The Centers for Medicare and Medicaid no longer provides state-level data on Medicaid expenditures and beneficiaries by age group, but it does provide state-level data on enrollment, expenditures, and expenditure per enrollee by “basis of eligibility.” Spending per enrollee isn’t as good as spending per beneficiary in analyzing how much is being charged by the health care industry, because expenditure per enrollee is affected by the number of people enrolled who do not currently require expensive care. And basis of eligibility is not as good as more detailed age groups, but it at least does provide separate data for children (under 18), non-disabled adults (18 to 64), seniors (65 and over), and disabled adults and children.
When I looked at the per enrollee New York State data for FY 2019, however, I found it was reported to be far below the level of 2018, and even below the U.S. average for children and non-disabled adults.
I once wrote a post on how New York’s Medicaid spending, by age and by type of service, compared with the national average and nearby states, every couple of years. The “State Datamart” that allowed crosstabulations of the number of Medicaid beneficiaries and expenditures, by age and by type of service, disappeared after FY 2012, after fewer and fewer states had been included for several years. That data had allowed expenditures per beneficiary, by age group and by service type, to be calculated for each state, and the number of beneficiaries in each age group to be compared with the total population in that age group, and the population in poverty in that age group, by state.
Today there is a different set of data that has been posted, and I plan to tabulate what is available and write a couple of posts. The PDF report is here.
And the data is at http.//macpac.gov/macstats.
It isn’t what I was once able to get, but it is more than I’ve been able to find for many years. A quick comparison of total Medicaid expenditures in 2020, as a percent of the personal income of residents of each state, and what it cost those residents in state and local taxes, follows.
According to Merriam Webster online, affordable means able to be afforded: having a cost that is not too high. And among New York’s Democrats and progressives there is always talk of having government policies make something affordable: affordable education, affordable health care, affordable housing, affordable transportation, etc. And yet observing 40 years of public policy in New York, I can think of only a handful of examples of policies that have actually made life, or a better life, less costly for the public at large.
When one examines the totality of public policies enacted in so-called Blue States, you see that the goal actually seems to be to make many things more expensive.
Sometimes for reasons I agree with. A developed country (and I’m not sure ours is) shouldn’t be making goods and services more affordable in the short run by making them more expensive, more dangerous, or more misery-inducing for the community as a whole, in the long run. That’s what the builders of the “affordable” Surfside condo in Florida did by cheaping out on the building structure.
But mostly for reasons that would be impossible to justify if openly admitted. To make some workers — those who work for the government, or are paid funded by government programs — richer compared other similar workers, at the expense of making those other similar workers pay more and become poorer. And to make it more expensive to live in politically influential “liberal” communities, ensuring the less well off, their burdens and troubles, will be somewhere else. The result is hypocrisy.
When Democrats and progressives say “affordable” what they really mean is “subsidized.” Part of the cost is paid for by someone else, so it seems to be more affordable. But since fiscal resources are not unlimited, even in New York City where we have the highest state and local tax burden and the most debt, the subsidies for “affordable” health care, education, transportation, housing etc. only end up going to the fortune few. And many if not most of those few often turn out to be among those were already fortunate. For the rest, somebody has to pay after all. Often those who are already burdened by policies to make things more expensive – policies that lead to the need for subsidies to begin with.
With a deteriorating mass transit system, despite high and rising taxes and fares, and soaring rents (and property tax revenues from renters), young workers have been leaving New York City since 2015, a trend that has accelerated since the COVID-19 pandemic. And there is talk that the wealthy will move away since they will now have to pay taxes, after not having to pay taxes in the past, according to various headlines over the past two years. From “not taxing the rich,” according to those headlines, New York is suddenly taxing the rich more than any other state. Even California.
In reality, of course, New York already taxed the rich, and everyone else, far more than any other state. And it isn’t close. As I showed here…
In FY 2017 New York State’s average state and local government tax burden was 13.8% of state residents’ personal income, compared with the U.S. average of 9.8% and 10.3% for California. If New York City were a separate state, its burden would have been 15.1% of income, and rising, compared with 12.9% on average for the rest of the state. And at that level, according to any elected officials who didn’t want to face a primary, and most of the local media, city residents deserved deteriorating public services, because they weren’t paying enough.
There is one group of people, however, who face a very different tax burden in New York, compared with other places.
Retiree David Fisher, 69, has lived in New York state since age 27. He has found that while living there was expensive while he was working, New York is much more affordable in retirement. This is primarily for three reasons: New York State doesn’t tax Social Security or retirement account distributions, the state has a program to reduce property taxes after age 65, and there’s a low cost of living in the Rochester, New York, area where he lives.
Retired public employees, like the Senior Voters in our tax analysis of three prototypical Brooklyn couples, have it even better – none of their retirement income, paid for by poorer working serfs, is taxable.
A surge of cold air into the Southern Plains has brought a disaster to that part of the country, most prominently to Texas. And once again the response has been political tribalism, biased reporting, and a failure to report any of the most important facts leading to the situation. Facts like those discussed below.
A quick check of American Community Survey data from the U.S. Census Bureau shows that 61.1% of all occupied housing units in Texas get their heat from electricity. That is one of the highest shares in the country. Other states above 60.0% are, in order, Florida (92.1%), South Carolina (70.9%), Alabama (66.4%), North Carolina (64.3%), Louisiana (64.0%), Tennessee (62.5%), and Arizona (60.5%). You can see what these states have in common – they have warm climates and don’t require that much heat. Electric heat (other than heat pumps) is very cheap to install, but very expensive to operate, which is why it is little-used in cold climates. If most Northeasterners have seen it at all, it has been in a cheap motel as an all-in-one electric heat and air conditioning unit for an individual room, placed there to limit the up-front cost for a space that is empty and little-heated much of the time. Or perhaps as a space heater, used for a cold room.
No matter what fuel is used to generate electricity – fossil fuel or renewable – it has to travel over the same electric grid. And there is no way, no way that the capacity of that electric grid is sufficient to power as much heating as is required for this kind of extreme weather. Not in Texas. And not in New York. Those who remember high school history might recall that the previous time air this cold swept down into the Southern Plains and created a disaster (killing off millions of cattle) was the 1880s. That was more than 130 years ago. Should Texans have paid enough every day to better prepare for something that only happens once every 130 years? That is just one of the questions raised by this event, questions without obvious one-sided answers.
The U.S. Census Bureau released 2019 data from the American Community Survey (ACS) last week, and 2019 will almost certainly represent the peak of the recent economic cycle. Because there are booms and recessions, an enlightening analysis of trends over time requires that similar years be used. For 2019, the peak of the everything bubble, that would be 2000, peak of the dot.com bubble, and 2007, the peak of the housing bubble. Unfortunately, when the Census Bureau shut down American Factfinder and replaced it with data.census.gov, it only included data starting in the year 2010 – near the bottom of the last recession. So this post only compares the latest data with data that I happen to have on my computer, downloaded over the past 15 years, or available on the Department of City Planning website.
In a break from my usual style, I’m not going to bury the lede. From 2000 to 2019, the number of employed New York City residents soared by nearly 850,000. And the number of households with work earnings — fell slightly, remaining at about 2.5 million! The number of households with Social Security income increased by nearly 200,000, or about the same amount as the increase in the total number of occupied housing units. Housing has continued to be occupied by Baby Boomers, now moving into retirement, including cost-privileged housing – rent regulated, Mitchell-Lama, public housing, owned units purchased at pre-housing bubble prices. Meanwhile, the young workers surging into the city were forced to double and triple up, sharing apartments and even rooms, because rents soared and they couldn’t afford their own place. No wonder so many left when they became able to work remotely. Comparing the 2000 Census with the 2019 American Community Survey, the median gross rent increased 42.0% — after adjustment for inflation. The percent of city renters paying at least 30.0% of their income in rent increased to more than 50.0%.
Over the years I’ve heard so-called conservatives try to make the case that the business sector is the foundation of the economy, while the public sector provides nice-to-have services that we may or may not be able to afford. As if what the government does is the cherry on top of a sundae, perhaps desirable but not absolutely necessary. There is a reasonable “conservative” case to be made about the relative value of services produced by the public and private sectors, but that isn’t it. The types of services that can’t fund themselves, and are in the public sector, include education, much of health care, most infrastructure and public safety. And certainly aid to the needy. The types of services that can fund themselves with sales in the private sector include alcohol, tobacco, other pleasurable but addictive substances, gambling, pornography, and prostitution. Do we need less of the former, and more of the latter?
Perhaps the conservatives where thinking about the subject of most of this post: Parks, Recreation, Culture, Natural Resources, and Libraries. They have certainly been among the first services to be wiped out in NYC when money gets tight, along with services to keep poor children from being abused, neglected and killed. But there was no fiscal crisis going on in FY 2017, the year of the latest Census of Governments, or in FY 2007 and FY 1997, prior Census of Governments years. So how much was spent on these services then, in NYC and elsewhere? This uses post Census of Governments data to find out.
The U.S Census Bureau conducts a Census of Governments every five years on the employment, payroll, revenues, expenditures, assets and debts of every state and local government in the country. (State-level estimates for state and local government are released in other years). The data is reported by government function (police, schools, parks, etc.) The Bureau recently released its employment and payroll data for March 2017, and I have spent a considerable number of hours tabulating it to get it into usable form.
I now have spreadsheets that show local government full-time equivalent employment (full time workers plus part time workers converted into full time workers based on hours worked), by function, for the United States, New York City, other areas of the state, every county in New York State and New Jersey, and other states and counties elsewhere in the country selected for comparison. This is expressed per 100,000 residents of each area. Selected private sector industries that are either substantially government-funded (health and social services and infrastructure construction) or a substitute for government services (private schools and automobile-related industries) are shown on the same basis. And local government payroll per worker of each area, expressed as a percent higher or lower than the U.S average for that function, and compared with the extent that an area’s private sector earnings per worker are higher and lower than the U.S. average. Similar data is provided for state government in for U.S. as a whole, compared with New York State, New Jersey, and other states I consider relevant. This is a process I will repeat for the finance phase of the 2017 Census of Governments, when it is released.
As is my custom, this post will simply provide the data in tables and spreadsheets, explain where it comes from and how I tabulated it, and provide a brief overview of trends in total state and local government employment and payroll. Function-by-function posts, with the data reorganized and charts included, will follow. Read this post to fully understand what you are seeing. Download the spreadsheets and look at the numbers to decide for yourself what they mean, before getting my take on them. I’ll write more when I can. But anyone else is free to use this information right now.
I was surprised to read an article in which the New York Times, of all publications, broke Omerta with regard to generational trends in society.
For Americans under the age of 40, the 21st century has resembled one long recession. I realize that may sound like an exaggeration, given that the economy has now been growing for almost a decade. But the truth is that younger Americans have not benefited much…This loss of dynamism hurts millennials and the younger Generation Z, even as baby boomers are often doing O.K. Because the layoff rate has declined since 2000, most older workers have been able to hold on to their jobs. For those who are retired, their income — through a combination of Social Security and 401(k)’s — still outpaces inflation on average.
The Times included a couple of charts, which I’ll show below, along with a bunch more of my own. But two comments on the article are worth noting up front.
It showed things getting better, but that is not a surprise given the economy has been up. I prefer to look at comparable years, at the same point in the economic cycle. Unfortunately, single-year data for 2007 was not available for NYC on American Factfinder, but I was able to get three-year data for 2006 to 2008 as a proxy. It shows New Yorkers are working more than they had been a decade ago, but they are paid somewhat less. Poverty is down and household income is up, however, because they are packing together, with more workers per household.