Dollars, Cents and Republican Sadism

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Democrats want to strengthen the social safety net; Republicans want to weaken it. But why?

G.O.P. opposition to programs helping the less fortunate, from food stamps to Medicaid, is usually framed in monetary terms. For example, Senator Orrin Hatch, challenged about Congress’s failure to take action on the Children’s Health Insurance Program, a part of Medicaid that covers nearly nine million children — and whose federal funding expired back in September — declared that “the reason CHIP’s having trouble is that we don’t have money anymore.”

But is it really about the money? No, it’s about the cruelty. Over the past few years it has become increasingly clear that the suffering imposed by Republican opposition to safety-net programs isn’t a bug, it’s a feature. Inflicting pain is the point.

To see what I mean, consider three stories about health care policies.

First, there’s the saga of Medicaid expansion under the Affordable Care Act. The Supreme Court allowed states to opt out of this expansion. But accepting expansion should have been a no-brainer for every state: The federal government would initially pay the full cost, and even in the long run it would pay 90 percent, meanwhile bringing money and jobs into state economies.

Yet 18 states — all of them with Republican-controlled legislatures, governors or both — still haven’t expanded Medicaid. Why?

For a while you could argue that it was about cynical political strategy: Medicaid expansion was a policy of Barack Obama, and Republicans didn’t want to give a Democratic president any policy successes. But that story can’t explain states’ continuing resistance to the idea of providing health coverage to thousands of their own citizens at minimal cost.

No, at this point it’s clear that G.O.P. politicians simply don’t want lower-income families to have access to health care and are actually willing to hurt their own states’ economies to deny them that access.

Second, there’s the issue of work…

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