You have no doubt heard some variation of the question “why does the Republican base continue to vote against their own self interest?” The overwhelming negative response to proposed Medicare cuts should be pealing working class voters away from the party, but these voters still appear for the moment to support what Republicans are doing in Congress. Understanding why could act to clarify how Democrats should be talking about the issue, and could be a golden opportunity to shift working class voters back to the Democratic party. So, why would folks in the lower two quintiles of wage earners be supportive of cuts to Medicaid, and how can Democrats seize the advantage in this debate?
When I talk to these voters, one thing I hear is that there is a real divide between voters who should be supportive of these programs. That bright line is drawn at 138% of the poverty line. That line is the cut off between a low income worker receiving benefits and getting nothing. There is a genuine resentment held by someone who works a difficult, sometimes back breaking job and who gets no subsidies, and people they know who may only make a dollar an hour less and do get help. This resentment is even stronger towards people on disability who appear to get rewarded for not working. To these folks it is a fundamental question of fairness, a conclusion supported by personal experiences and not by generalized statistics. So when Democrats discuss the intolerable cruelty of the Republican agenda, voters of this stripe just hear liberal condescension from people who obviously don’t know what is going on.
To change the conversion, I would propose to frame the issue in a different way. The problem with access to healthcare in America is that we do not pay people enough to afford it. We need to make it very clear that most people who receive these benefits are working. According to the Kaiser Family Foundation 59% of families enrolled are working families. additional sources claim that 41% of individuals on Medicaid are working 40 hours a week and an additional 15% are working 29 hours a week or less. So, if you believe that endless growth in entitlement spending is not sustainable, then raise the minimum wage.
I find the idea of a “working poor” obscene. Look at the numbers. The census bureau defines the poverty level for an individual as $12,082 per year.138% 0f that is $ 16,673 which works out to the lordly sum of $8.33 an hour. Meanwhile the federal minimum wage rate is $7.25 an hour. We have a federal wage standard that places full time workers well below the poverty line. Why, because Republican donors like cheap labor, it helps them get rich. You want to shrink Medicaid? The easiest, least complicated thing to do would be to raise the minimum wage to $15 an hour. Poof, right off the bat you could remove as many as 41% of enrollees from the Medicaid expansion under Obamacare.
Moreover, the practice of limiting hours to 29 or less is a direct attempt by some industries (fast food, retail) to avoid providing required benefits. You want to cut Medicaid, stop the immoral and probably illegal practice to avoiding required benefits by forcing workers into part-time status. As noted, that is an additional 15% of Medicaid recipients.
(I must leave it for my next diary to discuss how people making $30,000 a year can afford healthcare. I accept up front that this still poses a problem, albeit a much smaller gap to close. I also think the opiate crisis is a big enough problem to be dealt with as a discrete issue, and will write about that next time.)
There has been a deliberate and sustained effort to restrain wages in this country. It is killing the ability of the working class to afford housing, education, and yes healthcare. If there is something unfair about our system, this is it. So, you want to appeal to working class voters, look at an issue that unites and not divides them. You want to reduce Medicaid? Fine, reduce enrollment instead of cutting benefits. You want to cut Medicaid? Pay people enough that they don’t need it.