Former CBO Chief: Congress Never Meant to Limit Obamacare Subsidies
A Supreme Court ruling expected this summer will determine whether the federal government can subsidize the insurance costs of individuals in states that did not establish their own health care exchanges under the Affordable Care Act.
Douglas Elmendorf was the director of the Congressional Budget Office when Congress debated the bill, and on Tuesday he provided some ammunition to backers of the law who insist that that Congress did not intend to prevent payments of subsidies to consumers in states using the federal exchange.
Related: How Obamacare Could Be Squeezing Consumer Spending
In an interview with CNBC’s John Harwood at the Peter G. Peterson Foundation’s 2015 Fiscal Summit*, Elmendorf said that before the ACA passed, the CBO analyzed the bill for members of Congress, many of whom were powerfully opposed to it. At the time, he said, there was a common understanding on Capitol Hill that the subsidies would be available to states regardless of the status of their exchanges.
“That analysis was subject to a lot of very intense scrutiny and a lot of questions,” he said. “My colleagues and I can remember no occasion on which anybody asked why we were expecting subsidies to be paid in all states regardless of whether they established exchanges or not. And if people had not had this common understanding…then I’m sure we would have had a lot of questions about that.”
Pressed by Harwood, Elmendorf added, “My colleagues and I talked to a lot of people, with a lot of questions about nearly every aspect of the analysis that we did…and we could not remember anybody asking us any questions about what would happen in the federal exchange different from what would happen in the state exchanges.”
Even so, the language of the law states that the subsidies would apply to exchanges “established by the State” and the Supreme Court will decide how literally those words must be interpreted.
*Pete Peterson also funds The Fiscal Times.
The 10 Worst States to Have a Baby
The birth rate in the U.S. is finally seeing an uptick after falling during the recession. Births tend to fall during hard economic times because having a baby and raising a child are expensive propositions.
Costs are not the same everywhere, though. Some states are better than others for family budgets, and health care quality varies widely from place to place.
A new report from WalletHub looks at the cost of delivering a baby in the 50 states and the District of Columbia, as well as overall health care quality and the general “baby-friendliness” of each state – a mix of variables including average birth weights, pollution levels and the availability of child care.
Mississippi ranks as the worst state to have a baby, despite having the lowest average infant-care costs in the nation. Unfortunately, the Magnolia State also has the highest rate of infant deaths and one of lowest numbers of pediatricians per capita.
Related: Which States Have the Most Unwanted Babies?
On the other end of the scale, Vermont ranks as the best state for having a baby. Vermont has both the highest number of pediatricians and the highest number of child centers per capita. But before packing your bags, it’s worth considering the frigid winters in the Green Mountain State and the amount of money you’ll need to spend on winter clothing and heat.
Here are the 10 worst and 10 best states for having a baby:
Top 10 Worst States to Have a Baby
1. Mississippi
- Budget Rank: 18
- Health Care Rank: 51
- Baby Friendly Environment Rank: 29
2. Pennsylvania
- Budget Rank: 37
- Health Care Rank: 36
- Baby Friendly Environment Rank: 51
3. West Virginia
- Budget Rank: 13
- Health Care Rank: 48
- Baby Friendly Environment Rank: 50
4. South Carolina
- Budget Rank: 22
- Health Care Rank: 43
- Baby Friendly Environment Rank: 49
5. Nevada
- Budget Rank: 39
- Health Care Rank: 35
- Baby Friendly Environment Rank: 46
6. New York
- Budget Rank: 46
- Health Care Rank: 12
- Baby Friendly Environment Rank: 47
7. Louisiana
- Budget Rank: 8
- Health Care Rank: 50
- Baby Friendly Environment Rank: 26
8. Georgia
- Budget Rank: 6
- Health Care Rank: 46
- Baby Friendly Environment Rank: 43
9. Alabama
- Budget Rank: 3
- Health Care Rank: 47
- Baby Friendly Environment Rank: 44
10. Arkansas
- Budget Rank: 12
- Health Care Rank: 49
- Baby Friendly Environment Rank: 37
Top 10 Best States to Have a Baby
1. Vermont
- Budget Ranks: 17
- Health Care Rank: 1
- Baby Friendly Environment Rank: 5
2. North Dakota
- Budget Rank: 10
- Health Care Rank: 14
- Baby Friendly Environment Rank: 10
3. Oregon
- Budget Rank: 38
- Health Care Rank: 2
- Baby Friendly Environment Rank: 14
4. Hawaii
- Budget Rank: 31
- Health Care Rank: 25
- Baby Friendly Environment Rank: 1
5. Minnesota
- Budget Rank: 32
- Health Care Rank: 5
- Baby Friendly Environment Rank: 12
6. Kentucky
- Budget Rank: 1
- Health Care Rank: 33
- Baby Friendly Environment Rank: 20
7. Maine
- Budget Rank: 25
- Health Care Rank: 10
- Baby Friendly Environment Rank: 15
8. Wyoming
- Budget Rank: 22
- Health Care Rank: 17
- Baby Friendly Environment Rank: 7
9. Iowa
- Budget Rank: 14
- Health Care Rank: 25
- Baby Friendly Environment Rank: 9
10. Alaska
- Budget Rank: 50
- Health Care Rank: 6
- Baby Friendly Environment Rank: 2
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Worried About a Recession? Here’s When the Next Slump Will Hit
The next recession may be coming sooner than you think.
Eleven of the 31 economists recently surveyed by Bloomberg believed the American recession would hit in 2018, and all but two of them expected the recession to begin within the next five years.
If the recession begins in 2018, the expansion would have lasted nine years, making it the second-longest period of growth in U.S. history after the decade-long expansion that ended when the tech bubble burst in 2001. This average postwar expansion averages about five years.
The recent turmoil in the stock market and the slowdown in China has more investors and analysts using the “R-word,” but the economists surveyed by Bloomberg think we have a bit of time. They pegged the chance of recession over the next 12 months to just 10 percent.
Related: Stocks Are Sending a Recession Warning
While economists talk about the next official recession, many average Americans feel like they’re still climbing out of the last one. In a data brief released last week, the National Employment Law Project found that wages have declined since 2009 for most U.S. workers, when factoring in cost of living increases.
A full jobs recovery is at least two years away, according to an analysis by economist Elise Gould with the Economic Policy Institute. “Wage growth needs to be stronger—and consistently strong for a solid spell—before we can call this a healthy economy,” she wrote in a recent blog post.
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