SEATTLE – In its current form, the big tax bill now nearing passage in Congress would raise health-insurance premiums and force millions of people to lose access, according to one analysis of federal figures.

Health economist Emily Gee with the Center for American Progress estimates that nearly 290,000 Washingtonians would lose coverage over ten years. She says that's because the bill repeals the individual mandate, which now requires people to have insurance or pay a tax penalty.

Gee says without it, estimates are that annual premiums will rise.

"If healthy people leave the insurance markets, that means that overall, the average person is sicker," she explains. "Insurers would need to raise premiums. The Congressional Budget Office thinks that would be about a 10-percent increase over the next decade."

Congressional Republicans argue that repealing the individual mandate would permit people who want to, go without insurance. Gee counters that some of them would end up costing the system more, by showing up uninsured in emergency rooms when they need medical care.

Gee says that kind of uncompensated care decreased under the Affordable Care Act but could climb again if the tax bill passes. She adds it's an especially serious problem for smaller hospitals.

"Particularly in rural areas or areas where the hospitals are under a lot of financial strain, a big increase in demand for uncompensated care could be tough, or even devastating," she warns.

The Center also estimates that the bill would trigger more than $440 million in cuts to Washington state Medicare payments next year, because of Congressional spending rules. Gee says the bill would increase the deficit enough to force $400 billion in Medicare cuts nationwide over 10 years.

"These cuts are automatic," she stresses. "You wouldn't see Medicare necessarily mentioned anywhere in the tax bill. But it would, by law, these automatic cuts would go into effect starting in 2018."

The bill's supporters say Congress could decide to exempt Medicare from the cuts at a later date.


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A new report analyzes Pennsylvania's existing voucher programs, that divert public funds to private schools.

This comes on the heels of Gov. Josh Shapiro's plan to create a new voucher program for K-12 students.

Diana Polson - senior policy analyst with the Keystone Research Center - said last year's Commonwealth Court decision ruled that Pennsylvania's system of funding public education is unconstitutional, therefore the state doesn't have a dollar to waste on expanding existing private-school voucher programs or creating a new one.

"The basic-education funding commission estimated the state must pay $5.1 billion over the next seven years to make sure our public schools are funded equitably and adequately," said Polson. "Meanwhile, our report finds that existing private-school voucher programs are siphoning millions from taxpayers with little to show for it."

Supporters argue that vouchers let children leave under-performing public schools and get a better education at private schools.

Polson said Pennsylvania's voucher programs have no "meaningful educational or financial accountability," so they really have no way of knowing if these programs operate as intended or are beneficial to low-income or moderate-income students.

Polson said the report reveals that the programs have grown, and just this year they will cost the state nearly $500 million.

However, these voucher programs exclude students in rural areas, because there are few if any participating private schools in these regions.

Local public schools remain the primary option for most rural families.

"We also found that private schools receiving these funds are allowed to - and do - routinely discriminate against students for reasons including disabilities, sexual orientation, religious beliefs and more," said Polson. "These programs are also exclusive. They subsidize the state's most elite and expensive private schools as well as affluent families."

Polson said the report reveals that the Independent Fiscal Office estimated that the average EITC program scholarship was $2,314, while the Opportunity Scholarship Tax Credit was slightly less at around $2,000.

The cost of attending one of the top 25 private schools in Pennsylvania is around $41,000 per year. This means these schools are still out of reach for many low- and moderate-income families.

As Nebraska's 2024 legislative session draws to a close, family caregivers and their supporters are closely watching the progress of Legislative Bill 937, the Caregiver Tax Credit Act.

The bill provides eligible family caregivers up to $2,000 in tax credits for out-of-pocket expenses or up to $3,000 if the family member receiving care has dementia or is a veteran.

Jina Ragland, state director of advocacy and outreach for AARP Nebraska, said family caregivers are filling health care gaps in the state, especially with 15 Nebraska counties currently lacking a nursing home or assisted-living facility. Ragland argued the state's family caregivers need and deserve financial support.

"We really feel they're the backbone of the U.S. care system," Ragland emphasized. "Especially here in Nebraska because they're helping parents, they're helping loved ones live independently in their homes."

Family caregivers in the U.S. spend an average of $7,000 per year in out-of-pocket expenses. Employed caregivers sometimes lose wages when they have to take time off for caregiving responsibilities. Others retire early, losing both wages and retirement income.

The bill includes an income limit of $50,000 for individuals and $100,000 for married couples. Sen. Eliot Bostar, D-Lincoln, introduced the bill on behalf of AARP Nebraska. The legislature is expected to debate the measure for the second time this week.

Joyce Beck of Grand Island knows firsthand the emotional and financial strain of being a caregiver and losing a loved one. She retired early to care for her husband, who suffered from multiple sclerosis and cancer. In addition to significant out-of-pocket expenses, her Social Security and pension payments are both lower because she retired early.

Beck said she knows some Nebraskans face bigger financial struggles as a result of their caregiving.

"If there's any financial support that we can give, that would be so beneficial," Beck contended. "Some people don't have the option of a retirement account or a pension plan, so $2,000 would be huge for them. "

Ragland stressed family caregivers are helping Nebraska taxpayers as well. When their caregiving delays or prevents expensive-nursing home placement, it contributes to lowering the state's Medicaid costs.

"An important concept for people to understand is the value of those people who are just doing what they think is right," Ragland asserted. "The time and the money and the energy that they're providing as family caregivers to offset, again, the gaps in the care services that we have in our communities."

Six states currently offer a caregiver tax credit, and there is a bipartisan bill in the U.S. Congress to enact one at the federal level.

As California faces a $38 billion budget deficit, state lawmakers have identified $17 billion in potential cuts before the Legislature begins crunching the numbers later this week.

Initial plans include shifting some funds away from job training programs but the idea is getting some pushback. Advocates of the programs said at a time when skilled worker shortages plague essential sectors, investments in job training are needed.

Lisa Countryman-Quiroz, CEO of San Francisco-based Jewish Vocational Service, a nonprofit job training agency helping to match jobseekers with employers, said current economic conditions call for investment in programs like theirs.

"This is absolutely critical given the cost of living, given rising economic inequality in the state of California, the people who really want to be able to provide for their families, people who want to be able to advance in their careers," Countryman-Quiroz outlined. "We are helping people get there."

Democrats, who hold a supermajority, agreed last week to reduce the state's projected shortfall through spending cuts, delays, deferrals and cost-shifting. The budget debate could start as soon as Thursday.

Countryman-Quiroz said while job training can have high costs, workforce investments often pay for themselves by closing opportunity gaps in employment and creating economic revenue. She cited one program, known as the High Road Training Partnership.

"We see a really positive return on investment," Countryman-Quiroz pointed out. "Every dollar that JVS specifically has received in HRTP funds has resulted in $2 in wages for the jobseekers that we work with."

Jordan Hernandez, a graduate of the High Road Training Partnership, said he has successfully accessed both education and job opportunities.

"This program has given me a lot of confidence, especially with school things," Hernandez noted. "I never thought I'd be in school, so once I got into this program, I was very nervous, but they were very welcoming. They treated me with respect, and they understood where I was coming from."


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