Does Medicaid Expansion Help Or Hurt Hospital Finances? – Analysis

 April 24, 2026

By Damon L. Daniels

In debates over health care policy, one of the arguments against expanding access to health insurance is that this leads to increased utilization of emergency rooms – a phenomenon that would create serious problems for hospitals. But a review of the available research suggests that provisions in the Affordable Care Act that broadened access to insurance are not creating these problems – and in fact, states that did not take advantage of Medicaid expansion are more likely to see increases in uncompensated care costs for hospitals. 

Introduction

Prior to the expansion of health insurance coverage in the Affordable Care Act (ACA), people with insurance (whether commercial insurance or Medicaid coverage) were the groups with similar and highest shares of Emergency Department (ED) visits. People without insurance made much less use of EDs. They were discouraged from seeking health care in an ED in all but the most dire circumstances by their concerns about the cost of such care. Knowing that they could not afford to pay for care, they reasonably expected the unpaid medical debt to affect their credit reports and to interfere with their ability to rent an apartment or get a job. They also expected the unpaid debt to be sold to a collection agency and to be hounded and harassed as the agency pursued them for payment. 

This limited their use of ED visits for true emergency health conditions — like spiking blood pressure that could lead to a stroke if untreated, or a deep gash from a cooking accident that required immediate medical attention. In contrast, people with commercial insurance or Medicaid coverage knew that insurance would pay the ED bill and they would be responsible only for the copay, which would be waived if the patient was admitted to the hospital. 

Research examining ED use in the period following the ACA’s voluntary Medicaid expansion to the near-poor, who previously lacked health insurance, finds an increase in ED visits by the newly insured. This, however, need not be a negative for hospitals if hospital net revenue increased as a result of this population being covered by insurance and if the costs of uncompensated care went down due to the decrease in patients without insurance who would be unable to pay for care.

In this issue brief, we examine what happened to ED usage following Medicaid expansion as well as the effect on hospital finances.

Emergency Department (ED) Utilization

National Studies

National studies generally focused on ED utilization trends for people under age 65 that occurred before and after several provisions of the ACA went into effect, particularly state‑level expansions of Medicaid eligibility.1 Prior to these expansions, the highest shares of usage occurred among patients with private insurance or Medicaid access.2

Following Medicaid expansion, the highest shares of ED visits occurred among patients with Medicaid access, while the proportions of visits by uninsured patients declined. The sharpest changes in the insurance status of ED visitors happened during the first two to three years after a state expanded Medicaid coverage.3 Among the different types of insurance sources evaluated (private insurance, Medicaid, no insurance, and Medicare), the percentages of ED visits by patients with Medicaid as their primary insurance source were higher than those with private insurance, no insurance or Medicare access. ED visits among the uninsured declined following Medicaid expansion.

State Studies

Studies of ED utilization trends among states featured similar investigations of ED visits before and after major ACA provisions took effect. States that expanded Medicaid were typically compared to states that did not. Medicaid expansion was found to increase Medicaid’s overall share of ED visits and reduce the share of uninsured ED visits in several Medicaid expansion states.4 Moreover, the largest increases in shares of Medicaid ED visits occurred among states with the highest increases in Medicaid enrollment, especially among enrollees who were previously uninsured.5 Conversely, private insurance shares of ED visits typically decreased in Medicaid expansion states.

Low‑Acuity, Non‑Urgent, and Preventable ED Utilization

Findings are mixed regarding the role that Medicaid expansion plays in reducing the volume of ED visits for care that can otherwise happen through a regular doctor visit. Studies have found, for example, that in some cases recipients may receive care from a doctor prior to requiring care in an emergency department.6 Some researchers speculate that less medically urgent  conditions are potential factors for increases in ED visits due to the Medicaid expansions, but do not claim that it is a causal factor.7

Uncompensated ED Costs

National Studies

Several early national studies utilized data from the Centers for Medicare and Medicaid Services (CMS) and Internal Revenue Service (IRS) to estimate hospitals’ uncompensated care costs as a share of total hospital costs in ACA Medicaid expansion versus non‑expansion states, before and after expansion was available. This research finds that states that expanded Medicaid coverage saw reductions in their uncompensated care burdens. 

From CMS data, one study found that among expansion states, uncompensated care costs were reduced from 4.1 to 3.1 percent of total operating costs of hospitals between 2011–2014.8 Extending this study to include 2015, the same authors found that between 2013 and 2015, uncompensated care costs were lowered from 3.9 percent to 2.3 percent of operating costs, resulting in estimated savings of approximately $6.2 billion.9 Between 2011–2015, another study found that these costs were reduced by 1.5 percentage points (a 28 percent reduction overall).10 A third study using CMS data from 2011–2017 estimated a decline of 2.6 percentage points in average uncompensated care costs as a percentage of total expenses from 2013–2017, relative to the study’s 2011–13 pre‑Medicaid expansion period.11 This study also found that average annual Medicaid revenue as a percentage of total revenue rose by 2.5 percentage points between 2013–2017 among hospitals in Medicaid expansion states, while Medicaid revenue remained relatively unchanged among hospitals in non‑expansion states.

Similarly, a study using IRS data from 2010–2014 found that “net effect” hospital costs (the combined costs for uncompensated care and Medicaid payment shortfalls) fell by 1.6 percentage points among expansion states compared to non-expansion states, amounting to uncompensated care costs savings of 21 percent.12 Another IRS study found that through September 2020, uncompensated care costs in Medicaid expansion states were around 2.7 percent of all operating expenses, versus 7.3 percent for non‑expansion states.13

Studies also investigated the locations and types of hospitals most impacted by changes in uncompensated care costs. Uncompensated care costs were highest in states that did not implement the Medicaid expansion. Considering hospital geographies, research suggests that post‑Medicaid expansion coverage uptake may be higher in rural as opposed to urban hospitals,14 but uncompensated care costs were highest among rural hospitals in non‑expansion states. A 2014–2019 study found that uncompensated care as a percentage of a hospital’s total operating expenses was highest among hospitals in rural, non‑expansion states.15 Among only rural hospitals, this study also found that primarily non‑expansion states held the highest 2014 median uncompensated care shares; in fact, these proportions were higher in 2019. Regarding hospital types, studies found that savings can occur for both for‑profit and non‑profit hospitals.16

Disproportionate‑share hospitals (DSHs), which treat an outsized number of low-income patients, have also experienced notable reductions in uncompensated care. A study that measured these reductions in terms of the number of days that a hospital bed is occupied (referred to as “quantity of care”) found that uncompensated days per bed decreased 35 percent in 2014, relative to the years 2011–2013; DSHs in expansion states also experienced 1.4 fewer uncompensated care days per bed than non‐DSH hospitals in 2014, relative to hospitals in non‑expansion states.17          

Looking forward, the presumption is that any rollbacks to the policies that expanded health care coverage will reverse the gains in access and savings evidenced by the findings above. These gains were only enhanced during the COVID-19 period. Through the “American Rescue Plan Act,” Congress passed temporary provisions that (1) raised incentives for states that had not already expanded Medicaid access to low‑income adults to do so, and (2) expanded the ACA’s premium tax credits.18 As the state incentives expired in March 2023,19 and the premium tax credits expired at the end of 2025,20 researchers at the Urban Institute have projected that these reversions – and especially, the omission of any extension of the premium tax credits through the “One Big Beautiful Bill Act” – would yield drastic 2026 consequences for uncompensated care costs. The Urban Institute expects increased demand for uncompensated health care of 12 percent, or $7.7 billion, compared to demand with the premium tax credits still in place. Hospitals are projected to incur approximately $2.2 billion of these increased costs.21

Conclusion

Studies of ED visits and their effects on the financial viability of hospitals lead to two conclusions. First, people with insurance account for a larger share of ED visits. And second, providing insurance coverage to people who formerly did not have health insurance leads to substantial improvements in hospitals’ bottom lines, especially those in rural areas. It does this by increasing hospital revenue and reducing the high financial burden of uncompensated care that hospitals in states with large uninsured populations experience.

• This article was published at CEPR
• Acknowledgments: Thank you to Eileen Applebaum for providing valuable research insights and suggestions.

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1. See (as examples): Adam J. Singer et al., “US Emergency Department Visits and Hospital Discharges Among Uninsured Patients Before and After Implementation of the Affordable Care Act,” JAMA Network Open 2, no. 4 (2019),https://doi.org/10.1001/jamanetworkopen.2019.2662; Loredana Santo et al., “Trends in Emergency Department Visits Among People Younger Than Age 65 by Insurance Status: United States, 2010-2021,” National Health Statistics Reports, no. 197 (January 2024): 1–15, https://www.cdc.gov/nchs/data/nhsr/nhsr197.pdf.
2. Santo et al., 2024 (see Endnote 1).
3. Santo et al., 2024.
4. See: Madeline Guth et al., The Effects of Medicaid Expansion under the ACA: Studies from January 2014 to January 2020, Kaiser Family Foundation (KFF) (2020), 1–100,https://www.kff.org/affordable-care-act/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review/; Fan Zhao and Roch A. Nianogo, “Medicaid Expansion’s Impact on Emergency Department Use by State and Payer,” Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research 25, no. 4 (2022): 630–37, https://doi.org/10.1016/j.jval.2021.09.014.
5. Zhao and Nianogo, 2022 (see Endnote 4).
6. Afsaneh Asgharian et al., “Association Between the Affordable Care Act and Emergency Department Visits for Psychiatric Disease,” Western Journal of Emergency Medicine 24, no. 3 (2023): 447–53, https://doi.org/10.5811/westjem.57630.
7. Theodoros V. Giannouchos et al., “Association of Medicaid Expansion With Emergency Department Visits by Medical Urgency,” JAMA Network Open 5, no. 6 (2022): e2216913,https://doi.org/10.1001/jamanetworkopen.2022.16913.
8. David Dranove et al., “Uncompensated Care Decreased At Hospitals In Medicaid Expansion States But Not At Hospitals In Nonexpansion States,” Health Affairs 35, no. 8 (2016): 1471–79, https://doi.org/10.1377/hlthaff.2015.1344.
9. David Dranove et al., “The Impact of the ACA’s Medicaid Expansion on Hospitals’ Uncompensated Care Burden and the Potential Effects of Repeal,” Commonwealth Fund (2017), 1–9,https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_issue_brief_2017_may_dranove_aca_medicaid_expansion_hospital_uncomp_care_ib.pdf.
10. Jordan H. Rhodes et al., “Heterogeneous Effects of the ACA Medicaid Expansion on Hospital Financial Outcomes,” Contemporary Economic Policy 38, no. 1 (2020): 81–93,https://doi.org/10.1111/coep.12428.
11. Fredric Blavin and Christal Ramos, “Medicaid Expansion: Effects On Hospital Finances And Implications For Hospitals Facing COVID-19 Challenges,” Health Affairs 40, no. 1 (2021): 82–90, https://doi.org/10.1377/hlthaff.2020.00502.
12. Gary J. Young et al., “Impact of ACA Medicaid Expansion on Hospitals’ Financial Status,” Journal of Healthcare Management 64, no. 2 (2019): 91, https://doi.org/10.1097/JHM-D-17-00177.
13. Meghana Ammula and Madeline Guth, What Does the Recent Literature Say About Medicaid Expansion?: Economic Impacts on Providers, Kellogg Family Foundation (2023), https://www.kff.org/affordable-care-act/what-does-the-recent-literature-say-about-medicaid-expansion-economic-impacts-on-providers/.
14. Joseph A. Benitez and Eric E. Seiber, “US Health Care Reform and Rural America: Results From the ACA’s Medicaid Expansions,” The Journal of Rural Health 34, no. 2 (2018): 213–22, https://doi.org/10.1111/jrh.12284.
15. Emmaline Keesee et al., “Uncompensated Care Is Highest for Rural Hospitals, Particularly in Non-Expansion States,” Medical Care Research and Review 81, no. 2 (2024): 164–70, https://doi.org/10.1177/10775587231211366.
16. See: Thomas DeLeire et al., “Impact of Insurance Expansion on Hospital Uncompensated Care Costs in 2014,” U.S. Department of Health and Human Services – Office of the Assistant Secretary for Planning and Evaluation (2014),http://aspe.hhs.gov/health/reports/2014/uncompensatedcare/ib_uncompensatedcare.pdf; Danrove et al., 2016 (at Endnote 8); Rhodes et al., 2020 (at Endnote 10).
17. Susan Camilleri, “The ACA Medicaid Expansion, Disproportionate Share Hospitals, and Uncompensated Care,” Health Services Research 53, no. 3 (2017): 1562–80,https://doi.org/10.1111/1475-6773.12702.
18. Keith, Katie. “The American Rescue Plan Expands The ACA.” Health Affairs 40, no. 5 (2021): 696–97. https://doi.org/10.1377/hlthaff.2021.00597.
19. Centers for Medicare & Medicaid Services (CMS), “ARCHIVED: Unwinding and Returning to Regular Operations after COVID-19.” n.d., https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/archived-unwinding-and-returning-regular-operations-after-covid-19.
20. Ali Swenson, “Health Subsidies Expire, Launching Millions of Americans into 2026 with Steep Insurance Hikes,” Politics, Associated Press (January 1, 2026),https://apnews.com/article/affordable-care-act-health-subsidies-expire-35060610e82ca3257821c53f2a34ecf6.
21. Fredric Blavin and Michael Simpson, “Changes in Health Care Spending and Uncompensated Care under Enhanced Tax Credit Expiration for Marketplace Coverage: Updated 2026 State and National Estimates,” Urban Institute (2025),https://www.urban.org/research/publication/changes-health-care-spending-and-uncompensated-care-under-enhanced-tax-credit.

There Is Nothing New About Trump’s Economic Populism – OpEd

Trump’s policies are not guided by a coherent philosophy; they form a transactional strategy that draws on tactics employed by earlier Republican leaders. All this makes clear that such interventionism is a legacy of the GOP itself—rather than an aberration within the American right—as many analysts wrongly claim.

April 16, 2026 
By MISES
By Lorenzo Cianti


The Supreme Court’s 6–3 decision invalidating Donald Trump’s emergency tariffs, followed almost immediately by the President’s response reinstating and increasing them, reminds us once again how rapidly American politics evolves. Yet, in some cases, it pays to recognize that certain underlying threads in government policy remain constant, regardless of the period or the leaders in charge.

Too often, so-called “experts” weigh in on current events without any real command of economic history. Consider the outrage among prominent Republicans over Trump’s bombastic campaign promises and what his detractors see as troubling moves after returning to office.

In a December 2025 op-ed for The New York Times, former presidential candidate Mitt Romney contended that tariffs “burden lower- and middle-income families,” pointing to analyses showing they act as a regressive tax that hits the poorest Americans hardest. Still, in the same piece, he echoed progressive rhetoric by calling for higher taxes on the rich, himself included. We have no intention of defending Trump here, but one neglected aspect deserves attention.

For decades, a persistent myth has held that the Reagan-era GOP heralded an age of unfettered laissez-faire capitalism, nudging the entire ideological spectrum toward pro-free trade, business-friendly positions. It thus became natural to portray Trump as an outlier in the Republican fold—an irritating, heterodox chapter in the story of a party that, on the surface at least, has long championed individual liberty and small government. The truth, however, is far more nuanced than the dominant narrative would have us believe.

To debunk this simplistic notion, we must dissect the most salient aspects of Trump’s platform and compare them with the GOP’s historical record.

Protectionism

Protectionism stands as the policy Trump touts most proudly, so much so that he has proclaimed himself “Tariff Man.” He went further still, calling “tariff” the most beautiful word in the English language.

Contrary to conventional wisdom, the Republican Party emerged in the mid-1850s by inheriting Henry Clay’s “American System,” which formed the cornerstone of the Whigs’ agenda: leveraging the federal government to stabilize finance, protect and foster domestic industry, and build national infrastructure.

Whigs and early Republicans both favored higher tariffs not only to generate federal revenue, but also to safeguard and promote US manufacturers, with the goal of developing a more diversified, industrializing economy. As Lew Rockwell aptly noted in the introduction to Murray Rothbard’s For a New Liberty: The Libertarian Manifesto:


The Civil War, in addition to its unprecedented bloodshed and devastation, was used by the triumphal and virtually one–party Republican regime to drive through its statist, formerly Whig, program: national governmental power, protective tariff, subsidies to big business, inflationary paper money, resumed control of the federal government over banking, large–scale internal improvements, high excise taxes, and, during the war, conscription and an income tax.

The US House of Representatives passed the Morrill Tariff on the eve of Lincoln’s presidency. The measure sharply raised tariff rates on dutiable imports and widened the protectionist scope of federal policy. A subsequent adjustment soon pushed rates even higher.

The 1890 McKinley Tariff, named after then-Representative William McKinley, established the highest average tariff level in US history up to that time, with some rates surpassing 100 percent. The Fordney-McCumber Tariff of 1922, enacted under Warren Harding, produced substantial increases in a decade defined by isolationism and protectionist sentiment.

Yet it was the Smoot–Hawley Tariff Act of 1930, signed into law by Herbert Hoover, that delivered the most dramatic escalation of duties in American history to that point. This infamous measure lifted average tariff rates to approximately 60 percent—up from the Fordney-McCumber level of 38 percent—in an effort to shield domestic employment. The result was a cascade of retaliatory tariffs from trading partners around the world.


The Smoot-Hawley Act was a classic example of beggar–thy–neighbor policy, in which one country pursues its own national advantage at the direct expense of others. This zero-sum logic parallels the rationale behind Trump’s tariffs, as the following chart illustrates:

Source: PIIE, US Global Investors

Price Controls

On December 19, 2025, Trump announced nine new agreements with major pharmaceutical companies to lower prescription drug prices for American patients, bringing them in line with the lowest prices paid in other developed countries (known as most-favored-nation, or MFN, pricing). These voluntary deals lower costs for Medicaid programs and certain direct–to–consumer sales, building on earlier MFN efforts from his administration.

The best-known historical precedent came on August 15, 1971, when Richard Nixon declared a 90-day freeze on wages and prices as part of his New Economic Policy. That move aimed to combat runaway inflation and avert a currency crisis amid the collapse of the Bretton Woods system.

It was the first peacetime imposition of mandatory wage and price controls in US history, initially winning broad public support but then proving disastrous. Driven by stagflation and fears of a gold drain after the dollar’s convertibility ended, the inflation rate had climbed above 12 percent by 1974.

The program evolved through multiple phases, including the establishment of the Pay Board and Price Commission to oversee allowable increases. Artificially-suppressed prices quickly led to widespread shortages, most notably in gasoline and steel, with long lines at pumps and rationing conditions. Businesses, unable to cover costs, reduced output, cut quality, or were forced to shut down.

The controls disrupted market signals, prevented economic calculation, and failed to curb long–term inflation, contributing to distortions that lingered for years. Why should we believe similar interventions today would produce different results?

Tax Cuts

Through the 2017 Tax Cuts and Jobs Act (TCJA), Trump’s first term delivered the most significant federal tax overhaul since the 1980s.

This mirrors Ronald Reagan’s 1981 Economic Recovery Tax Act—which phased in a 25 percent across-the-board cut in individual rates (top marginal from 70 percent to 50 percent), accelerated depreciation, and inflation indexing—and the 1986 Tax Reform Act, which simplified brackets and dropped the top rate to 28 percent, but left overall revenue roughly intact due to offsets.

As Rothbard asserted in his critique of Reaganomics, these cuts were illusory and temporary in practice, offset by bracket creep, rising payroll taxes, stealth increases, and massive spending growth that ballooned the federal deficit without structural restraint. Although any tax cut should be welcome, in both cases, these were easily reversible measures that drove deficits higher because they were not accompanied by cuts to public spending and government departments.

Government Spending

The Republican embrace of expansive government spending under the banner of “compassionate conservatism” reached new heights during George W. Bush’s presidency.

In 2003, Bush signed Medicare Part D—a massive new entitlement program providing prescription drug benefits to seniors—with initial costs estimated at $400 billion over ten years, later revised upward to $534 billion. The voluntary benefit, administered through private insurers, represented a major expansion of federal involvement in healthcare, adding trillions to long-term liabilities without corresponding offsets.

Similarly, in October 2008, Bush enacted the Troubled Asset Relief Program (TARP) as part of the Emergency Economic Stabilization Act, authorizing $700 billion (then capped at $475 billion) to bail out financial institutions by purchasing troubled assets, ultimately disbursing $443 billion with a net cost of $31 billion after recoveries.

These interventions underscored the GOP’s willingness to deploy federal resources during crises and foreshadow Trump’s own big-spending tendencies. Bush’s 2008 Economic Stimulus Act also provided $152 billion in rebate checks to over 130 million households, aimed at boosting spending amid the financial crisis.

That approach finds a counterpart in Trump’s 2020 CARES Act—a $2 trillion package that included $1,200 direct payments per adult as part of broader relief, though on a vastly larger scale (12 percent of GDP in 2020 versus 1 percent in 2008). Both initiatives sought rapid economic stimulus but prioritized short-term aid over fiscal restraint.

Conclusion

Trump’s policies are not guided by a coherent philosophy; they form a transactional strategy that draws on tactics employed by earlier Republican leaders. They are best understood as a somewhat disorganized, contradictory blend of neo-mercantilism, national populism, and old-school protectionism, rooted in the Whig program and traditional Republicanism.

Trumpism combines higher tariffs abroad with “fewer regulations” at home, folding in Nixon’s price controls, Reagan’s tax cuts, and Bush’s expansionary policies. All this makes clear that such interventionism is a legacy of the GOP itself—rather than an aberration within the American right—as many analysts wrongly claim.

About the author:

 Lorenzo Cianti is a student of Political Science and International Relations at Roma Tre University. Passionate about Austrian Economics and political philosophy, he is a regular contributor to L’Opinione delle Libertà—Italy’s oldest continuously published newspaper—and to the online magazine Atlantico Quotidiano. He was a finalist in the 2026 Kenneth Garschina Undergraduate Student Essay Contest for the essay “The Chainsaw Revolution: Javier Milei’s Rothbardian Assault on Argentine Collectivism.”

Source: This article was published by the Mises Institute

The Mises Institute, founded in 1982, teaches the scholarship of Austrian economics, freedom, and peace. The liberal intellectual tradition of Ludwig von Mises (1881-1973) and Murray N. Rothbard (1926-1995) guides us. Accordingly, the Mises Institute seeks a profound and radical shift in the intellectual climate: away from statism and toward a private property order. The Mises Institute encourages critical historical research, and stands against political correctness.

These Proposals Would Make Life Better for Millions of People—And Most Americans Support Them

“That the US Congress is not debating or introducing bills to address the issues presented here represents a breakdown of democracy,” said an economic justice think tank.


Sister Diane Smith, with CLUE (Clergy and Laity United for Economic Justice), joins The Fair Games Coalition to announce the launch of the Overpaid CEO Tax Initiative in front of the Tesla Diner in Los Angeles on January 14, 2026.
(Photo by Genaro Molina/Los Angeles Times via Getty Images)

Julia Conley
Apr 13, 2026
COMMON DREAMS

A new report by an economic think tank takes aim at the broadly accepted idea that Americans are divided on the major issues affecting millions of people every day—the question of how to ensure everyone can get the healthcare they need without going bankrupt, how the government can ensure working people make enough money to live, and whether the US should take more aggressive climate action.

As it turns out, the Center for Economic and Policy Research (CEPR) suggested Monday, there’s far more agreement on those and more issues across the political spectrum than the corporate media and establishment politicians from both sides of the aisle would have the public believe.

Lawmakers who push for good, fair-paying jobs for all workers; raising the chronically stagnant federal minimum wage; guaranteeing healthcare for all Americans; clean energy investments; and ending the influence of corporations and billionaires on US elections would not be advocating for policies that are just popular on the left, the report says, but would actually be promoting a “Majority Agenda.”

“It may feel like Americans agree on nothing right now, but recent polling tells a different story,” said CEPR on social media. “From raising the minimum wage and strengthening Social Security to affordable housing and healthcare reform, these progressive policies are broadly popular despite the political establishment continuing to ignore them.”

The group pointed to one 2024 poll by the American Communities Project that showed more than 60% of Americans agreed that the economy “is rigged to advantage the rich and the powerful,” while 62% disagreed with the idea of cutting social programs to lower taxes.

Another 2024 poll by The Associated Press found that 91% of Americans supported equal protection under the law and 88% supported the right to privacy, while a 2020 poll by the Carr Center for Human Rights at Harvard Kennedy School revealed that 89% of Americans expressed strong support for affordable healthcare, 85% felt people have the right to a job, and 93% thought the right to clean air and water is essential.

Analyzing those surveys and other data, CEPR advised policymakers to consider the Majority Agenda as a “roadmap” to passing policies that large majorities of Americans view as major priorities to improve their quality of life.

The report is divided into three sections: Good Jobs, Strong Infrastructure, and Fair Play.

To push for fair, well-paying employment, said CEPR, lawmakers should support policies including:Increasing unionization‚ supported by 68% of Americans in one recent poll, through the Protecting the Right to Organize (PRO) Act, cracking down on retaliation against union members, and repealing or reforming the Taft-Hartley Act;
Raising the $7.25 federal minimum wage, supported by 86% of Americans; and
Setting a floor for paid time off from work by strengthening the Family and Medical Leave Act.

The section on strengthening US “infrastructure” looks beyond the traditional definition of the term regarding physical infrastructure projects, pushing for stronger policies that can help working people thrive by ensuring their healthcare, housing, and other basic needs are met.

A stronger infrastructure, said CEPR, would include:Guaranteed healthcare for everyone in the US through the passage of the Medicare for All Act, which has been introduced in the US House and Senate numerous times, and a corporate practice of medicine law to stop the corporatization of healthcare;
A reversal of the trend of federal housing policy directing “too much funding to the wealthy and too little for everyone else,” by ending federal restrictions on the creation of new federal public housing instead of investing in mortgage interest deductions for wealthy homeowners and the Low-Income Housing Tax Credit, whose benefits are greater for wealthy investors than for low-income renters; and
An investment in clean energy by reinstating Biden-era regulations and strengthening the Clean Air Act and other environmental protection laws in order to meet the demands of 59% of Americans who view the climate crisis as “very or extremely dangerous,” according to a 2021 poll by the University of Chicago.

CEPR pointed to three areas in which lawmakers could increase “fair play” for Americans:Strengthening and supporting Social Security, which Republicans frequently attack as rife with fraud and on the verge of going broke, by diverting some among of general revenue to the program and increasing monthly benefits modestly;
Passing a constitutional amendment to allow the government to regulate campaign fundraising and spending both by campaigns and outside individuals and artificial entities; and
Raising taxes on large businesses and the wealthy, as large majorities of Americans believe government should, and restoring funding to the Internal Revenue Service to ensure proper collection of taxes.

“That the US Congress is not debating or introducing bills to address the issues presented here represents a breakdown of democracy, one that comes at a considerable cost to the betterment of life for large swaths of Americans. At the same time, the access to and influence over our democratic processes by the monied class has upended our system of government, and all too often the tyranny of the wealthy minority has reigned,” reads the CEPR report.

“We hope this report stands as a reminder that even in a fraught political moment,” said CEPR, “there is a range of straightforward, broadly popular policy choices that could improve the lives of millions of people.”

New study reveals what the White House doesn't want you to know about prices

FILE PHOTO: Federal Reserve Chair Jerome Powell looks at U.S. President Donald Trump holding a document during a tour of the Federal Reserve Board building, which is currently undergoing renovations, in Washington, D.C., U.S., July 24, 2025. REUTERS/Kent Nishimura/File Photo

Matthew Rozsa

April 13, 2026 

ALTERNET

President Donald Trump insists the US economy has never done better than under his second term, but a right-leaning magazine just published an article claiming the opposite is true — indisputably so.


“Tariffs implemented last year by President Donald Trump's administration are entirely to blame for the recent surge in prices for consumer and household goods,” wrote Reason's economic policy reporter Eric Boehm on Monday. ”Those tariffs have raised core goods prices by 3.1 percent, according to a new study by a trio of economists at the Federal Reserve. Those higher consumer prices were the result of retailers passing the cost of tariffs along the supply chain.”

As of two months ago, Trump’s tariffs entirely account for the excess inflation of core goods that Americans have felt since the start of his second term.


"Our estimates indicate that tariff effects on prices gradually build over time, with cumulative effects seven months after implementation consistent with our theoretical measures of full dollar-for-dollar pass-through,” the economists wrote. Boehm added that “the study used the personal consumption expenditures price index (PCE), which is published quarterly by the federal Bureau of Economic Analysis and differs in some small ways from the monthly consumer price index published by the Department of Labor.”

“High prices causes real wages to fall, reversing the gains made since last summer in 2025,” former Special Assistant to President Joe Biden on the National Economic Council Mike Konczal wrote earlier this month regarding prices and tariffs under Trump. A former adviser to President Barack Obama, Betsey Stevenson, similarly wrote that "wars mean declining living standards for everyone,” referencing Trump's unprovoked conflicts against Venezuela and Iran.


Trump’s “tariff shock” has especially hit America’s auto industry, with car magazine WardsAuto reporting last month that “General Motors projects a tariff hit of $3.5 to $4.5 billion in 2025. Ford absorbed an $800 million second-quarter blow. Volkswagen is bracing for a €5 billion impact. Cox Automotive estimates the industry has collectively accumulated more than $25 billion in tariff obligations through just the first seven months of the year — roughly $5,200 per imported vehicle. For vehicles built in Mexico, a critical manufacturing hub, the added cost runs to approximately $4,800 per unit, effectively turning the build-in-Mexico business model upside down.”

As Americans continue to struggle economically because of Trump’s tariffs conservatives like Mona Charen of The Bulwark worry that Republicans will lose in future elections because of the economy.

“Voters are rarely able to connect policy to outcomes, but they have done so in the case of tariffs,” Charen wrote in February. “Back in 2024, Americans were about equally divided on the question of trade, with some favoring higher tariffs and roughly similar numbers opting for lower tariffs. Experience has changed their views.”


She concluded Democrats could win if they embrace as their campaign message, "Tariffs bad—full stop.”