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New York Times / Life - Entertain

Opinion | The Republican War on Children

Health care for a thousand kids, or tax breaks for one wealthy heir? The G.O.P. prefers the second.

The health care of Alexander Gardner, 7, is covered by a federal program whose funding expired in September. Mark Makela for The New York Times

Let me ask you a question; take your time in answering it. Would you be willing to take health care away from a thousand children with the bad luck to have been born into low-income families so that you could give millions of extra dollars to just one wealthy heir?

You might think that this question is silly, hypothetical and has an obvious answer. But it’s not at all hypothetical, and the answer apparently isn’t obvious. For it’s a literal description of the choice Republicans in Congress seem to be making as you read this.

The Children’s Health Insurance Program, or CHIP, is basically a piece of Medicaid targeted on young Americans. It was introduced in 1997, with bipartisan support. Last year it covered 8.9 million kids. But its funding expired more than two months ago. Republicans keep saying they’ll restore the money, but they keep finding reasons not to do it; state governments, which administer the program, will soon have to start cutting children off.

What’s the problem? The other day Senator Orrin Hatch, asked about the program (which he helped create), once again insisted that it will be funded — but without saying when or how (and there don’t seem to be any signs of movement on the issue). And he further declared, “The reason CHIP’s having trouble is that we don’t have money anymore.” Then he voted for an immense tax cut.

And one piece of that immense tax cut is a big giveaway to inheritors of large estates. Under current law, a married couple’s estate pays no tax unless it’s worth more than $11 million, so that only a handful of estates — around 5,500, or less than 0.2 percent of the total number of deaths a year — owe any tax at all. The number of taxable estates is also, by the way, well under one one-thousandth of the number of children covered by CHIP.

But Republicans still consider this tax an unacceptable burden on the rich. The Senate bill would double the exemption to $22 million; the House bill would eliminate the estate tax entirely.

So now let’s talk dollars. CHIP covers a lot of children, but children’s health care is relatively cheap compared with care for older Americans. In fiscal 2016 the program cost only $15 billion, a tiny share of the federal budget. Meanwhile, under current law the estate tax is expected to bring in about $20 billion, more than enough to pay for CHIP.

As you see, then, my question wasn’t at all hypothetical. By their actions, Republicans are showing that they consider it more important to give extra millions to one already wealthy heir than to provide health care to a thousand children.

Are there any possible defenses for this choice? Republicans like to claim that tax cuts pay for themselves by spurring economic growth, but no serious economists agree — and that’s the case even for things like corporate tax cuts that might have some positive economic effect. Applied to inheritance taxes, this claim is beyond absurd: There is no plausible argument to the effect that letting wealthy heirs claim their inheritance tax-free will make the economy boom.

What about the argument that estate taxes are a burden on small businesses and family farms? That’s a total, thoroughly debunked myth: Each year only around 80 — eight-zero — small businesses and farms pay any estate tax at all. And when you hear about family farms broken up to pay estate tax, remember: Nobody has ever come up with a modern example.

Then there’s the argument of Senator Chuck Grassley that we need to eliminate estate taxes to reward those who don’t spend their money on “booze or women or movies.” Yes, indeed, letting the likes of Donald Trump Jr. inherit wealth tax-free is a reward for their fathers’ austere lifestyles.

Meanwhile, here’s the funny thing: While there is zero evidence that tax cuts pay for themselves, there’s considerable evidence that aiding lower-income children actually saves money in the long run.

Think about it. Children who get adequate care are more likely to be healthier and more productive when they become adults, which means that they’ll earn more and pay more in taxes. They’re also less likely to become disabled and need government support. One recent study estimated that the government in fact earns a return of between 2 and 7 percent on the money it spends insuring children.

By the way, broadly similar results have been found for the food stamp program: Ensuring adequate nutrition for the young means healthier, more productive adults, so that in the long run this aid costs taxpayers little or nothing.

But such results, while interesting and important, aren’t the main reason we should be providing children with health care and enough to eat. Simple decency should be reason enough. And despite everything we’ve seen in U.S. politics, it’s still hard to believe that a whole political party would balk at doing the decent thing for millions of kids while rushing to further enrich a few thousand wealthy heirs.

That is, however, exactly what’s happening. And it’s as bad, in its own way, as that same party’s embrace of a child molester because they expect him to vote for tax cuts.

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