Episode 06: The 24 Million Person Question

With the TrumpCare crisis averted (for now), what’s next for healthcare. Plus, a trip across the pond, a trip to New Jersey, and a deep dive into the overlooked issue of hardship on college campuses. Subscribe to Off-Kilter on iTunes.

It’s not just U.S. politicians considering major cuts to programs that serve struggling families. Mary O’Hara, a columnist with The Guardian, joins with an update on how austerity is playing out in the United Kingdom. Next, Sara Goldrick-Rab, author of Paying the Price: College Costs, Financial Aid, and the Betrayal of the American Dream, sheds light on the overlooked issue of hunger on college campuses — and how the current financial aid system is failing many low-income students. Finally, continuing our #ResistanceWorks series, Rebecca speaks with an activist from a New Jersey chapter of Indivisible to get the inside scoop on how they helped flip their Republican Congressman on Trumpcare. But first, with efforts to repeal the Affordable Care Act dead for now, Rebecca and Jeremy sit down with Topher Spiro to talk about what’s next for healthcare.

This week’s guests:

Mary O’Hara, The Guardian
Topher Spiro, Center for American Progress
Sara Goldrick-Rab, Temple University
Elizabeth Juliver, Indivisible New Jersey

For more on this week’s topics…

Mary O’Hara connects the U.K.’s austerity cuts to where the U.S. is headed.
To follow healthcare updates in real time, look no further than Topher Spiro’s Twitter.
Sara Goldrick-Rab’s book in its entirety.

This program was released on March 31, 2017

Transcript

REBECCA VALLAS (HOST): Welcome to Off-Kilter, I’m your host Rebecca Vallas. It’s not just American politicians considering major cuts to programs that serve struggling families. I’ll speak with Mary O’Hara of The Guardian to get an update on how austerity is playing out in the United Kingdom. Next, the overlooked issue of hunger on college campuses and how our current financial aid system is failing many low income students. I’m joined by Sara Goldrick-Rab, she’s a professor of higher education and the author of “Paying the Price: College Costs, Financial Aid, and the Betrayal of the American Dream.” Finally, continuing our “Resistance Works” series, I sit down with an activist from Indivisible’s New Jersey 11th chapter to get the inside scoop on how they helped flip their Republican congressman on Trumpcare. But first, with the Republican efforts to repeal the Affordable Care Act dead for now, I’m joined by Jeremy Slevin and Topher Spiro, Vice President of Health Policy at the Center for American Progress to talk about what’s next for health care in this week’s “In Case You Missed It.” Topher, thanks for joining.

TOPHER SPIRO: Thanks for having me.

VALLAS: So I feel like I was going to call the 64 million dollar question but maybe it’s the 880 billion dollar question, we come up with some different numbers —

Slevin: The 24 million people question?

[LAUGHTER]

VALLAS: The 24 million people question; what’s, so people are saying the Republican efforts to repeal and they say replace the Affordable Care Act are dead after last week’s vote that couldn’t happen because they didn’t have the votes. Is that true? What’s next?

SPIRO: I think it’s likely dead. I mean, there are some rumbling that they’re still trying to work out a deal. But I think that’s something that they have to tell their donors that they’re still on something that they’ve promised for seven years. And it’s something that the Freedom Caucus obviously still wants. So obviously they’re going to talk about how it’s still in play. But there are Republicans in the Senate who want nothing more to do with this. Who want to just move on. So we’ve had McConnell say that he wants to move on. We’ve had the number two and number three Republicans say in the senate that they want to move on. And we’re getting, you know, some signals from the White House that they want to move on.

So I think you know, it’s likely that this is over. Time is not on their side. That’s one reason they were trying to rush this whole thing and why the bill was a policy dumpster fire was because they’re trying to get it down before Easter recess. Before they would have to face all the masses back in at home we are going to be protesting at town halls and you know, so that’s why they really needed to get it done by now. And the timeline has slipped.

JEREMY SLEVIN: And that says something. If McConnell is saying it’s done, technically the senate could still pass their own bill and then force the House to do something, but the fact that they’re like, “no, we’re moving on,” says something about how scared they are.

SPIRO: Republicans really want to cut taxes for rich people and so they want to —

VALLAS: I’ve noticed that!

SPIRO: So they want to, they really want to get on with that and Trump himself, you know, said that he would probably have preferred to start with that. That’s their number one priority. So they’ve got to, if they want to do that, they’ve got to move on.

VALLAS: Do you think that things might have turned out differently, I know everyone is kind of obsessed with the post mortem right now, but if they hadn’t led with health care, which is what the rumblings are, right, that Trump had wanted to lead with maybe taxes and infrastructure, that Paul Ryan was the one who wanted to lead with ACA repeal, Trump said, “Fine, whatever we’ll do it your way.” Do you think things would have turned out differently?

SPIRO: You know, I think the problem for them is that, and that what they realized is that healthcare is complicated. And guess what?

SLEVIN: No one ever said that according to Trump.

VALLAS: Wait wait, but can we actually just throw Trump’s words back in his face because this is maybe my favorite quote from the whole thing, he was talking to Republican governors and he literally said, “Who knew healthcare could be so complicated?”

SLEVIN: Who knew?

VALLAS: And the room all went, “Uh, we all did!”

[LAUGHTER]

SLEVIN: I think, as John Oliver said, “If you know one thing about healthcare it’s that it’s really complicated.”

[LAUGHTER]

VALLAS: But Trump knew no things, and that we now understand.

SLEVIN: He now knows one thing, that’s complicated and nothing more.

SPIRO: Well, you know, guess what? Tax reform is also complicated. I mean, there you’re not killing people but if they had started with that, I’m not sure would have been in a much better position because that would have been hard for them to do too. I think what Trump should have done, I mean I’m not in the business of giving him political advice, he should have started off with the infrastructure package that, really he really wanted to do. That he emphasized in his inaugural, and he might have gotten some bipartisan support. Instead, they felt like they had to do a lightning strike with repeal of the Affordable Care Act, the problem was that once they learned that they can’t just repeal and then delay the effective date of repeal by two years, they can’t just do that because in the interim insurers would have started to drop out of the markets due to the uncertainty. And so they started to get scared that that would not be a good idea.

VALLAS: Would have been a whole death spiral in the entire insurance market.

SPIRO: Yeah, and so that’s when the debate turned in our favor because then they started to see that repeal and quote unquote replace had to happen simultaneously, and once they were forced to put up a plan that could be compared side by side with the Affordable Care Act, it looked ugly. And you know, we started having the CBO score and it just blew up in their face.

SLEVIN: But shouldn’t they have known this? Like, Paul Ryan said, “Oh, now we’re learning to be a governing party.” They’ve controlled the House of Representatives since the election of 2010. They ran back then on repealing the Affordable Care Act and they realize now in 2017, oh we can’t just repeal it and then say we’re going to have a replacement plan because maybe it will cause a death spiral.

VALLAS: I’m curious, Vox put out a piece that I thought was maybe one of the smarter post-morts. And, I’m curious if you agree with this. And the argument was, essentially that the Affordable Care Act already was, in a lot of ways, a bipartisan compromise, even though Republicans don’t like the take any level of credit for it or be affiliated with it, didn’t vote for it, that their fingerprints are all over it. It has 200 or more Republican amendment incorporated as part of it, the entire concept of the mandate was a Republican idea. And so there was never going to be a replacement that was somehow all the good conservative ideas because they weren’t going to be able to come up with something that wasn’t going to look like the Affordable Care Act and that is what they were trying to do politically was prove that it was broken.

SPIRO: Yeah, I mean look, it’s actually really simple which is that if you’re staying within the same basic structure but spending a whole lot less money, you’re slashing the tax credits, you’re slashing Medicaid, it doesn’t take rocket science to know that that’s going to lead to millions of people thrown off their coverage. So, they were making promises that they could not keep and where the math would not add up. Which is you can’t lower deductibles and at the same time propose tax credits where you can only buy plans that are crappy with high deductibles. You can’t say you’re going to not throw anyone off coverage and then slash medicaid. So they were in a political box, which is they were making promises and they were inconsistent with their policies.

SLEVIN: So it turns out, actually what they wanted to do wasn’t that complicated. They were just taking money out of the health care system therefore people were going to lose insurance.

SPIRO: Well it was really that they really wanted to cut taxes for rich people —

VALLAS: That’s what they wanted to do.

SPIRO: That was a big part of the healthcare bill and part of the reason they wanted to lead off with that is because if they did all that stuff in the health care then they could cut taxes by even more in the tax reform bill. Because they wouldn’t have had to cut those taxes in the tax reform bill. So, that’s really what it was all about, and then you know, it’s really just an ideological thing where they wanted to save a lot of federal spending.

VALLAS: So, in a lot of ways, all eyes are now on the states. When it comes to what’s next. Oh my god, we got there, we’re there, guys we can talk about what’s next, it’s happening [LAUGHTER]. But so there’s on the one hand, looking at the states that are still hold outs when it comes to Medicaid expansion. And there’s the question being asked, are we actually going to see some of those hold outs flip and adopt expansion now at this point. Is the political climate actually going to permit that to happen? But then there is also this guidance that Tom Price at Health and Human Services and Seema Verma over at CMS, Medicaid and Medicare services, sent to states governors basically inviting them to do all kinds of terrible stuff to their Medicaid programs and saying, “Don’t worry, we’ll rubberstamp it all, yes,” even though no administrations in the past have said this was Kosher. So, what are we expecting from the states, Topher?

SPIRO: Well, on the one hand I think this whole debate has been great because everyone has learned to love Medicaid and Medicaid expansion. And that was a big part of the debate and a big part of the backlash. And right after the bill collapsed we’ve seen already a couple of states moving to expand Medicaid. We’ve seen Virginia wants to do it, by executive order. We’ve seen in Kansas in all places the senate there which is overwhelmingly Republican voted 25 to 14 to send Medicaid expansion to the governor’s desk, now he did I think today veto that Medicaid expansion but now they’re trying to cobble together votes to override his veto in one of the reddest states. So I think that there will a big push by grassroots advocacy to expand Medicaid in states that haven’t done so. On the other side we’ve got to play defense still. So that’s offense, we’ve got to play defense against some of these states that are going to try to rollback important protections.

SLEVIN: Why do you think, why is Kansas now on board with expansion, and then why do you have other states that are trying to roll back protections? Where’s the logic there?

SPIRO: I don’t know.

[LAUGHTER]

VALLAS: I want to say what’s the matter with Kansas, but for once they’re doing something right so no?

SPIRO: No, it’s really unbelievable. I mean, I can’t explain it. But, you know we’ve learned nothing is impossible and the power of grassroots advocacy to really influence a debate. And I think there is a real potential for that at the state level.

VALLAS: And I think the real question isn’t what’s making Kansas different, it’s if Kansas is doing it does that mean we’re going to see a groundswell of other states that are not quite as red actually follow in their footsteps. Have policymakers at all levels of government heard loud and clear that despite how folks may have voted in November, what they’re asking for is the keep their health insurance?

SPIRO: Yeah to keep and expand health coverage. I think with the opioid epidemic it’s something that’s become very important to states that have been hit by that and you know, so a state like Maine that hasn’t expanded yet where the crisis has hit it hard, they should really consider expanding their Medicaid program.

VALLAS: In the last 30 seconds that we have there are some on the left who are calling for now to be the moment where Democrats come out and call for Medicare for all. That truly universal health coverage is the next step that we should see is what they are saying. Agree, disagree?

SPIRO: Well, I think that we should in the short term push for this administration to enforce the law, to try to make the law work and that should really be our focus at the moment. We have to be very vigilant that they’re not going to sabotage the law because, let’s face it, we’re not going to get Medicare for all during the Trump administration. So I think —

SLEVIN: You never know.

SPIRO: There needs to be some focus in the short term and also some planning and hopes and dreams for the long term.

VALLAS: But is it smart politics if we were to do it? Long term?

SPIRO: I think that Democrats need to be proactive, we need to have an agenda for the long term. I don’t know where if that’s where they’ll go or not. But we certainly should be pushing this that will expand coverage, even under the Affordable Care Act, there are millions of people who are still uninsured. We’ve got to get them into the system one way or another.

VALLAS: Topher Spiro is the health guru here at the Center for American Progress, thanks for joining us to help us catch up on where things have gone and maybe where they’re headed.

SPIRO: My pleasure. Thank you.

[MUSIC]

VALLAS: You’re listening to Off-Kilter, I’m Rebecca Vallas. British Prime Minister Theresa May official began the Brexit process this past week but Brits continue to brace themselves for a whole lot more than their departure from the European Union. Since 2010, austerity has been the law of the land in the UK. Here to discuss how that’s been felt across the pond and to provide a cautionary tale to the United States is Mary O’Hara. She writes a social affairs column for The Guardian. She’s also the author of “Austerity Bites: A Journey to the Sharp End of Cuts in The U.K.” Mary, thanks so much for joining Off-Kilter.

MARY O’HARA: Oh, a pleasure Rebecca, thanks for having me.

VALLAS: So just to kick us off, the word austerity gets thrown around a lot. But in the context of U.K. politics and policy it has a very specific meaning. Can you maybe give us the background, how did the UK get to austerity, what does it mean and what has it meant for budget policy where you are?

O’HARA: I mean, austerity, as you say does get used in many guises but in the context of the U.K. with the election of a coalition government in 2010 and in the wake of the financial crisis which obviously hit America very hard too, the then Chancellor of the Exchequer George Osborne announced that Britain’s reaction would be austerity. Now that, the idea being if you pull back public spending and you reduce the size of the welfare state that stimulate private sector investment which would therefore grow the economy. That never came to be. But ostensibly what austerity in the British context meant was a retraction of state services, was a culling, if you like, of the welfare state and the support systems that take care of the most vulnerable and marginalized people in society and low paid workers, the group. It was basically an ideological drive that was wrapped up an economic justification that had no foundation.

VALLAS: And what are some of the programs that have been hit by these cuts? Maybe give us a couple of examples.

O’HARA: Yes, exactly. So things like anti-poverty programs, welfare programs that would help single mothers, children in poverty. Lots of benefits that affected disabled people, disabled people were particularly badly hit. Housing, for instance, homelessness has gone up in England. It’s doubled [inaudible] in 2010 for instance, after having gone through being reduced. So right across the various different social programs the cuts and social care as well for older people. All of those were hit really, really hard. And they hit already vulnerable people or people who were struggling. The working poor, for instance, were hit very, very hard.

VALLAS: You mentioned people with disabilities and that’s been one of the major sources of outcry to austerity in the U.K. is the impact on disability programs and people with disabilities and that’s been across a range of different types of cuts. Maybe tell a little bit of that story and how that’s played out for people with disabilities.

O’HARA: Yeah, it was interesting at the very start, of austerity in Britain Rebecca, because disabled people and disabled activists were really among the very first to point out just how awful it was about to be and how disproportionate the impact would be on people with disabilities. Obviously people with disabilities have more expenses in any given month, so the idea that the state would help people, you know, help them get into work. Help people with the equipment and the support and help them stay in their own homes rather than an institution. A whole raft of programs that were designed for those purposes were cut back. That had an enormous impact on the dignity and independence of disabled people. And I think one of the astonishing things about what transpired in Britain is A; that this was pointed out right at the very start and that B; the government’s response was basically just to keep going. That even though all the evidence backed up that this was detrimental to the wellbeing of disabled people, they kept going. And they’re keeping going.

VALLAS: Now advocates have complained and have elevated their voices and stories of people who would be impacted and who now are being impacted as you’re describing. But I’m curious the broader public reaction outside of the advocacy community or kind of the equivalent of your think tank community. Was there support for austerity at the outset and is there support now or are you seeing broad public opposition similar to the resistance that’s sweeping the U.S. in cities really, across the country?

O’HARA: Well, that’s a really interesting point because it has been fascinating to observe what’s happened here in response to these new policy initiative on the back of the new administration here because in Britain, there was widespread opposition to austerity but it was sort little understood in a way in the beginning because it was so effectively pitched as the only choice. The only choice was to cut government programs because government programs were a strain on the public purse, you know they were bad for taxpayers, et. cetera. That message resonated much more than the message that people were going to be very hard hit. You know that old phrase that “you’ve got to tighten your belt” or “you’ve got to, you know, pull yourself up by your bootstraps” kind of logic? That was very much what the right in Britain managed with the collusion of many newspapers and media outlets to get across to the public. So it took a long time really, for the public to begin to understand the level of what was happening. I think that has begun to trickle through but there was nowhere near the sort of widespread instance resistance what we’re seeing in the U.S. right now. I think had the U.K. had that, may have been a different story that we’d be telling today. But also, the main opposition party in Britain failed to oppose austerity and I think what is really important is that you have that alliance of the wider public and a viable political opposition. If you don’t have both in tandem, then the leaders in power seem to get away with whatever they want.

VALLAS: You mention that homelessness has increased and in particular people with disabilities are feeling tremendous impacts from these cuts. But I know you’re familiar with what’s happening here in the United States, President Trump released what we’ve been describing as a scorched earth budget, his blueprint for how he thinks federal spending should be done. And it included massive cuts to basically every aspect of our safety net, and of programs that serve low and middle income Americans, a lot of people have declared that budget “DOA”, saying it’ll never become law but Republicans in our congress are having similar conversations to a lot of what was in that budget. Should the U.K’s experience with austerity provide a cautionary tale to American politicians and also are there lessons to be learned for the resistance here and for advocates and average people on the streets looking to make their voices heard?

O’HARA: I think they’re very different systems, obviously but there are real lessons to be learned. The U.K. often looks to the U.S., for those innovations in policy which is often not very wise decision. But when it comes to the source of drastic cuts that are within Trump’s budget. I looked down the list of categories affected, they’re almost a mirror image of what has happened under austerity in Britain, low income families, huge target area hit by multiple programs if they’re cut. People barely getting by instead of the welfare state or the state per say being a stepping stone or an aid to people to move on in their lives, suddenly, what the cuts do is pull the rug right out from under them. Now, we know what the evidence says in the short, middle and long term this is bad for those individuals and families but it’s also bad for wider society. So

I think politicians really have to ask themselves what is the point? What is the point of removing these absolutely vital cushions for people? When really you just end up with increased child poverty, increased homelessness, increased distress, increased mental health problems, all of which have transpired in Britain. I mean you really need to start in that barrel if that is where you want to go. In terms of potential lessons here for the resistance in the U.S., from where I’m sitting having watched what happened in Britain over the years I would say just keep doing what you’re doing because the noise level from a distance here right on a local level right through to D.C. has been extraordinary and I think it probably has the potential to be much more effective than its equivalent back in 2010 in Britain.

VALLAS: And my final question for you in the last minute or so that I have with you is I’m curious what folks in the U.K. think about what’s happening here in the United States. President Trump is an interesting individual and there have been a lot of, we saw the day after inauguration Women’s Marches not just in the United States but across the globe including in the U.K. But now we’ve started to see not just what we think he might do but actually him coming out and clearly articulating his priorities for the country as we saw with his budget released last month. What’s the take in the U.K. as you guys are living the experience of austerity?

O’HARA: Well I think anybody who’s been on the sharp end of what happened in Britain would say to any American, just do not go down this road. You safety net wasn’t the strongest in the first place, it wasn’t the European style safety net to begin with so do not go down this road. I think probably the key thing that people in the U.K. and probably around Europe feel when they looked at the U.S. and what’s happened in the past few months is they felt almost similar levels of shock at what happened and what was being pledged. But I also think that there are serious worries about America’s place in the world, about the role model that can or can’t be across a whole range of policies. And I think one worry that people have is, OK, if America goes down one road, then how much does it pull others with them? And the real fear I think was this idea that the right, or the radical right would be emboldened in the U.K. and in Europe. And that has potentially very scary prospects. So I think people are waiting to see how the system [inaudible] itself out and whether the dynamic between the administration and congress changes the course of the direction. And I think it’s to wait and see for everyone, really.

VALLAS: I lied and I said that was my last question, but there is one more thing I’m dying to ask you. [LAUGHTER]. Which is you’ve been covering austerity and the pain that it’s causing for several years now, you’re actually going to come out with another book this summer looking at the continued effect of these policies, what is the future of austerity in the U.K.? Is it inevitable that it continues or do you feel that there will be a tipping point that the country may reach where it is so deeply unpopular that politicians actually have to reverse course?

O’HARA: It’s an interesting question. The book is that’s coming out in the summer, I’m contributing to along with a bunch of other people including economists and social theorist because after the amount of time that’s passed what we have realized is the violence that it’s unleashed. We’re talking really, really harsh consequences for people. You know, these aren’t minor shifts in policy. And I think one of the things that really brings home is that once you take these things away, things that it took decades to build a consensus around, you know they’re not coming back anytime soon. So I think what it has shown is what’s at stake is a fundamental of what you regard as a democratic and a welfare system. And the potential for that kind of social fabric to be torn apart. I mean I don’t think it’s too hyperbolic to say that we could in a direction that takes decades to get back from. I think the thing to always remember, and I’ve always tried to focus on is that in the middle of all of this is not numbers it’s human beings, it’s people’s lives. And that’s what’s at stake.

VALLAS: Mary O’Hara is a social affairs columnist with The Guardian. She’s also the author of “Austerity Bites: A Journey to the Sharp End of Cuts in the U.K.” Mary, thank you for what you do to put a human face on the consequences of these policies.

O’HARA: Well thanks for talking to me Rebecca, much appreciated.

VALLAS: And thanks for being on the show.

[MUSIC]

VALLAS: You’re listening to Off-Kilter, I’m Rebecca Vallas. Trump University may be back in the headlines but for-profit universities are just the tip of the iceberg when it comes to the problems plaguing higher education in the United States, particularly for low income students. Sara Goldrick-Rab is the author of “Paying the Price: College Costs, Financial Aid and the Betrayal of the American Dream”, she’s also the founder of the Wisconsin Hope Lab, the nation’s translational research laboratory seeking ways to make college more affordable. Sara, thank you so much for joining Off-Kilter.

SARA GOLDRICK-RAB: Thanks for having me.

VALLAS: So, just to bring conversations together that often are very separate, we hear a lot about college access, college affordability, the national student debt crisis, but very rarely do we hear those types of conversations come together with a conversation about hunger in this country. But that’s an intersection that you’ve looked a lot at. How are those issues related?

GOLDRICK-RAB: Well, I think they’re related in some expected ways and also some unexpected ways. So, you know first I’ll say this; we did not set out, my research team did not set out to be studying hunger and homelessness in higher ed. Because we, like so many other people, honestly didn’t realize it was a problem. We came to find out that it was a problem when we were out doing interviews for a study of financial aid. And we were trying to find out how college was going for people from lower income families, we thought we would hear about people not being able to buy books, or laptops, those sorts of things.

Instead what we heard was that they were having trouble buying enough food. That they were having trouble paying their rent. That they were getting run out of their homes. You know, and I think that in many ways it makes sense that these challenges would be happening because they’re happening for so many Americans. And some of the folks grew up going through spells of homelessness for example, as children. But in another way, it’s really kind of a new thing and that’s really being driven by the high prices of college that are coupled with the high costs of just living in this country. Leading some people to really fall through the cracks.

VALLAS: And that is the bulk of what your book, “Paying the Price” really looks at, you actually, you and a research team studied 3,000, and you spent time with 3,000 Wisconsin public college students who received support from federal aid, from Pell Grants. But you actually, you did this over the course of a number of years and across several campuses. Tell us a little bit about what you did for this book and then some of what you found about how financial aid is or isn’t working for students.

GOLDRICK-RAB: Well, what we really did was try to get to know the people who are popularly called Pell Grant recipients. These are folks who are beneficiaries of one of the nation’s largest entitlement programs that has really supported millions of people in their quest to be able to go to college by offsetting the price of college, discounting it to make it a little more reasonable. What we did was followed 3,000 students around for as you said, 6 years. And we were doing that because we were trying to figure out what would happen when they received a little more financial aid from a special private scholarship program. But the people we were following weren’t particularly unusual at all. They were just young people who had graduated from public high schools throughout the entire state of Wisconsin and had enrolled in one of the 42 public colleges and universities including technical colleges all over that state. And they went to college in part because they were able to fill out the financial aid application, the FAFSA. Which a lot of people know as a small American bureaucratic tragedy, you know, something that really holds up a lot of folks. They can’t get the money that they need because they can’t fill out that form.

Well, these folks filled out the form and they got the Pell Grant and they started trying to go to college. And what we wanted to know was, how were they going to make ends meet? I think we were asking a question that a lot of social scientists have asked for a long time, which is what do you do in this country when you don’t have a lot of money and you’ve got to pay for these things? And in this case, you’ve got to pay for expensive things like college. The real punchline is this; while they’re all Pell Grant recipients, which in theory should mean that college is affordable for them, we found that college wasn’t affordable at all, that the Pell Grant program in no way lives up to its promises. Not because people aren’t trying, but because there just isn’t enough money in the program and that the way the program is delivered is getting in the way of it’s trying to do.

VALLAS: And one of the things I would love for you to break down a little is people focus almost entirely on tuition. They think about rising costs of tuition and that is a huge part of what you’re talking about and what you look at in this book. But you also look at the other kinds of costs that are attendant along with tuition. Whether it’s just the costs of living, the costs of food, books, other types of things. How does that play into college affordability or the last thereof?

GOLDRICK-RAB: Yeah, we attend to those things frankly because those are the real life things that every adult goes through. Whether or not they’re in college. And it’s not the case when an 18 year old or a 20 year old or a 35 year old enrolls in college, their need to cover the costs of their housing and their food disappear. In fact, in some ways, those things get harder to cover. Because for example, the time that you would have spent working to cover your rent, you are now in school. And we find that actually people trying to divide their time. They try to go to school full time and try to go to work full time so that they can do things like pay rent. But also, because you’re in college sometimes you’re rendered ineligible for programs that are set up to assist people who are having trouble paying rent.

So there are, you know, rules in place for some housing, some subsidized housing programs that say look, if you’re in college you’re really not a priority. Because let’s admit it, relatively speaking you’re a little bit more advantaged. But in many ways you’re not. If you’re in college, just trying to get ahead, just trying to get a stable economic existence in place for yourself or your family and you don’t yet have the college degree. Which means you don’t yet have any of the money that comes with the college degree. So we study these things because actually they’re the primary thing that gets in the way of people being able to afford college. It’s really not about the tuition or even that much about the fees. It’s about the fact that you have to pay rent and buy food and you can’t necessarily do it in the way you would if you weren’t in school.

VALLAS: Now, college is maybe often talked about in the traditional sense, people are thinking of college students, they’re thinking of people who are 18 to 21, or 18 to 22, who have left home, they finished high school, they go straight to an institution of higher education, but that’s not necessarily the case for a lot of the folks that you were speaking with and a lot of folks in this country who are often described as “alternative students” or you know, students who didn’t follow that traditional, so-called traditional path. I would love to hear you talk a little bit about some of how other programs, whether what’s traditionally called welfare, Temporary Assistance for Needy Families, which was curtailed dramatically in the mid-nineties, or food stamps or other kinds of programs that are there in theory to help people get back on their feet and then hopefully be able to get ahead. How are those programs fitting or not fitting with say, Pell Grants and our systems of higher education, are they helping students in the way that they should or are they not meeting the task?

GOLDRICK-RAB: Yeah well, a lot of the way that higher ed is set up is based around the assumption that the college student will be a person who has a great deal of parental support. The idea is primarily that you will come out of high school, you will go directly to college, you go enroll full time and you be able to do so because your family will have saved for college and will have the resources to provide you with all of the things that you need. Whether it’s the right sheets that fit the bed in the dormitory that you’re living or whether it’s to send you a care package of extra food for the weekend.

None of those things, none of those images align with today’s students. The vast majority of today’s students are on their own. They are on their own sometimes because they are older and you know, like most 30 year olds don’t actually look to their parents to pay their finances, they’re on their own because they’re the first person in their family to attend college. They’re on their own because they’ve been on their own even as children. Because while their parents love them and support them emotionally they don’t have money for them. Being on your own in college is not, as I said earlier, is like being on your own outside of college. Partly because there are rules built into support programs that don’t work well for college students. So let’s just take SNAP. You know, I personally think that SNAP is a fabulous program and we need it desperately. It’s a good way to try to reduce the chances that somebody will not have had sufficient food that day or that a child will not have eaten.

However, SNAP contains some rules that are very much disadvantageous for college students. Rather than acknowledging that a person who is going to college doing exactly the right thing to try to avoid food insecurity, and to try to avoid even needing SNAP in the future, SNAP says to the college students, if you don’t have kids, you need to work 20 hours a week in order to get food stamps. And by the way, college doesn’t count as work. Now, again, makes very little sense because college is a lot of work and it requires a lot of time and we know from research that asking a college student to work 20 hours a week on top of their studies is a good way of reducing their chances of completing their degrees. But, to even take it further, there is the little exception that’s built in there that says well, college students, maybe we’ll let you out of the 20 hour a week work requirement if you’re receiving support from the work study program. Well this sounds good, because we’re thinking well if you’re a low income student you will be getting support from the work study program because we set it up to support you but it doesn’t work in practice. Because the federal work study program is a dramatically underfunded and badly allocated program that falls incredibly short relative to the need for it. So I reveal in the book that only 1 in 10 Pell Grant recipients who go to public colleges and universities gets any form of support from the work study program. What that really means is that there are tons of people who need to get on snap and who should be able to use the work study eligibility exception to get out of the work requirement but they don’t have work study funding so they can’t. And all that we would need to do to fix that is instead of saying you need to be getting work study funding, is to change it to you are eligible for work study funding. There are tons of students who are eligible and getting nothing.

VALLAS: And this is a set of issues that some colleges have started to try to address, there are food banks that are popping up on college campuses, there are hunger relief programs, campus kitchen projects a whole slew of anti-hunger programs on college campuses in response to this widespread problem. But it’s also something that state policy makers have started to take a look at. And in particular, in California.

GOLDRICK-RAB: That’s right. And California is leading here as they often do. And that’s for good reasons. I mean, not only are the politics better and more aligned, but the need is really substantial throughout California. The number of students in colleges and universities who are housing insecure is sizable. But we see this all over the country. I mean, California may have more need but our research has demonstrated a sizable amount of need.

For example, a couple weeks ago we released a new report called “Hungry and Homeless in College”. And it was based on a survey of 33,000 community college students at 70 school in 24 states. Where we found that two-thirds of those 33,000 people are food insecure. One-third of them have such low levels of food security so as to be associated with hunger. Half of them are housing insecure and 14% of them are homeless. What we have in response, primarily are campus food pantries. And that’s great, on the one hand, at least we have something. There are now about 450 colleges, so that’s about 10% of colleges and universities that have a college food pantry. But the organization that oversees that set of pantries, The College and University Food Bank Alliance, it doesn’t even have a budget. It’s run by volunteers who are donating their time, no entity has ever really given them any financial support. I’m happy to say that we just hired the director of that organization at Temple University and we’re trying to build out that organization not only so we can create more effective food pantries, but so that we can use those 400 points of contact to try to convince the colleges and universities and their states to do better than this. Because a food pantry is a bandaid. What we need are proactive policies to reduce the need in the first place.

VALLAS: And what would those policies look like? I’m curious, both on the side of ensuring not just access but affordability of higher education but also reducing hunger while students are there.

GOLDRICK-RAB: Right, I mean, let’s just take the issue of hunger. There are a lot of things colleges and universities could be doing. The first thing that they could actually do is just accurately tell people the cost of eating while in college. So it may sound funny but part of the cost of attendance that colleges and universities state up front is the cost of housing and food. But they don’t control those costs. Only 13% of undergraduates live on a college campus. And so those colleges are not actually dictating the costs. What they’re doing is guessing at the cost of food in the local community. Well that’s silly. Because colleges and universities are not equipped to make those estimates. However, there are other people who make those estimates and agencies that make those estimates for both food and housing and we need to be incorporating the real numbers into those official statistics that people use to assess if they have enough money in order to be able to go to college in the first place.

The second thing we need to do is we need to dramatically increase the attention paid to these issues by the higher education institutions, because a lot of them think they need to open sushi bars to attract students rather than offer affordable food. But we also need to draw attention to the issue in their surrounding community. Because programs that work to create affordable food opportunities are not integrated with colleges and universities. And they need to be collaborating. And the same thing is true when it comes to housing. So that’s the second point.

And then the third point is yes, we do need to work to ensure that policies that are there to support people when they don’t have enough to eat are present in college. And my favorite example is the national school lunch program. A program that does indeed provide a free lunch because we know that children cannot learn effective if they have not eaten. That program abruptly terminates when a student graduates from highschool, even though they may be going to the community college across the street where they are then told sorry, there is no free breakfast or free lunch and by the way, your federal Pell Grant only covers your tuition and doesn’t help with your food. So there are a lot of things we could be doing to improve on the situation.

VALLAS: In the last minute or so that I have with you, I think what we’re facing right now is a political landscape where there really is very little discussion of actually strengthening or ensuring adequacy of almost any program or benefit that goes to low-income or moderate income individuals or families. But we’re actually facing massive cuts that we’re seeing on the chopping block for a range of programs. Pell and higher education are possibly in the mix there. But your work has actually documented that Pell Grants have lost their purchasing power tremendously over years and that the costs of attending school have actually risen at a faster rate than the aid in those declining packages. So I’m curious, your message and your recommendation to advocates as we’re looking at this dreary political landscape but actually trying to continue to persuade policymakers that what we need to be doing strengthening these programs.

GOLDRICK-RAB: Yeah, I think we’re in a difficult spot. But I do think there is a lot we can be doing. I mean, first, of course, we’re trying mainly to protect the things we do have even when they are insufficient. Because the idea of operating in a country in which we have even less of a safety net than we have right now is scary for our kids. At the same time, I do think that one of the best ways to advance the conversation on college affordability is to go outside the usual route. I don’t think the Pell Grant program is politically sustainable. I think the attack right now is particularly challenging because it neither does what it needs to do for low-income people nor does it do anything for the middle class. And that has left it vulnerable for a very, very long time. Now I’m very well aware that the attacks that are coming right now are not evidence based and that they should be resisted. But we should also be looking at strategies that build a college financing system that does better both by low income people and includes the middle class so that it’s politically sustainable.

And that’s where I think we need to really engage in this conversation about free public higher education. And even if Washington’s not interested in it right now, we need to have that conversation at the state level, because that’s exactly how we got free public high school and I would challenge even this administration to try to roll back something that popular. We are not losing, we are not starting to charge for our high schools anytime soon. And it is because we have all realized that it was one of the most important achievements of the twentieth century and no one is even talking about taking it away. I also think it’s important that we begin to address living costs, not through grants to particular low income people which again, I don’t that we’re going to have particularly strong political support for, but instead by building these supportive programs that can operate in and around those individuals to bring resources to them without direct cash transfers that are in fact, again, politically difficult. That said I want money flowing in this direction, I support emergency aid programs for example, I certainly think it’s still worth fighting to protect what we have but I also hope at a time when we’re under such attack we don’t limit ourselves to just trying to do the same old thing over and over.

VALLAS: Sara Goldrick-Rab is a professor of higher education policy and sociology at Temple University. She’s also the founder of the Wisconsin Hope Lab and the author of “Paying the Price: College Costs, Financial Aid and the Betrayal of the American Dream”. Sara, I look forward to seeing what you’re up to at Temple, joining forces with other leaders on reducing hunger on college campuses, thank you so much for joining the show.

GOLDRICK-RAB: Thanks again for having me.

[MUSIC]

VALLAS: You’re listening to Off-Kilter, I’m Rebecca Vallas. The GOP’s so-called American Health Care Act is dead for now. And in many ways, we have people like Elizabeth Juviler to thank for it. Elizabeth is an activist with New Jersey 11th for Change, a chapter of the Indivisible movement that’s taken the country by storm. Located in Republican Congressman Rodney Frelinghuysen’s district, Elizabeth and her group helped secure a last minute ‘no’ from him on Trumpcare, which may have been one of the nails in the bill’s coffin. Elizabeth joins by phone as we continue our “Resistance Works” series.

You point actually in an interview that you did with the Washington Post looking at how this all played out that your congressman had not yet taken a position against the Republican Party. What did you do that was effective in putting pressure on him to stop moving forward policies that his constituents did not support?

ELIZABETH JUVILER: Well, the simple answer is we gathered, we showed up, and we told him what we thought. There were many, many more people giving Rodney Frelinghuysen a hard look on their own than he would have predicted. And in terms of his answer, his backing out of support for the AHCA, in his statement where he said he couldn’t support it he echoed our talking points, our message back to him. We hammered home, visit after visit after visit that tens of thousands stood to lose their care, their coverage in his district. Tens of thousands of people would be abandoned because of the Medicaid expansion end. And that’s exactly what he said when he came out against the bill, finally, at long last, that tens of thousands of people would lose their coverage because of the lack of Medicaid expansion in the AHCA. So we were absolutely thrilled.

And the way we got there was giving; it was really neighbors. It was, you know, neighbors gathering together. Lots of us woke up on November 9th, if we ever went to sleep at all, with a sense of unnatural disaster, it was like a mud slide. What happened? There are so many things at risk, what can we save? What can be resisted? How can we make sure that this never happens again? And we didn’t, you know, I didn’t have any answers at that moment, thousands of other people didn’t have answers but it seemed really important to gather the way that it would if your town was the victim of a mudslide or an impending flood, you would gather, you would go face to face with your neighbors, you would meet them together, in real time, which is what we did.

And it became clear really quickly that we had a trigger point, like an acupuncture point on the congress with our representative Rodney Frelinghuysen. He’s an under the radar guy. He’s got this affable demeanor, he’s got a reputation that’s based on a long standing family politics is his game. There’s been six or seven Frelinghuysens in congress, his ancestor signed the Declaration of Independence. And he’s never had to reveal himself as the closet hard right Republican that he is. He votes 100% of the time with the radical right but he talks a moderate game. So people hadn’t, you know, he’s little Rodney! His dad was in congress and everybody knew him around town and they hadn’t really him an examination. So we decided that we would. Who is he? Why does he vote the way he does? Does he know who we are? And you know, just like in the Indivisible Guide suggests we had been calling his office regularly with clear messages, clear asks. We’d encouraged people to write postcards, to write letters, letters to the editor, and we showed up by the thousands at his office on Fridays. Fridays with Frelinghuysen became by mid to late January a weekly event.

VALLAS: Was he willing to meet with you when you showed up?

JUVILER: No, he’s never met with us. He’s never met with us. We asked over and over, it was the main ask. We had a petition that was circulated, we got about 3,000 signatures from the district just to ask for a town hall. His staff said it was very hard to have a town hall, it was hard to get a venue. So we found and secured four venues for the district week, and held town halls and invited him and he never showed but we had really very inspirational and edifying experts come and talk about lots of different issues from politics to policy, and he never showed. He didn’t hear from us at all. We facebook live’d those events, they were all filled to capacity, we had about 15 or 1,600 people show up. And on facebook live they’ve been viewed over 25,000 times. So there is a lot of interest in talking to him and seeing him and hearing from him and making sure he hears from us.

He holds conference calls. That’s been his substitute for meeting with constituents face to face. He has these conference calls and he’s held them for many years. He’s not a typical politician in that he doesn’t like to, he never seeks out the camera. It’s hard to find quotes from him unless he’s asked directly because he doesn’t seek out ways to make statements, ways to communicate directly. So these conference calls, they’re, you’re kind of ambushed by a call to your landline if he has your number, without any warning and it’s a call from out of state and people don’t pick up and then they heard their message recorded; “Hi, this is Rodney Frelinghuysen. I’m inviting you to a town hall conference call underway.” So, you know, they miss it. But because of our pressure, one little change was he announced the last conference call, which he calls “tele-town halls”, conference calls, last week, he held one and he announced it ahead of time so that people could actually pick up their phones at 5 o’clock when he called. And listen in. And we recorded it, and wrote a transcript and it was the very first time that this kind of conversation with constituents was put on the record in five or six years of holding these conference calls.

VALLAS: Joe Dinkin, a friend who works with the Working Families Party has pointed out in looking at what brought about the demise of the American Health Care Act as Republicans call it, he observed that, quote, “for the first time in a long time, a sizable number of Republicans were more scared of grassroots energy on the left than of primaries on the right. What is your district look like; is it a safety red district? Is it a swing district? And what do you think that this latest win means in terms of where it may be headed.

JUVILER: I think it’s just music to my ears to hear that kind of reporting because we’ve been deemed a solid red district for a long time, twenty years. And it’s a self perpetuating story. The truth is we’re a very purple district. We’re about 40% with no affiliation registered voters, independent voters. And roughly equal registered Republicans and Democrats. But that number itself is skewed just because of the nature of town politics in New Jersey, there’s a lot of partisan town council elections and they all happen in the primary so people who may be Democrats live in a town that’s Republican. So those numbers are a little skewed but generally we’re purple. But Rodney Frelinghuysen hasn’t been, hasn’t had an opponent in many, many, really ever. I don’t know if you know, Michael Moore ran a Ficus tree against him back in mid-term elections of George W. Bush’s second term. That was an opponent of Rodney Frelinghuysen.

VALLAS: I remember that, but I didn’t realize it was your congressman! Oh, is that funny!

JUVILER: Yeah, it was him! It was a hard day for Rodney to run against a tree.

[LAUGHTER]

JUVILER: Exactly. But it’s, you know, there have been intelligent people who have run against him but they’ve never had any kind of support. Though, this year, the opponent, the Democratic ran on the line, on the Democratic ticket raised zero dollars for his campaign and he had no team. He had no campaign. And he got nearly 40% of the vote without even trying. So you look from a certain perspective and that’s a 20% spread. And that’s solid red. But just trying might close that up because there’s just a suppression in the votes of people, not necessarily Democrats but people who would like to oppose Rodney Frelinghuysen once and for all, after 22 years in D.C. But they haven’t had a choice. So, that’s really how we see our mission in a big way. We would like to wake up the district. Our goal if anything is to have the highest voter turnout in New Jersey in the 11th district in November of 2018.

VALLAS: Elizabeth Juviler is with New Jersey 11th for Change, it’s her local Indivisible chapter. Elizabeth, thank you so much for what you’re doing out there to bring about the level of pressure that we need on members of congress to see the difference between what their party is seeking to move forward and what their constituents are actually asking for. Elizabeth Juviler, thanks so much for joining the show.

JUVILER: Thanks so much, Rebecca.

VALLAS: And that does it for this week’s episode of Off-Kilter, powered by the Center for American Progress Action Fund. I’m your host, Rebecca Vallas. The show is produced each week by Eliza Schultz. Find us on Facebook and Twitter @OffKilterShow. And you can find us on the airwaves on the Progressive Voices network and the We Act Radio network, or anytime as a podcast on iTunes. See you next week.