Federal Fiscal Research Articles

The Impact of Federal Fiscal Rules on Debt: Insights from the European Union Countries

AbstractThis study analyzes the impact of federal fiscal rules on government debt in European Union countries. We describe the growth and institutional reforms of fiscal rules in European Union countries and conduct an empirical analysis to examine their impact on central government debt to draw comparative implications for federal fiscal rules in the United States. Our empirical results suggest that more stringent expenditure rules can reduce central or federal government debt relative to GDP, while other types of fiscal rules are found to be insignificant. We also find that certain design and structural features of fiscal rules are more important than others. Our findings offer timely and pertinent policy implications for the mounting federal budget and debt challenges of the United States.

Auswirkungen der Neuregelung zur nachgelagerten Besteuerung

Abstract In 2021, the Federal Fiscal Court pointed out to the legislator that future pensioners could be affected by potential double taxation due to deferred taxation. The Growth Opportunities Act passed in April 2024 now implements a flat-rate solution to avoid double taxation, extending the transition period until 2058. The results show, based on generational accounting, that this flat-rate solution has little impact on the sustainability of public finances. However, it leads to a considerable intergenerational redistribution at the expense of future generations.

Clocks, Caps, Compartments, and Carve‐Outs: Creating Federal Fiscal Capacity Despite Strong Veto Powers

This article examines four mechanisms for establishing federal spending programmes despite tough opposition based on identity or ideological politics, as well as disputes between haves and have-nots. It contrasts the use of clocks (time limits), caps, compartments (special justification for spending that would otherwise have been rejected), and carve-outs (exemptions to federal spending programmes to buy off objecting veto players) to secure political support for national-level programmes, and asks under what conditions those limits might be breached. We look at the EU, Canada, and the US. These tactics are most successful at “getting to yes” for federal authorities when they can isolate individual objections. As long as those objections persist, the limits will persist as well.

Supplemental Nutrition Assistance Program Education reductions during COVID-19 may have exacerbated health inequities

ObjectiveDescribe, and assess disparities in, the changes in Supplemental Nutrition Assistance Program Education (SNAP-Ed) that occurred the year before vs. the year when COVID-19 restrictions were implemented. DesignObservational study comparing reach, intensity, and dose of California Local Health Department (LHD) SNAP-Ed interventions in Federal Fiscal years 2019 and 2020 (FFY19, FFY20). AnalysisStudent t-tests determined significance of differences in the number of Direct Education (DE) programs, Policy, Systems and Environmental change (PSE) sites, people reached, and intervention intensity and dose between FFY19 and FFY20 using data reported online by LHDs. Linear regression assessed associations between census tract-level characteristics (urbanicity; percentages of population with income <185% of federal poverty level, under 18 years of age, and belonging to various racial/ethnic groups; and California Healthy Places Index) and changes in number of DE programs, PSE sites, people reached, and intervention dose between FFY19 and FFY20. ResultsFrom FFY19 to FFY20, the number of DE programs, PSE sites, people reached, and census tract-level intervention intensity and dose decreased. Higher census tract poverty, higher proportions of Black and Latino residents, and less healthy neighborhood conditions were associated with greater decreases in some intervention characteristics including PSE sites, PSE reach, DE programs, and DE dose. Conclusions and implicationsThese reductions in LHD SNAP-Ed interventions indicate reduced access to education and environments that support healthy eating and obesity prevention during a time when this support was especially needed to reduce risk of COVID-19 infection and complications. Disproportionately reduced access, may have worsened health disparities in already-disadvantaged communities. Assuring maintenance of SNAP-Ed interventions, especially in disadvantaged communities, should be a priority during public health emergencies.

Are Flat Rate Adjustments of the Customs Value Possible on the Basis of a Transfer Price Arrangement?: Judgment of the German Federal Fiscal Court in ‘Hamamatsu’ following the ECJ Judgment C-529/16

Are Flat Rate Adjustments of the Customs Value Possible on the Basis of a Transfer Price Arrangement?: Judgment of the German Federal Fiscal Court in ‘Hamamatsu’ following the ECJ Judgment C-529/16

Levels of Physical Activity before and after California’s COVID-19 Shutdown among a Population-Based Sample of Mothers from Low-income Households

We examined changes in levels of physical activity (PA) before versus after California’s COVID-19 shutdown among mothers from low-income households across California. By comparing the same time periods in Federal Fiscal Year (FFY) 2020 to those in FFYs 2018, 2019, and 2021, we were able to assess whether the changes observed in FFY 2020 were different from those in pre-pandemic years, and the potential longer term impact of COVID-19 on PA. Households with incomes ≤185% of the federal poverty level were randomly selected in FFYs 2018-2021. Within each FFY, cross-sectional interviews were conducted by telephone in English or Spanish. Two outcome variables were examined: minutes of PA per week and whether guidelines of ≥150 minutes of weekly PA were met. Analyses examined these outcomes across and within FFYs by COVID-19 shutdown time periods controlling for race/ethnicity, age, education, and multiple comparisons. Among our analytic sample of 13,267 mothers, 65.2% were Latina, 16.6% were white, and 12.7% were African American. Levels of PA among mothers increased following California’s COVID-19 shutdown. Similar findings were observed within each of the four FFYs for both PA outcomes. We attribute our findings to a seasonal effect, with levels of PA increasing during warmer, post-COVID-19 shutdown months (May through September). We also suggest that the low-income status of our study population may explain why our findings contradict those reported in previous studies. The initial and repeated closure of gyms and fitness centers may have been less disruptive to our samples of mothers, who reported walking at rates higher than the general US population. Mothers may have also been more likely to come from households that received enhanced unemployment or other types of COVID-19 benefits, offering the means and time to continue their pattern of seasonal increases in PA in FFYs 2020 and into 2021.

COVID-19 Benefits and Dietary Behaviors Among Mothers From Low-Income, Food-Insecure Households

ObjectiveTo examine the dietary behaviors of mothers from very low food security (VLFS) households following the availability of coronavirus disease 2019 (COVID-19) unemployment and Supplemental Nutrition Assistance Program benefits. MethodsDiet and food security status were obtained from 2,584 California mothers during Federal Fiscal Year 2020. Fruits, vegetables, and 100% fruit juice (FV100%FJ), sugar-sweetened beverages, and water intake, and Healthy Eating Index-2015 scores, were compared across 4 groups (before vs after COVID-19 benefits by VLFS vs non-VLFS households) with race/ethnicity and age as covariates. ResultsBefore COVID-19 benefits, VLFS was associated with fewer cups of FV100%FJ (P = 0.010), more fluid ounces of sugar-sweetened beverages (P = 0.004), and poorer diet quality (P = 0.003). After COVID-19 benefits, mothers from VLFS vs non-VLFS households reported similar dietary outcomes. VLFS mothers reported 0.96 (95% confidence interval, 0.53–1.38) more cups of FV100%FJ after COVID-19 benefits. Conclusions and ImplicationsCoronavirus disease 2019 benefits may have reduced dietary inequities among low-income families. Associations between increased Supplemental Nutrition Assistance Program and unemployment benefits and decreased costs associated with the negative health outcomes linked to food insecurity and poor diets would be of value.

Heterogeneous Capitalization of Local Public Goods Induced by Federal Fiscal Policy

Heterogeneous Capitalization of Local Public Goods Induced by Federal Fiscal Policy

Use of Customized Employment in State Vocational Rehabilitation Programs: A Retrospective Study 2017–2020

The purpose of this study was to examine the outcomes of customized employment via an analysis using the U.S. Rehabilitation Services Administration Case Service Report (RSA-911) from Federal Fiscal Years of 2017 through 2020. The independent variables were demographics, barriers to employment, and types of state vocational rehabilitation agency (SVRA) services, and the dependent variables were competitive integrated employment status and weekly earnings at exit. Descriptive analyses, multiple logistic regression, and hierarchical multiple regression comprised data analysis. The study sample ( N = 2,280) was 57.9% male and 42.1% female and had a mean age of 32.69 years ( SD = 12.83). Seventy-seven percent identified themselves as White and 46.7% had a cognitive disability. The results of this study indicated that consumers who have cognitive disability and cultural barriers; are migrant farmworkers and/or dependents; and receive job placement assistance, short-term job supports, maintenance services, benefits counseling, and supported employment are more likely to get competitive integrated employment at exit ( R2 = .34). Multiple variables were found to be significantly related to weekly earnings at exit and explained 24% of the variance. Rehabilitation counselors should take into consideration the findings of this study to determine from which supports consumers may benefit to attain successful employment goals, particularly for customized employment.

A NATIONWIDE EXAMINATION OF MEDICARE PART B UTILIZATION DURING HOSPICE ELECTION

Abstract This research characterizes trends in two hospice-specific modifiers: (1) “GV” indicating services for the terminal/related conditions by an attending physician not an employee of the hospice and (2) “GW” indicating physician services unrelated to terminal/related conditions. We identified Part B (carrier/physician supplier) claims during hospice elections in Federal Fiscal Year (FY)2020, and replicated an Office of Inspector General (OIG) approach calculating potentially “questionable” Part B claims, where the physician and diagnosis codes match between the hospice and Part B claims (without a GW modifier listed). Using logistic regression, we calculated adjusted odds ratio (AOR) and 95% confidence intervals (CI) to characterize this billing. Overall, $372.8 million in physician services occurred during hospice elections in FY2020. Of this, two-thirds ($247.8 million) included a GW modifier, one-quarter ($86.5 million) a GV modifier, $2.2 million both modifiers, and $40.8 million neither modifier. Replicating the OIG methodology, we calculated $19.4 million (5.2%) as “questionable”. Beneficiaries electing hospice for 180+ days were three times more likely (95% CI 2.99-3.12) to have questionable billing as a beneficiary electing hospice 14-29 days, and facility residents were more likely to have questionable billing, relative to beneficiaries in their own homes. Questionable billing rates were also highest in the northeastern quadrant of the country. Lastly, we found ten percent of physicians accounted for almost three-quarters of all questionable billing. CMS should further monitor physician services during hospice to maintain the integrity of the benefit and ensure beneficiaries receive adequate care.

Das Politische der Gemeinnützigkeit: Das Vereinsrecht zwischen Steuerrecht, Gefahrenabwehr und Antidiskriminierung

Private associations (<italic>Vereine</italic>) have recently become the object of increasing regulation in Germany from very different directions. The grounds for prohibiting extremist associations were expanded following the September 11, 2001 attacks, which caused a rise in prohibitions. Still more associations are today subject to surveillance by the offices for the protection of the constitution. In addition, the Federal Fiscal Court tightened the limitations for political engagement by charitable organizations in recent years. They clarified that charitable bodies may not get involved in political action beyond the scope of their official purpose as defined in their bylaws. Also, several courts denied privileged tax status to associations who do not allow women full access to their activities, or simply forced them to open all activities to all sexes. In the wake of these rulings, many NGOs, associations and other bodies fear for the many, often vital, tax advantages that come with their charitable status. This article analyzes these developments from a constitutional point of view and contrasts them with the jurisprudence on the freedom of association of the European Court of Human Rights and the German Constitutional Court. Arguably, the strict dichotomy which especially the fiscal courts establish between political parties and charitable associations does not stand up to scrutiny under constitutional law. European and German constitutional provisions view associations as necessary participants in the public discourse of a pluralist democratic order. These constitutional regimes appropriately acknowledge the important role associations, NGOs, corporations, and charitable foundations play in articulating, aggregating, and channeling the public will.

Patient safety and quality care: Time to focus on nonventilator hospital-acquired pneumonia

Background: A growing body of evidence has reported on the harm and cost of nonventilator hospital-acquired pneumonia (NVHAP), currently the most common hospital-acquired infection (HAI). Although the US Congress and the Center for Medicare and Medicaid Services (CMS) have acted to reduce rates of some HAIs through the Hospital-Acquired Condition Reduction Program (HACRP), NVHAP is not currently included. Thus, most hospitals do not engage in active prevention. Here, we report the findings from our analysis of Medicare claims data on hospital length of stay (LOS), cost for patients with hospital-acquired pneumonia (HAP), including both ventilator-associated pneumonia and NVHAP, and mortality. Methods: We used Medicare claims data for Federal Fiscal Year 2019 for inpatient and postdischarge services. Beneficiaries who died, were without continuous Medicare Part A and B enrollment, and patients eligible for Medicare for end-stage renal disease were excluded. Inpatient payments and 30-, 60-, and 90-day postdischarge episodes for 2,457 beneficiaries with HAP were examined and compared to a non-HAP control group of 2,457 beneficiaries. Groups were matched on age, sex, race, and the diagnosis-related group (DRG) for their index hospitalization. Results: Most HAP was NVHAP (N = 2,222; 89%) versus VAP (N = 275; 11%). LOS stay was significantly (p HAP patients were 2.8 times more likely to die vs non-HAP. Conclusions: These findings provide additional support to previous research on the harm and cost associated with NVHAP. Previous HACRP HAI initiatives, such as catheter-associated urinary tract infection (CAUTI) and surgical-site infection (SSI), have resulted in measurable HAI reductions. Although recent evidence-based NVHAP and initiatives indicate that NVAHP is largely preventable, to date, no acute-care inpatient hospital quality improvement program implemented by Medicare includes measures for NVHAP prevention. The time is right to include NVHAP as an HACRP HAI initiative.Funding: StrykerDisclosures: None

The Unprecedented Federal Fiscal Policy Response to the COVID-19 Pandemic and Its Impact on State Budgets

In response to the COVID-19 pandemic, within a year’s time span, the federal government enacted unprecedented fiscal response bills totaling over $5 trillion. This response amount equates to about 25% of U.S. GDP in 2020. These massive allocations funded direct pandemic public health responses, along with vast fiscal support for households, firms, and state and local governments. This enormous response supported state and local government budgets both indirectly and directly, resulting in a marked budgetary shift from anticipated shortfalls to significant revenue growth and inflationary budget pressures.

Unemployment, SNAP Enrollment, and Food Insecurity Before and After California's COVID-19 Shutdown

ObjectivesTo examine whether the decrease in very low food security (VLFS) observed in California shortly after California's coronavirus disease (COVID-19) shutdown remained throughout Federal Fiscal Year (FFY) 2020. To investigate associations among unemployment, Supplemental Nutrition Assistance Program (SNAP) enrollment, and VLFS across FFY 2020. MethodsTelephone interview responses from mothers from randomly sampled households from low-income areas throughout California to the 6-item US Department of Agriculture Food Security Survey Module identified VLFS families. Logistic regression examined VLFS rates before vs after California's COVID-19 shutdown, with race/ethnicity, age, and education as covariates. Pearson correlations were calculated for unemployment, SNAP enrollment, and VLFS. ResultsMost (66.4%) of the 2,682 mothers were Latina. VLFS declined from 19.3% before to 14.5% after California's COVID-19 shutdown (adjusted odds ratio, 0.705; P = 0.002). The correlation for unemployment and SNAP household participation was 0.854 (P = 0.007), and for SNAP participation and VLFS was −0.869 (P = 0.005). Conclusions and ImplicationsPublicly-funded assistance programs may lower food insecurity, even during a time of increased economic hardship. Examining the specific factors responsible for the observed decline in VLFS has merit. Whether VLFS remains below the rate observed before California's COVID-19 shutdown is worthy of ongoing study.

Distributions from Foreign Foundations and Trusts—The Case-law of the German Federal Fiscal Court (BFH)

Abstract The taxation of distributions from foreign foundations and trusts to beneficiaries resident in Germany is highly relevant in practice, but continues to be fraught with uncertainties. The article shows that recent case-law of the German Federal Fiscal Court (BFH) has clarified the position only partially. It is shown that economic double taxation burdens can only be avoided with careful planning which should ideally start before establishing German tax residency.

Recent developments in German taxation of distributions of foreign trusts and foundations to their Germany-based beneficiaries

Abstract Distributions of foreign trusts and foundations to their Germany-based beneficiaries may be subject to German income and gift tax. Fortunately, German tax authorities now have implemented a judgment of the German Federal Fiscal Court rendered on 3 July 2019 stating that distributions made by a foreign foundation to its Germany-based beneficiaries are not subject to German gift tax provided that (i) the distribution has been made in accordance with the foundation’s statutes and (ii) the beneficiary does not have a claim regarding the distribution received. However, there are still some cases in which gift tax may be levied on such distributions, so that the risk of potential double taxation with both income and gift tax is still not completely off the table.

P95 Process and Outcome Evaluation of the LSU AgCenter SNAP-Ed Program Using Microsoft Dynamics 365

<h3>Background</h3> Supplemental Nutrition Assistance Program Education (SNAP-Ed) encourages healthier eating through education and policy, systems, and environmental (PSE) changes to support access to healthier foods. Collecting and managing data for process and outcome evaluations is challenging for SNAP-Ed implementing agencies (IAs) with variation in direct education and PSE change projects implemented. Several IAs have used the Program Evaluation and Reporting System (PEARS) to gather and manage evaluation data, but this may be cost prohibitive for IAs with smaller budgets. The LSU AgCenter Information Technology (IT) department adapted Microsoft Dynamics 365 to the evaluation needs of the LSU AgCenter SNAP-Ed program. <h3>Objective</h3> To conduct a process evaluation of direct education and PSE change work conducted by the LSU AgCenter SNAP-Ed program in Federal Fiscal Year 2019-2020 using the Microsoft Dynamics 365 Application. <h3>Study Design, Setting, Participants</h3> LSU AgCenter IT staff adapted Dynamics to collect the data necessary to report against priority indicators in the SNAP-Ed evaluation framework. IT staff created separate reporting modules for individual direct education contacts, groups of direct education contacts, community partnerships, community coalitions, and PSE changes. SNAP-Ed frontline staff were trained on the reporting system in a series of hands-on, in-person meetings held prior to March 2020. <h3>Measurable Outcomes/Analysis</h3> LSU AgCenter staff report direct education contacts, partnerships, coalitions, and PSE changes made in the Microsoft Dynamics application. Data can be disaggregated according to demographic information, location, and implementing staff member, enabling data to be used in performance evaluations and analyses of equity in program access. <h3>Results</h3> Feedback about the reporting system was overwhelmingly positive. The system collected data necessary for reporting to state and federal funding agencies. Over the course of FY2020, LSU AgCenter established 502 partnerships, made 6,473 direct education contacts, and 118 PSE changes. <h3>Conclusion</h3> The Microsoft Dynamics 365 Application was easily adapted to the evaluation needs of the LSU AgCenter SNAP-Ed program. Process and outcome evaluation data indicated that the LSU AgCenter met its goals for FY2020.

Federal and Subnational Fiscal Power in Canada and the US

This paper examines the fiscal balance of power between national and subnational governments in Canada and the US. While it is generally acknowledged that Canadian provinces are more autonomous than American states in terms of own-source revenues and the conditionality of transfers, I argue that political dynamics within and between the two levels of government significantly impact the ability of federal governments to exercise their fiscal power on the subnational units. Even though Canada has more decentralized fiscal arrangements, the independence of its federal government and the interdependence of American federal-state relations results in a greater degree of federal fiscal power in Canada.

Rates of Diagnoses Indicating Opioid Dependence After Hospice Live Discharge: A National Study (SCI929)

1.Enumerate the rate of hospice live discharges associated with subsequent opioid dependence.2.Identify patient and provider trends in the rate of opioid dependence incidents after hospice live discharge. Medicare beneficiaries that elect the Medicare Hospice benefit often receive opioids as a standard medication to treat pain. Little is known about the prevalence of opioid dependence following live discharge from hospice. The Centers for Medicare & Medicaid Services Chronic Care Policy Group seeks to examine live discharges associated with subsequent opioid dependence and identify patient and provider characteristics of such discharges. Retrospective cohort analysis of Medicare hospice discharges during Federal Fiscal Years 2017-18 (FY2017-2018). Using 100% Medicare inpatient and Part B claims, we identified ICD-10 codes indicating opioid dependence indicated by a crosswalk maintained by the Agency for Healthcare Research and Quality. There were 2,673,218 hospice discharges FY2017-FY2018, of which 468,204 (17.5%) were live discharges. Among these, 9,282 discharges (2.0%) were associated with 28,962 opioid-related diagnoses after discharge. Approximately one quarter (26.4%) of these diagnoses appeared on inpatient claims. The states with the highest rates of opioid-related post-discharge incidents per 10,000 hospice live discharges were Kentucky (435.2), Wyoming (386.0), Tennessee (359.3), Washington (345.6), and Idaho (342.9). Post-hospice opioid diagnoses were more likely if the beneficiary was younger (for ages <65 relative to 85-89, AOR=6.23, 95% CI 5.73-6.77); dual-eligible (AOR=1.40, 95% CI 1.34-1.47); and relative to cancer, being diagnosed at admission with COPD (AOR=1.83, 95% CI 1.72-1.95), heart diseases (CHF: AOR=1.23, 95% CI 1.14-1.34; Other Heart Disease: AOR=1.23, 95% CI 1.14-1.33), or liver disease (AOR=1.25, 95% CI 1.10-1.42). There were no discernable patterns among hospice characteristics. Opioid dependence after hospice was more frequent among beneficiaries who were younger, dual-eligible, diagnosed with COPD, heart, or liver diseases, or residing in the lower Appalachian and Northwestern states.

Revisiting the Case for a Fiscal Union: the Federal Fiscal Channel of Downside-Risk Sharing in the United States

Differentiating between standard risk measures and downside risk has a longstanding tradition in finance. Interestingly, this fundamental distinction has been neglected in the literature on risk sharing. Drawing on a simple definition in Markowitz (1959), we translate downside-risk metrics appropriate for stock returns into ones that can be used in our macro-forecasting setting, and propose a new methodology to estimate channels of downside-risk sharing, with an application to the federal fiscal channel in the United States. Our work reinstates some discarded arguments as to why a fiscal union could be desirable, as our findings suggest that public risk sharing is considerably higher than was previously thought. We also show that the great importance long attributed to the capital market channel estimated with popular income smoothing methodologies is instead entirely driven by the neglect of the effect of capital depreciation. Therefore, our paper argues that the relative importance of the fiscal channel as compared to the capital market one has been substantially underestimated.