Not Just Kansas Anymore

April 26, 2017

Back in 2010, Kansas Governor Brownback and his Republican-controlled legislature initiated a “real-live experiment” in a particular brand of conservative economics. It blew up. And we, who don’t live in Kansas, may get hit by a much bigger explosion.

Experiment Blows Gaping Budget Holes

The Kansas Republicans eliminated income taxes for variously-structured small businesses. They also reduced income taxes for individual filers. This, Brownback said, would attract businesses, grow those there and create many thousands of jobs.

Well, Kansas, which must balance its budget every year, saw income taxes fall about $54 million short of projections — and then $333 million. Brownback filled the holes by shifting money from funds meant for special purposes..

Not enough. So Brownback cut funds for a range of programs, e.g., higher education, Medicaid, in-home services for seniors. And he tried to cut funding for K-12 education by $28 million — an action the Kansas Supreme Court found unconstitutional.

Why should we who don’t live in Kansas or have ties to anyone who does care? Because the Trump administration and leading Congressional Republicans have the same theory in mind for their tax cuts. And they’ll predictably trigger cuts in cuts in programs that benefit low-income people.

Faith in Theory Remains

A theory dating back to the mid-1970s, holds that tax cuts will stimulate so much economic growth that the additional revenues gained under the lower rates will offset the seeming losses, even reap more — because business will invest more, people work more, save and invest more.

It’s now commonly known as supply side economics — or pejoratively trickle down. Note how it favors tax cuts for corporations and well-off individuals, since lower-wage workers already have to earn as much as they can and have little or nothing left over to buy stocks and bonds.

Both the theory and some specific features of Brownback’s experiment underpin what the Trump administration and Congressional Republican leaders have in mind for their promised tax reform.

House Speaker Ryan’s Better Way tax reform plan includes large tax cuts on individuals’ investment income, lower tax rates for all businesses and an immediate, instead of a multi-year write-off on their investments.

The promise here is economic growth — in the labor force, productivity and wages. Though the cuts will be larger than “loopholes” and deductions eliminated, the package will, the plan says, be revenue-neutral, i.e. neither more nor less tax revenues collected.

Ryan cites a fairly recent House rule that requires the Joint Committee on Taxation to use dynamic scoring, rather than beginning with the current revenue baseline and then adding and subtracting estimated gains from increases and losses from cuts.

Last year’s concurrent budget resolution, i.e., the basic blueprint for budgets the House and Senate will develop, directed the Congressional Budget Office to do the same, insofar as it responsibly can.

No one with any basic economic smarts doubts that taxes have some effect on choices that affect growth. JCT and CBO factored these in their pre-dynamic scoring.

But the economists must build and use even more complex predictive models for dynamic scores. These — and so the results — can vary widely. But JCT and CBO  must deliver only one score, rather than a range, with explanations as they used to.

And now Trump’s Director of Office of Management and Budget says that both the budget and the administration’s tax reform proposal will reflect some dynamic scoring, but with a considerably higher growth rate than CBO’s.

The plan, he more recently said, ‘”will pay for itself” with growth — nearly $2 trillion over the first 10 years. The Tax Policy Center, on the other hand, estimates a $6.2 trillion loss in revenues, plus another trillion for interest on the mounting debt.

Devil Isn’t Only in Model Details

White House economists are still hammering out details of the tax reform plan, reportedly consulting with Congressional leaders — Republicans only, one infers.

Two things we know for sure. The business tax part will be “phenomenal” and the speaker, whom I trust need not be identified, believes the whole package “bigger than any tax cut ever.”

But what if, as in Kansas, it results in revenue losses? Edward Kleinbard, a former JCT chief of staff, thinks this likely — in part because the models assume that only individuals (and one assumes businesses) make productive investments. But government spending boosts growth too.

Less of that and the deficit will rise. The dynamic scoring partisans will push for deep cuts in investment programs and/or social insurance, he warns.

We know from experience that a rising deficit will prompt a wide range of cuts — both safety net and investments that give low-income people opportunities to earn more, e.g., by gaining more education and marketable skills, better public transportation, renovated neighborhoods that attract businesses.

These all give their children a better chance to do better too.

When Republicans balked at raising the debt ceiling in 2011, the Obama administration brokered a deal. Congress then passed the Budget Control Act — a two-part spending reduction measure.

We first had across-the-board cuts for both defense and non-defense programs that depend on annual appropriations, then caps on each, which Congress and the President later agreed to temporarily modify.

And look what’s happened.

As I’ve said before, programs generally need more funding just to sustain a steady state because costs rise — rent that housing vouchers subsidize, food and beverages that nutrition aid programs pay for* teaching materials, salaries and operating costs in public education programs, from pre-K through college, etc.

But funding for non-defense programs is now 16% lower in real dollars than in 2010. Title I funding targeted to high-poverty schools has remained basically flat, notwithstanding its current Every Child Succeeds Act name.

The Child Care and Development Block Grant — the largest source of federal subsidies for lower-income families serves fewer children in an average month than in any year since 1998, according to the latest official figures.

The Community Development Block Grant, which Trump wants to eliminate, lost $6 million last year alone. Local housing authorities are shy well over $26.5 billion needed to repair and/or renovate deteriorating public housing units merely to avoid further losses, estimated at 10,000 a year.

These are only examples I can readily recall in enough detail and find links for. We will surely have a plethora with those phenomenal tax cuts.

* Most nutrition assistance programs administered by the Agriculture Department must receive enough funding for everyone eligible. This is not true, however, for WIC or two programs that supply food directly, rather than as a cash-equivalent or a reimbursement.


What Do Our Federal Income Taxes Pay For?

April 24, 2017

We who didn’t request an extension (gloat) have filed our federal income tax returns. There’s a lot of chatter about where our taxpayer dollars go — even a Congressman who tells his constituents that they don’t pay his salary.

We do, of course. But more generally, what do we pay for? The National Priorities Project answers again this year. So I put what I owed into its online tool and converted the dollars into shares, since these would be the same for everyone.

Here’s what I learned.

The same shares would be true for everyone who owed income taxes. Only the actual dollars would differ.

The single largest share of my income taxes went for healthcare programs29%. About 80% of this helped pay for Medicaid and Medicare (one of its three funding streams).

Next largest share to the military — roughly 24%. Only about 20% of this went for personnel costs of any sort.

NPP also itemizes, for the interested, what the Pentagon pays for nuclear weapons and to Lockheed Martin, whose trouble-plagued F-35 fighter plane has cost us nearly $4 billion. An email from NPP tells me that we pay over six times more to Lockheed than what we spend on all foreign aid.

Third share went for interest on the debt — 13%. You may recall that Congressional Republicans used the government’s urgent need to borrow more so it could pay what it owed as a lever to force down spending through sequestration and the budget caps. And that they later actually shut down the government in hopes of defunding Obamacare.

Doubtful they’ll access their tax receipts. But the bill that simply suspended the debt ceiling expired a little over a month ago. And some are warning of another skirmish.

My fourth largest share paid for unemployment and labor programs — 7.5%, presumably everything federal agencies spend to get people into — or back into—the workforce.

This same share supports what the Labor Department contributes to unemployment insurance benefits when times are especially hard and the rules it issues and enforces to protect workers from workplace health hazards and wage theft. The latter now include updated overtime pay requirements, but may no longer, coming sometime next year.

Then veterans benefits — about 6%. This includes, among other things, payments veterans receive when they’re disabled while serving, the GI bill, home loans and pensions for low-income surviving spouses. Most of the rest of this share goes to the problem-riddled Veterans Health Administration.

Next come food and agriculture — nearly 5%. Here’s where we find, among other things, SNAP (the food stamp program) and the Agriculture Department’s other nutrition aid programs.

Also, in an altogether different mode, the subsidies Congress gives to farmers — mostly big agribusinesses — to cushion them against price drops, insure them against other business risks and more.

Government next — 4.2%. NPP breaks out only three pieces, all enforcement — and two clearly aimed at ramped-up actions against undocumented immigrants and would-be’s.

But we’ve got to assume, I think, that this line item includes spending for all non-military personnel and activities, including Congress members’ salaries — $174,000 this year, plus benefits.

Transportation gets a 3.2% share. Everything the Transportation Department does gets some share of this share. including controlling air traffic and, as all flyers know, vigilantly trying to keep us from hijacking or blowing up planes.

Education gets a 2.8% share, according to NPP’s analysis. I’d put it at 3.2% because NPP classifies Head Start and related programs as community spending.

It’s true that Head Start and Early Head Start for younger kids do more than ready them for kindergarten, e.g. screen them for health and developmental problems, link families to needed services. But their primary aim is starting low-income children off on as level a playing field as possible.

Wherever you put it, Head Start’s share is far from the largest NPP breaks out. That distinction goes to Pell grants, work-study and other forms of federal aid for lower-income college students. These rolled together receive a larger share than federal aid to elementary and secondary schools — 35 %, as compared to 27%.

And I’d be remiss not to note that the National Endowment for the Arts, which Trump wants to eliminate, gets less than .002% of education’s share, as NPP calculates it — and roughly a tenth of that for everything our federal government uses our income tax dollars for.

Shifting Head Start and EHS, as I have, leaves housing and community with a 1.7%, rather than a 2.1% share.

Here we have everything the Department of Housing and Urban Development spends to help make housing affordable for lower-income people, shelter and temporarily house those who are homeless and make lower-income neighborhoods better places to live, e.g., by attracting businesses and thus job opportunities, providing needed services.

The money goes to local communities as grants. The largest of these is the Community Development Block Grant — another program on the Trump hit list because it’s “not well-targeted to the poorest populations and “has not demonstrated results.”

Followers already know what I — and many others — think of that line of argument.

Energy and environment get a 1.6% share of our income taxes. Seems it’s likely to shrink to an even smaller fraction, what with Trump’s seeking a 31% cut in the Environmental Protection Agency’s budget, crippling its ability to fulfill its legal responsibilities for protecting us from range of environmental health hazards, including climate change.

Lastly, we have, in rank order international affairs and science. These together get about 2.8% of the total.

Say you don’t like the way the budget apportions your federal income tax dollars. NPP has a tool that lets you reallocate them — and gives you trade-offs.

These are mostly shifts from the $528.5 billion Defense Department budget, which NPP has long viewed as excessive. Interesting to see what even small nicks could do for lower-income people.


Bowser Budget Scants Needs of Homeless and Others at High Risk

April 20, 2017

Picking up where I left off, some major parts of Mayor Bowser’s proposed budget don’t link as obviously to the inclusive prosperity road its title promises as, for example, adult education and available, affordable child care.

Yet two other parts we care about do because both are virtual preconditions to earning income and having enough left over after basic needs to invest in boosting one’s marketable knowledge and skills.

But I don’t want to leave impression that I equate “prosperity” with income or wealth, as I think Bowser’s budget title does because it seems an indirect way of referring to the extraordinarily high level of income inequality in the District.

The Latin root of “prosperity” means made successful, but also made happy, according to one’s hopes. One can surely make a homeless family happy by providing it with decent, stable housing it can afford without—or before — doing whatever necessary to boost its income so that it can pay full rent.

So we need to look at the following from multiple perspectives.

Affordable Housing

No one, I suppose, needs anything further said about the acute shortage of housing in the District that its lowest-income residents can afford.

Such prosperity as they might achieve — through taking college courses, for example — is beyond their means because, if they’re not homeless, most are paying more than half their income for rent and more than half of those at least 80%.

The Mayor, to her credit, would again commit $100 million to the Housing Production Trust Fund, plus $10 million to a new fund dedicated solely to preserving existing affordable housing.

But helping developers finance new affordable housing construction and/or renovations isn’t enough to produce units affordable for the lowest-income residents.

Those units need housing vouchers attached to cover the difference between what tenants must pay — no more than 30% of their income — and ongoing operating costs, e.g., maintenance, utilities, staff wages. The Mayor fails to propose funding to increase the number of these so-called project-based vouchers.

And as I earlier said, additional funding could be needed merely to sustain vouchers now in use because if Congress extends the current funding level for federal Housing Choice vouchers, the DC Housing Authority won’t have the money to issue any.

If the Republican majorities in Congress accede to anything like Trump’s budget plan, a larger loss, as yet unestimated at the state/District level.

Homelessness

Want of affordable housing obviously causes homelessness. But it does more than that. It’s hard to get and keep a job when you’re living in a shelter.

That’s especially true if the shelter’s for adults only because they generally have to get in line in mid-afternoon to get back in. And those who make it may not be able to wash themselves and are highly vulnerable to theft.

There goes the cell phone that’s the only way to contact them — and the photo ID they’ll need, if they have one.

All but impossible to get a job if they’re among the chronically homeless without the safety, stability and appropriate services they’d get in permanent supportive housing.

The Mayor does increase PSH funding by $2.7 million. But that would meet only 30% of what’s needed to end chronic homelessness, the DC Fiscal Policy Institute reports. (The target year set by the strategic plan the Mayor’s embraced obviously won’t be met,)

Other single homeless people get shorted in several different ways. No additional rapid re-housing for them, though some temporarily down on their luck could pick up the full rent when their short-term subsidies end.

About 46% for less for families as in the current fiscal year. But its success in ending homelessness — or as the program’s formally titled achieving “stabilization” — is at the very least debatable.

And the District’s youngest homeless people — those under 25 who’re on their own in the city — will continue to suffer from neglect, in addition to the egregious neglect (or abuse) that caused some to leave home to begin with.

Others became homeless when they became legally adults. Various reasons for this. For example, they were either kicked out by their parents (something that can happen earlier) or reached the maximum age for foster care and didn’t have foster parents who’d foster them for free — or any one else who’d take them in.

These young people need safe, stable housing, but also education and/or training and mentoring because, as the National Network for Youth puts it, many are in a state of “extreme disconnection.”

In other words, they’re worst cases of youth commonly referred to as “disconnected” — or more hopefully, “opportunity.” They’re not only neither in school or working. They lack basic life skills, e.g., how to keep themselves healthy, look for a job, manage such money as they make.

The DC Interagency Council on Homelessness developed a five-year plan specifically for homeless youth, based on census (no link available) that’s surely an undercount. It nevertheless captured 545 youth who were either homeless or insecurely housed, e.g. couch-surfing.

The ICH developed a five-year homeless youth plan, as an amendment to the District’s basic homeless services plan requires. The Mayor’s budget invests $2.4 million — less than half what the upcoming (and first) year requires.

Homeless now — others to become so. How then will the District make not only youth, but former youth homelessness brief, rare, brief and non-recurring  — let alone enable these potential contributors to our economy and our civic life share in the prosperity the Mayor dangles before us?


Inclusive Prosperity Programs Shortchanged in Mayor Bowser’s Budget

April 17, 2017

My last post merely mentioned shortfalls in the Mayor’s proposed budget, due at least partly to the $100 million or so she chose to forfeit by doing nothing to halt the automatically triggered tax cuts.

I’ll turn now to my picks for programs she shortchanges, based on how she styles her budget — a roadmap to inclusive prosperity.” Still only summaries. And not all programs some advocates have flagged.

Nevertheless, more than I can cover in a single post with enough substance to convey what’s under-funded — or unfunded — and why that violates the budget’s promise. So I’ll deal here with what seem the most obvious and followup with a couple of others that matter too.

Education and Training

We also all know that education and relevant job training generally move people along the road to some modicum of prosperity. For many adults in the District, the first step must be remedial education — basic literacy in reading and math, help in preparing for the GED exams.

For others, appropriate programs include those leading to a regular high school diploma and /or vocational education courses in other publicly-funded institutions, e.g., charter schools and alternative education in regular public schools like the Ballou High School’s STAY program.

Several surveys have found that adult learners miss classes because they can’t come up with the transit fare. Eighty-six percent of the youngest who had subsidized transportation said it would hard or altogether impossible to attend without it.

No reason to believe that’s not true for at least as many older adults, who’ve often got to spend more of such income as they have on basic needs for both themselves and their children. And, of course, we’ve got to assume that some of all ages drop out.

The Deputy Mayor for Education recommended an adult learner parallel to the Kids Ride program, which covers the public transit costs of getting to and from school.

Not a big ticket item—a mere $1.5–2 million. But no money in the Mayor’s budget for it.

Double-Duty Work Support

The full, unsubsidized cost of child care in the District is higher, on average, than in any state. Though low-income parents are officially eligible for subsidies that help pay for it, as a practical matter it’s difficult, if not impossible to find a center that will accept them.

This is a long-standing problem rooted in the insufficient rates the District uses to reimburse providers. For this, among other reasons, it was shy roughly 14,000 slots for infants and toddlers in 2015.

They’re the most costly to care for properly, what with diaper changing, feeding and all — hence local center charges averaging $22,658 a year.

The kids are too young for pre-K, of course. But the quality of care, e.g., nurturing relationships, talking to, has more impact on brain development than at any later stage. The very young children who get it will do better in school — and thus have a better chance of sharing in prosperity.

Now, if you can’t find trustworthy care for your child, you’re unlikely to work. Nor enroll in an education or training program that would prepare you to do so. And you won’t do either if you can’t pay for it.

Charges for licensed childcare are likely to increase, since the District recently set new licensing standards that require not only teachers, but their assistants to have at least a two-year college degree, unless they’ve got an independently-awarded Child Development Associate credential.

Those who manage to get either surely — and reasonably — will expect increases in their pay. It’s already, on average, extremely low — $26,470, on average, according to the latest figures.

If they don’t get them they can find employers that will. And that’s likely to further reduce open slots, since replacing them would be as difficult as keeping those who left.

Yet the Mayor’s budget doesn’t nothing about this. It would instead put $15.3 million into a new initiative to increase center capacity. But the new slots would be market rate — helpful for better-off parents, but no help at all for the most in need of affordable care to move down her road.

Paid Family Leave

The Mayor proposes no funding to translate the paid family leave law the Council passed into an operating program.

That requires both the creation of a new agency to administer the law, e.g., to ensure employers pay what they owe, pay out to eligible workers for the time off they take, and a new computer system to make all this possible.

We know the Mayor doesn’t like the law. But the essence of being an executive is executing laws.

Forcing more than half a million workers to wait for who knows how much longer to either keep working when they need time off for compelling  for compelling family reasons — or at least as likely forgo needed income — hardly comports with including them in prosperity.

Her refusal to propose the $20 million needed to get the program started doesn’t, I think, reflect only spending constraints imposed by her deciding not to even hit the pause button on the tax cuts. But they do perhaps provide some cover.


DC Mayor Bowser Won’t Halt Triggered Tax Cuts to Gain Needed Funding

April 13, 2017

Just finished my annual dialogue with my tax preparation software. So as always, my thoughts turn to the tax laws that determine what I have to pay. A sweeping federal tax reform is much in the news. And I’ll probably have things to say about that.

But I’ll start with the automatically triggered tax cuts Mayor Bowser has decided to let alone in her proposed budget, styled “DC Values in Action: A Roadmap to Inclusive Prosperity.”

These because they don’t hinge on new legislation. And they push down spending because the District, like most states must balance its budget every year.

As you may know, the triggered tax cuts reflect recommendations made by the Tax Revision Commission in 2014. It didn’t recommend triggering them whenever a certain revenue projection exceeded the version the budget was built on.

That was the work of DC Council Chairman Phil Mendelson, who folded them, ranked according to his preferences into the final version of the legislative package that accompanied the Fiscal Year 2015 budget.

A last minute thing. Other Councilmembers had no chance to consider them — perhaps didn’t even know they were there.

The triggered tax cuts have already reduced revenues by $102 million — none a one-time loss. The rest will all kick next fiscal year, unless the Council decides to instead recoup about $100 million.

Some of the cuts, would benefit lower and moderate-income residents, though not those with incomes so low they already don’t owe income taxes, once they’ve taken all now allowable exemptions, credits and the like. Nor, of course, those who’ve no taxable income at all.

These cuts include a further increase in the standard deduction, which a very large percent of DC filers with incomes less than $75,000 choose because they don’t have more costly specific deductions like interest on a mortgage or real property taxes high out-of-pocket medical expenses. (The District relies on the federal government’s Schedule A for these.)

The other of this sort is a multi-part increase in the personal exemption, which applies to all filers and their dependents, except apparently those whose incomes exceed $275,000.

But the surplus also triggers a second increase in the threshold for the estate tax, bringing it to $5.49 million if left by an individual and twice that for a married couple — the same as in federal law.*

Why the District should aim to mirror a tax giveaway to heirs of the very most prosperous that Congressional Republicans insisted on as part of the deal that pulled us back from the fiscal cliff is a mystery.

Additional cuts in the business franchise tax, coupled with a further cut in the business income tax are, at the very least questionable.

Sure, we want profit-making businesses in the city — a source of jobs, among other things. But a recent survey indicates that the taxes they must pay are a relatively minor factor in their decisions on whether to locate here or elsewhere.

Topping the list is the ready availability of workers with the knowledge and/or skills they need. One could do a lot to help residents qualify for and get jobs with the potential loss of $35.7 million.

Advocacy organizations of various sorts have already flagged a wide range of shortfalls in the Mayor’s proposed budget. We’ll have a fuller accounting from the DC Fiscal Policy Institute fairly soon — and undoubtedly more from other concerned nonprofits too.

I’d thought to cite examples, based on the Mayor’s prosperity promise and my own topmost concerns. But even summaries made this post far longer than my somewhat flexible maxim. So I’ll return to them shortly.

Yet I don’t want to leave the impression that the Mayor’s budget shortchanges her low-income constituents in every way.

The most significant example of how it would benefit them is the funding she proposes to begin the Temporary Assistance for Needy Families time limit reforms recommended by diverse working group the Department of Human Services convened.

This will not only save roughly 6,500 families from losing all their benefits when the new fiscal year begins — and more as time goes on.

It will preserve those benefits for all children and all parents who’re meeting their work preparation and/or job requirements until they’ve found jobs or otherwise gained enough income to put them over the eligibility cut-off.

Cash benefits being as low as they are — and will be — the initiative in and of itself hardly shares the non-inclusive prosperity reflected in the District’s tax revenues. But it does save very poor families from the most dire poverty.

And the non-cash benefits — free training and, in some cases, formal education, no-cost child care and transportation — give parents a chance to move from welfare to decent-paying work and, in the process, improve their children’s future prospects.

* The thresholds were somewhat lower when the Council adopted the triggers, but the legislation refers to raising the threshold “to conform to the federal level.” And the federal level rises with the inflation rate.

UPDATE: I’ve learned that the Mayor’s budget doesn’t altogether reflect the working group’s recommendations. They would significantly protect children if their parents had their benefits cut for not complying with their work requirements by allocating 80% of the family grant to them.

The Mayor would split the grant 50-50. As a practical matter, this might not make much difference. The parents will have the same amount to spend, and it will surely go for the same basic needs. We will need to see how the Mayor justifies her split, assuming she or a Department of Human Services official is asked.


Looming Threats to Health Centers and Their Low-Income Patients

April 10, 2017

I recently met someone who follows my blog — one of the benefits I treasure. She’d come to the District for a meeting of the National Association of Community Health Centers. I learned a lot about this important piece of our federally-subsidized healthcare system.

I could see right off ways that they and the low-income people they serve are threatened now. But Terri told me about another that’s more than a threat.

Federally Qualified Health Centers

Terri serves as the strategist and advocate for a Southern California network of Federally Qualified Heath Centers — outpatient clinics that have met a set of requirements and receive grants from a Health and Human Services Department agency.

The FQHCs must, among other things. provide specific healthcare services — primary, preventive and emergency, plus education so that patients with diabetes and chronic kidney disease can monitor and control their conditions.

They must serve an otherwise under-served area or under-served people elsewhere. And they must use income and family size as the basis for their fees. So people with no income can get care, even if not enrolled or eligible for Medicaid.

A number of clinics provide additional services, e.g., dental care, mental health and/or substance abuse treatment. The clinic where Terri is based does all this and more.

It has social workers, for example, who link patients to sources of help, according to their individual needs, including navigating them through online enrollment in Medicaid.

The clinic goes beyond its diabetes management requirement by giving its diabetic patients cellphones that read their blood sugar levels and relay them to the clinic.

Terri, her colleagues and counterparts across the country are worried about how they will continue to operate — and what will happen to the low-income they serve if they can’t.

Her network receives some donations. But like all FQHCs, it depends largely on the HHS grants and partial cost reimbursements for patients enrolled in Medicaid.

Raid on Medicaid Still a Threat

California jumped at the chance to expand its Medicaid program when the Affordable Care Act became effective. The clinic Terri works in experienced a large influx of newly-eligible people with untreated conditions, e.g., diabetes, high blood pressure, oral diseases, mental health problems.

Congressional Republicans haven’t block-granted Medicaid or the similarly cost-shifting per capita alternative.

But the Affordable Care Act assured states that the federal government would reimburse 90% of care costs for their newly-eligible enrollees from 2020 on forward — the last phase in the incentive pay scheme.

What with Trump now trying to cut a deal with far right-wing members of the House, one might reasonably expect the product to end this level of funding like the failed repeal-replace bill. All expansion states, including California would face some tough choices then.

Federal Grants in Two-Part Jeopardy

The legislation that authorizes the federal government to award the FQHC grants will expire at the end of September. Without the grants, the health centers will collectively lose about 70% of their federal funding.

So a must-do for Congress is a straightforward extension, like the one included in the same law that kept the Children’s Health Insurance Program alive. Given the lack of hearings, other preoccupations and usual long summer break, simply kicking the expiration deadline forward is the only way to avert a for-sure funding loss.

But that would only give HHS authority to spend as much money as Congress chooses — and the President agrees to. Trump’s budget plan would cut the HHS budget by 17.9% — $15.1 billion less than it’s getting now. We don’t know the details, but we shouldn’t, I think, rule out anything.

Even if Congress won’t go along with such radical spending cuts (a likely response), the Budget Control Act’s cap on spending for non-defense programs will kick in again, after the latest two-year halt.

What this means it that Congress will have to cut spending on these programs by $2.9 billion. So the size and/or number of the FQHC grants are at risk — unless Congress decides to again defer or altogether eliminate the caps.

Immigrant Roundups and Healthcare Needs

The clinic where Terri is based is in a community where many immigrants live, including some unknown number without the documents authorizing them to live and work in this country.

Even immigrants here legally generally can’t qualify for Medicaid for the first five years, though they can receive Medicaid-financed emergency services.

California, as well as some other states provides a few others, regardless of immigration status. But as the Los Angeles Times reports, the community health care centers “treat all comers.”

We all know how federal immigration enforcement authorities have aggressively ramped up raids aimed at deportation. They’re active in the clinic’s community, where local authorities have partnered with them.

The agents have started patrolling side roads, including one leading to the clinic. Staff have witnessed a large drop off in immigrants seeking care.

One day an agent showed up in the building, with a warrant for something (not somebody). He opened the door to the waiting room. Patients fled, dragging children by the hands. What’s going to happen to them and their kids now that fear will keep them away?

These aren’t the only threats to the health of low-income people. The unremitting efforts to defund Planned Parenthood clinics put them at high-risk too, notwithstanding the anti-choice Congress members’ and supporters claim that clinics like Terri’s can fill the gap.

May have more to say about this than I already have.


No Proof Trump-Targeted Programs Work?

April 6, 2017

Congress set in motion a sensible response to the incessant claims from the right that anti-poverty programs don’t work.

It passed a bill that creates an expert commission to review federal program data and make recommendations for using it to support program evaluations and improvements based on results.

Now we’ve got justifications for Trump’s budget that fly in its face — specifically that certain programs that serve low-income people’s needs should cease to exist right now because we don’t have enough proof they work.

The Community Development Block Grant would end because it’s “not well targeted to the poorest populations and has not demonstrated results.”

Communities use CDBG funds to meet various needs. That’s what a flexible block grant is supposed let them do. Some unknown number support Meals on Wheels. They collectively supplied prepared meals for more than 2.4 million homebound seniors last year.

The OMB Director says that Meals on Wheels “sounds great,” but we can’t keep giving states money for “programs that don’t work.”

We do, in fact, have some research showing Meals on Wheels does—probably behind his ken. In any event, he brushes off the lost benefits by donning the mantle of fiscal responsibility.

The Trump budget would also zero-fund grants to local Community Learning Centers, which channel them to afterschool programs, especially in high-poverty, low-performing schools.

The director says more or less the same about them. “There’s no demonstrable evidence that they’re .. helping kids do better in school.” Again, we’ve got some evidence they do, though limited. Not, one infers, demonstrable enough to make the administration even pause.

The budget would also eliminate the Low Income Home Heating and Energy Assistance Program because it’s among the “lower-impact” programs and “unable to demonstrate strong performance outcomes.”

Now, we truly don’t want to fund programs that have no positive or only minimal effects. On the other hand, measuring a program’s effects by the so-called gold standard, i.e., a multi-year comparison of impacts on those who received benefits or services and a control group that didn’t, is a costly business — and still not conclusive.

One need only look at the gold-standard Head Start impact studies. The second, which tracked recent participants through the third grade found that gains didn’t last.

But when research teams at the Brookings Institution and UCLA looked instead at the long term, they found that the children fared better in significant ways

The real issue here, however, is what evidentiary standard a program has to meet for it to be considered funding-worthy.

Consider LIHEAP. It’s done less than it might for quite awhile because it’s been under-funded — and increasingly so. Its appropriations were small, even before the Budget Control Act capped spending on non-defense programs — just $5.1 billion in 2010. Less ever since.

At the same time, home heating costs have increased, as I’m sure you’ve noticed. So states, which get shares of the funding as block grant, have had to cut back on the number of low-income households whose home energy costs they subsidize and by how much.

The program nevertheless keeps the heat on for nearly 6.1 million poor households. Seventy percent are especially vulnerable, the National Energy Assistance Directors Association states, protesting what Trump intends.

Now, common sense tells us that that having heat in the winter averts new or aggravated illnesses due directly to the cold — even death, since roughly a quarter of LIHEAP households include a member who uses electrically-powered.medical equipment.

Bills paid for electricity also prevent injuries, since rooms can be lighted at night and food poisoning by keeping refrigerators running and stoves operating. (This last would be true of natural gas as well, of course.)

Whatever the energy source, the assistance LIHEAP provides can prevent homelessness and other hardships, e.g., food insecurity, because low-income households otherwise have to spend far more on home energy than the less cash-strapped—16%, as compared to 4%, according to findings when energy costs were lower.

Do we really need to find out what happened to another similar group of people who had their utilities cut off and couldn’t scrape up the money to get them turned back on?

It would be bad enough if the Trump administration were holding programs to an unreasonable standard — or merely ignorant of research-based evidence that they work.

But when it says it won’t fund programs without proof of that, it’s putting a self-serving, deceptive gloss on decisions made to cut spending on safety net and other non-defense programs.

How do we know? Well, Trump is bound and determined to fund private school vouchers. Do we have evidence of their outcomes? We do, to some extent, each focused exclusively on one state’s voucher program, plus the District of Columbia’s.

The earliest two found positive effects, e.g. higher graduation rates and, in the District, higher reading, but not math scores.

On the other hand, three of the four most recent, including one financed by a pro-voucher institute found that children in voucher programs scored lower in both reading and math than children in public schools. The fourth found no effect, as measured by graduates going on to college.

A foolish consistency isn’t always the hobgoblin of little minds. In this case, it’s minds of greater capacity engaging in inconsistency to justify their policy preferences — hoping futilely that no one will challenge their alternative facts.