A false premise

With the Senate effort to upend The Affordable Care Act — known as “Obamacare” — suspended for the Fourth of July holiday, there’s a chance to step back and examine the assumptions behind Republicans’ long-standing objections to the social safety net — as well as the flaws in those assumptions.

From Ronald Reagan’s invocation of a “welfare queen,” to Mitt Romney’s derision of “takers,” to the House and Senate bills to cut taxes for the rich by taking health insurance away from tens of millions of people, the premise of incessant Republican tax cutting is that the system robs the rich to lavish benefits on the poor.

But here is an essential and overlooked truth: As a share of the economy, federal spending on low-income people, other than for their health care, has been falling steadily since it peaked in 2011, after the Great Recession, and while it’s still slightly above the long-term average, it is declining, according to a recent series of reports by the Center on Budget and Policy Priorities.

… Spending has risen for Medicaid, which the Senate and House health care bills would slash. But the increase is not the result of generosity or waste. Much of it is from rising nursing home admissions as the population ages. Medicaid insures most nursing home residents — after they have exhausted their savings. …

By using Medicaid to cover millions of previously uninsured people, Obamacare chose the most economical anpart of the health care system to achieve a reduction in the number of uninsured.

In the next decade, higher spending on low-income health programs is expected to be offset by lower spending on other low-income programs. So total federal spending on people struggling to get by is projected to hold steady.

That is not lavish. And it is not an excuse for tax cuts that deprive tens of millions of people of health insurance.