PRELIMINARY DISCUSSION DRAFT September 1112, 2018
RESPONDING to the GLOBAL FINANCIAL CRISIS
What We Did and Why We Did It
The Fiscal Response to the Great Recession:
Steps Taken, Paths Rejected, and
Lessons for Next Time
Jason Furman
1
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Note: The views expressed in this draft are strictly those of the author(s).
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
2
Introduction
The fiscal response to the Great Recession started when President Bush signed the
Economic Stimulus Act of 2008 on February 13, 2008 and finished when the payroll tax
cut enacted under President Obama expired at the end of 2012. Congress enacted at least
18 different laws that explicitly included discretionary fiscal stimulus totaling over $1.5
trillion during those five years, with about half of that coming from the American
Recovery and Reinvestment Act signed into law by Obama on February 17
th
2009.
2
The
stimulus was 54 percent tax cuts, 19 percent individual transfers, 11 percent state and
local fiscal relief and 16 percent public investmentwith nearly all of that public
investment coming in the Recovery Act. The discretionary fiscal stimulus averaged 2.0
percent of GDP over those five years, boosting the level of GDP from what it otherwise
would have been by a maximum of 3.4 percent in the third quarter of 2010 with a smaller
effect thereafter. In addition, automatic stabilizers brought the total magnitude of the
countercyclical fiscal response to an average of 3.4 percent of GDP, the largest fiscal
response to a recession in U.S. history.
The first section of this paper describes the origins of these stimulus measures and
the second section summarizes their magnitude and composition. The third section
addresses some of the evidence evaluating the efficacy of the stimulus. The fourth section
describes some of the approaches that were considered by the Obama transition team
and Administration but not implemented. Finally, the last section discusses some lessons
for the future.
This paper is focused on the macroeconomic analysis of the fiscal response to the
financial crisis, and the extent to which it prevented a deeper recession, and helped
speed the economic recovery. It only briefly discusses other goals, like protecting the
most vulnerable as well as improving infrastructure, healthcare, broadband and energy
efficiency. These are all very important topics but largely outside the scope of this work.
3
I. The Three Phases of Stimulus
The fiscal stimulus went through three phases: (i) an initial set of responses in 2008 that
aimed to be “timely, targeted, and temporary”, (ii) a large response in the Recovery Act
in early 2009 that aimed to be “substantial, speedy, and sustained”, and (iii) a number of
laws passed in subsequent years that in retrospect could be described as “opportunistic,
extended, and under the radar.”
The 2008 Stimulus: “Timely, Targeted, and Temporary
In 2007 the U.S. economy was deteriorating rapidly. Most notable was a rise in the
unemployment rate from 4.4 percent in March 2007 to 5.0 percent in December 2007a
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PRELIMINARY DISCUSSION DRAFT September 1112, 2018
3
magnitude of increase that, based on historical precedent, signaled the coming of a
recession that would cost many more jobs. Between September and December of 2007
the Federal Reserve reduced its target federal funds rate from 5.25 percent to 4.25
percent, but because of lags in the effectiveness of monetary policy this was not expected
to substantially bolster the economy until late 2008. In addition, the Fed took a number
of other actions, like expanding the discount window and establishing the Term Auction
Facility (TAF), that had unknown efficacy and timing. As a result, there was significant
concern that the economy would get worse before monetary stimulus set in.
On December 5, 2007, Martin Feldstein (2007) became perhaps the first
prominent economist to raise the possibility of fiscal stimulus. “The American economy
is now very weak and could get substantially weaker,” he wrote. Current economic
conditions call for lowering interest rates and for enacting a tax cut now that is
conditioned on economic developments in 2008.” Lawrence Summers (2007) went on
to explicitly call for fiscal stimulus on December 19, 2007, saying it should aim to be
timely, targeted, and temporary.
By this time President Bush had already asked Treasury Secretary Henry Paulson
and his White House economics team to evaluate the need for a fiscal stimulus program.
In January, Paulson and the White House team reported back to Bush that a stimulus
plan was needed urgently and could be devised in a manner that would receive broad
bipartisan support and be quickly enacted. Bush wanted a package with the guiding
motivation being to put money into consumershands quickly to provide a fast boost to
the economy. On January 18, 2008, Paulson unveiled the broad parameters of a stimulus
package, saying, “Our economy is growing slower than expected, and that means we need
to act quickly to put together a package that is temporary, simple enough to get enacted
quickly, effective at boosting growth and job creation this year, and large enough to make
a difference.” (Paulson 2008). This was enacted with strong cooperation by
Congressional Democrats in a matter of weeks and largely took the form of one-time
refundable individual tax rebates. The first electronic payments were made in April 2008
and the first checks mailed out in May (Internal Revenue Service 2008).
While the economic threat at the time appeared to be nothing worse than a typical
recession, there were two prime rationales for the stimulus: (i) fiscal action could provide
a faster boost to the economy than monetary policy, filling in some of the gap before the
interest rate cuts started kicking in; and (ii) given that the effectiveness of monetary
stimulus was uncertain, it was best to diversify the response by using multiple
instruments (Elmendorf and Furman 2008).
The Recovery Act: “Substantial, Speedy, and Sustained”
Despite the fiscal stimulus and further interest rate cuts, the economic and financial
crisis intensified, particularly in the autumn after Lehman Brothers failed, with the
unemployment rate rising from 5.0 percent to 7.3 percent over the course of 2008. By
early January 2009 the numbers showed that the economy had lost an average of
510,000 jobs a month for the previous three months, a loss that was subsequently
revised up to 647,000 jobs a month.
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
4
As the economy weakened, the target size of stimulus plans increased. Running for
president, Obama originally proposed a fiscal stimulus in January 2008, proposed another
one in April, and expanded the size of the proposed stimulus over the course of the year,
including in June, August and October. Fiscal stimulus was also motivated by the concern
that the Fed, which had effectively cut its target rate to zero in December, 2008, was
running out of conventional monetary policy options and that all tools that relied on the
financial sector for transmission to the real economy were of uncertain and potentially
limited impact due to the crisis and associated breakdown of the financial system.
Building on these plans the transition team, which included Jack Lew, Dan Tarullo,
Jason Furman, and Austan Goolsbee, met with President-elect Obama on November 12
th
and presented him with the following rationale for a recommended $300 billion stimulus:
Broad expectation that economy will be anemic in 2009 and
beyond: job losses are accelerating; consumption deteriorating; Blue
Chip/WSJ Survey projecting negative GDP growth in Q1 2009 while other
analysts project negative growth for all of 2009; financially led recessions
tend to last longerGoldman Sachs projects unemployment to peak at
over 8% and remain high for most of 2009 and 2010.
Running out of other options: not clear where economic jumpstart
will come from with tight credit markets, tapped out consumers, trading
partners following behind economic cycle and heading into recession and
a stronger dollar.
Appropriate tool in current environment: fiscal stimulus only real
option since monetary tools are exhausted and there is room for monetary
policy response if fiscal policy overshootsrecession risk much greater
than fears of inflation and crowding out (though inflation concern will
increase once a recovery is underway).
The question of whether or not the stimulus should be paid for was also debated
during this meeting. Economically, there was no need to pay for a stimulus, and
politically, the desire to move quickly and without complication to passing relief was
compelling. On the other side of the argument, some were worried about the impact that
rising debt would have on financial markets. Ultimately Obama decided to advance a
stimulus plan that could pass on a standalone basis but to make it clear it was part of a
longer-run budget that, taken as a whole, would make the debt sustainable.
At the time, even a $300 billion unpaid-for stimulus would have been considered
large, pushing the bounds of what was possible in Congress. Any stimulus was expected
to need the votes of the Blue Dog coalition, about 50 House Democrats concerned about
the deficit and debt who had explicitly said they would not vote for another unpaid
stimulus. House Democratic leaders had been considering a $150 billion stimulus, with
some talking about packages of up to $300 billion. Leading progressive economists were
advocating similar top-line numbers: a November 19
th
letter organized by the Center for
Economic Policy Research and signed by hundreds of economists including George
Akerlof, Dean Baker, James Galbraith, Lawrence Mishel, and Joseph Stiglitz called for a
$300 billion to $400 billion stimulus that would be “spent quickly(Akerlof et al. 2008).
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
5
In an effort to create political space to pass a larger number through Congress the
transition team reached out to several signatories to encourage them to raise their public
requests, telling one economist speaking to the House Democratic caucus in the late fall
to call for $1 trillion in stimulus instead of the roughly $500 billion he had been planning
to recommend.
The economic news and forecasts continued to deteriorate. Macroeconomic
Advisers, a leading economic research and forecasting firm, made the largest negative
revision to a forecast in its history on December 8
th
. These developments plus the
filling out of the Obama economic teamChristina Romer and Summers were both
advocates of a much larger stimulusled to a further upward revision of the number,
with a memo to Obama stating:
We believe that $600 billion in stimulus over two years would create 2.5
million jobs relative to what would happen in the absence of stimulus.
However, this falls well short of filling the job shortfall and would leave
the unemployment rate at 8 percent two years from now. This has
convinced the economic team that a considerably larger package is
justified… The memo outlines four alternative plan [sic] ranging from
$550 billion to $890 billion with the difference between them being the
state fiscal relief and tax proposals.
The upper end of this range was estimated to be sufficient to close half of the
projected 7 percent of GDP output gap. The memo’s rationale for not attempting to close
the full output gap included: fiscal stimulus was not the only economic tool, concerns
about spooking markets and raising interest rates with too large of a fiscal package, and
the view that it would always be possible to add to stimulus but might not be possible to
subtract from it.
At a meeting with the transition team on December 16
th
Obama decided to pursue the
largest stimulus that his team thought was politically feasible, his view being that political
constraints would be binding well before any economic concerns about market confidence
would be relevant. This was agreed to be a stimulus in the $800 billion range and Obama
left it to his political and economic team to develop a strategy to hit this target.
The team decided that coming out with an explicit budget number this large would
risk a backlash in Congress, slowing passage. In addition, it decided that proposing a full,
explicit plan could slow passage given the limited resources of the transition team and the
desire of Congress to put its stamp on the measure. Instead, publicly Obama continued to
push for the general concept of fiscal stimulus, using a job target instead of a cost target,
which was originally 2.5 million jobs on November 22 but revised up to “at least” 3 million
by December 20. Based on the economic team’s analysis, this job target corresponded to at
least $850 billion in stimulus. In addition, on January 8, 2009 Obama (2009a) listed a
specific set of goals for these investments and framed the issue by saying:
It is not just another public works program. It’s a plan that recognizes
both the paradox and the promise of this momentthe fact that there are
millions of Americans trying to find work, even as, all around the country,
there is so much work to be done. That's why we’ll invest in priorities like
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
6
energy and education; health care and a new infrastructure that are
necessary to keep us strong and competitive in the 21st century.
Behind the scenes work was ongoing to have a bill well underway before the
inaugurationwith specific, detailed meetings with members and staff of Congress
beginning immediately after the December 16
th
meeting. Originally the transition team
privately asked Congress for a smaller number because it was concerned about a negative
reaction to a larger number, especially from the Blue Dogs, and expected that the total
would increase in the legislative process. This expectation was initially justified as the
House passed an $820 billion ten-year stimulus on January 28, 2009. The cost of the
Senate bill passed on February 10, 2009 had a slightly higher headline number, $838
billion, although the effective stimulus was smaller than in the House bill because the
Senate added an extension of a patch to the alternative minimum tax (AMT), a measure
that didn’t increase the effective magnitude of stimulus because it simply continued a
long-standing practice that would have been included in other legislation anyway. But
instead of the larger total package the Administration hoped and expected to get, the
conference agreement was smaller than either bill, coming in at an originally estimated
headline cost of $787 billion after three Senate Republicans insisted the cost come down.
The effective stimulus was even smaller because of the inclusion of the AMT patch.
Obama signed the Recovery Act into law on February 17.
The guiding philosophy for the Recovery Act was not “timely, targeted, and temporary”
but instead “substantial, speedy, and sustained.” The transition team evaluated a wide
range of potential provisions against several criteria: (i) how quickly would they spend the
stimulus money; (ii) what was their expected multiplier for GDP; (iii) how likely were they
to be made permanent (which was generally viewed as a minus because of concern about
the long-run deficit); and (iv) how “transformative” would they be for various public
purposes beyond immediately increasing GDP. The goal was to come up with a portfolio of
provisions that would span short-run stimulus to long-run transformation.
Originally the architects of the stimulus planned to have a limited set of areas for
“transformative” provisions centered on healthcare, energy, education and infrastructure.
All of these areas were chosen to build on campaign proposals that were more long-run
and structural in nature but could be plausibly (or in some cases, less plausibly) be
separated out from their broader context with a major down payment included in the
Recovery Act. In some cases, these more transformative provisions were motivated less
by their macroeconomic impact, instead heeding incoming Chief of Staff Rahm
Emanuel’s advice that you “never want a serious crisis to go to waste.” For example, the
campaign’s health information technology spending program and energy investment
program were put into the Recovery Actwhile the fuller plans for health insurance
coverage and cap-and-trade were left to be enacted later. Based on additional input from
the transition team and Congress, more items were added to the list including subsidies
for broadband in underserved areas and funding for high-speed rail.
When Obama (2009b) signed the Recovery Act into law he said:
Today does not mark the end of our economic troubles. Nor does it
constitute all of what we must do to turn our economy around. But it does
mark the beginning of the endthe beginning of what we need to do to
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
7
create jobs for Americans scrambling in the wake of layoffs; to provide
relief for families worried they won’t be able to pay next month’s bills; and
to set our economy on a firmer foundation, paving the way to long-term
growth and prosperity.
The New York Times (Stolberg 2009) headline noted that “Signing Stimulus, Obama
Doesn’t Rule Out More”which turned out to be the case in the next phase.
Post-Recovery Act: Opportunistic, Extended and Under the Radar
The unemployment rate continued to rise, hitting 9.4 percent in May 2009 (before the
bulk of the Recovery Act had even kicked in), which was well above what forecasters had
predicted as recently as early 2009. The economy was even worse, at least in part,
because the many external and internal forecasting models the transition team had used
insufficiently accounted for the role of the financial sector in exacerbating and, most
importantly, perpetuating the downturn. The Administration proposed more stimulus
packages, including in December 2009, September 2010, and the $447 billion American
Jobs Act in September 2011. All of these proposed a combination of public investment,
relief for individuals and states and public investment along the same lines as the
Recovery Act. Congress, however, had lost its appetite for major additional legislation
that was described as economic stimulus and did not enact another bill along these lines
after February 2009although the House did pass an infrastructure-oriented stimulus
bill in December 2009 but it was not taken up in the Senate.
Nevertheless, many of the different elements proposed by the Administration or
desired by Congress were still passed, attached to other legislation like defense
appropriations bills or FAA reauthorizations. The largest opportunity came when the
2001 and 2003 tax cuts were expiring at the end of 2010. Obama had long called for the
expiration of the provisions in the tax cuts that solely benefited high-income households.
Republicans were in a stronger position after large gains in the mid-term elections. It
was possible that Obama could still have pushed through the expiration of the tax cuts,
but in that case he would have had no leverage to get any additional priorities in the bill.
Instead, he chose to ask Vice President Joe Biden to negotiate a deal with as much fiscal
stimulus as possiblespecifically, trading a two-year extension of the high-income tax
provisions for a continuation of tax credits for low-income families with children and
replacing the Making Work Pay ($58 billion annually) tax credit with a larger but less
well-targeted payroll tax cut ($112 billion annually), and establishing 100 percent
expensing for business investment.
This phase of stimulus was necessarily opportunistic. The Administration generally
wanted as much fiscal support as possible, including increased public investment and tax
cuts. Congress generally wanted less stimulus, but was more supportive of additional tax
cuts than funding for infrastructure or other investments and more supportive of
extending existing provisions like expiring unemployment insurance benefits than of
devising new measures.
The net effect was a substantial additional stimulus: $657 billion above and beyond
the Recovery Act by the end of 2012, which resulted in an increase in total fiscal stimulus
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
8
as a share of GDP in 2010, maintained almost that level in 2011, and prevented a sharp
falloff in 2012. But this was still well below the size Obama requested and did not have
the composition the Administration desired (public investment was almost entirely
absent). The piecemeal nature of these additional provisions spread over at least 13
different pieces of legislation, most of which were not explicitly marketed as stimulus,
also sacrificed the potential benefit from clearly setting expectations and increasing
confidence that a more visible stimulus package might have generated.
II. The Size and Composition of the Fiscal Stimulus
Overall the cumulative discretionary fiscal stimulus totaled $1.537 trillion through the
end of calendar year 2012.
4
Nearly half of the fiscal stimulus came in the Recovery Act,
which provided a net new $712 billion for the economy through the end of CY 2012.
5
The
remainder came in at least 17 other laws that included the original 2008 rebate checks,
the cash for clunkers program to encourage auto purchases, a tax credit for hiring the
long-term unemployed, a tax credit for homebuyers, the payroll tax cut, and several
additional provisions.
Table 1
As shown in Figure 1, the overall discretionary fiscal stimulus averaged 2.0 percent
of GDP over the five years from 2008 through 2012, peaking at 2.7 percent of GDP in
2010. This was enhanced by automatic stabilizers which expanded unemployment
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PRELIMINARY DISCUSSION DRAFT September 1112, 2018
9
insurance, means-tested programs and reduced taxesaveraging another 1.4 percent of
GDP in stimulus and bringing the total stimulus to as much as 4.6 percent of GDP in
2010 and an average of 3.4 percent over the entire period.
Figure 1
The largest category of stimulus was tax cuts for individuals, with total tax cuts
making up 54 percent of the fiscal stimulus as shown in Figure 2although some of the
items formally classified as tax reductions are analogous in impact to increased
expenditures. Another 30 percent of the stimulus went for relief, either directly to
individuals or as fiscal relief for states. The remaining 16 percent of the stimulus was
devoted to outlays on public investment. Some of the larger or more notable items in
each of these categories along with their cost from 2008-12 are listed in the Appendix.
Figure 2
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
10
III. Evidence on the Impact of the Fiscal Stimulus
The principal basis for evaluating the fiscal stimulus should match its primary purpose:
raising GDP above what it otherwise would have been, thus preventing a deeper
recession and speeding economic growth. In addition, it would be desirable to analyze
the relative effectiveness of elements of the stimulus, but evaluating individual
provisions proved nearly impossible and those that have are not necessarily comparable.
Nevertheless, some general observations are possible.
Ex Ante Projections of the Macroeconomic Impact
The fiscal stimulus was part of a broader response to the crisis that included monetary
policy and policies affecting the financial, housing, and auto sectors. Evaluating the
causal impact of the entire response, let alone any individual element, is not
straightforward and may even be impossible because we cannot observe the baseline that
reflects what would have happened absent the policy response. For example, observing
that high unemployment rates follow a stimulus may establish nothing more than that
the stimulus was warranted in the first place. Conversely, observing the economy
recovering may just be the natural self-equilibration of the economy and not the result of
macroeconomic policy.
Time series econometric methods have attempted to figure out the impact of fiscal
expansions by separating out “endogenous” fiscal policy that is a response to where the
economy is from “exogenous” fiscal policy that is done for reasons unrelated to the state
of the economy. This method is impossible for the Recovery Act or other fiscal responses
because these are basically like a single data point and the fiscal response was clearly an
endogenous response to the fact that the economy was widely expected to weaken
substantially in the future.
As a result, most of the estimates of the macroeconomic impact of the Recovery Act
and other fiscal measures have been estimated ex ante. Specifically, they draw on
research that was done before the Great Recession to predict the impact that a given
fiscal policy would be expected to have on the economy. Generally, this is done by
assigning a set of multipliers (spread out over time) to different types of fiscal measures.
The multipliers used by the Council of Economic Advisers (CEA) ranged from 1.5 for
public investment outlays and for income and support payments, which were expected to
generate more economic activity as the initial round of stimulus was spent and re-spent
in the economy, to 0.1 for business tax incentives, reflecting the expectation that they
would mostly be saved by businesses in the form of larger retained earnings. CEA’s
multipliers are shown in Table 2, they generally fall in about the middle of the range for
the Congressional Budget Office’s (CBO) low and high multiplier estimates.
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
11
Table 2
Estimates for the macroeconomic impact of the Recovery Act alone are provided in
Table 3 generally based on these types of multipliers, showing it adding between 0.7
percent and 4.1 percent to the level of GDP in 2010, when almost all forecasts predicted
it would have its peak impact. Blinder and Zandi (2015) used similar methods to
estimate the impact of the broader set of fiscal expansions.
Table 3
These same methods can be used to estimate the macroeconomic impact of the full
set of fiscal stimulus legislation on GDP starting in 2008, which is shown in Figure 3.
6
The total raised the level of output by a maximum of 3.4 percent of GDP in the third
quarter of 2010 with the effect remaining around 3 percent of GDP through the nearly
the end of 2011 and falling off to about 2.2 percent in the beginning of 2012. In terms of
growth rates, this means that Q4/Q4 growth rates were raised substantially in 2008 and
2009 but were roughly unchanged in 2010 and 2011 and reduced in 2012 as the addition
to the level wore off. This is equivalent to adding about 3 million jobs at the maximum
point of the stimulus or a cumulative total of about 10 million job-years over the five-
year period the stimulus was in effect.
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PRELIMINARY DISCUSSION DRAFT September 1112, 2018
12
Figure 3
Ex Post Cross Sectional Effects
In general, it is difficult to evaluate any individual provision of the stimulus on GDP
because numerous provisions were going into effect simultaneously. Nevertheless,
research has exploited different types of variation to estimate the impacts of some of the
individual provisions. These impacts, however, cannot easily be compared to each other
because of different estimation strategies, noise, and because many of them did not
estimate national multipliers.
A number of papers have effectively used random cross-state variation in different
components of the fiscal stimulus to estimate the state-level macroeconomic impact of
these particular measures. Chodorow-Reich et al. (2012), for example, study the impact of
higher Medicaid matches on state economies by looking at the portion of Medicaid
matching that was based on pre-recession Medicaid spending and thus was not simply the
result of the recession. They find a state-level multiplier of about 2. Conley and Dupor
(2013) used a similar method for highway spending and found a much smaller multiplier.
Dupor and McCrory (2017), Dupor and Mehkari (2016), and Wilson (2012) examined
broader Recovery Act spending based on formula grants and found multipliers in between
these two. The different estimated multipliers are probably an artifact of different
modelling strategies, however, and thus not comparable. Chodorow-Reich (forthcoming)
provides more harmonized estimates studying these three sets of stimulus and finds
multipliers of 1.53 to 2.29, with imprecise measurement meaning that none of them are
statistically significantly different from each other at a 5 percent level. These estimates
suggest clearly that increased federal transfers to states through a higher Federal Medical
Assistance Percentage for Medicaid and other investments funded through state budgets
were macroeconomically effective.
Feyrer and Sacerdote (2011) use state- and country-level spending on a variety of
types of stimulus grants (again, excluding tax cuts and some individual-level transfer
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
13
payments) and find a smaller multiplier of 0.5 to 1.0, although this reflects
heterogeneous estimates including a multiplier of -0.7 to -3.3 for education and police
spending but much higher multipliers like 2 to 2.3 for low-income support and 1.8 for
infrastructure and other grants. Dube, Kaplan, and Zipperer (2015) also use county-level
stimulus spending, finding slightly larger effects than Feyrer and Sacerdote (2011).
Translating state-level multipliers into national multipliers is not straightforward
because of many factors, most notably the spillovers from one state to another and other
general equilibrium effects (Nakamura and Steinsson 2014 and Farhi and Werning 2016).
Chodorow-Reich (forthcoming), however, argues that in many cases the policy-relevant
multiplier should assume no interest rate response and deficit financing, in which case
he shows that state-level cross-sectional multipliers are a rough lower bound on what the
relevant Keynesian national multiplier would be. He summarizes his analysis as finding
that his own results and other cross-sectional results “implies a no-monetary-policy-
response deficit-financed national multiplier of about 1.7 or above. This magnitude falls
at the very upper end of the range found in a recent review article based mostly on time
series evidence (Ramey 2011). Thus, cross-sectional multiplier studies suggest the
national multiplier can be larger than often assumed.”
A few other provisions of the stimulus have also been studied, although most of
these estimates do not meaningfully change the ex-ante parameters originally assumed
when the stimulus passed.
7
The one case where the evidence suggests a substantially
larger effect than originally assumed is for bonus depreciation. The CEA estimates
assumed a multiplier of 0.1 for business tax provisions, similar to CBO’s low estimates.
Zwick and Mahon (2017), however, studied the actual data and found large effects of
temporarily expanded equipment depreciation on investment, particularly for small
and financially constrained firms. This finding is consistent with some of the thinking
that went into designing these provisions in the first place, which were intended in part
as an interest free loan whose benefit would be related to the cash flow in the initial
years but whose cost was the much lower present value to the government. The original
bonus depreciation, for example, provided $50 billion of tax reductions in the first two
fiscal years as firms shifted depreciation allowances earlier but then most of this
money was recouped in future years, leaving the 10-year cost at only $7 billion. If only
10 percent of the $50 billion was spent as additional investment that would lead to a
multiplier of nearly 1 evaluated against the entire fiscal cost of the measure.
8
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PRELIMINARY DISCUSSION DRAFT September 1112, 2018
14
Overall these results are not fully informative about how to design the composition
of stimulus. But they do suggest that the multipliers used by CEA, CBO and others may
have been too low, especially for some items like business tax incentives and possibly
state fiscal relief, and that the actual aggregate impact of the Recovery Act and other
stimulus programs may have been larger than previously estimated.
Evaluating Other Goals for Fiscal Stimulus: Protecting the Most
Vulnerable
In addition to its overall macroeconomic motivation, the Recovery Act and other fiscal
stimulus measures were designed, in the terminology of their creators, to “protect the
most vulnerable.” This category included both long-term poor who were viewed as being
more vulnerable to a downturn as well as people who temporarily fell on hard times by
losing their jobs. In total $289 billion was spent on direct aid to individuals like the
unemployed and those receiving the Supplemental Nutrition Assistance Program
(SNAP), but much of the $836 billion in tax cuts and $167 billion in state and local fiscal
relief also disproportionately benefited the same households.
The labor market did, indeed, disproportionately inflict harm on more vulnerable
populations. From the fourth quarter of 2007 through the fourth quarter of 2010 the
overall unemployment rate rose 4.7 percentage points but the unemployment rates for
those with less education and for African Americans and Hispanics rose much more
sharply, as shown in Figure 4.
Figure 4
The tax and transfer system, both the automatic measures already in the law and the
additions in the Recovery Act and other legislation, did a remarkable job in protecting
households from these job losses. Overall the poverty rate would have risen by 4.8 percentage
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
15
points from 2007 to 2010 absent these programs, but with them it only rose by at most 0.4
percentage points, and the increase may have been significantly less (Furman 2017).
9
A more comprehensive picture based of how the Great Recession affected incomes
from 2007 to 2010 is shown in Figure 5, which is based on CBO (2018) data for non-
elderly households.
10
The largest reductions to market incomes were for the bottom two
quintiles (due to the disproportionate job losses) and top quintile (due to the large declines
in capital income, although some of this is an artifact of the timing of capital gains). After
taking account of taxes and transfers, the bottom quintile for non-elderly households
experienced substantial income gains even in the face of a massive recession. The second
quintile also enjoyed small gains while taxes and transfers absorbed the bulk of the losses
for the third and fourth quintiles. For the highest quintile households, losses were similar
both before and after taxes and transfers. In other words, from the perspective of the fiscal
system low- and moderate-income households got a bailout, not high-income ones.
11
Figure 5
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PRELIMINARY DISCUSSION DRAFT September 1112, 2018
16
Evaluating Other Goals for Fiscal Stimulus: Public Investment
As shown in Table 4, the Recovery Act included about $300 billion in public investments
that were motivated not just by increasing short-run GDP but also by other goals like
enhancing long-run growth through more infrastructure or increasing energy efficiency.
The prior and subsequent stimulus was almost entirely tax cuts and relief for individuals
and states. This paper does not evaluate these goals.
Table 4
One goal of the Recovery Act was to spend investment funding as quickly as
possible through so-called shovel ready projects. It was well understood that some
measures, like high-speed rail and electronic medical records, would take some time to
deliver their benefits but the highway program was designed to spend out relatively
quickly. In fact, the actual spendout for the highway program was even faster than
initially predictedwith 80 percent of the funding actually spent by 2011, well above the
projection of 55 percent by that year (Figure 6).
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
17
Figure 6
IV. Alternatives That Were Not Taken
In putting together the Recovery Act and subsequent responses a number of different
alternatives were contemplated. Some were rejected by policymakers in the
Administration or failed to pass Congress. The following describes three of those
alternatives, the thinking that went into them, and potential considerations for future
fiscal stimulus.
New Jobs Tax Credit
During the campaign, Obama proposed a $3,000 tax credit for employers for each net new
additional job added in 2009 and 2010 (Obama-Biden campaign 2008). The transition
team further refined the idea and Obama signed off on proposing it as part of the Recovery
Act. Congress rejected the idea because lawmakers were skeptical of the efficacy of a
measure designed to add jobs at a time when firms were rapidly shedding jobs.
Obama proposed a retooled version in January 2010 that would have provided a tax
credit of $5,000 per net new job and a bonus for firms that raised total wages, with both
capped at $500,000 in credits per firm (White House 2010). The credits would have
been paid out quarterly and applied against payroll taxes so that even firms with tax
losses would have been eligible. This proposal evolved into the Hiring Incentives to
Restore Employment (HIRE) Act passed by Congress in March 2010, but it was
ultimately very different because it was a tax credit for hiring the long-term unemployed
rather than an incremental tax credit for adding net new jobs.
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
18
The theory behind the new jobs tax credit was that it would have the same
Keynesian boost as any tax cut while providing additional bang-for-the-buck in terms of
higher employment, effectively raising the number of jobs per unit of GDP. This
theoretical intuition was bolstered by academic evaluations of the 1977-78 New Jobs Tax
Credit, which found that it was effective at promoting hiring (Perloff and Wachter 1979,
Bishop 1981). Later in 2009 CEA and Treasury did extensive modelling and found that a
new jobs tax credit would cost about $20,000 per net new job added. About 90 percent
of the subsidy would go to jobs that would have been created anyway but the other 10
percent would have provided a net increase in new jobs. Even with this unbalanced ratio,
the cost per job created would have been considerably less than CEA’s (2014) implied
employment estimates of around $125,000 per job-year for the Recovery Act as a whole.
State Sales Tax Holiday
The transition team considered a state sales tax holiday as a way to shift consumption
forward by encouraging households to take advantage of temporarily lower prices.
Specifically, the transition team contemplated proposing something like a $250 billion
fund that would be available to states carrying out certain sales tax reductions. States
without sales taxes would have been allowed to use the money for income tax cuts. The
idea was ultimately not proposed to Congress.
The principal argument for the proposal was to take advantage of intertemporal
substitution, effectively setting a very negative real interest rate for consumer purchases
that would make it more attractive to make purchases in the short run before sales taxes
went up again. This would have acted as an additional stimulus on top of the normal
Keynesian response to the additional demand associated with tax cuts. The federal role
would have been simply to approve state plans and disburse money according to a
specified formula. States’ prior experience with sales tax holidays had demonstrated that
such a plan would have been relatively straightforward to administer. Concerns with the
proposal included worries that it could inhibit spending in the run-up to the tax or hurt
future demand by pulling spending forward. In retrospect, given how protracted the
downturn was, it was probably economically wise that this proposal was left on the
cutting room floor. Nonetheless, it has a number of benefits that merit consideration by
policymakers in future short, sharp downturns.
Expiring Debit Cards
A final idea that received substantial consideration during the transition but was
never proposed was to deliver rebates on a debit card. The debit card could have been set
with a use-it-or-lose-it feature so that, for example, anyone who did not spend all of the
money by the end of 2009 would have lost the remaining balance. The goal of the
proposal was to make the refund more salient than just getting a check or having fewer
taxes withheld, while also helping to ensure that people spent the money more quickly,
raising the short-term multiplier relative to traditional tax credits. Extensive work was
done with Treasury staff who believed that it would have been administratively possible
to provide such cards for all Americans at essentially no transaction cost to the federal
government because card issuers would bid for a contract that would earn them
interchange fees and float interest. Ultimately, however, it was considered too
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
19
administratively risky to design and launch a massive consumer-facing program in a
short period of time. Further effort and contingency planning on this idea may be
warranted because of its potential upside relative to conventional tax cuts.
V. Lessons for the Future
The experience with the 2008-12 fiscal stimulus and economic research that has been
conducted in the years since then provides six lessons for future fiscal stimulus.
LESSON 1: DISCRETIONARY FISCAL STIMULUS CAN BE PARTICULARLY
EFFECTIVE, ESPECIALLY AT THE ZERO LOWER BOUND. Prior to 2008
economists were generally skeptical of discretionary fiscal stimulus, concerned about
potentially large lags in recognizing the problem, passing a legislative response,
implementing the legislation, and having it take effect. In general, monetary policy was
considered superior on all of these counts and regarded as the first and potentially only
line of defense in downturns.
The 2008-12 experience suggests that these fears were overblown. Policymakers
proposed a fiscal response in January 2008, essentially just as the recession began
according to subsequent analysis by the National Bureau of Economic Research (NBER)
business cycle dating committee. Initial legislation was passed a month later and as the
situation became more severe at the end of 2008 the Recovery Act was passed within a
month of Obama’s inauguration. Many of the provisions were implemented quickly, with
electronic refunds first sent out in April 2008, two months after the first stimulus was
passed. Similarly, the reductions in withholding included in the Recovery Act were
implemented within months. Moreover, the evidence suggests that fiscal measures act on
the economy more quickly than with monetary policy.
Looking ahead, fiscal policy may become an even more important tool for aggregate
demand management. Research following the Great Recession has helped to build a
“new view” of fiscal policywhich in many ways is actually a rediscovery of the old
Keynesian liquidity trap views (see Furman 2016 for a summary). In particular, the new
view holds that if the equilibrium interest rate has fallen, then monetary policymakers
will more often hit the effective lower bound for interest rateslimiting conventional
monetary policy and increasing the importance of fiscal policy.
Moreover, fiscal policy may be particularly effective when interest rates are at the
lower bound. Traditional concerns about crowding out through higher interest rates may
be superfluous when interest rates are stuck at the effective lower bound: even with
additional demand the desired interest rate will not rise. Fiscal policy could also lead to
“crowding in,” either through an accelerator mechanism that increases growth rates and
thus investment growth or by raising expected inflation and thus lowering real interest
rates (Hall 2009; Christiano, Eichenbaum, and Rebelo 2011; Woodford 2011).
Concerns about fiscal space may be overstated in a highly depressed economy with
interest rates at the effective lower bound because fiscal expansions may raise GDP by
more than they raise debtthus reducing the debt-to-GDP ratio. This result has been
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
20
found in a variety of settings, including the Fed’s main macroeconomic model FRB-US
(Reifschneider and Summers as reported in DeLong, Summers, and Ball 2014), the
Organisation of Economic Co-operation and Development’s (2016) NiGEM and FM
models, the International Monetary Fund’s modelling (Gaspar, Obstfeld and Sahay
2016), simulations by DeLong and Summers (2012) and regression-based estimates of
past fiscal stimulus by Auerbach and Gorodnichenko (2017). On the other hand, there is
still some reason for caution: Romer and Romer (2017) found that countries that go into
financial crises with higher debt have smaller fiscal responses and worse macroeconomic
outcomes. (It is not clear if their result reflects high-debt countries having little economic
space for stimulus or making political mistakes about too little stimulus.)
LESSON 2: THE POLITICAL SYSTEM MAY TIRE OF FISCAL STIMULUS
PREMATURELY, SO TRIGGERS AND OTHER AUTOMATIC MECHANISMS
MAY BE WARRANTEDINCLUDING STRONGER AUTOMATIC
STABILIZERS. The transition team thought that if the initial stimulus was too small or
the economy worsened further it would not be very difficult to persuade Congress to
provide more fiscal stimulus. This view did not seem unreasonable at the time: in the
face of a much milder recession in 2001 Congress passed bills it described as fiscal
stimulus in 2001, 2002, 2003, and again in 2004, nearly three full years after the end of
the recession. In a time of widely appreciated national economic emergency it should
have been even easier to get more stimulus, especially given that lawmakers would
normally have wanted to be seen doing something closer to the 2010 election.
This view proved less wrong than popularly understood when you look at the more
than 13 subsequent bills that included additional stimulus. But this stimulus still fell well
short of the Administration’s subsequent requests and, in general, stimulus was removed
well before it was economically sensible to do socreating a fiscal drag starting in 2011
as the total magnitude of stimulus started to phase down.
The difficulty stems from three challenges. The first is that, paradoxically, the worse-
than-expected macroeconomic outcomes reduced the desire to take more
macroeconomic measures. Even though the bulk of the unexpected deterioration of the
economy happened by early-to-mid 2009, before the bulk of the Recovery Act went into
effect, this was viewed by some as evidence that the law had not worked, making future
stimulus counterproductive. The second is concerns over the deficitwhich nearly
reached 10 percent of GDP in 2009, putting the debt on a course to eventually more than
double as a share of GDP. The final reason was partisan politics, and in particular
Congressional Republicans not wanting to cooperate with the Administration in passing
more fiscal measures.
One way to address the political failures in the future would be to make the initial
stimulus package contingent on economic outcomes. For example, the Recovery Act
could have included an annual tax credit that would be in effect every year the
unemployment rate was above 7 percent. Such a trigger would have delivered more
consistent, predictable, and potentially larger fiscal support in subsequent years.
12
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PRELIMINARY DISCUSSION DRAFT September 1112, 2018
21
Even better would be to expand the automatic stabilizers permanently. In general,
the United States has smaller automatic stabilizers than most other advanced economies,
largely because their magnitude is highly correlated with the size of governmentand
the United States has a generally smaller government.
Such automatic stabilizers could be measures that automatically expand (like
unemployment insurance and SNAP). In fact, the health insurance tax credits and
Medicaid expansion in the Affordable Care Act (ACA) will increase automatic stabilizers
in future years. Alternatively, automatic stabilizers could be contingent on national or
state economic data, perhaps full federal funding for lengthening unemployment
insurance benefits or higher Medicaid matching rates in states with high or rising
unemployment rates.
LESSON 3: IMPORTANCE OF MAKING SURE THAT STATES AND
LOCALITIES DO NOT UNDERCUT THE FEDERAL FISCAL STIMULUS. As the
federal government was expanding fiscal support for the economy in the wake of the
Great Recession, states and localities were cutting spending and thus undoing a
meaningful portion of this stimulus. This was unusual. If State and local spending had
followed the average pro-cyclical pattern of six of the previous seven recoveries and
everything else was the same, the GDP growth rate would have been 0.6 percentage
point per year higher in the five years following the trough.
13
The reductions in state and local purchases may have been specific to this recession
because of the substantial and lagged effects of reduced housing prices on property tax
revenue. Nevertheless, the causes of the large departure from previous experience are
not fully understood and the 2001 experience was also worse than the historical
experience. That raises the concern that, in the future, state and local fiscal policy could
once again run against federal efforts or be insufficiently supportive of them. Moreover,
even optimal subnational policy will be insufficiently fiscally supportive in a recession
because states and localities do not take into account the substantial benefits of their
stimulus measures on other states.
This highlights the importance of steps to support state and local spending in future
recessions and their aftermath. One approach would be to legislate discretionary fiscal
relief, either general fiscal relief or labelled for a specific purposewith the
understanding that it would be fungible. Another and potentially better approach would
be to make state fiscal relief an automatic stabilizer that is triggered when the national
and/or state unemployment rates rose.
LESSON 4: THE IMPORTANCE OF MAINTAINING THE CONFIDENCE OF
TAXPAYERS WHEN UNDERTAKING A LARGE, RELATIVELY RAPID
SPENDOUT OF FUNDS. The Recovery Act included unprecedented transparency and
accountability measures, including an independent Recovery Accountability and
Transparency Board, regular and timely reporting of all contracts and other information,
.$&)"$-26$00+"N))*"smaller"6?7%/*2:"M.)"%)$3/*"53"2.$2"B^_"$*'";BM"3-/%)"0)R530$25/*"?%/N$N505325-$00+"$*'"
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PRELIMINARY DISCUSSION DRAFT September 1112, 2018
22
and an easily accessible website to share all of this public information. As a result, only a
miniscule percentage of the contracts were considered fraudulent and even Republican
Congressman Darrel Issa, a frequent critic of the Administration, acknowledged that the
new recipient reporting standards were “the key to the success of the Recovery
Accountability and Transparency Board in catching and preventing fraud, waste, and
abuse in stimulus spending.” (House Oversight Committee 2011).
LESSON 5: GROWING EVIDENCE THAT TAX CUTS MAY BE MORE
EFFECTIVE THAN PREVIOUSLY APPRECIATED, POTENTIALLY IF
TARGETED AT LOWER-INCOME HOUSEHOLD AND ALSO AT
ACCELERATED DEPRECIATION. Beyond the specific evidence that emerged from
studying the Recovery Act itself, economic research focused on a longer period of time is
finding growing evidence that tax cuts, in particular, may have a higher multiplier than
previously appreciated. Romer and Romer (2010) use a narrative method to identify
exogenous tax shocks and find that the impact of a tax cut worth 1 percent of GDP grows
over time to about 3 percent of GDP after 10 quarters, an effect that may reflect
expanded demand in a traditional Keynesian manner or increased supply through the
incentives to work. Barro and Redlick (2011), Mertens and Ravn (2013) and Mertens and
Montiel-Olea (2017) find impulse responses from tax cuts that are similarly large. Zidar
(2017) finds large responses as well but also finds substantial heterogeneity, with a much
larger multiplier for tax cuts for low-income households than high-income households.
Most of these papers are focused on tax multipliers but they generally find larger
effects than the papers focused just on spending multipliers (e.g., Ramey 2011 and
Ramey and Zubairy 2018). In some cases, the papers provide estimates for both tax and
spending multipliers on a consistent basis (e.g., Carlino and Inman 2016, Andrés, Boscá,
and Ferri 2016 and Ramey 2018) and also find larger tax multipliers than spending
multipliersin some cases by substantial magnitudes.
Zwick and Mahon (2017), discussed above, also finds very large responses to
accelerated depreciation, especially compared to the cost to the government. These
responses may be specific to a financial crisis, however, because the cash flow
improvement was especially potent and the present value cost to the government was
especially low given modest federal borrowing rates.
All of this said, the general evidence on generic tax cutslike any macroeconomic
evidenceis not definitive and in some cases is puzzlingly larger than one would expect
based on the economic theory of either Keynesian multipliers or possible supply-side
responses. Moreover, it is possible that both spending multipliers and tax multipliers
have been underestimated in the past.
Overall, however, the evidence suggests some upward revision in tax multipliers
relative to what was believed in 2009 and 2010, especially for tax cuts for lower-income
households and for businesses.
LESSON 6: SUGGESTIVE SUPPORT FOR THE NOTION THAT IT WOULD BE
BENEFICIAL TO INCREASE THE NUMBER OF JOBS PER UNIT OF GDP. The
Great Recession had a particularly severe impact on the labor market even conditional
on the large increase in the unemployment rate, including sustained record high long-
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
23
term unemployment rates, a spike in people working involuntarily part time, and a large
reduction in the labor force participation rate. Similar labor market dysfunctions
followed the much shallower 2001 recession as well.
In many ways the labor market experience was much worse in the United States
than in other advanced economies. Germany experienced a similar decline in GDP
without the large increase in unemployment that the United States had, as shown in
Figures 7a and 7b. Instead, hours worked were reduced in Germany, spreading the
employment decline across a much larger number of people.
Figure 7a Figure 7b
While Germany followed some different policies and has very different institutional
arrangements than the United States, their experience highlights the potential for
increasing the number of jobs conditional on a given amount of GDPnot just focusing
on maximizing GDP. One way to do this is through a new jobs credit, described above,
which CEA estimated would add one job year for each roughly $20,000 spentgiving it
a considerably higher employment impact than generic stimulus. Another possibility
would be to encourage more states to adopt the type of short-term compensation found
in Germany that provides unemployment insurance not just for people fired from jobs
but also for people who have their hours involuntarily reduced.
VI. Conclusion
The stimulus that started in 2008, was greatly expanded in 2009, and somewhat
expanded and extended further in the several years thereafter, was an integral part of
the overall macroeconomic response to the financial crisis. Absent these measures the
recession would have been much deeper and more prolongedpotentially even more
so than conventional models indicate because of the possibilities of self-fulfilling
vicious cycles and persistent losses in output. This stimulus acted in a synergistic
manner with monetary and financial policy, helping the U.S. economy fare better than
many historical precedents and outperforming other countries in the wake of the Great
Recession (CEA 2017).
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
24
Nonetheless, there were significant shortcomings in the fiscal response, largely the
result of the political difficulty of convincing Congress to pass sufficiently large stimulus
bills starting with the Recovery Act in 2009 and the failure to win support for additional
stimulus that was both large enough and weighted more towards public investment.
Much of the stimulus was designed with reasonably good aggregate macroeconomic
models, models that have been further corroborated by the experience of the 2008-12
stimulus bills. Knowledge of the different impacts of different types of measures,
however, was much less certain than the point estimates published by different
macroeconomic forecasters might lead one to believe. We know only a little more today
and it is likely that policymakers will still be flying blinder than should be the case when
designing the specific composition of the next fiscal stimulus. But, the evidence for the
overall importance of fiscal stimulus is stronger than ever.
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
25
Appendix
Some of the larger or more notable items in each of these categories along with their cost
from 2008-2012 were:
o! Individual Tax Cuts
o! Making Work Pay ($112 billion). A tax credit that was generally $400 for
individuals and $800 for married couples, phased out for higher-income
households. It was originally passed as part of the Recovery Act and lasted
for 2009 and 2010.
o! Payroll tax cut ($207 billion). A 2 percentage point reduction in Social
Security payroll taxes, with the cost reimbursed to the Social Security
Trust Fund. Originally passed for 2011 and extended through the end of
2012.
o! Tax credits for low- and moderate-income households with children
($41 billion). The Recovery Act expanded the Earned Income Tax Credit
for married couples and households with three or more children and also
increased the refundable portion of the child tax credit. These provisions
were subsequently made permanent.
o! Business Tax Incentives
o! Bonus depreciation and expensing ($180 billion). Originally allowed
businesses to deduct 50 percent of the cost of their equipment
investments up front and was expanded to 100 percent expensing of
equipment investment from September 9, 2010 through the end of 2011.
o! Discharge of business indebtedness ($43 billion). Allows certain business
repurchasing specific types of debt to pay taxes on the cancellation of that
debt income over five years beginning in 2014.
o! Tax credits related to clean energy and energy efficiency ($12 billion). The
Recovery Act included a number of tax credits for clean energy including
extending and expanding the energy tax credit.
o! Aid to Directly Impacted Individuals
o! Unemployment insurance expansions ($240 billion). Full federal
financing for benefits for up to 99 weeks of unemployment in high
unemployment States, initially also included temporarily increased
benefit amounts. In addition, the Recovery Act and subsequent legislation
included unemployment insurance reforms.
o! Increased Supplemental Nutrition Assistance Program (SNAP)
($38 billion). A temporary bump up to SNAP benefits that started in the
Recovery Act, was partially rescinded in two subsequent pieces of
legislation, and was phased out by November 2013.
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
26
o! Temporary Assistance to Needy Families (TANF) Emergency Fund ($5
billion). A temporary increase to TANF that could be used by States for
purposes including public employment and hiring subsidies.
o! State Fiscal Relief
o! Increased Federal Medical Assistance Percentage (FMAP) ($100 billion).
Increased Federal matching for State Medicaid programs originally
passed as part of the Recovery Act and extended in the summer of 2010.
o! State educational assistance ($63 billion). Federal subsidies for States and
localities to fund efforts to prevent teacher layoffs. Included the “Race to
the Top” program, a competitive grant for States undertaking major
reforms.
o! Public Investment Outlays
o! Increased investments in the highway and rail program ($28 billion).
Largely formula funding for the traditional surface transportation
programs.
o! Transportation Investment Generating Economic Recovery (TIGER)
Grants ($3 billion). Competitive grants available to States and localities
for a variety of transportation purposes.
o! High-speed Rail ($2 billion). Grants to support State high-speed and
inter-city rail projects passed as part of the Recovery Act.
o! Health information technology ($15 billion). Including, incentive
payments to medical providers to adopt and meaningfully use electronic
medical records, with penalties for those that took the subsidies without
meaningfully using them.
PRELIMINARY DISCUSSION DRAFT September 1112, 2018
27
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