The Nixon Effect. Douglas E. Schoen

anathema to most from the center rightward. In fact, the program was a guaranteed annual income, but it came with substantive conditions, and the guaranteed income in question was for children, not adults. Nixon tried to stress these points in defending the FAP, but ultimately the program became enshrined in the public mind as a massive new welfare benefit. Even George McGovern, Nixon’s opponent in the 1972 election, who in January of that year had proposed “demogrants” of $1,000—with broader eligibility and fewer conditions—for every poor family in America, retracted his proposal before election day in an effort to disassociate himself with what had become an unpopular (if poorly understood) proposal.

      However, the FAP’s defeat did not preclude Nixon’s achievements in other related programs. The original FAP plan, released in 1969, contained a proposal for supplemental security income (SSI), a new program that would provide regular income for disabled, blind, and aged recipients. On October 17, 1972, just two days after the FAP’s final demise in the Senate, SSI passed both houses of Congress. It is likely that SSI had such an easy time because its target population was unambiguously needy—the blind, the old, and the disabled, unlike poor mothers, have few critics. Some didn’t even regard SSI as a genuine “welfare” program, seeing it as more of a subset of the most unassailable of all American social welfare programs: Social Security. It seems no accident that SSI’s name resembles that of the much larger program. Still, SSI may not have seen the light of day without the momentum—temporary though it was—that the FAP achieved.

      Some Nixon critics see the FAP failure as incidental to his presidency. They point out, correctly, that Nixon’s true passion was foreign policy. Thus, they claim, his more liberal domestic policies were undertaken solely for political expediency—to blunt liberal initiatives and broaden his political base with moderate policies. Certainly there is some truth to this interpretation—Nixon’s domestic moderation did broaden his political base—but the critics don’t give Nixon enough credit (sometimes any credit) for caring about these issues. On welfare, in particular, the evidence in his presidential papers is that Nixon stayed engaged with the FAP—both in the long and sometimes contentious battle within his administration to formulate the policy and during the political battles that ran for years—to try to get it passed. Welfare reform was definitely something he wished to accomplish, and the time he devoted to it makes that clear. Even more proof of his commitment came in January 1974, when Nixon, already reeling under the Watergate scandal and fighting to save his presidency, still found time, in his State of the Union speech, to urge the Congress once again to take up the cause of welfare reform. This time, for obvious reasons, the effort never got off the ground.

      Nixon’s mostly unheralded efforts to reform welfare and address poverty and hunger in the United States grew out of his own personal experiences and the suffering he witnessed during his stark childhood. He remembered how his mother and father struggled to put food on the table and clothe their children, and their hardships left a searing mark on him. In an evocative memo to speechwriter Ray Price, Nixon wrote:

      In the depression years I remember when my brother had tuberculosis for five years and we had to keep him in a hospital, my mother didn’t buy a new dress for five years. We were really quite desperately poor, but as Eisenhower said it much more eloquently at Abilene in his opening campaign statement in 1952, the glory of it was that we didn’t know it.

      The problem today is that the children growing up in welfare families receiving food stamps and government largess with social workers poking around are poor and they do know it.⁵⁰

      As Nixon saw it, changing welfare from a system of services to a system of income maintenance would alleviate this problem. The state, he believed, should stop reminding the children of modern welfare families that they were poor, and thereby stigmatizing them, when they already had daunting challenges to face in their lives. He sympathized with those in such difficult circumstances—though he also agreed with millions of Americans that the welfare system, as it had evolved by the early 1970s, perpetuated dependency while offering no incentives to poor adults to improve their lives. And he agreed with conservatives that the AFDC was contributing to family breakdown, placing more and more children in undesirable and sometimes precarious circumstances. All in all, his welfare reform proposals were conservative in spirit, if liberal in their means—a description that fits much of his domestic policy.

      Nixon, Joan Hoff wrote, sought to use a “peace dividend” that he had gained from the withdrawal of American troops from Vietnam for domestic purposes. Under this moderate Republican president, social welfare spending more than doubled, from $55 billion in 1970 to $132 billion by 1975. It was Nixon, not Lyndon Johnson, Hoff wrote, who more properly deserves the label of “last of the big spenders” on domestic programs. Indeed, from 1970 to 1975, for the first time since World War II, spending on social welfare and other human resources exceeded defense spending.⁵¹ It’s never happened again.

      Health Care

      For years, health care has been a flashpoint of partisan conflict in the United States, and the Obama administration’s Affordable Care Act, passed in 2010, has recently elevated the issue to a defining one in American politics. Here again, however, the combatants on both sides are battling over terrain that Nixon had previously trod. And as many commentators pointed out in 2010, the ACA bears more than a passing resemblance to the various health care proposals that Nixon made during his presidency.

      These proposals were not incremental reforms but rather transformative new formulations designed to address the growing cost crisis in health care as well as the problem of the uninsured. Nixon’s first attempt came in 1971, in his State of the Union address, when he set out an ambitious reform agenda for health care that still sounds remarkably contemporary, over forty years later:

      I will offer a far-reaching set of proposals for improving America’s health care and making it available more fairly to more people. I will propose:

      —A program to insure that no American family will be prevented from obtaining basic medical care by inability to pay.

      —I will propose a major increase in and redirection of aid to medical schools, to greatly increase the number of doctors and other health personnel.

      —Incentives to improve the delivery of health services, to get more medical care resources into those areas that have not been adequately served, to make greater use of medical assistants, and to slow the alarming rise in the costs of medical care.

      —New programs to encourage better preventive medicine, by attacking the causes of disease and injury, and by providing incentives to doctors to keep people well rather than just to treat them when they are sick.⁵²

      Nixon called his plan the National Health Insurance Partnership, and included in it the now-familiar set of competing interests: private insurers who write plans for employers, government-provided plans for low-income people, and the then-new concept of health maintenance organizations (HMOs), which Nixon believed held great potential for improving services. In 1973, Nixon signed a bill sponsored by Ted Kennedy pledging federal dollars for the creation of HMOs (unfortunately, forty years later, HMOs haven’t quite fulfilled their promise, to put it gently). Nixon’s plan was comprehensive and ambitious, the first genuine attempt to provide national insurance since Harry Truman. However, Nixon’s 1971 plans never got anywhere in Congress.

      Yet again, as with welfare reform, Nixon did not give up. In his 1974 State of the Union address—the last he would give as president, delivered under a swelling cloud of the Watergate scandal—he put health care reform back on the agenda: “I shall propose a sweeping new program that will assure comprehensive health insurance protection to millions of Americans who cannot now obtain it or afford it, with vastly improved protection against catastrophic illnesses. This will be a plan that maintains the high standards of quality in America’s health care. And it will not require additional taxes.”⁵³

      Nixon also made clear during the address that he opposed what would come to be known as a “single payer” system—making the government the sole health care insurer in the United States in a vast federal system of nationalized health care:

      Now, I recognize that other plans have been put forward that would cost $80 billion