Paul Van de Water is a Senior Fellow at the Center on Budget and Policy Priorities, where he specializes in Medicare, Social Security, and health coverage issues. These topics have been a focus of his long career, which includes his role as a Founding Member of the National Academy of Social Insurance in 1987.
A formative first job
Throughout college and graduate school, Van de Water was interested in budget policy. His first job post-graduation was in Washington at the Department of Health, Education, and Welfare, where a group had just started to work on Social Security issues. “By good fortune, that first job was extremely formative for the rest of my career,” Van de Water said. “The work was led by Larry Thompson (a Founding Member of the Academy), who was a great personal and intellectual influence. Another key person was Jane Ross (another Founding Member of the Academy), who went on to a have a distinguished career in several government agencies. I had no idea what I was getting into, but it was a wonderful opportunity.”
Focusing on taxes and funding programs we need
Successful implementation of a program relies on having sufficient funding. “Budget and policy are not distinct,” says Van de Water. “The name of my workplace — Center on Budget and Policy Priorities —demonstrates that when you’re talking about policies you also have to think about how they’re going to be paid for and how they fit into the rest of the budget.
“As I often say, we don’t levy taxes because we like taxes; we levy taxes because there are programs and activities we feel are worth spending money on, and we need to raise the revenues to pay for them. Two years ago the administration enacted large tax cuts at a time when additional revenues are needed, so assuring adequate revenues to support the federal programs we need has been, and will continue to be, one of our most critical public policy issues.”
Current work on Social Security
At the Center on Budget and Policy Priorities, Van de Water’s analysis reaches members of the policy community, the media, and the public. When interviewed for this Spotlight, he was working on a brief about the income tax on Social Security benefits that people over certain income thresholds pay.
“The taxation of benefits has always been subject to some criticism,” he explained, “so this brief paper will review how it works, why there is a good rationale for it, and why it shouldn’t be scaled back or eliminated, as some are proposing. Bob Ball, a leading light on Social Security for many years, had long argued that it was appropriate to tax Social Security, because it should be treated the same as other earned benefits. The pressure of an imminent funding shortfall in 1983 was the reason that this step was taken. Today, the taxation of Social Security benefits produces a substantial amount of income for both the Social Security and Medicare trust funds.”
Medicare and the 2020 election
Health care access and affordability were driving issues in the 2018 elections, and there is every indication they will continue to be important in the run up to the 2020 presidential election. Some candidates are suggesting an expansion of Medicare as a way to provide health care coverage for more Americans and hold down costs. The Academy recently published “Changing Medicare Eligibility: Program Design Challenges”, a policy brief authored by Van de Water that addresses the technical and program design challenges involved.
Issues in changing eligibility for Medicare include its unique benefit package, how it meshes with private employer plans, and its relation to the Affordable Care Act (ACA) Marketplaces. “My paper is an introduction to the policy issues that have to be addressed when considering any expansion or contraction of Medicare,” says Van de Water. “The next step is a study panel of experts who will explore the same issues in more depth. I’m very pleased to have helped get this project off the ground and to participate as it progresses.”
More about Paul Van de Water
Before his position at the Center on Budget and Policy Priorities, Paul Van de Water was Vice President for Health Policy at the National Academy of Social Insurance. Previously, he served as Assistant Deputy Commissioner for Policy at the Social Security Administration (SSA), Associate Commissioner for Research, Evaluation, and Statistics at SSA, and Assistant Director for Budget Analysis at the Congressional Budget Office. He has written extensively on the topics of Medicare, Social Security, and health policy in professional and mainstream media. He received his A.B. in economics from Princeton University and his Ph.D. in economics from the Massachusetts Institute of Technology.