Keep your government hands off my Medicare! Such comments spotlight a central question animating Suzanne Mettler's provocative and timely book: why are many Americans unaware of government social benefits and so hostile to them in principle, even though they receive them? The Obama administration has been criticized for its inability to convey how much it has accomplished for ordinary citizens. Mettler argues that this difficulty is not merely a failure of communication; rather it is endemic to the formidable presence of the submerged state. In recent decades, federal policy makers have increasingly shunned the outright disbursing of benefits to individuals and families and favored instead less visible and more indirect incentives and subsidies, from tax breaks to payments for services to private companies. These submerged policies, Mettler shows, obscure the role of government and exaggerate that of the market. As a result, citizens are unaware not only of the benefits they receive, but of the massive advantages given to powerful interests, such as insurance companies and the financial industry. Mettler analyzes three Obama reforms - student aid, tax relief, and health care - to reveal the submerged state and its consequences, demonstrating how structurally difficult it is to enact policy reforms. She concludes with recommendations for reform to help make hidden policies more visible and governance more comprehensible to all Americans. The sad truth is that many American citizens do not know how major social programs work - or even whether they benefit from them. Suzanne Mettler's important new book will bring government policies back to the surface and encourage citizens to reclaim their voice in the political process.