Tag: medicaid
Trump Accounts Are A Sick Joke, Not A Replacement For Social Security

Trump Accounts Are A Sick Joke, Not A Replacement For Social Security

Many of the Trump crew seem to be delusional about Trump accounts. They claim to believe that they will replace Social Security. It shouldn’t be a surprise to us that many supporters of Trump are out of touch with reality, but that is not a reason for the rest of us to take their nonsense seriously.

Let’s keep our eyes on the ball. This is not three-dimensional chess; it is an account for newborn kids in which the government deposits $1,000. Parents or other relatives can add to it each year, like they can add to an education savings accounts in most states. The amount people contribute to the account is deducted from their taxable income. Also, the money accumulated in the account is not taxed until it is withdrawn.

Some people take advantage of these accounts; most don’t. The reason is that most people don’t have an extra $1,000 or $5,000 or whatever to contribute to a Trumo account. Furthermore, the tax benefit is not a very big deal to most moderate and even middle-income people.

The overwhelming majority of households are in the 12 percent bracket or below. More than a fifth are in the zero bracket, meaning they pay no income tax and would get no benefit from tax-advantaged accounts.

Furthermore, even if they wanted to put money in a tax-advantaged account, why would they choose a Trump account rather than an education savings account or an IRA? Money in existing tax-advantaged accounts can be withdrawn, albeit with a penalty. Money in a Trump account can only be accessed by the kid when they turn 18.

This brings us to the sick joke part of the Trump account story. Trump and Congressional Republicans have been gleefully cutting Food Stamps, housing assistance, Medicaid, and the subsidies in the Obamacare exchanges. As a result, tens of millions of people will be denied benefits that they previously depended upon.

Many of these people will end up hungry, homeless, and/or unable to obtain needed medical care. This means two or three years from now, there are likely to be tens, or even hundreds, of thousands of kids with $1,000 in their Trump accounts who are living on the streets, going hungry, or unable to get necessary medical care because Trump has cut the programs their families depend upon.

This will make for great photo ops. Maybe Trump can have some homeless kids over to the White House, or even Mar-a-Lago, and they can talk about living in the streets of Chicago in winter, or the needed surgery that they can’t afford, but they still have $1,000 in their Trump account. Then Trump and his entourage can all say how great that is!

The other part of the story is the nutty illusion about how rapidly these accounts will grow. The Trump gang likes to say they will grow 10% a year. Amazingly, many who are not on Team Trump are prepared to accept this nonsense.

The 10% rate of return is based on looking at the past, where stocks have yielded somewhere close to a 10% rate of return over the last eight decades. But this is a case of incredibly bad induction, sort of like the person who falls off an 80- story building and says as they pass the 60th floor, the 59th floor, and the 58th floor, “so far so good.”

The simple and obvious point that people who make this inference miss is that the stock market was valued far lower relative to corporate earnings in prior decades than is the case today. Through most of the decades of the 40s, 50s, 60s, and 70s, the price-to-earnings ratio (PE) was generally in the low teens and often considerably lower. When the PE is low, and the economy is growing relatively rapidly, it’s possible for the stock market to generate 10 percent nominal returns, or seven percent real (inflation-adjusted). That’s somewhat oversimplifying the inflation story, but it doesn’t affect the argument.

Today, the PE is over 30, and the economy is projected to grow roughly 2.0 percent a year going forward. In that world, the only way to generate the historic seven percent real rate of return is with an ever-rising price-to-earnings ratio.[1]

The Trumper’s story gives us a PE of almost 92 when today’s newborns turn 18 in 2044.[2] If we want to ask what happens if they hold their money until they hit the Social Security normal retirement age of 67, the PE will be over 2000. A Trump administration economist may be able to make this sort of projection with a straight face, but not many other people could.

Is there a way around this story? Well, the after-tax profit share of GDP could rise further, as it has been doing for the last quarter century. This would be a bleak story for the rest of us, since it would likely mean wages are shrinking. It would also have to almost triple in the next 18 years to keep the PE constant. This is close to unimaginable and a truly horrible story, even if it were. For what it’s worth, the Congressional Budget Office projects the profit share will fall in the next decade.

People could invest their Trump accounts overseas. China is having far more rapid growth than the United States, so perhaps people can get closer to 7.0 percent real returns there. Maybe this is what the Trump gang has in mind.

If we look at the actual returns that people can expect in their Trump account, it will be close to 3.0 percent a year in real terms, assuming that they are not ripped off badly on fees by one of Trump’s Wall Street friends. That will give today’s newborn $1,700, adjusted for inflation, when they turn 18.

Somehow, I don’t think this will lead people to discard Social Security. But I could be mistaken.

[1] I wrote about this issue in a paper with Brad DeLong and Paul Krugman 20 years ago in the context of the Bush Social Security privatization drive.

[2] The data for after-tax corporate profits Bureau of Economic Analysis, National Income and Product Accounts, Table 1.12, Line 15. The data for the valuation of the stock market comes from the Federal Reserve Board’s Financial Accounts of the United States Financial Accounts, Table L.2, Line 38, plus Table l.108, Line 20. The 2.0% GDP growth projection is from the Congressional Budget Office’s Long-term Budget Projections. The projection assumes that companies pay out 60 percent of their profits as either dividends or share buybacks, and the rest of the seven percent real return is made up through capital gains.


Dean Baker is a senior economist at the Center for Economic and Policy Research and the author of the 2016 book Rigged: How Globalization and the Rules of the Modern Economy Were Structured to Make the Rich Richer. Please consider subscribing to his Substack.


Trump and Hegseth

Iran War's Explosive Costs Could Finance Health Care Coverage For Millions

The Pentagon is asking the White House for an additional $200 billion to fight the president’s ill-conceived war in the Middle East.

While it’s unclear from the initial news reports whether this is a one-year or multi-year appropriation, the size of the request suggests this war is going to drag on a lot longer and involve far more manpower and firepower than President Trump and Secretary of Defense Pete Hegseth have let on. The now three-week-old war of choice has already left 13 soldiers dead and more than 140 wounded. It has already cost over $12 billion, according to reported estimates.

Let’s put that cost and this latest request in perspective. The $12 billion already spent is enough to have extended the Affordable Care Act subsidies for close to six months.

Instead, over two million or nine percent of people in ACA health insurance plans last year dropped them for this year (the first without the expanded subsidies) because they couldn’t afford the huge increase in their premiums, according to a new survey released yesterday by KFF, a health care think tank. That’s nearly a 10 percent increase in the ranks of the uninsured, which alone will bring the uninsured rate close to 10 percent overall.

And many more will drop coverage in the years ahead, given ACA marketplace purchasers’ concerns about their ability to pay the new, higher rates without subsidies.

The $200 billion the Pentagon is requesting is sufficient to extend the ACA subsidies for over five years. Where did I get that estimate? The failure to extend the subsidies helped pay for the $7.7 trillion in tax cuts for the wealthy and large corporations in last year’s One Big Ugly Bill (OBUB). It reduced health care spending by about $350 billion over ten years, an average of $35 billion a year. $200 billion ÷ $35 billion = 5.7 years.

The same math applies to the alleged Medicaid “savings” in the OBUB. Imposing work requirements (a lexicographic subterfuge for erecting bureaucratic barriers that will make it difficult for qualified Medicaid beneficiaries to re-certify their eligibility) will cut an estimated $326 billion from the program over the next decade, according to the Congressional Budget Office. Cuts to the federal share of aid to state Medicaid programs will “save” the federal government another $300 to $400 billion. The two together add up to at least $65 billion a year ripped from Medicaid.

To sum up: Cuts in ACA subsidies and Medicaid in the OBUB will average over $100 billion a year over the next decade. At the rate the Trump regime is spending on the war against Iran, the Pentagon will eat that up in two years.

This accounting doesn’t take into consideration the long-term costs of U.S. involvement in overseas quagmires of its own making. The Iraq War, which began in 2002, cost close to $1 trillion in direct military spending. The long-term cost of caring for the wounded, veterans’ special health care needs, and related spending has been estimated to cost an additional $2 to $3 trillion.

Those of us old enough to remember the Vietnam War will recall the “guns and butter” debate that accompanied President Lyndon B. Johnson’s slow descent into that quagmire. LBJ’s advisers assured him the U.S. could do both.

Wrong. Inflation began escalating by the late 1960s, throwing the country into a recession by December 1969. During the decade after regular combat began in 1965, prices rose by a total of 176 percent, twice the rate of inflation during the previous decade. The biggest increases were triggered by soaring oil prices due to an Arab oil embargo after the 1973 Middle East war.

President George W. Bush tried his hand at guns and butter in 2003 when, to bolster his reelection chances amid widening opposition to the Iraq War, he pushed through an unfunded Medicare drug benefit and pushed further deregulation of the financial sector. By the end of his term in office, the resulting housing bubble and sub-prime lending crisis led to the worst economic downturn since the Great Depression.

While looking up some of the specifics of that history, I stumbled across the origination of the phrase “guns and butter.” It wasn’t a 1960s coinage. It was popularized during the 1930s by German Reich Marshall Hermann Goering, who defended Germany’s huge military build-up by saying, "Guns will make us powerful. Butter will only make us fat."

It was Theodor Reik, a Jewish intellectual who fled Nazi Germany, who in 1965 took issue with the idea that history repeats itself. “This is perhaps not quite correct,” he said. “It merely rhymes.”

What does the Trump regime’s escalating military spending amid evisceration of social spending rhyme with?

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


Surrender Caucus: Enough Senate Democrats Cave To End Shutdown

Surrender Caucus: Enough Senate Democrats Cave To End Shutdown

Senate Democrats are caving on the shutdown.

The broad framework for agreement, which was negotiated in part by Sens. Angus King, Jeanne Shaheen, and Maggie Hassan, as well as GOP senators, has “more than enough” members of the Senate Democratic Caucus to advance, according to two people granted anonymity to disclose the terms,” Politico reported.

In exchange for their votes, these handful of “moderate” Democrats—which notably does not include Senate Minority Leader Chuck Schumer—are getting nothing.

Well, that’s not true.

They’re getting a promise of a vote on ACA subsidies in the Senate, which will easily go down in defeat. Not to mention, Speaker Mike Johnson has said he’ll never even bring the matter up for a vote in the House.The deal also fully funds the Veterans Administration and Department of Agriculture, and the operations of Congress, of course, because they have to take care of themselves.

Nothing in that is a victory for Democrats.The surrender is perplexing given how clearly the shutdown was hurting Republicans, so much so that President Donald Trump specifically cited it as one reason for why Republicans got their asses kicked in last Tuesday’s off-year elections.

But instead of letting Trump figure out a way out of his own mess, Democrats inexplicably threw him a life vest on Sunday night.There is one silver lining—this deal will eventually haunt Republicans. Had Democrats succeeded in saving ACA healthcare subsidies, clueless voters would never have known of the Democrats’ role in safeguarding their insurance.

When Republicans vote down Democratic efforts to save health care for millions of Americans, the blame will be crystal clear.

​Johnson Retreads His Unpopular, Previously Rejected 'Ideas' For Health Care Reform

​Johnson Retreads His Unpopular, Previously Rejected 'Ideas' For Health Care Reform

House Speaker Mike Johnson on Monday suggested that the "ideas" Republicans are kicking around for how to make health insurance more affordable is basically just the Obamacare-repeal plan that the GOP tried and failed to pass in 2017, during Donald Trump’s first term.

“When I say that the Republicans have been working on a fix for health care, we’ve been doing this for years,” Johnson said Monday at a news conference on Capitol Hill after he was asked how Republicans were planning on addressing the expiration of enhanced Affordable Care Act subsidies that, if not extended, will soon cause massive premium increases for millions of Americans.Johnson specifically pointed to the health care proposal he released when he was chair of the Republican Study Committee—a caucus of right-wing House Republicans.

"These ideas have been on paper for a long time," Johnson said. “There’s volumes of this stuff. Volumes of it.”

Of course, the reason they have been on paper but never passed is because the ideas in the RSC health care proposal are overwhelmingly unpopular.

The Center on Budget and Policy Priorities, a left-leaning think tank, reviewed a newer version of that RSC health care proposal found in the committee’s proposed budget. That review found the plan would weaken protections for preexisting conditions, cut the tax subsidies millions of Americans receive to make their ACA premiums lower, and "would slash $4.5 trillion in federal investment in Medicaid, Children’s Health Insurance Program (CHIP), and marketplace coverage"—all moves that would likely cause millions to lose their insurance.

“These proposals would create an environment where people with health conditions would pay higher premiums and out-of-pocket costs for less substantial coverage than is currently available,” the CBPP report says. “Given the increase in costs, more people would enroll in subpar plans that leave them exposed to high costs if they get sick.”

That sounds a whole lot like the Obamacare repeal that Republicans attempted to pass in 2017. That bill failed spectacularly amid public outcry because it would have kicked millions off their insurance and weakened protections to cover preexisting conditions.

In fact, the repeal effort was such an unpopular boondoggle that it helped to sink the GOP in the 2018 midterm elections.

If this is the plan Republicans will try to pass again, it’ll likely be an equally unpopular mess for the GOP.

Polling shows that the ACA is popular, with 64 percent of Americans viewing it favorably, according to a KFF tracking poll.

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