Buttigieg vs. Biden on Taxes and Spending

Buttigieg vs. Biden on Taxes and Spending

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Plus, watchdog questions $6.7 billion in Medicare payments
Friday, December 13, 2019

Pete Buttigieg Calls for Twice as Much in New Taxes and Spending as Joe Biden Does: Report

In his campaign for the Democratic presidential nomination, Pete Buttigieg may be positioning himself as a moderate alternative to Elizabeth Warren and Bernie Sanders, but he still calls for more taxes and government spending than Joe Biden does or than Hillary Clinton did in 2016, The Wall Street Journal’s Jacob M. Schlesinger and John McCormick write.

Buttigieg, they say, has proposed $6.9 trillion in new spending and nearly $7.2 trillion in tax increases, far less than Warren or Sanders, but double what Biden has proposed and triple what Clinton did:

“Like most other candidates in the race, the Buttigieg platform espouses a far more-activist government than Mr. Obama and Bill and Hillary Clinton ever proposed. The main 2020 agendas share in common plans to roll back much of President Trump’s signature 2017 tax cuts for business and the affluent, expand the earned-income tax credit for low- and middle-income workers and spend trillions of dollars on green infrastructure to make American industry carbon neutral by midcentury. They all focus more on redistributing wealth than expanding economic growth, and they try to show how they would pay for their plans without increasing government debt.”

The bottom line: Buttigieg faces plenty of pushback from the left, including questions about just how progressive he would be and how genuine — or focus-group tested — his policy proposals are. But his proposals may be an indication of how the top of the Democratic party has shifted since Clinton was the party’s standard-bearer.

Read more at The Wall Street Journal (subscription required).

Watchdog Questions $6.7 Billion in Medicare Payments

Health insurance companies in the Medicare Advantage program have received billions in extra payments after making adjustments to their patient charts – changes that the Department of Health and Human Services inspector general says “raise concerns.”

According to an IG report released this week, insurers have used a chart review process to add medical conditions such as diabetes and cancer to patient records, earning higher payments from Medicare to compensate for the risk of caring for sicker patients. But in many cases, the charts did not indicate that a medical service related to the added illness had been provided, raising questions about the legitimacy of the adjustments.

Illnesses added to charts but unrelated to any specific medical service resulted in $6.7 billion in risk-adjusted payments in 2017, the IG said. While the watchdog did not conclude that the payments were necessarily illicit, it did recommend that the government provide better oversight of the chart review and risk adjustment process.

The increasingly popular Medicare Advantage program covered 21 million people in 2018 and accounted for $210 billion of Medicare’s $711 billion in spending.

Medicaid Work Rules Approved for South Carolina

The Trump administration on Thursday approved South Carolina’s request to impose work requirements on Medicaid recipients. Seema Verma, administrator of the Centers for Medicare & Medicaid Services, said the new rules “will lift South Carolinians out of poverty by encouraging as many as possible to participate in the booming Trump economy.”

South Carolina is the 10th state to receive permission to impose work requirements in its Medicaid program. The new rules will require beneficiaries to work, train or volunteer at least 80 hours per month in order to maintain eligibility. Those who fail to do so for three consecutive months will have their benefits suspended, though the benefits can be restored once the requirements are met. The plan also extends coverage to 14,000 state residents who are homeless or addicted to drugs, though they too will have to satisfy the work requirements.

Legal challenges: A federal judge has ruled against work requirements in Arkansas, Kentucky and New Hampshire, and several other states have suspended their requirements pending final resolution of the issue. The judge said that work requirements violate the purpose of Medicaid and will result in thousands of people losing health coverage.

Losses expected in South Carolina: Sue Berkowitz of the South Carolina Appleseed Legal Justice Center told the Greenville News that the work requirements will result in 14,000 people losing Medicaid coverage in the state over the next five years. The state’s estimate puts that number at 7,100.

Joan Alker of the Georgetown University Health Policy Institute said Thursday that the South Carolina plan will disproportionately affect African-American women who are single mothers living in rural areas.

Partisan ping-pong: There’s little agreement about the benefits of work requirements for Medicaid beneficiaries, and the differences are starkly partisan. Echoing Verma’s comments, the Republican governor of South Carolina, Henry McMaster, said they are designed to help the poor, both economically and spiritually. "There is no reason for anyone who can work not to be working, especially if that person is able-bodied and is receiving public assistance," McMaster said at a press conference Thursday. “Without meaningful work, life loses its joy and meaning."

Presidential candidate Joe Biden expressed the typical Democratic response to such efforts: “Simply put, Medicaid work requirements are nothing but a vicious attempt at stripping low-income South Carolinians of access to affordable health care," Biden said in a statement. "Donald Trump is working side-by-side with governors and state legislatures across the country to play politics with people’s health care."

Chart of the Day

Lawmakers are considering three separate bills that are intended to reduce the cost of prescription drugs. Here’s an overview of the proposals, from a series of charts produced by the Kaiser Family Foundation this week. An interesting detail highlighted in another chart: 88% of voters — including 92% of Democrats and 85% of Republicans — want to give the government the power to negotiate prices with drug companies.

A New Guide to 2020 Candidates’ Tax Proposals

The Urban-Brookings Tax Policy Center this week rolled out a new guide to the tax proposals from 2020 presidential candidates.

The interface is less than completely intuitive — try clearing all selections on the left to choose specific candidates or areas about which you want to see more information — but it’s a good resource if you’re looking for a quick overview of where candidates stand, or if you want to dig a little more deeply into specific tax types and issue areas (such as business, income and wealth inequality or Social Security). And the Tax Policy Center promises to keep the guide updated as new proposals or candidates emerge.

Your Prize for Making It Through the Week

We’re less than a week away from the release of “Star Wars: The Rise of Skywalker,” the supposedly final installment of the nine-episode movie saga. In preparation, The Washington Post looks back at the five best lightsaber battles in Star Wars history and The Week’s Brendan Morrow runs through 22 burning questions the new film needs to answer.

We’re most interested in seeing if director J.J. Abrams can salvage some of the key “Star Wars” mythology that was blithely dismissed by “The Last Jedi.” It’s our only hope. (And at least we know from the trailers that this time we’ll get an actual lightsaber duel.)

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