Two political war horses, former Federal Reserve chairman Paul Volcker and Richard Ravitch, who helped restructure New York City after its near bankruptcy, released the final report of the task force they have led for the last three years. Their group, the State Budget Crisis Task Force, came to this conclusion:
I’m not sure anyone in muniland loves numbers more than the members of The National Association of State Budget Officers (NASBO). They are the geek squad who oversees the influx of tax and other government revenues. It’s the daily state money show.
Under the Affordable Care Act, all 50 states will have exchanges where individuals can buy healthcare insurance. But the second leg of the ACA, whether and how much to expand Medicaid, is every state’s choice. The Supreme Court gave states this right when it ruled on the Affordable Care Act last June.
Much as the Simpson-Bowles report aspired to be the foremost guide to reducing the federal deficit, the Volcker-Ravitch report on the state budget crisis that was released yesterday hopes to serve a similar purpose for state government spending. Paul Volcker, the former Fed chairman, and Richard Ravitch, who helped New York City work itself out of bankruptcy, led the State Budget Crisis Task Force, the group that produced this report. The task force also included two former U.S. Treasury Secretaries as members. The bottom line of the report is that there is less money to go around and that states should become better managers of the shrinking economic pie:
Millions of uninsured Americans will now have access to healthcare as a result of the Supreme Court’s decision last Thursday to uphold the Affordable Care Act. This is a big step forward for the nation, but it raises questions about funding. The nation is already starved for revenue and is supposed to cut $1.2 trillion from the federal budget over the next eight years through the sequestration process.
Senior citizens account for a greater share of the population of Florida than of any other state in the country: 18.1 percent of the residents of the Sunshine State are over the age of 65, compared with the national weighted average of 12.7 percent. There are some obvious reasons for the state’s popularity among the elderly: It has excellent winter weather and is one of nine states with no income tax.
A surprising campaign called Choosing Wisely launched this week. Nine of the nation’s top medical societies joined together to put their support behind the effort to cut the number of unnecessary medical tests. The campaign marks a turning point for the practice of medicine in an economy that devotes 17 percent of its resources to curing illness, the highest level in the world. Previously, efforts to rein in medical spending have been led by health management organizations (HMOs) and other groups responsible for the payment of healthcare. It is a big shift for healthcare providers to take the lead in reining in costs.
Thirty-one Republican governors have petitioned the Congressional supercommittee to devolve control of Medicaid to the states and away from Washington where it is currently supervised. Medicaid is the government health insurance program which covers low-income earners and the elderly committed to nursing homes. Unlike other federal social entitlements, states pay a portion of the costs of the Medicaid program. The Republican governors claim that the federal government constrains their ability to develop more flexible and effective coverage. In essence Republican governors are asking that the program be transformed into a block grant rather than a proscribed benefit program. From Bloomberg: