Reform First, Dollars Second

Posted on by Scott Tanner

If policymakers were worried about the One Big Beautiful Bill’s impact on healthcare in Missouri, they may soon find it’s paying dividends instead. Thanks to the new $50 billion Rural Health Transformation Fund established in the One Big Beautiful Bill (OBBB), Missouri could be rewarded for adopting reforms that expand the state’s healthcare options.

Created, at least in part, to help states deal with the reining in of Medicaid provider taxes, the fund guarantees each state $500 million (half of the $50 billion divided by 50 states), but the other half ($25 billion) is going to be awarded based on a scoring system the federal government recently rolled out. Most notable among the recently published scoring criteria are points for enacting many of the free-market healthcare reforms my colleagues and I have been writing about for years.

The scoring system doesn’t just assess demographics or the number of rural hospitals, though they are a big part of the rubric. It also awards states points for policy changes that reduce red tape and open the door for better care. Some of these items include repealing certificate of need (CON) laws, expanding scope of practice for nurses and other healthcare professionals, improving short-term health insurance options, and making telehealth more accessible. Missouri has debated each of these ideas for years, and made some progress, but now enacting these meaningful reforms has additional monetary stakes.

Despite recent incremental progress on the free-market healthcare front, there’s still a lot that Missouri could do. Our CON laws are some of the worst in the country. They stifle healthcare competition by forcing providers to receive permission, often from their competitors, before adding new hospital beds, building new facilities, or even purchasing certain types of equipment.

Scope of practice restrictions are another self-inflicted wound I’ve written a lot about in the past. Missouri gives advanced practice registered nurses less autonomy than in many other states. Our state already has a shortage of healthcare providers, and removing those restrictions would help improve healthcare access, make Missouri jobs more competitive, and ultimately lower costs—all without sacrificing patient safety.

On the telemedicine front, Missouri has made progress by expanding services to audio-only technologies earlier this year but has the potential to go much further. More flexible rules on prescribing and treating patients could dramatically expand access for families, especially for those in rural communities.

At the end of the day, many of the reforms incentivized by the OBBB are policies Missouri should have adopted years ago, but the federal funding offers lawmakers a new reason to finally take action. If Jefferson City seizes this golden opportunity, Missouri can both improve the state’s healthcare policy and score some additional resources that could help in these tough budgetary times. That sounds like a rare win-win to me.

Considering Coal-to-Nuclear Transitions in Missouri

Posted on by Scott Tanner

Kansas’s Department of Commerce and Evergy (the state’s largest utility) are partnering with TerraPower, a leading nuclear developer, to explore potential siting locations for a new advanced nuclear power plant. The three organizations signed a “memorandum of understanding” which is a nonbinding handshake to pursue a shared goal—in this case, bringing nuclear power to Kansas.

While no site has yet been selected for a TerraPower reactor, lessons from Wyoming and recent federal reforms offer clues about what might come next. As I have written before, the federal government has put extensive emphasis on converting retired coal plants into advanced nuclear reactors. These conversions, according to the U.S. Department of Energy, can save up to 35% on construction costs and retain much of the existing workforce. In Wyoming, TerraPower is currently building a reactor on a former coal site, and it would not be a surprise to see Kansas follow suit. This model could highlight a potential path forward for nuclear adoption in the historically coal-dominant Missouri.

Federal Reform and Cost Savings for Coal-to-Nuclear Transitions

The concept of coal-to-nuclear has drawn bipartisan attention in Washington, D.C., and has been codified in the recent ADVANCE Act, which directs the Nuclear Regulatory Commission to develop and implement strategies to enable more efficient licensing reviews for converting former coal plants and other former industry infrastructure into nuclear reactor sites.

A report prepared by experts at the Idaho, Oak Ridge, and Argonne National Laboratories found that these projects can achieve significant savings by repurposing existing infrastructure, such as steam-cycle components, since both nuclear and coal are thermal power plants that rely on generating steam to turn a turbine.

Missouri’s Long History with Coal and Transitioning Our Workforce

Coal has long been king in Missouri. Despite recent closures, Missouri remains the fourth most reliant state on coal, with coal supplying 57% of electricity generation in 2024. That legacy presents both a challenge and an opportunity.

Missouri has several coal plant sites that could be strong candidates for advanced nuclear conversion. A study from Oak Ridge National Laboratory identified three Missouri coal power plant sites (retired or slated for retirement between 2020 and 2040) as suitable for hosting a number of reactors.

Not only is there an opportunity to make use of our physical infrastructure, but Missouri can also use our existing workforce. The U.S. Department of Energy notes that many coal-plant and nuclear-plant jobs share identical or similar occupation codes, meaning a large portion of the existing workforce could transition with minimal retraining.

A Nuclear Advisory Council Could Help Identify Steps for Missouri

Another way to better identify potential nuclear sites is by creating a nuclear advisory council. If Missouri brought together the best and brightest minds in nuclear energy to discuss our unique opportunities, analyze trends in federal regulation, and address our state’s weaknesses, the Show-Me State could become a significant player in nuclear development.

Kansas is moving along in its process. Let’s hope the Show-Me State doesn’t let this same opportunity pass it by.

Interested in Nuclear Energy in Missouri?

Read my recent report, Connecting Nuclear Energy’s Past and Present: Guiding Missouri’s Future, here.

Jefferson City Residents Should Be Skeptical of Conference Center Project

Posted on by Mike Ederer

A version of this commentary appeared in the News-Tribune.

On November 4, Jefferson City voters will decide on a proposal to renew the city’s seven percent hotel tax. The proceeds from the tax will help fund a new conference center for the city. Supporters of the new conference center have claimed it will create 370 new jobs and generate over $100 million in economic growth. Exaggerated estimates such as this one have been made on behalf of convention and conference center projects all around the country for decades, and the historic evidence is clear that Jefferson City voters should be dubious of such claims.

Between now and November, Jefferson City residents who visit St. Louis should drive by the largely empty dome attached to St. Louis’s downtown conference center to see how these conference center promises often play out. That dome was a part of a large convention center expansion in the 1990s. The same promises of growth, revenue, and utopia were all made when St. Louis voters approved a hotel tax increase back then. Now the dome is mostly empty, and the regional body that manages it is struggling to pay for its upkeep. You can also visit the site of the taxpayer-subsidized convention center hotel that went along with the project. You can only visit the site of the hotel, not the hotel itself, because the hotel failed and was foreclosed on long ago.

Like a Cold War general in a Kubrick movie or a carpenter with a box full of nails, local tourism agencies have the same solution for every problem. Economic recession? Expand the convention center. Economic growth? Enlarge the convention center. Global nuclear war? Definitely gonna need a bigger convention center to commiserate in.

The renewed hotel tax isn’t the only public money being used as part of this plan. State tax dollars are being pursued in the legislature, and the conference center may receive local tax subsidies.

Supporters of the conference center plan in Jefferson City would likely say their plan is not as grandiose as a major convention center and dome project in St. Louis, and they are correct in that regard. However, there are plenty of examples of more comparable projects that have failed to reach the level of activity anywhere near was promised. Haywood Sanders is a researcher and writer with the University of Texas–San Antonio who has studied convention center expansions for decades. He has documented how cities and tourism agencies systematically inflate projections to get these projects approved. Sanders has cited the actual and underwhelming numbers of very comparable projects in Overland Park, Kansas, and St. Charles, Missouri. Overland Park opened its convention center and hotel in 2002. Project supporters had projected $36 million in annual hotel revenue by 2012, but the reality was much lower, coming in at under $20 million.

Sanders explains that the convention and conference-center industry peaked in the early 2000s and shows no signs of returning to the success it had back then. With a major convention area nearby in Lake of the Ozarks, a new center in Jefferson City will face intense competition for these limited conference opportunities.

Taxpayers should not be on the hook for conference centers whose overstated benefits, small as they will be, will largely go to private entities. Jefferson City is the capital of the Show-Me State, and the claims being made by convention-center supporters should be met with a healthy dose of skepticism by voters.

Springfield Voters Should Be Skeptical About Convention Center Claims

Posted on by Mike Ederer

A version of this commentary appeared in the Springfield Business Journal.

On November 4, Springfield voters will decide on a proposal to increase the city’s hotel tax by three percent. The proceeds from the new tax will help fund a new convention center for the city. A recent report paid for by the Visit Springfield tourism bureau said exactly what Visit Springfield wanted it to say: that a new convention center will generate enormous revenue for the Springfield area. The report claims a new convention center will drive $1.3 billion in new spending over the next 30 years. Exaggerated estimates like this one have been made on behalf of convention centers all around the country for decades, and the historic evidence is clear that Springfield voters should be dubious of such claims.

Between now and November, Springfield residents who visit St. Louis should drive by the largely empty dome attached to St. Louis’s downtown convention center to see how these convention center promises often play out. That dome was a part of a large convention center expansion in the 1990s. The same promises of growth, revenue, and utopia were all made when St. Louis voters approved a similar hotel tax increase back then. Now the dome is mostly empty, and the regional body that manages it is struggling to pay for its upkeep. St. Louis’s local tourism agency thinks the solution is the same thing it always is: further expansion of the convention center. Like a Cold War general in a Kubrick movie or a carpenter with a box full of nails, tourism agencies have the same solution for every problem. Economic recession? Expand the convention center. Economic growth? Enlarge the convention center. Global nuclear war? Definitely gonna need a bigger convention center to commiserate in.

The increased hotel tax isn’t the only public money being used as part of this plan. Other local sales taxes are slated to be used for funding, and state tax dollars are being considered. Tourists, Springfield residents, and possibly all of Missouri will get to pay for this new event space, whether it is actually needed or not.

Haywood Sanders is a researcher and writer with the University of Texas–San Antonio who has studied convention center expansions for decades. He has documented how cities and tourism agencies systematically inflate projections to get these projects approved. Sanders has reviewed the Springfield convention report and noted in an interview with a Springfield News-Leader reporter earlier this year that the report didn’t state how it calculated its room occupancy estimates and ignored underwhelming numbers of comparable convention centers in Overland Park, Kansas, and St. Charles, Missouri. Sanders states that the convention-center industry peaked in the early 2000s and shows no signs of returning to the success it enjoyed back then. With two major convention areas so close by in Branson and Lake of the Ozarks, a new center in Springfield will face intense competition. But I have no doubt that local Springfield convention-center boosters will ignore reality in their quest for tax revenue and city spending.

Visit Springfield wanted a report that claims a convention center will be an economic boon for the city. They got it. As Springfield residents prepare to decide on the hotel tax increase proposal, they should study the work of Heywood Sanders and others to learn about how these claims have been made about many other convention centers in many other cities, and how they usually fail. Springfield voters can also go to St. Louis to see the failures of these promises with their own eyes. Taxpayers should not be on the hook for convention centers whose overstated benefits, such as they are, will largely go to private entities. This is the Show-Me State, and the claims being made by supporters of the convention center for Springfield should be met with a healthy dose of skepticism by voters.

PRiME Summit Celebrates Schools with Impressive Test Score Growth

Posted on by Scott Tanner

I was fortunate to attend an event in late September celebrating Missouri schools that demonstrate high test score growth. The event, organized by the St. Louis University PRiME Center, was held at a central location in Columbia on the University of Missouri campus.

There are two aspects of the event that I really like. First, it recognized high-performing schools. Too often in education we choose not to differentiate school performance—we don’t punish poor performers, and we don’t reward excellence. I like that the event promoted the positive impacts of schools that generate high achievement growth. I was also pleased to see coverage of the recognition some schools received in the local media and in school newsletters and announcements (e.g., see here and here).

Second, I like that the event was centered on test-score growth, which is a far better measure of the impacts of schools than test-score levels or proficiency rates. Growth captures how much students learn during the year, not just where they start. This means schools in low-income communities are not penalized for low starting points as long as their students make good progress. This important design feature of growth is illustrated in this report from the Missouri Department of Elementary and Secondary Education (DESE). Not surprisingly, the high-growth schools recognized at the event included many in high-poverty areas.

We need more events like this. When schools perform well, we need to recognize them, thank them, and remind them they are on the right path. This validation matters, especially for schools that show high growth despite low overall achievement levels due to external factors. Without acknowledgment, educators in these schools might not realize the positive impacts they’re making.

I hope the PRiME event becomes a mainstay and is the beginning of a more concerted effort in Missouri to reward academic excellence. If we want our schools to thrive, we need to show them that their success matters.

(Disclosure: As a researcher, one of my main areas of work is on growth modeling and value-added modeling in education. I am part of the team of researchers who estimate the growth model for DESE.)

What’s Wrong with the Housing Market?

Posted on by Scott Tanner

If you’ve been in the market for a home recently, you know prices are through the roof. Prices went up sharply when interest rates bottomed out during the COVID pandemic. The low interest rates effectively made houses cheaper relative to the sticker price because most people borrow to buy a home. The lower total price, inclusive of loan interest, stoked demand, and prices went up in response.

Then, interest rates went up.

In a well-functioning market, the process should have reversed itself. The higher interest rates pushed the total price of purchasing a home back up, which surely lowered demand. At the same time, with house prices still far above the pre-pandemic level, builders should have been building like mad to bring homes to the market. These two forces should have resulted in a housing price correction. But this is not what happened. The higher interest rates have cooled demand, but prices remain high. Below is a chart I created using the Federal Reserve Economic Data (FRED) system. It shows the trend in the median U.S. home price since February 2020, just before the pandemic. The average price of a home in the United States grew by roughly $120,000, or about 38 percent, from the first quarter of 2020 to the third quarter of 2022. It has declined modestly of late, but not much.

The bizarre thing is that builders haven’t responded to the higher prices. In fact, FRED data show new housing starts today are lower than before the pandemic. Meanwhile, many existing homeowners are “locked in” with low-rate mortgages and reluctant to move, further constraining supply. Even with tempered demand due to the combination of high prices and high interest rates, the lack of supply is keeping prices elevated.

But what are the builders doing? They should be falling all over themselves to bring new houses to the market. Think of it this way: If it was profitable to build homes in Q1-2020, it should have been even more profitable by Q3-2022, continuing until today.

A recent issue of the Journal of Economic Perspectives (JEP) brings together several groups of economists to weigh in on the housing market. I read the issue with great interest. One of the most striking findings is that in many major markets, the price elasticity of housing supply is very low, which means builders barely respond to rising prices with new construction. This is odd. Normally, suppliers should respond strongly to higher prices, which put more money in their pockets. In fact, the invisible hand of the free market depends on it.

The articles discuss several reasons builders have responded so weakly to higher prices. With respect to the recent situation specifically, one might initially blame it on rising construction costs, but the articles suggest this is not the primary explanation. Rather, they emphasize the role of regulations and zoning. Local land-use rules, approval processes, and other restrictions make it slow and costly to build, even when market prices suggest that building more housing should be profitable.

Another interesting finding from the research is that we don’t need to focus on building low-income housing to make housing affordable. If we build higher-end homes, people will move into them from less desirable homes, which will then become more affordable. The effect of building homes at the higher end of the market cascades down.

In short, we just need to get out of the way of the market.

So, the next time you hear complaints about high home prices or a shortage of low-income housing, remember the biggest obstacle is the rules we’ve chosen for ourselves. Deregulating housing construction, and thereby expanding supply, offers the clearest path to putting homeownership in reach for more Americans.

Unsafe Schools and Parental Empowerment with Tiara Jordan-Sutton

Posted on by Susan Pendergrass

Susan Pendergrass talks with Tiara Jordan-Sutton, Founder and Executive Director of Activate Missouri, about school safety, parental power in education, Missouri’s failure to implement the federal Unsafe School Choice Option, and more.

Listen on Spotify

Listen on Apple Podcasts 

Listen on SoundCloud

Timestamps

00:00 Empowering Parents in Education
02:48 Safety Concerns in Schools
05:36 The Role of Legislation in School Choice
08:35 Mobilizing Parents for Change
11:25 Building a Movement for Educational Reform
14:16 The Future of Education in Missouri

Produced by Show-Me Opportunity

The Unsafe School Choice Option (USCO)

Posted on by Susan Pendergrass

The Unsafe School Choice Option (USCO) is a federal safeguard created under the Every Student Succeeds Act (ESSA), which ensures that students attending persistently dangerous schools can transfer to a safer public school. Yet, in the decade since ESSA became law, Missouri has never identified a single unsafe school, despite reporting tens of thousands of violent incidents and weapons violations. This one-pager explains how Missouri’s overly narrow definition leaves families without the protections ESSA guarantees and outlines steps policymakers can take to fix it.

If the PDF does not display, click here to download.

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