Latest news with #CatoInstitute
Miami Herald
a day ago
- Health
- Miami Herald
$50B rural health ‘slush fund' faces questions, skepticism
A last-minute scramble to add a $50 billion rural health program to President Donald Trump's massive tax and spending law has left hospital and clinic leaders nationwide hopeful but perplexed. The Rural Health Transformation Program calls for federal regulators to hand states $10 billion a year for five years starting in fiscal year 2026. But the "devil's in the details in terms of implementing," said Sarah Hohman, director of government affairs at the National Association of Rural Health Clinics. "An investment of this amount and this style into rural - hopefully it goes to rural - is the type of investment that we and other advocates have been working on for a long time," said Hohman, whose organization represents 5,600 rural health clinics. People who live in the nation's rural expanses have more chronic diseases, die younger, and make less money. Those compounding factors have financially pummeled rural health infrastructure, triggering hospital closures and widespread discontinuation of critical health services like obstetrics and mental health care. Nearly 1 in 4 people in rural America use Medicaid, the state and federal program for low-income and disabled people. So, as Senate Republicans heatedly debated Medicaid spending reductions, lawmakers added the $50 billion program to quell opposition. But health advocates and researchers doubt it will be enough to offset expected cuts in federal funding. Senate Majority Leader John Thune, a Republican from South Dakota, which has one of the largest percentages of rural residents in the nation, led the push to pass the budget bill. His website touts support for strengthening access to care in rural areas. But his office declined to respond on the record to questions about the rural health program included in the bill. Sen. Susan Collins, a Republican from Maine who introduced an initial amendment to add the rural program, also did not respond to a request for comment. On July 15, Sen. Josh Hawley, a Republican from Missouri, introduced a bill to reverse future cuts to Medicaid and add to the rural program. Michael Cannon, director of health policy studies at the Cato Institute, a libertarian think tank headquartered in Washington, D.C., said the money was set aside because of politics and not necessarily for rural patients. "As long as it's a government slush fund where politics decides where the money goes, then there's going to be a mismatch between where those funds go and what it is consumers need," Cannon said. The nonpartisan Congressional Budget Office estimates federal Medicaid spending will be reduced by about $1 trillion over the next decade. "These dollar amounts translate to actual people," said Fredric Blavin, a senior fellow and researcher at the Urban Institute, a Washington D.C.-based think tank that focuses on social and economic research. Most states expanded their Medicaid programs to cover more low-income adults under the Affordable Care Act. That has lowered medical debt, improved health, and even reduced death rates, Blavin said. By 2034, about 11.8 million people are expected to lose their health insurance from this bill, said Alice Burns, an associate director for KFF's Program on Medicaid and the Uninsured. And she said the Medicaid rollback may have an outsize impact on rural areas. In rural areas, federal Medicaid spending is expected to decline by $155 billion over 10 years, according to an analysis by KFF, a health information nonprofit that includes KFF Health News. If the goal of the rural program was to transform rural health care, as its name suggests, it will fall short, Burns said. The $50 billion rural program distributed over five years won't offset the losses expected over a decade of Medicaid reductions, she said. In Kansas, Holton Community Hospital Chief Executive Carrie Lutz said she doesn't "feel that the sky is falling right now." Lutz, whose 14-bed hospital is on the northern plains of the state, said she is bracing for the potential loss of Medicaid-covered patients and limits to provider taxes, which nearly all states use to get extra federal Medicaid money. The reduction in provider taxes has been delayed until fiscal year 2028, Lutz said, but she still wants her state's leaders to apply for a portion of the rural program funding, which is expected to be distributed sooner. "Every little penny helps when you've got very negative margins to begin with," Lutz said. The program's $50 billion will be spread over five years and may not be limited to bolstering rural areas or their hospitals. Half of the money will be distributed "equally" among states that apply to and win approval from the Centers for Medicare & Medicaid Services. The law's current language "raises the possibility" that a small state like Vermont could receive the same amount as a large state like Texas, Burns said. States are required to submit a "detailed rural health transformation plan" by the end of this year, according to the law. The law says states should use the funds to pursue goals including improving access to hospitals and other providers, improving health outcomes, enhancing economic opportunity for health care workers, and prioritizing the use of emerging technologies. Mehmet Oz, a Trump appointee leading Medicare and Medicaid, will determine how to distribute the other half, or $25 billion, using a formula based on states' rural population and need. The law says the money is to be used for such things as increasing use of robotics, upgrading cybersecurity, and helping rural communities "to right size their health care delivery systems." Spokespeople for CMS did not respond to a list of questions. Kyle Zebley, senior vice president of public policy at the American Telemedicine Association, said there is "a pretty significant degree of discretion" for the White House and the Medicare and Medicaid administrator in approving state plans. "We will urge states to include robust telehealth and virtual care options within their proposals going up to the federal government," Zebley said. Alexa McKinley Abel, government affairs and policy director for the National Rural Health Association, said that while the law calls for states to create and submit plans, it's unclear what state agencies will perform the task, McKinley Abel said. "There are a lot of gaps around application and implementation," she said, noting that an earlier version of the bill called for state plans to be developed in consultation with federally funded state offices of rural health. But those offices are proposed to be eliminated in Trump's federal budget, which will face congressional approval in the fall. McKinley Abel said her organization supports state offices of rural health helping develop the plans and working with states to disburse the money, "since they intimately know the rural health community." Hohman, with the rural health clinic association, said she is not sure money from the transformation program will even reach her members. About 27% of the patients treated at rural health clinics are enrolled in Medicaid, she said. "There's just some confusion about who actually gets this money at the end of the day," Hohman said. "What is it actually going to be used for?" ____ KFF Health News senior correspondent Phil Galewitz contributed to this report. Copyright (C) 2025, Tribune Content Agency, LLC. Portions copyrighted by the respective providers.
The Hill
3 days ago
- Politics
- The Hill
Amidst terrible tragedy in Texas, debates over misinformation cloud the truth
As search and rescue teams in Texas continue to search for those lost in extreme flash floods and communities try to piece together lives, claims quickly spread about what happened and who was to blame. Many on the left blamed the Trump administration 's cuts to the National Weather Service. On the right, keyboard warriors accused cloud seeding technologies of causing the devastating floods. Others in the community spread news of the miraculous survival of some of those caught in the flood. These claims and accusations have been called misinformation, commonly understood as 'false' or 'misleading' information. The floods in Texas have inundated news cycles with a broader discussion of what misinformation is, how it works, and the impacts it can have. It is not surprising that Americans are worried about misinformation. Recent polling by the Cato Institute shows that Americans believe misinformation is the greatest threat to their freedom. This finding is true for Republicans and Democrats, though they likely consider misinformation to be a threat for different reasons. Other polls have reported that 80 percent of Americans view misinformation as a major problem. And according to a 2023 Pew poll, 55 percent of Americans believe the U.S. government should take action to restrict false information, even if it limits freedom of information. Research on misinformation, though, shows that it is not as serious a threat as it is made out to be, and we must be careful that in our efforts to address it, we don't make matters worse. Misinformation is an incredibly subjective issue to which people respond to in complex ways. In fact, misinformation is most often adopted and spread by those who are already predisposed to believe it, as we can see clearly in the recent events in Texas. The cycle is familiar: Politically motivated actors spread false or misleading information that was too good to check because it reinforced their beliefs. Similarly, locals hoping for some good news shared and believed information that they desperately wanted to be true, but sadly, it was not. And as often happens during significant disasters, false or misleading information spreads because of the rapidly evolving nature of the tragedy — we often simply don't know what the truth is yet. So, while misinformation can be harmful, it is often more of a symptom than a disease. Research shows that misinformation itself often does not change the beliefs and actions of those who encounter it; rather, it tends to reinforce existing beliefs or behaviors. In that sense, misinformation does not have the powerful impact of which the media and political world commonly speak. Unfortunately, despite this evidence minimizing its impact and power, the clouds of misinformation loom large over our society today. Americans have been told for years now that we are in the midst of an 'infodemic' of powerful misinformation that infects our minds like a virus. For example, last year, the World Economic Forum's risk report labeled AI-powered misinformation and disinformation as the greatest threat facing the world in the next couple of years. The number of academic research, books, journalism and fact-checking resources has surged over the past decade. Rather than panicking about misinformation and opening the door to government censorship, the threat of misinformation must be addressed from the ground up rather than the top down. For tech companies, this means rebuilding user trust and helping users be better consumers of information. Tools like community notes — as being adopted or tested in some form by X, Meta, TikTok, YouTube and other platforms — are likely to be helpful in getting users to trust the fact-checks they are seeing. And efforts to 'pre-bunk' misinformation through better media literacy will help by empowering users. When the government begins funding counter-misinformation research, things tend to go awry. This may sound counterintuitive, but we often disagree about what misinformation is and tend to favor our political biases, as seen in the news around the Texas floods. So when the government doles out money to research misinformation, it is inevitably funding those biases, which over time contributes to polarization and a lack of trust in our institutions. Similarly, the U.S. government should limit what it deems 'foreign disinformation' to include only the most clear-cut and harmful cases. When not handled carefully, such efforts can and have turned into government attacks on Americans' speech and political views — see the intelligence experts getting the Hunter Biden laptop story wrong — further polarizing and degrading Americans' trust in their leaders. The flood waters are receding in Texas, but the storm of misinformation still rages within our society. Instead of doubling down on misplaced panic over misinformation, we must instead trust and help Americans discover the truth. More speech, more discussions — not less speech and more government control — are the way we sort through information and find a brighter tomorrow.
Forbes
4 days ago
- Business
- Forbes
How Government Corruption Hurts Economic Growth
Young woman holding a poster against corruption. Human rights and democracy concept. Government corruption of any magnitude is a problem. It erodes citizens' trust in government, fosters animosity between voters and public officials, and hinders economic activity. One study that looks at country-level corruption finds that a 1% increase in the level of corruption reduces the rate of economic growth by 0.72%. The authors attribute most of the negative impact corruption has on growth to the political instability corruption causes, which generates uncertainty for businesses. Another study finds that countries with more corruption receive less foreign direct investment and experience higher inflation, both of which reduce growth. There is evidence that corruption reduces economic growth in America, too. One study finds that more state-level corruption reduces investment and the growth of output per worker. Another study finds that states with more corruption convictions from 1976 to 1980 experienced slower income growth over the next 20 years. This study also finds that states with more educated populations are less corrupt on average. To explain this finding, the authors suggest that educated voters are more inclined and better able to monitor public officials which reduces opportunities for corruption. In a recent analysis, Chris Edwards of the Cato Institute examines corruption in the United States by federal judicial district. To measure the level of government corruption in America, Edwards' examines Department of Justice data on public corruption convictions across the country's 94 federal judicial districts. He orders the districts by the average annual number of convictions per 100,000 people from 2004 to 2023. Washington, D.C. has the highest conviction rate, and three U.S. territories are in the top five. In the contiguous United States, districts in Louisiana, Montana, Oklahoma, Kentucky, South Dakota, and Tennessee have the highest conviction rates. The least corrupt areas according to this measure are the state of New Hampshire and the Middle District of North Carolina, where Greensboro is located. Both have annual conviction rates of only 0.05. Closer inspection of the economic data in places with the most convictions reveals the adverse economic effects corruption can have on local economies. Take Louisiana and Illinois: Both states have reputations for being corrupt that are supported by the convictions data and recent stories. In Louisiana, federal officials recently arrested and indicted several former Louisiana law enforcement officials and businessmen allegedly involved in a U-visa scam. In Illinois, the corruption case around former Illinois House Speaker Michael Madigan is still playing out. A former CEO of Illinois utility company ComEd was sentenced just this week. In addition to high levels of corruption, both Illinois and Louisiana had personal income growth below the national average over the last year according to the most recent data from the Bureau of Economic Analysis (BEA). Income growth was 5.4% in Illinois, 5.9% in Louisiana, and 6.7% for the entire country. In the two states with the least corruption, New Hampshire and Utah, income growth was 6.6% and 7.2%, respectively. These are just a few observations, of course, but they are consistent with the studies discussed earlier. While government corruption in the United States is far below the levels of autocratic countries, it is still a problem that needs to be addressed. There are plenty of ideas, including strengthening the Inspectors General who oversee audits and investigations in government agencies. One recent study that examines political corruption in Brazil finds that strengthening government audits can reduce corruption. Other policies include better enforcement of anti-corruption laws already on the books; more investigative journalism to uncover corruption; and greater protection and rewards for whistleblowers that reveal corruption. None of these are a silver bullet, but in combination they would help reduce corruption. Voters should also emphasize character when evaluating political candidates to reduce the number of dishonest people elected to office. Monitoring public corruption is important since we cannot address a problem we do not know about. The Cato Institute analysis is a reminder that government corruption is alive and well in America. Reducing it will improve local economies and cultivate more trust between voters and elected officials.
Forbes
4 days ago
- Business
- Forbes
This Is The Most Corrupt Place In America
Young woman holding a poster against corruption. Human rights and democracy concept. When people think about government corruption they often think of authoritarian countries like Russia, Venezuela, or North Korea. While these and other countries run by autocrats have high levels of corruption, democracies like the United States are not completely pure. In a recent analysis, Chris Edwards of the Cato Institute examines corruption in the United States by federal judicial district. He finds that Washington D.C. is the most corrupt place in the country, followed by the Eastern District of Louisiana, where New Orleans is located. Government corruption of any magnitude is a problem. It erodes citizens' trust in government and fosters animosity between voters and public officials. To measure the level of government corruption in America, Edwards' examines Department of Justice data on public corruption convictions across the country's 94 federal judicial districts. The top ten districts ranked by the average annual number of convictions from 2004 to 2023 are in the table below. As mentioned previously, the nation's capital tops the list, and three U.S. territories are in the top five. In the contiguous United States, districts in Montana, Oklahoma, Kentucky, South Dakota, and Tennessee share Eastern Louisiana's proclivity for corruption. The least corrupt areas, which are not shown in the table, are the state of New Hampshire and the Middle District of North Carolina, where Greensboro is located. Both have annual conviction rates of only 0.05. Top 10 federal judicial districts ranked by conviction rate. In addition to eroding trust in government, corruption has adverse effects on economic activity. One study that looks at country-level corruption finds that a 1% increase in the level of corruption reduces the rate of economic growth by 0.72%. The authors attribute most of the negative impact corruption has on growth to the political instability corruption causes, which generates uncertainty for businesses. Another study finds that countries with more corruption receive less foreign direct investment and experience higher inflation, both of which reduce growth. There is evidence that corruption reduces economic growth in America, too. One study finds that more state-level corruption reduces investment and the growth of output per worker. Another study finds that states with more corruption convictions from 1976 to 1980 experienced slower income growth over the next 20 years. This study also finds that states with more educated populations are less corrupt on average. To explain this finding, the authors suggest that educated voters are more inclined and better able to monitor public officials which reduces opportunities for corruption. Closer inspection of the economic data in places with the most corruption reveals these adverse economic effects. Take Louisiana and Illinois: Both states have reputations for being corrupt that are supported by the convictions data and recent stories. In Louisiana, federal officials recently arrested and indicted several former Louisiana law enforcement officials and businessmen allegedly involved in a U-visa scam. In Illinois, the corruption case around former Illinois House Speaker Michael Madigan is still playing out. A former CEO of Illinois utility company ComEd was sentenced just this week. In addition to high levels of corruption, both Illinois and Louisiana had personal income growth below the national average over the last year according to the most recent data from the Bureau of Economic Analysis (BEA). Income growth was 5.4% in Illinois, 5.9% in Louisiana, and 6.7% for the entire country. In the two states with the least corruption, New Hampshire and Utah, income growth was 6.6% and 7.2%, respectively. These are just a few observations, of course, but they are consistent with the studies discussed earlier. While government corruption in the United States is far below the levels of autocratic countries, it is still a problem that needs to be addressed. There are plenty of ideas, including strengthening the Inspectors General who oversee audits and investigations in government agencies; better enforcement of anti-corruption laws already on the books; more investigative journalism to uncover corruption; and greater protection and rewards for whistleblowers that reveal corruption. None of these are a silver bullet, but in combination they would help reduce corruption. Voters should also emphasize character when evaluating political candidates to reduce the number of dishonest people elected to office. Monitoring public corruption is important since we cannot address a problem we do not know about. The Cato Institute analysis is a reminder that public corruption is alive and well in America. Reducing it will improve local economies and cultivate more trust between voters and elected officials.
Newsweek
5 days ago
- Business
- Newsweek
Social Security: Young Americans May Lose $110,000 to Keep Program Afloat
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. Social Security, a foundational program for U.S. retirees and disabled Americans, has come under renewed scrutiny as funding shortfalls loom. A new report by the Cato Institute warned that today's young workers might lose up to $110,000 in lifetime earnings to keep the program afloat. Why It Matters With the Social Security Trust Fund projected to reach insolvency in the next decade, younger workers now face the possibility of significant financial sacrifices to maintain the system for current and future beneficiaries. More than 60 million Americans receive benefits every month. And according to Justice in Aging, Social Security lifts more than 22 million people out of poverty, including over 16 million older adults and almost 1 million children. he Social Security Administration office in Brownsville. he Social Security Administration office in Brownsville. Robert Daemmrich Photography Inc/Corbis via Getty Images What To Know Social Security faces a potential crisis as its trust fund is predicted to be depleted by the mid-2030s, according to recent projections. The primary driver is an aging population, particularly as Baby Boomers retire and a shrinking base of younger workers are paying into the program. As a result, the Social Security Administration would only be able to pay about 80 percent of scheduled benefits unless funding solutions are enacted. The Cato Institute reported that keeping Social Security solvent in its current form would require today's young workers—those just entering the labor market—to contribute significantly more over the course of their careers. If changes are not made, these workers could see a reduction equivalent to $110,000 of their lifetime earnings due to higher taxes and/or reduced benefits, according to the Cato Institute. That figure is based on the latest report from the Social Security Trustees, which said Congress would need to hike the payroll tax rate immediately and permanently by 3.65 percentage points, from 12.4 to 16.05 percent, to close the program's $25 trillion funding gap and continue to send out scheduled payments. "That means less discretionary income in each paycheck, which could have ripple effects on their day-to-day finances and long-term savings," Kevin Thompson, the CEO of 9i Capital Group and the host of the 9 innings podcast, told Newsweek. "A tax increase would be a hit to growth as less discretionary spending means less in corporate earnings." According to the Cato Institute, this cut would be equivalent to giving up 20 months of pay at the worker's average monthly wage. "There are endless variables affecting Social Security, but in the end, the math does not lie," Drew Powers, the founder of Illinois-based Powers Financial Group, told Newsweek. "To keep the program going, there will be adjustments in the current payroll taxes, income caps, and full retirement age. We could see a return of the Retirement Earnings Test and may even see means testing for the highest income retirees." This could cause outrage across the general public, which has generally favored targeting higher earners rather than taking away from future retirees' payments. A University of Maryland Program for Public Consultation survey showed that 53 percent of American adults considered it acceptable to reduce Social Security benefits exclusively for the Top 40 percent of income earners. This targeted reduction would address approximately 23 percent of the program's projected funding shortfall. There was also bipartisan support for raising the retirement age, which could close an additional 15 percent of the funding gap. What People Are Saying Drew Powers, the founder of Illinois-based Powers Financial Group, told Newsweek: "Younger workers, especially the youngest of the Millennials and all of Gen Z and beyond, should expect Social Security to look different for them than it does now. Adjustments to Social Security are rarely popular, but in the past Congress has been willing to act in the face of dire circumstances, such as in 1983 when the Full Retirement Age was extended." Kevin Thompson, the CEO of 9i Capital Group and the host of the 9 innings podcast, told Newsweek: "While such an increase would extend the solvency of Social Security by about 75 years, it's not a complete solution. The real fix would likely require both raising the payroll tax and removing the income cap. But let's be honest—that kind of proposal is a tough sell politically. Running on a platform to raise taxes rarely gains traction, even when it's tied to securing the future of Social Security." Alex Beene, a financial literacy instructor for the University of Tennessee at Martin, told Newsweek: "There's been an assumption made by Americans for decades now, and that is regardless of warnings and political posturing, Social Security will always be there to provide for retirees. The reality is there's a tremendous shortfall coming in the next decade, and if Congress doesn't act, beneficiaries will see their monthly payments dramatically reduced." What Happens Next With Social Security's financial future uncertain, Congress and the public are set to debate possible reforms, including benefit reductions for higher earners, payroll tax increases, and changes to the retirement age. The conversation will likely intensify as insolvency draws nearer in the next decade, with any enacted policy changes affecting both current retirees and younger generations entering the workforce. No official policy changes have yet been passed, but the heightened awareness and survey support for targeted reform suggest continued bipartisan attention to the problem in upcoming legislative sessions. "There are obviously different solutions to the shortfall that don't involve raising that percentage, but it does present a grim prediction for the American workforce if Congress doesn't act on a more efficient solution," Beene said.
