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The Impact of Health Insurance on Mortality – Annual Review of Public Health

“…Studies using different data sources and research designs provide credible evidence that health insurance coverage reduces mortality.”

Saved by Medicaid: New Evidence on Health Insurance and Mortality from the Universe of Low-Income Adults – University of Chicago

“Recent Medicaid expansions increased enrollment by 12 percentage points and reduced mortality by 2.5% among low-income adults, saving roughly 27,400 lives for only $5.4 million and $179,000 per life and life-year saved, respectively.”

The study estimates that 5–20% of the mortality gap between low- and high-income Americans could be attributed to differences in health insurance coverage.

For more on the mortality gap, see: A Widening Gap in Life Expectancy Makes Raising Social Security’s Retirement Age a
Particularly Bad Deal for Low-Wage Earners – Karl Polzer/SOA

Mamdani warns of nearly 10% property-tax boost if no tax on wealthy – msn/WSJ

“Mamdani needs the council’s support to pass his budget and approve any property tax increases. The Real Estate Board of New York, a trade group, urged the city to first evaluate its spending. ‘Using tax hikes of any kind, including increases to an already egregiously regressive property tax system, to raise revenue or plug budget holes is a non-starter,’ said James Whelan, president of REBNY…”

Maryland bans partnerships with ICE, citing ‘unaccountable agents’ – msn/WaPost

Tom Homan Defends Masked ICE Agents by Claiming Threats Are Up ‘Over 8,000 Percent’ – Reason

“‘An anonymous police force is an unaccountable police force,’ Reason‘s C.J. Ciaramella wrote last year. ‘It’s essential for government transparency, public trust, and the rule of law that the officials dictating and enforcing public policies can be identified by media outlets and citizens without fear of retribution.'”

State Individual Income Tax Rates and Brackets, 2026 – Tax Foundation

“Last year continued the historic pace of income tax rate reductions. In total, 26 states have reduced their individual income tax rates since 2021, including 23 states that reduced their top marginal rate, and seven states have newly shifted from graduated-rate to single-rate individual income tax structures in that same time. Only Maryland, Massachusetts, New York, Washington, and the District of Columbia increased their top marginal tax rates in those years…”

Paid sick leave bill passes Virginia House of Delegates – Virginia Mercury

Members of the professional class – who make policy – take paid sick days for granted. But that’s not the case for a large segment of the working class who have to take a pay cut for time off to go to a doctor or hospital.

Some of our work on this issue:

What about a few paid sick days? Are low-wage workers simply invisible to Virginia’s elected leaders? – Karl Polzer

All Workers Should Have A Few Paid Sick Days. The President And Congress Can Make It Happen – Health Affairs

The Quintessential Epstein Files Email – David Dayen/American Prospect

“Jeffrey Epstein and his friends standing up for Mary Jo White against Elizabeth Warren tells you everything about the class war at the heart of the files.”

“…This is the Epstein class in all its glory. It’s an elite that schemes to remain as unaccountable for sexual crimes as it does for corporate crimes. It has its own hierarchy of friends and foes, and it will defend those friends no matter what they do, while the spoils of privilege flow. Its instinct is to protect and preserve money and power, with the concerns of anybody without a corporate jet tangential at best. And once you set those ground rules, once you build a wall around a certain class so they don’t have to pay any price for their actions, it’s inevitable that the actions will get darker and darker…”

Trump snubs Nobel winner who gifted him her golden peace prize – Daily Beast

Venezuela: the end game – Michael Roberts

“What explains this collapse from inspiration to nightmare?”

“By 2008, Venezuela also had the highest minimum wage in all Latin America, and inequality in the country dropped to one of the lowest in the Americas. By 2011, Venezuela was the second most equal country in the Western Hemisphere; only Canada had lower levels of inequality…But from 2013 onwards, things began to go wrong, big time…”

Inflation (Accurately Measured) Is Closer to 3% than 2% – William Emmons/Substack

“Errors in BLS data may mislead the public and policymakers. Core-CPI inflation in the year through Sept. 2025 was 3.0%; in the two months after the lost Oct. data (Nov. 2025 to Jan. 2026), annualized core-CPI inflation was 3.2%. The reported two-month annualized inflation rate of 1.1% bridging the data gap (Sept.-Nov. 2025) is implausible. The resulting embedded distortion in CPI inflation rates misleads the public and, if not recognized, could tip Fed policymakers toward an ill-advised interest-rate cut.”

Trump claims victory on affordability as public anxieties persist – msn/WaPost

“‘We’re hitting all-time-high stock numbers,’ Trump said Friday in a speech to troops at Fort Bragg in North Carolina. ‘All I know is forget about the stock market, forget about Wall Street, your 401(k)s are doing very well. I don’t have to ask you, “Is anybody doing poorly with their 401(k)?” If they were, you’re a pretty bad investor.’

“But the positive signs are unevenly felt, and skew toward the wealthy. About 40 percent of adults in the U.S. do not have a 401(k) or any other retirement savings account, according to a 2025 Gallup survey. Consumer sentiment among people without stock holdings remained near its lowest level since at least 2018, and the overall average was about 20 percent lower than in January 2025, according to the University of Michigan’s benchmark survey.”

Republicans worry party won’t do enough to address costs before midterms – Hill

Sunday, February 15, 2026

Eleven killed in Israeli strikes on Gaza, rescuers say – BBC

“Last week it was announced that Indonesia, a Board of Peace member, would deploy 8,000 soldiers to Gaza as part of phase two of the ceasefire agreement. The war was triggered by the Hamas-led attack on southern Israel on 7 October 2023, in which about 1,200 people were killed and 251 others were taken hostage. Israel responded to the attack by launching a military campaign in Gaza, during which more than 71,820 people have been killed, according to the territory’s health ministry…”

Trying to extract blood from a turnip?

New Cost-Sharing Requirements In Medicaid: Considerations For State Implementation – Health Affairs

“Increasingly, evidence also shows that cost-sharing can impact health, at least for some individuals. In the largest randomized controlled trial of cost-sharing in health insurance—undertaken in the 1970s when health care costs were much lower—participants who were both poor and had chronic conditions had worse health when they were enrolled in insurance plans with cost-sharing. More recent evidence corroborates these findings, showing that higher cost-sharing deters utilization of services valuable for health. Savings accrued from utilization reductions may be partially offset by higher hospitalizations. Recent evidence also finds that cost-sharing in older and low-income populations causes higher mortality…”

CBO Releases February 2026 Budget and Economic Outlook – CRFB

CBO Releases February 2026 Budget and Economic Outlook

CBO’s grim forecast of growing US government debt may include a ‘silver lining’ for fixing Social Security.  In its analysis, CBO figures that 2025 tax-cut legislation increased projected deficits by $4.7 trillion over the next decade. That’s about the amount of money Congress will have to raise to eliminate Social’s Security pending insolvency without reducing benefits.  Walking back the Trump tax cuts is not necessarily the best way to fully fund Social Security. But CBO’s analysis shows that there’s ample room to restore solvency by reversing tax changes of a magnitude that did not disrupt the US economy.  An amount equal to CBO’s estimate of 2025 tariff revenues could eliminate most of Social Security’s financing gap. For background, see:

US needs $28 trillion more over 75 years to pay promised Social Security benefits – CCSE

BTW, it’s good to see distributional analysis of lifetime Social Security taxes and benefits in CBO’s latest report on the program’s financial outlook.

CBO’s 2024 Long-Term Projections for Social Security

New York-Presbyterian Nurses Reject Contract By Overwhelming Margin – City

“…The dramatic development unfolded hours after more than 50 nurses delivered a petition to the New York State Nurses Association headquarters demanding a formal disciplinary investigation into top union leadership over members’ claims that leaders are forcing a vote on a tentative agreement with New York-Presbyterian that rank-and-file representatives already rejected at the bargaining table.”

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Thanks to the Richmond Times-Dispatch for publishing this column:

New governor prioritizing ‘affordability’ should push reforming Va.’s regressive tax code – Karl Polzer

“…It will take some time for the new governor and Democrats running the state legislature to find effective ways to make life in Virginia more affordable. Reducing the tax burden on low-income families should be part of their agenda. Meanwhile, legislators should avoid adding taxes that hit the poor the hardest.”

States Can Push Back Against Reckless Federal Tax Policy. Here’s How. – Governing

Beware of Republicans bearing cash!

Substituting Cash for Health Insurance Can Drive Up Costs, Medical Bankruptcy – Karl Polzer/CCSE

Not! (for now)

Senate GOP health care plan fails on mostly party-line vote – Hill

As suspected, the two health care subsidy votes were performative art organized by Senate leaders setting a high bar (60/100 votes). Clock’s still ticking for millions of Americans needing health insurance they can afford.

Health Care–Related Savings Accounts, Health Care Expenditures, and Tax Expenditures – JAMA
“Conclusions and Relevance: Participation in FSAs is associated with higher health care expenditures and tax expenditures, while HSAs are not associated with reduced expenditures. Tax policy could be better targeted to enhance insurance coverage and health care accessibility.”

Why Substituting Cash for Insurance Can Drive Up Both Total Costs and Individual Medical + Financial Risk – Statement to US Senate Finance Committee

Submitted to Finance Committee Hearing: “The Rising Cost of Health Care: Considering Meaningful Solutions for All Americans”

“No matter how many adjustments the government might make, giving people money to leave the risk pool and bargain on their own with the players in health system undermines the basic concept of insurance – which is pooling risk and resources to make hard-to-predict future expenses more affordable.”

A ‘conservative/progressive’ path to negotiating Social Security solvency: Bend the cost curve, grow revenue, and protect low earners – Karl Polzer/IQInk

Updated Oct. 8, 2025

“This paper presents options – some favored by conservatives, others by progressives – as a framework for negotiating an equitable solution to Social Security’s financing shortfall.  Taken together, the changes could generate up to twice as much in savings and revenue as needed to balance Social Security’s books…

“Congress could strike a deal drawing about half the savings needed to fix Social Security through a gradual benefit reduction by changing the formula for determining initial benefit levels while protecting the lowest earners.  The rest of the gap could be filled through tax increases.  These financing options provide room for targeted benefit improvements to help the lowest income pay their bills and families raise children.”

Judge says Trump administration ‘used antisemitism as a smokescreen’ against Harvard – USA Today

Trump Administration’s Cuts to Harvard Funding Are Unconstitutional, Judge Rules – msn/WSJ

CCSE correspondence with Harvard President Garber

“Prediction: Harvard University will be teaching students from all over the world long after what remains of Trump and his brain trust rest in silence beneath the ground. BTW, White House staff could benefit from taking free public finance courses at Harvard’s Kennedy School of Government. Harvard has a positive fund balance. The United State government, not so much.”

No peace, no prize. – Karl Polzer

“Republican members of the US Congress, which is financing Israel’s now escalating ethnic cleansing of Gaza, have nominated President Donald Trump for the Nobel Peace Prize.  It is hard to fathom the depth and irony of their fawning depravity.  The Nobel prize is clearly a trophy that he covets. But shouldn’t a peace prize have something to do with reducing conflict and killing? The US president and Congress, including a majority of Democrats, are doing the opposite of making peace.  They are facilitating Israel’s daily, systematic killing, starvation, and displacement of entire populations of Palestinians in Gaza and the West Bank…”

Trump ‘1-2 punch’ shifts tax burden from top onto middle-and lower-income Americans – Karl Polzer/CCSE

“Economists and business analysts increasingly agree that Trump’s tariffs are raising prices. There is far less awareness that the historic spike in tariffs – coupled with the tax cuts just made permanent by Congress – comprise a major shift in the tax burden. Taken together, these two changes promise to make the US tax system more regressive. In our increasingly unequal country, taxpayers at the bottom of the economic pecking order are taking on proportionally more of the tax burden as the well-off shoulder less…”

New capitalism III: Capital – Branko Milanovic

“Why is capital so concentrated and why so few have it?”

“The new capitalism has even in the rich countries failed to produce what Margaret Thatcher, and Friedrich Hayek before her, called ‘property-owning society’. (For good measure, Thatcher added ‘democracy’ too.) Even when we include income from forced savings that becomes pension wealth, between one-half and almost 90 percent of the population in rich countries are financial-capital destitute. That percentage becomes more than 90, or even more than 95, in less developed countries…”

Related CCSE work:

Half of Americans have no retirement savings — here’s how Congress can look after them …. op-ed

How the U.S. Retirement Saving System Magnifies Inequality – Society of Actuaries

Growing inequality has shrunk Social Security’s revenue. Revitalizing its tax base could help restore solvency without cutting benefits.

New Capitalism in America: Richest capitalists and richest workers are increasingly the same people – Global Inequality

Branko Milanovic: The World Under Capitalism – Stone Center/Toronto Public Library

Prof. Milanovic discusses two types of capitalism – “liberal capitalism” in the US and “political capitalism” directed by the Chinese Communist Party. Both systems have produced relatively high levels of income inequality.

Comparing United States and China by Economy – Statistics Times

2025 Social Security groundhog day:

US needs $28 trillion more over 75 years to pay promised benefits

“A few months after the Trump Administration chain-sawed Social Security’s leadership and staff, four newly installed senior officials overseeing the program released the annual report on its declining financial condition.  This year’s actuarial forecast is a bit gloomier due in large part to a benefit expansion enacted by the previous Congress.  However, in the big picture, not much has changed.  Social Security’s looming insolvency remains…

“As I have pointed out to the Senate Budget Committee, the process of spending down Social Security reserves already is increasing overall federal spending and pushing up annual deficits. Drawing down reserves in the Social Security trust funds requires the Treasury to sell bonds (or find other sources of revenue) to raise cash to pay the program’s 74 million beneficiaries.

“On pp. 51-52, this year’s report estimates that Social Security will draw down $181 billion from the combined trust funds in 2025 with the amount rising to $405 billion in 2033. As a result, the federal government is gradually moving to finance part of the program’s benefits through newly issued debt substituting for now-insufficient payroll taxes...”

More on these issues can be found in these CCSE articles and testimony:

‘Trump kids accounts’ in budget bill would drive up inequality and raise the national debt – Karl Polzer/CCSE

“Helping young people learn how to save and build up money for college and adult life are worthy goals. But new ‘Trump kids accounts’ embedded in the massive Republican tax and spending bill before the US Senate not only duplicate existing programs.  They also would widen financial gaps between families in our already very unequal country.  In addition, tax subsidies for money invested in Trump accounts would go mostly to well-off families and push up the national debt…”

Failure to prosecute and jail law-breaking employers is wasting $$ billions in the fight against illegal immigration – Karl Polzer/CCSE

“The federal government has had authority since 1986 to criminally prosecute individuals and companies employing workers not legally in the United State, but it has rarely used that authority regardless of the administration in office. A one-year snapshot taken during Trump’s first term found that no company was criminally prosecuted for having workers not authorized to be in the country, a Syracuse University study shows…

“Changing the equation to incentivize employers to help enforce, rather than skirt, the nation’s immigration laws does not mean subjecting them to cruel and unusual punishment.  No need to suspend billionaires and entrepreneurs in cages from a tower or use branding irons.  It does mean applying and stiffening laws against hiring illegals and tax avoidance.  Financial penalties, public shaming, and loss of contracts could be a start.  If that isn’t sufficient, start putting law-breaking employers in jail.  They are lining their pockets by stealing jobs from American workers, both native born and those immigrating legally.”

Thanks to the Virginian-Pilot for running our op-ed:

Many questions, few answers about exempting tips from taxes – Karl Polzer/Virginian-Pilot

“Gov. Glenn Youngkin’s proposal to exempt tipped income from state taxes — like President-elect Donald Trump’s on a national level — could help some low-wage workers.  However, it also poses risks for others and raises complex issues facing scrutiny as the state legislature begins its work…”

To provide access to all readers (the newspaper’s op-eds are gated), below is the original submission including links to sources:

Youngkin pitch to exempt tips from taxes could benefit some.  A better option is raising the $2.13 tipped minimum wage.

Statement to 11/20/24 US House Appropriations Committee hearing on Social Security:

A way to ensure Social Security can meet short- and long-term promises to American workers and their families: Bend the cost curve, grow revenue, and protect lower earners – CCSE

“As keeper of the federal government’s purse strings, the House Appropriations Committee plays a part in maintaining Social Security’s commitment to American workers, their families, and taxpayers.  First, Committee members can weigh in as Congress and the Treasury find hundreds of billions of dollars annually in cash outside the appropriations process to draw down Social Security reserves.  The Committee can also help ‘leave room’ in future budgets for revenue increases that might be necessary to keep Social Security solvent as it coordinates with House Ways & Means, Budget, and other Committees on tax and spending issues.”

A ‘conservative/progressive’ path to Social Security solvency: bend the benefit cost curve, grow revenue, and protect lower earners – CCSE

The next President and Congress will face daunting fiscal issues.  In the shadow of historic levels of national debt, lawmakers will be bargaining over trillions of dollars of taxes and spending as they deal with expiration of the Trump tax cuts.  On top of that loom major Social Security financing gaps.   Paying promised benefits will require the government to raise more than $2 trillion in cash over the next eight years and more than $24 trillion to achieve long-run solvency.

This paper presents policy options – some favored by conservatives, others by progressives – as a framework for negotiating a solution.  Taken together, the changes could generate more than twice as much in savings and revenue than needed to balance Social Security’s books. 

Four ‘low-budget’ ways Congress can help working-class families raise more children – Karl Polzer/ Washington Examiner op-ed

– Expand the child tax credit to help more working-class parents and grandparents raising kids.
– Provide Social Security credit for unpaid work raising young children.
– Update/improve SSI so more people with disabilities can work, save.
– If taxes must go up, hold the working poor harmless.

Click here for longer version including references and related articles.

It’s Social Security ‘groundhog day’ as trustees repeat annual forecast of declining finances

“…The trustees’ report, however, neglects to mention how Social Security already is impacting the overall federal budget.  As pointed out to the Senate Budget Committee, the mechanics of spending down Social Security’s reserves require the Treasury to draw funds from general revenue and issue new debt to the public.  As a result, Social Security is gradually and organically moving to paying for current benefits through debt substituting for now-insufficient payroll taxes that it traditionally relies on.”

Missing the obvious: life expectancy in the U.S. is closely related to income – Karl Polzer

“The underlying theory is simple:  More income and wealth allow people and governments to support more years of life.  Fewer resources put them at a disadvantage.  Some politicians who see the connection may be leery of talking about it.  Doing so would lead to awkward questions about improving working and living conditions for millions of Americans and dealing with growing economic inequality.

“The strong relationship between income and longevity is clear when comparing states… (E)ight of the nine states with the lowest median household income also are among the bottom nine in longevity.  Similar clustering occurs comparing the highest ranked states across the two categories. Seven of the nine states with the highest median household income also are among the top nine in life expectancy.   

“Realizing they are rowing in the same economic boat could prompt states to join forces on policy changes, particularly Mississippi, West Virginia, Louisiana, Arkansas, Alabama, New Mexico, Kentucky, Oklahoma, South Carolina, and Tennessee, and others ranking at or near the bottom…

“Presidential candidate and former South Carolina Governor Nikki Haley strongly proposes raising the program’s retirement age on the premise that increased life spans are undermining Social Security’s long-term solvency.  If long-held assumptions about longevity were challenged, and potential losses to low-income workers and low-income states caused by raising the eligibility age came to light, would she change her position?  Republican candidate Donald Trump, by the way, opposes cuts in Social Security as do most Democrats…”

Thanks to the Washington Examiner for running this op-ed:

Senate minimum wage bills make bipartisan compromise possible – Washington Examiner

For longer version with references, see:

Senate minimum wage bills make bipartisan compromise possible.  Now for the political energy to get it done. – Karl Polzer/CCSE

Previous work on this issue:

One way to make living easier in Virginia – letter to WaPost

Yes, raise the minimum wage, but don’t stop there – op-ed

Analysis: Considerations on Raising the U.S. Minimum Wage To Help Workers and Families While Minimizing Negative Impacts

The US should take a hard look at the Netanyahu government’s brutality before giving it more weapons – Karl Polzer/CCSE

“More Americans are rightly asking if Israel could neutralize Hamas without massive destruction and loss of civilian life.  Indiscriminate air attacks by the Netanyahu regime already have killed and injured tens of thousands of Gazans with no end to the violence in sight.  To put this in perspective, imagine how Washington, D.C., would look if a foreign government with the power to fence in the District of Columbia dropped a comparable number of bombs here while shutting off access to water and food and destroying most of the capital area’s housing and medical system.  UN officials say conditions in Gaza are catastrophic.”

Thanks to the Washington Post for publishing our letter to the editor:

One way to make living easier in Virginia – Karl Polzer/letter to WaPost

“Virginia Gov. Glenn Youngkin (R) told reporters he is ‘concerned about the cost of living in Virginia and we’re continuing to evaluate how best to address that,’ as reported in the Nov. 26 Metro article ‘Budget battle looms in Virginia. Facing a tighter fiscal environment and Democratic control of the legislature, Mr. Youngkin and fellow Republicans could help working families without denting the budget by making an expected Democratic push for a higher minimum wage a bipartisan affair.

“The GOP has been trying to attract more minority and working-class voters. However, party leaders have stopped short of addressing core economic issues, such as supporting higher wages and better benefits, and mainly stress cultural issues…”

Background Information on these issues provided to Virginia legislators

McCarthy & Co. offer themselves up on the cross to help motivate lazy poor people back to work

Work requirements are a policy failure: Why are they still an option? – The Hill

Thanks to the Washington Post for running our letter:

“Letting Americans Down”

“How can House Speaker Kevin McCarthy (R-Calif.), President Biden and Senate leaders claim to represent the working class and poor when Medicaid work requirements are a focal point in the debt ceiling standoff and the Trump-era tax cuts are not? According to the Congressional Budget Office, the work requirements in the Limit, Save, Grow Act would have a tiny impact (about $5.6 billion in fiscal 2025) on the nation’s $31.4 trillion national debt, but they would increase the number of uninsured and state costs and have no effect on hours worked by Medicaid recipients.

“In contrast, ending the Trump-era tax cuts, which disproportionately benefit the wealthy, could put a major dent in the national debt….”

Because most of this site’s readers won’t be able to get through the newspaper’s pay gate, here’s the draft of the letter sent to the Post:

Debt ceiling negotiators focus on a ‘speck’ in benefits for the poor, ignore the ‘logs’ in their own eyes.

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