Tag: affordability
Virginia's First Female Governor Inaugurates Her 'Affordability Agenda'

Virginia's First Female Governor Inaugurates Her 'Affordability Agenda'

Abigail Spanberger, inaugurated on January 17 as the 75th governor of Virginia, began to implement her agenda centered around her campaign pledges to make the state more affordable, improve education, and address gun violence almost immediately after taking office.

Minutes after taking her oath of office, Spanberger signed 10 executive orders. The first order, called the Statewide Affordability Directive, ordered all Cabinet secretaries and executive branch heads to report to her within the next 90 days “identifying immediate, actionable budgetary, regulatory, or policy changes that would reduce costs for Virginians” addressing cost savings in housing, health care, energy, education, child care, and living expenses.

Other orders created an Interagency Health Financing Task Force to strengthen Virginia’s health care system, ordered a multi-agency Housing Development Regulation Review to increase the supply of housing, directed the Department of Education to strengthen literacy, math, school accountability, and assessment in the commonwealth’s public education systems.

“Today, we are responding to the moment. We are setting the tone for what Virginians can expect over the next four years: pragmatic leadership focused on lowering costs and delivering results,” Spanberger said in a press release. “My administration is getting to work on Day One to address the top-of-mind challenges facing families by lowering costs for Virginians in every community, building a stronger economy for every worker, and making sure that every student in the Commonwealth receives a high-quality education that sets them up for success. These executive orders represent the first steps in our work to create a stronger, safer, and — critically — more affordable future for our Commonwealth.”

On the campaign trail, she promised to address rising housing, health care, and energy costs and touted an eight-page plan detailing how she would do so.

Spanberger laid out her policy agenda in an address to the General Assembly on January 19, which is centered around the Affordable Virginia Agenda she and Democratic leaders in the House of Delegates and Senate are proposing in order to lower those costs.

Among her proposals was legislation to limit the profits of pharmacy benefit managers, provide targeted assistance to Virginians at risk of losing health insurance coverage due to the expiration of federal subsidies, boost energy storage, help Virginians make their homes more energy efficient, help renters avoid eviction, and build more affordable housing.

“These are not hyperpartisan proposals; they are commonsense solutions,” Spanberger told lawmakers. “And I believe they deserve support from every member of this body, Democrats and Republicans.”

Spanberger urged legislators to create a statewide paid family and medical leave program, increase subsidized child care, raise the hourly minimum wage to $15, and increase pay for teachers. She promised to sign bills, vetoed last year by then-Republican Gov. Glenn Youngkin, aimed at curbing gun violence, such as a ban on ghost guns, a law blocking convicted domestic abusers from accessing firearms, and an expansion of Virginia’s red-flag law temporarily disarming those judged to be an imminent danger to themselves or others.

Finally, Spanberger expressed her support for three constitutional amendments to be voted on by Virginians in November that would guarantee reproductive rights, automatically restore the right to vote for individuals convicted of a felony after they have completed their sentences, and codify the rights of two adults to marry.

She defended a fourth proposed constitutional amendment to temporarily change the way Virginia draws its congressional maps, likely to be considered by voters in April, saying: “Virginia’s proposed redistricting amendment is a response to what we’re seeing in other states that have taken extreme measures to undermine democratic norms. This approach is short-term, highly targeted, and completely dependent on what other states decide to do themselves.”

Giving the Republican response, Republican state Sen. Glenn Sturtevant criticized Democrats for advancing the redistricting amendment, saying it would not lower costs, according to a Cardinal News transcript. “We also need to be honest about what Democrats are proposing, because it will make life more expensive,” Sturtevant said, “Their tax-and-spend agenda would cost Virginia families billions each year, adding thousands of dollars in new burdens for the typical household.”

Reprinted with permission from the Virginia Independent

'Great Healthcare': White House Delivers Trump's Concept Of A Non-Plan

'Great Healthcare': White House Delivers Trump's Concept Of A Non-Plan

One year into his second term, President Donald Trump on Thursday called on Congress to pass a health care plan that would do next to nothing to lower employer-based insurance costs or reduce out-of-pocket expenses for individuals and families.

The 20-paragraph “fact sheet” on the administration’s plan contained few specifics; no new ideas; had only one estimate of projected savings or costs. Its insurance reforms included either provisions already on the books or previously rejected Republican proposals that would make things worse and force more people into the ranks of the uninsured.

The stock market took notice. Insurance stock prices (IHF) rose almost 2% on the news.

Its lead provision called on Congress to enact a law forcing drug companies to set prices at international levels. Given the pharmaceutical industry’s widespread support on Capitol Hill (most of the GOP and a hefty share of Democrats have routinely opposed so-called international reference pricing), passage of such a law is highly unlikely.

Moreover, the administration could do this on its own if it really wanted to. The first Trump administration in its waning days proposed a far-reaching rule for international reference pricing, which was rejected by the Biden administration in favor of pursuing price negotiations with manufacturers. Last month, it proposed two pilot projects that would apply international reference pricing to only 25% of Medicare patients, and then for only five years. The plan unveiled today made no mention of either effort.

Nor has the administration moved to expand rules over the drug prices it already has some say over — those for Medicare. The Medicare drug price negotiations law affected only a handful of high-priced drugs. The plan makes no mention of expanding that authority.

Financial markets took notice. Drug company prices (XPH) fell by less than 1% after the announcement.

The health care trade press was duly skeptical about the plan, calling it “a hodgepodge of health care policies that would create new price-control power over pharmaceutical companies, but that otherwise wouldn’t fundamentally overhaul America’s existing system,” as StatNews report opined.

Here’s what one investment advisory firm told its clients: “We view this new document as a largely political exercise. We think it is intended to demonstrate that the White House is doing ‘something’ about affordability and healthcare prices, but we believe the policies either stand little chance of being enacted by the current Congress or will have a minimal impact if enacted.”

The ‘details’

For drugs:

Beyond asking Congress to codify international reference pricing, the plan calls for making more drugs available as cheap over-the-counter medications. While this could limit sales of a few prescription anti-acids and pain relievers, for which there are already plenty of cheap over-the-counter alternatives, it would have no impact on the high prices of biotech specialty drugs, which are the major drivers of escalating pharmaceutical spending.

Nor would it affect the slow progress in bringing biosimilars to market, or their pricing. Most biotech drugs are either injected or infused in clinical settings, which makes them inappropriate for over-the-counter sales.

The plan also calls for Congress to end the kickbacks pharmacy benefit managers receive from large drug companies for including their products on preferred drug lists. The CBO estimated the GOP bill that passed the House in December with this reform would save drug insurance plans about $15 billion a year, a tiny fraction of the more than $300 billion that patients and their insurers spend at retail pharmacies each year.

For health insurance premiums:

The plan calls for scrapping the existing subsidy system for Obamacare plans and replacing it with a voucher that allows people “to buy the health insurance of their choice.” This refers to the GOP-backed Lower Health Care Premiums for All Americans Act (H.R. 6703), which would expand association plans that don’t meet basic Obamacare requirements like providing essential benefits or setting limits on out-of-pocket expenses.

The White House fact sheet touts the Congressional Budget Office estimating the association plan proposal would save $36 billion for the federal government. It didn’t mention the CBO’s conclusion it would cause 100,000 people to drop existing coverage each year over the next decade while adding just 700,000 newly insured through inferior association plans.

The White House plan also calls on insurance companies to publish the percentage of their revenues paid out in claims versus overhead and profit costs. The Affordable Care Act of 2010 already limits insurers, both on the exchanges and in the private market, to paying out at least 85% of the revenue in medical costs for large company plans and 80% for small businesses.

If there’s a problem, it’s in enforcement, not the standard. Indeed, I would like to see a 90% medical loss ratio as the best way to limit insurance industry marketing spending.

For providers:

The plan includes nothing about limiting hospital pricing; enforcing antitrust rules in every health care sector; or rectifying pay inequities between primary care physicians and specialists. Instead, its sole approach to addressing provider sector pricing is greater price transparency, which is already required by a rule adopted by the Centers for Medicare and Medicaid Services in 2019.

That has been a bust for two reasons. First, hospitals post those prices on websites or in places where consumers can’t find them or in such complicated tables that the average person has no idea what they mean.

But more importantly, even if prices were published in an easy-to-read format and posted on a wall, as the plan proposes, what would mean to most people? An analysis by the Health Care Cost Institute of the 70 most shoppable services (routine procedures like colonoscopies or cataract surgeries, for instance) accounted for just 12% of health care spending.

To sum up: When it comes to health care, affordability is most Americans’ number one concern. The plan the Trump administration announced Thursday does almost nothing to address that problem.

Merrill Goozner, the former editor of Modern Healthcare, writes about health care and politics at GoozNews.substack.com, where this column first appeared. Please consider subscribing to support his work.

Reprinted with permission from Gooz News

Sorry Mr. President, But The Affordability Crisis Isn't A 'Hoax'

Sorry Mr. President, But The Affordability Crisis Isn't A 'Hoax'

It was yet another performance that left us wondering about President Donald Trump’s failing mental faculties. Speaking to supporters at a rally in Mount Pocono, Pennsylvania last week, Trump was typically unhinged.

And we have two price charts. Do you remember the last time I pointed to a chart? I don't care what these charts say. My all-time favorite chart was the chart I had in Butler. I said, "Let's look at the chart." I don't care how good that chart looks, it's shit by comparison to the one in… It's nothing. I like the Butler chart. Remember that was on how great employment was and all this, but I like it for other reasons. Look at that chart. It's good. But now that I talk about the Butler chart, I don't even want to look at it, doesn't mean anything. But look, Biden price increases and Trump price increases. Look at Biden. Up 37, 24%, 22, 21, 30.7, 30.7 again, 10.4%, 49%. Trump, the price is down 5.1, 4.2, 0.5, down 4%, 2.9. Look at that. Our prices are coming down. Their prices, it's a hoax. They're just … Remember they said the Inflation Reduction Act, remember that? Billions and billions, hundreds of billions of dollars, the inflation, and after they got it approved, because we had a few Republicans that went along with that whole hoax.

If there was a coherent thought buried in all that gibberish, he later tried to summarize it this way: “Prices are coming down very substantially. But they have a new word. They always have a hoax. The new word is affordability.”

He can call it a hoax all he wants, but Trump and his team know affordability is a real problem. That’s why he’s suddenly trying to co-opt the term, like a cringe Truth Social post declaring himself “THE AFFORDABILITY PRESIDENT.” It’s also why his team has sent him out on what it’s calling an “affordability tour,” which is how he ended up in Mount Pocono at the Mount Airy Casino Resort. The largest ballroom there holds about 1,200 people—a telling choice by a campaign clearly afraid of empty seats at a sizable venue.

What should worry Republicans is not just the optics, but the substance. A rally supposedly designed to counter Democratic attacks on affordability instead showcased Trump creating an entire alternate reality.

“We’re getting inflation,” he said. “We’re crushing it, and you’re getting much higher wages. I mean, the only thing that’s really going up big, it’s called the stock market and your 401(k)s that’s going up.”

That line should sound familiar, because Democrats already tried it—and paid the price. President Joe Biden and Vice President Kamala Harris spent much of the 2024 campaign insisting the economy was strong, that inflation was cooling, that wages were up, and that voters simply didn’t understand how good things really were.

Voters didn’t buy it. Telling people they’re wrong about their own financial stress is a losing message, no matter which party delivers it.

Trump is now making the exact same mistake, only he’s louder and more detached from the lives of the people he claims to be fighting for. Instead of acknowledging the pain people are actually feeling, he reached for a familiar crutch: bragging about the stock market, as if that is supposed to mean something to an audience in Appalachia or to anyone struggling to pay rent or buy groceries.

And he couldn’t stop.

“The stock market has set 51, this is in less than 10 months,” Trump said. “The stock market has set 51 all-time record highs. There’s never been anything like that. Bum, bum, bum, bum, bum, bum.” He repeated the claim again for good measure.

Then came a reprise of the “let them eat cake” routine he’s been workshopping for a while. After bizarrely claiming that without his tariffs “you would have no steel,” Trump explained that Americans should simply do without other consumer goods.

“You can give up certain products. You can give up pencils because under the China policy, every child can get 37 pencils. They only need one or two,” he said. “You don’t need 37 dolls for your daughter. Two or three is nice, but you don’t need 37 dolls.”

It’s remarkable watching so many cultish conservatives swing from “Don’t tread on me” to “Please daddy Trump, tell me how many dolls my daughter can have.” For the broader electorate, though, this message is political poison.

A Decent Slice: The Affordability Crisis Isn't Only About Prices

A Decent Slice: The Affordability Crisis Isn't Only About Prices

As readers know, I yield to none when it comes to elevating the affordability crisis, along with the policy and politics therein. But in most of my work in this space, I at least tip my hat to the fact that it’s not just about P (prices). It’s about Y/P (where “Y” is income, so Y/P is inflation-adjusted, or real, incomes). By which I mean, affordability is not just about prices. It’s also about how far your paycheck goes, given how much things cost.

As Neale Mahoney and I wrote a bit ago:

Another way in which economists historically think about affordability is in terms of the real purchasing power of paychecks and incomes. That is, we are more prone to think about incomes relative to prices (Y/P) than prices in isolation. This makes good economic sense as an equal percentage increase in prices and incomes has no impact on affordability in real terms.

We go on to point out, however, that this…

…is not how most people tend to internalize the problem. As recent research by Stefanie Stantcheva has shown, people tend to credit themselves for wage or income gains but believe price increases are imposed on them by outside forces. This means that even when a price increase is matched by a wage gain, people end up feeling worse off.

I’m acutely aware of how much price levels—what things cost—have been a core source of economic angst for a good while now, which is why I’ve been devoting most of my policy time working with folks to craft affordability policies.

But that said, I’ve lately been seeing affordability takes that go too far for my comfort in leaving off the income part of the equation. A typical example shows a price of a good or service on the affordability docket, like groceries, going up over time, and declaring that therein lies the problem.

That’s a mistake on numerous levels. Progressives, especially in periods of rising inequality, have long argued that workers’ paychecks should grow closer to the rate of productivity, which is a fancy way of saying that the bakers, not just the bakery owners, ought to get a fair slice of the pie they’re baking. But, of course, as the Economic Policy Institute has long shown, that’s not always been the case (though contrary to claims that inequality only goes up, there are periods, often during full employment labor markets, wherein median compensation growth kept pace with productivity).

The table below provides a useful microcosm of this story by tracking the growth in both hourly wages and groceries over various time periods. Over the long-term, since the mid-1960s, annualized wage growth has outpaced grocery-price growth by a half-a-percent per year. Cumulatively since 2019, grocery prices are up by almost a third, which is a lot for this series, but wage growth is up almost six percent more since then.

Bureau of Labor Statistics data through August 2025, wages for production non-supervisory workers

However, the ‘21-’22 period, when inflation spiked in general and groceries in particular, wage growth lagged well behind. Though affordability issues had loomed large well before this shock, it was this sudden, huge jump in the price level—and again, not just groceries, but gas too, especially post-Russia’s invasion of Ukraine—that unleased the affordability crisis that remains predominant today.

How that crisis eventually dissipates must be some combination of these events: prices fall back to where they used to be, incomes growth outpaces price growth, effective affordability policies take hold, and time passes. Falling prices are very unlikely and, because it would take a huge, negative economic shock—think deep recession—to get there, not desirable (of course, removing the tariffs would definitely help for specific goods). I suspect if you asked the average person would you rather egg prices go back to where they were if it meant losing your job, they wouldn’t take the deal.

Policy work can help too, but a) not until competent policymakers are in power, and b) policymaking and implementation take time. And speaking of time, its passage is a critical piece of the puzzle. You don’t see me walking around enraged that gas is no longer $0.60/gallon, which it was when I started driving. In fact, the combination of low inflation, income growth beating that low inflation, and time passage is a reliable recipe for affordability, though, as noted, structurally unaffordable sectors like child care, health care, and housing must be addressed and ameliorated by policy.

I mentioned income growth above, so before we close, let’s look at that. Because hourly wages are the fundamental building block of working-family incomes, they were the focus of the grocery table above. But affordability at the household level is a function of n*h*w/p, were n is the number of people in the household who are working in the paid labor market, h is their average annual hours of work, and w/p is their average real hourly wage (and that’s just market incomes; non-market incomes, like tax credits, unemployment benefits, etc., also matter).

Here’s real median household income. Because of n and h in the formula above, it’s somewhat cyclical. In this regard, solid research reveals that tight labor markets help boost the bargaining clout of middle and lower-wage workers, boosting n, h, and w/p. But if you eyeball the end of the figure, you see the pandemic and the inflationary spike that followed led to sharply falling household incomes. From 2019-22, nominal income grew eight percent which isn’t bad, but inflation grew 13 percent, with the difference, -five percent, being the rate at which real income fell. That too is a source of the current affordability crisis.

But doesn’t the figure show household income jumping back up, and doing so with a slope that’s as steep as any other in the picture? Yes, it does, and that’s a key ingredient of the recipe above, driven by lower inflation, the strong job market, and solid real wage gains that for awhile there were stronger at the bottom of the pay scale than at the top. But you’ll also note that the recent gains just take the real income level back to where it was pre-pandemic, and that too feeds the affordability crisis.

Bottom line, while prices are understandably a current obsession, and the Stantcheva point above regarding the psychology of these dynamics is also in the mix, we must not ignore or downplay the importance of the earnings, incomes, wealth. They are just as important to affordability as prices, and the gap between real pay and productivity—i.e., wage inequality—is an historical factor that has played a key role not just in how people feel about economic fairness, but in how they vote about it.

Jared Bernstein is a former chair of the White House Council of Economic Advisers under President Joe Biden. He is a senior fellow at the Council on Budget and Policy Priorities. Please consider subscribing to his Substack.

Reprinted with permission from Econjared.

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