The wrong lesson to take from Trump’s gutting of Medicaid
Last week, the Senate passed the largest cut to America’s welfare state in modern history. President Donald Trump’s inaptly named “One Big Beautiful Bill” would take health insurance from 11.8 million Americans and slash food assistance to low-income families by about $100 a month.
In the face of this unprecedented setback, some progressives argue that the Democratic Party must rethink its entire approach to social welfare policy.
Over the past half-century, Democrats have expanded the welfare state primarily through means-tested programs — benefits that are reserved for Americans below a certain income threshold. The left has long criticized this model, arguing that the party should instead pursue universal programs, which is to say, programs that don’t screen beneficiaries by affluence (for example, Social Security provides pensions to all senior citizens with a sufficient work history, irrespective of their wealth, making the program “universal” in this sense of the term). After all, such policies require less bureaucracy to administer, more reliably reach their intended beneficiaries, and don’t punish people for getting a raise (unlike some means-tested programs, which can abruptly cut off benefits to a person whose income rises).
In my view, these substantive arguments for favoring universal benefits over means-tested ones are strong. But debate on this subject tends to focus on political considerations. After all, a policy that is optimally designed — but legislatively nonviable — helps no one.
Many proponents of means-tested programs recognize their flaws but insist that such policies are the most politically sound way of aiding the disadvantaged in the United States. The American public’s tolerance for higher taxes or deficits is limited (at least, in today’s context, when higher deficit spending is liable to push up inflation or interest rates). As a result, the politicians who make or break Democratic majorities — which is to say, the lawmakers who win tight races in purple areas — have historically had a limited appetite for new social spending. Given that reality, some argue that the most effective way to combat inequality and disadvantage in the US is by targeting social benefits at the needier segments of the population.
But progressives have countered that this is politically myopic. In their account, means-tested programs are more vulnerable to repeal than universal ones, which boast the buy-in of more powerful segments of society. Republicans are constantly trying to cut benefits for the poor, but tend to be warier about slashing Medicare and Social Security. If what one truly cares about is expanding the welfare state in a politically durable manner,........
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