clinton's slashing of the welfare state is a matter of degree, not the only instance of purported beneficiaries losing benefits. medicare part d doesn't allow the government to negotiate prices and thus functions more as a subsidy for the pharmaceutical industry than people for whom it is ostensibly intended to prescription access. lots of games can be played with budgets (such as block grants, one notorious example being the 1981 repeal of the mental health systems act) so the raw dollars of entitlement spending can grow without representing a true shift in resources. when cost of living (eg rents, healthcare) outpaces spending, all while units of public housing are destroyed without being replaced, and the terms of occupation have grown ever more stringent (for example, requiring maintenance come out of tenants' rent while lowering the maximum eligible income for tenants), the mere dollar amount of spending becomes a less definitive measure, i think.