What the Dependency Portal Changes

Over the weekend, two people whose opinions I value disagreed — with disconcerting vociferousness — with my objection to the innovation that the RI Center for Freedom & Prosperity is calling “dependency portals.” When that happens, there are two possibilities: either my gut aversion was wrong and my reasoning was mere rationalization, or I’m not adequately explaining what I find objectionable.

Figuring out which is the truth is a matter of immediate importance.  If I was wrong, then I’d best begin walking statements back, because charging forward would be a lunge toward a trap on the prayer that it won’t go off.  And if I was right, then it’s critical to prevent such impressions as I heard this weekend from solidifying more broadly.

In summary, both people argued that it is entirely appropriate, if not obligatory, for the government to inform people that the law makes them eligible for various programs. Put differently, it would be inappropriate for the government to making hiding eligibility a budgeting consideration.

With two full nights and a day of thought (including contemplative time in the pew at church and philosophically fecund time pushing a lawn mower), I have to say that I’m inclined to march on.  The reasons organize into three statements.

First, though, let me be perfectly explicit about what the dependency portal is.

As part of the Patient Protection and Affordable Care Act (PPACA, aka ObamaCare), states are encouraged to set up health benefits exchanges.  The details are still somewhat nebulous, but the basic concept is that people looking for a health plan will visit a government Web site, input the necessary information, and automatically be presented with a list of plans that apply to their circumstances.

When relevant, government subsidies will automatically be applied.  And users in the range of eligibility for Medicaid will be enrolled in that.

This idea will become a “dependency portal” when, in addition to health plan information, the Web site serves up other government services, from food stamps to cash payments to child care subsidies.  The full vision of public-service activists is that users will automatically be enrolled in every applicable program automatically — unless they opt out — and everybody will be repeatedly screened as they renew health plans every six months or annually.

Here’s why this is objectionable:

1. Promotion is part of the policy.

All business plans include a strategy for marketing, and investors want estimates of how effective it will be. If an organization sends out 1,000 mailers and expects 1% response rate, its revenue will be $X.  The same is true for government policy, if in a different sense.

When legislators contemplate a program, they project the eligible population and the likely participation. They present an estimate to the public and debate whether bringing such a program into existence is worth the projected cost.  That estimate will (or should) include the cost of promotional activities and the expected increase in enrollment on their basis.  This has appropriately been part of the debate for ObamaCare’s Medicaid expansion and the “woodwork effect” of new enrollees who were already eligible.

Innovations in promotion change the nature of the programs and should therefore be a matter of public discussion. The view of my interlocutors is that a failure to actively expand promotions is tantamount to preying on the ignorance of the public.

Suppose I sell you on a program that will provide an apple to any child who attends a free activity center alongside a jobs fair for parents. From prior experience, I project that the cost of doing so will be $100, give or take.  Being of a charitable nature, you commit to the expense.

The next day, I return to you with an apple bill for $5,000.  Finding it convenient after the fair, I visited all of the area unemployment offices, welfare offices, temp offices, low-income daycares, and playgrounds in urban neighborhoods, giving apples to every child I spotted and every adult who reported children at home. I also had crates of apples sent to similarly situated families throughout the country.

The parable is exaggerated, to be sure, but it illustrates the fact that a variation of the bait and switch has been executed. Every child who received an apple would clearly have been eligible had his or her parents attended the fair, and apples are nutritious fare to which more children should have access, but it brings something new to the program to actively expand its reach without adjusting estimates and seeking renewed approval.

2. Some minimal threshold of effort is a legitimate measure of need.

The first was an argument in terms of civic process.  Next is the moral argument.  Namely, is it moral to limit benefits to those who seek them?

The initial point must be put rhetorically: Does anybody not know that there are such things as social programs? In 2012, few people in need would be surprised to hear that the government has welfare programs.

The crossed line that makes dependency portals something new — even in the view of those who advocate on behalf of the concept — is that its targets will be roped in while seeking a consumer service.  Mind you, too, that it’s a consumer service that they will be required by law to obtain, via the individual mandate.

Any given user may even be going so far as to inquire whether he or she can get a government discount (read, “subsidy”) for that service, but that’s still a fundamentally different act than going to the government and saying, “I’m struggling and need help.”

The point, here, is that income and assets aren’t the only legitimate measures of need. Suppose a woman’s parents are helping her to pay for child care while she works, offered partly on the general sense that family support is preferable to government support.

This woman does not need the taxpayer redistribution for which she’s eligible.  But if the health benefits exchange informs her that she only has to insert the name of the child care provider to have the money automatically contributed, she’ll surely take the deal.

3. The larger objection is to the entitlement mentality.

That example leads directly to the most basic objection of all — that the dependency portal will change the relationship of people with the government and, thereby, change the culture in an unhealthy way.

Both of the acquaintances whom I mentioned above stressed that the individual programs might be debatable, but that full implementations of the rights that they create is not. The problem with that statement is that it makes a death-pact of the ideal.

In general, Americans exhibit an interest in walking the precarious line between providing a safety net and encouraging people to take care of themselves and those close to them whenever possible.  The latter is more efficient and more conducive to human connections and community building.

The working woman’s parents were willing to step in and help when circumstances led her to a difficult place, with either her own bad decisions or simple, unattributable misfortune to blame.  But when once she’s entitled to a “benefit” in compensation for adversity, the blame shifts to whomsoever should seek to take that entitlement away.

No matter how unsustainable the program may be.  No matter how clearly better uses could be found for limited resources.  The blame for lost entitlement falls on those who would change the public policy, and a political weapon arises for those willing to promise to preserve and expand it. The bureaucrats who profit from the services know this and therefore have incentive to slip in as much expansion as they can, with as little public input as possible.

That is why there is and must be a difference between eligibility and entitlement. Without such subtleties — more cultural and felt than written in clear legalese — it will not be possible to forge a middle path between strict, untenable libertarianism and strict, untenable statism in the long run.

  • bill

    1. Your first argument distorts the case: In your hypothetical, you contracted to give apples to children who attended, and then switched to supplying apples to children who did not.

    2. In your second, the daughter uses the new procedures to overrule her parents' preference, something she could have done initially. Perhaps an argument for teaching better parenting.

    3. Really your only meaningful argument but amounting only to asserting that the underlying benefits program is bad and seeking ways to under-cut it. So change the underlying law.

  • justinkatz

    1. It does not distort. Broadly speaking, the agreement of the public to provide benefits is premised on the estimated costs and participation rates for the programs, with particular distribution and marketing methods taken into consideration (e.g., only children whose parents attend the fair). Distributing and marketing more broadly is sufficient change to justify repeated public assent. In the case of "dependency portals," the process will have expanded beyond offering services to those who request help, even beyond advertising the fact that help is available, to offering services (and perhaps giving them automatically) to those who did not request them.

    2. You interpretation of the example does more than I intended. The parents aren't objecting to the use of public services, but they're willing and able to help before requiring the daughter to turn to the government. If the daughter finds public money thrust at her, that familial help will not be utilized.

    3. Incorrect. The distinction remains between (a) making services and payments available to those who exhibit a need by requesting help and (b) making services and payments a right to be instantly payable to all eligible people. As pure and simple as it may make the thinking behind your objection, eliding the distinction between (a) and (b) is a sure way to destroy public assistance programs, whether by requiring complete cessation for lack of an ability to draw meaningful lines or by exploding the enrollment beyond what society can afford.

    • bill

      I thought that was your objective; i.e., to destroy this particular this particular assistance program.

  • justinkatz

    Not particularly. There are multiple assistance programs intended to be incorporated into the dependency portals, and they have varying merits and various opportunities for reform and enhancement.

    I just don't think innovations and efficiencies will be conceivable once the dollars begin appearing in folks' bank accounts just because they went shopping online for health insurance.

    More profoundly (and culturally), I fear that the entire mentality encouraged will be one that makes the government the first place one looks for help, and not the last. The latter is what a "safety net" is supposed to be about, but one senses that the objective of advocates for these programs isn't a safety net so much as a redistribution of wealth, thereby purchasing a permanent voter base and expanding taxpayer resources.

  • lblais

    I admire the way Justin thinks and the explicit manner in which he expreses his thoughts.

    I boil it down to this: proclaimed intent vs. "well, while we are at it…"
    The public sound-bites were all about getting the federal dollars to determine how RI would meet one of the basic "requirements" of the Affordable Care Act – Obamacare. The HIE was announced as a portal to compare, contrast and purchase health insurance. It was presented in ways that gave the direct impression that it would provide an opportunity for people to purchase "affordable'" health insurance. Putting aside the fact that the Lt, Gov, and the new ED stepped back from their deliberate messaging that the choices would be "affordable," the bottom line is that it was created with the public focus on health insurance – nothing else. So now it becomes most convenient while developing the technology to build the Exchange to offer up "other taxpayer funded services "? Btw, services that one must "opt-out " of..a lovely bait setting technique. That is what is wrong and that is why it certainly is, now, a deliberately built (being built) portal to dependency.

    Look for the interview with Bill Rappleye months & months ago as he questioned and questioned again Lt. Gov. Roberts about the HIE. No mention of using it for purposes of welfare. But, numerous attempts by Bill to get the Lt. Gov. to explain how the HIE would provide opportunities to purchase affordable health ins.

    A passing thought- a bill was introduced in this past GA session requiring zero-based budgeting (implemented over a 5 year period). Setting up the dependency portal makes a helluva statement about where the Exec. and Admin. branches of govt. stand on zero-based budgeting!

  • Monique

    "Btw, services that one must "opt-out " of"

    Why is our state gov't facilitating the obtaining of tax-payer funded services – making it so easy to obtain them, steering people inexorably into the entire safety net – while continuing to maintain the worst, most un-user-friendly climate for businesses?