That’s despite the fact of the dawning realization among some lawmakers, notably Rep. John Yarmuth, that there’s another way. “The federal government is not a family. And it’s not a small business. And it’s not a local government. And it’s not a state government,” he said last month. “We can spend whatever we need to spend in the interest of serving the American people.” He has yet to convince his peers.
One of the promises made by President Biden was $400 billion over the next 10 years for home and community-based health care, paying care providers living wages, and expanding that care to allow people who are elderly or disabled to stay in their homes, and live on their own outside of institutions. That funding could include direct caregiving support, or helping with lifeskills, jobs, and housing—the support people need to live as independently as possible. That’s a proposal that doesn’t just create well-paying jobs for caregivers, but could allow family caretakers more freedom as well, easing the burden of responsibility for them. It would also keep many people out of long-term care institutions who end up in these facilities simply because there isn’t an alternative.
Now Democrats are talking about cutting that initiative by as much as half, from $150 to $250 billion over 10 years. That, Matthew Cortland, a senior fellow at Data for Progress and a high-profile disability rights advocate told HuffPost, “would be a staggering betrayal of the disability community that has disproportionately suffered devastating losses during this pandemic.”
“There doesn’t seem to be an understanding that this is a policy that … can’t be cut down to the extent that we are hearing is being considered,” Nicole Jorwic, senior director for public policy at The Arc, a disability rights organization, told HuffPost. “The states need a clear signal that the federal government is committed to this,” she said. “Otherwise the policy won’t work.”
“Congress needs to include all $400 billion … and pay for it by reforming the tax code so that billionaires and international corporations pay their fair share,” Alex Lawson, executive director of Social Security Works, told HuffPost. “We unequivocally reject the notion that money for one health care priority takes away from another. We are the wealthiest country in history, and we refuse to leave anyone behind.”
At the same time, lawmakers are tied up in knots trying to fulfill the promise of dental care for Medicare enrollees, as this thread from New York Times health writer Margot Sanger-Katz details. To make it less expensive over 10 years, the House Ways and Means Committee adopted a strategy of putting the benefits off for another seven years—politically risky given the big promise they’ve all made to current seniors—and asking seniors to pay more. Also politically risky and not a good way to fulfill the promise made. Part of the problem, lawmakers say, is the amount of time it would take for the government to ramp the program up, to identify dentists to participate, and to revamp benefits systems.
Senate Democrats have an alternative idea: Take a page from the stimulus benefits and send everyone eligible a direct payment, vouchers that could be used to get dental care as a stop gap until the whole system is launched.
House leadership wants to focus on the Affordable Care Act, extending the enhanced subsidies people have been receiving as COVID-19 relief, and is prioritizing expanding Medicaid to the 12 hold-out Republican states. These are laudable goals as well.
The point is, we are the richest country in the goddamned world. We can afford all of these things. We don’t have to treat policies—and the people whose lives they would change—as game pieces to be traded.