How much of a safety net? Quist, Gianforte differ

The role of a social safety net in America has been at the heart of key debates between Montana’s two U.S House candidates.

Both say that the cornerstone federal programs must exist, but often disagree about how directly the government should manage them, the extent to which private companies should be involved, which services to offer, and whether they should be universal or limited to a narrow set of Americans.

Philosophically, the safety net was designed to give people a solid footing even in the toughest times so they could achieve the American Dream, with programs ranging from health care and Social Security to disability services and affordable housing.

Democrat Rob Quist often spoke of his personal experience with safety net programs and in stark terms of defending them from what he sees as an attempt to turn them into corporate profit machines.

“I was talking with Pat Williams (the last Democrat to hold Montana’s U.S. House seat) and he said from the time he became congressman that the goal of the Republican administrations were to privatize everything. To me, there’s a danger in that,” said the Creston musician best known as founding member of the Mission Mountain Wood Band.

Republican Greg Gianforte said the social safety net is one of the four primary purposes of a federal government, along with national defense, making and enforcing laws, and paying for infrastructure.

“We need the safety net, but I believe the best path forward is to actually improve the economy so there are more jobs,” said the Bozeman tech entrepreneur. “We do that by letting people keep more of their hard-earned money, lowering taxes, reducing regulations so people that create jobs can create more jobs.”

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Health care has been a primary topic of campaign stops leading up to the May 25 special election to fill the seat vacated by Ryan Zinke when he was confirmed as Interior Secretary. Quist has started and ended his campaign with statewide tours to talk about health care, mostly calling for a defense of the Affordable Care Act and condemning the current Republican replacement plan, the American Health Care Act.

“We have to resist this,” Quist said during an event at Great Burn Brewing in Missoula on Tuesday.

He hammered on the GOP proposal for allowing insurers to charge people with pre-existing conditions higher premiums and changing the way the federal government funds state Medicaid expansions, which he said would kill Montana’s program that has insured more than 70,000 people since it launched in January 2016.

Beyond defending the Affordable Care Act, Quist has advocated for a single-payer system, which he said would simplify the whole system and significantly reduce administrative costs driven, in large part, by existing reporting and compliance requirements.

To fight the rising cost of prescriptions, he has suggested that Medicare, the free health care program for the elderly or people with disabilities, should be able to negotiate prices like other federal programs. He also has supported lifting an importation ban on pharmaceuticals, noting his wife’s Epipen costs just $20 when relatives buy it for her in Canada rather than the $500 here in the United States.

Gianforte said the federal government has “an obligation to all Americans to make health care affordable.”

“That’s why I believe we should repeal and replace Obamacare,” he said, referencing the Affordable Care Act.

He did not fully support the first version of the American Health Care Act and has raised questions about the latest iteration in interviews, saying that preserving rural access and reducing premiums will be his primary concerns when evaluating a proposal.

Gianforte has been criticized, however, for a phone conversation leaked to The New York Times in which he told lobbyists that he was “thankful for” the House votes that moved the American Health Care Act forward.

Those reforms also could dramatically affect the financial ability of states to continue Medicaid programs expanded under the near-complete reimbursement rates promised in the Affordable Care Act. Montana, for instance, raised the income threshold for people to qualify and allowed all adults - not just single mothers, children and people with disabilities - to receive the government-funded health care coverage.

The Republican reforms discussed in the last several months have proposed capping federal appropriations to states to pay for those expansions, or providing the funding as block grants that would have fewer rules about what types of services must be covered. Some fear those block grants, like similar ones instituted for food subsidy programs, would lead states to tighten eligibility requirements and force people off the programs since money would not go far enough to cover all need.

Gianforte said the government needs to maintain the expanded coverage.

“We can’t pull the carpet out from under them,” he said. But he did not answer questions about the fears that a cap or block grant would do just that and about whether he supports those ideas.

Speaking about health care reforms, but also safety net programs in general, Gianforte said he wants to see tapered benefits so the neediest people receive complete support, with some assistance for middle-class families.

“We need to make sure that we don’t put incentives that discourage people from getting up on their own feet and being self-sufficient,” he said. “Some programs have benefits that just fall off a cliff at a certain income level or hours worked per week.”

Quist wouldn't say whether he generally supported programs that provide universal benefits, like Medicare, or one that limits aid based on income or other factors, like Temporary Assistance for Needy Families.

“It’s a complex thing,” he said, nonetheless lauding Medicare as an example of why a universal program can work best.

“It all comes down to philosophy about whether you’re into service of self or service to others,” he said, taking a swing at Republicans in Congress he suggested were looking for more tax breaks for themselves rather than seriously reforming health care.

“Universal (programs) are a service to everyone. That’s what’s been so great about Medicare. It’s probably been the most successful program ever instituted. You show your card and you’re covered, no questions asked. It takes out the administrative costs," Quist said. "It’s a much more efficient system than a system where people have to find and pay exorbitant prices for insurance.”

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In the final weeks of his campaign, Quist also has argued that he is the best person to defend Social Security. He has seen firsthand how the program can keep American families afloat, he said. As he has done frequently, Quist said when he had health troubles and was “facing the possibility of bankruptcy” that the ability to take Social Security income early “really saved me and my family.”

In campaign stops Quist has raised the specter that Republicans, Gianforte among them, want to end or roll back Social Security.

Democrats criticized Gianforte during his failed gubernatorial bid last year for comments he once made about Noah, the Biblical figure who built an ark to survive a catastrophic flood.

Speaking to Montana Bible College students, he reportedly said: “ There’s nothing in the Bible that talks about retirement … . How old was Noah when he built the ark? Six-hundred. He wasn’t, like, cashing Social Security checks, he wasn’t hanging out, he was working. … The role we have in work may change over time, but the concept of retirement is not biblical.”

Gianforte declined multiple requests to clarify those comments or address the backlash to them during a Wednesday interview. Instead, he repeatedly said, “I will always protect Social Security.”

Earlier, he said some of the nation’s safety net programs do not fit his vision for what those should be - only those services that “take care of the people that can’t take care of themselves” - but nonetheless “exist because as a society we’ve decided to have them.”

He said Social Security is “a contract between the federal government and those recipients” who have paid into the system their whole lives.

“So we cannot do anything to jeopardize those benefits in anyway,” he said.

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The Republican administration of President Donald Trump, including Secretary of Housing and Urban Development Ben Carson, have proposed restructuring many of the nation’s core affordable housing programs, and also want to cut funding from block grants that pay for the majority of affordable housing built here in Montana for people with low incomes, disabilities or who are elderly. Funding for maintenance of public housing also could be cut dramatically.

Carson has said Trump intends to fund affordable housing initiatives in a to-be-released infrastructure proposal and notes that the government can get more “bang for its buck” by expanding an existing tax credit program that provides incentives for private developers.

Those tax credits have been criticized by some housing advocates, who say they often do not do enough to guarantee housing is built where it’s needed most, in part because of market dynamics, and in a way that does not exacerbate existing economic or racial segregation.

A Quist interview ended before he could discuss his views of the housing proposals, and requests Thursday and Friday for additional time were not fulfilled.

Gianforte did not answer some specific questions about the proposals, but said that higher-paying jobs would make housing affordable for more Americans. He also said he generally supports public-private partnerships over programs that are managed entirely by federal agencies.

“Very often the private sector can do things more efficiently than government can,” he said. “If we decide we have a goal as a country, like more affordable housing, I’m a fan of incentive programs to help the private sector fulfill that need.”