That isn’t to say the budget is free of gimmickry or outlandish projections (we’ll get to that in a moment). But let’s look at some of the rather notable things it would do:
• Turn Medicare into a voucher program. This is accompanied by a lot of rhetoric about how the magic of the market will hold down costs (just as it has with private insurance — oh, wait) and free seniors from the tyranny of their government insurance plan. Let’s see how that will go over.
• Roll back the Affordable Care Act’s expansion of Medicaid and lay the groundwork for further cuts. All those millions of low-income Americans who got coverage through the expansion are suffering terribly, because “Medicaid’s promises are empty, its goals are unmet, and its dollars are wasted.” House Republicans would liberate them from this oppression by taking away their health insurance. The rest of the program would be block-granted so that states could have “flexibility,” which in practice means the flexibility to dump even more patients from their coverage.
• Repeal the rest of the ACA. The subsidies that have allowed millions of people to afford insurance? Gone. Protection against denials for preexisting conditions? Not anymore. If you were expecting this to be accompanied by a few comically vague words about “patient-centered reforms” with which the ACA would be replaced while 16 million people are wondering what to do about the coverage they lost, then you’ve been paying attention.
• Cut regulations on Wall Street. They’ve been having a real hard time over there, and they could use a helping hand.
• Cut environmental regulations. Let’s face it, if the environment is ever going to learn to take care of itself, it needs a little tough love.
• Cut Pell grants, which they describe as “targeting Pell Grants to students who need the most assistance.”
• Block-grant food stamps, or turn them into a “State Flexibility Fund.” There’s that word again.
Most of these ideas are presented without any actual dollar figures attached to them, but there is “a magic asterisk” in a table located in an appendix, as Max Ehrenfreund points out. This is more than a trillion dollars of savings they claim they’ll get from “Other Mandatory” spending. Ehrenfreund explains:
Other than health care and Social Security, mandatory spending includes a range of programs such as food stamps, disability payments for veterans, the earned income tax credit, and Pell grants for college students. The budget document did not specify which would be cut. Even presuming very large cuts to these programs, though, it was still unclear how lawmakers expected to come up with $1.1 trillion, said Bob Greenstein, president of the Center on Budget and Policy Priorities.By comparison, the Republican majority in the House voted in favor of reducing the budget for food stamps in 2013. The controversial measure passed only narrowly, with every Democrat and a few Republicans opposed. Many worried the cut was too severe, but it totaled $40 billion, just a sliver of the savings claimed in this week’s proposal.
At this stage, it isn’t so terrible for their proposals to lack specificity; this part of the budget process is meant to sketch a broad outline, while later legislation will set all the particulars. But let’s give the House Republicans credit. They aren’t shying away from talking about voucherizing Medicare (as their Senate colleagues did), and the rest of the document lays out a virtual war on the poor and middle class. They may toss the word “opportunity” in here and there, but the document is a bracing statement of Republican ideology.
Which is as it should be. Sure, the White House is going to criticize it, because the Democrats’ priorities are very different. Now we can have a debate. Should we turn Medicare into a voucher program? Should we toss millions of people off Medicaid and take away the subsidies that allow millions more to afford insurance? Should we cut food stamps and education grants? What are the alternatives? Those are the questions that debate should address, and then the two sides will have to arrive at a budget that incorporates the answers.