Labor, HHS, Education Appropriations FY 2023

House Appropriations, Labor, Health and Human Services and Education, May 26, 2023

I will address 

1. an immediate COLA for Social Security beneficiaries and generally higher benefits and, in the meantime, inform them that they are eligible for Food Stamps at the $250 per month pandemic level;
2. including all Social Security and SSDI recipients in Medicaid (Medicare for All) by federalizing Medicaid for Dual Eligibles as Medicare Part E; 
3. options for increased funding for ESL, GED, other adult programs, Community College and other undergraduate education in light of the President's Build Back Better  proposals;
4. making Unemployment Insurance a no-fault program with new funding sources; 
5. study how the Public Option under the Affordable Care Act system would be passed.

1. Please see my comments to the Agriculture FY2023 Appropriation for my Food Stamp Story. Here is the video.

2. The morning of this hearing, I had an interview on an application for Medical Assistance. My application was submitted. I will likely be approved.  In prior years, I had not applied because my income was too high. The federal poverty line has caught me. Because my benefits are in line with most Social Security beneficiaries, I must believe that it has caught them too. The reality is that Medicare for All has caught up to the vast majority of retirees and the disabled, as M4A is essentially expanding who can receive benefits as a “dual eligible.”

State governments were under financial pressure as a result of the pandemic, especially in the area of healthcare costs, most especially for seniors in nursing homes who are “dual eligibles.” The heart of President Reagan’s New Federalism Proposal was the transfer of state Medicaid expenses to the federal government, largely to fund baby boomers who would become dual eligible with time. Time is now up, or will be shortly. 

Welfare has been reformed, allowing state and federal governments to save money - which was part of the New Federalism bargain that was not accepted when Reagan proposed it. The irony is that federal money was reduced without the second part of the trade-off. Finish the process and create Medicare Part E for low income disabled and retirees. This will put investigation of nursing home conditions into the federal sector. States have done a poor job in enforcement of health and safety standards. It is time to make this a national responsibility.

3. The President’s Build Back Better Proposals included funding human capital needs.  These needs are urgent for not only young people going to college, but everyone who is ill served. from English as a Second Language and up through an Associates Degree. 

We recommended that funding include the freshman and sophomore year at four-year institutions as well. Add this proposal back to the proposed legislation. The Senate Majority needs to stop negotiating with itself, even if that means passing the FY23 appropriation in the next Congress.

Technical training should be covered as well at both public and accredited private schools, including religious schools. In Espinoza v. Montana, prohibitions on funding private schools (Blaine Amendments) were found to be unconstitutional. New (and existing) funding should reflect that fact.

A main problem with current training regimes is that potential students have opportunity costs that are not covered by training. TANF is simply too narrowly tailored and directs too many people to low wage work, especially in the dirtiest jobs in the medical field. The woke among us do not have to look hard for the intrinsic sexism and racism in this scheme.

Payments for tuition, stipends and family support would be funded by employer-paid subtraction value added taxes. Ideally, both state and federal subtraction VAT will be enacted. A federal VAT would be levied to assure that a minimum amount of child tax credit funding is available should states underfund their programs, which some will.

The American Recovery Plan Act required payment of the child tax credit in advance of the annual tax filing. This is appropriate and will change the culture of such credits, which should be for continuing support, not an annual bonus. The IRS managed payments. I submit that, over the long-term, it would be more acceptable to distribute them either through other government subsidies, such as Unemployment Insurance, Disability Insurance, or a training stipend OR through wages. In the latter case, until a subtraction value added tax is in place, the credit would be paid in advance by employers and then deducted from their quarterly tax payment.

4. Unemployment insurance must be less punitive, particularly where younger workers are concerned. In lower wage jobs, the preference is to find potential supervisors (whose compensation is usually subpar as well) and keep a file of infractions to justify firing workers who do not work out. A punitive work environment like that does not exactly make any kind of work attractive. 

In certain circumstances, unemployment compensation should be available on a no-fault basis. Better still, employees should be allowed to voluntarily leave firms with a history of quickly dismissing employees without any penalty. There should be no expendable jobs or workers. 

Current punitive taxes on employers would not be appropriate, so a more general levy, such as employer-paid subtraction VAT (if employers continue to pay former workers and help them find jobs or paid training) or a goods and services tax, likely levied, at least partially, at the federal level, with states providing most of the funding.

Unemployment Insurance would include CTC payments and automattic subsidized health insurance coverage with eligibility in the Public Option under the Affordable Care Act framework.

5.  Developing the Public Option needs to be funded in this budget. Particularly, it should explore the impacts on coverage and cost of automatically enrolling individuals who are denied coverage under pre-existing condition rules. Such rules must be revoked as the price of passing the bill.

Video https://youtu.be/iho38sbZTRo