Bernie Sanders is a pretty big fan of government, and he is not afraid to talk about it.
The self-described Democratic-Socialist has repeatedly said during his time on the campaign trail that his presidential candidacy is about “creating a government that works for all of us.” He has crafted proposals to mirror that ideal, promoting several policies that would add new responsibilities for federal agencies and in so doing, grow the number of workers they employ.
Perhaps the Independent senator from Vermont’s best-known proposition is his call to expand Medicare for all Americans, creating the single-payer health care system long the white whale of the nation’s left wing. His Democratic and Republican opponents alike have debated the policy merits of the issue, and the Sanders campaign has yet to spell out in great detail exactly how the program would run.
What is clear, however, is the program would create a hiring surge and a new management challenge at the Health and Human Services Department.
Tom Scully, the administrator of the Centers for Medicare and Medicaid Services under President George W. Bush, said the main growth at his former agency under the Sanders plan would be in the contractor workforce. The federal CMS staff, he estimated -- which currently amounts to about 6,000 employees -- would increase by “a couple thousand,” similar to the uptick after the passage of the Affordable Care Act.
Medicare currently pays for about 60,000 contractors, however, a number Scully predicted would roughly double under Sanders' proposal. The contractors work for insurance providers like Blue Cross and are responsible for handling the day-to-day claims from Medicare participants. Managing the large surge among those contract employees would not be difficult, Scully said, as the federal employees are “just writing checks.” Writing more of them, he explained, would not be a significant lift.
Still, the former CMS chief warned the process would not be all smooth sailing. While Medicare for all “sounds wonderful,” he argued it would do little to drive efficiency in health care.
In the most recent Democratic debate, Sanders discussed another new proposal that would expand government operations: to have the Justice Department review all deaths at the hands of local law enforcement. While Justice occasionally reviews high-profile police shootings, usually at the request of the local agency, it currently holds no mandate to do so.
The Federal Law Enforcement Officers Association met the proposal skeptically, saying it would require the creation of a whole new agency within the Justice Department.
Specifically reviewing every law enforcement shooting is “an unnecessary use of taxpayer funds,” a FLEOA spokeswoman said. “All law enforcement shootings, whether state, local or federal, undergo a great deal of scrutiny.” The shootings already have “multilayers of review,” she added.
Michael Briggs, a spokesman for the Sanders campaign, said the senator has not proposed specific instructions for the review process, noting he would instead “leave it up to the Justice Department” to implement the policy.
Another Sanders proposal would ban the federal government from contracting with private prison companies, while simultaneously reinstituting the federal parole system. The U.S. Parole Commission -- housed within Justice -- still exists for federal prisoners sentenced before 1987 and Washington, D.C., offenders sentenced before 2000, but is a shell of its former self since federal paroling was abolished for new criminals. The number of federal parolees has declined by 67 percent since it stopped being an option for new prisoners, according to a 2015 Government Accountability Office report.
Fully ramping up the commission, while bringing more federal responsibility to the Bureau of Prisons, would require an additional hiring spree at the Justice Department.
Not surprisingly, E.O. Young, the national president of the American Federation of Government Employees' Council on Prison Locals, supports ending contracts for all federal prisons.
Young's union believes "correctional work is inherently governmental and we also collectively believe this kind of work should be left to trained civil servants in law enforcement," he said. He added the move would require far more BOP employees, noting the agency is already understaffed: "Many positions are vacant and we are having difficult times filling recently opened prisons because of their rural locations," Young said.
Sanders has for years been one of the loudest supporters of the U.S. Postal Service in Congress, and has said as president he would expand the services the mailing agency offers. A key part of that growth would be in postal banking, which the senator has said would enable USPS to leverage its in-every-community infrastructure to offer customer friendly financial services.
“At a time when more than 68 million lower-income Americans have no bank accounts or are forced to rely on rip-off check-cashing storefronts and payday lenders, allowing the Postal Service to offer these kinds of financial services would be of huge social benefit,” Sanders told the American Postal Workers Union All Craft Conference in October (APWU went on to endorse Sanders shortly thereafter).
To offer services like check cashing, savings accounts and lending, said Charles Crum, a director at the Postal Service’s inspector general’s office, Congress would need to authorize the new task and USPS would likely need to hire a new team to manage it at the headquarters level. The Postal Service would likely have to partner with a bank to provide the actual mechanics of the banking. USPS hired such bankers before it eliminated postal banking in 1967, Crum said.
Because USPS already handles services like money orders, its employees are already trained on some of the basics of banking, such as the Banking Secrecy Act. Postal employees are well equipped to handle a more basic expansion of financial services, according to Crum, but to dive more deeply into options like lending would require a new contracted corps.
Sanders has demonstrated his willingness to grow federal rolls and boost funding when reforming agencies. When most lawmakers were focusing on ways to hold employees accountable at the Veterans Affairs Department after widespread manipulation of patient data was unearthed, he fought to authorize 27 new medical facilities and to provide $5 billion to hire more doctors and nurses. He eventually co-wrote the Veterans Access, Choice and Accountability Act, which included those provisions (though it also included provisions making it easier to fire senior executives at the department).
While the insurgent candidate is still viewed as an underdog in the Democratic primary, his odds have increased significantly as he has climbed the polls in early voting states. Federal employees have warmed up to him as well, giving Sanders slightly higher favorability scores than Hillary Clinton in the most recent poll conducted by Government Executive Media Group’s research arm, the Government Business Council. The percentage of feds saying they would vote for Sanders grew by 10 percent in that October poll compared to an August survey, though he still trailed Clinton by 17 percent among Democratic feds.
Even if Sanders completed the massive political upset, his administration would face significant pushback on his ambitious agenda. While the Republican-controlled Congress has fought to shrink government and rein in what it views as an out-of-control bureaucracy, Sanders is looking to expand it and give it more responsibility. Assuming a President Sanders had some modicum of success in pushing forward his ideas, however, the federal and contractor workforces would certainly have their hands full.