In a new polling memo, the Center for American Progress Action Fund argues that this is a fight Democrats should want to have. The memo points out that social programs poll extremely well and that we’ve seen recently how much GOP attacks on those programs motivate voters. Health care was a central issue propelling Democrat Ralph Northam to victory in the Virginia governor’s race in November, and the Republicans’ attempt to repeal the Affordable Care Act produced a huge backlash in large part because of the millions of Americans they wanted to toss off Medicaid.
But Republicans remain committed to making deep cuts to these programs. Medicare, Medicaid, food stamps — it’s all in their crosshairs. And since those programs are quite popular, they’ve settled on a two-prong strategy to chop away at them while hopefully minimizing the backlash. The first prong is to cut the programs both directly and indirectly, not by just reducing their budget but also by introducing new requirements and bureaucratic hurdles meant to reduce the rolls. The second and related prong is to change the terms we use to talk about these programs to make their efforts to undercut them more palatable.
And so, the “starve the beast” strategy Republicans have used since Ronald Reagan’s time is being renewed yet again. It goes like this: First, you pass a huge tax cut (going mostly to the wealthy and corporations). Then, when that causes the deficit to increase, you use that increase to argue that we have no choice but to institute savage cuts to social programs.
Thus it is that House Speaker Paul D. Ryan (R-Wis.) insists to whoever asks that, despite the huge deficit-busting tax cuts Republicans just passed, he’s still a deficit hawk.
“Social Security is a part of a solvency problem … but nothing like we do on the health-care entitlements,” Ryan told Fox Business. “That’s why we can never give up on health-care reform, because that is the key driver of our debt in the future.” The Trump administration agrees; the budget proposal the administration just released would cut Medicare by $554 billion and Medicaid by $250 billion over the next decade. It would also cut food stamps by $214 billion.
Meanwhile, there are things the administration is doing right now to restrict people’s access to health care. The administration has just opened the door to allowing states to impose work requirements on recipients. The idea is to drive people out of programs such as Medicaid by forcing them to overcome as many bureaucratic hurdles as possible, which both discourages eligible people from signing up in the first place, then provides a justification for yanking away their coverage. It can’t be said strongly enough: The difficulty of navigating these bureaucratic requirements, with all their forms and notifications and deadlines, is exactly the point. The administration has already approved Kentucky’s and Indiana’s requests to impose work requirements, and more Republican states are sure to apply.
This is generally presented to the public as a way of improving the lives of the program’s recipients by getting them to get jobs and become part of their communities. But the idea that getting health-care coverage through Medicaid somehow keeps people from seeking work is utterly ludicrous. First of all, according to the Kaiser Family Foundation, “nearly 8 in 10 [adults on Medicaid] live in working families, and a majority are working themselves.” And those that aren’t tend to have good reasons, like disability or caring for a loved one. Second, it just makes no sense. Nobody says, “I was going to get a job, but now that I’ve got this sweet health coverage, I don’t need to anymore!”
Meanwhile, a group of Republican states is asking the administration for permission to impose lifetime limits on Medicaid, which would inevitably leave millions of low-income people with no ability to get health-care coverage.
Republicans will sell these policies with various buzzwords. One is “reform.” Another is “welfare.”
You might ask, “What does welfare have to do with this?” Welfare, which is now called Temporary Assistance to Needy Families (TANF), is a shadow of its former self, with fewer recipients and stingier benefits than it provided before it was overhauled in the 1990s. Yet Republicans, knowing that “welfare” conjures negative stereotypes particularly among whites, have decided to use the word to refer to all social programs to stigmatize them and ease the way for drastic cuts.
Those cuts — whether to Medicaid, food stamps, unemployment benefits or any of a dozen other programs — will be called “welfare reform,” which no doubt polls well. It’s already having an effect on media coverage, as gullible reporters and editors repeat the phrase with no acknowledgment that its meaning has suddenly been transformed. For example, here’s a Politico article from a couple of weeks ago about Ryan discussing broad cutbacks in a variety of programs; even though TANF isn’t mentioned at all, the title reads “Ryan renews welfare reform push.”
So it’s increasingly looking like the battle over social programs will figure in the midterm elections. The Center for American Progress Action Fund memo argues that the message that Republicans are trying to take away people’s health care is particularly potent when it’s mentioned alongside the fact that they just gave a huge tax cut to the wealthy and corporations. We’ll see if that turns out to be true. But Democrats shouldn’t be shy about using the GOP assault on the safety net as a campaign issue in November.