Yesterday, the Congressional Budget Office (CBO) released its analysis of the American Health Care Act (AHCA)—legislation designed to “repeal and replace” the Affordable Care Act (ACA). The House of Representatives passed the AHCA earlier this month, in its second attempt at doing so , before the CBO released a score. The bill makes substantial changes to current law, which have large effects on both the costs of care and the coverage rates. I’m going to walk through some key provisions and their effects on specific populations, and compare these effects to those in the version of the AHCA that the CBO scored in March. The bottom line is that, if the AHCA becomes law, the number of uninsured Americans will grow by 23 million by the year 2026—just a bit lower than the 24 million more people who would have been uninsured under the original bill. This is the result of about 14 million fewer people on Medicaid, 6 million fewer with nongroup insurance coverage, and 3 million fewer with employer-sponsored health insurance; substantially fewer people will be on nongroup coverage under the House-passed bill than in the originally-score bill, while more will be covered by employers, likely because of provisions that make the nongroup market considerably less desirable.

The total change in coverage from all these sources is shown in the figure below, copied in its entirety from Figure 2 in the CBO cost analysis. The share of each age group without coverage under current law is shown in the first bars of each set in dark blue, under the March 23 CBO score in the second set in the lightest blue, and under the legislation passed by the House is shown in the third set (mid-tone blue). The three sets of bars on the left show coverage rates for nonelderly adults below 200 percent of the federal poverty line (FPL), while the three sets of bars on the right show coverage rates for those above 200 percent of FPL. The width of the bars represents the relative size of the population, so you can see that adults between 19 and 29 years of age are more likely to be lower income, while those between 30 and 64 years of age are more likely to be higher income. In general, low-income adults are more likely to be uninsured under current law, but that difference is exacerbated under the proposed legislation. However, no group is spared. While low-income people face much higher rates of uninsurance, even significant shares of high-income young and middle-aged adults will be less likely to be covered.

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Breaking a promise not to cut Social Security, the Trump administration released a budget that would slash Social Security payments for disabled workers by shrinking many of the federal government’s disability-based programs by $72 billion over the next decade. Press coverage has emphasized that the budget avoids large cuts for programs that benefit mostly older workers, but this is inaccurate—especially for Social Security Disability Insurance (SSDI), which disproportionately benefit older Americans.

It is true that the Trump administration is desperate to cut programs like food stamps that overwhelmingly benefit poor children, but it is incorrect to claim that the administration’s draconian budget reductions spare older people. In fact, the administration’s budget cuts are remarkably comprehensive in their cruelty across the age distribution. Cuts to Social Security disability payments will especially burden older Americans, as they are precisely the individuals most likely to be disabled. Do you know people with cancer advanced enough that it prevents them from working? Or how about a family member with diabetes or arthritis? These and other illnesses prevent older Americans in particular from holding steady employment.

The figure below shows that the share of the population receiving disability insurance payments indeed rises rapidly with age. Nearly one-in-ten (9.9 percent) people between the ages of 50 and 65 receives SSDI, in contrast to the small shares of younger individuals receiving these payments. As a result, nearly three quarters of those receiving Social Security disability are between the ages of 50 and 65.

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Today, the House Committee on Ways and Means is holding a hearing on President Trump’s budget proposals, with Treasury Secretary Steven Mnuchin providing testimony.

In the past, Mnuchin has claimed that in the Trump administration’s tax plan, “there will be no absolute tax cut for the upper class.” This claim has been dubbed the “Mnuchin rule.” However, the Center on Budget and Policy Priorities has found that both the Trump campaign and House GOP “Better Way” tax plans flagrantly violate this rule. Tax Policy Center (TPC) estimated that 47 percent of the Trump campaign tax plan would go to the top 1 percent while 76 percent of the House GOP tax plan would go to the top 1 percent in their first years, and this regressivity just grows over time. And the scarce details from the administration on their tax plan have not deviated much from the campaign plan.

Despite this, yesterday at the 2017 Peter G. Peterson Fiscal Summit, Mnuchin again echoed (see 2:08 in the video) this claim, stating that “the president’s objective is to create a middle-income tax cut, it’s not to create tax cuts for the high-end.”

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Today, the Trump administration published their full budget request for fiscal year 2018. The budget is basically par-for-the-course with recent Republican budgets— doubling down on the austerity policies that have been harming American households for about a decade. But besides containing cruel cuts and deeply-dodgy economic assumptions, this proposal should also dispel any last remaining hope that fiscal policy under the Trump administration would boost, rather than drag, on growth and jobs. Were this proposal enacted, it would put a large and rapidly growing drag on economic growth going forward. All else equal, job-losses stemming from this budget’s spending cuts would total 177,000 in 2018, 357,000 in 2019, and 1.4 million in 2020. While it gets increasingly hard to estimate precise numbers further into the future, the fiscal drag just increases dramatically after 2020.

The economic intuition for why the Trump budget’s cuts would hinder growth is simply that they would reduce growth in economy-wide spending, or aggregate demand. It is always possible that the spending slowdown caused by the Trump budget could be neutralized by spending increases in other parts of the economy. Before the onset of the Great Recession, it was thought that this spending increase could be reliably engineered by the Federal Reserve lowering short-term interest rates. Since the Great Recession, however, the economy saw seven years of historically slow recovery even while the Fed held short-term rates at zero (and undertook other measures to boost growth). The reason for this slow growth despite expansionary monetary policy is clearly historically austere public spending.

This should make clear that while the Fed certainly has the ability to curtail growth by raising interest rates, their ability to offset a negative fiscal shock by lowering rates seems severely constrained. Given that a monetary policy response should not be relied on to neutralize the negative fiscal shock of the Trump budget and the AHCA, we think these estimated job-losses should certainly inform the debate. Further, the federal funds rate (the rate the Fed lowers to offset negative demand shocks) sits at just about 1 percent today, meaning the Fed simply doesn’t have much room to boost the economy in response to contractionary fiscal policy that begins next fiscal year and then ramps up. For reference, in the past five recessions, the peak-to-trough change in the federal funds rate as the Fed aimed to stop the contraction and spur recovery was over 3.5 percent.

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The president’s budget was released today and a House budget resolution will follow in June. Though the two plans will undoubtedly differ in certain areas—the president’s budget includes infrastructure and paid parental leave proposals that aren’t guaranteed to be taken up by the House—both will seek deep cuts to programs helping vulnerable citizens while calling for immense tax cuts for the wealthy.

The proposed budget and tax cuts come on the heels of the House effort to repeal the Affordable Care Act (ACA) and replace it with their American Health Care Act (AHCA), which the Center on Budget and Policy Priorities noted would be “the largest transfer in modern U.S. history from low- and moderate-income people to the very wealthy,” should it become law. The White House is banking on this repeal passing, assuming $250 billion in supposed savings in the president’s budget.

Voters who believed Trump’s assurances that he opposed cuts to Social Security, Medicare, and Medicaid may be surprised to learn that he wants to gut Medicaid (not just reversing the expansion embedded in the ACA, but essentially doubling the cuts in Medicaid called for in the House-passed AHCA), cut Social Security Disability Insurance, and hasten the exhaustion of the Medicare trust fund. Funding for Medicaid and the Children’s Health Insurance Program (CHIP) would be slashed by $616 billion over the 10-year budget window, as Medicaid would be transformed from a coverage guarantee for low-income families and nursing home residents who have exhausted their savings into block grants or similar programs constrained by per capita spending limits at a time when Baby Boomers are aging into their peak Alzheimer’s years. The Medicaid cuts would do nothing to restrain health cost inflation but would leave sick kids and frail seniors to fend for themselves.

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Every year, retirement savers lose $17 billion because they receive bad advice from financial advisers—like being steered into investments that provide larger payments to the adviser but lower returns for the saver. Currently, that fleecing of retirement savers is legal. Unlike the strict requirements in place for lawyers and doctors, not all financial advisers are legally required to act in their clients’ best interest. Just over a year ago, the Department of Labor issued a rule (known as the “fiduciary rule”) that would close this loophole and require financial advisers to act in the best interest of clients saving for retirement. But the Trump administration has made its interest in weakening or rescinding this rule clear. Following direction from President Trump, the Department of Labor delayed the implementation of the rule by 60 days, from April 10th to June 9th, to conduct a new “examination” of the rule, despite the fact that the department has already conducted an exhaustive analysis.

Secretary of Labor Alexander Acosta, after earlier saying he was actively seeking a way to further “freeze the rule,” has now stated that while the Department “should seek public comment on how to revise this rule,” they “have found no principled legal basis to change the June 9 date while we seek public input.” The fact that there will be no further delay is very good news. Further delay of the rule would have been a huge win for the financial industry and a huge loss for retirement savers all across the country, with every additional week of delay costing retirement savers $431 million over the next 30 years. However, while the rule’s fiduciary standard will take effect on June 9th, key compliance provisions built into the rule’s exemptions have been further delayed to January 1st, 2018. Moreover, the department has stated that it will not enforce the rule the during the gap period between June 9th and January 1st. This means the loopholes that allow financial advisers to take advantage of savers are not fully closed, and retirement savers will continue to be harmed during this period. Further, it is far from certain that the rule will in fact become fully applicable on January 1st. The Department has made clear (see Q4 in these Department of Labor FAQs ) that—as requested by the financial industry—they are considering proposing additional changes to the rule and delaying it beyond January 1st. Thus, we can expect further attempts in coming months to weaken and delay the rule—actions that would yet further harm retirement savers. In order to truly protect retirees and working people saving for retirement from predatory financial advisers, we need a fully applicable, vigorously enforced rule to protect their savings from the large losses that conflicted advice is causing.

One year ago, the U.S. Department of Labor issued a final rule to update the Fair Labor Standards Act’s overtime rules. The old rules—written by the Bush administration in 2004—have a loophole that leaves millions of salaried employees without the right to overtime pay (and even without the right to be paid the minimum wage). An employer may legally require salaried employees earning as little as $23,660 a year to work 70 or 80 hours a week with no additional pay. If an employer determines that a salaried employee works in an “executive, professional, or administrative capacity” the employee’s effective hourly pay could fall below $6.00 an hour.

If the new rule had taken effect on December 1, 2016, as planned, 4 million employees would have become entitled to overtime pay and another 9 million would have had their right to overtime pay strengthened and clarified. In 2017 alone, workers would have gotten $1.2 billion in extra pay.

But Republican politicians and big business groups sued to block the rule, and a U.S. District Court judge in Texas blocked the rule from taking effect, not just in Texas, but nationwide. Obama’s Department of Labor appealed the case, but the Trump administration has repeatedly delayed the appeal while it figures out whether to side with the employees or with big business.

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In January 2010, the Supreme Court’s Citizens United decision allowed corporations, for the first time ever, to spend unlimited money on politics. Within a few months, Republican strategists and the U.S. Chamber of Commerce hatched a plan to take advantage of the newly available corporate cash. They called it Project “RedMap,” or “Redistricting Majority Project.” Its goal was to use corporate money— much of it contributed secretly through the Chamber— to win Republican control of state legislatures in the Fall of 2010. That year’s elections were particularly important because the officials who came into office that year would be charged with redrawing legislative district boundaries based on the 2010 census.

The business lobbyists were more successful than they could have hoped. With their help, eleven states that had previously been governed by a combination of Democrats and Republicans became wall-to-wall Republican, with the GOP controlling both houses of the legislature along with the Governor’s mansion. Critically, this included a swath of traditional swing states with strong labor movements running from Pennsylvania to Wisconsin across the upper Midwest.

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Sixty-three years ago on Wednesday, the Supreme Court prohibited school segregation. In the South, Brown v. Board of Education was enforced slowly and fitfully for two decades; then progress ground to a halt. Nationwide, black students are now less likely to attend schools with whites than they were half a century ago. Was Brown a failure?

Not if we consider the boost it gave to a percolating civil rights movement. The progeny of Brown include desegregation of public accommodations and the mostly unhindered right of African Americans to compete for jobs, to vote, and to purchase or rent homes. Brown’s greatest accomplishment was its enduring imprint on the national ethos: the idea of second-class citizenship for African Americans, indeed for any minority group, is now universally condemned as a violation of the Constitution and of American values. None of these transformations came easily, and none are complete, but none would have happened were it not for Brown.

Yet the decision could not accomplish its stated purpose. Today, nearly half of all black students attend majority black schools, with over 70 percent in high-poverty school districts. New York is the most segregated state: two-thirds of its black students attend schools that are less than 10 percent white. A growing number are “integrated” with low-income Hispanics and other recent immigrants, but still isolated from the mainstream.

Because schools remain segregated, we have little chance to substantially boost the achievement of black children, especially those from low-income families. Of course, some children will always surmount their disadvantages and excel. But when separate schools concentrate students who are in poorer health and more frequently absent, who may be homeless or in unstable housing, and whose parents are less-educated, achievement lags when teachers are overwhelmed by non-academic challenges.

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