Many Minnesotans struggle to make ends meet while others prosper

income-inequality-blog-contrast-02Income inequality has gotten worse in Minnesota – and every state – over the past 50 years, and the highest-income households today hold a much higher share of total income, according to Census data. Even in the last decade, the share of income that has gone to the top 5 percent of households in Minnesota has risen. In 2006, their incomes were about seven times as high as the incomes of the 20 percent with the lowest incomes. By 2015, their incomes had grown to almost eight times that of low-income households.

Growing income inequality contradicts some of the country’s most deeply held values. Americans believe that hard work should pay off, that people who work full-time should be able to support their families, and that everyone should have the opportunity to succeed no matter their background. Income inequality can also be bad for the economy. When low- and middle-income households have a smaller share of the economic prosperity they help produce, it can dampen consumer spending, and slow down an important driver of economic growth.

Low-income households struggle to make ends meet and cover the costs of living. And while the cost of living is often lower in parts of Greater Minnesota, it can actually be even harder to make ends meet there. For example, in Hennepin County, low-income workers’ household incomes are $4,900 below the regional cost of living for one person, but low-income households in Mahnomen County earn nearly $10,000 less than what it costs for basic necessities.

Minnesota has some work to do so that all Minnesotans can get ahead in today’s economy. This includes improving wage and job quality standards, improving access to affordable health care and child care, and making sure workers can find housing and have transit and transportation options to get to where the jobs are. The ways we do that need to take into account the specific barriers facing Minnesota workers in each part of the state, but there’s no doubt that we need all workers to thrive for our state to thrive.

-Nathan Williams

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October economic update shows state revenues and expected economic growth down

This week’s October Revenue and Economic Update gave us somewhat unwelcome news about the state’s economic and budget landscape. The quarterly report from Minnesota Management and Budget (MMB) showed that recent state revenues have come in below projections, and national economic growth is expected to be slightly lower for the next few years than previously projected.

Some of the top takeaways from the Update include:

1. State revenues are coming in below projections. The state’s revenues for the first quarter of FY 2018 (July to September 2017) came in $66 million below projections; that’s 1.4 percent less than projected in the state’s February 2017 Economic Forecast. This is primarily due to lower income taxes received. One spot of good news is the state’s FY 2017 revenues. While preliminary estimates showed revenues coming in 0.5 percent below expectations, the final revenue numbers for FY 2017 are in and were right on target.

2. Slightly lower national economic growth projected over next few years. The national economic forecasters predict 2.2 percent national economic growth for 2017. Despite recent natural disasters, which have delayed economic growth, this is only slightly below the projection from the February forecast. Also, the state’s economic forecasters have changed their assumptions about federal policy action. Previously, the forecasters assumed that federal policymakers would enact tax reductions and increase infrastructure spending, which would boost growth in 2018. They have now removed those assumptions from the model they use to predict how the national economy will fare, bringing down expected growth in 2018 from 2.7 percent to 2.4 percent.



3. Unemployment nationally expected to remain low. Nationally, unemployment in September declined to 4.2 percent. The annual unemployment rate for 2017 is expected to be 4.4 percent, which is expected to improve slightly to 4.3 percent until 2020.

4. Despite uncertainty around federal policy changes, forecasters are fairly confident in their projectionsThe forecasters assign a 65 percent chance to their baseline forecast. They also give a 20 percent chance for a more pessimistic scenario and assign a 15 percent probability to a more optimistic scenario.

This week’s Update brings us reason for caution. At the federal level, policymakers are proposing serious funding cuts that will make it more difficult for Minnesota to continue to make the investments that strengthen our state and build shared prosperity. President Donald Trump, and the U.S. House and Senate have all put federal budget plans on the table that:

  • Significantly cut into annual non-defense appropriations, a substantial portion of which go to state and local governments;
  • Include massive cuts to health care funding, again much of which goes to states to fund Medicaid, which helps Minnesotans of all ages access the health care they need; and
  • Make deep cuts in assistance to low-income and middle class families through the entitlement portion of the budget, which includes SNAP food assistance, Supplemental Security Income for seniors and people living with disabilities, unemployment insurance, Pell grants and student loans. Again, some of these cuts would push funding responsibility to the states, and others would increase hardship among Minnesota residents and pressure for the state to respond.

This week’s update should give Minnesota’s policymakers pause. The budget that they passed in the 2017 Legislative Session left very little of the projected surpluses, even though there were warning signs that the job of meeting the needs of Minnesotans is likely to get a lot harder.

The next look at the state’s fiscal and economic health will come in early December with the release of the November Budget and Economic Forecast, which will give us a full picture of state revenues, expenditures and economic projections.

-Clark Goldenrod

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Minnesota’s Health and Human Services budget deal puts state fiscal stability at risk

Minnesota legislators put both the state’s balanced budget and Minnesotans’ health at risk with the Health and Human Services budget bill signed into law this session. The legislation cuts $463 million in general fund spending in FY 2018-19 for the portion of the budget that includes critical services for sick children, Minnesotans struggling with mental health issues or addiction, people with disabilities, and the elderly. The bill relies on fund transfers and various shifts to make up some of the difference. But it has left Minnesotans more vulnerable to federal policy changes, such as those that threaten access to affordable health care through the Children’s Health Insurance Program (CHIP), MinnesotaCare, and Medicaid.

Putting affordable health care in jeopardy with risky financial choices and a new layer of unnecessary bureaucracy

For over two decades, a 2 percent provider tax has generated revenue intended to fund statewide access to affordable health insurance. The revenue from the provider tax accrues in the Health Care Access Fund (HCAF). From there, it typically covers the state’s share of MinnesotaCare and a portion of Medical Assistance, health insurance options for Minnesotans who can’t afford the insurance offered by their employer or on the individual market.

Prior to the 2017 Legislative Session, the provider tax more than covered all of its commitments until FY 2021. As a result, a surplus built up in the HCAF. The surplus was projected to rise to $1.2 billion by FY 2021. This critical reserve could have helped offset any forthcoming federal cuts to health insurance assistance. It could have financed innovative new policies to connect even more Minnesotans with affordable health insurance, building on our past successes to ensure that fewer Minnesotans would need to choose between pay for a prescription and making a car payment.

Instead, the HHS budget bill nearly empties the HCAF, using those funds for existing services previously financed by the general fund and paying for the state’s high-risk pool for health insurers. As a result, the HCAF will have just $4.4 million available in FY 2021. This leaves Minnesota with fewer resources to respond if federal policymakers follow through on their plans to slash federal health care funding.

Making matters worse, policymakers left in place the scheduled cancellation of the provider tax in FY 2020. As a result, the HCAF will almost certainly face a deficit in FY 2022. Extending the provider tax would be a simple way for the state to maintain its commitment to affordable health care, and was included by Governor Mark Dayton in his budget proposal.

Minnesota policymakers also put low-income Minnesotans’ health coverage at risk by enacting a new paperwork barrier to affordable health insurance. Minnesotans who have already filled out forms to become eligible for Medical Assistance will now be subject to an additional verification program. If the experience of other states is any guide, this new program will likely result in people losing their health insurance even when they are eligible for assistance.

Shifting state costs to health care providers and counties

The bill includes a cut to the amount Medical Assistance pays to the providers of health insurance for low-income Minnesotans. The lower rates will make it harder for the insurers to find doctors and other health care providers who can serve low-income Minnesotans without taking a loss. That could mean reduced access to care for the more than 1 million Minnesotans who are covered by Medical Assistance, including many of our most vulnerable neighbors.

The bill also reduces funding to counties for assessments for long-term services for people with disabilities by $19 million in FY 2018-19. This policy change was included without any prior hearings on the impact of the funding shift.

Accounting gimmicks leave Minnesota more exposed to future risk

The bill delays payments to health insurers by a few months. On paper, that creates $173 million in “savings” for FY 2018-19 and $24 million for FY 2020-21. In reality, the state will need to make up for some of these savings by paying providers what they are owed in FY 2022-23.

Some progress made on improving Minnesotans’ access to affordable child care

Minnesota policymakers took a step in the right direction by removing a barrier to stability for families participating in the Child Care Assistance Program (CCAP). CCAP makes child care affordable for low- and moderate-income families. While the new HHS budget will not reduce the CCAP’s 2,000-family waiting list, it will invest $19 million in FY 2018-19 and $30 million in FY 2020-21 to make the program work better for child care providers and the families they serve.

Minnesotans deserve better

The HHS budget determines how Minnesota will support many of our most vulnerable neighbors — seniors, children, people with disabilities or struggling with addiction, and Minnesotans who have just plain had a string of bad financial luck. Given the state projected a $1.7 billion surplus for FY 2018-19, policymakers had an opportunity to thoughtfully invest in policies that would support these neighbors in their efforts to get ahead. In one especially disappointing example, policymakers chose to leave the Minnesota Family Investment Program cash grant amount stagnant for the 31st year in a row — meaning Minnesota’s most economically struggling families will still have to somehow try to make ends meet on a budget that won’t even cover the cost of rent.

By choosing disinvestment and budget gimmicks over investments in the everyday Minnesotans who face significant barriers to financial stability, the HHS budget doesn’t just miss an opportunity to make our state stronger. In a time of great uncertainty, it leaves our existing supports much more vulnerable to threats from the federal government.

-Ben Horowitz

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Most of federal framework’s tax cuts go to top 1 percent

The federal tax framework released last week fails to prioritize our nation’s working families. Instead, it would provide most of its tax benefits to the highest-income Americans and profitable corporations. And when we consider the deep cuts in health care, food assistance and other essential federal services that the tax plan would require, it’s clear this is a bad deal.

The large majority of the framework’s tax cuts would go to the highest-income Americans. Preliminary estimates from the experts at the nonpartisan Tax Policy Center are that, when the framework is fully in effect in 2027:

  • 80 percent of the net tax cuts would go to the 1 percent of households with the highest incomes; and
  • 40 percent of the net tax cuts would go to the 0.1 percent with the highest incomes. These households would get a tax cut of more than $1 million annually.


It’s not surprising the tax framework skews so heavily to the well-off; many of the plan’s centerpiece provisions provide the greatest benefit to those with high incomes. These provisions include:

  • Reducing the top individual tax rate from 39.6 percent to 35 percent;
  • Creating a new top rate of 25 percent for “pass-through income” – a type of business income that predominately goes to households with incomes over $1 million;
  • Repealing the estate tax, which is paid by 0.2 percent of the highest-value estates nationally;
  • Eliminating the Alternative Minimum Tax, which was designed to ensure that higher-income people with a large number of deductions and other tax benefits still pay a minimum level of tax; and
  • Cutting the corporate rate — most mainstream economists believe investors and CEOs would receive the bulk of the benefit from this policy change, rather than workers.

In contrast, American families who live paycheck to paycheck would receive only a small sliver of the tax framework’s benefits. The 40 percent of American households with the lowest incomes would receive only 5.2 percent of the tax cuts in 2018, and less than 4 percent when the plan is fully in place in 2027, according to the Tax Policy Center.

The tax framework offers a number of changes in the individual income tax in the name of simplification. But the framework would make little real difference in the average working-class person’s tax-filing experience, and could even result in a tax increase. The tax framework’s proponents laud its increase in the standard deduction and Child Tax Credit, but some families will find that any benefits from those provisions are reduced or even outweighed by the loss of personal exemptions and increasing the tax rate in the lowest tax bracket from 10 percent to 12 percent. The Child Tax Credit expansion and new credit for other dependents are structured in a way that means they aren’t available to our country’s lowest-income families.

The tax framework proponents’ claim that this plan will unleash strong economic growth relies more on wishful thinking than on evidence. Let’s set aside the question of whether it is fair for the wealthy and profitable businesses to see immediate and certain tax cuts while everyone else crosses their fingers and hopes for some kind of trickle-down economic benefit. Past experience with federal tax cuts and in states like Kansas shows that tax cuts aren’t a silver bullet for creating economic growth, especially when those tax cuts are combined with increasing deficits or cuts in public investments that support working families and build the economy.

What is certain is that we all would be harmed by the budget choices that come along with this tax plan. The tax framework is estimated to cost $2.4 trillion over the next decade. In the House, the budget vehicle that is being used to advance the tax framework calls for cuts in federal services that help families afford the basic necessities — such as Medicaid, Medicare, and food assistance through SNAP. And under the Senate’s budget framework, $1.5 trillion of the tax plan’s costs would be added to the deficit, creating additional pressure down the road on anti-poverty programs as well as other federal priorities from transportation to scientific research.

This unbalanced and fiscally irresponsible tax plan isn’t the way to build more broadly shared prosperity. Instead it would increase hardship and inequality. Policymakers should go back to the drawing board and make strengthening working families and our communities a priority, instead of draining critical resources from public investments that build a stronger economy.

-Nan Madden

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Join the Minnesota Budget Project team as our Policy Advocate

The Minnesota Budget Project is seeking a Policy Advocate to advance effective strategies to address poverty. This essential member of our team conducts analysis, explores policy solutions, and engages with state and national partners on public policies that reduce poverty and improve the economic well-being of low- and moderate-income Minnesotans and communities of color.

The Minnesota Budget Project is an initiative of the Minnesota Council of Nonprofits that combines sound research and analysis with advocacy, engagement, and communications strategies to expand opportunity and economic security to all Minnesotans. The Minnesota Budget Project is a member of the State Priorities Partnership, which provides strong peer-to-peer learning and professional development opportunities.

The ideal candidate will have a combination of advocacy and analysis skills. The full job description, including information about how to apply, can be found in our posting on the Minnesota Council of Nonprofits’ job board. The deadline to apply is October 11; resumes will be reviewed on a rolling basis.

-Nan Madden

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Census: Incomes on the rise, but many still struggle to get ahead

New data from the Census released today show the nation’s economic recovery is boosting incomes and reducing hardship, including in Minnesota. The median household income in Minnesota rose to $65,599 in 2016, and the share of Minnesotans living in poverty held fairly steady at 9.9 percent. Minnesota’s median household income now stands almost $8,000 above the national figure and the share of Minnesotans living in poverty is well below the national figure of 14 percent.

This year’s income gain puts the income of a typical Minnesota family at its highest since 2007. In that year, the Great Recession began dragging the median household income down, reaching a low point of an inflation-adjusted $60,780 in 2011.

Minnesota has tended to outperform the nation because of economic factors and because of policies enacted by Minnesota policymakers that contribute to a more equitable state economy. Examples of such policies include increasing the state minimum wage and expanding tax credits that boost the incomes of low-income families, and expanded access to affordable health insurance and child care. As part of the 2016 budget process, Minnesota policymakers spent time researching policy options with an explicit focus on closing racial disparities.

These data also remind us that economic growth by itself does not guarantee broad prosperity, and economic opportunity is not yet available to all. Minnesotans of color aren’t sharing in our state’s economic gains to the same degree as white Minnesotans.

 2016 Median Household Income 2016 Poverty Rate
All Minnesotans$65,5999.9%
Asian Minnesotans$70,85316.0%
White, non-Hispanic Minnesotans$68,6877.0%
Latino Minnesotans$45,94618.1%
American Indian/Alaskan Native Minnesotans$37,03431.6%
Black/African American Minnesotans$33,43629.8%

Source: American Community Survey

The Census data demonstrate that economic gains did not accrue equally in all communities in Minnesota. Communities of color continue to face structural hurdles to getting ahead. They are less likely to have access to affordable child care, affordable housing, or transportation options that would enable them to get to good jobs. Some of these barriers have long historical roots; policies such as redlining limited where people of color could live, and inadequate investment in their communities created further barriers.

These structural and historical factors are reflected in the Census numbers on income and poverty in Minnesota’s communities of color. The median household incomes of Black, Hispanic or Latino, and American Indian households are significantly lower than that of their white neighbors. In fact, the median household income for Black Minnesotans remains about half of the median income of white Minnesotans. And, while Asian Minnesotans’ median household income is comparable to that of white Minnesotans, the poverty rate for Asian Minnesotans is more than twice as high as that of white Minnesotans.

Racial disparities are also reflected in the poverty rate. While 9.9 percent of all Minnesotans had incomes below the federal poverty line in 2016, the rate was much higher in communities of color. Overall, around 530,000 Minnesotans struggled to make ends meet on poverty-level incomes, which is currently $24,600 for a family of four.

These data remind us that policy choices matter. We learned earlier this week that, in part thanks to the Affordable Care Act, a higher share of Minnesotans had health insurance than ever before. When people earning lower wages can boost their incomes as a result of federal investments like the Earned Income Tax Credit, they are more likely to succeed at school, at work, and in building a secure future for themselves and their families.

Unfortunately, federal policymakers have created budget plans that would put the country in reverse, increasing poverty and hardship. Budget proposals by the U.S. House of Representatives and President Donald Trump would deeply cut federal investments that reduce the number of Minnesotans who go to bed hungry, forego needed medical treatment, or are unable to build the skills they need to get ahead.

Instead of investing in job training, affordable child care, and other proven solutions that expand opportunities, these budgets would make trillions of dollars in funding cuts and at the same time enact huge tax cuts that would largely benefit those households and companies who are already doing well. And the large cuts in funding to states and local governments would undermine Minnesota’s ability to enact the policies that will truly make ours a state where economic security is within reach for us all.

The data reflect both the progress we’ve made and the distance we have yet to travel. In recognition of both, federal policymakers should re-focus their efforts on building on the investments we’ve already made.

-Ben Horowitz and Clark Goldenrod

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New Census data highlight what’s at risk from federal health care threats

The share of Minnesotans covered by health insurance is historically high, according to new U.S. Census data released today. Minnesota was already a national leader on this front before the Affordable Care Act (ACA) provided our state with even more tools to connect Minnesotans with affordable health insurance.

In 2016, only 4.1 percent of Minnesotans went without health insurance. That’s an improvement over the 4.5 percent who lacked coverage in 2015. And it’s also markedly lower than the 8.2 percent of Minnesotans who went without insurance in 2013, the last year before the full rollout of the ACA.

Our low uninsurance rate is good enough to rank Minnesota fifth among the 50 states and Washington, D.C. However, Minnesota’s progress – and that of states across the country that have seen improvements in their health care coverage rates – is currently under threat.

Health care legislation proposed in the U.S. Congress would slash federal funding on health care assistance, for both Medicaid and the individual market. More than 1 million Minnesotans find affordable insurance through Medicaid, called Medical Assistance in Minnesota. Federal assistance to bring down the cost for those getting health insurance through the individual market means that many Minnesotans are shielded from increasing premiums, and also pay less for other out-of-pocket costs than they would have before the ACA.

Our avenues to affordable health insurance improve Minnesotans’ lives in many ways. Most obviously, participation in Medicaid has been linked to better overall health, and people insured through Medicaid are generally able to find health care similar to those with employer-based coverage. Children covered through Medicaid perform better in school, too. And following recent gains in health insurance coverage, less strain has been placed on our health care providers from bad debt or uncompensated care.

The ACA, Medical Assistance, and MinnesotaCare also play critical roles in reducing barriers for Minnesotans who have struggled to afford health care insurance. The pathways to affordable health insurance offered through the ACA undeniably benefited people who traditionally have had less access to health care coverage: people of color, young adults, part-time workers, those with less formal education, and those in low-income families.

But threats remain. In the U.S. House of Representatives, legislators approved giant cuts to Medicaid that finance huge tax cuts for high-income Americans, and insurance and other medical industry companies. Meanwhile, senators are still considering a proposal that would deeply cut federal funding for health care and remove important protections for people with pre-existing conditions.

The past several years, Census data on health insurance has told a story of how public policies have meant more Americans can afford health care for themselves and their families. Policymakers should build on that success instead of pulling the rug out from underneath the Americans who live and thrive because of it.

-Ben Horowitz and Clark Goldenrod

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Cassidy-Graham: Different lipstick, same pig

U.S. Senators are reportedly still considering a health care bill that would leave millions of Americans uninsured, eliminate protections for expectant mothers and people with mental illnesses, and threaten the stability of state budgets. Known as the Cassidy-Graham plan, this latest version contains many of the bad ideas of its predecessors along with some provisions that are harmful and novel.

Like its predecessors, Cassidy-Graham would:

  • Create massive funding cuts to Medicaid and reduce federal assistance for people buying insurance on the individual market by changing their federal funding mechanisms, resulting in a $2.1 billion annual loss for Minnesota by 2026;
  • Eliminate protections for people with pre-existing conditions by allowing states to waive consumer protections established by the Affordable Care Act (ACA), and by potentially adopting the Cruz Amendment;
  • Cause millions of people to lose their health insurance; and
  • Leave people on the individual insurance market paying more in out-of-pocket costs.

Additionally, Cassidy-Graham eliminates all funding for the ACA’s Medicaid expansion and marketplace subsidies after 2026. The additional Medicaid cuts come on top of the aforementioned $2.1 billion reduction in annual funding for Minnesota. Both policy changes would leave big holes in our state budget, threatening the coverage of the more than 1 million Minnesotans who access affordable health care through Medical Assistance — many of whom are working, caring for a disabled relative, have been laid off, or are dealing with a disability.

The elimination of marketplace subsidies after 2026 would mean that people who aren’t offered insurance through their employer would no longer receive any help to bring down the cost of their health insurance on the individual market — costs that would go up even more under Cassidy-Graham.

Cassidy-Graham also threatens a uniquely Minnesotan and successful avenue to affordable health insurance for people who earn too much to qualify for Medicaid. The bill would reduce funding for MinnesotaCare, placing more than 90,000 Minnesotans’ health insurance in jeopardy. MinnesotaCare covers Minnesotans who earn less than 200 percent of the federal poverty guidelines ($24,120 for a single individual). Since costs on the individual market will also increase under Cassidy-Graham, these Minnesotans are likely to lose their coverage without being offered an affordable alternative.

Just like previous attempts that would reduce the assistance for health insurance available to Americans through the ACA, Cassidy-Graham has been crafted behind closed doors. The proposal is not significantly different from the one that died on the Senate floor last month. A few tweaks around the edges cannot save a bill that is rotten to its core.

Instead of drawing on proposals crafted in the shadows, senators should return from their summer recess and work on strengthening the ACA in a transparent, bipartisan fashion. Right now, the number of people without health insurance represents the lowest share of uninsured Americans ever. Any step in the opposite direction is unacceptable.

-Ben Horowitz


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Join us in telling Congress to reject the U.S. House plan to pay for tax cuts for the wealthy by decimating the safety net

No matter how hard somebody works or tries to do the right thing, a simple twist of financial fate can leave most Americans struggling to afford the most basic necessities. The budget plan awaiting a vote in the U.S. House of Representatives would devastate the investments we make in services that connect Americans with food, shelter, education, job training, and health care during troubled times. The proposed budget cuts cuts would have implications for everyone, from an infant whose parent struggles to buy formula to a senior whose family can’t afford long-term care. At the same time, the budget would give massive tax breaks to the wealthiest Americans and most profitable corporations through a special fast-track budget process.

We have penned a letter to Minnesota’s congressional delegation calling on them to oppose this upside-down budget, and we’re asking your organization to lend its voice. Our deadline for signatories is August 24. Read the letter and sign-on instructions here, and contact Ben Horowitz for more information.

-Ben Horowitz

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US Senate votes mean Medicaid and affordable health insurance for millions of Americans are preserved for now

Several proposals to radically alter health insurance for the worse failed in the U.S. Senate last month. Congress should now turn to policy solutions that strengthen Americans’ ability to find affordable, quality health insurance. In the meantime, advocates should be prepared for the potential next wave of attacks on the health insurance safety net.

Earlier this spring, the U.S. House of Representatives voted to cut more than a trillion dollars from health care funding for low- and moderate-income Americans, while at the same time cutting taxes for the nation’s highest-income people, insurance companies, and the medical device industry. Once the bill came to the U.S. Senate, Senate leaders tinkered with it behind closed doors before unveiling a series of amendments that also threatened to undo many of the coverage and patient-protection gains made under the ACA without effectively addressing any of the problems Americans still face when they shop for insurance.

These Senate proposals differed in their details, but all shared a few things in common. Like the House bill, they would have essentially ended the protections for people with pre-existing conditions, cut funding for people who are insured through Medicaid or receive subsidies to shop on the individual market, and would have left 22 to 32 million more people without health insurance within a matter of years.

A last-ditch effort to move American health care in the wrong direction failed to pass in a dramatic, late-night vote in the Senate after an incredible groundswell of support for Medicaid, through which millions of Americans find affordable care. Unfortunately, these proposals are unlikely to be the last attempts to roll back access to affordable health insurance in the coming months.

President Donald Trump and Congressional leaders have proposed budget plans that would decimate the safety net that connects vulnerable Americans with basic necessities like food and shelter. The current House budget plan suggests dramatic reductions in Medicaid, and the Trump budget similarly proposed cuts on top of what was included in the stalled Congressional health care legislation.

On top of the damage that would be done by these proposals, Trump has added uncertainty to the current market by threatening to withhold funding that lowers the costs of health care for low-income families. This threat could result in some insurers raising premiums for 2018.

It’s now time for Congress to build on the gains made under the ACA. The share of Americans without health insurance is at an all-time low. The remaining challenge: how to ensure that all Americans — regardless of age, pre-existing conditions, or locality — can afford both the monthly premiums and the cost of health care for a comprehensive health insurance plan.

That requires stabilizing the health insurance market, lowering premiums for those who find them out of reach, and controlling the costs of providing health care. Simply cutting our public investments in affordable health insurance won’t do the trick.

-Ben Horowitz

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