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GCU US Leading Socioeconomic Inequities & Healthcare Access Discussion

GCU US Leading Socioeconomic Inequities & Healthcare Access Discussion

1. When we think about social justice, we think about fairness
and equitable distribution of social goods.Social policy research is the core of
creating change. Rigorous research designs that display reliable and valid
results can give a face to social inequities and can be used to encourage
politicians to make changes.My social justice research interests
include the following:Housing policiesSpecial education servicesFood distribution programs for the elderlyI like to use qualitative designs to gain a
deep insight into the human experience. For example, an open-ended question
survey can be distributed to individuals in a community whose income is at or
below the national poverty level to explore their experiences with fair housing
attainment. A project that could explore the effects and implementation of the
Fair Housing Act. If the research results indicate housing disparities, racism,
etc., the outcomes could be used to advocate or lobby for needed policies.2.Chapter 3 of your text book address the social inequities
we in the US experience. Unfortunately, the US leads the world in some some
inequities. A focus for me is income disparity and related healthcare accessibility
and can be traced back to slavery.When thinking about the US ranking top on
this list of social disparities, reflect on:Is this something you were already aware of?What inequities do you think are the most
important to address? Why?The website “Pewresearch” has
great articles on social justice and inequities. You may want to start your own
discussion using an article from that site.
American social policy evolved in stages over roughly 270 years if we begin counting in 1750. Policy
advocates have transformed the nation’s social policies from relatively primitive ones at the local level in
the colonial period to a substantial welfare state in 2019 that includes thousands of social policies of
local, state, and national governments. Policy advocates engaged in policy advocacy when they realized
that ordinary people were harmed by new problems as the nation moved from an agrarian to an
industrialized nation. They initiated major periods of reform. They opposed persons and movements that
sought to rescind social reforms with proven effectiveness. They fought for resources to fund social
policies and against efforts to defund them. They advocated for marginalized populations when they
were attacked by persons and movements. They developed movements that sought social justice such as
for women’s rights, civil rights, gay rights, rights of disabled persons, seniors’ rights, and rights of
workers.
The Colonial Period
The United States constructed its welfare state from the bottom up from the colonial period to the
present. The initial set of 13 colonies had a primitive set of social institutions at the local level. These
included almshouses (also called poorhouses) where destitute persons were placed only after they
passed a test, called a means test, that revealed they had no money and were unable to find work. They
engaged in manual work, such as cutting wood, ate spartan meals, and sometimes engaged in prayer.
Some of them received “outdoor relief” in their homes. Public schools did not exist, so some youth
attended private schools or were tutored by their parents. Some prisons existed. These colonies were
overwhelmingly agricultural with only a smattering of small towns. Even Philadelphia, which hosted the
Constitutional Convention, had only about 2,000 residents in 1789. The colonies relied on property taxes
mostly for public roads and bridges and local administration. When the colonists ratified the Constitution
in 1787, they failed even to mention “social policy” in it because they believed social policy fell
exclusively in the province of local and state governments (Jansson, 2019b). Schools, poorhouses,
prisons, and other charitable institutions were ceded to local and state governments, whereas the
federal government was assigned foreign policy, developing a uniform national currency, regulating
trade, developing a military force to fend off foreign powers, and overseeing federal elections. It was a
small federal government that lacked even a federal income tax, forcing it to rely only on excise taxes on
certain products, tariffs placed on foreign imports, and several smaller taxes. State legislatures rarely
met. The federal government did not participate in social policy in a major way until the Great
Depression of the 1930s. Local, state, and federal governments remained small by modern standards
from 1789 to the Great Depression of the 1930s even as the nation developed mandatory public
education through high school, public universities, and a sizable number of private colleges. States
developed “mental asylums” but with no federal assistance after President Monroe convinced Congress
in 1848 that the Constitution did not give the federal government the power to fund social programs.
States and private charities developed charitable institutions for orphans and blind and deaf people and
institutions for delinquent youth. Many local public and private hospitals were constructed by the end of
the 19th century (Jansson, 2019b). State-funded prisons supplemented local prisons. Many local, state,
and federal regulations were established in the late 19th century and the early 20th century including
ones that regulated the safety of food and water, housing regulations, and work-safety regulations.
Major setbacks took place in the colonial period, such as the legalization of slavery in the U.S.
Constitution; failure to honor the rights of women to vote, own property, or join professions; and the
forcible pushing of Native Americans westward. Yet the colonists enacted a Bill of Rights in 1791 that
protected free speech, established local and state legislatures, and developed infrastructure. Possibly
their most significant achievement was to auction land to settlers so that many persons in this agrarian
society owned relatively small plots of land aside from plantation owners in the South. If we exclude
slaves, Native Americans, and women, colonial society had high levels of economic equality because
many white males possessed relatively small landholdings, such as 60 acres.
The Gilded Age
A mismatch between public policy and social problems became glaringly obvious, however, as the
nation rapidly industrialized from the start of the Civil War in 1860 through the 1920s. Tens of millions of
penniless immigrants from Europe and Russia flooded growing American cities and provided labor for
the many factories that were constructed. Deep recessions and a depression in the 1890s devastated
these immigrants, who were forced to wait in bread lines outside police stations during economic
downturns. Local regulations over housing and factories hardly existed or were not enforced, leading to
catastrophes like the burning of a garment factory in 1911 in New York that killed 87 female immigrant
workers who jumped to their deaths from upper stories. Like most workers in factories, these factory
workers were not unionized. The period from 1865 to 1900, known as the Gilded Age, was a period of
extreme economic inequality that juxtaposed these penniless immigrants with multimillionaires and
billionaires, including Andrew Carnegie, John D. Rockefeller, and Henry Ford, who owned factories,
railroads, and mines. Nor did either the Republican or Democratic Parties represent workingclass
Americans who found no allies when they engaged in strikes for better wages. Local police and federal
troops forcibly attacked them when they protested their working conditions. Nor were conditions
favorable for Native Americans, African Americans, and Latinos (Jansson, 2019b). Not immune to
Europeans’ diseases, millions of Native Americans perished from cholera, typhoid fever, and other
illnesses. Survivors were pushed westward by the incessant flow of European immigrants prior to the
Civil War. The U.S. military killed many Native Americans who refused to reside on reservations after the
Civil War, where many of them remain today. African Americans were emancipated during the Civil War
only to suffer extreme hardships when they were not given land. Roughly 25% of them starved during
and after the Civil War. Many of them became tenant farmers who rented land from former plantation
owners on terms that left them nearly penniless. The Ku Klux Klan that terrorized African Americans,
Catholics, Jews, and other minorities plagued them. The United States forcibly appropriated much of the
lands of the southwestern part of the nation from Mexico when it invaded Mexico and forced its national
government to cede this territory. White settlers took the land of indigenous Latinos by force or by
claiming that their deeds under Mexican laws were bogus. Having lost their land, many Latinos became
agricultural and mining laborers who were exploited by white owners. Workers in manufacturing plants
were treated harshly, lacking minimum wages, ceilings on hours worked, and lack of trade unions. Social
policies that we take for granted in contemporary society did not exist, such as the Supplemental
Nutrition Assistance Program (SNAP), unemployment insurance, Social Security, and housing programs.
The Progressive Period
It seemed that the extreme inequality of the Gilded Age might be broken by the first urban reform
movement in the 20th century when Theodore Roosevelt became president in 1901 after the
assassination of President William McKinley. Called the Progressive movement, it was led by middle-class
reformers drawn from both the Republican and Democratic Parties. Roosevelt challenged the
industrialists by coming to the aid of striking workers and sought to break up monopolies. Progressives’
signature victories were enactment of local and state regulations over child labor, unsafe working
conditions in factories, fire codes, public health, and housing codes. They enacted a small and relatively
punitive “Mothers’ Pensions” program for destitute single mothers. Wanting far greater reforms, Jane
Addams, a founder of the social work profession who had established the settlement house known as
Hull House in Chicago, teamed with Theodore Roosevelt to form the Progressive Party in 1912 (Addams,
1907). Roosevelt and Addams hoped to enact major federal social programs but lost the 1912
presidential election to Democrat Woodrow Wilson. The primitive nature of American federal
government was illustrated by its lack of Constitutional authority to levy income taxes. Without
resources obtained from taxes, the United States could not fund major social programs. Even when this
deficiency was removed when the 16th Amendment to the Constitution was enacted in 1913 (which
allowed the federal government to levy income taxes), the federal government failed to collect major
income taxes until World War II and beyond—and even today collects far lower levels of taxes as a
percentage of gross domestic product (GDP) than most other industrialized nations (Jansson, 2019a).
Jane Addams and other social workers engaged in micro, mezzo, and macro policy at a time when federal
safety net programs did not exist (Addams, 1961). Jane Addams’s Hull House intersected with public
agencies as it guided immigrants who spoke no English to educational programs, helped persons who
lived in unsafe housing obtain help from city housing enforcement programs, worked with fire
departments to place exits in multilevel garment factories, and helped establish juvenile courts so that
children and youth would not be sent to prisons peopled by adult offenders. They engaged in mezzo
policy advocacy when they developed Hull House, which provided literacy training, employment, money
management, and other services to immigrants. Addams found ways to fund Hull House at a time when
local, state, and federal governments had scant resources and when few public programs that we
currently take for granted existed. Addams mobilized people to participate in protests about housing
conditions, workplace hazards, and corruption in city government. She initiated research projects that
measured the incidence and location of specific problems, such as malnourishment of children (Addams,
1961). She engaged in macro policy advocacy when she backed reform-minded candidates in municipal
and state elections as well as when she worked with Roosevelt to form the Progressive Party.
The Great Depression
The Great Depression savaged the nation from the stock market crash in 1929 to American entry into
World War II in December 1941. The national unemployment rate surged as high as 25% by 1933 and still
remained about 15% in 1940 until it was erased by wartime industrial production during World War II.
Unemployment remained far higher among African Americans, women, and Latinos. Roughly 60% of the
wealth of affluent Americans disappeared in the wake of the crash of the stock market and the
bankruptcy of many businesses. Franklin Roosevelt, a rich man afflicted with polio, became the unlikely
advocate for ordinary people during this national emergency. He orchestrated two major
accomplishments. He proposed and enacted sweeping federal social legislation for the first time in
American history (Jansson, 2019b). He attracted millions of working-class voters to the Democratic Party
that he headed, making it a powerful advocate for these voters as compared with the Republican Party,
which came mostly to represent relatively affluent people (Leuchtenberg, 1963). The Democratic
coalition included those African Americans who were allowed to vote in the North and the South,
intellectuals, Jews, and members of the working class. White conservative Southerners also joined the
Democratic coalition because they had shifted to the Democratic Party in the wake of the Civil War away
from the Republican Party, headed by Abraham Lincoln, who had emancipated slaves. Most Southerners
belonged to the Democratic Party until the 1980s and beyond. Franklin Roosevelt developed and
nurtured this Democratic coalition as he developed his New Deal legislation to get people through the
Great Depression (Patterson, 1967). Tens of thousands of persons became homeless as their houses
were foreclosed on. Farmers were unable to sell corn, beef, and other products. Even conservative
politicians mostly voted for New Deal programs because their constituents, too, had lost jobs and
houses. New Deal programs included the following (Jansson, 2019a): The Federal Emergency Relief
Administration (FERA) that provided grants to states allowing them to make welfare payments to
destitute individuals and families. It required them to establish state commissions separate from their
existing welfare programs with uniform eligibility processes throughout the state and provisions to
discourage discriminatory administration. It began in 1933 and was ended when welfare programs in the
Social Security Act were enacted in 1935. It ended so-called poorhouses funded by local governments,
where unemployed persons were required to reside under harsh conditions. A variety of work-relief
programs that gave recipients jobs, including the Civilian Works Administration (CWA), which hired 16
million Americans for 190,000 work projects between November 1933 and January 1934 alone; the
Civilian Conservation Corps (CCC), which provided jobs to 2.5 million young men, mostly in rural areas
under the administration of the Army and the Department of Interior; and the Public Works
Administration (PWA), which built complex projects like airports, dams, and roads throughout the 1930s.
Roosevelt replaced the CWA with the Works Progress Administration (WPA) in 1935, which funded
hundreds of projects across the nation. The Federal Deposit Insurance Corporation (FDIC) and other
programs to stabilize banks. Programs to combat the aggressive cutting of prices by corporations as they
sought to retain sufficient market share to remain afloat during the Great Depression, including the
National Recovery Act of 1933 (NRA). It helped industries in specific sectors negotiate set prices but was
declared unconstitutional by the U.S. Supreme Court in 1935. Programs to cut foreclosures, such as the
National Housing Act of 1934, that established the Federal Home Administration Act (FHA) to help banks
refinance home mortgages at lower rates of interest. He averted foreclosures on farmers and home
owners by having the government purchase mortgages and refinance them under the Emergency Farm
Mortgage Act and the Farm Relief Act in 1933. He established the FHA to insure mortgages and home
improvement loans. He established the Wagner-Steagall Housing Act of 1937 to provide low-interest
loans to local authorities to build public housing. Programs to encourage economic growth in entire
regions, such as the Tennessee Valley Authority (TVA), through a network of dams and generating
stations to power fertilizer plants and to help fund reforestation and flood control projects. The Social
Security Act that provided pensions for seniors financed from payroll deductions of employers and
employees. It also provided welfare programs funded by matching federal and state funds that included
Aid to Dependent Children (ADC), old age assistance (OAA), and Aid to the Blind (AB); funds for child
welfare and public health programs; and unemployment insurance by appropriating funds to help states
administer their unemployment funds in return for an agreement by the states to hold fair hearings to
avoid discrimination in their distribution of unemployment benefits. The Fair Labor Standards Act of
1938, which established fair working conditions and minimum wages. The Wagner Act of 1935, which
allowed workers to decide whether they wanted to unionize in elections monitored by the National
Labor Relations Board (NLRB). A variety of programs that addressed nutritional, health, dental, and other
needs of impoverished persons, which included partnerships among the federal government, states, and
not-for-profit organizations. The Agricultural Adjustment Agency in 1933, which convened producers of
specific crops to reduce crop surpluses that had driven their prices so low that many farmers were
bankrupted—and other legislation that protected sharecroppers. Make no mistake: When taken
together, these programs helped persons in the lower economic echelons in ways that were
unprecedented in the United States. They increased their resources, wages, food, housing, and
employment. They increased their morale during an unprecedented decade of mass unemployment.
They kept families together. They averted disease and starvation. They cut homelessness. These policies
were revolutionary in a nation where virtually no social programs had been enacted by the federal
government. Many social workers worked in New Deal agencies. Above all, New Deal programs gave the
federal government the power to fund and administer a host of social programs as compared with state
and local governments that had exclusively served these roles prior to the New Deal. Notable exceptions
to the generosity of the New Deal included Roosevelt’s decision not to support federal anti-lynching
legislation and his decision to incarcerate tens of thousands of Asian Americans primarily of Japanese
descent at the outset of World War II. He feared that southern conservatives in the Congress would veto
New Deal legislation if he supported antilynching legislation. He incarcerated Japanese Americans due to
mass hysteria and racism against them as contrasted to white German and Italian immigrants (Jansson,
2019b). The work relief programs of the New Deal were terminated during World War II by Republicans
and conservative southern Democrats who argued they were no longer needed when the nation had
returned to full employment in World War II as the United States manufactured munitions for nations
that opposed Germany, Italy, and Japan (Jansson, 2001). Yet the programs of the Social Security Act
remained intact as well as the federal minimum wage, housing programs, prohibition of child labor, and
regulations that allowed unions to organize. Social workers engaged extensively in policy advocacy in the
1930s. They engaged in micro policy advocacy to help destitute individuals use the New Deal work
programs (Wenocur & Reisch, 1989). They engaged in macro policy advocacy to help establish and
implement work relief and welfare programs for millions of people. They worked to educate local
residents about the myriad services and programs established during the New Deal. Roosevelt’s wife,
Eleanor, worked with distressed communities during the 1930s to develop social services, housing, and
businesses when most residents suffered extreme poverty. She helped find resources to rebuild their
infrastructure. She helped African Americans gain access to work relief programs. Franklin Roosevelt
repeatedly visited persons in the Dust Bowl in Oklahoma to find ways to improve their lives by
introducing new agricultural techniques that would decrease the dust storms that ruined farmlands. The
federal government did not aggressively use its power to levy income taxes until World War II, when it
had to fund American military forces at high levels. As we shall see, this power was eventually used, as
well, to fund many social programs enacted in the 1960s and early 1970s even if these taxes were lower
as a percentage of GDP than in most other industrialized nations. Moreover, the United States spent far
more money on military forces during the Cold War from 1949 through the 1980s than other
industrialized nations (Jansson, 2001).
The Great Society
Lyndon Johnson succeeded John Kennedy when he was assassinated in November 1963. Inheriting
Roosevelt’s coalition of working-class people, African Americans, white Southerners, and intellectuals, he
won a landslide victory over Republican Barry Goldwater in 1964. He encountered massive levels of
poverty, the oppression of African Americans throughout the nation, lack of medical care for seniors, and
many other social problems. The Great Society included the following (Jansson, 2019b): Enacting the
Civil Rights Acts of 1964 and 1965, which protected voting rights of African Americans, desegregated
public facilities and transportation, prohibited hiring discrimination in federal contracts, gave the U.S.
attorney general the right to file suits to desegregate schools—and gave rights to women through Title
VII of the Civil Rights Act of 1964 Enacting the so-called War on Poverty that came to include the Job
Corps, Head Start, the Neighborhood Youth Corps, legal aid centers, health clinics, and community action
programs Enacting Medicare and Medicaid, with the former providing health care for seniors and the
latter providing means-tested medical benefits for low-income persons Establishing the Department of
Housing and Urban Development (HUD) and enacting or expanding public housing and affordable
housing programs Enacting the Older Americans Act, which provides Meals on Wheels and other
programs Enacting the Elementary and Secondary Education Act (ESEA), which provided federal funds
primarily to schools with large numbers of low-income children Johnson was the first American president
to fund scores of new social programs. They were often funded, however, at low levels because he
enacted a massive tax cut in 1964 and made an ill-advised decision to commit 600,000 troops to the
Vietnam War (Jansson, 2001). The war split the Democratic Party because many white Southerners and
blue-collar voters favored the war in contrast to many liberals and Martin Luther King. Johnson chose not
to run for a second full term in 1967, leaving the door open for Vice President Hubert Humphrey to
oppose Richard Nixon in the election of 1968.
Nixon’s Surprise
Many liberals feared that Nixon’s accession to the presidency would doom further social reforms
because he was a staunch Republican conservative. Nixon chose, however, to initiate social reforms that
rivaled ones that Johnson enacted because he wanted to rebuild the Republican Party by gaining credit
for domestic reforms that had traditionally been initiated by the Democratic Party. He also wanted to
draw conservative southern Democrats and white blue-collar voters into the Republican Party by
supporting the Vietnam War, opposing school busing of minorities into white schools, and opposing
affirmative action (Reichley, 1981). Nixon correctly predicted that many white northern Catholics and
southern white Democrats, angered by Johnson’s civil rights measures, would join the Republican Party.
He could not accomplish this goal because he resigned from the presidency before the Congress was on
the verge of impeaching him. Nixon nonetheless achieved these domestic reforms (Jansson, 2019b):
Indexing Social Security benefits to inflation to assure regular increases Enacting the Supplementary
Security Income (SSI) Program to provide means-tested benefits to seniors and persons with disabilities
Enacting the Earned Income Tax Credit of 1975 to give working persons in families tax credits if they
earned less than a specified income Expanding the Food Stamps Program by federalizing it and
increasing its benefits Enacting the Housing and Community Development Act of 1974, which
established rental subsidies for low- and moderate-income persons Establishing the Occupational Safety
and Health Administration (OSHA) of 1970 to regulate and improve working conditions Enacting Title XX
of the Social Security Act to fund the social service programs of states Enacting the Comprehensive
Employment and Training Act (CETA) to train workers and provide them with jobs in public and not-forprofit agencies, with an emphasis on longterm unemployed persons; fund summer jobs for high school
students; and providing fulltime jobs for 12 to 24 months with the goal of providing marketable skills
Passing the Rehabilitation Act of 1973, which prohibited discrimination on the basis of disability in
programs conducted by federal agencies, in programs receiving federal financial assistance, in federal
employment, and by federal contractors Enacting the Education for All Handicapped Children Act of
1975, which required all public schools that accept federal funding to provide equal access to education
and one free meal a day for all children with physical and mental disabilities Establishing the U.S.
Department of Education Approving affirmative action in the wake of the Supreme Court’s decision in
Regents of the University of California v. Bakke When taken together, enactments of the Great Society
and Nixon’s presidency transformed America. Nondefense spending went from 8.1% of the gross
national product in 1961 to 11.3% in 1971 and 15.6% in 1981 (Jansson, 2001). About two-thirds of this
domestic budget consisted of social insurance and means-tested social programs. Total federal social
spending rose from $67 billion in 1960 to $158 billion in 1970 (in 1980 dollars) and to $314 billion in
1980. Social workers engaged in advocacy during the Great Society and Nixon’s presidency. They helped
persons learn about and gain access to the scores of social programs enacted in the 1960s and early
1970s including food stamps, Section 8 housing vouchers, Medicaid, and the Earned Income Tax Credit
(EITC)—all new programs. Many social workers worked in programs of the War on Poverty. They helped
residents in marginalized communities develop community action councils that engaged in planning to
develop new programs. They worked with welfare rights organizations (WROs) that worked to increase
welfare grants for single mothers and to decrease punitive practices of some welfare departments, such
as raiding homes to see if men lived in households with women on welfare. Even with the reforms of the
Great Society and the Nixon presidency, critics believed that many of them were underfunded. Welfare
programs reached relatively few poor people because many states established harsh eligibility standards
for Aid to Families with Dependent Children (AFDC), just as the federal government established harsh
eligibility standards for food stamps. Huge sections of American cities housed persons of color in
segregated communities with poor schools and housing (Jansson, 2001).
Conservative Counterrevolutions
History demonstrates that policy advocates often encounter counterrevolutions in which the nation
turns sharply toward conservatism. Policy advocates guided by social work’s code of ethics feared that
elections of Ronald Reagan in 1981 and Donald Trump in 2016 might lead to repudiations of prior social
reforms because both opposed social programs widely used by marginalized populations. If Reagan
repeatedly sought cuts in social programs, Trump followed suit and also attacked immigrants, African
Americans, Latinos, women, and Muslims (Jansson, 2019b)
Gridlock During the Presidencies of Ronald Reagan, George H. W. Bush, and George W. Bush
In the blink of an eye, many voters bought into the arguments of Ronald Reagan, a former movie star
who had changed from liberal views in the 1930s to conservative ones in the 1950s and beyond. A twoterm Republican governor of California in the late 1960s and early 1970s, Reagan ran unsuccessfully for
the presidency in 1976 but won a landslide victory over Jimmy Carter in the presidential contest of
1980—and won another one-sided election in 1984. He glamorized the Gilded Age even with its extreme
income inequality and racism. He invented the term “welfare queen” to describe a woman in Chicago
who he alleged had many children to increase her welfare grants. (Only later was it established that he
had invented this woman.) He liked the theories of economist Arthur Laffer, who believed that deep tax
cuts stimulated economic growth without causing deficits because economic growth caused by lower
taxes would produce higher tax revenues (Roberts, 1984). Many economists and David Stockman,
Reagan’s budget director, believed Laffer was wrong (Stockman, 1986). Their forecasts proved to be
correct: Reagan’s deficits exceeded the sum total of all the deficits of all prior American presidents.
Reagan created a rival coalition to Roosevelt’s that included evangelicals, southern whites, affluent
Americans, and suburbanites. Reagan’s policy agenda flowed from his ideology and his coalition. He cut
taxes deeply for everyone but with the largest cuts given to affluent Americans whose top marginal rates
were cut from 70% to 28%. He increased military spending to the level during the Vietnam War even
though the nation was not at war. He argued that the resulting budget deficits required him to cut
domestic discretionary spending deeply—including food stamps, welfare, housing vouchers for poor
people, and many other programs. He enacted all of this legislation in 1981 (Stockman, 1986). Reagan
ushered in a new era of income inequality that came to equal the income inequality of the Gilded Age
(Jansson, 2019a). He initiated few social reforms aside from the Immigration Reform and Control Act of
1986, which gave more than 3 million undocumented immigrants a path to citizenship. He made many
Americans averse to increasing taxes. He attacked the federal government and social welfare programs in
general but did not cut Social Security, Medicare, and Medicaid. No major legislation was enacted in the
presidency of George H. W.
Gridlock During the Presidencies of Bill Clinton and Barack Obama
Two relatively liberal presidents (Bill Clinton from 1993 through 2000 and Barack Obama from 2008
through 2016) were unable to initiate new liberal eras because the federal government was gridlocked
by Republicans who controlled one or both of the chambers of Congress. Recall that Presidents Franklin
Roosevelt and Lyndon Johnson achieved their legislative successes because Democrats controlled both
chambers of the Congress, unlike Presidents Clinton and Obama (Jansson, 2019a). Bill Clinton hoped to
enact national health reform and social investments but was stymied by the Republican Congress.
President Obama was able to enact the Affordable Care Act (ACA), the Stimulus Plan, and banking
regulations in 2009 and 2010 because Democrats barely controlled both chambers of the Congress for
most of that period. He was gridlocked, however, for the rest of his presidency as Republicans gained
control of one or both chambers of Congress. He encountered numerous budget battles leading to a
budget deal in 2013 that required huge cuts in domestic and military spending up to the year 2023
(Jansson, 2019a). Clinton and Obama lacked resources for major social reforms because they were
burdened by the huge increases

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