What Does Welfare Do?

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As the New York Times goes after New York’s Medicaid program for fraud, waste, and abuse, it’s worth taking the time to read this new report by the Center on Budget Policy Priorities documenting the positive side of social welfare programs. The safety net in the United States, meager as it is, has nonetheless managed to cut the number of Americans living in poverty in half, has reduced the severity of poverty for those who are poor (raising their incomes from 29 percent of the poverty line to 57 percent), and providing health insurance to tens of millions of individuals—many of those children. The report, I guess, is a bit of cheerleading, but sometimes this cheerleading gets lost when all the headlines are screaming about waste, fraud, and abuse.

As far as Medicaid goes, there’s another sort of waste, fraud, and abuse that goes on and, sadly, won’t garner a two-part investigative feature: namely, the lengths towards which states will actively try to deter people from getting on the Medicaid roles. This can be done through a complex registration process, or making it harder for people to figure out whether they’re eligible or not, or what have you. This sort of abuse augurs for expanding, not contracting, Medicaid. (Ideally, of course, we’d revamp the entire health care system, but in the absence of that, Medicaid ought to be expanded.) There’s absolutely no reason to cut the program—as George Pataki and the Republicans in Albany have been doing for the past decade—just because unscrupulous dentists are making a killing by gaming the system. Police it better. Offer stiffer penalties for this sort of white-collar crime—after all, serious jail time is more likely to deter white-collar criminals than, say, murderers. But don’t gut it; as CBPP shows here, it’s working far too well and is far too important for far too many people.

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