458 CHAPTER 14|ECONOMIC AND SOCIAL POLICY
that the law would actually reduce the federal defi cit by
$143 billion over the fi rst decade.^48
Yet the battle over health care reform was not over
when Obama signed the bill into law. Opponents prom-
ised to repeal the law and featured this pledge in their
campaign strategy during the 2010 midterm elections.
Republicans have argued for market-based reforms that
would introduce more competition into the system to
help keep costs down. Critics say that Medicare is more
effi cient than private insurance, so such reforms will
only drive up the overall cost of health care. However,
Medicare is currently not on a sustainable path, so some
change is necessary.
Many other issues related to health care will come
up in the next decade, including assisted suicide and
the “right to die.” Voters in Oregon approved a law that
went into eff ect in 1997 allowing the terminally ill to take a fatal dose of medi-
cation, which was upheld by the Supreme Court in 2006.^49 Other issues involve
the increasingly high-tech nature of health care: DNA research provides great
promise for curing many diseases, while moral and ethical questions arise about
cloning, surrogate parenthood, and stem cell research. The coming years will be a
challenging period for health care policy.INCOME SUPPORT AND WELFARE
Welfare is usually thought of as cash support for people who cannot support them-
selves. However, income support can take many forms, including food stamps,
unemployment insurance, Supplemental Security Income, and the Earned Income
Tax Credit. Moreover, a signifi cant reform of welfare occurred in 1996.
The Supplemental Nutrition Assistance Program provides food stamps, which
today are government-issued debit cards that may be used as cash to buy grocer-
ies. Anyone whose income is less than 130 percent of the poverty level and whose
resources do not exceed specifi c levels may qualify for food stamps. In 2012 the
maximum monthly gross income for a family of four to qualify for food stamps
was $2,422. As the eff ects of the recent economic crisis lingered through 2011, the
number of people using food stamps hit a record of nearly 44.7 million, with an
average monthly benefi t of $133.85 per person.^50
The Federal-State Unemployment Compensation Program was established in
1935 as part of the Social Security Act. The U.S. Department of Labor oversees
the program, but it is administered by the states. The program provides tempo-
rary and partial wage replacement for people who have been laid off and to help
stabilize the economy during recessions. States set a broad range in benefi t levels,
minimum amount of income earned, and hours worked during the period leading
up to unemployment. Also, laid-off workers have to ma ke themselves “ava ilable for
work.” About 97 percent of all workers are covered by unemployment insurance,
but only about half of the eligible unemployed make use of the benefi t. The regular
state programs provide up to 26 weeks of income support, and the Federal-State
Extended Benefi ts Program temporarily provides up to 20 additional weeks
in states with relatively high unemployment rates. In January 2012 the aver-
age weekly benefi t check was $296, which replaced 32.8 percent of the average
worker’s previous salary.^51THE UNFUNDED LIABILITIES FOR
Medicare are estimated to be
about 6 times as large as the
Social Security shortfall. Yet
Congress has a very diffi cult
time acting, because any solution
involves the politically unpopular
combination of tax increases and
benefi t cuts.
income support Government
programs that provide support to
low-income Americans, such as
welfare, food stamps, unemploy-
ment compensation, and the Earned
Income Tax Credit.