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Yahoo
22-05-2025
- Business
- Yahoo
House Republicans Are About to Touch the Third Rail
Among the more striking changes in American politics over the past half-century is the evolution of Medicaid into a 'third rail.' House Republicans, as they rush to cut not quite $1 trillion from Medicaid over the next 10 years, are at best only dimly aware of this. They're in for a terrible shock. Medicaid's progress, from a stepchild program in 1965 that provided limited health care for the indigent, into today's much more ambitious and capacious program serving significantly more lower-income Americans, happened gradually. Medicaid once served a small and politically powerless constituency that conservatives could threaten to defund without much fear of reprisal. But today, Medicaid commands not merely a significant voting bloc, but a significant Republican voting bloc. Not many House Republicans wish to hear about that. Until now, the 'third rail' cliché (the metaphor being an electrified steel subway rail that kills any who touch it) was reserved exclusively for Social Security and Medicare. These two, very expensive programs serve people age 65 and over, a cohort that's long been the most powerful constituency in American politics thanks to elevated voter turnout (and is more numerous now as the Baby Boom ages). Exempting these two programs from budget cuts is not always good policy (Social Security benefits should be taxed more aggressively at high incomes), but since 1982, when Tip O'Neill aide Kirk O'Donnell first coined the third-rail metaphor, it's been smart politics. Social Security and Medicare encompass 36 percent of all federal spending. Add in interest on the national debt that absolutely must be paid, and 47 percent of all federal spending is un-cuttable. If the discussion is among Republicans (and it usually is), then defense spending, being sacrosanct, must also be exempted, taking 60 percent of all federal spending off the table. You can see why Republicans are reluctant to grant Medicaid third-rail status. It constitutes 10 percent of all federal spending; protect Medicaid and now you're excluding from spending cuts 70 percent of the total (actually a little more, because Republicans won't likely cut military pensions or veterans benefits either). Even with just 60 percent of spending off limits, Republicans aren't going to find anywhere near enough in cuts to pay for $4.6 trillion in tax cuts over the next ten years. This week's Freedom Caucus rebellion was about adding a teensy bit less than $5.1 trillion to the current $1.9 trillion deficit by whacking Medicaid a little more. To characterize these rebels as fiscal conservatives is, as I've noted, preposterous. The main vehicle for the House GOP's Medicaid cuts is to require Medicaid recipients to get a job. That's pretty ironic, because the program, as it was first implemented in 1966, required Medicaid recipients to be unemployed. Enrollment was almost entirely limited to people receiving Aid to Families With Dependent Children, the pre-1986 cash welfare program for jobless mothers. The federal program's cost-sharing with the states further limited enrollment because many states didn't want to pay up. As late as the mid-1970s, Medicaid still excluded about 40 percent of the nation's poor, and enrollees struggled to find a doctor willing to accept Medicaid patients. That was fine by conservatives, who, according to Laura Katz Olson, a political scientist at Lehigh University, writing in her 2010 book The Politics of Medicaid, 'were assuming that the program's scope would be kept in check by its clients' lowly status.' That calculus was wrong from the beginning, because unlike cash welfare, Medicaid distributed funds directly to nursing homes, hospitals, and physicians, all constituencies with political clout. From the start Medicaid also provided nursing home care to middle-class elderly people who spent down their savings to qualify for subsidies. States warmed to the program as they figured out clever accounting tricks to shift more program costs to the federal government, Liberal members of Congress—most notably Rep. Henry Waxman, a California Democrat—quietly extended Medicaid eligibility year after year. Waxman was aided, the Rutgers political scientist Frank J. Thompson writes in his 2012 book Medicaid Politics, by 'keen negotiating skills and an understanding of how to take advantage of budgetary rules,' which through the 1980s did not oblige Waxman to show how much these expansions would cost. Colleen Grogan, a University of Chicago political scientist, calls this strategy 'Grow and Hide.' Much of the growth, however, was right out in the open. In 1997 a Children's Health Insurance Program—created as a sort of consolation prize after Hillarycare went down in flames—was appended to Medicaid. Passage of the Affordable Care Act in 2010 included a provision further expanding Medicaid eligibility, with the federal government picking up 90 percent of the cost. Despite initial partisan resistance by red states, today only 10 states continue to refuse the money. The price these 10 states pay for their principled resistance is more deaths among lower-income people. A recent paper by economists Angela Wyse of Dartmouth and Bruce D. Meyer of the University of Chicago (and reported by NPR) found that those states that chose to expand Medicaid saved 27,400 lives. A program that had only four million enrollees in 1966, and 22 million in 1980, today has 71.3 million enrollees—78.5 million if you include CHIP. That's more than Medicare, which has 68.5 million enrollees. Let me say that again. More people are on Medicaid than on Medicare. And yes, most of these Medicaid enrollees—64 percent—have jobs. (The rest mostly attend school, take care of a family member, or are disabled.) In a March poll by the Kaiser Family Foundation, a 53 percent majority reported that either they or a family member had received Medicaid coverage; when close friends were added in, that rose to 65 percent. Seventy-seven percent reported a favorable opinion of Medicaid, including 64 percent of Republicans. Among Republicans, only 33 percent favored a federal decrease in Medicaid spending, against 67 percent who wanted the spending level to rise or stay the same. 'Medicaid, you gotta be careful,' Steve Bannon warned in February. 'Because a lot of MAGAs are on Medicaid, I'm telling you.' Nobody listened. Now Republicans are slashing away at at a program on which their political base has come to rely. If the bill clears the Senate in anything like its present form, these cuts will be extremely bad for America. But they will also be bad for those Republicans who signed their name to them.
Yahoo
04-05-2025
- Politics
- Yahoo
We need a return to civility and respect in politics. Here's how we get there
Whether you're a child of the '80s or not, you've likely seen the images: Republican President Ronald Reagan smiling with his arm around Democratic Speaker of the House Tip O'Neill. They disagreed often — even vehemently. But there was respect at the heart of their relationship. The way our elected leaders talk to one another in public has changed dramatically: bitter partisanship, public name-calling, villainization of political opponents. The practice of building and maintaining relationships, regardless of political beliefs, has deteriorated. Civil discourse is no longer a priority, and we are worse for it. As citizens, we follow the example of our elected officials. We shout. We cancel. We unfriend. We've been taught not to talk about religion or politics, so we have zero practice discussing difficult topics with genuine respect and curiosity. The result is a deeply fractured culture that mistrusts people with different points of view. We can't agree on how to advance or even operate the very institutions we rely on to keep us safe, healthy and prosperous. Forty-five years ago, a group of young Texans from business, professional and academic circles came together to convene the various segments of the state in a nonpartisan, nonpolitical and non-adversarial setting to address the problems confronting Texas. The result: The Texas Lyceum. Today, the Lyceum endures and brings together Texans across political ideology, identity, geography and sector. Earlier this year the Lyceum launched a Campaign for Civility calling on elected officials at the local, state and federal levels to adopt core values that have stood the test of time; principles that are the cornerstone of our democracy: • To engage in civil discourse on critical public policy issues facing our communities. • To seek to understand before being understood. • And to exercise the ability to disagree without being disagreeable. The annual Texas Lyceum Poll, which was released this past week, shows that Texans are ready for this campaign: • 69% of survey respondents believe it is possible for people to disagree about politics respectfully and that nasty exchanges are avoidable. • Elected officials were cited by the poll respondents as the entity most responsible for causing divisions among Americans (42%). More so than social media (28%), cable news channels (13%) and other countries (4%). This Campaign for Civility is a call to all Texans — and especially elected leaders — to model the art of listening, understanding and engaging to find solutions. Here are some tactics to consider: • Befriend people across the political spectrum and engage with them on the issues you care about. • Remind yourself of our shared values. It's easy to perceive the other side as the enemy, when in reality, most Republicans and Democrats strongly agree on the importance of most values. • Be willing to acknowledge points of agreement. When engaging with people you disagree with, acknowledge where there's overlap. • Diversify your media diet with media sources from the right and the left, plus both local and national outlets. Your political opponent is not your enemy. There must always be room for diverse perspectives. But how we argue matters as much as what we argue. Relationships must always transcend political lines, and that happens when we care more about the person than their politics. We have an opportunity to rededicate ourselves to the traditions of civility, respect and the enduring quest to give the best version of ourselves back to our great state and move our country forward. Crayton Webb is president of The Texas Lyceum and CEO of Sunwest Communications in Dallas. Danielle Rugoff is a director of The Texas Lyceum, vice president of its Campaign for Civility and founder and CEO of Purple Lexicon. This article originally appeared on Austin American-Statesman: We need a return to civility. Here's how we get there | Opinion
Axios
13-03-2025
- Business
- Axios
Who loses if Social Security breaks
DOGE is taking its wrecking ball to the Social Security Administration, the agency responsible for overseeing retirement and disability benefits for 73 million Americans. Why it matters: The cuts underway could wind up breaking critical parts of a system that millions of the nation's most vulnerable citizens rely on, including nearly 90% of Americans over age 65. The big picture: Monkeying with Social Security was always viewed as a " third rail" in politics, even before an aide to House Speaker Tip O'Neill coined the phrase in the early 1980s. Many presidents have tried to reform the system in ambitious ways, but the costs were always too great, perhaps until now. State of play: The agency announced last month it seeks to cut about 7,000 employees, or 12% of staff, through voluntary resignations and a reduction-in-force plan due Thursday. Employees have been fleeing, resulting in "a significant loss of expertise," former staffer Tiffany Flick said in an affidavit filed late last week. The agency also announced plans to shutter six of 10 regional offices. Also closed? The office inside the agency that had been tasked with moving some of these processes online, the Office of Transformation. "That office was doing what DOGE purports to do," said Kathleen Romig, director of Social Security and disability policy at the Center on Budget and Policy Priorities, who worked at the agency for years under different administrations, most recently in the Biden administration. DOGE has also gained access to crucial systems, packed with private data that Flick and others said the group doesn't have the expertise to handle. Some systems rely on very old programming languages, Flick said in her affidavit, and are vulnerable to being broken by inadvertent user error. Between the lines: Most federal agencies operate largely outside of view of everyday Americans. The Social Security Administration is different. Its staff primarily handle customer service, connecting with the public at vulnerable life moments, such as the decision to retire, or when you can't work because of illness or injury, or when your spouse or parent has died. Context: There's no doubt there are ways the agency could be made more productive and efficient, according to Andrew Biggs, a senior fellow at the American Enterprise Institute, who has long pushed to overhaul the system, dating back to his time working in the Bush administration. "I just find it hard to accept that you can go in there having been there just a few weeks, and do these far reaching changes, having fully thought out the consequences of them," he said. That doesn't mean benefits will be disrupted, he said. Those checks are handled by automation. Claims to the contrary are likely overblown. That said, disruptions to customer service are possible. "It's kind of a foot race between whether they can improve service before these cuts are impacting service," Biggs said. The White House has said it wants to root out "waste, fraud and abuse" in Social Security. Other than that, Social Security won't be touched, the administration reiterated in a press release Tuesday. "Any American receiving Social Security benefits will continue to receive them. The sole mission of DOGE is to identify waste, fraud, and abuse only," White House press secretary Karoline Leavitt said in a statement to Axios. Elon Musk and President Trump have made repeated debunked claims that droves of dead people are getting checks. Musk has described the program as a Ponzi scheme lousy with fraud, and has repeated a conspiracy theory that undocumented immigrants receive payments. In fact, they pay Social Security taxes — more than $25 billion in 2022, according to one estimate — but do not collect benefits. The intrigue: The Social Security administration was already struggling to provide customer service to Americans before these recent cuts. The worry now is the changes will worsen the situation, though the administration said its intent is the opposite. By the numbers: Amid staffing shortages, it's taking the agency longer to make decisions on disability benefit applications. This year, folks are waiting an average of 240 days to hear back, up from 120 days before the pandemic, according to agency data analyzed by the Urban Institute. What they're saying:"You pay into the system, you become disabled and it's time to get your benefit, but you have to wait eight months at best or possibly years," said former official Romig. "What good is it? Do you lose your house in the meantime? What good is a benefit you can't access. That's a major problem." The bottom line: Moving fast and breaking things isn't a huge deal when the thing is a social media site. Social Security is a whole other story.
Yahoo
09-02-2025
- Politics
- Yahoo
Ken de la Bastide column: Lawmakers should leave municipal elections alone
As stated by former Speaker of the U.S. House Tip O'Neill many years ago, 'All politics is local.' In many respects, no truer words were ever uttered. There is legislation pending in the Indiana Senate authored by Mike Gaskill of Pendleton that would move municipal elections starting in 2027 to even-numbered years. What that would mean is that candidates to serve as mayor, council members, judges and clerks in Anderson, Elwood and Alexandria could be running during the same election cycle as president and statewide offices. Gaskill contends moving the election would save taxpayer dollars and increase voter turnout in municipal elections. The problem with the concept is that issues of local concern in the state's municipalities would be overshadowed by federal and state issues. The fact is, Indiana is considered a strong red state, with no Democrats winning state office in several election cycles, and in the history of the state few Democrats have carried the state in presidential election years. Could this be a backdoor attempt at assisting Republicans to win the mayor's chair in the few Indiana cities where Democrats currently are holding office? Since the 1970s the Republican Party has seen its candidates for Anderson mayor win a total of four terms. Democrat Mark Lawler served four terms, Kris Ockomon was elected once, and current mayor Thomas Broderick Jr. is serving his third term. Would running the municipal election in the same cycle as federal and state offices help the GOP win in cites like Anderson, Elwood, Indianapolis and Gary? Gaskill's bill is not expected to become law anytime soon. The Indiana House has already indicated it won't consider the legislation this year. An interim study committee has been proposed in the House to look at the possible cost savings and turnout if the municipal election cycle was changed in the future. As with most interim study committees, nothing can be expected to take place. If Gaskill's bill is intended to increase voter turnout, why would Republicans in the Legislature consider reducing the number of days for early voting in the Hoosier State? Reducing the number of early voting days could result in longer lines as people wait to cast ballots. If lawmakers really want to increase voter turnout in Indiana, the number of early voting days should be extended, not reduced. With supermajorities in both legislative chambers, GOP lawmakers can make or change the rules if they so desire. Conducting municipal elections in the present form has been taking place for decades. If the system isn't broken, there is no fix required.
