Social Policy in the Aftermath

For policy analysts, social scientists, human services professionals, and journalists, the recent presidential election was an existential smackdown.

Leaving aside your views about politics or the winner, perhaps the most troubling factoid of the campaign leading up to the election was the absolute dearth of policy coverage and policy discussion.

According to Nicholas Kristof’s analysis (relying on Tyndall data), the three major networks allocated a total of 36 minutes to independent policy coverage for the entire 2016 season: “there was zero independent coverage in 2016 on those nightly programs about poverty, climate change or drug addiction.”^[i]

The lack of standing for facts, expertise, analysis, policy ideas, or policy experience in the campaign is a devastating message to citizens and professionals committed to reasoned public policy.

My friends in the academic/think tank/policy analysis worlds have been (justifiably) wondering about their own relevance, roles, and meaning in the aftermath of this election. One of my most committed policy analyst friends, reflecting on the frightening misunderstandings of policy facts by voters (including the 37 percent of Trump supporters who believe uninsurance rates increased under Obamacare), wondered, “What the heck….Why do we even try?”

This disrespect for facts and experience is reinforced by the cabinet and major policy appointments that have been proposed so far. While Ronald Reagan campaigned on a slogan that “government is the problem,” he still made an abundance of quality leadership appointments in the White House and the agencies. The implicit statement in so many of the President-elect’s nominations is that expertise and experience do not matter, or worse, that they will get in the way of wholesale dismantling of policy and programs – the modus operandi of the new administration.

We are obviously in a new world order for social policy. The overwhelming realities of Presidential positions, the emerging Congressional agenda, and state gubernatorial and legislative pronouncements add up to a seemingly overwhelming attack on evidence-based social policy as we know it.

In the short run, several dynamics in social policy bear watching:

Appointments are key. No appointment is more important than the Secretary of HHS. This is historically true, and powerful Secretaries have had outsized impacts on social policy. The selection of Tom Price is worrisome for the public health, social policy, and human services communities. As is widely known, Price’s policy raison d’etre for the last ten years has been the replacement of the ACA with his own version of tax credits and “choice.” He is regarded to be sympathetic to Paul Ryan’s agenda for entitlement reform.

Close behind the appointment for Secretary of HHS in social policy significance are the nominees for Labor, Education, HUD, the VA, and of course the White House policy appointments.

Less visible at the moment but equally worrisome is the potentially large out-migration of talented career public sector professionals who work on social policy, and in-migration of ideological appointments bent on undermining the very mission of many of the agencies.

The challenge for the Democrats in the appointments process will be to seize one of the few moments to get the nominee’s policy positions into public view. So far, the comments of Chuck Shumer and other Democratic leaders have not been reassuring about their commitment to shine bright light on the positions of the Trump health and social policy nominees.

Action will be shifted to states and localities. Under the new federal regime, greater discretion, federal cost-sharing, and legal authority will go to the states. Greater delegation to the states will be supported in the Senate and the House, and will go hand-in-glove with the larger agenda to limit the size and scope of the federal government. Look for increased use of block grant mechanisms, unwinding of executive orders and slow-play of federal regulations, and a lack of federal appetite to provide legal protection or enforcement.

The Affordable Care Act (ACA) will be only the first battleground. In many ways, the administration boxed itself in with the slogan commitments to “Repeal and Replace” during the campaign. While Secretary-designee Price has his health plan proposal on the shelf, there appears to be a dawning in the Congress that any immediate action will run into the politics of constituents who have benefited from health insurance coverage under the ACA, the unintended consequences in the insurance markets of a sudden change, and the budget realities of so many large-scale promises. As a corollary to the above, virtually all aspects of health coverage, the health care delivery system, and research will be in play: reproductive health, funding of the safety net, mental health and social services, the VA system, and medical and health services research have all been named as targets of the new administration and Congress.

Paul Ryan will be the puppet-master on Medicare and Social Security: Entitlement reform has been Paul Ryan’s ultimate priority during his legislative career. His single-minded commitment to his Social Security and Medicare proposals may explain his “reluctant” agreement to serve as the Speaker of the House and his accommodation of the wild swings of the Trump campaign and post-election behavior. Although Donald Trump made commitments to preserve existing Social Security and Medicare benefits, few believe these commitments are principled or durable. Look for Ryan to zealously pursue his agenda and for Trump to take credit for whatever occurs.

Privatization of programs and policy will rule: Excuse the expression, but private solutions, often private-equity solutions, will “trump” government sponsored or provided services in the new administration and the new Congress. The private for-profit industry in prisons, municipal services, mental health and substance abuse services, social services, and housing is gearing up for new opportunities coming both from federal changes as well as transitions in state governments.

Keep your eye out on collateral damage: We now know that perhaps the biggest influence on social policy over the past 50 years was massive transformation of the criminal justice system, so well documented by Elizabeth Hinton. President-elect Trump’s emphasis on law and order; Jeff Session’s advocacy opposition to immigration reform; Steven Mnunchin’s attitude towards consumer protections; and Andy Puzder’s positions on compensation and benefits all portend major collateral effects on communities, social services, and the legal system.

Don’t get distracted by the rabbit: A hallmark of the Trump campaign and transition has been the use of distractions – some would say the genius of distractions – from tweets, casual statements, and showmanship to divert attention from fundamental moves of governance. While we are looking at the rabbit, other more important magic is happening elsewhere.

Some of the most consequential influences on social policy will occur in the non-legislative, often invisible (to the public) arenas of policy-making. The ability of any administration to slow-code, defund, deregulate, and not-implement programs and policies is amazing. Executive orders can be issued or rescinded. Key appointments can lay dormant. Delays in implementation can occur.

This is why some of the most important nominations are off-radar. Mick Mulvaney, the proposed head of the OMB, is a hugely important appointment for social policy. One of the original Tea Party representatives in 2010, Mulvaney is a zealous opponent of federal spending, regulation, and rule-making. Similarly, appointments such as Seema Verma for CMS, signal not only the administration’s priority for the demise of the ACA, but also the transition of authority and funding for health and social services to the states.

Other tea leaves: Much attention has been given to Ivanca Trump’s interest in women’s issues, maternity leave, child care and elder care benefits, and wage equality. Especially if she transitions into a formal or quasi-formal role in the administration, these initiatives may receive some air time. In reality, Ivanca’s agenda is so far from the priorities of the other administrative and Congressional leaders that they may not receive much opposition.

So what to do?

A clear implication of the election and its aftermath is that the so-called evidence-based policy enterprise has failed in communicating and marketing its ideas, analyses, and findings. Consider this failing over and above whatever failings you may read into our political and media discourse. The policy failure is a more complicated and subtle problem than mere dissemination of policy research and analysis. A wholesale assessment of the content, styles, channels, and audiences of policy communications is in order. A radical rethinking of what it means to influence politics and policy is also in order.

It is worth asking if we need major changes in our institutions and organizations to both protect the policy interests of vulnerable groups as well as influence the next agenda of policy change. It is clear that the traditional channels of publication, advertising, cable chatter, and even nascent social media are not effective.

In past posts I have highlighted the efforts and funding of major institutions such as the Ford and McArthur Foundations to bring evidence to bear on social change. Foundations, universities, think tanks, and advocacy groups will all need to take stock and ask if a new model of policy translation is necessary in light of what we have learned in this election and its aftermath. Similarly, those in the business of training policy, public management, social work, public health, and journalism professional students need to regroup and consider the tools and audiences for the graduates of these fields in order to have significant social policy influence.

There also needs to be a new focus on community, city, rural, and state level policy making as the loci of action.

The good news is that the quality and relevance of social science and policy-relevant research are at an all-time high. The bad news is that its impact and uptake are arguably at an all-time low. Considerable effort and resources will be needed to tackle this problem or we risk a continued slide into a polity of fake-news, disinformation, demagoguery, and division. Perhaps as important, policy analysts will need a reservoir of morale, resilience, and motivation to tackle the next era of “speaking truth to power.”

^[i] Nicholas Kristof, Lessons from the Media’s Failure in Its Year With Trump, The New York Times, December 31, 2016.