578 Chapter 16Chapter 16 || Social PolicySocial Policyin the Elementary and Secondary Education Act of 1965. Perhaps the most significant
legislation was in health care, with the creation of Medicare, the national program that
funds medical care for the elderly, and Medicaid, which funds health care for the poor.^13
Over the following decades, Johnson’s Great Society suffered some setbacks. The
mounting costs of the Vietnam War in the late 1960s and early 1970s created a trade-
off: it wasn’t possible to continue funding both ambitious social programs and the war
without causing inflation. In addition, there was some conservative backlash against
the “welfare state,” especially during the Reagan years (1981–1989), as spending on
social programs was cut and some programs were eliminated. However, with some
exceptions, the Great Society programs remain core components of today’s social
safety net.
President George W. Bush maintained most existing programs with some cuts
and one major expansion, the addition of a prescription benefit to Medicare. As a
“compassionate conservative,” Bush attempted to place his stamp on American social
policy with the idea of an ownership society, in which people take more responsibility
for their own social welfare. Bush proposed privatizing part of Social Security and
creating private savings accounts to cover more out-of-pocket medical expenses, in
combination with more free market forces and a bigger role for private and religious
charity. President Obama favored an approach that emphasized the market and
community while preserving an important role for government. As the 2008–2009
recession and natural disasters such as Hurricane Sandy have demonstrated, crises
may overwhelm even the most aggressive and sustained community responses.
Market forces cannot adequately address the needs of the unemployed and very poor,
especially in times of economic recession.
President Trump and the Republican Congress have attempted to scale back social
policies, most significantly Obamacare, as noted in the chapter introduction. By
eliminating the individual mandate, giving employers the freedom to provide policies
with less coverage, cutting back on the open enrollment period, and reducing subsidies
to buy insurance, the opponents of Obamacare are trying to create a “death spiral”
in which the health insurance program will become more expensive and therefore
less attractive. Trump is also attempting to reshape welfare programs; he issued an
executive order in 2018 directing federal agencies to review their social programs, with
the goal of getting more people to work and off of welfare. House Republicans have
tried to move policy in this direction, approving a bill by a 213–211 vote in June 2018,
that would impose work requirements for 5 to 7 million of the more than 40 million
recipients of the Supplemental Nutrition Assistance Program (SNAP), more commonly
known as food stamps.^14 At the time of this writing, it appeared unlikely that this bill
would pass the Senate.ownership society
The term used to describe the social-
policy vision of President George
W. Bush, in which citizens take
responsibility for their own social
welfare and the free market plays a
greater role in social policy.“Why
Should
I Care?”
Historical context is always important for understanding current policy, but this is
especially true for social policy. Most of our important social policies today, such as
Social Security, Medicare, and Medicaid, date back to the New Deal or Great Society
periods. All Americans will be touched by the “social safety net” at some point in their
lives. Some of this may seem remote—you may feel that you don’t have to think about
it until you are closer to retirement. However, most of you will be affected in the next
few years by an important change in social policy: the ACA allows you to stay on your
parents’ health insurance until you are 26 years old.Working for a just distribution
of the fruits of the earth and
human labor is not mere
philanthropy. It is a moral
obligation. For Christians, the
responsibility is even greater: it
is a commandment.—Pope FrancisFull_17_APT_64431_ch16_572-613.indd 578 16/11/18 11:28 AM