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Articles by Emma Curchin
The Payment Model for Health Services for Seniors Rewards Insurers and Private Equity, Not Patients
This piece is a summary of a new CEPR working paper, Do Capitated Payments Deliver Value in US Health Care? The system that CMS (the Center for Medicare and Medicaid Services) uses to pay for hospice care, Medicare Advantage, and Medicaid Managed Care is called, ironically enough, value-based care payments.
First, They Took Our Wages; Now They Want Our Social Security
There is now a bipartisan consensus that Social Security faces a serious crisis, and something has to be done. That “something” almost always involves a large cut in benefits. There is some truth to this story. On its current path, the Social Security Trust Fund will only be able to pay a bit less than 79 percent of scheduled benefits by 2033. The standard story puts the problem as too many baby boomers being supported by too few workers.
Social Security's Real Problem Is Income Distribution, Not Demographics
The rich almost completely control debate in this country. There is no better proof of this fact than the current debate over the future of Social Security. This has been conveniently framed as a problem of demographics. You know, too many people living long into retirement and not enough kids entering the workforce. That sounds compelling, as long as we don’t try to think about it too much. First, we knew this basic story long ago.
The Washington Post Says We Should Stop Paying Interest on Government Bonds Because It All Goes to the Rich
Of course, Jeff Bezos opinion section didn’t advocate a measure that would hurt his rich friends, it gave a version this absurd argument as a reason to get rid of Social Security. It lent space to right-wing commentator Ramesh Ponnuru to tell people “Don’t Save Social Security.” Ponnuru quickly tells us of Social Security’s fatal flaw: “As two experts on the program recently wrote, Social Security sends only 7 percent of its benefits to the poorest 20 percent of senior citizens.
Trump Rx: It Doesn’t Help Patients, but Gets Trump’s Name on Something
This country has had some bad presidents, but it’s a bit hard to imagine a president whose main goal is to put his name on things and who would openly steal billions from the Treasury. But that is Donald Trump. Starting with the quest to get his name on stuff. We now have the Donald J. Trump Institute of Peace, which used to be the United States Institute of Peace, before Elon Musk shut it down. We have the Donald J. Trump John F. Kennedy Memorial Center, which Trump also shut down.
Oren Cass Is Right: Finance Has Become a Wasteful Industry
Oren Cass, the chief economist at the conservative populist think tank American Compass, is completely on the money in his New York Times column attacking the financial sector. The financial sector is a massive source of waste and corruption, which has grown like a cancer on the economy over the last half century. Just to get some orientation, finance is essential to the economy, which I’m sure Cass would never dispute.
Spending Under Trump: Drugs Up, Factories Down
Today I thought I would discuss two of my favorite Trumpian lies about the economy: he lowered drug prices 1500% and we’re bringing in $18 trillion in foreign investment. These are among my favorite Trumpian lies because they involve important issues and Trump repeats them all the time. They are both also absurd on their face. All of us who learned arithmetic in fourth grade know that the price of an item can’t fall more than 100%. Once the price drops 100%, it is free.
The High Cost of Living: What Working Families Pay For Health Care
Total Expenditures on Health Care are Strongly Correlated with Family Income In 2024, the median working family spent $3,960 on health care-related expenses (see the first column of Table 1).9 In what follows, we generally refer to the median family as the “typical” family since half of all families spent less than the median and half spent more.10 Typical health care expenditures, however, vary strongly with income.
Fraud, Drugs, and Hope for 2026
The year 2025 ends the way Donald Trump began his foray into politics: full-fledged, unapologetic, racism. Team Trump is pushing his anti-Somali campaign for three big reasons. First, insofar as he succeeds, it justifies his mass deportation. He has explicitly attacked Somalians as a people and imposed new bans on their entering the country. The immediate cause is that some were involved in committing fraud against government programs, sort of like white people.
Jeffries’ Strong Floor and No Ceiling: We Need to Fix the Roof
It’s amazing how many times the same stuff can be recycled as “new ideas” to get high praise from the serious people. The latest effort at recycling comes from “investor” Owen B. Libby, who wants to promote growth with equity, but touts ideas that have been around forever. The Washington Post tells us that he has won the ear of House Democratic Party leader Hakeem Jeffries, and apparently also the Washington Post.
Rip Van Winkle Comes to the White House: Trump Goes After “Money Sucking” Insurance Companies
There is an old children’s tale about Rip Van Winkle. He fell asleep for 20 years and wakes up after the America Revolution and finds the world has changed in big ways. Donald Trump seems to be doing his own Rip Van Winkle routine. Yesterday, Trump suggested that as an alternative to Obamacare — which he said feeds the “money sucking” insurance industry — we just give money directly to people and let them buy their own healthcare.
Trump Craziness on BLS: Job Numbers Were Actually Undercounted on Election Day
Donald Trump fired Bureau of Labor Statistics Commissioner Erika McEntarfer because he said she rigged the numbers to make him look bad. There is an effort by Republicans, and some in the media, to rewrite history in front of our eyes and to say the concern was competence and transparency. That is a lie as bad as Trump’s. Trump claimed she rigged the numbers: full stop.
Why do millions of working Americans still lack health insurance? Dean Baker sits down with economist John Schmitt to break down the massive gaps in U.S. healthcare coverage and what it means for workers across the country. They look at which workers are getting left behind, how the Affordable Care Act changed the game, and why low-income workers are still struggling to get coverage. Plus, they explore the maze that is our current healthcare system and discuss what real reform might look like.
Trump’s Team of Cowards: Loyalty Over Truth at the BLS
Donald Trump’s decision to fire Erika McEntarfer, the commissioner of the Bureau of Labor Statistics (BLS), brought his administration to a new level of crazy. Firing the head of a statistical agency because he didn’t like the data is extreme even by Trumpian standards. But Trump’s statements on the firing and the response of his top aides also tell us a lot about the people he has surrounding himself with.
Trump DOL Rule Would Strip Home Care Workers of Wage Protections
On July 2, the Department of Labor’s Wage and Hour Division issued a proposed rule that would overturn home care workers’ rights to earn a minimum wage and overtime pay. This move would diminish the rights of up to 3.7 million caregivers, personal care aides, and home health aides employed by agencies across the country. Specifically, the rule would allow home care agencies to avoid paying minimum wage or overtime if no state law requires it, by reverting to the .
Trump is Hitting Us With Huge Tax Increases. Does He Know That?
Whenever Donald Trump boasts about his latest tariff victory, what he’s really doing is bragging about the taxes he is imposing on the goods the United States imports from various trading partners. And there’s plenty of evidence to show who’s actually paying the costs. Trump seems to think that it is a great thing that we are imposing high taxes on imports from longstanding allies like the European Union (EU), Japan, Canada, and Mexico.
Trump’s Medicaid Cuts Will Kill Healthcare Jobs
There has been substantial reporting and commentary on the impacts of the Medicaid cuts in Trump’s One Big Beautiful Bill Act (OBBA). The Congressional Budget Office recently estimated that those cuts will total $911 billion, and that about 10 million people would lose their insurance coverage through a combination of factors.
Quick Thoughts on the Job Report: July Was Bad News
I always caution not to make too much of a single report or single month’s data, but I think we can look at the July report and say it was unambiguously bad news. The job growth number for the month wasn’t bad at 73,000, but with the sharp downward revisions to the prior two months’ data, the average for the last three months was just 35,000. That is bad. But it gets worse. Health care accounted for 55,400 of the new jobs created in July.
Unemployment Rises to 4.2 Percent in July as Job Growth Slows Sharply
The unemployment rate rose to 4.2 percent in July as the rate of job growth slowed to just 73,000 in the month. Perhaps more striking than July’s figure was the sharp downward revisions to the prior two months’ data, putting May and June job growth at 19,000 and 14,000, respectively. The average for the last three months now stands at just 35,000. Furthermore, all of the job growth was in health care, which accounted for 142 percent of the gains.
CPI May 2025 Preview: Tariffs and Gas Prices to Shape Inflation
The May Consumer Price Index again showed inflation to be tame, with the overall inflation rate coming in at 0.1 percent and core CPI coming in at 0.2 percent for the month. The year-over-year rate for the two indexes were up 2.4 percent and 2.8 percent, respectively. Through May we were not seeing much evidence of the tariffs in the CPI or other price indexes. However, the government is now raising considerably more revenue from tariffs.
Republicans Love the Government and Democrats Who Claim Otherwise Are Jerks
I realize Democrats and progressives more generally love to lose. What else can possibly explain their insistence on framing their policies in the worst possible way? This point is continually pounded home when progressives adopt the framework where the right wants the unfettered market, but progressives want the government to have more control. This is wrong logically and it is horrible messaging politically. Most people like the market and distrust the government.
Cuts to Medicare Prescription Drug Assistance Will Cost Lives
A lesser-known impact of the “One Big Beautiful Bill” is the loss of vital prescription drug assistance for millions of low-income Medicare beneficiaries. The Low-Income Subsidy (LIS) program – also known as Medicare Part D “Extra Help” – lowers monthly premiums, deductibles, and copays for low-income people on Medicare.
Jobs Report: 147K Jobs Added, Wage Growth and Work Hours Fall
The jobs report for June was mixed. Job growth was solid at 147,000 and the unemployment rate edged downward to 4.1 percent. However, there were some less encouraging signs in the report: More than half the job growth came from the state and local government sectors, and wage growth slowed sharply. Also, aggregate hours fell by 0.3 percent in the month. The drop in the unemployment rate was encouraging.
June 2025 Jobs Preview: What to Expect
We have been seeing signs of a slowing labor market through the first five months of this year. The rate of job growth has slowed modestly, averaging 135,000 over the last three months. That compares to an average of 170,000 in 2024. There also has been a modest uptick in unemployment from 4.0 percent to 4.2 percent. Wage growth also appears to have slowed slightly. While unemployment insurance claims are relatively low, the number of continuing claims has been edging higher.
Workers Most Likely to Lose Medicaid Can’t Rely on Employer-Based Coverage
In a recent CNBC interview, Sen. James Lankford (R-OK) said the people who lose Medicaid coverage under the Republican-backed “One Big Beautiful Bill Act” will merely transition to employer-sponsored health care: “It’s not kicking people off Medicaid. It’s transitioning from Medicaid to employer-provided health care.
Workers Most Likely to Lose Medicaid Can't Rely on Employer-Based Coverage
In a recent CNBC interview, Sen. James Lankford (R-OK) said the people who lose Medicaid coverage under the Republican-backed “One Big Beautiful Bill Act” will merely transition to employer-sponsored health care: “It’s not kicking people off Medicaid. It’s transitioning from Medicaid to employer-provided health care.
My Abundance Agenda
Since “abundance” is apparently the in-thing, I thought I should get in on the act. At the onset, I will admit I don’t have much new to offer to those familiar with my writings, but sometimes a repackaging is useful. I have my usual favorites: Patent and copyright monopolies, The bloated financial sector, The corrupt corporate governance structure, Protection for doctors and other highly paid professionals.
Health Insurance for US Workers: Coverage Gaps, Inequities, and Policy Risks
APPENDIX Data and Definitions We use nationally representative data from Annual Social and Economic Supplement (ASEC), which is conducted annually by the Census Bureau as part of the monthly Current Population Survey (CPS).25 The ASEC collects information from approximately 60,000 households on demographics, incomes, work status, and other characteristics, including detailed information on health insurance coverage.
Donald Trump Becomes Jimmy Carter
When Jimmy Carter died at the start of the year, the media was full of warm praise for the former president. He had spent his long post-presidency promoting human rights, combatting disease in poor countries, and homelessness in the United States. He had a modest lifestyle, living with his wife in the small Georgia town he had grown up in. However, we would have heard a very different story at the time he left office.
News for Elon Musk and the DOGE Gang: Government Can be More Efficient than the Private Sector
Elon Musk is the poster child for the famous line “if you’re so rich, how come you’re not smart?” Mr. Musk is undeniably incredibly rich, but in his chainsaw crusade against the government he is not looking very smart. He is botching almost everything he does in his supposed role as an efficiency warrior, laying off essential workers who then need to be rehired and making cuts at agencies where he doesn’t even know what they do.
The Social Security Administration Predicted Joe Biden’s “Great Replacement” 20 Years Ago
When Elon Musk and his DOGE boys were raiding the Social Security Administration (SSA) and coming up with their nutty fantasies about millions of dead people getting Social Security, they apparently didn’t bother to spend any time looking at actual data about the program. If they had, they might have gotten a bit of understanding about not only the program, but also the labor market and immigration.
Government Efficiency and DOGE Government “Efficiency”
Yesterday the Social Security Administration (SSA) announced that it was reversing plans to eliminate the option of providing direct deposit information for benefits over the phone. This was a response to a public outcry over the proposed policy. The reason for the outcry was that many older people (the type most likely to get Social Security benefits) are distrustful and uncomfortable with the Internet.
The Trump Dream of Balanced Trade
Donald Trump constantly complains about our trade deficit, promising us the good life of balanced trade. I’m not sure exactly how he sees ending our trade deficit as the key to prosperity, but let’s play the game. What does the world look like if Trump, through his tariffs, threats, and promises, gets the trade deficit down to zero? According to Trumpian rhetoric, the big prize is that we would get manufacturing jobs back.
The Trump-Musk Recession: Because They Can
Past recessions have been the result of policy errors or disasters. The most typical policy error is when the Federal Reserve Board raises interest rates too much to counter inflation. That was clearly the story in the 1974-75 recession as well as the 1980-82 double-dip recession. Then we have recessions caused by collapsing financial bubbles, the 2001 recession following the collapse of the stock bubble and the 2008-09 recession following the collapse of the housing bubble.
The Musk-Trump Big Lie on Social Security
Back during the campaign JD Vance began running around saying that Haitian immigrants in Springfield, Ohio were eating the pets of their neighbors. When reporters went to Springfield they couldn’t find any evidence of pet-eating Haitians. The police and city’s mayor said they had not heard any reports of dogs or cats ending up as a neighbor’s dinner. There were reports of some tensions with the new immigrants, but none involved pet consumption.
Trump’s Dead People on Social Security Lie
Donald Trump told many lies in his address to Congress last night, but the one I found especially galling was when he repeated the absurd claim that millions of dead people are receiving Social Security benefits. My anger probably is part due to the fact that I spent many years studying and defending the program. Part of the story is that I look to soon be getting benefits from the program myself. But a big part of the story is that it is just such an obvious lie.
RFK Jr’s False Choice: Why Infectious and Chronic Disease Research Must Go Hand in Hand
Last month, the Senate pushed past concerns by public health experts to confirm Robert F. Kennedy Jr. as secretary of the Department of Health and Human Services (HHS). One of RFK Jr.’s signature proposals is to “take a break” from funding infectious disease research to focus on chronic disease. On the surface, this may sound like a reasonable reallocation of resources – but it fundamentally misunderstands the connection between infectious and chronic disease.
The Phony Argument Behind Medicaid Work Requirements
House Republicans have put Medicaid at the top of their federal government chopping block. Their budget plan that passed on February 25 would direct the Energy and Commerce Committee (which has responsibility for Medicaid and other health programs) to come up with at least $880 billion in savings to pay for extending the 2017 Trump tax cuts. Medicaid is at the greatest risk of facing cuts.
Will Trump's FEMA Review Force States to Take on More Disaster Relief?
The Trump Administration’s approach to governing so far appears to be to “nuke it from orbit,” which will have a detrimental effect on how the federal government provides aid. While the administration’s early focus was on USAID and foreign aid, in late January, Trump issued an executive order to establish the Federal Emergency Management Agency (FEMA) Review Council. It has drawn far less attention but could prove to be massively disruptive.
As Wildfires Rage On, Federal Investment in Fire Protection Declines
As job cuts at the US Forest Service and National Park Service become one of the latest casualties in the Department of Government Efficiency’s attack on the federal workforce, questions turn to how this will affect efforts to prevent and battle wildfires. Sadly, both agencies have been underfunded and understaffed for quite some time.
Medicaid Under the Gun: The Block Grant Scam
Since its inception in 1965, the Medicaid program has provided health care to millions of low-income families. In 1997 it was expanded with the establishment of the State Children’s Health Insurance Program, and again in 2010 with an extension under the Affordable Care Act, a.k.a. “ObamaCare.” Now it is all under grave threat from the Trump Administration and the new Congress.
MAGA on Medicaid
As has been explained in detail since the election, the principal legislative goal of the Trump administration and the Republican majority in Congress is to extend the tax cuts – which are overwhelmingly tilted towards the wealthy – that expire this year. To do so, they are looking for massive spending cuts in order to ‘offset’ this tax agenda. The largest cuts are likely to hit Medicaid.
What Does a Budget from Congress Mean When Elon Decides What Gets Spent?
The House just passed its budget resolution, with large cuts to the Medicaid budget over the next decade. It remains to be seen whether it can get the Senate to go along, but there is a more basic question that really needs to be answered as background to the budget negotiations. What do Congressional appropriations mean in the Musk-Trump MAGA era.
Social Security Zombies: Another Big Lie for the MAGA Collection
Good followers of Donald Trump have to believe an increasingly large collection of ridiculous lies. First and foremost, they have to believe that the 2020 election was stolen. Then they have the corollary, that January 6th was an inside job pulled off for some reason by the FBI. Of course, they have to believe global warming isn’t happening and apparently now that that Ukraine started its war with Russia.
Medicaid By the Numbers: Cuts Would Hurt Millions
Created in 1965, Medicaid provides comprehensive health insurance for tens of millions of Americans who have low incomes or qualifying disabilities. As the overall cost of healthcare has skyrocketed in the United States, federal spending on Medicaid has risen as well, leading President Trump and Congressional Republicans to target the program as a place for significant cuts.
Can Trump Tank the Biden Economy? Here Are Eight Ways
President Biden handed off the best economy to an incoming president since at least the 2001 handoff from Clinton to Bush II. In his last quarter in office, GDP grew at a 2.3 percent annual rate (final demand, which excludes inventory fluctuations, grew at a 3.2 percent rate). That brought the average growth rate for Biden’s presidency to 3.2 percent, the highest since Clinton’s second term.
Real Corruption that Could Meet Republican Cost-Saving Targets
The news has been filled with stories in recent days about Republicans desperately hunting for $2.0-$2.5 trillion (2-3 percent of the budget) in budget cuts over the next decade to cover the cost of extending tax cuts to the rich. While Elon Musk and his DOGE team have been screaming about corruption all through the government, they actually have found little that can be helpful here. They appear to have found virtually nothing by way of actual corruption.
Financialization through Health IT, Part II: From Electronic Health Systems to AI
Industry Evolution Today’s billion-dollar industry of buying, selling, and mining patient data has its origins in the drug marketing agencies that emerged just after World II. In Our Bodies, Our Data (2016), Adam Tanner presents a thoroughly researched account of the industry’s evolution over 75 years.
Financialization through Health IT, Part I: Lessons from Electronic Health Systems
Information Blocking and Interoperability By 2013, the failure of interoperable systems became salient because many physicians, clinics, laboratories, and other small healthcare providers complained about the hidden fees they had to pay to link their electronic records to other healthcare organizations.
Preview: What to Look for in the January 2025 CPI
The overall CPI rose 0.4 percent in December, while the core rose at just a 0.2 percent rate. This put their year-over-year increases at 2.9 percent and 3.2 percent, respectively. The main factor pushing the overall index above the core in January was a 4.4 percent jump in gas prices. Gas prices are unlikely to show any comparable rise in January, and may actually decline modestly. However, food inflation could go in the other direction. Egg prices in particular have been soaring.
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