Sharon Day, co-chair of the Republican National Committee, asserted at the opening of her party's national conference last week: "[This] is the most important election in our nation's lifetime."
Well, it depends. That probably isn't true if your number-one issue of concern is drone attacks, the endless conflict in Afghanistan, the drug war, civil liberties, or the seemingly endless expansion of executive power. None of these are minor issues and the parties presently do not differ greatly on any of them.
But this election will decide the future of our welfare state. The strongest comparisons, for barroom purposes, are 1964, when LBJ ran on medical and hospital care for the elderly against Barry Goldwater, who compared such frivolousness to giving free cigarettes to smokers. Or perhaps the better comparison is 1932, when Americans voted in the New Deal against the disastrous austerity of Herbert Hoover.
In either case, the choice is just as stark between Barack Obama – and the Affordable Care Act (ACA) – and Mitt Romney, who endorsed Representative Paul Ryan's House budget (before he was even selected as the VP nominee) that would cut $3.3 trillion from a multitude of programs for working Americans. Depending on who wins in November, the welfare state battles of the next four years, and beyond, will either be over the implementation and possible strengthening of a new universal healthcare scheme, or a series of rearguard battles to defend the safety net stitched together over the last 80 years.
"Many people believe the issue is that are we going to repeal healthcare reform and go back to what the world looked like in 2008," says Harold Pollack, professor at the University of the Chicago School of Social Service Administration and expert on health care and anti-poverty policy. "That's one of the issues, but it goes much deeper than that. The Republican platform is a direct attack on the post-New Deal structure of American social insurance. I applaud the selection of Paul Ryan: I think it brings a clarity to this election."
The wave of "Vote Democrat: Save Medicare" posts that swept Facebook within minutes of the Ryan pick immediately showed that the Democrats, quite sensibly, are trying to fight this election on the safety net issues that enjoy the most support. (He plans to shift Medicare cost increases onto the backs of seniors and raise the retirement age.) Less frequently mentioned is the ACA which does not go fully into effect until 2014. The actual universal healthcare potion of the law will probably be unassailable once it's actually in place, so 2012 may be the last chance for Republicans to kill it.
But all the acrimonious debate around Medicare, the ACA and Social Security (privatization is not featured in the GOP platform, but Ryan targeted it repeatedly in the past) diverts attention from the equally devastating consequences of a Republican victory. Programs that specifically assist low-income Americans—Medicaid, along with food, education and housing assistance—are first on the chopping block. These programs don't only help the jobless and destitute. They are there for the 43 percent of American families that would fall below the poverty line in the event of a crisis, like a layoff or a serious accident.
Here are four ways Romney-Ryan would decimate our already threadbare social safety net.
1. Gut Medicaid
Medicaid is best known as the public healthcare program for the poor, but that doesn't mean that all poor people are able to access it. (It is not just low-income adults who benefit from the program, most of the beneficiaries are retirees, children and the disabled.) The program is funded partially by the states and partially by the feds, but it is the former that control the income limits and other restrictions that determine eligibility. One of the most important aspects of the Affordable Care Act is that it would universalize Medicaid accessibility under 133 percent of the poverty line.
Vice-presidential candidate Ryan's budget plan would eliminate the Affordable Care Act, vaporizing the $642 billion allotted to that expansion. But that's just the warmup. The Ryan plan would also reduce present Medicaid spending by $750 billion over the next 10 years. That's about a third of the program gone, and between 14 and 19 million more Americans added to the ranks of the uninsured, already well to the north of 50 million.
The savings would come from turning Medicaid into a block grant program, which means that the federal government's contribution to Medicaid would be frozen, with annual adjustments for inflation and population growth. The problem is that medical costs rise faster than the general rate of inflation, especially in America's unregulated medical markets, so the block grant provided for each state would quickly decline in value.
The other problem with block grants is that they cannot respond to need. If a recession strikes and millions are suddenly plunged into poverty, Medicaid as currently constituted can expand to accommodate the needy. But the strictly defined allocations of block grants do not include provisions for economic crisis and in the event that would mean the states would have to handle the entire expanded burden. And since most state governments can't run budget deficits, even in times of economic turmoil, they would simply be unable to cover the newly uninsured.
2. Eliminate Low-Income Housing
Public housing programs would suffer badly under a Republican presidency as well. Romney has strongly hinted hat he would eliminate the entire Department of Housing and Urban Development (HUD). The vast majority of HUD funding goes towards an array of public and affordable housing programs.
For example, Section 8 of the Housing Act provides assistance to help families rent in the private market. But as Ben Adler recently noted, Republicans have long fantasized about transforming Section 8 from its current flexible budget to a rigid block grant funding structure. Under such a scheme, states would probably also be given the power to regulate eligibility just as they currently do with Medicaid, which would mean that many fewer Americans will be able to access the program.
Here are some numbers to go with that airy fretting. This spring HUD Secretary Shaun Donovan was asked to testify before a Congressional committee and queried (by a Democrat, naturally) about the impact of the Ryan budget upon public housing: He estimates that more than one million households would be at risk. That includes 585,000 lost units of housing under the Housing Choice Voucher Program (the largest of Section 8's programs), 425,000 from the Project-Based Voucher Program, and from 110,000 to 180,000 from an array of programs for the homeless. Donovan also testified that tens of thousands of new affordable housing units simply wouldn't be built. Lord knows, there aren't, say, 636,017 Americans in need of homes or anything.
3. Stamp Out Food Security
The supplemental nutritional assistance program (SNAP), what used to be called food stamps, is destined for vast cuts under a Republican administration, and largely through a tool that should now be familiar. Block granting SNAP would render it ineffectual in the face of a recession, just like Temporary Assistance for Needy Families (TANF) during the recent downturn. When poverty and unemployment went up during the Great Recession, SNAP enrollment rose right along with them, demonstrating its effectiveness at partially protecting Americans from the economic turbulence. But TANF, the block grant cash assistance program created by President Clinton's welfare reform in 1996, did not. Its strict budgetary limitations did not allow it to respond to the woes of millions of Americans who could have used the help.
Ryan's budget would cut SNAP by 17 percent, or $133 billion in the next 10 years. In his March budget he did not make clear whether that would be achieved by cutting the amount of benefits or just by making it harder to access them. Either way, a program that was once a bipartisan commitment will be seriously damaged.
4. Give the Ax To Education
Ryan's plans for higher education funding are just as dire. The Pell Grant program is meant to help low-income students afford college, providing assistance of up to $5,550 in 2012. The program is already facing a shortfall of $58 billion over the next 10 years, but the Ryan budget does not attempt to fix Pell's problems. Instead, it makes them far, far worse.
Ryan's plan would freeze the maximum grant at the current $5,550 level, leaving no room for increases with general inflation, let alone the spiraling costs of higher education. Eligibility will also be slashed. In total, Pell's size by will be reduced by $58 billion. Ryan's budget would also end all mandatory funding for Pell Grants, a total of $101 billion over the next 10 years. But, wait, there's more! Ryan also wants to cut all the non-defense discretionary spending (programs that aren't Medicaid, Medicare, and Social Security and a few others), by $1.2 trillion over the next decade. "It is extremely unlikely that Pell Grants would not be cut significantly...given the magnitude of the...funding reduction," according to the analysts of the Center on Budget and Policy Priorities.
"This is Robin Hood in reverse," says Jared Bernstein, senior fellow at the Center on Budget and Policy Priorities and former chief economist to Vice-President Joe Biden.
"If Romney and Ryan do prevail in November, it will mean that voters accept the need to modernize the welfare state," wrote Ramesh Ponnuru, conservative columnist. But as the New York Times reported earlier this year, when voters were presented with the contents of Ryan's budget (including huge tax cuts for the rich) "respondents simply refused to believe any politician would do such a thing. What became clear was that voters had almost no sense of Obama's opponent."
It's also worth remembering that whoever is elected in November will nominate a Supreme Court justice or two. Recall that most of the current conservative judges were very willing to throw out the entire Affordable Care Act on ideological, not constitutional, grounds. If their numbers are bolstered, woe to the welfare state.
"This election would tip the balance decisively in the Supreme Court in a way that would force us to relitigate some legal issues in a way we thought had been put to rest after the New Deal," Pollack warns.
Four years after Obama's initial election, it looks like 2012 may be just as historic as its predecessor.