Quantcast

Gotham Gazette

The Place for New York Policy and politics

 

Opinion

Opinion

The Threat of the Trump Budget to New York City’s Social Safety Net is Very Real


children

(photo: Ed Reed/Mayor's Office)


Last month, President Trump offered a cynical vision of the future with the release of his fiscal year 2020 budget. If enacted, it would deepen poverty and widen economic and racial disparities by denying millions health care and food, ramping up anti-immigrant enforcement, sabotaging the census, and disinvesting in housing and education. Meanwhile, the proposal prioritizes guns over butter by bloating the military budget and increases tax cuts to high-income taxpayers and heirs to very large estates.

FPWA analyzed the president’s budget by showing both the present danger to New York City and putting the proposal in context with historical funding trends, as illustrated in FPWA’s recently-launched Federal Funds Tracker.

According to our analysis, the proposal would collectively cut federal revenue to a handful of key human service agencies by nearly a half billion dollars (16 percent of their federal revenue) by ending or devastating programs that support the needs of communities, children and older adults, and those who are unable to afford a basic standard of living.

Although the president’s budget is non-binding, it is still of great concern because it is a statement of priorities from the country’s top officeholder, and unless an agreement is made before the coming fiscal year (which begins October 1), Trump’s deep cuts could become reality.

Moreover, a pattern has emerged in which the Trump administration turns to administrative action when its proposals fail to get through Congress, such as the proposed rule that would slash the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) by making it even harder for unemployed and underemployed workers to access food assistance, including 50,000 New York City residents.

We evaluate the impact of the proposal on the nearly 40 federal grants that support the four New York City agencies featured in the FPWA Federal Funds Tracker – the Administration for Children’s Services (ACS), Department of Youth and Community Development (DYCD), Department for the Aging (DFTA), and Department of Social Services (DSS) – and in turn, the nonprofit human service providers who rely on these grants.

These four agencies’ federal grants represented 38 percent ($2.9 billion) of the City’s total federal grants in FY 2018.

fy19 adopted budget by

FPWA analysis of FFIS and NYC CAFR and OMB data, and Congressional Budget Justifications

Trump’s FY 2020 vision extends the economic pain that has endured throughout this decade into the next. Our analysis reveals that, adjusting for inflation, all federal grants to the City fell by nearly $2 billion since FY 2010, including hundreds of millions in support for human services.

In large part, disinvestment over the last decade is due to the 2011 Budget Control Act (BCA), which set caps on defense and nondefense discretionary funding through 2021 and further reduced funding over time through across-the-board spending cuts known as sequestration.

This disinvestment has real life consequences. Federal grants are often passed through from City agencies to nonprofit human-service providers to support the needs of their communities and attract and retain qualified staff.

For example, the Chinese-American Planning Council, Inc. relies on federal support to serve more than 60,000 individuals and families across Manhattan, Brooklyn, and Queens. CPC’s federal support would be cut by 44 percent ($2.5 million) under Trump’s budget, driven in part by the proposal to eliminate the Community Services Block Grants.

CSBG – which has already fell by 14 percent since FY 2010 – supports a wide range of community-based activities to reduce poverty, such as CPC’s LEAD program at the High School for Dual Language and Asian Studies. The LEAD program helped a struggling high school student assimilate into a new school, improve her language skills, and ultimately go on to be a successful student.

When the federal government abdicates its responsibility, New York City’s commitment to caring for people who are struggling to afford basic needs means that it is often left to fill the gaps. Indeed, since FY 2010, the City has invested an additional $2.2 billion (nominally) to support these agencies. In other words, the money that New York City spends on human services in the absence of sufficient federal support could be spent on other investments equally important to the City’s quality of life, such as transportation, safety, education, cultural institutions, and the environment.

Americans have already endured nearly a decade of federal austerity. Congress – which has begun work on FY 2020 spending bills – should chart a new vision for the new decade by reaching an agreement that not only reverses course on the planned sequestration cuts but also meaningfully increases support for the woefully underfunded programs that serve low-to middle-income families, and that, when properly funded, strengthen the economy and improve the quality of life for all New Yorkers.


***
Derek Thomas is Senior Fiscal Policy Analyst and Gaurav Gupta-Casale is Fiscal Policy Associate at FPWA. On Twitter @FPWA.

***
Have an op-ed idea or submission for Gotham Gazette? Email This email address is being protected from spambots. You need JavaScript enabled to view it.

SimCity Showed Us Brilliant Civic Tech Interfaces 30 Years Ago. We Should Build Them for Real Now


simcity balkind

(SimCity image via nycj blogspot)


I was eight years old when I first encountered a computer game called SimCity. The general premise of the game was that you were the mayor of a virtual city, and you would use game money to create a place for communities of “Sims” to live.

First you set up basic infrastructure like roads, pipes, and zoning and soon after, the “Sims” would arrive to build buildings and pay taxes. As tax revenue flowed in, you would use it to make citywide improvements by establishing public infrastructure like schools, hospitals and parks. The more robust your city’s services, the more Sims would want to live there, and the more tax revenue would roll in. As the game progressed and your city grew, your decisions as mayor became increasingly complex. However, an easy-to-use interface simplified the tasks and made the whole experience a lot of fun.

That was 1994, and at the time, I assumed that one day, my neighbors and I would all have a hand in understanding and shaping New York City through tools and interfaces like SimCity’s. Apparently I wasn't the only one. A recent story in the LA Times claims that "'Sim City' inspired a generation of city planners."

As the internet was getting increasingly popular, my confidence in that idea strengthened. How difficult could it possibly be for the biggest city in the world’s richest country to create “Sim NYCity”?

Apparently it's quite difficult -- not from a technical perspective, but from an organizational development one.

Technically, government agencies have the vast majority of the data SimCity offers to viewers, such as geographic information like zoning and elevation; statistical information like crime and graduation rates and population; and infrastructure monitoring like traffic, electricity use, water flow rates, etc. But bringing it all together to give the residents an intelligible, (relatively) real-time dashboard for seeing their city operate clearly just isn't a priority.

Thanks to the tireless work of open source software developers and open government advocates, we don't have to wait for our city to organize this information for us. We can -- and should -- begin to do it ourselves.

Here are a few of the features that would make "SimNYCity" such a valuable contribution to civic life.

Interactive Community Maps
The centerpiece of the system is a map similar to Google Maps or the City's Planning Lab's new Community District Profiles website. It would have highly curated data layers that display education, health, police, fire and mass transit indicators (in SimCity parlance: data maps), as well as useful demographic information of residents.

Anyone could click a few layers on and off to see which neighborhoods have access to which services, and which don’t. Users could select which facilities they’d like to see added to an area, and then receive a projection of how the addition of such a facility would impact access in the neighborhood. Of course, accurate projections would be difficult to create, but basic estimates wouldn’t be, and more importantly, the existence of such a tool would whet the public’s appetite for more information and involvement in planning processes.

Citizen-Driven Budgets

citizen driven budget 1

[Offering opinions on the budget could be as easy as pulling a few sliders]

Managing the budget was one of the most important jobs of the mayor in SimCity. The tool for doing this was similar to a mortgage calculator. Income and expenses were presented with about 10 line items each, and you could pull the slider in one direction or another to change funding allocations and see how those allocations impact the entire city's budget.

We should offer a similar tool to New Yorkers. We can synthesize the New York City budget from thousands of line items into a dozen or so, enabling anyone to quickly see how money flows in and out of the city’s government. Then we can invite them to create their budget by pulling sliders. As they do, the city’s budget projections change.

So, if someone would like to increase the education budget they would toggle education to the right. Then they might adjust revenue by increasing taxes to balance the budget. Bonds could be included into the mix too by showing a list of public bond offers and requests. This type of tool would allow New Yorkers to create the budgetary mixes they want to see, and they can share it with others.

We could also generate statistics about all the different budgets New Yorkers create to develop insights about how the city’s budget could more accurately reflect the values of the city's residents.

Decision-Making Moments

decision making moments

[City advisers could send out messages to New Yorkers and ask for their direct feedback]

When time sensitive decisions were needed in SimCity, a popup would appear with a message from an adviser asking the mayor for a decision. “SimNYCity” could work similarly by providing citizens with more opportunities to indicate their preferences on key civic issues.

For example, when a controversial zoning change is being proposed, an alert from the Commissioner of City Planning could be sent to SimNYCity users saying something like: "Residents are wondering what you plan to do with the Bedford Armory. Here's some information about the various interest groups. Do you think the current proposals should move forward or should it be rewritten?" Users could then say what they think.

This type of feedback could provide useful information for city leaders that they could incorporate into their decision-making processes. A similar workflow could be used for legislative and administrative decision-making.

Moving Beyond the Vote

moving beyond vote

[Imagine if all the active and proposed city ordinances were laid out in a simple list]

Our current democratic processes are, unfortunately, failing New York City. Less than 25% of eligible New Yorkers voted in the 2017 election cycle, in which over 95% of incumbents won their primaries and went on to win uncompetitive general election races. This means that a very small group of Democratic Party insiders are the people determining who will serve in New York City government. That isn’t very democratic, and it's the main reason so few New Yorkers show up to the polls.

We don’t have to wait for deep reforms to our city’s democratic processes before we start experimenting with new and innovative ways to provide participatory democratic experiences to New Yorkers. We can offer citizens methods for engagement right now - and if these methods turn out to be popular, then we can organize the public to pressure existing politicians into incorporating these methods into their decision-making processes.

These are just a few interfaces SimCity has for making cities and their governments more legible, and interacting with them more enjoyable. The technical hurdles to implementing similar interfaces for the city are certainly significant, but not impossible to overcome.

Planning Labs, a digital service organization within New York City’s city planning agency is building open source software and open data resources that could power many of the complicated mapping elements. Furthermore, New York City's Open Data law mandates that much of the information we'd need from the government to build such a system is being published to the city's official Open Data Portal.

Exploring what that data is and how it can be connected together to build the type of deep data resources needed to power interfaces similar to SimCity's is the next step -- and it's work my team at Sarapis has begun to do by extracting and connecting nearly a dozen (and counting!) city datasets together to create data-driven government agency profiles that will make it easier for civic-minded people, especially journalists, to navigate and use for their work.

Through this process, we’re learning what data is and isn't available, how that data can be connected together and visualized to deliver insights to our users, and what next steps need to be taken on the long journey of delivering New Yorkers a SimCity style interfaces for their city.

***
Devin Balkind is the president of Sahana Software Foundation, founder of Sarapis.org, and a former candidate for New York City Public Advocate. He speaks regularly at conferences around the world about using technology to overcome environmental and political crisis. On Twitter @DevinBalkind.

***
Have an op-ed idea or submission for Gotham Gazette? Email This email address is being protected from spambots. You need JavaScript enabled to view it.

At 94%, New York Health Insurance Coverage Best of Four Most Populous States


protecting hc nyc

(photo: Kevin P. Coughlin/Office of Governor Andrew M. Cuomo)


New York State had achieved the highest percentage of residents with health insurance coverage of the four most populous states in the country by 2017, according to the Kaiser Family Foundation, one of the nation's leading health research organizations.

Ninety-four percent of New York's residents had health insurance coverage that year; California was second, with 93%. Both of these states accepted the Obamacare Medicaid Expansion, and both had 26% of their populations served by Medicaid in 2017. Texas and Florida, the other two of the four most populous states, both rejected the Medicaid expansion and had 83% insured and 87% insured, respectively. The United States as a whole had achieved 91% of its population covered by health insurance by 2017.

health insurance coverage1

A report by State Comptroller Thomas DiNapoli actually pegged New York's health insurance coverage rate even higher in January 2018, at 95%, citing Center for Disease Control data. Either number for New York, 94 or 95%, reflects a solid record of attainment of social well-being in the state; not perfect, by any means, but very good.

So how did New York get there?
This article looks at how New York's policies achieved these positive results, as well as prospects for improvement.

First, however, it's useful to take a look at the immediate pre-Obamacare environment for the nation and these most-populous states, as well as how the states and the nation were faring in 1998-2000 as the Clinton administration came to a close in a period of substantial economic growth.

The following tables look at health coverage in the United States and the four big states in 2008 and 2010, as the Great Recession was beginning and ending.

health insurance coverage2

In 2008, 15% of the nation's residents did not have health insurance and 13% were in the Medicaid program. In New York, 12% of residents were uninsured and 13% of residents were on Medicaid. By 2010, after the Great Recession, the uninsured had risen to 16% of the country, and 17% on Medicaid. In New York, uninsured was still 12%, but 22% were on Medicaid.

A 2001 U.S. Census Bureau report showed uninsured rates for 1998-2000.  As the American economy continued to expand at the end of the Bill Clinton years, health insurance coverage reached 14% uninsured by 2000.

New York's situation was worse than the nation in 1998-2000, with 15.7% of its residents uninsured in 1998, and 15.1% uninsured in 2000.

In 2000, California had 17.9% uninsured, Texas 23.2%, and Florida, 17.2%. New York, at 15% uninsured, had a higher percentage of its residents with health insurance of the four largest states, but all four had higher levels of uninsured than the nation.

What happened? First: the Defeat of Block Grants for Medicaid
After the Republican Party won the House and Senate in 1994, the new Republican majorities passed legislation to limit Medicaid spending by providing a capped lump-sum amount of money for Medicaid to every state in the country, effectively eliminating the program as an entitlement. This lump sum was called a Block Grant.

Initially, welfare and other spending for poor people would also be given to states as a block grant. President Clinton vetoed this entire package in December 1995. New York Governor George Pataki made similar proposals, which were rejected by the Democratic-controlled Assembly. Ultimately, Clinton was able to force Congress to separate Medicaid from welfare, with welfare becoming the "Temporary Assistance to Needy Families" block grant (in New York), while Medicaid health care was preserved as an entitlement for the poor.

Enter Child Health Plus and Family Health Plus
In 1997, President Clinton proposed and Congress approved a program to expand health insurance coverage for children up to age 19. In 1999, the New York State Legislature passed legislation, which Governor Pataki signed, authorizing New York to apply for approval from the federal government for a program to be named Family Health Plus, enrolling the parents of children in Child Health Plus (CHP), up to 150% of the poverty level, in the Medicaid program.

Childless adults earning up to 100% of the poverty level would also be permitted to enroll. CHP in New York had enrolled over 500,000 children by 2001, and the federal government approved the Family Health Plus waiver. Implementation was planned for the fall of 2001.

A Health Emergency is Declared in New York After 9/11
The horrific impacts of the September 11, 2001 attacks on the United States and New York are known as part of American history.

But there was a side story about health care in New York that is less well-known. The New York State government's Medicaid computers were in the World Trade Center and were destroyed in the attacks.

These computers contained the information on the eligibility of those enrolled in the Medicaid program. Medicaid was very bureaucratic; recipients had to submit proof of their continued eligibility every year in a recertification process. After the Medicaid computers were destroyed, Governor Pataki announced on September 19, 2001 that New York had received an emergency waiver of the recertification requirements for Medicaid for New York City only through January 31, 2002.

A program known as Disaster Relief Medicaid was implemented that allowed persons to merely fill out a one-page document and attest they were eligible for Medicaid -- 350,000 people enrolled by the deadline.

New York's Family Health Plus program began its implementation shortly after 9/11 as well, allowing adults with children and earning up to 150% of the poverty line to enroll in Medicaid. A national recession was underway at the time of the 9/11 attack -- exacerbated in New York, of course, by the devastation in downtown Manhattan.

New York State lost nearly 200,000 jobs between August 2001 and August 2003, heavily concentrated in New York City. The confluence of all these events resulted in a major expansion of the Medicaid program in New York State; enrollment rose from 2.7 million in 2000 to 3.9 million in 2004.

New York State also began subsidizing small-group private health insurance through a program known as Healthy New York, where subsidized enrollment reached 145,000.

New York 2005-2013: The Great Recession, Medicaid Reform, Preparing for Obamacare
The New York State economy recovered from the recession and the Trade Center attack from 2003-2008, and the Medicaid rolls remained fairly stable, reaching 4.1 million in 2008. The Great Recession began in 2008, with the nation losing 8.5 million jobs from 2008 through February 2010.

New York lost more than 300,000 jobs and about 1 million residents were added to the Medicaid program, bringing Medicaid enrollment to about 5 million before Obamacare, enacted in 2010. This major new program, intended to provide health insurance to 30 million or more additional Americans, had a lead time of several years for the states to develop the ability to implement it.

The recession caused staggering New York State budget deficits. Struggling to cope, both Governors Paterson and Cuomo undertook intensive cost-containment efforts in the Medicaid program while maintaining and even enhancing eligibility. Participation in managed care became standard for Medicaid recipients, even the disabled. New York enacted some utilization limits and tightened reimbursement rates for providers. But the State still took steps to streamline and simplify Medicaid, such as allowing 12-month eligibility periods, eliminating the asset test and fingerprinting, affirming the experience of Disaster Relief Medicaid.

New York also accepted grants from the federal government to get Obamacare up and running by the beginning of 2014. New York integrated its Medicaid program with the new Obamacare health exchanges, in what became known as New York State of Health. Family Health Plus was folded into Obamacare. State government planned for the state to centralize Medicaid administration and take over enrollment processing for persons newly applying for Medicaid as well as the private health insurance plans offered on the exchanges.

Obamacare: 94-95% of New Yorkers Now Insured
By 2013 New York had reached 89% of its population covered by health insurance, and launched Obamacare in 2014. Another 1.2 million New Yorkers were enrolled in the Medicaid program and 250,000 in the new private plans during the Obamacare rollout.

New York adopted a screening policy for applications through the Exchange to enroll residents in Medicaid if they were determined to be eligible, resulting in New York's small private plan enrollments. After all, the federal government was covering 100% of the new costs up to 2019.

New York also received approval in 2015 from the federal government to add residents not eligible for Medicaid into a new insurance program called New York Essential Care, which now covers nearly 750,000, including adults from the Family Health Plus program whose eligibility for Obamacare Medicaid had not been preserved in the switchover. Comptroller DiNapoli's report cited New York as one of only two states in the country to create such a Plan (which is being paid 93% by the federal government). Adding this program to Medicaid enrollment (now 6 million plus) brings 7 million New Yorkers into non-Medicare public plans. 95% of New Yorkers now have health insurance.

The state government recently took important steps to codify elements of the Obamacare rollout into state law through the new state budget, protections toward stability in case there is significant undercutting of the health care law via the Supreme Court or other federal action.

Three Legislators
Three members of the New York State Legislature deserve special mention for extraordinary leadership in the state’s achievements in health insurance. One is Assemblymember Dick Gottfried of Manhattan, the senior member of the Legislature who has chaired the Assembly Health Committee since 1987. Second is State Senator Kemp Hannon, a Republican from Nassau County, who chaired the State Senate Health Committee and supported the Medicaid expansions and shepherded them through the Republican-controlled State Senate. He was defeated in 2018. And third, James Tallon, who served in the State Assembly from 1975-1993, as Majority Leader and Gottfried’s predecessor as chair of the Health Committee. He became President of the United Hospital Fund in 1993 and became the state’s intellectual leader in health care.

What’s Next?
New York still has 1 million to 1.2 million residents without health insurance. The Kaiser Foundation reports that 8% of New York non-elderly adults age 19-64 still do not have health insurance.

Recently the de Blasio administration announced a plan to enroll several hundred thousand more New York City residents without health insurance into a New York City insurance plan based on its network of municipal hospitals and clinics, which have their own Medicaid Managed Care Plan (the city is also attempting to enroll undocumented immigrants, who can’t be insured, into health care plans where they are assigned primary care doctors).

The city’s efforts are a good idea and the New York State government should help the city by paying for outreach and facilitated enrollment.

New York could still build on the substantial increases in health insurance outside New York City as well, and continue efforts to provide small group coverage through its Exchange. The top five states for insurance coverage in the nation have reached 96-97% of their residents insured.

And Single-Payer? Don’t Forget Donald Trump
The New York State Assembly has passed a single-payer health plan, called the New York Health Trust, several times, as recently as 2018,; it is now bill A. 5248 in the current legislative session.

Moving forward with such a plan still has innumerable hurdles, one of which involves folding the Medicare program into a comprehensive New York health insurance plan, necessitating federal government approval under the Trump administration, which is not likely. Single-payer must also pass the State Senate and be supported by Governor Cuomo.

Going into the 2020 presidential election, even if Donald Trump is defeated and the Democrats take back the United States Senate it's not certain there will be a national consensus on single-payer or Medicare-for-All. Incremental progress might still be the choice. It is clear New York State has made great progress and still has the capacity to do better, something New Yorkers should be proud of.

***
Jim Brennan was a member of the New York State Assembly for 32 years, where he chaired four committees. On Twitter @JimBrennanNY.

 

***
Have an op-ed idea or submission for Gotham Gazette? Email This email address is being protected from spambots. You need JavaScript enabled to view it.



Print Friendly and PDF

Editor's Choice


Gotham Gazette: What's The [Data] Point? 5, with former Deputy Mayor Alicia GlenWhat's The [Data] Point? 5, with former Deputy Mayor Alicia Glen Gotham Gazette: City Council Examines De Blasio's 'New York Works,' Said to Have Produced 3,000 Jobs of 100,000 Goal City Council Examines De Blasio's 'New York Works,' Said to Have Produced 3,000 Jobs of 100,000 Goal Gotham Gazette: City Council Seeks Expanded Power, Sweeping Change in Charter Recommendations City Council Seeks Expanded Power, Sweeping Change in Charter Recommendations Gotham Gazette: The Max & Murphy Podcast The Max & Murphy Podcast