When John Gardner headed the old Department of Health, Education and Welfare in the 1960s, he looked at the challenges facing the country and declared: “What we have before us are some breathtaking opportunities disguised as insoluble problems.” He argued that government had a moral and a practical duty to find solutions so that all Americans could enjoy those opportunities.
Tom Price is different. As secretary of health and human services he doesn’t fret much about solving problems. Instead, he uses government as he always has—to create breathtaking opportunities for a small circle of wealthy Americans and, in particular, for a very wealthy physician named Tom Price.
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THE HEALTH CARE PROFITEER
Seema Verma
Administrator, Centers for Medicare & Medicaid Services
Here’s a powerful federal agency that you’ve probably never heard of: the Centers for Medicare & Medicaid Services. Perhaps you do remember it from when it was called the Health Care Financing Administration. But probably not.
The Centers for Medicare & Medicaid Services is one of the agencies that most Americans would prefer not to think about. They hope it does nice things because, after all, Medicare and Medicaid are nice and necessary programs. And as part of the Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services should be providing a service.
But what kind of service?
On March 14, 2017, one day after the Senate confirmed her nomination on 55–43 vote, Donald Trump’s administrator for the Centers for Medicare & Medicaid Services began her tenure by sending a letter to the nation’s governors announcing that she and HHS secretary Tom Price were “ushering in a new era for the federal and state Medicaid partnership where states have more freedom to design programs that meet the spectrum of diverse needs of their Medicaid population.” How could they exercise that freedom? Verma suggested that they could impose insurance premiums for Medicaid and charge Medicaid recipients for emergency room visits. They could also, the letter noted, encourage recipients, no matter how sick or ailing, to get a job.
That doesn’t sound very nice.
That sounds like the person in charge of Medicare and Medicaid was making health care more expensive and more difficult to obtain for some of the most vulnerable people in America.
Meet Centers for Medicare & Medicaid Services administrator Seema Verma, who was charged with reshaping Indiana’s Medicaid program when Vice President Mike Pence was governor of that state. She was a crafty consultant who used waivers to get around federal guidelines and to make a tidy sum of money for herself, somewhat controversially, as the Indianapolis Star revealed in 2014, reporting that “the state has paid her millions of dollars for her work—amid a potential conflict of interest that ethics experts say should concern taxpayers.”
“Largely invisible to the public, Verma’s work has included the design of the Healthy Indiana Plan, a consumer-driven insurance program for low-income Hoosiers now being touted nationally as an alternative to Obamacare. In all, Verma and her small consulting firm, SVC, Inc., have received more than $3.5 million in state contracts,” explained the paper. “At the same time, Verma has worked for one of the state’s largest Medicaid vendors—a division of Silicon Valley tech giant Hewlett-Packard. That company agreed to pay Verma more than $1 million and has landed more than $500 million in state contracts during her tenure as Indiana’s go-to health-care consultant, according to documents obtained by The Indianapolis Star.”
The conflicts surrounding Verma, who made even more money as a consultant for other states (most of which had Republican governors), raised a question, the Indiana paper said: “Who is she working for when she advises the state on how to spend billions of dollars in Medicaid funds—Hoosier taxpayers or one of the state’s largest contractors?”
The answer is that Verma is working for the sort of profits-first, patients-last health care system that allows people like her to, as Washington senator Maria Cantwell notes, “[make] millions of dollars in consulting fees by kicking poor, working people off of Medicaid for failure to pay monthly contributions similar to premiums.”
When Verma was nominated by Trump, Dr. Robert Zarr, the president of Physicians for a National Health Program, decried the consultant as the architect of a plan that “forced impoverished Medicaid enrollees to pay dearly for care, imposing unprecedented copayments and premiums on people with little chance of affording them; those who miss a payment are denied coverage.”
The past president of the DC chapter of the American Academy of Pediatrics, who holds adjunct professorships at Children’s National Medical Center and George Washington University, Dr. Zarr warned that “her actions in Indiana signal that she will inflict cruel and unusual punishment on America’s most vulnerable citizens.”
President Trump and House Speaker Paul Ryan did not set out to prove the concerned physician to be correct. But, as they unveiled health care “reforms” that would further empower Seema Verma’s Centers for Medicare & Medicaid Services, and her cruel and unusual vision, they did just that.
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THE INVESTOR WHO GOT A HIGH RETURN
Betsy DeVos
Secretary of Education
In March of 2017, the eleventh secretary of education for a nation founded on James Madison’s premise that “learned institutions ought to be favorite objects with every free people” because “they throw that light over the public mind which is the best security against crafty and dangerous encroachments on the public liberty” embraced a federal budget proposal to cut $9 billion from programs that support public education. Yes, public schools would suffer. But Betsy DeVos was delighted that the Trump administration’s budget blueprint called for steering $1.4 billion toward the gimmicky “school choice” programs that she had championed for decades as an alternative to public education—and that historian of education (and U.S. assistant secretary of education during George H. W. Bush’s presidency) Diane Ravitch decries as a “hoax” that destroys communities and destroys public schools.
DeVos had gotten what she paid for.
Twenty years before she joined Donald Trump’s wrecking crew cabinet, DeVos had explained as a billionaire campaign contributor to conservative causes that she was on a mission.
“I know a little something about soft money, as my family is the largest single contributor of soft money to the national Republican Party. Occasionally a wayward reporter will try to make the charge that we are giving this money to get something in return, or that we must be purchasing influence in some way,” she wrote in an essay for the Capitol Hill newspaper Roll Call. After explaining that she did not always get everything that she demanded, DeVos concluded that “I have decided, however, to stop taking offense at the suggestion that we are buying influence. Now I simply concede the point. They are right. We do expect some things in return.”
“We expect return on our investment,” wrote DeVos, an heir to a manufacturing fortune (and the sister of Erik Prince, the founder of Blackwater USA, the private military services contractor exposed by writer Jeremy Scahill) who married into the Amway fortune. She described that “return” as Republican Party election wins and the advancement of “a conservative governing philosophy consisting of limited government and respect for traditional American virtues.”
Over the next two decades, DeVos used her money to make the Republican Party an ever more outlandish critic of public education and an ever more unapologetic advocate for steering public money into discredited choice, charter and privatization schemes.
A special-interest power player who travels in the elite circles of billionaire political players like the Koch brothers and Sheldon Adelson, DeVos has used inherited wealth to buy her way into the elections of states across the country. She has done so in order to advance an agenda that is as unworkable as it is irresponsible—an agenda that has very little to do with education and very much to do with reshaping society to reflect the fever dreams of Betsy DeV
os and the people she pays to share those dreams.
DeVos has never been an education “reformer,” as she is frequently described. She’s a right-wing political activist who entertains “Make America Great Again” fantasies about recreating the Gilded Age. It just happens that DeVos has settled on the public schools as the vehicle for advancing the societal transformation she seeks. Real reformers recognize this. When Trump nominated DeVos to serve as secretary of education, one of the most prominent education reformers in the United States, billionaire Eli Broad, wrote to senators urging her rejection. “I believe she is unprepared and unqualified for the position,” explained Broad. “Indeed, with Betsy DeVos at the helm of the U.S. Department of Education, much of the good work that has been accomplished to improve public education for all of America’s children could be undone.”
Broad supports charter schools, and he has clashed at times with teacher unions over school issues. But, as he explained in his letter: “We must have a Secretary of Education who believes in the sincere and positive reform of public education and the need to keep public schools public.”
Though the Senate did not follow Broad’s wise counsel, his point was well taken. DeVos is not interested in the sincere and positive reform of public education; she is interested in politics, and in using politics to engage in right-wing social engineering.
“Betsy DeVos claims she’s a reformer but actually she’s a privatizer. She wants everybody to be able to take their money and go to a religious school—that’s her first choice,” Ravitch says of the secretary of education who never attended a public school and has throughout her adult life been an ardent advocate for religious-right doctrines and the schools that teach them.
“Betsy and her husband Dick DeVos engineered a referendum in 2000 in Michigan on vouchers that failed. Then they began putting their money into charter schools. They have also put their money into states across the country through their different political PACs to elect people who are opposed to public education,” Ravitch told WBEZ radio in Chicago as the DeVos nomination fight raged. “What makes DeVos an unusually bad choice for the U.S. secretary of education is that she’s a lobbyist. She’s not an expert in education. Since 1980, most secretaries have been governors with experiences dealing with budgets and understanding that 90 percent of the kids in their state go to public school—not to charters or vouchers. But she’s an advocate that comes in with hostility to public education. She invests money into election campaigns across the country to defeat people who support their public schools, so it’s a bizarre choice to say the least.”
Bizarre, and dangerous.
Many of Trump’s cabinet picks were critics of the agencies they were chosen to head, but DeVos was more than that. She was the leader of a movement to attack public education itself. American Federation of Teachers (AFT) president Randi Weingarten identifies DeVos as “the most ideological, anti–public education nominee put forward since President Carter created a Cabinet-level Department of Education.”
Weingarten, who has worked closely with teachers and parents in states across the country, objected to the nomination of DeVos because of the billionaire’s advocacy for an agenda that the AFT president said would put the focus of the Trump administration on “privatizing, defunding and destroying public education in America.”
But Weingarten, who got her start teaching history and government classes at Clara Barton High School in Crown Heights, Brooklyn, kept returning to a deeper concern regarding this particular Trump designee: “DeVos has no meaningful experience in the classroom or in our schools. The sum total of her involvement has been spending her family’s wealth in an effort to dismantle public education in Michigan.”
That fact should have derailed DeVos, who is best understood as a political operative, not a serious thinker regarding education, and whose confirmation hearing was a train wreck. But DeVos got a narrow 51–50 pass from a Senate that included at least twenty-one Republicans who had accepted major campaign donations from the DeVos political operation. The individual donations by DeVos and her family totaled almost $1 million, coming in increments as high as $98,300 for Florida’s Marco Rubio. If Rubio alone had turned against DeVos, she would have been rejected by the Senate. Instead, he hailed the nominee of the man who had humiliated him during the 2016 Republican presidential race as a champion of “educational opportunity for all.”
Betsy DeVos had explained that “we do expect some things in return.” And she got them.
The Department of Education gig served as a formal return. But the real value of her investments was far greater for DeVos. She bought the framing of the debate about education in the United States—by spending hundreds of millions of dollars to “help people become more open to what were once considered really radical reforms. Reforms like vouchers, tax credits, and education savings accounts” that allowed someone with her extreme views to be considered for secretary of education.
The problem, for DeVos and for America, is that she never promoted honest debate about whether her proposals would actually benefit elementary and secondary school students. She was too busy playing politics.
A former chair of the Michigan Republican Party, DeVos and her husband, Dick (a former Michigan gubernatorial candidate), have directed hundreds of millions of dollars into the ideological and electoral infrastructure that supports school privatization. While many DeVos investments were ideologically inspired as opposed to explicitly partisan, she acknowledged to the Senate that total DeVos family giving to Republican candidates and campaigns could total $200 million. “Nowhere is the impact of the DeVos family fortune greater… than in the movement to privatize public education,” explains a People for the American Way study on how the DeVos political operation has used a family fortune to “create an intricate national network of nonprofits, political action committees and federal groups known as 527s that effectively fund the political arm of the school voucher movement.”
The DeVos operation warped politics not just in Michigan but in states such as Wisconsin, where the billionaires were early and ardent supporters of Governor Scott Walker and his anti-labor allies.
Walker got $70,000 in direct contributions to his 2010 gubernatorial race from “choice” advocates. But even more money was spent on so-called independent campaigning by groups that poured hundreds of thousands of dollars into promoting Walker and his legislative allies and into attacks on supporters of public education. Walker and the other Republican governors whose exploitation of a politics of resentment gave rise to Trumpism could not have succeeded as they did without DeVos’s money machine. All of this made Betsy DeVos incredibly influential at the state level years before she became incredibly influential at the federal level. But not in a good way.
One group with which DeVos has been associated, the political action committee All Children Matter, was fined a record $5.2 million by the Ohio Elections Commission after it was charged with illegally shifting money into the state to support candidates considered friendly to private-school “choice” initiatives. It was also fined for political misconduct in Wisconsin, where officials determined that the secretive group’s 2006 campaigning violated campaign finance laws by expressly urging voters to cast ballots against legislative candidates who were strong backers of public education.
Those troubles led to the evolution of All Children Matter into the American Federation for Children, which has collected money from a who’s who of right-wing millionaires and billionaires, including the political operations of right-wing donors Charles and David Koch. The money helped Republicans to win elections, in Michigan, Ohio, Wisconsin and elsewhere, and solidified DeVos’s reputation as a go-to donor for national Republican contenders. But it has not improved education in the states. Rather, it imposed a failed ideological construct that borders on fantasy, and that has much more to do with attacking the unions that represent teachers and the infrastructure of public education than with helping students achieve their full potential. In Wa
lker’s Wisconsin, for instance, the group One Wisconsin Now noted that “we have seen her school privatization playbook in action in Wisconsin, and the result is more failure and less accountability.”
“Betsy DeVos has been a driving force for the privatization of our public schools. She’s used her family’s wealth to reward politicians who support her agenda across the nation, including Scott Walker and Republicans in Wisconsin,” said One Wisconsin Now’s Scot Ross. “Being a billionaire whose hobby is underwriting campaigns to steal our public school dollars and send them to unaccountable private schools disqualifies her from being our secretary of education.”
Ross was right. But in Donald Trump’s Washington, where big money and insider connections matter far more than relevant experience and good ideas, Betsy DeVos got a return on her investment.
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MR. SECRETS AND LIES
Scott Pruitt
Environmental Protection Agency Administrator
It is possible to pinpoint the moment at which “the world’s greatest deliberative body” was remade by Senate majority leader Mitch McConnell to serve as nothing more than a rubber stamp for Trump’s presidency, and for the fossil fuel industries that have risen to the pinnacle of their power with the billionaire’s assumption of the presidency. It came on Friday, February 17, 2017.