How States Can Begin Cutting the Costs of Health Care
Federal efforts to reduce wasteful spending haven't achieved much. It's an opportunity for states to innovate.
Ryan Holeywell is the communications manager for the Texas Medical Center Health Policy Institute in Houston. He previously worked at Rice University's Kinder Institute for Urban Research. Holeywell is a former reporter for the Houston Chronicle as well as Governing magazine, where he covered infrastructure and federal policy from 2010 to 2014.
Holeywell earned his bachelor’s degree in political communication from George Washington University and is pursuing a master's degree in public Affairs from the University of Missouri.
Federal efforts to reduce wasteful spending haven't achieved much. It's an opportunity for states to innovate.
Waze and other apps want to save drivers 10 minutes every day, but safety experts say it's too dangerous to use these apps while driving.
More than half the states enacted laws to combat metal theft last year, but there’s little analysis of which legislative policies actually work.
In the 1980s, San Francisco faced a court order similar to the one the state is facing now to reduce overcrowding. Rather than simply throwing the book at people, the city now often treats jail as a last resort and focuses on reintegrating ex-offenders back into society.
Recent departures mean familiar faces will take on DOT's top roles.
The committee chairman says he wants a highway bill on the House floor by August.
Three of the nation's top metros for carpooling are in the Aloha State.
At a press conference Thursday, the New Jersey governor said he was misled when he asked his staff about the closure of bridge lanes -- which some speculate was political payback for a mayor's decision not to endorse Christie for re-election.
One of the New Jersey governor's top aides ordered lane closures that gridlocked a town -- a move that Democrats say was political payback for the mayor's refusal to endorse Christie.
Wantwaz Davis, who served nearly 20 years for murder before being elected to the Flint, Mich., city council in November, sees his background as an asset -- not a liability.
Polly Trottenberg, a higher-up at the U.S. Department of Transportation, takes over an office that's been redefined in recent years.
Fewer stops can reduce travel times and operating costs, researchers say.
State Department of Transportation has awarded the final contract for improvements on roads impacted by the energy sector.
Wildfires in the U.S. are becoming bigger, more destructive and more frequent. And the extra cost of putting them out comes straight from the budget for fire prevention.
After Mayor John Cranley campaigned on opposition to the project, he announces "we're going to have a streetcar."
Plus six trending issues that could be big this year.
Voters elected an unusually high number of new big-city mayors in November.
According to the U.S. Department of Transportation's lead watchdog.
The highlights included a new transportation secretary and big funding hikes at the state level.
The newly proposed legislation comes as federal regulators consider lifting restrictions on the devices.
Congressional negotiators are supposed to deliver the outline of a budget deal next week. State officials are urging them to produce.
The legislation will eventually mean more than $2.3 billion annually in additional funds for transportation infrastructure.
Chicago’s infrastructure bank has been hailed as an innovative new financing model that could revolutionize the way cities build new projects and manage risk. If only it could get off the ground.
Land bank programs have become a popular way for cities to acquire abandoned property and do something productive with it.
The new facility, which is being built less than 20 years after the current one, will cost Cobb County, Ga., $300 million.
The bipartisan group of lawmakers say the legislation, which provides a new way to pay for infrastructure projects, would allow states and localities to build quicker.
In the ultimate sign of the country's stadium-mania, the baseball team is poised to get another stadium despite moving to Turner Field in 1997.
In some places, cuts in intergovernmental aid played a particularly significant role in causing budget strain.
Plagued by drought, voters in the Lone Star State approved a plan to use rainy day funds to pay for projects that will preserve or expand the state's water supply.
Chicago's Gabe Klein and New York's Janette Sadik-Khan are poised to leave office within a few months. Their influence on their cities can't be overstated.
The ruling means that Virginia -- a national leader on public-private partnerships -- will likely continue its tolling push.
Public-private partnerships have become a trendy way to finance transportation projects. But there are big questions to ask before entering into a P3.
With a rapidly growing population, stagnant water supply and regular droughts, Texas voters are being asked to make $2 billion in state financing available for local and regional projects.
Some security responsibilities are being shifted away from the federal government and to airports themselves. Critics say the change could cost airports more than $200 million a year.
Protesters say they'll cause congestion on Washington's Beltway starting Friday, but state transportation leaders aren't saying much about how they'll respond.
Arlington County, Va., police went back to the basics and to everyone's surprise, a sign that says "Don't Hit the Car in Front of You" seems to be reducing accidents.
Even the country’s most sprawling, least dense, most automobile-dependent city in America is trying to adapt to people’s preference for urban living.
New York officials believe they're the first to use signs to encourage drivers to use cellphones in safe, designated places like rest stops.
With Congress back in session, tough issues like Syria and the deficit may put the bill known as the Marketplace Fairness Act on the back burner.
Backers say the Water Resources Reform and Development Act will cut approval time for much-needed upgrades to ports, inland waterways and flood control projects.
U.S. Rep. Bill Shuster, chairman of the House Transportation and Infrastructure Committee, will take a spin in self-driving vehicles Wednesday morning.
The rapid proliferation of smartphones and tablets has led an increasing number of schools to allow students to bring their own devices into the classroom, leaving administrators with the big job of re-evaluating security and privacy policies and updating networks.
Long-time executive director Gary Thomas reflects on the milestone and the future of mass transit in North Texas.
In 1984, Los Angeles reduced traffic and accidents during the Olympics in part by banning trucks from freeways during peak hours. Some lawmakers think it's a policy worth revisiting.
Called Integrated Corridor Management, the program emphasizes coordination across all transportation agencies.
Helmet dispensing machines will debut in Boston over the next few weeks. Plus, more news you should know about transportation and infrastructure.
As more states pass laws authorizing testing of autonomous vehicles, key legal questions need to be answered.
The president's proposal would reduce the top corporate tax rate, eliminate loopholes and use the one-time revenue to pay for roads, transit and other transportation systems.
The former county executive says that Maryland's new transportation funding package was key to his decision to take the cabinet-level post.
U.S. DOT tells states to be prepared for a slowdown in cash disbursements.
Many states ended fiscal year 2013 with a surplus, but experts warn that it doesn’t mean their financial woes are over.
The high-profile light-rail project will link Detroit's two most vibrant sections. Financing for the $131 million line includes a huge amount of private and philanthropic support.
The legislation, which awaits the governor's signature, would mark a radical departure from the traditional gas tax to fund transportation infrastructure.
The struggling Pennsylvania city is auctioning off items that were acquired for an ill-conceived Wild West museum.
As U.S. Transportation Secretary Ray LaHood leaves office Tuesday, he sees a path forward for solving transportation's biggest problems.
After eight years in office, Los Angeles Mayor Antonio Villaraigosa has put an indelible mark on the city's transportation network.
One Congressman hopes to solve the problem of overseas tax havens and failing infrastructure with one piece of legislation.
Transportation stakeholders have become increasingly vocal in recent years over the disconnect between the president's lofty rhetoric about the need to invest and his lack of serious policy proposals on the matter.
The four-lane bridge north of Seattle that collapsed and send several cars into the Skagit River Friday was rated by the Federal Highway Administration as "functionally obsolete" and was in far better shape than many bridges around the country.
The Charlotte mayor didn't face many hardball questions from senators.
As passenger rail legislation expires this fall, those money-losing routes could be in the cross hairs of House Republicans.
"Bertha," named after Seattle's first female mayor, will soon start digging tunnels to replace the city's iconic highway that was destroyed by a disaster more than ten years ago.
In an effort to increase revenue, transit agencies are working to find new twists to old advertising methods.
The two initiatives could quickly become the largest bike sharing programs of their kind in the U.S.
It's conventional wisdom in Washington that voters won't support a gas tax hike or a vehicle miles traveled fee. A new study suggests that long-held belief is wrong.
The president's new budget proposal increases total federal grant funding to states and localities, but some programs are on the chopping block.
The president's budget calls for ambitious infrastructure investments but -- yet again -- doesn't provide many details on how to pay for it.
Secretary of State Kate Brown wants to make Oregon the first state to instantly register voters when they apply for a driver's license.
Communities struggle with what to do with stadiums once sports teams leave. Indianapolis is converting its historic minor league ballpark into apartments.
In an effort to reduce congestion, every traffic light in Los Angeles is now controlled remotely by a software the city has given the federal government to share with other cities.
The legislation fizzled last year as Congress became mired in the fiscal cliff debate. But advocates are hopeful for a different result this time.
The study, published every four years, is a key tool for infrastructure advocates.
Gov. O'Malley's plan borrows many ideas from Virginia's sweeping overhaul, but differs in a couple key ways.
The highway bill was passed last year, but lawmakers are already discussing its successor.
Under Bloomberg, the cityscape has been reshaped in unprecedented ways.
Programs for the poor are of particular concern.
The decision brings Michigan's largest city one step closer to a state takeover.
Transportation stakeholders are urging the FCC to slow plans that could undermine much anticipated technology that can help drivers avoid crashes.
Gov. McDonnell's plan to scrap the gas tax got national attention. But the legislation's time is running out.
A new report estimates that offshore accounts maintained by corporations and wealthy individuals caused states to miss out on nearly $40 billion in tax revenue in 2011.
New line extends service to French Quarter, Superdome and downtown.
Vienna has figured out how to offer high-quality apartments with low-cost rent and renters' rights that would be unheard of in the United States. Advocates say it's a model worth examining.
In an effort to reduce HIV rates that were approaching development-world levels, a government-run facility in the Canadian city welcomes people to use illegal substances under the supervision of medical professionals.
Few states have offices dedicated to examining increasingly popular P3 deals. Experts say it's time to copy Canada and change that.
Rep. Oberstar and others explore disconnect between need for investment and public will.
Says current path is unsustainable.
A new report warns of governments' continued "failure to invest" in roads, airports, electrical grid and other critical forms of infrastructure.
Scheduled automatic spending cuts, while delayed, still mean uncertainty for some key programs.
Cities across the country are being forced to deny food and shelter to those in need, according to a new study.
The mayor-elect discusses the city's $5 billion elevated rail line.
While states as a whole are seeing their financial position slowly improve, the results have been uneven.
Lawmakers stressed the importance of avoiding the so-called "fiscal cliff" and made their case for programs they want to protect.
See which programs get the biggest cuts, and when they'll really happen.
The federal tax code has, in effect, subsidized the cost of borrowing for state and local governments. Some say that could be poised to change.
With the passing a handful of ballot measures on Election Day and the surface transportation bill this spring, 2013 will be a busy year for infrastructure and transportation projects.
Three major cities will get new mayors next year.
A wealthy opponent of Detroit's new international bridge fails to derail the project, despite spending big.
Voters repealed a unique law that gave state-appointed officials unprecedented power in struggling cities and school districts. But the debate is far from settled.
Voters will decide whether to create a new open-primary system that threatens the power of political parties.
Once a relative novelty, communal living facilities continue to increase in popularity -- and they could become a key part of the way developers and cities accommodate an aging population. View our series on aging here.
Reforms are largely the result of a final subway crash in Washington, D.C.
Hundreds of cities are trying to follow federal orders to clean up their wastewater systems -- sometimes at a cost of billions of dollars.
Social impact bonds are a relatively new financial instrument that promises to earn returns for investors while giving state and local governments the upfront capital they need to pursue money-saving programs.
State and local leaders say that in order to fix their budgets, they'll need to view citizens and government employees and partners.
Engineers say failure to maintain and expand facilities will make American goods more expensive.
A new report emphasizes collaboration between state agencies and local partners.
Unlike California's well-known attempt to build a bullet train, a company in Texas says it can bring high-speed rail to the state at no cost to taxpayers.
The EPA released a new framework that it says will offer cities more flexibility and maybe more savings as they try to stop sewer runoff into lakes and rivers.
Agencies are seeking ways to curb the growing use of expensive paratransit service, but advocates question their methods.
Henry Cisneros discusses his new book on senior housing and what local and federal governments need to do to address the housing needs of seniors.
Atlanta-area voters rejected a one-cent tax for transit projects. But voters in three regions chose to make the investment.
After the company's president expressed opposition to gay marriage, two mayors said they'll try to prevent it from expanding.
Localities from San Francisco to Jacksonville, Fla., are embracing bus rapid transit -- even if not everyone in the transportation community is sold on the idea.
It’s one of several bills introduced in the last year that could let states tap into a valuable revenue source.
After a weekend conference in Williamsburg, Va., governors are still trying to figure out what the Supreme Court's ruling means for the future of Medicaid.
Our northern neighbor is paying for a new international bridge between Detroit and Canada. Is it too good to be true?
States are seeking to spend billions of dollars to build bigger ports to accommodate the massive ships that will soon be traveling through the canal. Can they move quickly enough?
The City Council hopes bankruptcy protection will help it avoid a total collapse, but experts say it's only a short-term fix.
Forty-seven projects across all modes awarded nearly $500 million.
New study shows states owe $1.38 trillion more to retirees than they've set aside. That's about 9 percent higher than last year's report.
But growing Medicaid costs remains a concern.
Gov. Rick Snyder discusses the state's workforce, as well as his ideas for economic development.
Money's tight. So why don't governments work to determine how to get the best bang for their transportation buck?
The state is finalizing a four-year construction project for one of the world's oldest schools for deaf and blind students.
At least six states this year issued their tax refunds on debit cards, in a move they say will save money for both the taxpayer and the government.
In the past, cities have resisted big-box stores. But now, government leaders from New York to New Orleans are actively courting places like Walmart and Home Depot to move in.
Federal legislation could prohibit agencies from attending multiple conferences hosted by one organization.
Legislation would require banks seeking city business to submit detailed local lending data.
Weston, Fla., relies almost entirely on contractors to perform city work.
The Motor City has a new CFO who faces an enormous task: putting one of the country's most financially stressed cities on sound footing.
State and local governments say without federal funding, a bill working its way through Congress threatens to greatly increase the costs of reporting.
The American Society of Civil Engineer's latest report says a failure to invest in energy infrastructure could have huge economic consequences for the country.
In Michigan, financial advisers take control of cities on the brink of bankruptcy.
One idea floating around on how to help cities pay for water infrastructure has already helped finance big transportation projects with large, low-interest loans directly from the feds.
A new report from the federal watchdog says that state and local governments should move quickly to address financial challenges facing them.
"Each flag has a story to tell," says the head of the North American Vexillological Association. Here's 13 of the best, as determined by Governing's Ryan Holeywell.
As the country debates the future of highways and transit, a major investment in air is planned.
Big winnings could mean big taxes for states that sold winning tickets.
In what might be the first suit of its kind, a federal judge ruled the mortgage giants must pay transaction taxes owed to state and local governments.
Business records in many states can be edited by just about anybody, making them an easy target for scammers.
From Washington, D.C., to California, read about the five biggest projects in the country right now -- and the five biggest ones in jeopardy.
Former President Dwight D. Eisenhower's grandchildren asked a commission tasked with designing his memorial to return to the drawing board.
With the latest highway and transit bill extension expiring at the end of the month, Transportation Secretary Ray LaHood says another will be needed.
State Treasurer was allegedly sent a recording of his wife having sex with another man.
Congress has until the end of March to pass a highway bill or extend the current one. How that will happen is anyone's guess.
Reduced revenue and federal funding, combined with unsustainable employee costs, are making it difficult for the Oregon city to stay on top.
After being trapped on a train for eight hours with no food, water or heat in the middle of winter, passengers want to make sure it doesn’t happen again.
Gov. Martin O’Malley says his controversial plan will help manage the state’s growth while protecting rural areas and the Chesapeake Bay. But is he overreaching?
He and others with business and political interests are leading a group working to buy the Philadelphia Inquirer.
The administration, for the second year in a row, requests cuts to a program that helps poor people pay their heating and cooling bills.
The battle over University of North Dakota's nickname continues, reports The Forum of Fargo-Moorhead.
A new report suggests Republicans haven't found the revenue they promised they had.
The president has an ambitious proposal that probably won't be considered seriously by Congress.
Cities and counties hope to fill budget gaps by recovering unpaid debts.
The news comes on the same day House leaders will reveal their surface transportation legislation.
The study could be a lightening rod in the ongoing debate about government employee compensation.
President Obama says it can, but analysts say that's an oversimplification.
But the National Parks Service director says the agency will “very soon” begin to enforce anti-camping regulations.
New legislation would subject the legislature to greater transparency.
Cities and counties knew they'd lose CDBG money in 2012. But a quirk in the formula is causing some to see even larger cuts.
With Cecilia Muñoz in a new position, it's unclear who will take the reins at IGA.
Money will reimburse states for repairs prompted by natural disasters.
A popular grant that funds the often-thankless work of forming master plans and zoning codes is no more.
Federal Rail Administrator Joseph Szabo says that the feds remain committed to the controversial program.
After 20 years of neglect, the waterfront venue has been completely transformed -- for the worse. One group wants to restore it to its former glory.
A new report shows state revenue and spending still hasn't returned to pre-recession levels. But it's getting close.
Houston’s sports teams left the Astrodome over a decade ago, and leaders still don’t have the answer.
The federal government is working to improve the way it administers grants. But states and localities aren't part of the council taking on the issue.
Maryland Gov. Martin O'Malley says state governments should stop cutting the public workforce.
Phoenix -- the only large city to elect a new mayor yesterday -- selects Democrat Greg Stanton as its new mayor.
Pilot program could mean less wasted time for local affordable housing offices.
Without getting wonky, Gary Hustwit's latest shows what's working -- and what isn't -- in cities across the globe.
Lawmakers hear from those who helped perpetrate the HOME program.
But federal officials say they'll likely need more data before they can make any change.
The largest elections jurisdiction in the country is trying to develop its own unique voting system. But it faces some hurdles to get there.
Underwater borrowers would be able to take advantage of historically-low interest rates under changes to HARP.
After Harrisburg files for bankruptcy, state lawmakers pass a bill that allows a receiver to enact a recovery plan.
The transportation secretary urges Republicans to invest in infrastructure, despite defeat of legislation.
But a top Republican says the efforts are "a drop in the bucket" compared to the task at hand.
One program, designed to help up to 4 million homeowners get relief, has offered permanent aid to less than 900,000.
As Congress mulls and tweaks the president's legislation, a key adviser says a 'no' vote won't stop Obama's efforts.
Retirement plan assets just had their fourth consecutive quarter of growth.
Two senators are calling on Congress to adopt a technique used by some state legislatures: biennial budgeting.
The White House office is more prominent and responsive than it ever was.
Cities are tapping rainy day funds, which have lost 40 percent of their value from the pre-recession days.
New study analyzes unique voting option in Nevada that lets voters choose "none of these candidates."
States are signing on to a plan that will drastically change the way the country selects its president. Supporters say they're halfway toward achieving reform.
The design for the 34th president’s monument is too trendy and cold, critics say.
Without the aid package, the country's unemployment rate could have been 18 percent higher.
Lawmakers say the onslaught of legislation is due to federal inaction. But could it be sending the wrong message to Washington?
As Congress eyes domestic cuts, the bankrupt Rhode Island municipality shows what happens when a city can't afford to function.
When the FAA's taxes expired, passengers could have saved money, but instead the airlines raised ticket prices. Now, the Treasury may try to claw that money back.
Gov. Jack Dalrymple acknowledges "growing pains" but says the oil industry will be a long-term benefit to the region.
The state's oil boom is bringing unmatched growth and unanticipated problems.
Western counties say they're getting stuck with the costs of taking care of abandoned livestock.
The alleged scam affected at least 93 municipal bond transactions in 31 states, according to federal authorities.
The new fiscal year for most states begins July 1. With it comes an increase in their portion of the Medicaid burden.
Here's how to plan, fund and make a safer, more efficient transportation system.
Owners wanted municipalities to build them stadiums -- and taxpayers ponied up. Now the NFL may refuse to play games at the very facilities they requested.
To prevent default, the Treasury Department stopped issuing a security that's key to municipal bond issuers.
The president's budget calls for a highway bill that's nearly double the size of its predecessor. How to fund it, LaHood says, "is up to Congress now."
States spent $131 billion on transportation last year. But most can't say fully whether those investments paid off.
A new report gives credence to a plan that state and local government officials say will overstate the challenges facing pensions.
As the federal government marks the death of Osama bin Laden, local leaders highlight the millions just cut from anti-terrorism programs in transit systems.
Only 7 percent of federal highway funds go directly to metro areas. Most gets funneled through the states. Kasim Reed says that needs to change.
In an interview with GOVERNING, the new head of the National Governors' Association disputes recent data on pension gaps, and lays out his federal priorities.
Once again, BATSA is proposed in the House. Under Republican control, it might have better luck.
Republicans tried to paint Scott Walker as an expert at solving state budget woes. Democrats portrayed Peter Shumlin as an alternative to Walker. Congress challenged both of their approaches.
To prevent deficits, states and localities would have to reduce expenditures or increase revenues by about 12.5 percent.
The plan could save $60 million annually in denied payments.
Plan would freeze spending at 2008 levels for five years, remove transportation as a priority.
Trash collection would stop and libraries would close in the nation's capital.
States may have to develop plans for employees funded by federal dollars.
States could get exemptions from the Affordable Care Act -- provided they provide the same level of coverage.
Mayors say Chicago's new leader could provide them with valuable connections and provide a national voice on municipal issues.
Trucking jobs might take a hit. But trade advocates say there's an even greater upside.
Just 15 percent have raised property tax rates. Instead, they're cutting services and cutting personnel.
Republican leaders from Idaho and Utah testify against the Bureau of Land Management's new policy on "wild lands."
Airline tickets to and from rural areas are becoming more expensive. Without a federal program that gives millions to airlines, they could be even worse.
USA Today finds a $2,500 gap between public- and private-sector compensation.
When legislators need nonpartisan reports, Dartmouth students do the legwork.
The president makes his case for investments at a time when governors are refusing federal money.
Critics say new oversight rules would make volunteering an onerous process.
Some leaders are now hoping to apply the techniques used by the stimulus bill's auditors to others areas of government.
The White House's plan to cut more than $2.5 billion from a program that helps poor people pay for heating and cooling bills may leave millions out of luck, advocates say.
CDBG isn't the only local program getting cut. Learn about funding that's in jeopardy for affordable housing, historic preservation and other areas.
President Obama proposed cutting $300 million from CDBG, a favorite program among mayors. Saving it had been one of their biggest priorities for 2011.
The proposed cuts would be the largest reduction in discretionary spending in the country’s history.
Witnesses disagree over whether state bankruptcy is a viable option, but Rep. Patrick McHenry says one thing is for sure: States aren't getting a bailout.
FY 2011 funding would be cut by 17 percent in those areas under Republican plan
Economist Mark Zandi told GOVERNING's Outlook conference that GDP is growing, but that doesn't mean state and local governments will be able to increase expenditures.
Just one month into 2011, ten police officers have been fatally shot.
Forget the border wall. Leaders see economic development opportunities in opening and updating international bridges.
The Los Angeles mayor warns localities to be strategic in their requests given that funding may be hard to come by this year.
Some critics think state and federal lawmakers are too focused on things like mandating hands-free phones and outlawing texting while driving.
The president and at least one GOP lawmaker are united in a push to cut millions from preservation grants.
States say the new rule change in Congress will cause uncertainty in how money is distributed for roads projects.
State and local officials are up in arms over a proposal in Congress that would change the way pension data is reported.
Incoming governors in two states pledged they wouldn't move forward on implementing President Obama's high-speed rail efforts in their states. So the federal government is distributing their funds elsewhere.
The tax bill the White House has negotiated fails to renew the popular Build America Bonds program, which makes borrowing less expensive for local governments.