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Is Supporting Family Caregivers Good For The Economy? – Forbes

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The congressional proposal to increase federal funding for Medicaid’s home and community-based (HCBS) long-term care program likely would benefit the US economy, although it could increase costs for those not receiving Medicaid.  

The HCBS expansion is included in the current House version of President Biden’s Build Back Better (BBB) social spending, climate, and tax plan. Sen Joe Manchin (D-WV) and nearly all Hill Republicans claim the roughly $2 trillion proposal would damage the US economy. But independent analysis suggests the home care provisions would produce an overall benefit.

Several elements of BBB—including paid family leave, the Medicaid HCBS expansion, and related provisions—are aimed at helping those receiving long-term services and supports and their families.  

Short and long run benefits

In September, the economic research firm Moody’s Analytics projected the Medicaid home care provision alone would benefit the economy in the short run by increasing pay for direct care workers. In the longer term, it would make it possible for more women who now stay home to care for family members to re-enter the paid workforce.

It concluded, “The elderly and disabled population will receive higher-quality care from better trained and more highly paid direct care workers. Meanwhile, more of those people who now informally care for the elderly and disabled will be able to take other jobs. The economy will receive an immediate boost from this increased government spending along with a lift in long-term growth from higher labor force participation, particularly by lower-income females who are currently most likely to provide home care.”

Other studies have found that a substantial number of working age women either quit jobs or scale back hours to care for parents, spouses, or other family members with care needs.   

Moody’s analyzed a $250 billion boost in federal HCBS spending, lower than Biden’s proposed $400 billion increase but higher than the $150 billion hike currently included in the House’s Build Back Better bill.   

300,000 new jobs

It estimated a $250 billion expansion of Medicaid home care would create up to 300,000 new jobs by 2031 and increase real (inflation-adjusted) Gross Domestic Product (GDP) by about 0.2 percent. Moody’s has not updated its estimate to reflect the $150 billion increase.

When economists look at federal programs—either spending or tax cuts, they think in terms of multipliers. In other words, how much would a dollar of new spending or tax cuts boost GDP. Moody’s concluded that every additional dollar of federal spending on Medicaid HCBS would boost the economy by $1.17.

That return would be comparable to programs such as universal pre-K education and child care. It would be only slightly less beneficial than an expansion of the Child Tax Credit and more beneficial than the multiple rounds of the economic impact checks the government distributed as pandemic relief in 2020 and early 2021. It would be far better for the economy corporate or individual income tax rate cuts.

One downside

While the Moody’s study looked at the overall inflationary effects of more HCBS spending, it did not address one complicating issue: If Medicaid increases pay for home care workers, their wages are also likely to rise for families that are not eligible for Medicaid and must pay out of their own pockets.

Because Medicaid is the primary payer of long-term care, it effectively sets the wage rate in many communities. In other words, private pay home care agencies would have to raise their wages to compete with Medicaid agencies for workers.

That could be especially true today when there are severe shortages of direct care workers. Moody’s analyst Bernard Yaros Jr. told me, “With or without the expansion, private home care costs will rise meaningfully in the near term.”

The burden on non-Medicaid families

Those wage increases benefit underpaid aides but add to the burden of millions of families that pay for care out of pocket.

In August, 2020, the Genworth Cost of Care survey found the average hourly cost of a home care aid was $24 and the average monthly cost was almost $4,600. Aides hired through agencies generally receive about half that amount as wages. Those expenses likely have risen substantially due to the pandemic.

Overall, increasing the federal contribution to Medicaid HCBS would be good for those families who rely on Medicaid to help support frail older adults living at home, good for the workers who help provide that care, and good for the economy. But it may have the unintended consequence of adding to an already challenging burden for middle-income households not on Medicaid.

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Economy

B.C.’s debt and deficit forecast to rise as the provincial election nears

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VICTORIA – British Columbia is forecasting a record budget deficit and a rising debt of almost $129 billion less than two weeks before the start of a provincial election campaign where economic stability and future progress are expected to be major issues.

Finance Minister Katrine Conroy, who has announced her retirement and will not seek re-election in the Oct. 19 vote, said Tuesday her final budget update as minister predicts a deficit of $8.9 billion, up $1.1 billion from a forecast she made earlier this year.

Conroy said she acknowledges “challenges” facing B.C., including three consecutive deficit budgets, but expected improved economic growth where the province will start to “turn a corner.”

The $8.9 billion deficit forecast for 2024-2025 is followed by annual deficit projections of $6.7 billion and $6.1 billion in 2026-2027, Conroy said at a news conference outlining the government’s first quarterly financial update.

Conroy said lower corporate income tax and natural resource revenues and the increased cost of fighting wildfires have had some of the largest impacts on the budget.

“I want to acknowledge the economic uncertainties,” she said. “While global inflation is showing signs of easing and we’ve seen cuts to the Bank of Canada interest rates, we know that the challenges are not over.”

Conroy said wildfire response costs are expected to total $886 million this year, more than $650 million higher than originally forecast.

Corporate income tax revenue is forecast to be $638 million lower as a result of federal government updates and natural resource revenues are down $299 million due to lower prices for natural gas, lumber and electricity, she said.

Debt-servicing costs are also forecast to be $344 million higher due to the larger debt balance, the current interest rate and accelerated borrowing to ensure services and capital projects are maintained through the province’s election period, said Conroy.

B.C.’s economic growth is expected to strengthen over the next three years, but the timing of a return to a balanced budget will fall to another minister, said Conroy, who was addressing what likely would be her last news conference as Minister of Finance.

The election is expected to be called on Sept. 21, with the vote set for Oct. 19.

“While we are a strong province, people are facing challenges,” she said. “We have never shied away from taking those challenges head on, because we want to keep British Columbians secure and help them build good lives now and for the long term. With the investments we’re making and the actions we’re taking to support people and build a stronger economy, we’ve started to turn a corner.”

Premier David Eby said before the fiscal forecast was released Tuesday that the New Democrat government remains committed to providing services and supports for people in British Columbia and cuts are not on his agenda.

Eby said people have been hurt by high interest costs and the province is facing budget pressures connected to low resource prices, high wildfire costs and struggling global economies.

The premier said that now is not the time to reduce supports and services for people.

Last month’s year-end report for the 2023-2024 budget saw the province post a budget deficit of $5.035 billion, down from the previous forecast of $5.9 billion.

Eby said he expects government financial priorities to become a major issue during the upcoming election, with the NDP pledging to continue to fund services and the B.C. Conservatives looking to make cuts.

This report by The Canadian Press was first published Sept. 10, 2024.

Note to readers: This is a corrected story. A previous version said the debt would be going up to more than $129 billion. In fact, it will be almost $129 billion.

The Canadian Press. All rights reserved.

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Mark Carney mum on carbon-tax advice, future in politics at Liberal retreat

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NANAIMO, B.C. – Former Bank of Canada governor Mark Carney says he’ll be advising the Liberal party to flip some the challenges posed by an increasingly divided and dangerous world into an economic opportunity for Canada.

But he won’t say what his specific advice will be on economic issues that are politically divisive in Canada, like the carbon tax.

He presented his vision for the Liberals’ economic policy at the party’s caucus retreat in Nanaimo, B.C. today, after he agreed to help the party prepare for the next election as chair of a Liberal task force on economic growth.

Carney has been touted as a possible leadership contender to replace Justin Trudeau, who has said he has tried to coax Carney into politics for years.

Carney says if the prime minister asks him to do something he will do it to the best of his ability, but won’t elaborate on whether the new adviser role could lead to him adding his name to a ballot in the next election.

Finance Minister Chrystia Freeland says she has been taking advice from Carney for years, and that his new position won’t infringe on her role.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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Nova Scotia bill would kick-start offshore wind industry without approval from Ottawa

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HALIFAX – The Nova Scotia government has introduced a bill that would kick-start the province’s offshore wind industry without federal approval.

Natural Resources Minister Tory Rushton says amendments within a new omnibus bill introduced today will help ensure Nova Scotia meets its goal of launching a first call for offshore wind bids next year.

The province wants to offer project licences by 2030 to develop a total of five gigawatts of power from offshore wind.

Rushton says normally the province would wait for the federal government to adopt legislation establishing a wind industry off Canada’s East Coast, but that process has been “progressing slowly.”

Federal legislation that would enable the development of offshore wind farms in Nova Scotia and Newfoundland and Labrador has passed through the first and second reading in the Senate, and is currently under consideration in committee.

Rushton says the Nova Scotia bill mirrors the federal legislation and would prevent the province’s offshore wind industry from being held up in Ottawa.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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