Thirty years later, President Lyndon B. Johnson built upon that structure by leading the fight to establish Medicare. For the first time in our nation’s history, seniors no longer had to worry about whether they could afford the health care they needed to stay alive.
A lot has changed since 1935, but Social Security and Medicare remain popular and effective.
That is because they are universal. They don’t depend on income caps or eligibility verification; every American can start receiving these benefits in their 60s. And while some at the very top of our society need not rely on these programs, the majority of older Americans can and do.
This year, we have a once-in-a-generation opportunity to build again on the cornerstone Roosevelt laid decades ago by passing President Biden’s Build Back Better Act. This legislation provides historic investments in child care and higher education, and an expansion of Medicare to include dental, vision and hearing coverage.
But for Biden’s agenda to meet its potential, we must heed the lessons of the past. That means making our investments universal.
We can’t, as some have insisted, weaken the proposals by “means testing” them: restricting benefits only to those who meet arbitrary income requirements and who have the ability to prove they do.
Proponents of means testing propose it under the guise of “fiscal responsibility” — saving the government money by providing benefits only to individuals who actually need them.
The reality is not that simple. Means-tested programs cost more to administer, because complex systems, processes and entire offices must be created to determine who qualifies. A 2011 study by the Center for Economic and Policy Research found that administrative costs “would add substantially to the operating cost of the program” and “eliminate most, if not all, of the savings from a plausible means test.” Instead of wasting money on bloated bureaucracy, universal programs allow us to maximize our investment in the American people.
In theory, means testing excludes the undeserving rich; in practice, it often excludes the most vulnerable poor, who aren’t always able to jump through the required hoops to prove their eligibility. As a result, the people most in need — disproportionately low-income Americans and people of color — can’t access the programs at all, either because they can’t complete the application process or they’re too intimidated to try.
The federal government has never been particularly accurate at measuring need anyway. To this day, we still base some forms of assistance on the “poverty line,” a measurement whose criteria have not been updated since 1963. The poverty line also fails to account for regional variation in cost of living. The needs of people in our home states of California and New York, where cost of living is high, are defined by the same standard as those in cheaper states. When we draw arbitrary lines based on imperfect measurements, it’s no wonder we draw the line too low.
Universal programs are good policy and good politics. They build solidarity that helps them stand the test of time — when we all have a stake in the success of a public program, it can withstand changing political winds. Medicare and Social Security are so untouchable that Donald Trump ran on protecting them. Means-tested programs such as SNAP and TANF, in contrast, have been cut by Democrats and Republicans alike in the past decade.
We need to show that government can still work for all Americans. We do that by creating programs that are broadly accessible, understandable and beneficial. That’s why the child-care program that we fought to include in the Build Back Better Act in the House doesn’t include means testing, and why we’re fighting to keep means testing out of any part of the final bill that’s signed into law.
Fundamentally, means testing is a choice to deprive millions of our neighbors of what they need simply to cope with a budget artificially limited by regressive tax policy. The truth is, there is enough to go around when we make the wealthiest Americans and big corporations pay their fair shares.
The Build Back Better Act is an investment in our nation, our economy and our most precious asset: our people. In the wealthiest nation on Earth, there is no justification for means testing that investment.