Obamacare-Subsidy-Calculator

Embrace Universality, Reject Means Testing

Elizabeth Warren has proposed a student loan forgiveness program that would cancel up to $50K in student loan debt. Warren says that her plan would totally eliminate student loan debt for 75% of Americans who have that debt and would at least reach 95% of Americans with some debt (there’s even a nifty calculator). Kamala Harris has a student loan forgiveness proposal that would forgive up to $20K in student debt if you received a Pell Grant and start as well as operate a business successfully for 3 years. The business would have to be in an income-disadvantaged neighborhood. Bernie Sanders also has a student loan forgiveness proposal; he wants to forgive all of it. That’s it. There are no formulas, no missives full of technocratic language, and no barrier to entry other than having accumulated student loan debt. To quote democratic strategist James Carville “the less you say, the more you heard”. Simplicity matters, and the broadest policies with the easiest to understand messages typically beat out complexity no matter how much wonkish nerds at think-tanks spend on market testing for whatever candidate they’re writing policy for.

“Build the Wall” was and continues to be more effective at energizing voters than “comprehensive immigration reform.” In 2008, “Universal Coverage” had a much better ring to it than “replacing the tax exemption with a tax credit to be applied to a health savings account.” There’s a separate argument that can be made about messaging and how that can matter when campaigning. As we’ve seen, voters don’t always care too much what actual legislation looks like as long as they can identify it with the campaign message. This would in part explain why Trump voters are satisfied with current policy on immigration despite there being no new wall construction.

However, there are relevant considerations that are obviously more important than messaging such as whether something is good policy. Unequivocally, universal programs are better than means tested programs and that’s why Democrats need to run on them and then fight for them once in government. Whether it’s Medicare-for-All vs. “Medicare-for-All-Who-Want-It” or forgiving all student debt as opposed to forgiving most of it, there are at least 3 reasons why (especially in this campaign) universal programs are better.

  1. Universal Programs are More Resistant to Attack from Opposing Interests
    1. Nine states have approved work requirements for Medicaid, and each would have implemented those requirements if not for federal judges blocking implementation. [The Trump Administration is appealing those decisions]. As of 2017, fifteen states have passed legislation to drug test recipients of SNAP or other public assistance programs. Obamacare has been undermined by the failure of 14 states, including 2 of the 3 largest states in the union, have refused to expand Medicaid and have denied millions of people access to healthcare coverage. Meanwhile Medicare benefits have only expanded since its creation in 1965 and has continued to enjoy broad support from voters from both parties. The difference is obvious, Medicare eventually covers everyone while the other programs have formulas for determining coverage and harsh cut-offs. It is easier to oppose a program when it will never benefit you and it’s harder for monied corporate interests to fund opposition to programs that help everyone. That is why privatization of Social Security and Medicare will never become a mainstream right-wing talking point and also serves an effective scare tactic from democratic politicians.
  2. Universal Programs Always Help Who They’re Meant To
    1. Hillary Clinton, Pete Buttigieg, and other liberals have made the argument that “we shouldn’t be paying for billionaires’ kids to go to college.” The implication being that public money would be used on the super wealthy to pay for things that they themselves can already afford. That falls apart rather quickly when you go policy by policy. Students take out loans because they can’t afford the cost of school, children of wealthy families are not taking out student loans because they are from wealthy families who can afford tuition and therefore universal student debt forgiveness wouldn’t apply to them in the first place because they have no student debt. The same is true of universal free-public college, most wealthy families send their children to elite private universities and would still pay tuition. When it comes to Medicare-for-All, an argument has been made that we would create a dual-system where the rich are able to afford a higher standard of care under private insurance while the masses must use a public system. That analysis misses two things; we already have the dual-system where wealthy people receive better healthcare and at least in our new paradigm, everyone has healthcare where currently that is not the case. What is most important is that in a universal system, there is no chance that those who need help won’t receive it. Even the best means-tested programs still create incentives for people to work less or stay unmarried or be generally unproductive because without public subsidies they would not be able to afford to live.
  3. Politics is About Negotiating, If You Don’t Start High Then You’ve Lost
    1. As anyone who has ever bought a car or home or any product where there isn’t a fixed price knows, you don’t offer the price you’re willing to settle for. If you start with where you’re willing to settle, then you’ll either end up paying more or not buying anything at all because you have to convince the seller that they also received a fair deal. The same is true in politics, we have a bicameral legislature and it will be necessary to deal with conservatives elements in both parties (especially in the Senate) in order to pass any legislation. For Medicare-for-All to be accomplished in the next 4 years a number of extraordinary events would need to happen. Democrats would need to win the Presidency, hold the House, win the Senate, whip every Democratic vote, abolish the filibuster, and appoint a Supreme Court justice to ensure that the law can survive court challenges. That all probably won’t happen, but we can still make sure that we get the best healthcare legislation possible. We may very well end up with Beto’s “Medicare-for-America” or Buttigieg’s “Medicare-for-All-Who-Want-It” or Biden’s “ACA 2.0”. These plans would cover millions more people and make our healthcare system better, but these are plans that we should settle for. We will all be better off if we end up in the middle of Medicare-for-All and our current ineffective system. I don’t know that the same will be true if we’re in the middle of ACA 2.0 and the ACA. By promoting universal programs, we are shifting the Overton window and what is possible in regard to policy which will make it easier to eventually achieve those big progressive ideas.

This country needs big structural change and piecemeal reforms or tinkering around the edges will not make life meaningfully better for most people. Government ought to be viewed as a tool to make people’s lives better and we should not be afraid of unleashing its power to combat the inherent problems present in our political economic system.

It’s time for Democrats to put down the calculators, delete the Brookings Institute from their Rolodex, and embrace big ideas.