#government

Public notes from activescott tagged with #government

Thursday, August 27, 2026

The immediate catalyst was the US Treasury’s decision to at least double its purchases of government bonds with longer maturities, from $2 billion to $4 billion a month with the aim of reducing longer-term Treasury yields, which have surged recently to highs last seen in 2007.

Bitcoin reacted almost immediately, rising nearly 6% on Aug. 19 before extending its gains. According to André Dragosch, head of research Europe at Bitwise, the Treasury announcement was the “major macro catalyst,” signaling a greater willingness to ease fiscal policy and contributing to a weaker US dollar.

“There are several drivers behind the recovery in bitcoin over the past week,” says Macellari, pointing to the recent White House crypto summit and potentially positive momentum on the Digital Asset Markets Clarity Act under consideration by the US Senate. “But the most significant driver is the debasement trade narrative coming back into the spotlight.”

Once prices started moving higher, leveraged short positions, which use borrowing to bet on the price weakness of bitcoin, were forced to close. According to Dragosch, last week there was a record amount of liquidated short positions, which added another layer of buying pressure, creating a classic “short squeeze”.

But the level of $80,000 remains the key test. CoinShares’ Butterfill expects bitcoin to remain within its current range unless the Federal Reserve provides clearer confirmation that the risk of further rate rises has disappeared, which “could provide the catalyst for a stable bitcoin breakout above the $80,000 threshold.”

Wednesday, August 26, 2026

Until recently, the government rarely asked the justices to decide cases on the emergency/interim/shadow docket. Presidents George W. Bush and Barack Obama sought such action only 8 times in 16 years. But in the last decade, the Court’s definition of “emergency” has grown to include almost any lower-court ruling the justices feel like weighing in on. While these shadow docket orders are not final in a legal sense, they often are in a practical one — say, when the Court allows the president to deport an undocumented immigrant or fire thousands of civil servants.

Combine this with a president who believes everything is an emergency — during Trump’s first term his administration sought shadow docket relief 41 times — and you have a recipe for the sort of arbitrary, unexplained exercise of power that led Americans to declare their independence from the Crown in the first place.

Currently the Court is considering emergency appeals from Trump regarding whether he can build a new White House ballroom without going through Congress, and whether he can make it harder for Americans to cast their vote by mail (the way Trump himself votes).

Requiring officials to give reasons for their actions is the foundation of liberal society, the sine qua non of modern representative government. It’s what separates a constitutional democracy from an authoritarian regime. Indeed, it’s right there in the Constitution: The Great Writ — habeas corpus — is based on the principle that if the state wants to detain you or deprive you of your liberty, it must first bring you into open court and provide the precise reasons why.

In an incident from another case last fall, a veteran federal district judge, William G. Young, blocked the Trump administration from canceling millions of dollars in grants by the National Institutes of Health. Apparently, Young had failed to intuit the meaning of an earlier shadow docket ruling by the Supreme Court, which involved the canceling of grants by a separate agency while offering almost no actual reasoning. For this crime, the judge endured a harsh public scolding by Justices Neil Gorsuch and Brett Kavanaugh.

“Lower-court judges may sometimes disagree with this Court’s decisions, but they are never free to defy them,” Gorsuch wrote.

Young, a Reagan appointee and judge for 47 years, apologized in open court. “Never before this admonition has any judge in any higher court ever thought to suggest that this court had defied the precedent of a higher court — that was never my intention,” he said. “I simply did not understand that orders on the emergency docket were precedent,” he added. “I stand corrected.” (Never mind that the justices seem unable to agree even with themselves on this point: In his smackdown of Young, Gorsuch wrote that a Supreme Court decision is a “precedent that commands respect in lower courts,” but only five years ago Justice Samuel Alito had said emergency docket rulings are not precedential.)

Sunday, July 26, 2026

What was Citizens United about?

Citizens United arose in 2007 when a conservative nonprofit organization challenged campaign finance rules that stopped it from promoting and airing a film criticizing then presidential candidate Hillary Clinton.

The Supreme Court eventually decided 5–4 that Citizens United was within its First Amendment rights to spend its money disseminating the film. But rather than opining solely on the case before it as it had been asked to do, the Court took the opportunity to entirely strike down century-old prohibitions on corporate “independent” spending — money that doesn’t go directly to a candidate or party.

The justices who decided Citizens United held that independent spending could not pose a substantial risk of corruption on the erroneous assumption that the money wouldn’t be under the control of any single candidate or party.  They also assumed that existing transparency rules would require all the new spending they were permitting to be fully transparent, allowing voters to appropriately evaluate the messages targeting them.

Both assumptions have proven to be incorrect. While super PACs and other outside spenders are supposed to be separate from candidates and parties, they usually work in tandem with them — to the point where affiliated super PACs that can raise unlimited money are now integral to most major campaigns. Legal loopholes also mean that many of these groups can keep their sources of funding secret.

These trends reached new heights in the 2024 election. Billionaire-backed super PACs helped the winning presidential candidate close a substantial fundraising gap. These groups also went beyond just running supportive ads. A group funded by Elon Musk, the world’s richest person, took on core components of the winning campaign, including voter outreach operations. And dark money from groups that do not disclose their donors topped $1 billion, including at least $182 million that was funneled through groups closely aligned with the two major parties’ congressional leadership campaigns.

Political action committees, known as PACs, are organizations that raise and spend money for campaigns, or whose major purpose is to support or oppose political candidates or ballot initiatives. Traditional PACs are permitted to donate directly to a candidate’s official campaign, but they are also subject to contribution limits, both in terms of what they can receive from individuals and what they can give to candidates. For example, PACs are only permitted to contribute up to $5,000 per year to a candidate per election.

In the 2010 case Speechnow.org v. FEC, however, a federal appeals court ruled — applying logic from Citizens United — that outside groups could accept unlimited contributions from both individual donors and corporations as long as the groups don’t give directly to candidates. Labeled “super PACs,” these outside groups were still permitted to spend money on independently produced ads and on other communications that promote or attack specific candidates.

In other words, super PACs are not bound by spending limits on what they can collect or spend. Additionally, super PACs are required to disclose their donors, but those donors can include dark money groups, which make the original source of the donations unclear. And while super PACs are technically prohibited from working directly with candidates, weak rules that are supposed to enforce this separation have often proven ineffective.

For example, in the 2022 midterms, just 21 of the biggest donor families contributed $783 million and billionaires provided 15 percent of all federal election financing — most of which went to super PACs supporting congressional campaigns. These donors easily outspent the total given by the millions of small donors giving to House and Senate candidates that cycle.

Citizens United allowed big political spenders to exploit the growing lack of transparency in political spending. This has contributed to a surge in secret spending from outside groups in federal elections. Dark money expenditures increased from less than $5 million in 2006 to more than $1 billion in the 2024 presidential elections alone.

Over the long-term, Citizens United would have to be overturned by a constitutional amendment or the Supreme Court. In the meantime, there are policies that can combat the dominance of big money in politics and the lack of transparency.

At a minimum, it is critical to ensure that all large campaign donors are disclosed. Strong disclosure laws, like the one enacted in Washington, require groups spending significant sums on election activity to report their largest donors. Separately, lawmakers and regulators should pass stricter rules to prevent super PACs and other outside groups that can raise unlimited money from coordinating directly with candidates and parties. Existing laws also need to be fully enforced, which has been a longstanding challenge at the federal level thanks to dysfunction at the Federal Election Commission.

Further, candidates can be offered alternative means to fund their campaigns without relying on big donors and super PACs. The most effective way to do that is public campaign financing, specifically small donor matching, in which small private contributions are amplified using public funds. Fourteen states and dozens of large cities and counties have enacted some form of public financing, with other localities actively considering it. Such a system recently went into effect in New York State and candidates have widely adopted it, allowing them to raise far more in small donations from their own constituents.

Notably, overwhelming majorities of Americans across party lines have consistently expressed disapproval of Citizens United. At least 22 states and hundreds of cities have already voted to support a constitutional amendment to overturn it. And national polls routinely show that reducing the influence of money in politics is a top policy priority for Americans, a finding consistent across demographics including race, age, and political party affiliation.

So to start matters, Franklin was writing not as a subject being asked to cede his liberty to government, but in his capacity as a legislator being asked to renounce his power to tax lands notionally under his jurisdiction. In other words, the “essential liberty” to which Franklin referred was thus not what we would think of today as civil liberties but, rather, the right of self-governance of a legislature in the interests of collective security. What's more the “purchase [of] a little temporary safety” of which Franklin complains was not the ceding of power to a government Leviathan in exchange for some promise of protection from external threat; for in Franklin’s letter, the word “purchase” does not appear to have been a metaphor. The governor was accusing the Assembly of stalling on appropriating money for frontier defense by insisting on including the Penn lands in its taxes--and thus triggering his intervention. And the Penn family later offered cash to fund defense of the frontier--as long as the Assembly would acknowledge that it lacked the power to tax the family’s lands. Franklin was thus complaining of the choice facing the legislature between being able to make funds available for frontier defense and maintaining its right of self-governance--and he was criticizing the governor for suggesting it should be willing to give up the latter to ensure the former.

In short, Franklin was not describing some tension between government power and individual liberty. He was describing, rather, effective self-government in the service of security as the very liberty it would be contemptible to trade. Notwithstanding the way the quotation has come down to us, Franklin saw the liberty and security interests of Pennsylvanians as aligned.

Saturday, July 25, 2026

Thursday, July 23, 2026

The Brennan Center for Justice at NYU Law is an independent, nonpartisan law and policy organization that works to reform, revitalize, and defend our country’s systems of democracy and justice.

We have solutions for democracy’s most pressing problems.

Voting & Elections

Americans still face many barriers to voting. Meanwhile, elections require secure systems and independent administration of the casting and counting of ballots. The Brennan Center fights for voting rights, and we advocate for plans that will safeguard the election system — and the officials who work in it — from attacks and political interference.

Money in Politics

Americans are fed up with the role of big money in political campaigns. The Brennan Center’s solution: small donor public financing to put power back in the hands of individuals.

Shortly before the 1956 presidential election, President Dwight D. Eisenhower used a recess appointment to place Brennan on the Supreme Court. Brennan won Senate confirmation the following year.

Due to his ability to shape a wide variety of opinions and bargain for votes in many cases, he was considered to be among the Court's most influential members. Associate Justice Antonin Scalia, who served alongside Brennan between 1986 and 1990, called Brennan "probably the most influential Justice of the [20th] century."[4][5]

Brennan strongly believed in the Bill of Rights, arguing early on in his career that it should be applied to the states in addition to the federal government.[41] He often took positions in favor of individual rights against the state, favoring criminal defendants, minorities, the poor, and other underrepresented groups.

Furthermore, he generally shied away from the absolutist liberal positions of Justices Hugo Black and William O. Douglas, being very amenable to compromise in order to win a majority of Justices.[42]

he believed that the deliberate taking of human life by the state, as a punishment, was inherently cruel and unusual.

In Glass, the Court chose not to hear a case that challenged the constitutionality of the use of the electric chair as a form of execution. Brennan wrote:[47]

Th[e] evidence suggests that death by electrical current is extremely violent and inflicts pain and indignities far beyond the "mere extinguishment of life". Witnesses routinely report that, when the switch is thrown, the condemned prisoner "cringes," "leaps," and "fights the straps with amazing strength." "The hands turn red, then white, and the cords of the neck stand out like steel bands." The prisoner's limbs, fingers, toes, and face are severely contorted. The force of the electrical current is so powerful that the prisoner's eyeballs sometimes pop out and "rest on [his] cheeks." The prisoner often defecates, urinates, and vomits blood and drool.

Brennan concluded by stating that electrocution is "nothing less than the contemporary technological equivalent of burning people at the stake."

Brennan wrote the majority opinion in Roth v. United States which set new standards for obscenity laws, allowing some prosecutions, but drastically loosening the laws overall.[48] He later reversed his position in dissent in Miller v. California arguing that obscenity laws were unconstitutional.

He is regarded as one of the most liberal justices in the history of the court.[54]

Friday, July 17, 2026

According to a 2022 review study in the Journal of Economic Literature, there is overwhelming causal evidence that shows that the CAA improved air quality.[78]

According to a 2011 study by EPA, when compared to the baseline of the 1970 and 1977 regulatory programs, by 2020 the updates initiated by the 1990 Clean Air Act Amendments would be costing the United States about $60 billion per year, while benefiting the United States (in monetized health and lives saved) about $2 trillion per year.[79] In 2020, a study prepared for the Natural Resources Defense Council estimated annual benefits at 370,000 avoided premature deaths, 189,000 fewer hospital admissions, and net economic benefits of up to $3.8 trillion (32 times the cost of the regulations).[80] Other studies have reached similar conclusions.[81]

Mobile sources including automobiles, trains, and boat engines have become 99% cleaner for pollutants like hydrocarbons, carbon monoxide, nitrogen oxides, and particle emissions since the 1970s. The allowable emissions of volatile organic chemicals, carbon monoxide, nitrogen oxides, and lead from individual cars have also been reduced by more than 90%, resulting in decreased national emissions of these pollutants despite a more than 400% increase in total miles driven yearly.

A 2018 study found that the Clean Air Act contributed to the 60% decline in pollution emissions by the manufacturing industry between 1990 and 2008.

Signed into law by President Lyndon B. Johnson on December 17, 1963

Saturday, July 11, 2026

Buried inside the KIDS Act are provisions that will push online services to verify all users’ ages, require government-directed moderation policies for online speech, and even create new rules about private and encrypted communications. While supporters continue to claim this bill protects minors online, its requirements come at the expense of privacy, free expression, and the ability of people of all ages to use the internet without revealing sensitive data.

Friday, June 26, 2026

Cutting costs by cutting benefits is difficult, but the program can also achieve substantial economies of scale in the prices it pays for health care and administrative expenses—and, as a result, private insurers' costs have grown almost 60% more than Medicare's since 1970.[citation needed][106][original research?][107] Medicare's cost growth is now the same as GDP growth and expected to stay well below private insurance's for the next decade.

Saturday, May 23, 2026

In March 1919, Benito Mussolini founded the first Italian Fasces of Combat (FIC) at the beginning of the so-called Red Biennium, a two-year long social conflict between the Italian Socialist Party (PSI) and the liberal and conservative ruling class. Mussolini's Fascists suffered a defeat in the election of November 1919, winning no seats in the Italian parliament.

During the "two red years", there were numerous strikes, protests against rises in the cost of living, occupations of factories and land by industrial workers or agricultural laborers, and other types of clashes between socialists on one side and landowners and business owners on the other side.

Local elites felt themselves vulnerable and established an alliance with the small Fascist movement, which contained many veterans of World War I and had a reputation for violence, in the hope of using Fascist paramilitary squads to destroy socialist organizations.

Since 1919, Fascist militias, known as squadristi or "Blackshirts" due to their uniforms, had frequently attacked socialist politicians and militants. In August 1920, the Blackshirt militia was used to break the general strike which originated at the Alfa Romeo factory in Milan

Local elections in 1920 were won by the socialists in many towns, cities and villages across Italy, and in response Fascist militias attacked union organizers and municipal administrators, making it difficult for local governments to function.

A local deputy from the town of Budrio sent a telegram to the prime minister in October 1921 to report that the Fascists had effectively taken over, that "unions and socialist clubs [were] ordered to dissolve themselves within 48 hours or face physical destruction" and that the "life of the town is paralysed, authorities impotent".

within the National Blocs of Giovanni Giolitti, an anti-socialist coalition of liberals, conservatives and fascists. The Fascists won 35 seats and Mussolini was elected in the Parliament for the first time.

After a few weeks, Mussolini withdrew his support for Giolitti and his Italian Liberal Party (Partito Liberale Italiano, PLI) and attempted to work out a temporary truce with the Socialists by signing the so-called "Pact of Pacification" in the summer of 1921.

the Pact with the Socialists was nullified during the Third Fascist Congress on 7–10 November 1921, during which Mussolini promoted a nationalist program and renamed his movement National Fascist Party (PNF), which enrolled 320,000 members by late 1921.

In August 1922, an anti-fascist general strike was organized throughout the country by the socialists. Mussolini declared that the Fascists would suppress the strike themselves if the government did not immediately intervene to stop it, which enabled him to position the Fascist Party as a defender of law and order.[13] On 2 August, in Ancona, Fascist squads moved in from the countryside and razed all buildings occupied by socialists.[13] This was then repeated in Genoa and other cities.[13]

Then, with the support of local business owners, they took over local government and expelled the elected socialist administration from the town hall

The Italian national government in Rome did nothing to react to these developments, and its inaction prompted Mussolini to plan a march on Rome.[13] From their new power base in Milan, the Fascists gathered the financial support of large companies who were determined to fight against "strikes, bolshevism and nationalization".

Also a few days before the march, Mussolini consulted with the U.S. Ambassador Richard Washburn Child about whether the U.S. government would object to Fascist participation in a future Italian government and Child gave him American support.

Squadrismo (Italian: [skwaˈdrizmo]) was the movement of squadre d'azione (English: action squads), the fascist militias that were organised outside the authority of the Italian state and led by local leaders called ras (a noble Ethiopian title). The militia originally consisted of farmers and middle-class people, who created their own defence from revolutionary socialists. Squadrismo became an important asset for the rise of the National Fascist Party, led by Benito Mussolini, and systematically used violence to eliminate any political parties that were opposed to Italian fascism.

The violence was not only an instrument in politics but also a vital component of squadrismo identity, which made it difficult for the movement to be tamed. That was shown in the various attempts by Mussolini to control squadrismo violence with the Pact of Pacification and later the Consolidated Public Safety Act. Squadrismo, which ultimately became the Blackshirts, served as a source of inspiration for Adolf Hitler's Sturmabteilung.

Tuesday, May 19, 2026

For some reason in the US we constantly assume government is useless and corporations create all innovation. Yet the evidence repeatedly demonstrates that the two are often deeply intertwined...

The emergence of firms like SpaceX and Blue Origin has made space a leading example of how private enterprise drives innovation, marking what many see as a sharp break between Old Space and New Space. Yet little systematic evidence documents when the transition to this new phase of space innovation occurred and which firms drove it. We use patent data to provide this measurement and find that the largest surge in space innovation occurred in the 1990s, coinciding with demand-side market creation, and preceding the entry of high-profile startups after 2005.

Throughout this period and since, incumbent aerospace firms account for most of the space-related patenting, with entrants contributing a growing but minority share. The same geographic regions that dominated space innovation during the post-Apollo era remain dominant today. These patterns are consistent with directed technical change: incumbents direct R&D toward policy-created markets accessible from existing capabilities, while entrants bring science-based insights into domains requiring new paradigms.

Our findings suggest that New Space is more closely connected to Old Space than prevailing narratives imply, and that government's most consequential role in space innovation may lie in constructing appropriable markets.

Tuesday, April 21, 2026

In the United States, an executive order is a directive by the president of the United States that manages operations of the federal government.[1] Executive orders are only binding on the federal government's executive branch. The legal or constitutional basis for executive orders has multiple sources. Article Two of the United States Constitution gives presidents broad executive and enforcement authority to use their discretion to determine how to enforce the law or to otherwise manage the resources and staff of the federal government's executive branch. The delegation of discretionary power to make such orders is required to be supported by either an expressed or implied congressional law, or the constitution itself.

And we need to show New Yorkers that we’re able to not only address a generational fiscal crisis, but also able to advance a vision that makes it easier to live in the city, because, frankly, for a working class New Yorker, they measure their life not in the city’s deficit, but in the cost that they have to pay, and it doesn’t mean much to a tenant who’s struggling to pay their rent if the city is facing a $5.4 billion deficit. What means something is if you’re willing to hold a bad landlord accountable, and we’ve held enough bad landlords accountable to win more than $30 million in settlements, have more than 6,000 apartments be repaired, host more than 1,000 New Yorkers at these rental rip-off hearings. And what we’ve found oftentimes is the conditions that people have had to live with have been a part of their life, not just for weeks or months, but for years, sometimes decades, and within that kind of relationship to such impunity, comes a diminished faith in government.

I would say that she’s a good fit for our administration because she’s delivering on our administration’s commitment to make this a safer city and that I do not need to agree with every one of my commissioners or city workers at large about every single issue within their purview. I do, however, need to agree with the decisions that they make and the outcomes that those decisions create.

I would say it is very much the same in terms of being a democratic socialist and believing in government’s ability to transform working people’s lives. I did not think I would think this much about the weather and the relentless nature of it, but the job of a leader is to respond to the crisis, not to ask why the crisis picked them as the leader to respond to.

The president and I disagree on many things in public and in private. We do, however, agree on one thing, which is a love for New York City, and that love, it is one that allows for our relationship to be a productive one, and allows for the city to know that it will not simply be affected by threats, but rather one that, as the president said, the better this city does, the happier he is.

It’s productive, even though he’s “a fascist?” Yes.

I just want to clarify one thing that you said in the beginning, because you mentioned you will need as long as you’re mayor to make good on your three biggest promises. Is that two terms or one term? [Laughing]: Inshallah, it’s two terms.

Monday, April 13, 2026

From taxes to the environment to public broadcasting like PBS and NPR, the Senate has recently passed record levels of legislation and confirmed record numbers of nominations with senators representing less than half the people.

Using historical data, GovTrack found 56 examples of Senate votes on legislation that passed with senators representing a “population minority.” 26 of those 56 examples, nearly half, have occurred since President Donald Trump’s current term began.

Several of the second Trump administration’s most prominent members were confirmed by Senate “population minority” votes – including RFK Jr. (Secretary of Health and Human Services), Pete Hegseth, Pam Bondi, Kash Patel, and Tulsi Gabbard.

The oldest example GovTrack found of a “population minority” Senate vote is actually  famous: Clarence Thomas’s 1991 Supreme Court nomination by President George H. W. Bush. The Senate approved Thomas with 52% support, but 49% of the population.

He still serves on the Court today.

GovTrack found three other “population minority” Senate confirmations for Supreme Court justices, totalling four: Thomas plus Trump’s three first-term nominees. All four still serve on the Court.

Currently, Republicans hold a Senate majority: 53 to 47. However, based on the Census Bureau’s current estimates, it’s actually the other way around by population: Democratic senators represent a 53% majority of the states’ population, versus Republicans with 47%.

How is this possible? Because while the U.S. House is apportioned based on population, with larger states receiving more representatives, the U.S. Senate guarantees each state two senators regardless of size.

This was baked into the American system from the beginning, creating what political scientists call a “counter-majoritarian” institution.

In 2025, according to Census Bureau estimates, the most populous state (California) had about 67x the population as the least populous: Wyoming. Today, a Senate voting majority could be cobbled together from senators representing just 17% of the population.

But that’s actually been the same for a while. Going back to 1900, a Senate voting majority could be cobbled together with senators representing 16% to 20% of the population.

Instead, small states may be more politically aligned than they used to be and are voting together more often as a bloc.

Senators have recently taken advantage of old rules, and also changed some rules, to use lower vote thresholds. This means votes are more often succeeding with less support.

Both parties contributed to this.

In 2013, under President Obama, Senate Democrats changed the threshold for most nominations from three-fifths to a simple majority. They left it at three-fifths for the Supreme Court, though.

Then in 2017 during Trump’s first term, Senate Republicans changed the threshold for the Supreme Court, too, to confirm Justice Gorsuch by a simple majority. (This rule applied to all subsequent justices, too.)

As for legislation, many of the recent “population minority” Senate votes used the Congressional Review Act of 1996, which lowered the usual Senate vote threshold from three-fifths to a simple majority for certain deregulation bills. The One Big Beautiful Act and the Rescissions Act were both voted on under other rules, which lower the vote threshold for certain spending-related bills.

So the three-fifths threshold is now gone for nominations and some types of legislation.

It might not stop there. Trump has called for the Senate to end the three-fifths threshold for all legislation, in order to enact certain Republican policies – particularly regarding election rules. If that happens, “population minority” Senate votes could become even more frequent.

Why does this usually benefit Republicans?

This discrepancy usually benefits the GOP, since they tend to represent smaller states.

This small-state Republican benefit also holds true at the presidential level. Indeed, two presidents in living memory won election despite losing the national popular vote, both Republicans: George W. Bush in 2000 and Donald Trump in 2016.

The Congressional Review Act, which makes it easier for Congress to deregulate – and the rules for rescissions bills, which makes it easier to cut funding – also are more aligned with Republican goals than Democratic goals.

But for better or for worse, it’s clear that the Senate is diverging from popular opinion far more than ever before, at least in recent memory. Even if one believes the Senate is, in fact, “right” while popular opinion is “wrong.”

Thursday, January 29, 2026

Thursday, January 15, 2026

In 2019, differences in diagnostic coding caused Medicare to pay MA plans $9 billion more than it would have spent if the same beneficiaries had been enrolled in FFS Medicare.

Excess payments to MA plans may benefit enrollees in the MA program (when used to increase the value of extra benefits offered rather than increase profits) but cost taxpayers more than if these enrollees were covered in FFS Medicare. Further, excess payments to MA plans increase fiscal pressure on the Hospital Insurance (Part A) Trust Fund as well as on the taxpayers, beneficiaries, and state Medicaid programs who pay premiums to finance the Part B program.