Democrats Slashed Medicaid and Food Assistance Because We Didn’t Fight

Rhode Island state senator Sam Bell shows how Democrats have refused to fight on issues that matter, with tragic consequences for working people.

America faces a crisis. Federal politicians are plunging low-income people into financial chaos. Decisions made in DC are driving a maelstrom of policy pain through the family budgets, healthcare plans, and stomachs of millions of people in our country. As Trump-era programs to boost the safety net in response to the pandemic get axed, three massive changes are coming:

  1. Medicaid will be purged, kicking millions, if not tens of millions, of Americans off their publicly funded healthcare. Medicaid purge victims will be thrown into the cruel embrace of the private health insurance industry.  
  2. Our life-saving food assistance program, SNAP, will be slashed, drastically increasing the numbers of Americans who will go hungry. The cuts will average out to roughly $90 per person per month or $2,676 per year for a family with children. SNAP stands for the Supplemental Nutrition Assistance Program, and it has sometimes been referred to as “food stamps.”
  3. State budgets will be devastated. The percentage of Medicaid spending that the feds pay for will be cut by a whopping 6.2 percentage points, forcing states to make brutal cuts or face budgetary pain elsewhere.

I think it is fair to say this is not good. It’s certainly a major reduction in our social safety net. It’s certainly a major shift to the right in American public policy. “How did DC Democrats let this happen?” you might be asking. It’s simple. They voted for it. All of these policies passed in the Consolidated Appropriations Act of 2023, which Joe Biden signed on December 29, 2022.  Representative Alexandria Ocasio-Cortez was the only Democrat to vote no. Representative Rashida Tlaib voted “present.” Only nine Republicans in the House voted yes. This was a Democratic bill passed with Democratic votes.

It used to be that Democrats opposed cuts to Medicaid. Back when Obama was President, quite a few House Democrats signed a letter pledging to vote against any cuts to Medicare, Medicaid, or Social Security. Lots of Americans signed onto the letter as citizen signers. I was one of them. I remembered this when I got elected to the Rhode Island Senate, and we had a state budget bill that cut Medicaid reimbursement rates for nursing homes. I remembered that I had promised to vote no. And I did.  

I guess things are different now. We see Biden going around making lots of noise about opposing cuts to “Medicare and Social Security.” Instead of no cuts to “Medicare, Medicaid, and Social Security,” it’s no cuts to “Medicare and Social Security” now for today’s DC Democrats. We don’t talk about Medicaid cuts anymore. Especially not when we’re doing brutal ones.

There’s always an excuse, of course. But in this case, robust Democratic support and a total lack of vocal opposition or pushback in any circles of power means powerful DC Democrats haven’t had to really articulate those excuses. Here’s my best guess at the excuse: All of these cuts came from eliminating Trump-era programs to address the pandemic, and we all need to pretend the pandemic is over. Democrats of course have to repeal the expansion of the social welfare state Donald Trump signed into law or created via executive order, rather than—God forbid—make the Republicans actually fight for these cuts. These were just supposed to be temporary programs. So these cuts don’t count. Or something like that.

This is, of course, extremely silly. To begin with, the pandemic is not over. Not even close. So right there that excuse falls apart.

But more than that, we have to ask exactly why Democrats should be doing Republicans’ dirty work for them. Why should our party be lending our votes to massive whacks at the American social safety net? As long as Biden kept extending the emergency declaration, there was nothing Republicans in Congress could do to kill these popular policies. Why should we do this without even trying to make Republicans take the hit for slashing Medicaid and SNAP? Why should Joe Biden and congressional Democrats take away healthcare and food assistance funds from millions of American voters? Remember, Republicans love attacking Democrats for backing right-wing policies.

But what about Kyrsten Sinema and Joe Manchin? Aren’t they the reason for everything bad Democrats do?  Not exactly.  It’s crucial to remember that Sinema and Manchin kill progressive legislation by refusing to vote for it. This situation here was different. This was already the law. All the Democrats had to do to stop these cuts was to keep the law from being changed. It’s maybe theoretically possible that Sinema and Manchin might have tried to kill the whole bill had Democrats not made these cuts. Maybe. But we don’t have much evidence of that. And even then, progressives could have done the same thing with much more leverage.  Left-wing members of Congress could have easily refused to vote for the bill if it contained these brutal cuts. They would have had an awful lot of leverage, since the bill didn’t contain much good stuff for the left, and even a government shutdown would have been preferable to these cuts. Anyway, Kyrsten Sinema seems to have rather lost her appetite for public fights with the Democrats as she approaches a tough reelection. And shutting down the government because you just can’t stomach the thought of not throwing people off their healthcare and forcing them to go hungry isn’t a great sell politically.

So let’s move on from the excuses and talk about the real reasons this happened. I see two big ones. First of all, not doing Medicaid purges is quite progressive, and many Democrats may have felt it was just too left-wing for them. Donald Trump was a horrendous president, but he was also very erratic. In this very rare case, Trump’s quite random behavior led him to do something progressive. His decision to shut down all Medicaid terminations in America was, actually, a very good thing. Had that continued for a few decades, anyone who had ever been eligible for Medicaid would have been able to keep their healthcare. Gradually, Medicaid would have come to cover more and more Americans. The private market would have lost a lot of market share.  It would have gotten us much closer to Medicare for All. It would have made that transition a lot easier.  Democrats who oppose Medicare for All had a strong incentive to restart the purges.

But mostly, the story is just that progressives didn’t fight. A few brave policy experts did speak up, but there was no real, organized campaign. Progressive lawmakers didn’t send out a flood of tweets, speeches, and op-eds. They didn’t even threaten to vote no and then cave. They made no noise. The big progressive advocacy groups didn’t run campaigns. Even Representative Ocasio-Cortez, the only Democrat to vote no, didn’t discuss the Medicaid and SNAP cuts at all in her statement on her no vote. Instead, she focused on the bill’s harsh immigration enforcement component.

When progressives don’t object to right-wing policy, it’s hard to expect the party leadership to do it. When progressives stay silent, when progressives seem cool with conservative stuff, the establishment looks silly fighting it. When progressives actually fight, it changes the game. It makes a difference. That’s how our movement killed the Obama-era effort to slash our social safety net. We fought. We won. Here, we didn’t fight. So we lost before we even began.

Every progressive lawmaker gets sat down and told that you need to avoid fighting so many things, that you need to “keep your powder dry.” The establishment always tells us to shut and be quiet so we can “get things done.” Eventually, even the best progressives start listening. And this is what following that advice looks like. There was no fight. Everyone got to avoid stress and drama. Everyone, of course, except for the millions of Americans losing their healthcare and getting their live-saving food assistance cut.

We can’t always predict which issues will motivate lawmakers and activists to actually fight. This time, it didn’t happen. Millions of Americans are paying the price. Next time something comes up that threatens the basic living conditions of low-income people, let’s all remember to fight. Politics is exhausting. The fights aren’t always fun. It’s a long, hard slog. It’s easy to forget just how much it matters. And when we forget, people get hurt.  Let’s try not to let that happen again.

On the left, sometimes we get beaten down and wonder if our fight matters. But it does.  And when we don’t fight, very bad things happen. That’s why we have to fight. America needs us.

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