The Democrats seem content with arguing that Republicans are mean people who live to hurt the poor and in that way they refuse to discuss the actual policy provisions of budgets, healthcare reform proposals, or just about anything else.
Predictably, as an editorial in today's Wall Street Journal points out, critics of the Trump budget proposals are accusing it of "gutting the safety net." But that is not what is being proposed:
In reality, the White House is proposing long-needed reforms that would fix a dysfunctional disability system that traps Americans in dependency.
Under the Trump budget proposes, federal outlay for disability programs would be cut by $72 billion over a decade. The largest disability program is the much-abused Social Security Disability Insurance (SSDI). As early at 1995, Heather Mac Donald was writing that SSDI was going to become "Welfare's Next Vietnam" because its rolls were growing so rapidly.
There would be an improved appeals process for denied claims, severe punishment for swindlers, and incentives to get people back to work. In other words, safeguards would be set up to determine if people seeking SSDI are genuinely disabled. The program, as currently administered, is unsustainable:
The number of disability-insurance recipients has tripled since the 1980s, when Congress relaxed requirements. (See nearby.) A worker can cite several smaller ailments, such as back pain, to illustrate an inability to work, as opposed to one debilitating condition. An applicant can appeal a denial up to four times, and most cases reach administrative-law judges, who are slammed with hearings and have an incentive to award benefits and move on.
Mark Warshawsky and Ross Marchand of the Mercatus Center report that administrative-law judges approved 70% of appeals on average in 2008. About 9% of judges approved more than 90%. The authors estimate that a decade of judicial failures will lead to lifetime mispayments of $72 billion. As it happens, that is the ballpark for Mr. Trump’s supposedly shocking 10-year cut. The budget proposes a probationary period on judges who currently enjoy lifetime appointments.
The disability program is among the most susceptible to fraud in the federal government, which is an achievement. In 2015 more than 100 New York City police officers were charged with defrauding the program by faking anxiety attacks and other maladies to receive up to 75% of their salary. A Senate report from 2013 detailed how trial lawyers in Kentucky colluded with doctors and steered appeals to one munificent judge.
The less-noticed harm is that a mere 1% of beneficiaries return to work every year, as Andrew Biggs has noted in these pages. Most benefits are terminated only when a person dies or is transferred to a retiree program. But by one study’s estimate, half of applicants age 30 to 44 will find a job again if they aren’t approved for benefits.
. . .
A dark irony is that disability insurance has expanded to cover mental-health issues, which may aggravate the ailments. The literature on mental health suggests that anxiety and depression can be alleviated in part by healthy routines like work and maintaining social connections. Members of Congress like to fret about mental-health policy, but permanent-disability payments contribute to cultural problems like the opioid crisis.
In effect, SSDI, as presently constituted, actually depriving people of meaning in their lives by setting up a system that makes it easy for them to scam the system and avoid work–and it is doubly unfair to the genuinely disabled who need this program. it will be difficult to sustain it without reform.
Don't expect the Democrats to talk about any of this, though. They'll rely on their old standby: Republicans are so mean.