The coming Medicaid coverage cliff

In July 2025, President Trump signed the One Big Beautiful Bill Act into law. The legislation is a large budget reconciliation bill that mainly focuses on tax cuts and reduced social spending. One social program facing a substantial reduction in spending due to the bill is Medicaid, the largest single insurer in the United States.

There is a laundry list of changes coming to Medicaid in the next few years, but the ones affecting beneficiaries the most are new work requirements for Medicaid expansion coverage and more frequent eligibility checks.

New work requirements for Medicaid

By 2027, states must mandate that recipients engage in at least 80 hours per month of paid employment, job training, education, or community service to remain eligible for Medicaid coverage. Exceptions to this rule include parents with children ages 13 and younger and those who are medically frail. 

Currently, states are generally prohibited from making Medicaid eligibility contingent on work. During the first Trump presidency, 13 states received approval to implement work requirements through Section 1115 waivers, which allow states to experiment with Medicaid models that differ from federal statutes. All 13 of these states either had these waivers rescinded during the Biden presidency or withdrew them voluntarily. As of now, Georgia is the only state that maintains work requirements, also through a Section 1115 waiver.

Work requirements for Medicaid coverage are likely to result in fewer covered individuals due to procedural barriers such as submitting documentation to prove they have met the hourly quotas. This may disproportionately impact nontraditional workers such as those who rely on gig work. Recipients who meet an exception, such as those who are chronically ill, may also find it more challenging to navigate complex online portals or submit specific medical documentation.

More frequent eligibility checks for Medicaid

The One Big Beautiful Bill Act also requires states to check for eligibility for Medicaid more frequently. By 2028, states must verify whether Medicaid enrollees are still eligible for services at least every six months, with flexibility provided to states to check more often if they choose. Currently, states are only required to confirm Medicaid eligibility annually.

More frequent eligibility checks are expected to reduce Medicaid coverage due to procedural barriers such as address changes, missing notifications, and increased opportunities for administrative errors. It is also likely that more recipients will become temporarily disenrolled and then reenrolled, which only serves to increase the administrative burden for state and local governments.

Medicaid enrollment reductions due to the One Big Beautiful Bill Act

In total, between 4.9 and 10.1 million people will lose Medicaid coverage in 2028 due to work requirements and more frequent eligibility checks. Roughly 2 to 3.1 million of these recipients will lose coverage due to their eligibility being redetermined more frequently, and roughly 3 to 7 million will lose coverage specifically due to work requirements.

Because Medicaid is administered primarily at the state level, the impacts of these proposed changes will ripple through the states, with the individual effects varying widely by region. In the following table, we show the number of disenrollments expected from each state in 2028 based on analysis from the Robert Wood Johnson Foundation, ordered from highest to lowest percent change.

Medicaid Enrollment Reductions
State	Projected Coverage Loss	Percent Change
Massachusetts	−161,000	−54%
Connecticut	−155,000	−51%
Maryland	−172,000	−51%
Vermont	−20,000	−50%
Minnesota	−91,000	−49%
New York	−955,000	−48%
Virginia	−269,000	−47%
Missouri	−169,000	−47%
California	−1,995,000	−46%
Delaware	−28,000	−45%
New Jersey	−242,000	−44%
Arizona	−197,000	−44%
New Hampshire	−23,000	−44%
Illinois	−324,000	−44%
Rhode Island	−34,000	−43%
Colorado	−165,000	−43%
Hawaii	−57,000	−43%
Washington	−260,000	−43%
West Virginia	−61,000	−42%
Wisconsin	−70,000	−42%
Maine	−28,000	−41%
Kentucky	−166,000	−41%
Louisiana	−205,000	−41%
District of Columbia	−46,000	−41%
Ohio	−285,000	−40%
Iowa	−72,000	−40%
Michigan	−287,000	−40%
Utah	−33,000	−40%
Idaho	−30,000	−38%
Nevada	−113,000	−38%
Pennsylvania	−276,000	−37%
Oklahoma	−87,000	−37%
Montana	−28,000	−36%
Arkansas	−78,000	−36%
North Carolina	−249,000	−36%
Alaska	−23,000	−36%
New Mexico	−87,000	−36%
Nebraska	−25,000	−35%
Indiana	−201,000	−35%
Oregon	−185,000	−34%
South Dakota	−11,000	−34%
North Dakota	−8,000	−30%

Many of the states with the highest Medicaid enrollment rates are the states projected to be most affected by changes to Medicaid from the One Big Beautiful Bill Act, such as Massachusetts and Connecticut. Generally, states are expected to lose between 30% to 54% of their expansion populations due to eligibility changes.

How the One Big Beautiful Bill Act will change uninsured rates

While Medicaid is frequently considered a program intended solely to improve health outcomes, it effectively serves as a mechanism for fiscal relief for millions of American households. By ensuring access to low-cost health insurance, Medicaid frees up household budgets, providing recipients with more disposable income for necessities like housing and food, while reducing the likelihood of falling into medical debt. When people lose Medicaid coverage, especially lower-income populations, they face a tradeoff: pay out-of-pocket premiums for a private health insurance plan or forego coverage to save money for other immediate expenses.

To understand how changes to Medicaid from the One Big Beautiful Bill Act will affect uninsured populations, we compare current uninsured numbers to the potential increases expected from Medicaid recipients losing eligibility in 2028.

Impact on Uninsured Populations
State	Projected Coverage Loss	Current Uninsured	Projected Total Uninsured	Percent Change
New York	−955,000	973,715	1,928,715	98%
California	−1,995,000	2,314,464	4,309,464	86%
Oregon	−185,000	219,386	404,386	84%
Massachusetts	−161,000	198,589	359,589	81%
Connecticut	−155,000	211,726	366,726	73%
West Virginia	−61,000	100,543	161,543	61%
Louisiana	−205,000	348,045	553,045	59%
Michigan	−287,000	507,760	794,760	57%
Kentucky	−166,000	308,763	474,763	54%
Washington	−260,000	511,691	771,691	51%
Virginia	−269,000	595,595	864,595	45%
Maryland	−172,000	390,741	562,741	44%
Iowa	−72,000	174,113	246,113	41%
New Mexico	−87,000	211,289	298,289	41%
Indiana	−201,000	512,807	713,807	39%
Delaware	−28,000	71,608	99,608	39%
Illinois	−324,000	860,898	1,184,898	38%
Pennsylvania	−276,000	752,566	1,028,566	37%
Maine	−28,000	76,864	104,864	36%
Ohio	−285,000	782,626	1,067,626	36%
Missouri	−169,000	474,886	643,886	36%
Colorado	−165,000	463,722	628,722	36%
New Jersey	−242,000	727,278	969,278	33%
Minnesota	−91,000	290,828	381,828	31%
Nevada	−113,000	366,606	479,606	31%
Alaska	−23,000	77,532	100,532	30%
Montana	−28,000	98,102	126,102	29%
Arkansas	−78,000	284,915	362,915	27%
North Carolina	−249,000	927,893	1,176,893	27%
Arizona	−197,000	767,380	964,380	26%
Wisconsin	−70,000	310,536	380,536	23%
Oklahoma	−87,000	461,884	548,884	19%
Nebraska	−25,000	139,831	164,831	18%
Idaho	−30,000	181,552	211,552	17%
South Dakota	−11,000	73,403	84,403	15%
Utah	−33,000	288,681	321,681	11%

We project some of the most populated states to see the highest percent increases in the number of uninsured residents. We project New York, for instance, to see its uninsured population surge by over 98%, effectively doubling the number of uninsured residents. Similarly, California and Oregon face increases of 86% and 84% respectively, penalizing states with high populations and high Medicaid enrollment.

If those who lose Medicaid coverage remain uninsured, health systems in low-income communities which rely on Medicaid funds may become strained, worsening accessibility to medical facilities for low-income communities even more.

The Long-Term Outlook

The changes coming to Medicaid in the One Big Beautiful Bill Act will likely lead to millions of people losing coverage across the country. This change represents a shift in the priorities of Medicaid spending from promoting health insurance coverage for low-income households to reducing state and federal spending on Medicaid line items. While these changes may save taxpayers in the short run, they risk straining the administrative capacities of state and local governments and worsening healthcare options for low-income households across the nation.

Original Analysis: Oklahoma Wage Increase Would Lift 40,000 Oklahomans, including 16,000 Children, out of poverty

A new Scioto Analysis study examining the impact of Oklahoma’s upcoming minimum wage ballot measure estimates that raising the state’s minimum wage to $15 per hour will lift 40,000 residents, including 16,000 children, out of poverty. 

The report, written by Scioto Analysis on behalf of This Land Research and Communications Collaborative analyzes how increasing the minimum wage to $15 impacts poverty and the cost of living.

“Our analysis shows an increase in the minimum wage to $15 an hour will have a significant impact for Oklahoma families and the overall economy,” Rob Moore, Principal of Scioto Analysis and lead author of the report said, “Lifting 40,000 Oklahomans out of poverty, giving pay raises to the parents of more than 200,000 children will help more Oklahoma families keep up with rising costs and will make Oklahoma the most affordable state in the region for minimum wage workers.”

Oklahoma currently ranks as the eighth-poorest state in the nation, with one in seven residents living below the federal poverty line. The study found that rising costs following the COVID-19 pandemic have made Oklahoma increasingly expensive for working families.

In this study, we estimate a $15 minimum wage for the state would result in

• 40,000 fewer people in poverty

• 16,000 fewer children in poverty 

• ALICE “household survival budget” becoming affordable for single childless full time workers

 The research also examined the impact on working Oklahomans’ ability to afford basic living expenses. According to United Way estimates, a single adult in Oklahoma needs $2,315 per month to cover housing, food, transportation, healthcare, technology, and taxes. Under the current minimum wage, workers must work nearly 74 hours per week to afford these necessities. A $15 minimum wage would reduce that requirement to roughly 36 hours per week.

Additionally, the research suggests that a $15 minimum wage would make Oklahoma the most affordable state for minimum-wage earners in the region–improving the state’s competitiveness in attracting and retaining workers.

This study was the fifth in a series of Scioto Analysis studies on the minimum wage in Oklahoma. Past studies were on the minimum wage’s impact on housing affordability, public safety, health, and economic growth.

Can child care reforms help families overcome benefit cliffs?

Last week, Ohio House Representatives Desiree Tims and Crystal Lett introduced a bill to expand eligibility for publicly funded child care in the state of Ohio.

Ohio House Bill 827 would expand eligibility for the Publicly Funded Child Care program for families first enrolling in the program, and families staying on the program. In general, the bill would expand eligibility for child care for more low- and middle-income families that are above the federal poverty line.

Publicly funded child care is generally designed as a work support program. Much of the debate around how the program works in Ohio revolves around how it supports working families and how it impacts their ability to support themselves.

The topic has become a flashpoint in the debate around benefits cliffs. Many people worry about how benefit eligibility can create disincentives for workers to take raises, promotions, or otherwise advance in low-wage careers due to steep drop-offs in benefits eligibility.

Think of it this way: say you are working in a low-wage profession and you have an infant in a child care center who is covered by publicly funded child care. According to price research by Child Care Aware, this child care slot would cost nearly $14,000 on the private market.

Now say you get offered a $5 an hour raise. Sounds like a good deal, right? Well it is if you keep eligibility for your child care benefit. But $5 an hour only adds up to a little over $10,000 over the course of a year for a full-time worker. So taking the raise will actually end up putting you a few thousand dollars behind if you lose your child care benefit in the process.

Over the years, policymakers have been working to reduce these disincentives, making benefits taper off slowly as workers move from low to middle-income, rather than having strict income eligibility thresholds that make workers face these “cliffs.” H.B 827 aims to help with this by expanding eligibility for publicly funded child care for low- and middle-income families.

There is another justification for this reform: need. A large research project by the United Way has been arguing for years that the costs of a range of “basic” goods should lead policymakers to pay attention to low and middle-income families above the federal poverty threshold when designing policy. Elevated inflation rates over the past few years has made this pressure even more salient for families.

It’s worth noting, however, that this policy will primarily benefit households above the federal poverty line. This matters in a state where 1.5 million residents, including 400,000 children, are living on incomes below the federal poverty threshold. A reform like this could help some of these families by removing barriers to economic advancement.

This reform could also be a part of a continuing trend of shifting social spending from families that are in deep poverty to middle-income families. Large safety net programs like the Earned Income Tax Credit and the Child Tax Credit are designed for families that have higher incomes than the lowest-income families. They support families much more who are above the federal poverty threshold than who are below it.

In an ideal world, our safety net will help families who are in poverty while also supporting families to escape poverty. We still have a lot of work to do to realize this ideal.

This commentary first appeared in the Ohio Capital Journal.

What could state and local governments buy with the cost of the war in Iran?

As of the writing of this article, the United States has spent half a month in a ceasefire with Iran. According to the New York Times, the White House has not released any estimates of the cost of the war, but independent groups estimate it has cost between $28 and $35 billion since it began.

It can be hard to get our heads around what these tens of billions of dollars mean. The Census Bureau did recently give us one yardstick that we can use for some sort of comparison, though: a first look at the 2024 results of the Annual Survey of State and Local Government Finance.

The Annual Survey of State and Local Government Finance is a valuable data source for people like us who spend our time analyzing state and local budgets. This survey collects data from state and local governments across the country which the Census Bureau then uses to estimate what total spending looks like in state and local governments across the country.

The data released this month is just a “first look.” This means that they are releasing aggregate nationwide data–basically what state and local governments spent on a number of different categories taken as a whole. This does give us an interesting point of comparison for spending on the war in Iran. If this money was instead given as a transfer to the nation’s state and local governments, what could they finance with it?

State revenues that could be replaced by Iran War spending

First, let’s look at the revenue side of the equation. The way we could think of this is what revenue streams could be completely replaced if the federal government gave its Iran War money to states instead of using them to wage the war. Below are a few examples.

State property taxes: $23 billion

Coming in below the $28-35 billion estimated cost of the war in Iran are state property tax costs. Now most property tax is collected by local governments–the recent First Look estimate is that local governments collected about $700 billion in property taxes in 2024. But state governments collected $23 billion of their own property taxes. This matters because property taxes are regressive since low-income people spend a larger proportion of their income on housing than upper-income people, and renters pay the brunt of property taxes for their landlords in the form of higher rents. Giving a grant that would allow state governments to do away with their property taxes would put a lot of cash back in the pockets of low-income families.

Motor vehicle licenses: $34 billion

Yep, that’s right: we could make all registrations of cars free with the amount of money the federal government has spent on the war in Iran. This is another fee that often falls more heavily on low-income families since it is usually assessed as a flat fee that falls on each vehicle. Doing away with this fee would be very helpful for low-income households in parts of the country where a car is essential for work.

Local education charges: $25 billion

Local governments charge fees for education services they provide, like community colleges they run, school lunches they charge for, some tuitions they charge, and other charges. All of these could be made free for the cost of the war in Iran. I don’t want to gloss over this portion of it: local governments collected $4.4 billion in lunch fees in 2024. This means that dialing the war spending back by as little as 12% could have freed up enough funds to make school lunches free for the whole country.

State lotteries: $35 billion

State lotteries collected about $35 billion in funds, much of which went to education and funding other state programs. These lotteries could be done away with or just become free with the cost of the war in Iran. This could be a boon for addictive gamblers who lose money on the lottery and also could do away with a regressive institution which costs that fall much more heavily on low-income people than on upper-income people.  

State programs that could be financed by Iran War spending

Now let’s look at expenditures. These are categories of spending in state and local government that could be financed at the cost of the war in Iran.

State elementary and secondary education spending: $24 billion

While the bulk of elementary and secondary school spending comes from local government, states supported elementary and secondary schools to the tune of $24 billion in 2024. That means that a grant that financed all state contributions to elementary and secondary school spending could have been financed with the cost of the war in Iran.

Local library spending: $16 billion

This one is considerably less than the current estimates of the war in Iran, but I had to include it. Local governments across the country spent about $16 billion on libraries in 2024. That means that all the local libraries in the country could have been funded for a year and the federal government could have still had enough money left over to fund a small war in Iran.

State police spending: $24 billion

States have police forces like state patrols that are in charge of keeping highways safe and enforcing state laws. These could be funded across the country for a year for the cost of the war in Iran.

Local jails: $35 billion

Local jails across the country are used to hold people who have been convicted of minor crimes and to hold people before sentencing. The nation’s local jails could be financed for a year with the cost of the war in Iran.

State transit spending: $21 billion

States across the country spent about $21 billion on transit support in 2024. For the cost of the war in Iran, the United States could fund all the state support for transit agencies across the country for a year.

Spending has opportunity costs. The federal government could be making school lunches free, replacing state property taxes, or funding all the local libraries across the country. Instead, it is fighting a war in Iran. I am not an expert in foreign policy, but I can tell you that the opportunity costs for this spending are steep.

Which states have the most no-car households?

Last month, I attended the National Bike Summit, a conference hosted by the League of American Bicyclists. I did this because the executive director of the Iowa Bicycle Coalition was presenting the results of the economic impact analysis we had conducted on their behalf the previous year.

At the conference, I heard a range of different presentations. These ranged from a county commissioner from Houston speaking about the growth of bicycle infrastructure in his city to the editor-in-chief of the Cook Political report speaking on the federal prospect to the midterms to cycling economists from the Netherlands running a simulation on cycling reform at the local level. 

The final talk of the conference, though, was the most fiery. It was given by the hosts of a popular podcast called The War on Cars that is focused on pushing back against car culture in the United States.

Full disclosure: I am a bit more on the “ditch your car” side of the transportation spectrum myself. I never owned a car in high school or college and managed to live without one until an employer in Omaha required me to buy one as a condition of employment. Once I moved to California, I got rid of my car and was able to live mainly walking, bussing, and biking until my current fiancee moved in with me a couple of years ago. I am now the owner of 0.5 cars.

The message of the “War on Cars” is intentionally provocative. One of the hosts even went as far as to say that no one was going to listen to a podcast called “incremental change for win-win solutions.” But there are reasons to worry about reliance on cars.

In a 2019 policy brief I wrote–one of our first as a firm–I wrote about the opportunity for the automation of cars to open the door to vehicle miles traveled fees. In this brief, I went over the many costs of another car on the road.

One is congestion. While road usage can function like a public good under most circumstances, at the time that people want to use cars the most, space on roads becomes rivalrous and car speed slows. This leads to higher commute and travel times for drivers, which is time people do not get back. Fewer cars on the roads means less congestion, which means more time for people.

A second cost of cars is crashes. Tens of thousands of Americans lose their lives to car crashes every year, and many others lose their cars or sustain injuries due to them. Fewer cars on the roads means lower chances of sustaining injury or risking death due to being in a car.

Cars also emit pollution into the atmosphere. Local emissions like particulate matter and nitrous oxide clog lungs and lead to cardiovascular disease and death. Carbon emissions hasten climate change. The fewer cars are on the road, the fewer emissions are impacting human health and the long-term sustainability of the earth.

A final impact of cars is infrastructure degradation. Every time a car drives on the road, it slowly wears down the road and degrades its quality. More degradation of quality can lead to more dangerous roads which can cause damage to cars or even lead to more crashes. If roads degrade too much, they will become inoperable. More cars on the roads means more spending on maintenance of roads. Fewer cars on the road increase their lifespan.

The socially optimal number of cars on the road is a number determined by the marginal social cost of an extra car on the road equalling the marginal social benefit of an extra car on the road. This could be different in different states since different states have different topography and economies. That being said, understanding how many households do not have cars gives us some idea of how reliant a given state is on cars and how much that state has been able to diversify its transportation system. It also could give a snapshot of deprivation. In many parts of the country, it is difficult to participate in the economy without a car. Seeing what percentage of people do not have cars gives us a view of the percentage of people who are not able to participate in the economy in a certain way.

So here it is. In the table below, you can see what percentage of households do not have a car in each of the 50 states.

Households Without a Vehicle

From this list, I have noticed a few things.

There is a large concentration of states in the northeast that have high levels of no-car households. Nearly one in three New York households do not have a car, likely due to its inclusion of the largest city in the United States, which has a strong multimodal transportation network. Massachusetts, New Jersey, Pennsylvania, Rhode Island, Maryland, and Connecticut are all within a state or two of New York and also in the top 10 states for no-car households.

Many states in the Midwest are in the top half of the list of no-car households: Illinois (3), Ohio (12), Minnesota (18), Michigan (19), Missouri (20), North Dakota (21), Wisconsin (22), and Indiana (25). A random Ohio household is less likely to own a car than a random California household.

The states with the highest levels of car ownership are Western states. Idaho, Wyoming, Utah, and Montana are the top 4 states for car ownership, all with over 95% of households owning cars. The only other state to meet that threshold is South Dakota (95.2% car ownership).

There is one strange outlier in this list: Alaska. The state of Alaska has over 9% of households without a car. This could be for a combination of reasons: spread out infrastructure that makes cars less viable as a form of transportation, higher costs of car ownership in Alaska than in the “lower 48,” or high levels of poverty in Anchorage. Whatever reason, Alaska is a strange inclusion in the top 10 least car-dependent states.

Prevalence of no-car households is a little bit of a chicken-and-egg problem. Do these places have fewer cars because there are more alternatives or do more alternatives exist because there are fewer cars? It is likely a combination of the two. The benefit they get, though, is fewer costs associated with having too many cars on the road.

Market failure: Tragedy of the commons

In this post, I am going to explain the basics behind another common market failure, the tragedy of the commons. If you would like a more broad overview of what a market failure is, I have a previous blog post on that topic. If you want more deep dives on market failures, check out my posts on externalities and natural monopolies. Additionally, I won’t be going into any of the math behind this concept. Instead, this will be a more intuitive discussion of how the tragedy of the commons works and what its impact on markets is.

What is a “common good?”

Common goods are sometimes confused with public goods because they are both non-excludable and the public sector ends up intervening in these markets. The key difference between these two is that common goods are rivalrous, meaning that one person’s consumption of the good does prevent others from consuming it as well. A common example is a lake that people commonly use for fishing. It is largely impractical to exclude people from fishing on the lake, but if too many people fish they will overfish the lake and there will be no fish left in the future. 

Why the tragedy of the commons happens

The “tragedy” in the tragedy of the commons comes from a mismatch between individual incentives and collective outcomes. Each individual user of a common good has an incentive to use as much of the resource as they reasonably can. If I am fishing in a shared lake, I benefit directly from catching one more fish. However, the cost of that extra fish (slightly reducing the fish population) is spread out across everyone who uses the lake now and in the future.

Because each person only experiences a small fraction of the total cost, it becomes rational for individuals to keep using the resource heavily, even when it harms the group as a whole. If everyone behaves this way, the resource eventually becomes depleted or degraded. In the fishing example, this could mean smaller catches over time, collapsing fish populations, or eventually a lake that can no longer support fishing at all.

Why common goods are market failures

Common goods lead to market failure because private markets alone often struggle to manage them efficiently. Since these goods are non-excludable, it is difficult to assign clear property rights or charge people directly for their usage. A competitive market would establish an equilibrium price where the consumers of the good are directly bearing the costs of consumption.

This leads to overuse, underinvestment in maintenance, and long-term damage to the resource. The total value society gets from the resource declines because there is no built-in mechanism to protect it from overuse.

How policymakers respond to the tragedy of the commons

Because common goods are vulnerable to overuse, public policy often plays an important role in managing them. One common solution is to create rules that limit how much individuals can use the resource. Fishing quotas, hunting seasons, and permits for backcountry campsites are examples of this approach. By restricting total usage, policymakers can help ensure that the resource remains available over time.

Another approach is to introduce forms of exclusion where they were previously difficult. For example, governments may issue licenses or permits that limit the number of users who can access a resource. In some cases, resources are assigned property rights, allowing individuals or groups to take responsibility for managing them. When users have a stake in the long-term health of the resource, they often have stronger incentives to conserve it. This has been a successful strategy for conservation of forest lands used for logging. There are also hybrid approaches that rely on community management. In some areas, local users collectively develop rules for sharing resources in sustainable ways. 

With thoughtful rules, incentives, and oversight, common goods can be managed in ways that balance individual use with long-term sustainability. When done well, these solutions help preserve valuable shared resources while still allowing people to benefit from them.

Original analysis: housing first vs treatment first approaches to reducing homelessness in Hawaii

This morning, Scioto Analysis published a cost-benefit analysis about the impacts of spending on homelessness programs in Hawaii. 

The analysis compares two different approaches to addressing homelessness. The “Housing-First” approach emphasizes the importance of funding permanent supportive housing above other services. An alternative “Treatment-First” approach prioritizes funding for emergency shelters and transitional housing above permanent supportive housing.

Using conservative estimates, analysts estimate that $10 million in housing-first spending would provide $54 million in net benefits. It would deliver housing to 340 residents of Hawaii, save four lives, and increase crime negligibly.

The treatment-first approach would create $15 million in net benefits, housing 114 Hawaii residents and saving one life.

Scioto Analysis estimates several differences in outcomes between these two policy programs:

• For every dollar in costs, housing-first spending delivers five dollars in benefits, while treatment-first spending delivers two dollars in benefits

• Housing-first spending will house 340 residents of Hawaii and treatment-first spending will house 114 residents

• Housing-first spending lifts 170 children out of homelessness while treatment-first spending lifts 57 children out of homelessness

• The average child lifted out of homelessness will gain $27,000 in income over their lifetime under both programs; the difference in the number of children supported by each program will create a gap of $1.1 million in benefits between the two programs

Both programs increase the social cost of crime in surrounding areas negligibly, and both programs may lead to modest reductions in property values surrounding homeless shelters.

Analysts conducted 10,000 simulations of each program with different variables and costs to test the model. They find that the benefits outweigh the costs in 99% of instances for housing-first spending and 97% of instances for treatment-first spending. For the housing-first program, 90% of simulations had net benefits between $10 million and $59 million. 90% of treatment-first simulated outcomes produced net benefits between $800,000 and $17.5 million.

This study is the latest in a series of cost-benefit analyses conducted by Scioto Analysis to demonstrate the use of cost-benefit analysis to analyze state policies. Past cost-benefit analyses and other analyses can be found here.

Market failure: Public goods

In this post, I am going to explain the basics behind another common market failure, public goods. If you would like a more broad overview of what a market failure is, I have a previous blog post on that topic. If you want more deep dives on market failures, check out my posts on externalities and natural monopolies. Additionally, I won’t be going into any of the math behind this concept. Instead, this will be a more intuitive discussion of how public goods work and what their impact on markets is.

What is a “public good?”

Public goods are defined by two key characteristics: they are non-exclusive and non-rival. In other words, it is difficult or impossible to restrict people from consuming the good and one person’s consumption of the good doesn’t impact the ability of another to consume it.
Nice weather is an example of a public good. It isn’t realistic for some company to come around and try to get me to pay before I’m allowed to go on a walk when it’s 70 degrees and sunny, nor does my walk on that day prevent anyone else from enjoying that nice weather. Even though I have a very high willingness to pay for days that are 70 degrees and sunny, it isn’t realistic for a private company to participate in the nice sunny day market.

As a more practical example, consider some public infrastructure like roads and sidewalks. These things are largely non-rivalrous,* and they are almost entirely non-excludable. Toll roads enable a small amount of exclusion, but they can almost always be avoided if you are willing to drive on backroads around them.

Why public goods are market failures

The fact that public goods are non-exclusive and non-rival means that private firms are largely unable to sell them in a traditional market. If a private firm decided they were going to try to build roads and charge people for using them, they would inevitably fall victim to the free rider problem. 

These are public goods we collectively have a willingness to pay for but no real structure to pay for. The solution to this problem is to have the public sector levy taxes to fund them. Taxes create some drag on the economy, but they are great for reducing the severity of the free rider problem since the public sector can create a wide tax base. 

Ideally, the public sector will try to provide public goods at a level that reflects the community’s overall willingness to pay. Roads, sidewalks, street lighting, and emergency services are all examples of goods that are difficult to sell individually but make communities function much more smoothly. When done well, public provision of these goods can improve productivity, safety, and overall quality of life in ways that far exceed their upfront cost.

Of course, not every good fits perfectly into the public good category. Some goods are partially rival or partially excludable, and policymakers can use hybrid approaches like user fees, special assessments, or public-private partnerships. But the underlying idea stays the same: when markets struggle to provide something valuable on their own, carefully designed public action can help fill the gap.

* Traffic and congestion make these goods slightly rivalrous, but after those conditions clear up the roads still remain for others to use.

Market failure: Natural Monopoly

In this post, I am going to explain the basics behind one of the most common market failures in economics, the natural monopoly. If you would like a more broad overview of what a market failure is, I have a previous blog post on that topic. Additionally, I won’t be going into any of the math behind this concept. Instead, this will be a more intuitive discussion of how natural monopolies work. If you would like a mathematical explanation of this topic, this is a great resource.

Regular Monopoly vs. Natural Monopoly

A natural first question when learning about natural monopolies is what makes them natural? There are two main factors that lead to this distinction.

First, with regular monopolies there is a single producer operating in a market because some factors outside the market have made it so no new suppliers can enter the market. The cost to enter the market for a new firm is too high, so only one remains. These barriers may come from outside the market, such as legal protections, control of resources, or anti-competitive behavior. A natural monopoly is also characterized by a high cost to enter the market that makes it so only one producer remains, but the difference is that in this case the high cost to enter is a factor of conditions within the market. 

For example, a bad actor might create a regular monopoly by throwing bricks through the windows of their competitors. Now, any new firm that might want to enter the market knows that the cost to enter for them also includes daily window repairs, and they will choose to not bother. The end result is that only the bad actor remains and a monopoly forms. 

Now consider the market for electricity distribution. If you wanted to independently enter the market for electricity distribution, you would need to rebuild the entire electric grid including substations and transmission lines, and you would need to connect individual buildings to your own wires just to begin selling to people. The upfront costs are so high that competing against an established provider doesn’t make sense for prospective businesses. 

The second main characteristic of a natural monopoly is that they have economies of scale. That means that after a firm manages to get established and pay the high upfront costs, it costs them very little to expand their operation and serve a wide range of customers. Consider again electricity distribution. Once a company builds power poles all across a city, it takes relatively very little to hook up one additional building. 

The end result is that unlike regular monopolies, natural monopolies result organically from market conditions. The upfront costs and the economies of scale make it so that adding a new provider would actually be less efficient overall, since firms would have to charge extremely high prices in order to cover the high fixed costs. 

Policy implications

If left to its own devices, a natural monopoly will create the same economic problems that regular monopolies do: higher than optimal prices and lower than optimal supply of the good. Unfortunately unlike regular monopolies it doesn’t just work for the government to force a natural monopoly to split up. Instead, policymakers allow natural monopolies to exist, but impose regulations on them that try to bring the market conditions more into balance with what we might hope for from a competitive market. 

In practice, this usually means regulating the prices that natural monopolies can charge and the level of service they must provide. For example, many utilities are required to justify their prices to regulators, who review the company’s costs and allow prices that cover those costs plus a reasonable profit. This helps ensure that firms can maintain infrastructure and continue operating, while also protecting customers from excessive pricing.

Another approach policymakers sometimes consider is public ownership. In some communities, essential services like water or electricity distribution are operated by government-owned utilities rather than private firms. Both regulation and public ownership aim to solve the same core problem: how to capture the efficiency of a single provider without allowing monopoly power to harm consumers.

What are the benefits of active transportation?

Recently, I was made aware of a super cool tool the Ohio Department of Transportation put together for performing cost-benefit analysis at the state and local level. I am extremely happy to see a state organization put together such a helpful reference that local governments can easily access to help inform infrastructure projects. Today, I wanted to go through some of the benefits they highlight in their tool and talk about how active forms of transportation can create broader economic value.

When we’re talking about “active transportation,” we are typically referring to modes of transportation that rely on human power rather than engines like walking and biking. In addition to being desirable amenities that people enjoy, these projects can generate meaningful economic benefits that show up across many different parts of the transportation system.

Safety benefits of active transportation

One of the main assumptions underpinning this cost-benefit analysis is that by providing active transportation infrastructure, cities can reduce the number and severity of traffic crashes.

When roads include dedicated space for cyclists and safer crossings for pedestrians, crashes with motor vehicles decline. Drivers also tend to slow down when streets are designed to accommodate multiple modes, which reduces both the likelihood and severity of crashes.

These safety improvements generate economic value because crashes are expensive. They impose costs through medical bills, lost productivity, emergency response, insurance claims, and property damage. Even relatively small reductions in crash rates can produce large economic savings when aggregated across an entire community. From a cost-benefit perspective, investments that prevent crashes often pay for themselves over time through avoided losses.

Vehicle operating costs

Another major category of benefits comes from reduced vehicle operating costs. When people substitute even a small number of car trips with walking or biking, they reduce the amount they spend on fuel, maintenance, tires, and vehicle depreciation.

These costs are often overlooked because they are spread out over time. A single avoided trip might only save a small amount of money, but over the course of a year those savings can add up. For households operating on tight budgets, reducing transportation costs can free up resources for housing, food, or other necessities.

At a broader level, fewer vehicle miles traveled also reduces wear and tear on roads. That means governments can delay expensive maintenance and reconstruction projects. While active transportation infrastructure has its own maintenance needs, those costs are generally much lower than maintaining infrastructure designed to support heavy motor vehicles.

Pollution reductions

Active transportation also reduces pollution by lowering the number of vehicle trips made using gasoline or diesel engines. This includes both traditional air pollutants such as particulate matter and nitrogen oxides, as well as greenhouse gas emissions that contribute to climate change.

The economic value of pollution reductions shows up in several ways. Improved air quality leads to fewer respiratory illnesses, fewer missed workdays, and lower healthcare costs. These benefits are particularly important in urban areas where traffic-related pollution can concentrate near major corridors.

Highway externalities

Economists use the term externalities to describe costs that drivers impose on others but do not directly pay for themselves. Highway congestion is one of the most familiar examples. When one additional car enters a crowded road, it slows down everyone else.

By shifting some trips to walking or biking, active transportation can help reduce congestion, especially for short-distance trips where alternatives to driving are most feasible. Even small reductions in traffic volumes can meaningfully improve travel times during rush hour. Other types of externalities include vehicle noise and roadway wear. Reducing vehicle dependence helps lower these indirect costs, which benefits both drivers and non-drivers.

Consumer surplus

In the context of active transportation, consumer surplus captures the value people receive from having more transportation options. Some people genuinely prefer walking or biking for short trips, but they may not currently do so because safe infrastructure is unavailable. When new infrastructure makes those trips possible, people experience benefits that go beyond direct cost savings.

For example, someone might prefer biking to work because it is faster than driving in congested traffic or because it avoids parking hassles. Even if the monetary savings are small, the convenience and time savings create real value. Cost-benefit analysis attempts to measure these gains so they can be compared to project costs.

Health benefits

Regular physical activity is associated with lower risks of chronic diseases such as heart disease, diabetes, and obesity. By integrating physical activity into daily routines, walking and biking infrastructure can help people stay active without requiring dedicated exercise time.

From an economic perspective, these health improvements translate into reduced healthcare costs, fewer missed workdays, and longer, more productive lives. These benefits can be especially large when projects make it easier for people to incorporate small amounts of physical activity into everyday trips, such as walking to transit stops or biking to nearby stores.

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Taken together, these categories illustrate how active transportation projects generate value across many different dimensions. As more communities consider investments in active transportation, tools like this one provide a useful reminder that the benefits extend far beyond recreation. When evaluated through a cost-benefit lens, active transportation is not just about mobility, it is about improving economic efficiency and quality of life across an entire community.