We in the human needs community know better. What we saw and heard last night was the continuation of a pattern in the 2016 presidential campaign and in this young Trump administration: He says one thing and does another.
Let’s take health care as an example. During the campaign, Trump promised to “broaden health care access” while repealing the Affordable Care Act. But in many ways large and small, we now see the false promises, that continued access to quality health care for millions of low- and middle-income Americans will be compromised if Trump and his allies in Congress have their way.
A key issue with health care is the future of Medicaid, which touches the lives of some 74 million Americans – almost one in five. Trump said Tuesday night he wants to make sure no one is left out of Medicaid. But he quickly added that he wants to give governors “flexibility” in how they receive and spend Medicaid funds.
We in the human needs community know that when the words “Medicaid” and “flexibility” are used in the same sentence, it is dangerous code. This code means restricted federal funding for Medicaid, giving governors the “flexibility” either to cut eligibility or benefits, or to spend a lot more in state funds to replace the shrinking federal share. We hope governors will fight this very bad deal, and help to prevent sweeping cuts that will strip millions of lower-income Americans from access to health care.
Just as seriously, the threat facing Medicaid is actually an existential threat to the health care system in the U.S. The promise of Medicaid is that during economic downturns, when more Americans lose their livelihoods, Medicaid is a safety net that will be there for them. Too, when an unexpected crisis arises – think Zika or the epidemic of opioid addiction or natural disasters such as Hurricane Katrina – Medicaid has the flexibility to expand to meet the sudden and exacting need.
Medicaid is just one challenge we face when we hear Trump’s talk of repealing and replacing the Affordable Care Act. There are other false promises. Health savings accounts are a great tax break for upper income people, but won’t help people with less income afford health care – many people live paycheck to paycheck and can’t afford to sock money away for times of need. There will be lapses in coverage – Trump says he wants to cover preexisting conditions, something the current law guarantees. But that likely will be through reviving “high risk pools,” which failed in the past because they had a price tag millions of Americans could not afford.
There are other false promises Trump made Tuesday night. On education, he promised school choice – vouchers to let families send their children to private schools. But the budget he is expected to roll out later this month will force cuts in public education, leading to funding crises for public schools that will harm far more students than the relative few who would benefit from school vouchers. Far too often, subsidized access to private schools has enabled white flight, studies show, actually resegregating many communities.
He promised us clean air and clean water. That is a pipe dream. Trump already has proposed slashing the Environmental Protection Agency’s budget by $2 billion, or 24 percent. Clean air and clean water require enforcement, and we won’t have that if the EPA is gutted.
Trump has proposed increasing military spending by $54 billion, and to take those funds from domestic and non-defense international programs like foreign aid. That will mean cuts to programs like Head Start, low-income housing, K-12 and college education, environmental protection, the Women, Infants and Children (WIC) nutrition program, and public health. The President talked about affordable child care, but there won’t be funds to reverse the loss of 373,100 child care placements lost since 2006.
There is a pattern here. President Trump makes false promises to make health care, private school education or child care affordable. But the tax breaks and vouchers that emerge are not enough to help working class people afford the education, child care and health insurance they need. Instead, they will pad the incomes of higher-income people, giving help where it is not needed. The pattern continues with the “big, big” corporate tax cuts. Despite the false promises of more jobs and opportunities, revenues will decline, and needed services will be starved for resources yet again.
And to what end? Michelle Chen, writing for The Nation, gives us a hint:
“Now Trump, the great disruptor, threatens to further destabilize the most vulnerable workers, with a budget centered around tax cuts for the wealthiest. Though he has talked a big game about protectionist trade policies and closing unfair tax loopholes for exporters, his fiscal agenda is fundamentally about redistributing wealth upward.”
That’s right. Repeal of the Affordable Care Act, cuts to vital domestic programs, dismantling Medicaid all serve one master: strangling the federal government’s capacity to provide services while allowing Trump and Congress to pass massive tax cuts for corporations and the wealthiest Americans. Will the false promises to the rest of us distract us from seeing the losses they intend to inflict?
Maybe not: millions of Americans are marching, calling, and showing up at town meetings to tell Congress and the President they won’t be distracted and see through the false promises. There’s hope in that.
Weinstein is executive director of the Coalition on Human Needs (CHN). CHN is an alliance of national organizations working together to promote public policies which address the needs of low-income and other vulnerable populations. CHN’s members include service providers and faith groups, civil rights, religious, labor and professional organizations and those concerned with the well-being of children, women, the elderly and people with disabilities. For more information please visit www.chn.org.