OPINION
DAVID
FIRESTONE
How to Use the Debt Ceiling to Inflict Cruelty on
the Poor
May 17,
2023
David
Firestone
By David
Firestone
https://www.nytimes.com/2023/05/17/opinion/debt-ceiling-republicans-poor.html?searchResultPosition=2
Mr.
Firestone is a member of the editorial board.
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Seen from
outside Washington, the debt ceiling battle might seem like an abstract
argument between the political parties over federal spending and deficits. But
for millions of low-income Americans who depend on the federal government for
health care and basic nutrition, the debate is about their very lives. That’s
because Republicans have singled them out, yet again, as a prime target in this
year’s extortion scheme.
The bill
that Speaker Kevin McCarthy muscled through the House last month would impose
tough new work requirements on Medicaid, food stamps (now known as the
Supplemental Nutrition Assistance Program, or SNAP) and welfare for needy
families. The demands would effectively cut off health care for 1.7 million
low-income people and cut off food stamps for 275,000 people. House Republicans
say that if their demands are not met, they will refuse to raise the debt
ceiling, plunging the country into an unprecedented default and almost
certainly creating a recession.
It’s not
that there is some crisis or scandal gripping those federal programs;
Republicans are making these demands simply because the debt ceiling gives them
the opportunity to do so. And they are going after the same group of people
their party has demonized for decades.
“I don’t
think hard-working Americans should be paying for all the social services for
people who could make a broader contribution and instead are couch potatoes,”
said Representative Matt Gaetz of Florida. (His deep concern about excessive
spending didn’t stop him from requesting a $141.5 million earmark for a
helicopter training hangar at Naval Air Station Whiting Field in his district.)
“Couch
potatoes” isn’t that far from the “welfare queen” myth conjured by Ronald
Reagan or Newt Gingrich’s 1994 claim that a system of orphanages was necessary
because low-income babies were being dropped off balconies or showing up in
dumpsters. None of these slurs had any significant basis in reality, and all
were intended to whip up fears among members of the white middle class that
they were being played for fools by people of color who were lazily living it
up on taxpayer dollars and ignoring their family responsibilities.
But these
largely racist attacks, very much including the one now on the table,
persistently ignore the little-mentioned fact that a vast majority of the
people receiving these benefits are already working or are unable to work. In
2021, 61 percent of the 25 million people on Medicaid were working in full- or
part-time jobs. The rest were retired or disabled or taking care of small
children or in school. Similarly, most food-stamp recipients work, and
able-bodied adults younger than 50 are required to work in order to get more
than three months of benefits in three years, unless they are taking care of
children.
The
existing work requirements don’t get discussed by the drill sergeants who want
to whip the vast army of couch potatoes into shape; they want more people to
work and to work longer hours. Mr. McCarthy’s bill would require adults 50 to
55 to work at least 20 hours a week to receive food stamps, no matter that
people in that age bracket often find high barriers to employment.
The bill
would also require many adults 19 to 55 to work 80 hours a month to receive
federally subsidized health coverage from Medicaid. (States could pick up the
cost of those who are cut off, but many would not.) As the Center on Budget and
Policy Priorities notes, this requirement would particularly hurt low-income
beneficiaries in states that expanded Medicaid under the Affordable Care Act
and seems designed as a backdoor way of undermining the expansion. Republicans
couldn’t repeal the act through the front door, so they are using the leverage
provided by the debt ceiling to try to achieve their ideological aim. It’s yet
another illustration of why the ceiling needs to be abolished.
It’s been
clear for years that these kinds of work requirements don’t actually put people
back to work; they just pry people away from the benefits they need. In 2018,
Arkansas became the first state to impose very similar work requirements on
Medicaid, before a federal judge ended the experiment the next year. A study in
The New England Journal of Medicine found that 13 percent of Medicaid
recipients there lost their health coverage — about 17,000 people — but that
there was no significant change in employment.
One of the
reasons for this phenomenon is that it’s very difficult for the subjects of
these cruel experiments to report their employment or their search for a job to
the state. Many people in Arkansas didn’t know about the work requirements or
didn’t understand the rules or lacked internet access, the study found. But
since the goal of Republicans is cutting spending, not putting people back to
work, the burdensome rules do save billions through human suffering. The
Congressional Budget Office estimated that the work requirements in the
McCarthy bill, which the speaker said on Tuesday were a “red line” for his
caucus, would save $120 billion over 10 years.
Once
President Biden made the unfortunate decision to negotiate on the debt ceiling
with the House hostage takers, the work requirements were on the table, and the
president has not been clear about his intentions. On Sunday he told reporters
that he had voted for work requirements currently in the law, apparently
referring to cash welfare, and was waiting to see what the Republican proposals
were. That was not exactly a comforting sign, particularly because the
proposals are quite clear, though he did suggest that Medicaid changes were off
the table. After progressives raised concerns, he issued a tweet on Monday condemning
the harsher requirements for food benefits.
But with
the default clock ticking and lives on the line, Mr. Biden needs to do more
than send out a tweet. The most important thing the White House could do right
now is say explicitly that using the debt ceiling as a cudgel to change federal
safety net policy is unacceptable and inappropriate and will not be the subject
of negotiation. Mr. McCarthy shouldn’t be the only one at the table with red
lines, particularly when the health of millions of people is at stake.
A
correction was made on May 17, 2023: An earlier version of this article
referred incorrectly to Representative Matt Gaetz of Florida. He is not a
member of the House Freedom Caucus.



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