Medicaid is popular. So why are Republicans still trying to cut it?

“There is a certain logic to Republicans’ commitment to pursuing Medicaid cuts: Social Security and Medicare are universal programs. Everyone pays in while they work, and then enjoys the benefits when they retire. Medicaid, on the other hand, is targeted to people who have low incomes. Republicans argue that this program, like food stamps and cash welfare, discourages people from seeking work, since they only qualify for benefits if their income is below a certain threshold.
“Assistance programs are supposed to be temporary, not permanent,” McCarthy said. “A hand up, not a handout. A bridge to independence, not a barrier.”

The problem is their diagnosis may be wrong. For starters, about two-thirds of the people covered by Medicaid — those who are children, elderly, or disabled — are usually exempted from work requirement proposals. Working-age adults who are expected to meet them can end up losing coverage even if they are attempting to satisfy it, if they have irregular work hours for example, or if they have trouble filing the necessary paperwork. One estimate of a Medicaid work requirement proposal in Michigan found that only about one-quarter of the people expected to lose their coverage were considered “out of work,” meaning they could work but weren’t. The rest were already working, retired, caring for a loved home at home, or unable to work for some other reason.

In Arkansas, where implementation of a work requirement was eventually blocked by a court order, nearly 17,000 people lost coverage after the requirement was put in place. Analyses later found that Medicaid beneficiaries had not started working more or earning more money as a result of the policy. Instead, lots of people got kicked off Medicaid, but it didn’t lead to an improvement in their economic status; they simply became uninsured.”

Bringing the Child Tax Credit Back to Life Is Too Costly

“At the end of 2021, not quite a year into Joe Biden’s presidency, something unusual happened: Congress actually allowed a massive government program to expire. That program was the expanded child tax credit, which had been enacted as a temporary program under the American Rescue Plan (ARP), a roughly $2 trillion spending package passed exclusively with Democratic votes in March 2021.
A year after the expansion expired, however, Democrats began looking for ways to bring it back. The cost of doing that would be very high.

The ARP raised the maximum child tax credit from $2,000 to $3,600 per child for families making up to $150,000 a year. The one-year program made the credit fully refundable, meaning that people would qualify for it even if they owed no income taxes. That change expanded the benefit to millions of households that previously had earned too little to qualify.

The ARP also turned what had been an annual lump sum around tax season into a monthly payment that in many cases was directly deposited into parents’ bank accounts. In effect, the law set up a program of monthly checks, sent directly to the bank accounts of most families.

Although the program was initially designed as a one-year expansion, supporters hoped it would become permanent. As The New York Times reported in January 2022, the benefit “was never intended to be temporary,” and “many progressives hoped that the payments, once started, would prove too popular to stop.”

Yet at the end of the program’s first year, after paying out about $80 billion, Congress declined to extend the program. Even with Democrats in control of both the House and the Senate, there simply weren’t enough votes to keep it going. Sen. Joe Manchin, the moderate Democratic senator from West Virginia, was vocally opposed, citing cost concerns and warning that the expanded eligibility would subsidize unemployment. Progressive ambitions were foiled”

Millions of people are about to get kicked off Medicaid

“Perhaps the greatest success of the American health care system these last few benighted years is this surprising fact: The uninsured rate has reached a historic low of about 8 percent.
That’s thanks in part to the pandemic — or, more precisely, the slew of emergency provisions that the government enacted in response to the Covid crisis.

One policy was likely the single largest factor. Over the past three years, under an emergency pandemic measure, states have stopped double-checking if people who are enrolled in Medicaid are still eligible for its coverage. If you were enrolled in Medicaid in March 2020, or if you became eligible at any point during the pandemic, you have remained eligible the entire time no matter what, even if your income later went up.

But in April, that will end — states will be re-checking every Medicaid enrollee’s eligibility, an enormous administrative undertaking that will put health insurance coverage for millions of Americans at risk.

The Biden administration estimates upward of 15 million people — one-sixth of the roughly 90 million Americans currently receiving Medicaid benefits — could lose coverage, a finding that independent analysts pretty much agree with. Those are coverage losses tantamount to a major economic downturn: By comparison, from 2007 to 2009, amid the worst economic downturn of most Americans’ lifetimes, an estimated 9 million Americans lost their insurance.”

The radical proposal to let Medicare and Social Security lapse, explained

“Florida Republican Sen. Rick Scott’s plan to “rescue America””

“Scott’s proposal would radically overhaul how the federal government operates, forcing Congress to re-pass every federal law or else let them lapse — a move that, in Democrats’ telling, would endanger much of what the government does, including beloved federal programs like Medicare and Social Security.
It’s a short proposal, with little detail to flesh it out. But on its face, its meaning is plain: Every five years, every federal law would need to be passed anew in order to stay on the books.”

““Instead of making the wealthy pay their fair share, some Republicans want Medicare and Social Security to sunset,” Biden said in his State of the Union address. “It is being proposed by individuals. I’m politely not naming them, but it’s being proposed by some of you.”

It was a new twist on a familiar trope: Republican proposes cutting government benefits, Democrat attacks him for it. And it seems to have left a mark: After more than a week of uproar since the State of the Union, Scott formally revised his 12-point “rescue America” plan to specify that its provision requiring every federal law to be re-passed every five years would not, in fact, apply to Social Security and Medicare. And so, at least officially, the senator has papered over the main political weakness of his plan.”

Biden Promises To Let Social Security’s Ship Keep Sinking

“Social Security will be insolvent by 2034. One of the trust funds for Medicare will be insolvent even sooner. When insolvency hits, both programs will be subject to mandatory benefit cuts. The exact size of the cuts will depend on payroll tax collections in that year, but the current estimate is that Social Security will be able to pay only 80 percent of promised benefits in 2034.
As I wrote last month, when Republicans such as former President Donald Trump were making similar vows not to cut Social Security benefits: Promising to do nothing amounts to promising a roughly 20 percent benefit cut in a little more than a decade. There is no getting around that fact.”

“Standing up for seniors (and everyone else who has been paying into Social Security and Medicare for their entire working lives) requires acknowledging that there is no reality in which the politicians do nothing and the entitlement programs continue functioning normally. The choice is between making changes now or accepting mandatory cuts in about a decade.”

We forgot to fix unemployment insurance yet again

“Hey, remember the pandemic economy? How could you not, right? In early 2020, millions of people lost their jobs in the blink of an eye, through no fault of their own. In the United States, their subsequent attempts to get help from the government overwhelmed unemployment offices across the country, revealing the system to be fundamentally broken. The infrastructure was bad, the benefits insufficient, and the entire scheme next to impossible to navigate.
And then, something remarkable happened: The federal government stepped in to shore things up. It added extra dollars to state unemployment benefits to make sure people could get by and pay their bills. It expanded the pool of people who were eligible for benefits, so workers such as freelancers and contractors could access them, too. While far from perfect, the extra efforts to help the unemployed made a real difference in people’s lives and played a part in the country averting a deeper and longer recession.

It felt, for a while, like maybe there would be momentum to finally address the issues in America’s unemployment system. So many people had experienced first-hand just what a disaster it was on a massive scale, from outdated administrative systems to inadequate benefits. It seemed obvious that this hybrid state-federal program that had left so much discretion up to individual states just didn’t work.

And then … America’s UI setup didn’t really get fixed, because it never does.”

“As workers stare down the barrel of another potential recession — and the layoffs that would accompany it — the problems that dogged unemployment insurance before the pandemic, many of which have persisted for decades, remain. Most of the momentum to repair the system has dissipated.

Congress and the White House allocated $2 billion to the Department of Labor in 2021 to try to help states update their unemployment systems, combat fraud, and promote equitable access to benefits. But that funding and the accompanying efforts can only go so far, and they are aimed at administrative fixes, not policy fixes. The benefit amount a worker is entitled to, how long the benefits last, and the requirements to get them largely depend on which state that worker lives in. Many states are still digging themselves out from under the last crisis. Given the narrative that has taken hold around unemployment during this most recent economic recovery — that UI kept people out of the workforce, that too much government assistance contributed to inflation — it’s not clear what kind of appetite would exist in Congress to help workers if and when another recession hits.”

“The point of unemployment insurance is to replace income for people who have lost their jobs and keep them attached to the labor market. It’s meant to be a support for the broader economy in times of economic downturn, too, and keep consumer spending going. If I lose my job and can’t pay my rent, it is a problem for me and for my landlord and for the sandwich guy I no longer buy from down the street.”

“UI is financed through state and federal payroll taxes that are supposed to cover both administrative systems and the benefits themselves. Many states have kept those taxes quite low, leaving the system chronically underfunded and resulting in luck-of-the-draw situations for workers applying for UI, depending on where they live.

The average weekly benefit paid out in regular unemployment insurance nationwide was about $385 in the 12 months ending in September. But if you look at Mississippi, for example, the average benefit is in the low $200 range, while it’s now above $600 for Washington state.

These benefits do not move with inflation, either.”

“Many UI offices are understaffed, are still dealing with pandemic-era backlogs, and are using outdated technologies to administer benefits. Or, they’ve updated their technologies and they’re intentionally designed to make the whole thing harder for workers to navigate, or the update was just bad.”