accountable only to its employer and its shareholders, had

no obligation to measure the automation experiment's impact

on poor and working-class Hoosiers, The problem with the auto-

mation experiment was not that the IBM/ ACS coalition failed to

deliver, it was that the state and its private partners refused to an- ticipate or address the system1s human costs.

Afi:er an expensive series of appeals of Judge Dreyer's decision,

in March 2016 the Indiana Supreme Court ruled that IBM did

in fact materially breach its contract with the state, But the legal

case only seeks to apportion blame and levy penalties, Indiana v,

IBM, as Judge Dreyer pointed out, was about material breach of contract, not the public trust or public injury, The teal cost of

the privatization experiment-the loss of life-saving benefits for

struggling families, the cost of the contract and legal disputes to

taxpayers, and the weakening of the public service system and

democratic process-has yet to be calculated, It is perhaps incal- culable,

"There's a cost to people," said Jamie Andree oflndiana Legal Services, "The cost of just waiting around without Medicaid ben-

efits is enormous; it's really hard to make somebody whole, Most

people will stop getting medical care while eligibility is being de-

termined, There's no way to compensate them for that,"

The state now uses the hybrid eligibility system, which combines

face-to-face interactions with public employees with the electronic

data processing and privatized administration of the automated

system, Its design allows applicants to contact a team of regional

caseworkers assigned to their case by phone, by internet, by mail,

76 \ AUTOMATING lNE~ALITY

or in person, providing increased contact with state workers. But

the hybrid system still relies on privatized, automated processes

for many core functions and retains the task-based case manage-

ment that caused so many problems during the modernization.

In the hybrid system, re-staffed local offices function as problem

resolution centers, while regional and statewide "change

centers"-run by Xerox, which bought ACS in 2009 for $6.4

billion-review applications, collect and digitize documents,

schedule appointments, screen applications for fraud, process fair

hearing requests, provide a first point of contact for clients, and

perform most updates to cases.

The move to the hybrid system in 2009 certainly quieted the

automated system's most vocal detractors. But it is unclear if it

works better to secure benefits for those who deserve them. "They

got marginally better when they ditched IBM and did the hybrid

thing," said Chris Holly in December 2014. "They got better for

people like me. People who help poor people have access to the local office directly to solve problems. So they took care of us. I

don't think they took care of the normal person. I won't say they

bought us off, but they responded to us. We were the ones that

were complaining the loudest."

Representative Gail Riecken of Evansville agreed with Holly

in an op-ed she wrote in the Fort Wayne journal Gazette in May 2010. "[FSSA Secretary Anne] Murphy reported that fewer

people are filing appeals for mistakes and wrong decisions [under

the hybrid system]. But it is not clear why the appeals have de-

creased. Is it because the system is better, or have people simply

given up fighting the system?" 10

For some caseworkers, the hybrid system is just the automated

system with a different name. "I don't see any change," said Jane

Porter Gresham. "We're still working mandatory overtime. We

still have the same number of people clamoring to be heard in

face-to-face interviews. The workload has not diminished ... ,

AUTOMATING ELIGIBIUTY JN TH.E HEARTLAND j 77

The people that were the most vocal had their needs mer." When

I asked her why we weren't hearing more about the problems of

the hybnd system, she replied, "Experienced workers who knew

how it was supposed to be aren't there any more." Glenn Cardwell retired FSSA worker and advocate agreed "veah" h 'd "w, ' '

, • 1. 1 , e sa1 , we re not satisfied [with the hybrid system], but that's partly a matter of

energy. We won a big battle, but we weren't ever sure we won the war."

, . '"I~~y set that system up to just slide stuff under the rug and

mde 1t, argu~d Kevin Stipes, Sophie's dad. "People [on public as- sistance] don t have a voice That's one of th

· e reasons we went down [to the state house]." Kim chimed in, "To put a face on it!"

Kevm nodded at his wife. "We didn't mind standing up," he said.

But there were a lot of people who didn't know what to do, or felt too vulnerable to rally to their own defense "Myw·c · · . . . He 1s persistent, mtelligent-1 mean, it should have been a breeze for her to get the

paperwork turned in correctly. I just can't imagine people with lesser skills ... I know they couldn't, they didn't do it."

"The system doesn't seem to be set up to help people. It seems to be set up to play t h " 'd Ch · H 11 " . . go c a, sa1 ns o y. In our legal system 1t 1s better that ten guilty men go free than one innocent man go

to Jail. The modernization flipped that on its head." Automated eligibility was based on the assumption that it is better for ten eli- gible applicants to be denied public benefits than for one ineligi-

ble person to receive them. "They had an opportunity to make a

syste_m that was responsive and effective, and ensure people who

qualified for benefits received those benefits," Holly said. "My

gut feelmg 1s that they did not respect the people who needed their help."

In_the fall of 2008'. Omega Young of Evansville missed an ap-

pomtment to recemfy for Medicaid because she was in the hospi- tal suffenng from terminal cancer. The cancer that began in her

78 j AUTOMATING INE~A.UTY

ovaries had spread to her kidneys, breast, and liver. Her chemo·

therapy lefi: her weak and emaciated. Young, a round-faced,

umber-skinned mother of two grown sons, struggled to meet the

new system's requirements. She called the Vanderburgh County

Help Center to let them know that she was hospitalized. Her

medical benefits and food stamps were still cut off for failure to

cooperate. "The SO-year-old Young, who lived alone in a tiny apartment,

was frantic," reported Will Higgins in the Indianapolis Star. 11

She

called Cecilia Brennan, a staffer with Evansville-based South-

western Indiana Regional Council on Aging who had been help- '"Wh I . d >"' H ingwith her case, crying, asking, at am gomgto o. er

sister, Christal Bell, refrained from telling the press that rhe

Medicaid denial hastened Young's death, bur she did blame the

automated system for making her last days full of extra worry and

trouble. Her brother-in-law, Tom Willis, rnld Higgins that he

routinely hid Young's medical bills from her so she would nor ob-

sess about the $10,000 she owed. Because she lost her benefits, Young was unable to afford her

medications. She lost her food stamps. She struggled to pay her rent.

She lost access co free transportation to medical appointments.

Omega Young died March 1, 2009. The next day, on March 2, she

won her FSSA appeal for wrongful termination and her benefits

were restored. The public welfare system has never been simple, particularly

for Black women. The most restrictive eligibility rules were his-

torically aimed at them. "Suitable home" and "employable mother"

rules were selectively interpreted to block African American

women from claiming their benefits until the rise of rhe welfare

rights movement in the 1970s. "Man in house" and "substitute

father" rules legitimized intrusion into their privacy, judgment of

their sexuality, and invasions of their homes. Ronald Reagan's

1976 stump speech about the lavish lifestyle of "welfare queen"

AUTOMATING ELIGIBILITY IN THE HEARTLAND I 79

Linda was intended to make the face of welfare both Black

and female. "There's a woman in Chicago," he said during the

New Hampshire Republican presidential primary contest. "She

has 80 names, 30 addresses, 12 Social Security cards and is col-

lecting veterans' benefits on four non-existing deceased hus-

bands. She's got Medicaid, getting food stamps and she is

collecting welfare under each of her names. Her tax-free cash in-

come alone is over $150,000." 12 Ms. Taylor was eventually charged

with using 4 aliases, not 80, and collecting $8,000, not $150,000, but Reagan's overblown claims found fertile ground, and the im-

age of the welfare queen has remained central to our country's understanding of public assistance.

Even today, audit studies find rhat nonwhite applicants in

welfare offices face more unprofessional behavior from casework-

ers than whites: withholding crucial information, refusing to pro-

vide applications, and other forms of outright rudeness. 1' States

with higher African American populations have tougher rules,

more stringent work requirements, and higher sanction rates.14

Casework is a complex, human endeavor that relies on relation-

ships, requires a difficult mix of canniness and compassion, and is

vulnerable to all the biases about race, class, and gender that are

woven through our society. Concerns about discretionary excesses

are valid. Caseworkers do turn down individuals based on bigotry or unconscious bias.

The majority of public assistance recipients in Indiana are

white, but race still played a major role in the automation experi-

ment. Governor Mitch Daniels played on rural-urban tensions

and white racial anxiety when he persistently framed problems in

terms of dependency, cheating, criminality, and collusion despite

evidence that only a small proportion of those eligible for public

assistance benefits actually claimed them and that fraud was not a

particularly severe problem at FSSA. The fraud case he held up as

mdicative of the worst problems in the system-the Greater Faith

80 \ AUTOMATING INE~ALITY

Missionary Baptist scam-involved Black defendants, It's hard

not to suspect that Daniels, like his anti-AFDC mentor Ronald

Reagan, cagily stoked Hoosiers' stereotypes about race, class,

and public assistance to drum up support for the move to an au-

tomated, privatized welfare system, The Indiana counties with the smallest African American

populations were transitioned to the automated system first, and

the experiment was halted before it reached Indianapolis and

Gary, the two cities a large share of Black Hoosiers call home, But

despite being rested primarily on poor whites, the automation

experiment had profound impacts on African Americans, Ac-

cording to census data, in 2000, African Americans made up

465 percent of the state's TANF rolls, and whites held a very slim

majority in the program, at 47,2 percent, At the end of the auto-

mation experiment in 2010, the gap between white and African

American TANF and food stamp/SNAP recipients had widened

precipitously, Despite the fact that the African American popula-

tion of Indiana had grown over the decade, the TANF rolls were

now 54,2 percent white and only 32,l percent African American,

Though eligibility modernization was tested on primarily white

communities, Black families still felt its worst effects, Removing human discretion from public assistance eligibility

may seem like a compelling solution to the continuing discrimi-

nation African Americans face in the welfare system, After all, a

computer applies the rules to each case consistently and without

prejudice, But historically, the removal of human discretion and

the creation of inflexible rules in public services only compound

racially disparate harms, For example, in the 1980s and 1990s Congress and many

state legislatures enacted a series of "Tough on Crime" laws that

established mandatory minimum sentences for many categories

of crime and removed a great deal of discretion from judges, Iron-

ically, the changes were a result of organizing both by conserva-

AUTOMATING ELIGIBILITY IN TH.E HEARTLAND j 81

tive law-and-order types and by some progressive civil rights

acnv1sts who saw the bias in judicial discretion as creating racially

disparate outcomes in sentencing.

The evidence of the past 30 years is clear: racial disparity in

the criminal justice system is a great deal worse, As the Leader-

ship Conference on Civil and Human Rights wrote in a 2000 re-

port called "Justice on Trial," "Minorities fare much worse under

mandatory sentencing laws and guidelines than they did under a

system favoring judicial discretion, By depriving judges of the ul-

timate authority to impose just sentences, mandatory sentencing

laws and guidelines put sentencing on auto-pilot,"15

Automated decision-making can change government for the

better, and tracking program data may, in fact, help identify pat-

terns of biased decision-making. But justice sometimes requires

an ability to bend the rules, By removing human discretion from

frondine social servants and moving it instead to engineers and

private contractors, the Indiana experiment supercharged dis-

crimination.

The "social specs" for the automation were based on time-

worn, race- and class-motivated assumptions about welfare recipi-

ents that were encoded into performance metrics and programmed

into business processes: they are lazy and must be "prodded" into

contributing to their own support, they are sneaky and prone to

fraudulent claims, and their burdensome use of public resources

must be repeatedly discouraged, Each of these assumptions relies

on, and is bolstered by, race- and class-based stereotypes, Poor

Black women like Omega Young paid the price,

New high-tech tools allow for more precise measuring and track-

ing, better sharing of information, and increased visibility of tar-

geted populations, In a system dedicated to supporting poor and

working-class people's self-determination, such diligence would

guarantee that they attain all the benefits they are entitled to by

82 \ AUTOMATING INE~ALlTY

law. In that context, integrated data and modernized administra-

tion would not necessarily result in bad outcomes for poor com-

munities. But automated decision-making in our current welfare

system acts a lot like older, atavistic forms of punishment and con-

tainment. It filters and diverts. It is a gatekeeper, not a facilitator.

The Indiana automated eligibility system enhanced the state's

already well-developed diversion apparatus, turbo-charging what

must be seen as a remarkably efficient machine for denying appli-

cations. By narrowing the gate for public benefits and raising the

penalties for noncompliance, it achieved stunning welfare roll re- ductions. Even under the hybrid system and during the greatest

economic downturn since the Great Depression, drops in the

state's TANF caseload continued to outpace national averages.

As poverty in Indiana increased, caseloads dropped. When the

governor signed the contract with IBM in 2006, 38 percent of

poor families with children were receiving cash benefits from

TANF. By 2014, the number had dropped to 8 percent.

Struggling people like Omega Young, Lindsay Kidwell, and

Shelli Birden were the first victims of the automation, and they

bore the system's most terrifying impacts. Though the Stipes

family managed against incredible odds to reestablish their

daughter's Medicaid, the experience took a dreadful toll. "During

that time, my mind was muddled because it was so stressful,"

said Kim Stipes. ''All my focus was getting Sophie back on that

Medicaid. Then crying afterwards because everybody was calling

us white trash, moochers. It was like being sucked into this vac-

uum of nothingness."

In the seven years between the Stipes' battle with the automa- tion experiment and my visit, Sophie's life improved: She gained

weight, learned sign language, went to school and made friends,

But eight days after I interviewed the family in their Tipton

home, Dan Skinner sent me an email. "Sad news," it read. "Kim

Stipes called and told me that little Sophie died. She had been

AUTOMATING ELIGIBILITY IN THE HEARTLAND I 83

sic~ and throwing up on Friday and when rhey found her dead

;:i ;u;ay she was curled up in a fetal position looking peace- . e octor said her heart simply stopped."

. _In the end, the Indiana automation experiment was a form of d1g1tal d1vers1on for poor and working A . I d . b rnencans. t en1ed them

enefirs, due process, dignity, and life itself "W, . . . fi . we were not invest- mg m our ellow human beings the way we should be," said John Cardwell of The Generations Proiect "We were b . ll .

I , · as1ca y saying to a arge percentage of people in Indiana •v ' h h 'Wh ' wu te nonvon a

s it. at a horrible waste of humanity."