Is New York's "Safety Net" A Success?

One of the many specialized publications here in New York is something called “Crain’s New York Business.” As its title suggests, Crain’s covers mostly the affairs of the business community, although from time to time it also dabbles in political and policy matters. Sometimes it even has some sensible things to say. And sometimes not.

This week’s issue of Crain’s is dominated by a cover story titled “The State of Inequality: A Program for Every Problem.” The article has the byline of Crain’s head editor Greg David (although I doubt he actually wrote it — it’s not his usual style at all). It purports to be a review of the state of the “safety net” and its many subsidiary programs here in New York, together with, to some degree, a comparison of same to similar programs in certain other states (Georgia, Texas, Washington).

This lengthy piece is a serious embarrassment to Crain’s. It could not be worse if they simply had published verbatim a pile of campaign propaganda fed to them by a Cuomo or a de Blasio — which may very well be what this actually is. I’ll first take you through what the article says, and then I’ll go over a few of the elephants standing around here that they have somehow missed.

The basic theme of the piece is that New York has the most extensive array of social safety net programs in the country, and THEY’RE WORKING !!!!!! And how do we know that THEY’RE WORKING !!!!! ? Because we have followed the basic journalistic technique of interviewing some of the beneficiaries of the programs, and some of the bureaucrats who run the programs. And, remarkably, those people are unanimous in declaring the great success of the programs that they benefit from and/or administer. QED! Now, has anyone thought to maybe go out and collect some data as to, for example, how New York compares to other jurisdictions in actually reducing poverty, or reducing income inequality, or (in the case of medical programs) extending life expectancy? Of course, you will not find any of that in this article. Really, it’s shameful.

The piece starts with a litany of some of the vast array of safety net programs that are unique to New York, either as to their existence or scope. Some examples:

New York state spends $57 billion on Medicaid and other health care, while the city spends $6 billion on Medicaid and home care and allocated $1.1 billion for affordable housing last year. Universal prekindergarten costs the city $863 million a year, and extending it to 3-year-olds will add $203 million. The city also spends about $1.5 billion on shelter operations and housing placement, plus $670 million on programs for HIV/AIDS, domestic violence and employment services. . . . In the last fiscal year, the state spent some $1 billion for Family Assistance, $400 million for Safety Net Assistance and $2.9 billion for food stamps in New York City. From its own budget, the city will spend an additional $24.8 million on its Emergency Food Assistance Program in the current year; this helps feed 1 million residents through the Food Bank of New York, food pantries and other social-services operators.

And you thought that welfare and food stamps were fully funded by the feds? Wrong! Around here, when the time-limited federal benefits run out, the state steps in and keeps paying indefinitely. And the result? Success!

New York City looks after its poorest with a generosity, scale and effort unmatched anywhere in the country. It does this by knitting together a safety net of federal, state and city programs, aggressively enrolling beneficiaries using outreach such as through the Public Engagement Unit and providing money to supplement federal benefits, especially those under assault by Republicans in Washington.

Oh, those evil Republicans! And how about over on the medical side? There, New York has gone for every possible bell and whistle that might be added on top of basic Obamacare and Medicaid:

New York not only accepted the federal funding offered by the Affordable Care Act for Medicaid expansion, but it also added an Essential Plan, which is like Medicaid for those with slightly higher incomes and costs no more than $20 a month in premiums with no deductible. For individuals earning up to $17,655 and families of four making up to $36,374, everything else in the plan is free except for prescription drugs, which are $1 to $3. Only in the highest-earning tier are there any copays. . . . The state's Child Health Plus also chips in to insure children whose family income is between 1.6 and four times the poverty level at a cost to households of $60 per child per month—maxing out at $180—with no copays. All told, the expanded coverage shrank the uninsured rate in the city from 15.1% in 2013 to 8.9% in 2016.

And the result? Success!

The state's medical coverage is not just large; it's also effective, innovative and more affordable thanks to reforms made during the first year of the Cuomo administration. A key has been integrated approaches to managed care, pioneered at Montefiore Health System, where Williamson receives her care. The model works by coordinating treatment—and costs—among providers. That means pushing health clinics to be more like social-services centers, said Stephen Rosenthal, chief operating officer at Montefiore's CMO, The Care Management Co., which focuses on the patient experience. "We have learned that, in order to be effective at managing care, we have to go one step beyond and manage their lives," [said a Montefiore spokesperson].

I could go on. The Crain’s article also contains lengthy sections attributing recent increases in incomes at the low end of the distribution 100% to state-mandated minimum wage increases and 0% to the booming economy; and attributing recent improvements in housing affordability 100% to government “affordability” programs and rent regulations and 0% to increased supply stemming from healthy levels of private housing construction. But I’ll skip over those in the interests of not overly boring the readership.

So are there any elephants standing around here that Crain’s seems to have missed? For example, if you were looking to find out if New York City’s by-far-the-most-generous-in-the-nation anti-poverty programs actually were more successful than the less-generous efforts of the other places, would you maybe look to see how the “poverty rate” has trended over time in New York City compared to the country as a whole? Naive as I am, that would be my first idea. And it turns out that those data are readily available.

This link goes to a report put out by the New York Federal Reserve Bank in 2008, titled “Poverty in New York City: 1969-1999.” I can’t tell you why it took them 9 years after 1999 to put this report together. But here’s what they say about the poverty rate in New York City versus the nation in 1969: “In 1969, 14.5 percent of [New York City] residents lived below the poverty line, a rate comparable to the nation’s 13.7 percent.” Thirty years later: “In 1999, the [New York City] poverty rate stood at 21.9 percent, more than 7 percentage points above the 1969 level and nearly 10 points above the U.S. rate of 12.4 percent.” For the most recent data (2016 is the most recent I can find specific to New York City), the “NYC Opportunity 2018 Poverty Report” gives a New York City rate of 19.5%; the Census Bureau gives a national rate for the same year of 12.7%.

Success? I can’t think of any way of painting this other than as an unmitigated disaster. How could it be that for all of our extra spending and extraordinary generosity, we end up with a “poverty rate” nearly 7 points above the national norm? And really, it’s worse than that, because we started out right around the national norm, and the billions and billions of extra spending have clearly made the problem far worse.

Surely though, that huge suite of anti-poverty programs must have put a big dent in income inequality? Actually, of course, again it’s the opposite. The Axios website helpfully supplies a scatter plot of income inequality by Congressional district, updated to the most recent data (again 2016). The metric is the famous Gini coefficient, where 1.00 is perfect inequality (one person gets all the income) and 0.00 represents perfect equality (everyone’s income the same). As in past years, the champion of all Congressional districts is my own NY-10 — the very core of New York City, home to the New York Times, NYU and Columbia Universities, Wall Street and Mayor de Blasio’s office at City Hall — with a Gini coefficient of 0.58. And right up there at 5th place and 0.56 is the other big Manhattan district, NY-12. (Out there in flyover country, where government handouts are far less generous, Gini coefficients go all the way down to 0.39.)

OK then, one more try. It must be that New York City’s extraordinary generosity with Medicaid and other medical benefits and healthcare “coverage” have dramatically improved the health outcomes of the poor? Well, not that you can find in the data. In 2016 New York City published a neighborhood-by-neighborhood breakdown of health outcomes, which I covered in this post from March 2017. What those data showed was that universally the neighborhoods with high rates of Medicaid coverage (Harlem, the South Bronx, Bedford-Stuyvesant, Bushwick, Brownsville) had dramatically worse health outcomes than the more prosperous neighborhoods. The New York Post, reporting on a Summary of Vital Statistics put out by the City in June 2017, had this to say:

[T]he chasm [in health outcomes] between the city’s richest and poorest neighborhoods remains striking. Manhattan’s wealthiest residents can expect to live a full decade longer than those in Brownsville, Brooklyn, and the South Bronx. Brownsville has the city’s highest murder rate, and several Bronx neighborhoods lead the city in infant morality.

In short, another unmitigated disaster.

With the newly enhanced numbers of Democrats in the state legislature after the recent election, it is likely that we will be seeing yet more efforts to expand our already-generous safety net programs, supposedly to attack poverty and homelessness and to improve health outcomes. Obviously, there is a high level of support among the voters in New York for such efforts. And even I could be convinced to support such programs, if there could be a demonstration that some program or other actually worked to some degree to ameliorate the problem at hand. But instead what we find is advocacy journalism, intentionally suppressing easily-available data and information that make it completely clear how these programs only enrich the bureaucrats and leave the supposed beneficiaries languishing in a lifetime of poverty.