People with disabilities often deal with a variety of complex medical issues, which makes them the costliest group to cover under today’s Medicaid program. It follows that reducing this group’s enrollment would lower costs. But the models don’t actually project lower total enrollment for disabled Missourians. Instead, the models employ what they call “PTD shifting,” which is an attempt to get the federal government to pay more for a significant portion of Missouri’s currently disabled enrollees.

In practice, PTD shifting refers to reclassifying currently enrolled disabled Missourians into the newly eligible Medicaid expansion population. Once reclassified, Missouri would be able to receive nine federal dollars for each state tax dollar it spends to cover the “newly eligible” recipients. This is a stark improvement over the state’s current federal match, which is roughly two federal dollars for each dollar Missouri spends. The problem—and it’s a big one—is that purposely classifying those who meet pre-expansion Medicaid eligibility requirements as newly eligible in order to receive additional federal funds is not allowed, and if money is collected under such a scheme it would need to be returned.

Don’t just take my word for it. New York tried PTD shifting, and its Medicaid program was then audited by the federal Office of Inspector General (OIG). Here’s what the OIG concluded:

Beneficiaries Were Disabled – Individuals may not be enrolled in the new adult category if they are otherwise eligible for Medicaid through a mandatory category. For 3 of the 130 sampled beneficiaries, the State agency incorrectly enrolled the individuals in the new adult group despite their case files demonstrating that they were certified as disabled and receiving Social Security disability benefits—a mandatory coverage group for which the standard FMAP rate applied.

There is an argument to be made that individuals who first apply for Medicaid may not know whether they are eligible to qualify for the program using their disability, but the OIG report concludes that it is the state’s responsibility to determine whether they are categorically eligible for Medicaid based on disability (someone who would be currently eligible, and thus only receiving the 2 to 1 federal match) before enrolling someone in Medicaid based on income (which would be someone newly eligible, thus receiving the 9 to 1 match).

Missouri’s Medicaid enrollment for people with disabilities has totaled over 150,000 annually for well over a decade. Models that project savings based on disregarding federal law should be met with extreme skepticism, to say the least.  And once you remove the PTD shifting assumption, the projected savings disappear entirely. Instead of continuing to look for a free lunch, we need to face the harsh truths about the cost of covering thousands more Missourians under Medicaid.

The post Uh Oh: Are Medicaid Expansion Savings Built on False Promises? appeared first on Show-Me Institute.

Well, you could try the hidden ball trick. Indiana’s Trine University softball team played this old ruse to perfection in advancing to the 2019 Women’s College World Series.

In a surprise pick-off move, Trine pitcher Kate Saupe turned and fired a bullet to second base. But the ball got away from the infielder and rolled into the outfield. So it seemed. Actually, the ball never left the pitcher’s glove. When the runner tried to advance, Saupe tagged her for the game-winning out.

In promoting the idea of a cost-free expansion of Missouri’s Medicaid program, the Missouri Budget Project, the Missouri Hospital Association, and others are using a similar (and equally spectacular) misdirection play to gain public support for a policy initiative that would be neither cheap nor free.

At $10.9 billion, Medicaid already accounts for 39.6 percent of Missouri’s 2019 budget. That’s more than education, prisons, public safety, or roads. It’s the most for any service funded in part or total by Missouri taxpayers.

So how can Missouri boost the number of Medicaid participants from 850,000 to more than a million people—and save money? It can’t. If we increase Medicaid enrollment more than quarter, there has to be a similar increase in costs—something on the order of $2 billion a year.

The hidden ball here is to treat the federal contribution in this joint state-federal program as “free money” —a manna-from-the-heavens gift from Uncle Sam to the Show-Me State. But the money is not free. Like the residents of other states, Missourians are on the hook for federal Medicaid obligations, no less than state Medicaid obligations. They pay the final bill either way—through state and federal taxes.

Under the Affordable Care Act, the federal government set out to expand Medicaid to include people earning up to 138 percent of federally defined poverty level.

As originally written, this legislation would have required states to comply with the planned expansion of Medicaid or face the loss of all federal matching funds, split roughly on a $3-to-$2 basis between the federal government and the states. The Supreme Court struck down that part of the law in 2012. The Obama administration then agreed to a $9-to-$1 split in favor of the states if they opted to participate in the expansion. What had been a “gun to the head” (as Chief Justice John Roberts wrote) suddenly became a mouth-watering carrot.

Kansas recently became the 37th state to opt into Medicaid expansion. If Missouri were to follow suit, it would still need to put up 10 percent of the cost. Citing a Washington University study, Medicaid expansionists think they have found a way to make even that cost disappear. But this is just one more example of cost-shifting as opposed to cost reduction.

According to the study, Missouri could re-enroll existing recipients currently classified as permanently and total disabled (PTD) based on income, rather than disability. That would trigger the new $9-to-$1 federal match—meaning more federal funds for the same people.

But there is a problem: This maneuver appears to be against the law. So the federal Office of Inspector General said in a recent audit of New York State when it tried to do same thing.

Over the last two decades, Medicaid has been a rapidly rising cost at both the state and national levels. But it remains a deeply troubled program that is not succeeding in its basic mission of providing ready access to high-quality healthcare for low-income families and individuals.

When it comes to promoting needed change in healthcare, using feel-good, sleight-of-hand accounting to promote a false idea of something-for-nothing benefits is a step backward, not forward.

The post The Myth of “Free” Medicaid Expansion appeared first on Show-Me Institute.

• The top tax rate is cut by .1 percent per year if state revenues increase by $150 million. Once fully phased in, the new top tax rate will be 5.5 percent.
• Tax brackets are to be adjusted for inflation.
• Business owners who pay their company’s taxes at the individual level will be able to deduct 5 percent of their business’s income. This deduction will increase by 5 percent every year until it reaches 25 percent.
• Creates an additional $500 personal exemption for people with incomes less than $20,000.

Nixon already denounced the legislation and will likely veto the bill. He has trotted out the same talking points he used when he vetoed last year’s tax cut. “Once again, members of the legislature have chosen to ignore evidence that Missouri is already a low-tax state — sixth lowest in the nation,” Nixon said. I guess the governor felt that Missouri’s taxes weren’t low enough for Boeing when he signed a $150 million incentive package for the company to move manufacturing jobs here. Also, Missouri is not a low-tax state, particularly when it comes to income taxes.

You probably also will hear progressive groups complain that passing this bill will blow a hole in our budget and seriously harm state revenues. That’s what the Missouri Budget Project is doing. However, the group doesn’t show its arithmetic in its report. This is par for the course for the Missouri Budget Project and the “report” isn’t very useful for actually discussing the bill’s merits.

I’m glad the legislature is trying to cut taxes. I prefer more significant cuts (such as fully eliminating the individual and corporate income taxes). However, I’ll take any forward progress in cutting taxes. Hopefully, this time, the cuts will get enacted.

The post Here We Go Again . . . appeared first on Show-Me Institute.

Imagine your great uncle passes away and leaves you a huge sum of money, but there is a catch. To get the money, you have to spend $30 million on Missouri’s public education system and make a demonstrable impact on student achievement. Contrary to the plot of the 1985 comedy “Brewster’s Millions,” your great uncle demands results. Would you follow Missouri Budget Project’s advice and put the $30 million into the state’s foundation formula for public schools to make up for the funding gap?

If so, you could probably kiss your riches goodbye. You might be better off following Monty Brewster’s lead and organizing a baseball game against the St. Louis Cardinals. You could invite disadvantaged students to watch the game on a field trip. After all, one study has shown that “poor” readers with more knowledge about baseball outperformed “good” readers with relatively little knowledge about baseball.

All levity aside, there is little reason to believe that pumping more money into the funding formula will lead to improved results.

Let’s imagine that you do put the money in the formula to fill the “underfunding” gap. In the table below, I display how much Missouri schools would get from your great uncle’s generosity. In this graph, schools were sorted into deciles based on the percentage of students scoring proficient or advanced on the state’s math exam (districts were weighted for size). As you can see, you would be giving almost as much money to the highest-performing schools as you would to the lowest-performing schools.

If you would not invest your own money in this manner, why would you invest taxpayer money this way?

I have never denied that Missouri is underfunding the foundation formula; the state is. This does not mean that the formula is infallible. The formula is flawed and is in need of change. It is time to stop asking how much money we can spend on schools and start asking how we can spend our money more effectively, so that we can truly improve the lives of students.

The post Spending ‘Brewster’s Millions’ On Missouri Public Schools appeared first on Show-Me Institute.

Yesterday on the Show-Me Daily blog, my colleague Michael Rathbone pointed out that “there is no correlation between how much a school district is ‘underfunded’ and its actual performance.” In other words, districts that are more underfunded do just as well as districts that are nearly fully funded.

In the table below, I present all of the districts that scored a 100 percent and a 70 percent or below on the 2013 Missouri School Improvement Program Annual Performance Report (MSIP 5). Next to each district’s MSIP 5 score, I present the amount each district is underfunded per student as reported by the Missouri Budget Project. As you can see, in many cases, schools that are doing very well are relatively more “underfunded” than our lowest-performing schools.

So, are Missouri schools “underfunded”? It depends on what definition you use. They are underfunded when using the definition that the Missouri Budget Project uses, but they may not be if underfunded means “adequately” funded. Maybe we need to start rethinking how we fund education, not just how much.

Level of “Underfunding” in Missouri’s Best- and Worst-Performing Schools

The post Are Missouri Schools Underfunded? appeared first on Show-Me Institute.

I agree with Shuls when he says that, on principle, the foundation formula (which is the state’s method of determining how much of its annual appropriation to district aid goes to each school district) should be fully funded. The people at the Missouri Budget Project would have you believe that the more underfunded the school, the worse its performance will be. Shuls and I were skeptical that this was actually the case so we tested the Missouri Budget Project’s claim.

In our analysis, we used the Missouri Budget Project’s numbers for the amount each district was underfunded per student. In the past, I have raised issues with the Missouri’s Budget Project’s methodology (or lack thereof) in their work. However, for the sake of argument, Shuls and I decided to accept their results at face value. To measure a district’s performance, we used each district’s English and math MAP (Missouri Assessment Program) test scores and the percentage of students who scored proficient or advanced. We then ran the numbers through STATA to determine if any correlation existed between a school’s academic performance and their level of “underfundedness.” We found none (for more on our results, please see the comments section).

The underfunding of Missouri’s school districts “hurts” school districts if you define hurt as not getting money. If, however, you define hurt as having a negative impact on performance, these results indicate that is not the case. Even if these schools were fully funded, it would not guarantee that their performance would improve. A growing body of evidence suggests that increasing funding for schools will not necessarily lead to an improvement in educational outcomes. We believe in adequately funding our schools, but the state should first make sure that taxpayer money is spent wisely before asking taxpayers for even more.

The post Does An Underfunded Formula Really Hurt Schools? appeared first on Show-Me Institute.

This isn’t the only time the Missouri Budget Project has come up with revenue estimates out of whole cloth. In one of its write-ups about a Senate tax cut bill last year, the Missouri Budget Project stated that the bill would “slash Missouri’s general revenue budget by nearly $1 billion when fully implemented.” Page two of the report shows the year-by-year breakdown of estimated revenue losses, but you won’t see anything explaining how MBP came up with these numbers. There isn’t even an endnote.

Compare that to some of the analysis we do at the Show-Me Institute. When my colleague Policy Analyst Patrick Ishmael and I wrote “Passing Through Missouri: Left Behind On Taxes,” we included an entire section of the Appendix detailing our methodology and on what we based our estimates. The Missouri Budget Project’s tax analyses don’t contain anything like that. Yet when MBP officials are quoted in news articles, their numbers are accepted, seemingly without question.

The Missouri Budget Project is free to come up with any numbers it wants, but why aren’t those numbers backed up with explanations? As Wendy’s (and Walter Mondale) used to ask, “Where’s the beef?”

The post Taking The Missouri Budget Project Seriously appeared first on Show-Me Institute.

It’s true that Texas faced a serious budget shortfall after a recession hit. So did many states. However, Texas has managed to climb out of the hole it was in. Now, according to the Texas comptroller, Texas is looking at an $8.8 billion surplus. Even after making up for much of the cuts imposed by earlier budgets, Texas is still looking at a surplus. Texas also has significant assets in its “Rainy Day” fund. According to the Tax Foundation, Texas’ “Rainy Day” fund is 18.58 percent of general spending compared to 3.28 percent for Missouri.

Nixon and liberal advocacy groups such as the Missouri Budget Project worry about effects an income tax cut will have on education. Yet Texas, without an income tax, performs just as well as Missouri on a variety of education metrics.

Income taxes are among the most economically damaging taxes a state can impose. The Show-Me Institute has published research on how Missouri could eliminate the state income tax, or for the less bold, eliminate just the corporate income tax. Maybe instead of letters, Missouri can try real reform.

The post Texas And Taxes: Time To Set The Record Straight appeared first on Show-Me Institute.

The author emphasizes the problems with Missouri’s budget by repeatedly comparing it to a “sinking ship.” She calls for tax credit transparency, but taxpayers would benefit even more from tax credit limits or reductions, as the governor has suggested.

The author also suggests raising taxes. At any point, but especially during a recession, taxes impinge on further economic growth because an increase in the tax burden decreases compensation for additional time spent working. The decision to work or not work is a marginal trade-off; the lower per-hour compensation makes other activities — like leisure or spending time with family — more appealing. Economists have shown that economic growth occurs when production increases, but taxes decrease the incentive to work and save.  A recent study released by the Show-Me Institute demonstrates this inverse relationship with taxes and economic growth. Spending cuts are better for Missouri’s overall fiscal health than tax increases because they promote growth and allow money that would have gone toward government spending to instead flow toward generally more efficient market uses.

The 2011 budget relies on $7.22 billion in tax revenue, which is lower than the $8 billion collected before the recession, in fiscal year 2008, but still higher than the $6.97 collected in fiscal year 2010. Within that budget is room to pay for the vital services the author calls for, like schools, roads and health care for the elderly. It is a matter of prioritizing and “rearranging the deck chairs.” If tax credits are not the most efficient expenditure of resources, as the higher education system is currently contending, as the recent audit suggests, and as Show-Me Institute scholars have repeatedly pointed out, then it makes sense for Missouri to place more stringent limits on tax credits. In any case, Missouri’s present and future economy would benefit the most from lower taxation and spending rates, which would promote future growth and higher living standards for the state’s residents.

The post Tax Loophole Analysis Sinks in Its Own Metaphor appeared first on Show-Me Institute.

There are certainly legitimate arguments one might make against the Fair Tax proposal — simply stating, perhaps, a belief in in the fairness of progressive income taxation, wherein one’s tax burden automatically increases with income. I would disagree with that argument, but it is a perfectly legitimate argument to make because it doesn’t employ a demonstrably false set of facts. Repeating a figure based on a faulty set of assumptions about a proposal in order to score political points through fear, however, is not a legitimate form of argument.

The Missouri Budget Project again used its 11-percent sales tax figure in a Saint Louis Beacon op-ed today. Only a few days ago, I witnessed two economists tell the author of the MBP piece that her number was incorrect. They corrected her politely and professionally, and explained why it is wrong. Months ago, the MPB also received a copy of the Show-Me Institute’s case study, which went into great detail on the question and explained again why their 11-percent estimate is far too high. Unfortunately, they’ve continued to repeat their unreliable figure at every opportunity.

If you want to argue against Fair Tax legislation, that is fine with me. And, yes, it is likely that different people will come up with somewhat different estimates for how high the revenue-neutral replacement level of the sales tax would need to be. But if your estimate differs so dramatically from everybody else who has studied the issue that it appears to be just plain wrong, you should cease using it once that has been brought to your attention — or attempt to demonstrate where your opponents’ reasoning is faulty, in a detailed, systematic way. And if you don’t, people should stop taking you seriously.

The post The Missouri Budget Project Is Wrong appeared first on Show-Me Institute.

I am by no means an expert on this issue, but one of Blouin’s arguments against the sales tax struck me as odd. Blouin contended that if we replaced all other taxes with one simple sales tax right now, it could tie Missouri’s government to recession levels of revenue, which are much lower than normal. The first problem with that is a tax on consumption should not be any more sensitive to economic fluctuations than a tax on income — both rise and fall with the business cycle. In fact, the Show-Me Institute’s executive vice president Joseph Haslag, who is also an economics professor at the University of Missouri–Columbia, has argued that sales taxes tend to be less volatile than income taxes.

More importantly, however, even if the Fair Tax were to lock Missouri’s government into a relatively low level of taxation, what’s wrong with that? According to this chart I generated using our new “Show-Me: The Spending” tool, government spending in constant 2009 dollars has grown from $14 billion in 2000 to $19.1 billion last year — an increase of more than 35 percent.

Even as revenues fell in 2009, spending still increased at a rate of 9 percent during 2008. Maybe if revenues were to remain low, politicians and bureaucrats would learn more quickly that they cannot spend tax dollars with no thought for the long-term consequences.

The post Pick Your Poison: Income Tax or Sales Tax appeared first on Show-Me Institute.

In Missourinet’s piece, Amy Blouin, executive director of the Missouri Budget Project, claimed:

“Childcare … that’s going to be taxed,” said Blouin. “Educational services, tutoring, private K-12 education if your kids are in a private school – a Catholic school – you’re going to pay this on those schools.”

Former Missouri Budget Director Jim Moody echoes Mrs. Blouin’s concerns and worries about the effects of the expansion of the tax base:

“That [includes] hospitals, doctors, everything in medical care,” said Moody. “So you’re going to tax, at 5.11 percent, things you’re not currently taxing – prescription drugs, medical care, hospital visits, nursing homes.”

They’re right. It’s true, all those goods and services will be taxed under the change, along with several others that have historically been exempt from taxation. Unfortunately, Blouin and Moody fail to appreciate that tax changes do not happen in a vacuum. This is a subtle point, but — as we have argued before — although the prices of these newly taxed goods would increase by the sales tax rate, several changes would simultaneously occur elsewhere in the economy to make consumers better off.

To begin with, its important to understand that a change in the tax code implies a change in incentives. People and firms alike respond to these changing incentives in many ways, including altering their supply and demand of goods and services. With that in mind, the claim that the prices on all goods and services would increase by the tax rate is misleading. In the long run, prices would increase at most by the tax rate, but this increase would be dampened by microeconomic changes.

Prices would indeed increase, but consumers would also become richer following the repeal of the income tax, and some of that reclaimed wealth would be used to protect against price increases stemming from the sales tax. Meanwhile, lower corporate and personal income taxes would create strong incentives for the inflow of people and investment funds to the state. In the long run, this translates to higher employment, higher incomes (which shield against price increases), and, ultimately, greater revenues from sales tax receipts.

In the process of presenting her case against the tax change to the state legislature, Blouin has suggested that 95 percent of Missourians would be hurt by HJR 56. It’s difficult to follow her reasoning. It is clear that 100 percent of Missourians would be affected by this policy change, but the claim that 95 percent would be hurt is unsubstantiated by the evidence. In the study I cowrote with Dr. Haslag, we presented a model that we used to compare tax burdens under both the current income tax rate and the proposed sales tax rate. We even used our own computation of the sales tax rate, 5.96 percent, which is higher than that suggested in the bill. We found that the break-even point was $60,000. At this income level, the burden under both tax systems was comparable. Because only 28 percent of Missouri tax filers in 2008 earned incomes higher than $60,000, the 95-percent figure that Blouin cites seems highly suspect. Hopefully, she will clarify her arguments and engage our own.

The post Addressing the FairTax Critics … Again appeared first on Show-Me Institute.