Commentary, Trump Administration

Trump’s budget would sink SHIIP counseling and leave seniors struggling to stay afloat

The ongoing effort in Congress repeal the Affordable Care Act is far from the only bad news from Washington of late when it comes securing health care for vulnerable people. Both of the budgets proposed by the Trump administration and the U.S. Senate would completely eliminate funding for State Health Insurance Assistance Programs. This would affect North Carolina’s assistance program, NC Seniors Health Insurance Information Program (NC SHIIP), which relies heavily on federal funds to provide valuable services to North Carolina’s Medicare beneficiaries.

NC SHIIP offers free, unbiased, accurate, and highly personalized one-on-one counseling to residents in all 100 North Carolina counties. In 2016 alone, NC SHIIP counseled more than 105,000 Medicare beneficiaries. NC SHIIP operates under a cost-effective and innovative model, utilizing a small paid staff and a network of approximately 1,000 trained volunteer counselors to meet the needs of North Carolina’s Medicare recipients. The counselors meet with Medicare beneficiaries, many of whom are elderly, retired, or disabled, to explain the increasingly complex Medicare program and to ensure consumers are taking full advantage of their benefits. Last year, NC SHIIP helped North Carolinians save more than $44.3 million on Medicare coverage and prescription drug costs. These cost savings are especially pertinent, given that 1 in 4 beneficiaries who rely on NC SHIIP have incomes below 150% of the Federal Poverty Level. This blatant disregard for the importance of consumer assistance programs puts the future of NC SHIIP at risk.

Mike Causey, North Carolina’s Commissioner of Insurance shared his support for NC SHIIP in a recent brief, stating, “Removing this program would eliminate the best and most reliable free and local resource that Medicare beneficiaries have in North Carolina.”

Without NC SHIIP, confused consumers will be forced to utilize a federal resource that is not equipped to handle the call volume or offer personalized assistance necessary to adequately explain Medicare benefits.

The proposed federal budgets are a direct attack on North Carolina’s most vulnerable. NC SHIIP protects the Medicare benefits of North Carolina residents who are elderly, disabled, and low-income. The program ensures access to affordable and comprehensive health care coverage. Without federal funding, NC SHIIP would be unable to provide these critical services. The House of Representatives is scheduled to debate the 100% funding cut for State Health Insurance Assistance Programs in the next few weeks.

Sydney Idzikowski is an MSW intern at the N.C. Justice Center.

NC Budget and Tax Center, Trump Administration

Oh, those pesky facts: White House wrongfully attacks nonpartisan Congressional Budget Office

Non-partisan government agencies that often go unnoticed but are grounded in upholding principles such as accountability, integrity, and reliability include the U.S Congressional Budget Office (CBO) and the Government Accountability Office (GAO). You might recall that CBO is the office that recently analyzed the President’s proposed budget as well as the Senate’s proposed health care bill and found:

Unfortunately, earlier this week, the White House released a video on Twitter to continue a discouraging and damaging pattern of attacking the CBO. At the state level, this would be equivalent to the Governor attacking the General Assembly’s Fiscal Research Division (FRD) or Program Evaluation Division (PED). It is worth noting that as the party in control of Congress, Republicans were the ones that hand-picked the current CBO director in 2015.

This is what Maya MacGuineas, the President of the nonpartisan Committee for a Responsible Federal Budget had to say in response to this latest attack:

“The CBO is the fiscal scorekeeper of Congress. Its work is solid, nonpartisan and provides a tremendous service in understanding the costs and tradeoffs of thousands of different proposed policies.

Going after the CBO reminds me of those parents on the soccer sidelines screaming at the ref who, while he may not be 100-percent perfect, isn’t rooting for either team. He sure as heck is doing a better job than the screaming parent would be if he or she were calling the game.

It is important to remember that their estimates are just that — estimates. Of course the CBO is not perfect. But importantly, they do their work employing rigorous analysis, excellent oversight and no political agenda. Their output is incredibly important and helpful in guiding the policymaking process.

As former CBO Director Rudy Penner said, ‘A forecast does not have to be perfectly accurate to be useful. If a weather forecaster predicts three inches of rain and only two inches fall, it can be said that it was a terrible forecast in that it was off by one-third. Nevertheless, it was useful to know that a lot of rain was coming.’

Thank goodness the CBO continues to play by the rules, release unbiased estimates and continues to contribute important information to the discussion. It’s not as though they make up economic growth numbers to make the numbers add up. Now that would be something to tweet a snarky video about.”

Luis A. Toledo is a Public Policy Analyst for the Budget & Tax Center, a project of the North Carolina Justice Center.

NC Budget and Tax Center, Trump Administration

CBO: President Trump’s budget policies lack details, drastic budget cuts won’t solve debt issue

The Congressional Budget Office (CBO) has released its first analysis of President Trump’s proposed 2018 budget and it is worth noting that CBO could not provide a comprehensive analysis of the effects of the proposed policies in the President’s budget because many of them do not contain the details necessary to assess those effects.

Throughout its analysis of the President’s 2018 budget, CBO indicated:

“The President’s proposals would affect the economy in a variety of ways; however, because the details on many of the proposed policies are not available at this time, CBO cannot provide an analysis of all their macroeconomic effects or of the budgetary feedback that would result from those effects.”

Unfortunately, this is not surprising as we’ve previously reported that the President’s initial budget omitted 85% of details that previous administrations have included.

CBO’s analysis also shows that even though President Trump has proposed to cut spending by $4.2 trillion over the next ten years the deficit would generally rise each year under the President’s budget, totaling $720 billion in 2027. The cumulative deficit over the 2018–2027 period would total $6.8 trillion. In other words, the President’s drastic budget cuts to critical programs that various communities and families across the country and here in North Carolina depend on to thrive will not solve the federal debt issue.

CBO is not blunt in calling out the President’s incoherent budget a disappointing mix of unrealistic assumptions, gimmicks and punts, but points out in a restrained way that:

The deficits that CBO estimates would occur under the President’s proposals are larger than those estimated by the Administration. Nearly all of that difference arises because the Administration projects higher revenue collections—stemming mainly from a projection of faster economic growth.

Based on CBO’s analysis it is clear the President’s budget is not a real blueprint that would help America. A credible and strategic budget would at least contain details for proposed policies, would improve the debt issue in the long-term, and would be based on credible economic assumptions.

Below are other key points from CBO’s latest report: Read more

Commentary, News, Trump Administration

NC joins lawsuit against Betsy DeVos on behalf of student loan borrowers

It comes as no surprise that the the administration of the Prevaricator-in-Chief — a man who for whom ripping off college students was an important business practice prior to becoming president — would be doing his worst to stop those same students from getting out from under debilitating and often predatory loan debt. Last month, Trump’s education secretary, the eminently unqualified Betsy DeVos, took just such action when she put the kibosh on new Obama administration-drafted rules that were designed to, as the New York Times reported, “speed up and expand a system for erasing the federal loan debt of student borrowers who were cheated by colleges that acted fraudulently.”

Now, however, 18 states (including North Carolina) and the District of Columbia are pushing back. This from a story on NPR:

Attorneys General from Massachusetts, New York, and 16 other states filed suit against Education Secretary Betsy DeVos and her department Thursday, accusing DeVos of breaking federal law and giving free rein to for-profit colleges by rescinding the Borrower Defense Rule.

The filing by 18 states and Washington, D.C., asks a U.S. District Court to declare the Education Department’s delay of the rule unlawful and to order the agency to implement it. The states say they have pursued “numerous costly and time-intensive investigations and enforcement actions against proprietary and for-profit schools” that violated consumer protection laws.

The Borrower Defense Rule was adopted by the Obama administration last November and had been set to take effect this month. It was created to make it “simpler for students at colleges found to be fraudulent to get their loans forgiven,” as NPR’s Ed team has reported….

“Since day one, Secretary DeVos has sided with for-profit school executives against students and families drowning in unaffordable student loans,” Massachusetts Attorney General Maura Healey said in a news release about Thursday’s court filing. “Her decision to cancel vital protections for students and taxpayers is a betrayal of her office’s responsibility and a violation of federal law. We call on Secretary DeVos and the U.S. Department of Education to restore these rules immediately.”

The Borrower Defense Rule was negotiated after two large for-profit chains — Corinthian Colleges and the ITT Technical Institute — shut down hundreds of campuses following regulatory crackdowns in recent years. The rule would allow borrowers to have their loans forgiven if a state has successfully taken action against a for-profit school. It would also empower the Department of Education to seek money from schools where loans were forgiven.

“For-profit schools receive the vast majority of their revenue from the federal government in the form of federal student loans and grants,” the civil complaint notes. “In 2009, the 15 publicly traded for-profit education companies received 86 percent of their revenues from taxpayer-funded loans.”

The attorneys general who filed the lawsuit are from California, Connecticut, Delaware, Hawaii, Iowa, Illinois, Maryland, Massachusetts, Minnesota, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia. (Emphasis supplied.)

“These rules served as critical protections against predatory for-profit schools that exploit hardworking students – students who are simply trying to invest in their own education and future,” said New York Attorney General Schneiderman. He added, “When Washington abdicates its responsibility to protect New Yorkers, we won’t hesitate to step in.”

Good for Attorney General Stein for adding North Carolina to the list. As we have reported previously in this space, for-profit colleges have a terrible record of ripping off vulnerable students in our state and nation — particularly students of color. Let’s hope the lawsuit is just the latest in a long line of defeats for the Trump junta.

NC Budget and Tax Center, Trump Administration

Would the U.S. Senate healthcare bill affect NC’s budget in a negative way? Definitely, here’s why…

The Senate GOP has released its proposed healthcare bill, and analysis shows that it would cut federal Medicaid spending even more over the next ten years than the House passed health plan. How much more? $467.4 billion. This cost shift to the states would cause greater state budget shortfalls: Instead of North Carolina losing at least $6 billion over the next 10 years in federal funding for Medicaid, it is estimated that the state would now lose and have to make up at least twice as much ($13 billion) over the same period for Medicaid.

To put that in perspective, North Carolina has only had to contribute $3.1 billion a year for Medicaid in state appropriations, on average, each of the past seven years.

How does this happen? Through a framework proposed by the GOP in Congress called Medicaid Per-Capita Caps. The Urban Institute explains that the American Health Care Act (AHCA) changes the way Medicaid is funded by capping federal Medicaid payments per enrollee, beginning in 2020. Under the House version of the AHCA, these caps would grow at the rate of the medical Consumer Price Index (m-CPI) for most Medicaid enrollees, adding 1 percent to the rate for the elderly and disabled.

The Senate bill, however, lowers the growth rate to the Consumer Price Index for All Urban Consumers (CPI-U) beginning in 2025. Over the next decade, it’s projected to grow at 2.4 percent, compared to the m-CPI rate of 3.7 percent used in the House version. This means a shortfall between federal Medicaid payments and projected costs that will grow over time, and states will have to make the difference up by raising taxes, cutting enrollment, reducing benefits, or reducing provider reimbursement.

President Trump has admitted that he used the word “mean” to describe the House GOP’s health plan. Given the fact that the Congressional Budget Office (CBO) is set to release its estimate for the Senate GOP health care plan very soon, and that it will show that millions of Americans will lose health coverage and billions in Medicaid costs will be shifted to the states, there is one question left to be answered:

Will North Carolina’s own U.S. senators, Richard Burr and Thom Tillis, do the right thing and reject the current proposal that would cut health coverage for millions of vulnerable Americans and shift billions in costs to North Carolina?

In Case You Missed It

Most of the debate regarding North Carolina’s state budget took place last week. And interestingly enough there was one topic that legislators did not address: the federal funding cuts that loom overhead. This is concerning given the massive cuts to federal funding proposed by the President and GOP in Congress. Based on those federal cuts, we know that North Carolina would have to come up with at least $13 billion in additional revenue over the next 10 years to maintain existing vital programs – one of those being Medicaid.

Before the Senate released its proposed health care bill last week we reported that the GOP’s health plan secrecy and Medicaid per-capita caps should raise alarms in NC. We stated If the Senate produces a new health plan bill and keeps Medicaid per-capita caps in its framework, North Carolina’s state budget and its people will suffer in the long-term.”

Luis A. Toledo is a Public Policy Analyst for the Budget & Tax Center, a project of the North Carolina Justice Center.