If Joe Manchin Cares About Medicare, He Should Invest in the People Who Fund It

Since President Biden took office, Second-President Joe Manchin has been the principal obstacle to the Democrats’ achieving their goals. His stubborn nostalgia for a mythologized Senate that hasn’t existed for years (and wasn’t so great when it did: see civil rights) is holding Democrats hostage to the filibuster and forcing them to shoehorn their entire agenda into an omnibus budget reconciliation bill. His personal coal fortune has defanged efforts to stem climate change, even as its early attacks have caused massive flooding in his own state. His opposition to everything from universal higher education to paid family leave has cut President Biden’s Build Back Better agenda in half.

Manchin choreographs his opposition to broadly popular social spending to yield maximum press attention, usually voicing his disapproval in press scrums where he can tout his regressive bona fides to his donors back home. As he was blocking Medicare’s provision of vision, dental, and hearing benefits for seniors, yet another broadly popular Democratic goal, he voiced his “concern” this way:

“My big concern right now is the 2026 deadline [for] Medicare insolvency, and if no one’s concerned about that, I’ve got people—that’s a lifeline. Medicare and Social Security is a lifeline for people back in West Virginia, most people around the country.… You’ve got to stabilize that first before you look at basically expansion. So if we’re not being fiscally responsible, that’s a concern.”

But in his ostensible quest to make the government more “fiscally responsible,” he’s doing quite the opposite. It comes down to demographics. In 2020, half of U.S. states saw more people die than were born. It’s not just the pandemic—it’s that Americans are having fewer babies. Last year was the sixth straight during which U.S. birth rates declined—a larger decline than in any of the previous years. After all, you can’t blame people for choosing not to bring children into a pandemic-ridden world.

Taken together, the overall birth rate is down by 19 percent since 2007. And according to the Centers for Disease Control and Prevention, the U.S. population is on its way to contracting. None of this bodes well for the “insolvency” that Manchin tells us he is so worried about. Why? Because as our population contracts, it will age. An aging population means that there will be fewer young people struggling to pay for the mounting price tags of their elders’ benefits.

Before you blame yet another thing (in addition to killing cable, golf, diamonds, and mediocre casual dining) on the “kids these days,” consider why young people are delaying or forgoing having children. A New York Times poll of parents having fewer kids than they would like showed that 64 percent found the cost of childcare prohibitive. That doesn’t even tell the whole story. Student loan debt has ballooned, doubling since 2007 to an average of nearly $37,000, and saddling more young people with loan obligations that siphon off critical assets that could have been invested in childcare. Then consider the housing market. The average homebuyer in 1981 was 31. She or he is 47 today. In a 2017 study by the National Association of Realtors, 83 percent of non-homeowners blamed their student debt.

Our contracting population comes back to the financial morass into which we are forcing young people. Universal childcare, paid family leave, two years of universal community college: Each of these is intended to address that morass. Each would dismantle one of the obstacles that is delaying or preventing young people from having children. That, in turn, is critical to preserving a steady-enough flow of a population that would grow up and pay into Medicare and Social Security. And yet accomplishing each of these goals was either killed by or severely curtailed by Joe Manchin.

The kind of fiscal responsibility that Manchin preaches, in light of the system that is financially strapping young people at every turn, is penny-smart but dollar-foolish. His opposition highlights something more profound about the myopia of cost-cutting, in general, and the way it often comes at the cost of investing in people, in specific. In a Wall Street Journal op-ed, Manchin argued that he wouldn’t support a $3.5 trillion Build Back Better package because of what it might mean for the national debt. “Some in Congress have a strange belief there is an infinite supply of money to deal with any current or future crisis, and that spending trillions upon trillions will have no negative consequence for the future,” he said. What’s fascinating here is that while he doesn’t want America’s debt to grow, he’s more than willing to pass that debt on to Americans. While he’s asking young people to make an investment in their future, he’s unwilling to allow America to invest in theirs.