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As Congress wrapped up its business for 2005,
legislators attempted to present an unwelcome holiday offering to
low-income families: a budget bill that rolls back programs providing a
lifeline to families struggling to make ends meet.
On Dec. 21, with the tie-breaking vote of Vice
President Dick Cheney, the Senate passed the Work, Marriage, and Family
Promotion Reconciliation Act of 2005. The 51-50 vote fell largely along
party lines, except for five Republicans who voted against the bill —
Sens. Smith (OR), DeWine (OH), Snowe (ME), Collins (ME), and Chafee (RI)
— and independent Sen. Jeffords (VT). However, as a result of a
successful procedural challenge to the bill, the Senate version of the
budget bill was amended at the last minute and therefore differs
slightly from the version passed by the House of Representatives (on a
vote of 212-206) on Dec. 19. The House must now approve the Senate's
amended version before it can be sent to the president for his
signature. The House will not likely reconvene for a vote on the budget
bill until late January, providing advocates additional time to make
sure that their representatives understand the harsh impact of the
proposed budget on low-income families.
The long saga of this year's budget process
was initiated by a March budget resolution calling for approximately $35
billion in cuts to mandatory (entitlement) programs over five years.
The "budget reconciliation" process, originally scheduled for September,
was first postponed in the immediate aftermath of Hurricanes Katrina and
Rita, and was delayed again to avoid the unseemly appearance of a
simultaneous cut in benefits for the poor and enactment of tax breaks
for the wealthy. When the House and Senate finally passed their
respective budget reconciliation bills, the differences were
substantial: the Senate adhered to the $35 billion in savings required
by the budget resolution and made some attempts to shield beneficiaries
from the brunt of the cuts, while the House enacted nearly $50 billion
in cuts, imposing new restrictions in core antipoverty programs such as
food stamps, Medicaid, and Temporary Assistance for Needy Families (TANF).
One measure in the original House bill targeted immigrants directly,
cutting an estimated 70,000 lawfully present immigrants from the Food
Stamp Program by extending from five to seven years the period that
"qualified" immigrants must wait before securing assistance. The
bicameral Budget Conference Committee was charged with "reconciling"
these two disparate budget bills and crafting a compromise bill that the
House and the Senate could approve.
As the December recess approached, it was
unclear whether Congress could reach, with sufficient support, a
compromise. In the Senate, bipartisan motions passed by overwhelming
majorities, instructing the budget conferees not to accept any
compromises that undercut assistance to food stamps or Medicaid
beneficiaries, thereby calling into question the possibility of a
workable compromise. However, the Republican leadership redoubled its
efforts to bring the process to a conclusion. Before the conferees were
named, deals were quietly being made regarding the content of the final
conference report on the bill. Immediately after they were announced,
the conferees engaged in a flurry of closed-door weekend negotiations
and, shortly after midnight on Monday, Dec. 19, released a 774-page
conference report including nearly $40 billion in budget cuts. Only a
few hours later, voting on the conference report began in the House,
which passed the bill by the narrow 212-206 vote. The conference report
quickly headed to the Senate for approval. Realizing that the Senate
vote would be close, Vice President Cheney cut short a trip overseas so
he could return to the Capitol to cast the deciding vote in the Senate.
The conference report bills that passed the
House and Senate include a range of spending cuts that harm
beneficiaries of a variety of safety-net programs. However, in this
otherwise bleak budget bill, Congress spared the Food Stamp Program from
any cuts, including the cuts that had specifically targeted immigrants.
This was an important victory. The House's budget bill had arbitrarily
targeted immigrants for cuts in food stamps just a few years after their
eligibility had been restored by the bipartisan 2002 Farm Bill. While
the proposed cuts would have harmed tens of thousands of immigrants
directly, the political impact of the new restriction would have been
even more extensive. It would have marked the first time that Congress
reversed its own attempt to correct the harsh immigration status–related
restrictions in the 1996 welfare law.
At times it seemed that advocates faced an
uphill battle fighting the food stamp cuts targeted at immigrants. Rep.
Bob Goodlatte (R-VA), chair of the House Agriculture Committee, had
opposed the 2002 food stamp restorations to immigrants and appeared
intent on using his leadership position to roll them back. President
George Bush, widely credited for successfully championing the 2002
restorations, failed to defend against their unraveling by the House's
initial budget bill. After the White House's "Statement of
Administration Policy" was silent on the House bill's immigrant food
stamp cuts, immigrant and ethnic organizations from across the country
sent a letter to Bush, urging him to lend his leadership on the issue.
In the end, the coalition of organizations that led the 2002 campaign to
restore food stamps to immigrants successfully coordinated to defend
against inclusion of food stamp cuts in the budget reconciliation
process. Antihunger groups, faith-based organizations, immigrant
advocacy groups, and broader antipoverty organizations opposed any food
stamp cuts and were steadfast in their insistence that cuts targeting
immigrants were wholly unacceptable.
Several legislators deserve special
commendation for their leadership in protecting food stamps. Sen. Saxby
Chambliss (R-GA), chair of the Senate Agriculture Committee, expressed
no interest in undoing the 2002 restorations and spared food stamps from
any cuts in the bill introduced to his committee. Sen. Gordon Smith
(R-OR) made clear that he would not vote for a conference report that
contained food stamp cuts and rallied fourteen other Senate Republicans
to sign a letter urging Chambliss not to compromise with the House on
the issue. Senate Minority Leader Harry Reid (D-NV) and Sen. Tom Harkin
(D-IO), ranking member of the Agriculture Subcommittee with jurisdiction
over the Food Stamp Program, were outspoken in their defense of food
stamps and the injustice of targeting immigrants for cuts. Rep. James
Walsh (R-NY) used his leverage to insist that food stamp cuts not be
included in the conference report. Rep. Joe Baca (D-CA), a consistent
defender of immigrants' participation in the Food Stamp Program,
implored his colleagues again and again to stand by the accomplishments
of the 2002 restorations.
In spite of this victory, the conference
report passed by the House and Senate is no cause for celebration. It
includes harsh cuts to key programs on which many low-income families
depend. Citizens and noncitizens alike will face greater obstacles to
securing critical assistance under Supplemental Security Income (SSI),
TANF, subsidized child care, and foster care assistance. The bills also
cut funding for child support enforcement and student loans.
Legislators also targeted the Medicaid
and Medicare programs to achieve the bulk of the cost savings, but the
Senate and House proposed different approaches. The Senate's original
version of the budget bill did not include spending cuts that would harm
beneficiaries directly. Instead, the Senate achieved cost savings by
obtaining rebates from drug companies and eliminating wasteful payouts
to health plans to encourage their participation in the Medicare
program. In contrast, the House's version of the budget imposed costly
new burdens on Medicaid beneficiaries. Unfortunately, the conference
report adopts many of these proposals and eliminates existing Medicaid
protections by permitting states to impose monthly premiums and costly
copayments for needed medical services — with few exceptions. Not only
would Medicaid families be forced to choose between paying for health
care and other basic necessities on their limited income, but they could
lose Medicaid coverage and be denied medical care by their doctor or
pharmacist if they fail to pay the new premiums or copayments. The cost
savings from these burdens will ultimately be achieved from anticipated
reductions in the number of Medicaid-eligible beneficiaries and in the
rate of utilization of medical services because beneficiaries will not
be able to afford the premiums and copayments to stay on Medicaid and
obtain medical services. At the same time that beneficiaries are forced
to pay more for necessary medical care, states will be free to reduce
the minimal level of medical services available to Medicaid
beneficiaries. This new state flexibility is likely to lead to the
elimination of Early and Periodic, Screening, Diagnostic, and Treatment
(EPSDT), an essential program that guarantees comprehensive health care
to children under age 19. The bill also would effectively increase the
cost of the monthly Medicare Part B premiums for certain low-income
individuals who receive both Medicare and Medicaid ("dual-eligibles").
Finally, the bill introduces yet another
barrier to Medicaid enrollment and imposes an unfunded mandate on
states, which will be forced to require U.S. citizens to provide
specific documentation of their citizenship in order to obtain
Medicaid. Without any evidence, legislators claimed that this provision
was needed to prevent noncitizens from improperly obtaining Medicaid by
falsely stating that they are U.S. citizens. Noncitizens already
provide documentation of their immigration status during enrollment and
have disincentives under immigration laws that prevent them from falsely
claiming U.S. citizenship. Instead, the new documentation requirement
will harm U.S.–born citizens by denying them Medicaid if they are unable
to produce or pay for specific documents such as a birth certificate or
passport. The cost savings from this requirement would be realized by
preventing citizens from enrolling in Medicaid rather than by preventing
any nonexistent fraud by noncitizens.
In light of the life and death choices that
low-income families could face under the budget bill, it is a holiday
"miracle" that the draconian conference report was not enacted into law
as the year comes to an end. We are proud of the effort we and other
advocates made to ensure that people need not experience hunger or food
insecurity as they maintain eligibility for food stamps. Our efforts
should now focus on protecting low-income families from severe cuts to
other safety-net programs by preventing enactment of the budget
reconciliation bill in 2006. Members of the House, who will reconvene
in late January to approve or reject the Senate-passed budget bill, need
to remember the true spirit of the underlying holiday celebrations, and
advocates need to remind them of the real human harms that would occur
if they approve such a Scrooge-like budget.
By
Jonathan Blazer, NILC
public benefits policy attorney, and
Sonal Ambegaokar, NILC health policy attorney
blazer@nilc-dc.org | ambegaokar@nilc.org
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