Many Americans spent the week before Christmas thinking about their neediest fellow citizens. But in Washington this year, something rather different took place. In the middle of the night on December 19, members of the House of Representatives were presented with a 774-page budget reconciliation bill, written behind closed doors by Republicans, less than five hours before they had to vote on it. The legislation, which passed the House by 212 to 206 and the Senate by 51 to 50 (Vice President Dick Cheney rushed back from Pakistan to break the tie), includes $40 billion in reductions to various domestic programs over the next five years, ostensibly to balance the budget but in reality to make way for yet another round of tax cuts for the rich.
Who will have to suffer? Medicaid recipients, to begin with, since the budget allows states to impose premiums and increase co-payments--as high as 10 percent of the cost of a medical service--on low-income Americans. For a $1,000 hospital stay, this could mean $100 in out-of-pocket costs, a change that may sound minor but is sure to be profound. In 2003, when Oregon began charging slightly higher co-payments ($5 a doctor's visit) and premiums for Medicaid recipients, 40,000 swiftly dropped out of the program. "We thought the premiums were relatively small," a state official told the New York Times, "but for people with very low incomes, they proved to be significant."
Congress could instead have reduced the amount Medicaid pays pharmaceutical companies for prescription drugs, as an earlier Senate version actually did, which would have saved $10.5 billion over ten years. Billions more could have been saved by eliminating a wasteful fund that encourages managed care companies to participate in Medicare. Neither measure was included in the reconciliation bill.
The miserliness--toward those without campaign contributions to dispense--doesn't end there. The same budget bill cuts child support enforcement and foster care programs (family values, anyone?). It slashes $13 billion over five years from student loan programs. It imposes an unrealistic 90 percent work participation rate on two-parent families receiving public assistance, with no allowance for workers who are ill, who must take care of a sick child or who simply can't find a thirty-five-hour-a-week job. At the same time, it leaves states with $11 billion less than what the Congressional Budget Office calculates they'll need to meet work requirements and provide low-income citizens with childcare. The Center on Budget and Policy Priorities estimates that 255,000 fewer kids from struggling families will be receiving childcare assistance by 2010.
That Republicans had the nerve to ram through such a budget a week before Christmas vividly illustrates that when it comes to so-called class warfare, it is the right that is on the offensive. In their book Off Center, Jacob Hacker and Paul Pierson argue that Republicans are able to promote such an agenda not because the country hankers to return to the Gilded Age but because they mask the plutocratic effects of their policies. Will Republicans get away with it this time? The House will have to approve the budget one more time, probably in late January. House minority leader Nancy Pelosi has made it clear that Democrats will stand united against the draconian cuts. To prevail, they'll need moderate Republicans who supported the legislation when it was last voted upon--among them Christopher Shays, Nancy Johnson, Rob Simmons and John Sweeney--to reverse course.
These and other Republicans ought to consider the context. In a speech delivered four months ago from Jackson Square in New Orleans, George W. Bush spoke of the "duty" we have to confront the "deep, persistent poverty" that has "cut off generations from the opportunity of America." At the time, Hurricane Katrina had shocked the conscience of millions of Americans by casting stark images of poverty--which has increased for four straight years--into their living rooms. The number of people living in extreme poverty is the highest ever recorded since the Census Bureau began tracking such data three decades ago. While tax cuts are showered on millionaires, 45.8 million Americans don't have health insurance. Perhaps this is why moderates who once gave Bush the benefit of the doubt for caring about the plight of the less fortunate harbor no such illusions anymore.
"The Administration has hammered the final nail in the coffin of compassionate conservatism with this vote," said Jim Wallis of Sojourners. "And now our political leaders will race out of town, join their families, celebrate good fortune and hope, and proclaim goodwill toward all. Merry Christmas!" Let's assume some members of Congress didn't read the fine print in the budget bill the first time around--after all, that was the GOP aim. They'll have no excuse this time.