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“None Of Ryan’s Ideas Are New”: Stop Calling The GOP The Party Of New Ideas

Paul Ryan, the perennial media darling and the Republican vice-presidential nominee in 2012, has released an anti-poverty plan that has been widely hailed by a group of conservative policy enthusiasts known as the reformicons. According to Ross Douthat, The New York Times‘s house reformicon, the plan represents new and exciting conservative thinking, reflecting the “growing contrast between the policy ferment on the Republican side of the aisle and the staleness and/or small-ball quality of the Democratic Party’s ‘what comes after Obama?’ agenda.”

The problem with this argument is that none of Ryan’s ideas are new, and many of them are the antithesis of exciting.

Yes, the Ryan plan contains some ideas that are genuinely good. Its calls for major criminal justice reform are salutary — mass incarceration is fiscally wasteful as well as wasteful of human lives, and seeing an endorsement from a prominent Republican public official is reason for cautious optimism. It’s easier to propose cuts to corporate welfare in white papers than in the congressional sausage-making process, but to do so is unobjectionable. And proposing reforms to local regulations such as licensing requirements are at least defensible in some cases. None of these ideas are new, but originality is overrated — there is the potential basis for agreement here.

The core social welfare proposals of Ryan’s plan, however, fail both the originality and goodness tests. The plan does, at least, avoid the direct, savage cuts to discretionary spending that were a hallmark of Ryan’s previous budgets. Ryan’s proposal entails converting a great deal of federal anti-poverty spending into block grants to state governments, which would be free to experiment with those funds. There is, to put it mildly, nothing novel about this idea. Going back to conservative southern Democrats in the New Deal, conservatives have advocated giving states more discretion about how to use federal money.

But more to the point, in addition to being very old, the block grant idea is terrible. As the economist Max Sawicky notes, spending through block grants has the effect of creating disincentives for states to spend adequate money on poverty, while also undermining the political basis for maintaining the programs. In addition, giving the states discretion has tended to involve withholding spending from the “underserving” poor, who tend to be overwhelmingly people of color. The intrusive paternalism the Ryan plan encourages is also unattractive.

The notion that “let them eat states’ rights” is a new and exciting idea is particularly perverse given some other recent developments. To the widespread applause of Republicans, a panel on the D.C. Circuit Court of Appeals read the Affordable Care Act as not providing subsidies to people purchasing health insurance on federally established exchanges. According to defenders of the decision, this was not a drafting mistake; they say Congress intended to only make the subsidies available on state-established exchanges, but were surprised by how few states went along.

As a reading of the ACA, this argument is absurd — clearly Congress anticipated that some states would not establish exchanges, which is why the federal backstop was created. Virtually nobody involved in creating the ACA believes that the law was designed to create federal exchanges that wouldn’t work. It is fair to say, however, that some Democrats were surprised by how many states proved unwilling or unable to establish their own exchanges.

But consider the implications of this. The latest conservative legal argument against the ACA boils down to: “you screwed up — you thought the states actually wanted to provide people with health care!” And the Supreme Court re-writing the ACA in 2012 to make it easier for states to reject the Medicaid expansion has also been a catastrophe, with Republican statehouses inflicting easily avoidable pain and suffering on millions of people to prove their anti-Obama bona fides.

So — why is devolving anti-poverty policy to the states supposed to be a great idea again?

Indeed, the experience of the ACA is a compelling repudiation of the idea that giving states more discretion over social policy is a good idea — or that Republicans at the state level genuinely care about helping the poor and the needy. Many statehouses are opposed to federal anti-inequality measures in principle, and even less hostile ones have proved administratively inept. Anti-poverty policy in the U.S. needs more federal intervention, not less.

 

By: Scott Lemieux, Professor of Political Science, College of Saint Rose in Albany, N.Y; The Week, July 30, 2014

July 31, 2014 Posted by | GOP, Paul Ryan, Poverty | , , , , , , , | Leave a comment

“Paul Ryan’s Stale Ideas On Poverty”: Retreaded Idea’s Surrounded With The Language Of Innovation

Paul Ryan is counting on this: Because he says he wants to preserve a safety net, speaks with concern about poor people and put out a 73-page report, many will elide over the details of the proposals he made last week in his major anti-poverty speech.

The Wisconsin Republican congressman is certainly aware that one of the biggest political difficulties he and his conservative colleagues face is that many voters suspect them of having far more compassion for a wealthy person paying taxes than for a poor or middle-income person looking for a job.

So Ryan gave a well-crafted address at the American Enterprise Institute in which the centerpiece sounded brand spanking new: the “Opportunity Grant.” The problem is that this “pilot program” amounts to little more than the stale conservative idea of wrapping federal programs into a block grant and shipping them off to the states. The good news is that Ryan only proposes “experiments” involving “a select number of states,” so he would not begin eliminating programs wholesale. Thank God for small favors.

Ryan surrounds his retread idea with the language of innovation. “The idea would be, let states try different ways of providing aid and then to test the results — in short, more flexibility in exchange for more accountability,” he declared. “My thinking basically is, get rid of these bureaucratic formulas.”

Who can possibly like those “bureaucratic formulas”? The phrase is another disguise. Among the programs Ryan would block grant are food stamps (now known as the Supplemental Nutrition Assistance Program or SNAP). Food stamps are one of our most valuable initiatives because people are automatically eligible for them when they lose a job or their income drops sharply. Studies have amply documented how important food stamps are to the well-being of children.

For the economy and for the disadvantaged, curtailing SNAP would be devastating. While providing nutrition help to families in desperate need, food stamps also offer an immediate economic stimulus at moments when the economy is losing purchasing power. Economists call such programs “automatic stabilizers.”

Ryan’s block grant would not be nearly as responsive to economic changes. If Congress would have to step in, its reaction would be slow. And the history of Ryan’s own budgets shows that increasing spending for poor people is not exactly a priority on his side of politics.

Food stamps aren’t the only programs that get wrapped into the grant. Housing vouchers go there, too, which could lead to more homelessness. So does money for child care. Ryan says there would be rules barring states from using funding from his Opportunity Grant for purposes other than helping the needy. But it’s not clear from his outline how he’d stop states from using their new flexibility to move spending away from the needy indirectly by substituting block grant money for existing expenditures.

Ryan might reply: You just don’t trust the states! And my answer would be: You’re absolutely right, there are some states I don’t trust to stand up for their poor people. I’d point specifically to the 24 states that are depriving roughly 5 million Americans of health insurance because they refuse to participate in the Medicaid expansion under the Affordable Care Act.

In his speech and report, Ryan movingly described two hypothetical Americans, “Andrea” and “Steven,” and how much they could benefit from intense counseling by a case worker. There may well be something to this, but it’s expensive. How much would states have to cut basic assistance to the poor to hire additional case workers?

And by the way, one of the programs Ryan would eliminate to pay for an undoubtedly positive part of his plan — a roughly $500-a-year increase in the Earned Income Tax Credit (EITC) for childless workers — is the Social Services Block Grant, which helps pay for the kinds of interventions he wants for Andrea and Steven.

There is such a hunger for something other than partisanship that the temptation is to praise the new Ryan for being better than the old Ryan and to leave it at that. It’s good that he moved on the EITC and also that he embraced sentencing reform. I also like his suggestion that we re-examine occupational licensing rules.

But forgive me if I see his overall proposal as a nicely presented abdication of federal responsibility for the poor. “Experimenting” with people’s food-stamp money is not something we should sign onto.

 

By: E. J. Dionne, Jr., Opinion Writer, The Washington Post, July 27, 2014

July 29, 2014 Posted by | Paul Ryan, Poor and Low Income, Poverty | , , , , , | Leave a comment

“The Big Problem With Paul Ryan’s New Poverty Plan”: Accountability Is Only Required Of Poor People

Today, Rep. Paul Ryan is unveiling his latest idea to change the federal government’s poverty programs. For someone who is constantly saying how concerned he is about poverty, Ryan’s previous budgets have relied an awful lot on slashing benefits to poor people. But this time, he promises that his proposal doesn’t cut benefits, but merely reorganizes them. Some parts of the proposal might be worthwhile. But it’s hard to avoid the conclusion that it’s still driven by the longstanding conservative desire to limit the help we give to the poor.

The centerpiece of the proposal is a consolidation of multiple separate programs into a single block grant that would be given to states; they could decide how to dispense the money, and the federal government’s job would essentially be reduced to oversight. States would choose whether or not to participate.

This sounds reasonable until you start to think about how it would play out. In practice, it’s likely that the states most eager to sign on would be precisely those that aren’t too happy about the ways the federal government provides benefits now. The devil would be in the details; what if a state decided to take its entire block grant and devote it to giving lectures to poor people on why they should get married? There could be a lot of needs going unmet while states implement their ideologically-driven visions of how poverty ought to be addressed.

Ryan’s plan assumes that the same Republican states that rejected the federal government’s offer to insure poor citizens through the expansion of Medicaid — in other words, who would rather see poor people go uninsured than get coverage from the government — are now going to be spectacularly committed and creative in working to help those same poor citizens through their time of need. Color me skeptical.

Ryan insists his plan would hold funding for these programs constant, not cut them. But it’s more complicated than that. Conservatives have long advocated block-granting of poverty programs, always with the justification that states will better deliver assistance to poor Americans if they aren’t hamstrung by requirements from Washington. But there’s little evidence that block granting accomplishes anything other than making it easier for these programs to be cut in future years or simply whittled away by inflation. As Jared Bernstein points out, Temporary Assistance to Needy Families, which we used to call “welfare,” was block-granted in 1996 and has since then seen its value slashed by 30 percent in inflation-adjusted terms.

One of the real dangers of Ryan’s approach is that it would render the programs unable to deal with economic downturns unless Congress stepped in and supplied more money, which would be unlikely as long as Republicans control at least one house. So for instance, right now the food stamp program is an entitlement; if you meet eligibility standards you’re entitled to food stamps. The program can never run out of money in a given year. When the Great Recession hit, millions of Americans found themselves newly out of work and thus eligible for food stamps.

But under Ryan’s program, food stamps would be part of a block grant whose total amount is fixed. If and when another recession hit, states would be flooded with people who needed assistance, but they’d have the same limited sum of money they got at the beginning of the year. So they’d either have to turn people away or find a way to rob Peter to pay Paul, taking money out of other poverty programs to meet the increased need for food.

(There’s a brief discussion of inserting a provision into the plan to account for this kind of eventuality, but it seems neither particularly well thought-out nor nearly adequate to address what could be a major need.)

Ryan’s plan would also require “accountability” from those receiving assistance, in the form of time-limited benefits and work requirements (how you satisfy those requirements when people can’t find work is its own sad story). This too is a hallmark of the Republican approach to poverty programs, in which poor people have to jump through hoops to demonstrate their moral worth to get benefits. “Accountability” is something that is required of poor people, and only poor people. Farmers who get government subsidies don’t have to be “accountable.” Nor do government contractors who waste huge amounts of taxpayer money. Only the poor are forced to pee in a cup or account for their time or endure a hundred other petty humiliations, so we can be sure that if they get any government assistance they have proven themselves to be morally upstanding enough to deserve help.

That isn’t to say there’s nothing worthwhile in Ryan’s proposal. As he writes in a USA Today op-ed, “Right now, you have to go to a bunch of different offices to enroll in a bunch of different programs, often with different paperwork requirements and eligibility standards. Under the Opportunity Grant, you could go to one office and work with one person.” As anyone who has tried to apply for assistance knows, the paperwork requirements seem designed to hold down enrollment by making it as difficult as possible to apply. Streamlining that process would be terrific.

While this plan isn’t going to become law (at least not any time soon), it does serve a political purpose of showing that Republicans are thinking about poverty, and Ryan isn’t the only one in his party trying to revive “compassionate conservatism.” We can give him credit for addressing the issue. If only there was more reason to believe his ideas would do much to help Americans who are struggling.

 

By: Paul Waldman, Contributing Editor, The American Prospect; Published at The Plum Line, The Washington Post, July 24, 2014

July 27, 2014 Posted by | Paul Ryan, Poor and Low Income, Poverty | , , , , , , | Leave a comment

“Medicaid Is the Real Target”: Mitt Romney’s Priorities, Aid For The Rich, Paid For By The Poor

Since August, when Mitt Romney chose Paul Ryan as his running mate, the two campaigns have fought a fierce battle over who is the most stalwart protector of Medicare. In the first presidential debate, Romney assailed President Obama for his $716 billion in Medicare cuts, and Ryan did the same in last week’s vice presidential face-off. Likewise, the Obama campaign has hit Team Romney for the Ryan plan and its Medicare “premium support”—which, if implemented, would gradually replace traditional Medicare with subsidized, regulated private insurance.

The irony is that—in the short term, at least—Medicare will stay unchanged, regardless of who wins the election. Seniors are among the most mobilized voters in the electorate, and there’s too much political risk involved in making big, immediate changes to Medicare. For that reason, Medicare reform plans on both sides are backloaded and will take time to unfold.

The same isn’t true of Medicaid, the other major federal health-care program. The primary constituency for Medicaid—poor and working-class families—lacks the clout and influence of seniors. And while the Obama administration expanded the program in the Affordable Care Act, it has also made Medicaid a ripe target for conservative cuts to social insurance.

This means that, as Mother Jones’ Kevin Drum pointed out last week, Medicaid, not Medicare, is the actual flashpoint in this election. Romney has promised to “block grant” the program, giving states more flexibility in dealing with eligibility and benefits. Some states would use this as an opportunity to innovate. But as Drum notes, just as many would use it as an excuse to drop health coverage for poor people:

Lots of states, especially poor states in the South, don’t have much interest in experimenting. They just want to slash eligibility for Medicaid. Given the freedom to do it, they’d adopt what Ed Kilgore calls the “Mississippi model,” cutting off coverage for a family of three earning anything over $8,200. For all the talk of fresh thinking and new solutions, what they really want to do is simple: They want to stop providing medical care for poor people.

Admittedly, this is a little speculative. It’s possible—albeit, unlikely—that a future governor of South Carolina or Alabama might want to use the new flexibility to improve services for lower-income people. With that in mind, it’s also worth noting the extent to which Romney’s block-grant plan involves a massive cut to overall Medicaid spending. The Center on Budget and Policy Priorities finds that with a Paul Ryan-style block grant in place, overall Medicaid spending would decline by one-third over the next decade. When you put this in the context of Romney’s budget proposals—which include new defense spending and a promise to protect Medicare—and his promise to repeal the Affordable Care Act, the result is a $1.5 trillion reduction in Medicaid spending by 2022. These cuts would add an additional 14 to 19 million people to the ranks of the uninsured, on top of the 30 million people who would lose coverage as a result of full Obamacare repeal.

It’s his approach to Medicaid, more than anything else, that reveals Mitt Romney’s priorities—aid for the rich, paid for by taking relief from the poor.

 

By: Jamelle Bouie, The American Prospect, October 15, 2012

October 16, 2012 Posted by | Election 2012 | , , , , , , , , | 2 Comments

“Pilfering The Federal Treasury”: Mitt Romney’s Medicaid Shell Game

Mitt Romney is lambasting federal aid in his campaign for the presidency, including derisive comments against those who receive government assistance. But he pulled all the stops to pursue federal aid as governor of Massachusetts, even hiring “revenue maximization” contractors to scour federal programs for every possible penny — and using financial schemes to maximize and then divert the aid from his needy constituents.

In his first budget proposal, Romney promised balancing the budget without tapping reserves, and “without the use of fiscal gimmicks.” However, buried in the details, he suggested tapping reserves such as taking $4 million from the Catastrophic Illness in Children Relief Fund, and he included fiscal gimmicks to maximize and divert federal aid into his general state coffers.

His strategies are akin to tax schemes using offshore bank accounts — but instead of avoiding federal taxes, seeking to pilfer the federal treasury. The Wall Street Journal labeled such financing mechanisms “Medicaid Money Laundering” and a “swindle.”

Medicaid is a matching grant program. If a state with a 50 percent match rate like Massachusetts spends $50 on qualifying services, the federal government will provide an additional $50 so there is $100 total for Medicaid services. The federal match payment is much higher in some states, such as Mississippi where its almost 75 percent.

Unfortunately, some states concocted budget shell games, often with private consultants, providing an illusion of state spending to claim federal matching funds, when no state spending has occurred. As governor of New Hampshire, Judd Gregg developed such a practice labeled “Mediscam.” Gregg taxed hospitals serving the poor, routed the money into an “uncompensated care fund” which he sent right back to the hospitals, and used the round-trip of money to claim federal matching funds. Then, the swindle gets worse, because he routed the federal Medicaid funds into his general coffers rather than for Medicaid services.

Romney’s schemes were similar to Gregg’s. Buried in his 2004 budget, Romney proposed maximizing federal aid by taxing hospitals, shifting the resulting tax payments in and out of an uncompensated care fund, back to hospitals as adjustment payments, and diverting resulting federal Medicaid funds to state general revenue. He also proposed using taxes on nursing homes and pharmacies in his efforts to maximize and divert federal aid.

In such strategies, health care facilities serving the poor are used to claim federal funds to help the poor. But the health care facilities and the poor may get nothing, as the state diverts the federal aid to general coffers — and revenue maximization contractors reap millions in contingency fees. Romney used such private companies to help carryout his strategies.

After a US General Accounting Office report responding to concerns of Republican Senator Charles Grassley, the Romney administration vigorously defended using contingency-fee revenue maximization consultants and revenue practices – that the GAO labeled illusory. The GAO responded that “hospitals should benefit from increased federal reimbursements and Massachusetts’s arrangement appeared to result in lower payments to hospitals, despite increased claims for federal reimbursement.” The Romney administration even defended double (if not quadruple) billing practices “of allowing multiple agencies to bill Medicaid” for “services for the same beneficiary.” The GAO concluded that the Romney administration “did not provide convincing evidence that the [Medicaid] services provided by the four state agencies were unique,” and the Bush administration agreed with the GAO’s conclusions.

The Bush administration implemented regulations trying to reduce such practices, and the Obama administration continues efforts to improve fiscal integrity in the Medicaid program. However, Romney would virtually end federal oversight by block-granting federal Medicaid funds to states.

It’s not hard to imagine how a governor — one that employs complex shell games to find loopholes in federal rules in order to maximize and divert federal aid — would use the federal funds if handed to the state without any federal oversight. The answer to state misuse of federal aid is not to give those states even more discretion to do whatever they wish – but to simplify the claiming process, reduce loopholes allowing the revenue schemes, and improve oversight to ensure Medicaid funds are used as intended.

Romney has undergone dramatic and hard to follow shifts in his apparent views of government aid. Romney2004 proposed cutting healthcare while simultaneously proposing illusory schemes to maximize and divert federal Medicaid funds. Romney2006 changed course with the first nearly universal healthcare plan. Now Romney2012 is turning back to cuts, denouncing federal aid he once schemed to maximize and divert, condemning those who need government aid, and seeking repeal of national health care reform that is nearly identical to the plan he signed into law. And now he proposes giving all the federal money from the Medicaid program to states without federal control.

Romney2004 would have a field day with Romney2012’s plan.

 

By: Daniel L. Hatcher, Law Professor, University of Baltimore, Published in The Boston Globe, October 12, 2012

October 15, 2012 Posted by | Election 2012 | , , , , , , , , | Leave a comment

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