Healthcare lost 1.4 million jobs in April amid the COVID-19 pandemic, primarily in ambulatory healthcare services, according to the latest jobs report from the U.S. Bureau of Labor Statistics.
The April count compares to 43,000 healthcare jobs lost in March.
Within ambulatory healthcare services, April job losses included offices of dentists (503,300), offices of physicians (243,300), and offices of other healthcare practitioners (205,100).
Hospitals lost 134,900 jobs last month, compared to the 200 positions they added to the U.S. economy in March.
The April jobs report marks the second consecutive month that healthcare employment did not grow. In the 12 months prior to March — the month the World Health Organization declared the COVID-19 spread a pandemic — industry employment had grown by 374,000, according to the bureau.
Bloomberg reported the number of healthcare workers has doubled to 16 million in the last three decades, and until March, the industry has lost jobs in only four months during that period.
Overall, the U.S. lost 20.5 million jobs in April, and the unemployment rate reached 14.7 percent, the highest since the Great Depression, according to the bureau.
The unemployment rate does not reflect Americans still working who have had their hours or pay reduced, The New York Times noted.
Minorities and low-income people are more likely to become seriously ill if infected with the coronavirus, according to a new Kaiser Family Foundation analysis.
Why it matters: These populations are also less likely to be able to social distance, or have been hit hardest economically by doing so. The coronavirus may be a national problem, but its impact is most devastating to the people who were already worse off.
The big picture: Even before the virus hit, minorities suffered from worse health outcomes, in part because they’re more likely to be low-income — which is also correlated with higher rates of chronic conditions.
Between the lines: People with low-income jobs deemed essential — like grocery store workers, home health aides or delivery drivers — are also at higher risk of contracting the virus.
https://www.axios.com/coronavirus-states-economy-295ac091-9dc2-4852-be67-d070ec268d8c.html
YEAR-OVER-YEAR CHANGE IN STATE TAX REVENUES
April 2020 vs. April 2019, select states
Early numbers show how significantly the coronavirus is devastating states’ revenue streams — and could force choices between raising taxes or gutting services and laying off public employees.
Why it matters: Even as some states move toward reopening, the economic ramifications of having shut down will haunt them far into the future.
What to watch: Sens. Bob Menendez (D-N.J.) and Bill Cassidy (R-La.) plan to introduce bipartisan legislation as soon as next week that would create a $500 billion fund designed to help struggling state and municipality budgets in the wake of COVID-19.
By the numbers: The Urban Institute has been compiling lost revenue data as states make it publicly available. So far, there are figures for about one in four states that compare this April’s state income and sales tax revenue collections against those from April 2019.
The big picture: Democratic-leaning cities have seen the highest case and death rates. But red and blue states alike are facing serious budget shortfalls.
Between the lines: Much of the burden will likely be pushed on struggling local governments’ plates, White said.
Some state and local governments will wait to make tough budget decisions in the hopes that they get needed funds from Congress, which is in heated negotiations around the fourth stimulus package.
Republican lawmakers have been hesitant to provide this much federal help to states, but they’ve been warming to the idea.
Small hospitals going through bankruptcy are suing the Small Business Administration, arguing it is unlawful for the federal government to deny them loans under the Paycheck Protection Program, Axios’ Bob Herman reports.
Why it matters: Allowing bankrupt hospitals access to PPP loans could keep their doors open, and could force the federal government to reverse its stance and allow other bankrupt firms to get PPP loans.
Driving the news: Faith Community Health System, a small rural hospital in Texas that filed for bankruptcy in February, sued the SBA Thursday.
The big picture: Courts are starting to take hospitals’ side.
The bottom line: Rural hospitals have been in dire straits for years, and for those that are on the precipice of or are going through bankruptcy, they may be eligible for this bailout funding despite SBA exclusions.
You’re either a liberal snowflake controlled by big government or a greedy conservative willing to sacrifice Grandma for the economy. It took less than two months for Americans to get here.
Wear a mask? You’re a liberal snowflake controlled by big government. Want to reopen restaurants? You’re a greedy conservative willing to sacrifice Grandma for the economy.
It took less than two months for the coronavirus pandemic to become just the latest battle in the culture wars.
With the country still in the firm grip of the coronavirus pandemic, conservatives are on social media and Fox News stoking protests that argue masks, stay-at-home orders and social distancing violate constitutional rights and are causing unacceptable harm to the economy.
Liberals, at the same time, say personal liberties must be sacrificed for public health, even as millions file for unemployment and more than a quarter of the work force is jobless in some states.
Take a look at what two governors — one from a reliably Republican state and another from a reliably Democratic state — said this week.
“We have a public health crisis in this country, there’s no doubt about it,” Gov. Tate Reeves of Mississippi said in an appearance on “Fox News Sunday.” “But we also have an economic crisis.”
“We have turned the corner and we are on the decline,” Gov. Andrew M. Cuomo said, citing an article showing that the death rate has fallen by half in New York City, in his daily briefing on Wednesday. “To me, that vindicates what we are doing here in New York, which says: Follow the science, follow the data, put the politics aside and the emotion aside. What we’re doing here shows results.”
The problem with all these politics? Epidemiology.
So far, the virus has hit Democratic states the hardest, with the most cases per capita in five deeply Democratic states — New York, New Jersey, Massachusetts, California and Illinois. Cities have borne the brunt of the caseload. And African-Americans and Latinos — a key part of the Democratic coalition — are getting sick and dying of the virus at higher rates.
But anyone who believes this virus is fading away — or somehow contained to urban areas — is engaging in some serious magical thinking.
At least 25,000 new coronavirus cases are identified almost daily, meaning that the total in the United States — which has the highest number of known cases in the world — is expanding daily by 2 to 4 percent.
A New York Times analysis found that 18 of the states that are reopening had an increase of daily average cases over the last two weeks. Fifteen of those states are led by Republican governors.
Three of the top five states where the virus is spreading the fastest — Texas, Georgia and Ohio — have Republican governors and Republican-controlled legislatures. All three have moved toward reopening.
In the Midwest and South, smaller towns and more rural areas have suddenly been hit hard as the virus tears through nursing homes, meatpacking plants and prisons.
The nation’s highest per capita infection rate can be found in Trousdale County, Tenn., a rural county where a prison has become a hot spot. Businesses in the county are reopening this week.
In the Trump era, rural counties like Trousdale have represented the backbone of the Republican base. In Trousdale, nearly 67 percent of the county supported President Trump in 2016. Over all, the average margin of victory in rural counties won by Republicans was nearly 47 percent in 2016.
Rural areas tend to be older and have a larger share of the population with pre-existing medical conditions, making them far more vulnerable to the worst health effects of the virus.
Republican governors and conservative activists may think the coronavirus is an urban problem. Or a density problem. Or, quite frankly, a Democratic problem.
They may soon find out that it’s not.
https://www.goldmansachs.com/insights/pages/reopening-the-us-economy.html
Allison Nathan, senior strategist for Goldman Sachs Research, discusses her latest Top of Mind report where she speaks with leading experts across health and policy to understand how well-positioned the U.S. is to achieve a safe reopening of the economy and how quickly it would translate into economic recovery.
With COVID-19 mitigation measures leading to an apparent leveling off of case
growth globally at the same time that the economic costs of such measures continue
to mount, several countries around the world have begun to plan for—or have
already started to implement—economic reopening. But absent herd immunity or
a vaccine for the virus, such reopenings increase the risk of disease resurgence.
With this in mind, what a safe reopening might look like, how well-positioned the
US is to achieve one and how quickly reopening would really translate into economic
recovery is Top of Mind. We consult three experts on these questions: University of
Pennsylvania’s Dr. Zeke Emanuel, Duke University’s Dr. Mark McClellan and Harvard
University’s Dr. Barry Bloom. And we share our own take on a potential US recovery path, informed by lessons from
China’s reopening experience so far. Finally, with more complete economic normalization only likely with an effective
testing regime, treatments, or a widely available vaccine for COVID-19-we discuss where we are on all of the above.
Several hours later, we got another example of the White House resisting what those health experts are advising.
The Associated Press reported around midnight that the White House had shelved planned guidelines from the Centers for Disease Control and Prevention. The document, which was due nearly a week ago, was aimed at providing local authorities with step-by-step guidance on how to reopen:
The 17-page report by a Centers for Disease Control and Prevention team, titled “Guidance for Implementing the Opening Up America Again Framework,” was researched and written to help faith leaders, business owners, educators and state and local officials as they begin to reopen.It was supposed to be published last Friday, but agency scientists were told the guidance “would never see the light of day,” according to a CDC official. The official was not authorized to talk to reporters and spoke to The Associated Press on the condition of anonymity.
A coronavirus task force official told The Washington Post that the document has not been completely shelved but was in the process of being revised because it was “overly specific.” The official also indicated that it was felt the document was too broad, as “guidance in rural Tennessee shouldn’t be the same guidance for urban New York City.”
The denial, though, reinforces that the White House is reluctant to submit to the CDC’s more detailed prescriptions for reopening the economy. And it’s difficult to divorce the delay in this document’s publication from Trump’s anxiety to reopen the economy — and the tension that has created with past guidelines.
The administration in mid-April issued phased advice on when areas should start to reopen places such as restaurants and other nonessential businesses. But many states have moved forward with certain elements of reopening without actually satisfying those guidelines. Most notably, they have begun to reopen without meeting the Phase One guideline that they should see a decrease in confirmed coronavirus cases over a 14-day period.
As The Post’s Philip Bump reported, some states that have pushed forward with reopening have also seen an increase in cases — which would prevent them from satisfying the requirement for moving into Phase Two. That requirement is that the decline should continue for another 14 days after Phase One begins.
Issuing a detailed document would seemingly complicate further reopenings, because it would again restrict what states and local authorities are supposed to do.
The Washington Post’s Lena H. Sun and Josh Dawsey previewed what the document was set to look like last week. And they also obtained a draft of the document. The new guidelines were to go beyond the initial ones in prescribing specific actions that could be taken in each phase of the reopening. Advocates for reopening have worried that strict guidance could make it difficult for businesses, churches, child-care centers and other facilities to actually function.
Trump, who has long signaled a desire to begin reopening that economy sooner rather than later, has doubled down on that rhetoric in recent days. Despite a steady national death rate that approached previous highs on Tuesday and Wednesday, and even though cases continue to increase outside the major U.S. hotbed of New York City, Trump on Tuesday signaled that we are entering the “next stage” of reopening the economy.
“Thanks to the profound commitment of our citizens, we’ve flattened the curve, and countless American lives have been saved,” Trump said. “Our country is now in the next stage of the battle: a very safe phased and gradual reopening. So, reopening of our country — who would have ever thought we were going to be saying that? A reopening. Reopening.”
Trump has been resistant to the advice of the health officials around him, from the early days of the outbreak when he continuously downplayed the severity of the situation. On several occasions, this tension has boiled over.
We’re also hearing from those officials less and less. The CDC long ago ceased holding briefings on the coronavirus outbreak, and the White House coronavirus task force briefings, which often featured health experts Anthony S. Fauci and Deborah Birx, have now been halted in favor of less-frequent and less-coronavirus-focused briefings from McEnany. Fauci has also been prevented from testifying to the Democratic-controlled House, although he is still slated to testify in the GOP-controlled Senate and has continued doing some interviews. The cumulative effect is that these health experts aren’t on the record as much as the effort to reopen the economy begins in earnest.
In the place of those public comments, the CDC guidelines were to provide firm and detailed advice from those officials for the new stage. But for reasons that seem pretty conspicuous, we still don’t have them.
Market participants got another pulse check on the U.S. labor market Thursday, as the world continues to grapple with the COVID-19 pandemic and ahead of the highly-anticipated April jobs report.
Another 3.169 million Americans filed for unemployment benefits in the week ending May 2, exceeding economists expectations for 3 million initial jobless claims. The prior week’s figure was revised higher to 3.846 million from the previously reported 3.839 million. So far over the past seven weeks, more than 33 million Americans have filed unemployment insurance claims.
Continuing claims, which lags initial jobless claims data by one week, totaled a record 22.65 million in the week ending April 25. The prior week’s 17.99 million continuing claims was revised higher to 18.01 million.
The weekly number of jobless claims has been steadily declining even as the cumulative number remains high.
“Jobless claims in the U.S. slowed again last week, but not as much as hoped. As the economy re-opens more broadly this process should accelerate, but the economic pain resulting from mass unemployment will restrain the recovery process,” ING economist James Knightley said in a note Thursday.
“This report tells us nothing about hiring though, which is likely to remain weak for some time to come given the economically depressing effects of social distancing, consumer caution relating to Covid-19 fears, travel restrictions and the legacy of tens of millions of people being out of work,” Knightley added.
Certain states got hit harder than others last week, as backlogs continue to get processed. California saw the highest number of initial jobless claims at an estimated 318,000 on an unadjusted basis, down from 325,000 in the prior week. Texas reported 247,000, down from 254,000 in the previous week. Georgia had an estimated 227,000 and New York reported 195,000. Florida, which had the highest number of claims in the prior week, reported 173,000 in the week ending May 2, down considerably from 433,000.
Thursday’s weekly claims report comes ahead of the Bureau of Labor Statistic’s April jobs report and on the heels of the ADP employment report. Wednesday morning, the U.S. private sector lost 20.23 million jobs in April and was the worst loss in the report’s history, according to ADP.
“Job losses of this scale are unprecedented. The total number of job losses for the month of April alone was more than double the total jobs lost during the Great Recession,” ADP Research Institute Co-Head Ahu Yildirmaz said in a statement.
“Additionally, it is important to note that the report is based on the total number of payroll records for employees who were active on a company’s payroll through the 12th of the month. This is the same time period the Bureau of Labor and Statistics uses for their survey,” Yildirmaz added.
Though the ADP report is not always a reliable indicator of what the BLS report will illustrate, it does provide a bit of insight into the health of employment in the U.S.
“The report is a bit light on details of any potential methodological problems this month. The ADP counts anyone on the active payroll rather than just people who were paid during the month, which is the official non-farm payroll definition. Within many people put on temporary layoff, that could have created a discrepancy, with those people still on the active payroll, but not counted in the official non-farm payroll figures and also qualifying as unemployed in the other official household survey,” Capital Economics said in a note Wednesday.
Economists polled by Bloomberg expect 21.3 million jobs losses in April when the BLS releases its report Friday morning, down significantly from 701,000 job losses in March. The unemployment rate is estimated to have surged to 16% from 4.4% in the prior month.
“April jobs report should go down in infamy,” Bank of America economists said in a note Wednesday. “The April employment report will reveal unprecedented job losses as the economy has been shutdown to control the spread of COVID-19.” The firm projects 22 million job losses during the month amid the global pandemic.
One important thing to note with April’s jobs report is that there might be some discrepancies in the two surveys. A furloughed person, who is not working but has not been laid off, will be classified as unemployed or temporarily laid off in the household survey. However, if they were paid at any point during the establishment survey period, they will be classified as employed.
As of Thursday morning, there were 3.7 million confirmed coronavirus cases and 264,000 deaths globally, according to Johns Hopkins University data. In the U.S., there were 1.2 million cases and 73,000 deaths.
Three states have cut back state spending on the program since the pandemic hit, and more are warning of painful cuts to benefits and services.
States facing sudden drops in tax revenue amid the pandemic are announcing deep cuts to their Medicaid programs just as millions of newly jobless Americans are surging onto the rolls.
And state officials are worried that they’ll have to slash benefits for patients and payments to health providers in the safety net insurance program for the poor unless they get more federal aid.
State Medicaid programs in the previous economic crisis cut everything from dental services to podiatry care — and reduced payments to hospitals and doctors in order to balance out spending on other needs like roads, schools and prisons. Medicaid officials warn the gutting could be far worse this time, because program enrollment has swelled in recent years largely because of Obamacare’s expansion.
The looming crisis facing Medicaid programs “is going to be the ’09 recession on steroids,” said Matt Salo, head of the National Association of Medicaid Directors. “It’s going to hit hard, and it’s going to hit fast.”
Medicaid programs, among the largest budget items in most states, provide health insurance to roughly 70 million poor adults, children, the disabled and pregnant women. The federal government on average pays roughly 60 percent of program costs, with poorer states receiving a higher share. States have the latitude to adjust benefits, payments to health care providers and eligibility requirements with oversight by the federal government.
Now, governors are turning to Congress for help as it weighs a new package to rescue state budgets battered by the pandemic. They’re asking lawmakers to provide a bigger boost to Medicaid payments and provide hundreds of billions of dollars in aid to shore up state budgets.
Medicaid naturally faces heightened demand as economic conditions worsen. But that leaves states facing more need at the same time that they have less money.
“The cruel nature of the economic downturn is that at a time when you need a social safety net is also the time when government revenues shrink,” Ohio Gov. Mike DeWine, a Republican, said Tuesday as he announced $210 million in cuts to his state’s Medicaid program in the next two months.
The vast majority of a $229 million spending cut made by Colorado Democratic Gov. Jared Polis last week came from Medicaid, though new federal funds will forestall an immediate reduction in benefits or payments to health providers. State legislative committee staff have warned Medicaid enrollment there could spike by 500,000 by the end of the year.
In Georgia, where Medicaid enrollment is projected to rise by as much as 567,000, Republican Gov. Brian Kemp and legislative leaders have instructed every state agency to prepare for 14 percent reductions across the board.
House Democrats are pushing to deliver a $1 trillion-plus package in aid to state and local governments and to support safety net programs, which could alleviate pressure on states to make deep cuts to health care during a pandemic. Some Republican lawmakers have questioned the need for more aid, after Congress has shoveled out trillions of dollars in rescue funding.
Congress already gave states a temporary 6 percent increase in the federal portion of Medicaid spending in an earlier coronavirus package. That prompted Alaska Gov. Mike Dunleavy, a Republican, to cut state Medicaid spending $31 million last month, saying the temporary federal boost would make up the difference.
State officials largely agreed the increase was helpful but said it likely will be washed out by an expected enrollment surge. The nation’s governors say Congress — in addition to providing at least $500 billion in direct support to states — must double the Medicaid funding boost to 12 percent as it did in the previous recession. At least one Republican senator facing a tough reelection fight, Cory Gardner of Colorado, said his state sorely needs extra Medicaid funding to avoid “harmful budget cuts.”
Anywhere from 11 million to 23 million more people could sign up for Medicaid over the next several months. The demand will be even greater in roughly three-quarters of states that expanded Medicaid enrollment to poor adults under the Affordable Care Act.
The portion of state budgets devoted to Medicaid spending has grown quickly since the previous recession, making it a riper target for cuts. Medicaid spending on average accounted for 15.7 percent of state budgets in fiscal 2009, a number that jumped to 19.7 percent in fiscal 2019.
Medicaid enrollment data in some states often lags, making it difficult to determine how much national sign-ups have climbed since jobless claims began surging two months ago. Some states have begun to report notable surges, however, and larger increases are expected in the coming months.
Arizona in the past two months saw 78,000 people enroll in Medicaid and the Children’s Health Insurance Program, which receives more generous funding from the federal government. Virginia has seen a 20 percent increase in enrollment applications since mid-March.
In New Mexico, where 42 percent of the population was already enrolled in Medicaid, sign-ups in the first two weeks of April surged by about 10,000 more people than were expected before the pandemic.
New Mexico’s top Medicaid official said the budget is a significant concern for a state heavily reliant on oil and natural gas. She worries a prolonged economic downturn could force the state to roll back pay increases to Medicaid providers enacted last year, and another planned pay raise for next year is almost certainly off the table.
States that accepted the temporary Medicaid payment increase from Congress are barred from cutting back enrollment while they’re receiving the enhanced funds. That leaves states with the option of cutting benefits or provider payments to find Medicaid savings, which could ignite fierce brawls in state capitals.
Michigan state Rep. Mary Whiteford, the Republican chairwoman of a health care appropriations panel, said the state’s Medicaid enrollment could increase from 2.4 million to 2.8 million by the end of the year.
“We are just planning for major cuts moving forward,” Whiteford said.
Before the pandemic, states had socked away $72 billion in rainy day funds — an all-time high, said Brian Sigritz of the National Association of State Budget Officers. But that figure was easily dwarfed by the $150 billion Congress provided to state and local governments in an earlier package, and it’s far short of what states are demanding.
“Now, we’re looking at greater declines than what we saw during the Great Recession and increased spending,” Sigritz said. “If there aren’t more federal funds, states will have to look at cutting funding for key services: public safety, education, health care. That’s where the money is.”
HENRY KOTULA 