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The EU Goes Fishing for an Antitrust Case Against Apple — But There’s One Problem

Posted on by The Progressive Policy Institute

On Tuesday, the EU announced it had opened two antitrust investigations into Apple — one concerning the company’s mobile payment system, Apple Pay, the other looking into Apple’s conduct in managing its App Store and how it treats third party developers.

For some apps, Apple requires developers to use its proprietary in-app purchase system and forbids developers from telling users in the app that they can make purchases outside the app (and thus let the developer avoid paying Apple’s fee). The European Commission will investigate whether these policies violate EU competition rules.

The announcement from the EU offers no details on what the Apple Pay investigation will entail, but it might look into the limits Apple has placed on access to the Near Field Communication (NFC) functionality — which enables contactless payments — of its iPhone and Apple Watch devices.

In the US, under the consumer welfare standard, an investigation like this would need to show (1) that Apple was dominant in a relevant product market, (2) that its conduct was anticompetitive, and (3) that it harmed consumers. In a hypothetical US case, Apple could plausibly argue in its defense that a tight integration between hardware and software is a key selling point for consumers, including Apple Pay for payments. Apple might also point out that a tightly curated App Store benefits consumers by improving security and increasing trust.

In the EU, by contrast, regulators don’t need to prove consumer harm so long as they can meet the first two conditions. If a company is shown to be dominant in a market, then abuse of that position via unfair conduct toward competitors is a violation of EU antitrust laws. However, if the EC decides to bring a case against Apple, it will still need to overcome a significant hurdle: Apple is not dominant in the European market.

Do iPhones compete with Android phones?

According to data from StatCounter, Apple iOS has less than 30% of the European mobile operating system market. By comparison, Google’s Android has more than 70% of the market.

The European Commission’s guidance on “abusive exclusionary conduct by dominant undertakings” is clear on what cutoff it uses to determine an absence of market power (emphasis added):

The Commission considers that low market shares are generally a good proxy for the absence of substantial market power. The Commission’s experience suggests that dominance is not likely if the undertaking’s market share is below 40% in the relevant market.

Apple’s market share in the operating system market is likely a rough proxy for its share of the app store market, as the App Store is tightly integrated with iOS and the Play Store is tightly integrated with Android. An antitrust case related to payments might be even harder to make, as Apple Pay accounts for only about 5% of global card transactions. Even if its share in Europe is double or triple its global rate, Apple is far from being a dominant player in payments.

So how might the European Commission overcome its burden and find that Apple has a dominant market position?

The EC’s Android decision is instructive here. In that case, Google was fined $5 billion for illegally tying its Chrome browser and search apps to its Android operating system. The EC narrowly defined the market as only licensable mobile operating systems. Since iOS is exclusive to Apple and non-licensable, the EC was able to conclude that Google had a virtual monopoly on the licensable mobile OS market. The EC reached this decision despite that fact that according to its own market survey, 89 percent of respondents said Android phones compete with iOS phones. (Google is appealing the decision and many commentators believe the case is on shaky ground.)

As Thibault Schrepel and Nicolas Petit pointed out in recent comments to the European Commission, the market definition in the Android decision “leads to curious implications such as the idea that a merger between Apple and Google in smartphone OS” would be “unproblematic.” In spite of these logical inconsistencies and common sense contradictions, it is likely the EC will conclude once again that Apple and Google are not competitors in this market and find that Apple has a near-monopoly in non-licensable mobile operating systems. 

While there are certainly individual cases where Apple has been inconsistent or imperfect in its enforcement of App Store policies, in general, Apple has created a trusted and privacy-conscious platform for users and developers to transact. As Benedict Evans said, “[C]urated app stores have been hugely, unambiguously good for users and software developers, and especially for user security and privacy.” In 2019, the App Store facilitated more than half a trillion in billings and sales for third parties. Since Apple doesn’t charge a commission on the sale of physical goods and services, for 85% of that economic activity, the value accrued entirely to the third party.

This data is in line with a report last year from Michael Mandel which found that a “preliminary scenario analysis suggests that the revenues collected by the app stores could be in the range of 4-7% of the value generated by all apps in the app stores, including both free and paid.” This is a far cry from the 30% App Store “tax” Apple critics like to tout. Capturing a single-digit percentage of all the value created seems like a reasonable exchange for developing and maintaining a safe and secure global platform for users and developers.

We can contain the spread of COVID-19 — but the federal government must step up before it’s too late

Posted on by The Progressive Policy Institute

States and localities are proceeding with “opening” their economies despite the fact that most states have not met the re-opening criteria put forward by the White House.

In order to head off spikes in cases, states and localities will need aggressive testing, contact tracing, and isolation programs. Testing is only as good as what you do with that information. And the key next steps are to inform the person with the positive or negative test and then track the contacts of all positive tests — and asking those people to self-quarantine — ideally giving people a place to do so if they don’t have one of their own. Because the U.S. has such widespread cases of COVID-19, federal support of contact tracing programs is needed.

The best way for the federal government to contain the spread of the coronavirus is to provide guidance and funding to state and local programs which then do the work on the ground:

1. Numbers. Experts estimate the U.S. will need 100,000 to 300,000 contact tracers. These can be epidemiologists, nurses, and trained citizens. Ideally, these people will be employed by local health departments in their area. The National Association of County and City Health Officials says public health departments should have 30 contact tracers per 100,000 people.

2. Funding. Andy Slavitt, former director of Medicare and Medicaid in the Obama administration, and Scott Gottlieb, former director of the Food and Drug Administration for President Trump, called for $46 billion in federal funding for contact tracing and related activities to bolster public health departments and contain the spread of the virus.

3. Support local public health departments. Rather than creating a new federal entity — which would take time and additional bureaucracy — it makes the most sense to quickly funnel funding to local health departments on the ground. To inform policymakers, data should be standardized and centralized at the Centers for Disease Control and Prevention.

4. Provide cultural competency guidance. Much of the success of contact tracing relies on the contact tracer getting the interviewee to divulge who they have been in contact with. This requires the ability to create trust with people quickly over the phone — at a time when many people don’t answer calls from unknown numbers. Cultural competency is an integral part of an interviewer’s ability to quickly build rapport. It is vital that the federal government provide local jurisdictions guidance on cultural competency including local jurisdictions hire contact tracers from a variety of backgrounds and from communities that are most affected.

5. Training. The federal government should support the training of contact tracers by providing funding and guidance. The hope is that these jobs will be short-lived as once the spread is under control, the surge of contact tracers will no longer be necessary. Thus the federal government should also support transitioning contact tracers into other positions that support the health of communities.

6. Privacy. As large technology companies work to develop products that support contact tracing efforts, it is paramount that they work with public health departments. They should not solely control the data collected. Furthermore, the efforts to develop new products should be in conjunction with public health departments not siloed apart from them.

Read more here.

Community Health Centers and COVID-19

Posted on by The Progressive Policy Institute

Community Health Centers (CHCs) have an important role to play in SARS-CoV-2 response. CHCs are community-based and organizations that provide primary care, mental health care and even dental care to populations with limited access to health care. Both House and Senate members are pushing leadership (Senate, House) to include increased funding for CHCs in the next relief package.

Funding is an important first step to helping CHCs provide care to the 28 million low-income and disproportionately uninsured patients they see annually. But it’s not the only issue at play.

Any legislative action to support community health centers should:

1. Authorize relief funding

2. Expand telehealth services

3. Increase the number of Community Health Workers

Authorize relief funding: Like most health care providers, CHCs saw a dramatic decline in appointments during the second quarter of this year — almost 40 percent. As a result, nearly 2,000 sites closed their doors. Though the Coronavirus Aid, Relief, and Economic Security (CARES) Act directed $1.32 billion to Community Health Centers for COVID-19 response and to maintain some regular capacity, it was not enough. To provide long-term stability for CHCs, the call for a five-year extension with $69.7 billion in funding makes sense.

Expand telehealth services: Many hospitals and physicians offices were able to adapt to the pandemic and move appointments online. Unfortunately, unlike their more resourced counterparts, CHCs were not prepared to transition appointments to telehealth. In 2018, 56 percent of CHCs did not have any telehealth use. Barriers included limited reimbursement, equipment, training for providers and inadequate broadband. CHCs provide mental health services, chronic care management, and primary. Moving these services online would help them better serve patients and meet them where they are at. Relief funding should include dedicated dollars to help CHCs modernize for the 21st century.

Increase the number of Community Health Workers: CHCs provide primary care services, mental health services, oral health services and countless other procedures to underserved populations on a sliding fee schedule. But often people don’t know the services are there and available to them. I find the health care system difficult to navigate as someone who has a career in health policy — I don’t know how to find out if a dentist is good in a new city or how to establish a relationship with a new primary care doctor. Yet there are millions of Americans who are uninsured, maybe who don’t speak English, and then they are expected to navigate a bureaucratic, convoluted system on their own.

Community Health Workers (CHWs) are worth their weight in gold — or more precisely they save $2.47 for every dollar spent. CHWs typically serve their own communities and are hired to provide social support, help patients navigate the health system and connect people to any services they may need. As we attempt to mitigate the damage of COVID-19 and move beyond this crisis, CHWs can be a key part to helping communities rebuild and access needed health care services — in particular services offered at Community Health Centers. One can imagine that it would make sense to have CHWs work in communities with meat packing facilities, nursing homes, and other communities ravaged by COVID-19. Unlike contact tracers which are necessary to get us through the pandemic, with adequate investment, CHW jobs could stick around for a while to provide vital services to underserved communities.

COVID-19 fact of the week: People with type A blood are 50 percent more likely to require a ventilator, according to a new study of patients in Italy and Spain. Furthermore, 23andme found that people with O type blood are less susceptible to the virus.

Read more here.

America’s COVID-19 Debacle: A Chronology

Posted on by The Progressive Policy Institute

Updated on October 21, 2020.

As the coronavirus pandemic enters its 10th month, the United States continues to lead the world in deaths and infection rates. The hard truth is America ranks dead last when it comes to responding effectively to COVID-19.

As of mid-October, more than 222,000 Americans have been killed by the virus, some 70,000 more fatalities than second-ranking Brazil. The United States accounts for about one-fifth of global deaths. We have more than 8.2 million confirmed cases of COVID-19, and the number is rising as the pandemic’s “third wave” spreads throughout the Midwest and mountain West, and in rural America. 

Since the United States is rich and technologically advanced, and spends far more than other countries on health care, there can only be one explanation for our abysmal showing against the coronavirus pandemic: An epic failure of political leadership, especially at the top.

The Trump administration’s manifest inability to contain the pandemic has cost tens of thousands of preventable U.S. deaths and prolonged the nation’s worst economic crisis since the Great Depression. More than 50 million Americans have filed for unemployment, countless small businesses have gone under, and national output has plummeted. 

COVID-19 deaths have been concentrated among the elderly in nursing homes; front-line health workers and those in “essential” industries like meat packing; and, poor and minority communities where people are more likely to make medical conditions that make them more vulnerable to the virus. 

The crisis also has aggravated the nation’s pre-existing economic inequities. Layoffs have been heaviest in low-paid hospitality and service jobs, while many office workers with college degrees have been able to keep working remotely. Even as the economy has contracted, the stock market keeps rising, widening the nation’s wealth gap. 

Millions of K-12 students suffered acute learning losses when public schools closed last spring, and many disadvantaged children also lost access to school meals. Many schools remain closed this fall, putting a heavy burden on parents forced to stay home to look after their kids and help them keep up with their studies online. 

No one expected the United States to escape the ravages of COVID-19 unscathed. But the enormous scale of our human and economic losses was not inevitable. Other countries have managed the COVID-19 crisis far more effectively. For example, South Korea, which reported its first case of infection on the same day as the United States, reports less than 400 deaths and about 22,000 cases.  

In fact, the COVID-19 crisis has posed a kind of “governance stress test” to countries around the world. It is casting a remorseless light on the quality of each country’s political leadership and the competence of its national government. 

Comparing America’s performance with that of other countries, the political scientist Francis Fukuyama concludes that President Donald Trump proved incapable of rising to the challenge:  

“It was the country’s singular misfortune to have the most incompetent and divisive leader in its modern history at the helm when the crisis hit, and his mode of governance did not change under pressure. Having spent his term at war with the state he heads, he was unable to deploy it effectively when the situation demanded. Having judged that his political fortunes were best served by confrontation and rancor than national unity, he has used the crisis to pick fights and increase social cleavages. American underperformance during the pandemic has several causes, but the most significant has been a national leader who has failed to lead.”

Now, with an eye to this November’s election, President Trump and his party seek to convince Americans the debacle they have been witnessing throughout 2020 is a mirage. In a surreal spectacle, speaker after speaker in the Republican National Convention extolled Trump’s “decisive action” against COVID-19, while Trump himself bragged about ordering an “unprecedented national mobilization” against the “China virus.” 

In fact, the mobilization of national will and resources our country needed never happened. The president’s negligence and disdain for taking elementary precautions against the disease, like wearing a mask, has contributed to outbreaks in the White House itself, infecting him and his family and many top staffers.

Even now, with the rate of infection surging again, it’s painfully clear that President Trump has no plan to contain the disease. Instead he’s fighting it with happy talk and promises that a vaccine is just around the corner. He and his party have given higher priority to adding another conservative Supreme Court justice than to passing a major COVID-19 relief bill to check the disease, boost our sputtering economy and maintain unemployment benefits.

The Progressive Policy Institute believes the 2020 presidential election should be a referendum on Donald Trump’s handling of the gravest national crisis he has faced as president. To help voters distinguish fact from fiction, PPI has assembled this comprehensive chronology of key events and milestones in the COVID-19 crisis. As it continues to unfold, we will update this instant historical record as necessary. If readers think we have missed any important events or information, please notify Kate Hinsche at khinsche@ppionline.org.

*Note: The main source for each entry can be found by clicking on the date.

COVID-19: Chronology of a Debacle

2017

JANUARY 12 – Speaking at Georgetown University, Dr. Anthony Fauci, Director of the National Institute on Allergy and Infectious Diseases, urges the incoming Trump administration to be prepared for outbreaks of viral diseases. “If there’s one message that I want to leave with you today based on my experience, it is that there is no question that there will be a challenge to the coming administration in the arena of infectious diseases.” 

JANUARY 13 – Outgoing Obama administration officials run a crisis simulation for President-elect Trump’s national security team on how to react to the outbreak of a deadly respiratory disease. The incoming administration is also given a 69-page playbook with best practices for handling global pandemics.

MAY 11 – Dan Coats, Director of National Intelligence, reports to Congress about threats to the United States, including global pandemics. 

MAY 27 – In his first budget, President Trump proposes a $1.3 billion cut in the Center for Disease Control (CDC) for 2018. In each year of his presidency, President Trump has proposed similar cuts to the CDC’s funding. (2019) (2020) (2021)

 

2018

FEBRUARY 13 – DNI Coats again warns Congress about the threat of a global pandemic.

APRIL 10 – Tom Bossert, White House homeland security advisor, resigns at the request of National Security Advisor John Bolton. Bossert had repeatedly called for a comprehensive biodefense strategy against pandemics and biological attacks. 

MAY 7 – Speaking at Emory University to mark the 100th anniversary of the 1918 influenza pandemic, Luciana Borio, the National Security Council’s Director of Medical and Biodefense preparedness, warns “The threat of pandemic flu is the number one health security concern. Are we ready to respond? I fear the answer is no.” 

MAY 8 – President Trump calls for cuts in emergency funds for Ebola and other pandemics, as well as the State Department’s Complex Crisis Fund for “emerging or unforeseen crises.”

MAY 10 – As part of his effort to “streamline” the National Security Council, Bolton disbands the Directorate for Global Health Security and Biodefense and removes its director, Rear Admiral Timothy Ziemer. 

OCTOBER 19 – “In a move that worries public health experts,” the New York Times reports, “the federal government is quietly shutting down a surveillance program for dangerous animal viruses that someday may infect humans.” 

 

2019

JANUARY 29 – DNI Coats again warns Congress that the United States remains “vulnerable to the next flu pandemic or large scale outbreak of a contagious disease that could lead to massive rates of death and disability, severely affect the world economy, strain international resources, and increase calls on the United States for support.”

JULY 28 – DNI Coats, who had publicly differed with President Trump over Russia’s interference in the 2016 election, steps down.

SEPTEMBER 15 – The President’s Council of Economic Advisers (CEA) warns that an influenza pandemic could cause enormous health and economic losses. 

OCTOBER 1 – The Department of Health and Human Services (HHS) issues a draft report on a series of exercises code-named “Crimson Contagion.” The report warns that the federal government is “underfunded, underprepared and uncoordinated” to fight an influenza pandemic. 

DECEMBER 31 – China reports the outbreak of the novel coronavirus (COVID-19) to the World Health Organization.

 

2020

JANUARY 

JANUARY 6 – The CDC issues a travel notice for Wuhan, China following reports of the outbreak of a new infectious disease.

JANUARY 10 – Chinese state media reports first death in China due to the novel coronavirus. 

JANUARY 18 – HHS Secretary Alex Azar warns President Trump of the possibility of a pandemic stemming from the outbreak in China. 

JANUARY 21 – The CDC reports the first coronavirus case in the United States: An unidentified Washington State man, in his early 30s who recently had traveled to Wuhan. 

JANUARY 22 – In an interview in Davos, Switzerland, President Trump dismisses concerns about the coronavirus, saying “We have it totally under control.”

JANUARY 22 – White House officials turn down an offer to buy millions of N95 masks manufactured in America, according to the manufacturer. 

JANUARY 24 – President Trump congratulates Chinese President Xi on his handling of the outbreak in Wuhan, tweeting: “The United States greatly appreciates their efforts and transparency.”

JANUARY 29 – White House advisor Peter Navarro circulates a memo outlining the risks of coronavirus contagion. It estimates that, in a worst-case scenario, a pandemic could claim up to 500,000 U.S. lives and cost close to $6 trillion.

JANUARY 30 – Amid serious outbreaks in Italy and China, the World Health Organization (WHO) declares COVID-19 a global public health emergency. 

JANUARY 30 – HHS Secretary Azar again warns President Trump of the possibility of a pandemic. The New York Times reports, “Mr. Azar was blunt, warning that the virus could develop into a pandemic and arguing that China should be criticized for failing to be transparent.”

JANUARY 30 – In a press conference, President Trump assures Americans have little to worry about: “We think we have it very well under control. We have very little problem in this country at this moment — five — and those people are all recuperating successfully.”

JANUARY 31 – President Trump issues an executive order ostensibly banning travel to and from China. 

 

FEBRUARY 

FEBRUARY 2 – “We pretty much shut it (coronavirus) down coming in from China,” President Trump tells Fox News’s, Sean Hannity.

FEBRUARY 6 – COVID-19 claims its first U.S. victim: Patricia Dowd, 57, of Santa Clara, California. This fact isn’t disclosed until after an April 21 autopsy. 

FEBRUARY 8 – Labs receiving coronavirus tests from the CDC start to complain that they don’t work properly. The problem isn’t resolved until weeks later when the FDA waives rules against tests developed elsewhere.

FEBRUARY 10 – President Trump continues to express confidence in China’s management of the pandemic. He tells governors at the White House that President Xi of China feels “very confident” because “by April or during the month of April, the heat, generally speaking, kills this kind of virus.”

FEBRUARY 23 – Navarro sends a second memo to President Trump, warning of the “increasing probability of a full-blown COVID-19 pandemic that could infect as many as 100 million Americans, with a loss of life of as many as 1-2 million souls.”

FEBRUARY 24 – “The Coronavirus is very much under control in the USA,” President Trump tweets.

FEBRUARY 26 – President Trump introduces the White House coronavirus task force, even while continuing to minimize the danger: “The flu, in our country, kills from 25,000 people to 69,000 people a year… And again, when you have 15 [COVID-19 victims], and the 15 within a couple of days is going to be down to close to zero, that’s a pretty good job we’ve done.”

FEBRUARY 27 – “It’s going to disappear. One day it’s like a miracle, it will disappear,” President Trump declares in a White House briefing with African American leaders.

FEBRUARY 29 – Stung by criticism of White House inaction, President Trump tells the press: “We’ve taken the most aggressive actions to confront the coronavirus. They are the most aggressive taken by any country and we’re the number one travel destination anywhere in the world, yet we have far fewer cases of the disease than even countries with much less travel or a much smaller population.”

 

MARCH

MARCH 1 – First reported U.S. COVID-19 death in Washington State. The unidentified patient was a man in his 50s with serious health problems. 

MARCH 2 – President Trump predicts that a COVID-19 vaccine is imminent. “I’ve heard very quick numbers, that of months.” This contradicts Dr. Fauci’s repeated warnings that a vaccine may not be available for a year or a year and a half. 

MARCH 6 – At a press briefing, President Trump boasts about his understanding of the coronavirus: “I like this stuff. I really get it. People are surprised that I understand it. […] Every one of these doctors said, ‘How do you know so much about this?’ Maybe I have a natural ability.” 

MARCH 6 – “Anybody that wants a test can get a test,” President Trump asserts after touring the CDC headquarters in Atlanta.

MARCH 6 – The Coronavirus Preparedness and Response Supplemental Appropriations Act — Congress’s first response to the pandemic — becomes law. It provides $8.3 billion in emergency funding for federal agencies to combat coronavirus.

MARCH 9 – In a tweet, President Trump again compares COVID-19 to the flu: “So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!”

MARCH 10 – Following a meeting with Republican Senators, President Trump again praises his administration’s handling of COVID-19: “It hit the world. And we’re prepared, and we’re doing a great job with it.”

MARCH 10 – In a televised address to the nation, President Trump asserts, inaccurately, that Americans won’t have to pay for COVID-19 treatment.

MARCH 11 – In a press briefing, President Trump again downplays the danger of COVID-19. “The vast majority of Americans, the risk is very, very low. Young and healthy people can expect to recover fully and quickly if they should get the virus.”

MARCH 11 – President Trump announces increased travel restrictions for 26 European countries. In practice, however, the order is riddled with loopholes that create long lines for some and zero screening for others. 

MARCH 11 – WHO upgrades COVID-19 from a public health emergency to a global pandemic.

MARCH 11– News reports say that the United States has tested just over 7,000 people for the coronavirus, compared to 222,395 tests conducted in South Korea. Both countries reported their first COVID-19 case on the same day.

MARCH 13 – Asked by a reporter if he would “take responsibility for the failure to disseminate larger quantities of tests earlier,” President Trump replies, “I don’t take responsibility at all.”

MARCH 15 – 33 states plus the District of Columbia close their public schools.

MARCH 16 – President Trump announces self-isolation guidelines for Americans to follow for the next 15 days.

MARCH 16 – President Trump denies understating the danger of COVID-19: “I’ve always known this is a real — this is a pandemic. I felt it was a pandemic long before it was called a pandemic.”

MARCH 17 – U.S. COVID-19 death toll exceeds 100.

MARCH 18 – Congress passes a second relief bill, the Families First Coronavirus Response Act. It provides close to $3.5 billion for coronavirus testing, 14-day paid leave for workers affected by the pandemic, and removes work requirements for food stamps.

MARCH 19 – President Trump touts, without evidence, chloroquine, and hydroxychloroquine as a potential cure to COVID-19. 

MARCH 22 – In a flurry of tweets, President Trump voices frustration over governors’ handling of the pandemic. The public, however, expresses far more confidence in their governors than the president in national polls.

MARCH 23 – The first nine states implement stay-at-home orders (Washington, Oregon, California, Louisiana, Illinois, Ohio, New York, Massachusetts, and New Jersey).

MARCH 23 – The media reports that 48 states plus the District of Columbia have closed their public schools for the rest of the academic year.

MARCH 24 – In the daily coronavirus task force briefing, President Trump imagines the U.S. economy reopening in a matter of weeks: “I would love to have the country opened up and just raring to go by Easter… I think Easter Sunday — you’ll have packed churches all over our country.” 

MARCH 25 – In the daily briefing, President Trump claims the United States leads the world in testing. “We have tested, by far, more than anybody…There’s nobody even close. And our tests are the best tests.” On a per-capita basis, however, the United States ranks low on tests. 

MARCH 25 – U.S. COVID-19 death toll passes 1,000.

MARCH 26 – Twelve more states implement stay-at-home orders (Idaho, Colorado, New Mexico, Michigan, Wisconsin, Kentucky, Indiana, West Virginia, Hawaii, Connecticut, Vermont, and Delaware).

MARCH 26 – U.S. cases surge to 82,404, overtaking both Italy and China to make America the world’s leader in reported COVID-19 infections. 

MARCH 27 – Congress passes its third and largest aid bill, the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act provides $2 trillion to aid businesses and workers, procure medical supplies and equipment, and expand Unemployment Insurance. 

MARCH 28 – In signing the CARES Act, President Trump claims that the Inspector General charged with oversight of the bill requires his permission before reporting to Congress. 

MARCH 30 – Nine more states implement stay-at-home orders.

MARCH 31 – President Trump concedes that COVID-19 “is not the flu. It’s vicious. When you send a friend to the hospital… And you call up the next day, ‘how’s he doing?’ And he’s in a coma? This is not the flu.” 

MARCH 31 – U.S. COVID-19 death toll surpasses 5,000.

 

APRIL

APRIL 3 – President Trump tells the public that COVID-19 is retreating. “I said it was going away – and it is going away.”

APRIL 3 – New York City COVID-19 deaths surpass the number of Americans killed on 9/11. 

APRIL 3 – The U.S. Chamber of Commerce reports that 24% of small businesses have closed due to the coronavirus lockdown and predicts another 40% could close soon.

APRIL 3 – In response to the CDC’s recommendation that Americans wear facial masks, President Trump declines to lead by example, saying, “I don’t think I’m going to be doing it.”

APRIL 4 – U.S. COVID-19 death toll passes 10,000. 

APRIL 6 – Twelve more states issue stay-at-home orders, bringing the total number to 42.

APRIL 6 – The United States overtakes Spain’s COVID-19 death toll with 13,298 fatalities, the second-highest in the world behind Italy.

APRIL 7 – President Trump ousts Glenn Fine, the DOD Inspector General picked to oversee the implementation of the CARES Act.

APRIL 9 – The United States overtakes Italy’s COVID-19 death toll with 19,802 fatalities, becoming the world leader in COVID-19 mortality. 

APRIL 14 – President Trump halts America’s contribution to WHO funding and calls for an investigation into the agency’s role in ”severely mismanaging and covering up the spread of the coronavirus.”

APRIL 14 – U.S. COVID-19 death toll passes 30,000. 

APRIL 17 – In a series of tweets, President Trump encourages protests against Democratic governors’ social distancing restrictions: “LIBERATE MICHIGAN,” “LIBERATE MINNESOTA,” “LIBERATE VIRGINIA.

APRIL 17 – The BLS reports that national unemployment grew 0.9% in March, to 7.4 million unemployed or 4.4%. 

APRIL 19 – U.S. COVID-19 death toll passes 40,000. 

APRIL 21 – Tests from autopsies performed in early February come back positive for coronavirus, revealing COVID-19 deaths before the CDC reported the first U.S. fatality on March 1.

APRIL 21 – The White House removes Rick Bright, Director of the Biomedical Advanced Research and Development Authority (BARDA). Bright had said the president’s claims for the curative powers of chloroquine and hydroxychloroquine “clearly lack scientific merit.”

APRIL 23 – In a fourth relief bill, Congress approves $484 billion in additional funding for small businesses, hospitals, and coronavirus testing.

APRIL 23 – President Trump is widely ridiculed for musing in a task force briefing that COVID-19 might be treatable with disinfectants and sunlight. “I see the disinfectant, where it knocks [the virus] out in a minute… is there a way we can do something like that, by injection inside or almost a cleaning?”

APRIL 24 – Georgia becomes the first state to start lifting restrictions and reopening some businesses.

APRIL 28 – U.S. COVID-19 death toll surpasses the official tally (58,300) of Americans who died in the 1955-1975 Vietnam War. 

APRIL 29 – The Bureau of Economic Analysis reports that the U.S. economy shrank at an annual rate of 4.8% in the first quarter of 2020.

 

MAY

MAY 1 – President Trump announces his intention to replace Christi Grimm, the Inspector General of HHS, who released a late April report documenting shortages of medical supplies and testing delays.

MAY 4 – Media reports say that almost 20 states have begun to lift social distancing restrictions. 

MAY 5 – Trump announces he’ll wind down the coronavirus task force by the end of May so that the White House can focus on restarting the economy.

MAY 5 – U.S. COVID-19 death toll passes 70,000. 

MAY 6 – President Trump again expresses impatience about opening the economy. “We can’t have our whole country out. We can’t do it. The country won’t take it. It won’t stand it. It’s not sustainable.”

MAY 10 – Two White House employees test positive for COVID-19.

MAY 11 – The BLS reports that the unemployment rate in April has ballooned to 14.7% with 20.5 million unemployed, much higher than at the peak of the 2008 Great Recession. 

MAY 11 – President Trump castigates Pennsylvania Gov. Tom Wolf for “moving slowly” to reopen his state as protestors rally. 

MAY 18 – President Trump admits he has been taking daily doses of hydroxychloroquine, which has yet to be proven effective and may even be harmful to those who contract coronavirus.

MAY 21 – President Trump, after conducting a Michigan factory tour without a face mask, explains, “I wore one in this back area, but I didn’t want to give the press the pleasure of seeing it.”

MAY 26 – U.S. COVID-19 death toll passes 100,000.

MAY 26 – 36 states have reopened or are in the process of reopening.

MAY 28 – The total number of new jobless claims surpasses 40 million.

 

JUNE

JUNE 2 – Trump suggests GOP move convention to Jacksonville, FL after N.C. Gov. Roy Cooper refuses to allow packed arenas.

JUNE 3 – According to a new study from the University of Minnesota, the malaria drug hydroxychloroquine does not prevent people from contracting COVID-19.

JUNE 6 – 35.4 million Americans are receiving unemployment benefits.

JUNE 8 – Following an easing of lockdown conditions in many parts of the country, infections are rising in 21 states.

JUNE 11 – U.S. COVID-19 cases surpass two million.

JUNE 11 – News outlets report that more than 20 European countries have reopened their schools. Most U.S. schools remain closed.

JUNE 16 – In an op-ed, Vice President Mike Pence dismisses reports about a “second wave” of coronavirus infections and boasts that the Trump administration is “winning the fight against the invisible enemy.”

JUNE 17 – Vice President Pence tells governors that an apparent rise in U.S. coronavirus outbreaks stems from an increase in testing.

JUNE 19 – Gov. Andrew Cuomo wraps up 111 consecutive days of widely praised coronavirus briefings as COVID-19 hospitalizations in New York have dropped below 1,000 for the first time since March 18.

JUNE 19 – Nine Texas mayors write a letter to the states’ residents, urging them to wear masks. Coronavirus cases in Texas continue to surge and the number of hospitalizations has been climbing since May.

JUNE 20 – Disregarding warnings from administration health officials against large public gatherings, Pres. Trump resumes mass campaign rallies in Tulsa, with 6,200 people in attendance.

JUNE 21 – President Trump complains that more COVID-19 testing is increasing the number of confirmed U.S. cases. “When you do testing to that extent, you’re going to find more people, you’re going to find more cases, So I said to my people, ‘Slow the testing down, please’,” he says at the Tulsa rally. 

JUNE 22 – Two members of President Trump’s campaign advance team, who attended Trump’s rally in Oklahoma, test positive for coronavirus. 

JUNE 22 – New data confirms that COVID-19 cases are growing in 29 states.

JUNE 23 – President Trump again insists that more tests are to blame for the increase in coronavirus infections. 

JUNE 23 – At a Congressional hearing, Dr. Fauci says U.S. health officials see a “disturbing surge” of infections in some parts of the country, as Americans ignore social distancing guidelines.

JUNE 23 – Texas tallies more than 5,000 new cases in a single day for the first time. “The coronavirus is serious. It’s spreading,” Texas Gov. Greg Abbott told a local television station.

JUNE 23 – President Trump addresses a crowd of student supporters at a tightly packed megachurch in Phoenix. Trump appeared without a mask, flouting a Phoenix rule that came into force less than 72 hours earlier.

JUNE 26 – VP Pence’s Coronavirus task force hails states for “safely and responsibly” reopening their economies. Yet Texas and Florida officials reimpose restrictions on bars and restaurants amid record levels of new cases and tightening hospital capacity.

JUNE 30 – The E.U. bloc will allow visitors from 15 countries, but the U.S., Brazil and Russia were among the notable absences from the safe list.

JUNE 30 – New York Times data confirms 40,041 U.S. COVID-19 cases.

 

JULY

JULY 2 – Daily number of new COVID-19 cases in the U.S. tops 50,000 for the first time, the largest single-day total since the start of the pandemic.

JULY 2 – The unemployment rate declines by 2.2 percentage points to 11.1 percent, and the number of unemployed persons falls by 3.2 million to 17.8 million.

JULY 2 – GOP 2012 presidential candidate Herman Cain is hospitalized with COVID-19 a week after attending the Trump rally in Tulsa, where many attendees were not wearing masks. 

JULY 5 – President Trump dismisses the impact of COVID-19 and says that while the testing of tens of millions of Americans had identified many cases, “99 percent” of them were “totally harmless.”

JULY 7 – Pres. Trump insists U.S. colleges and universities should remain open for the fall semester, citing several European school openings, “We’re very much going to put pressure on governors and everybody else to open the schools, to get them open.” 

JULY 8 – The U.S. reports more than three million coronavirus cases, with all but a handful of states struggling to control outbreaks of COVID-19.

JULY 10 – The United States reports 68,000 new cases, setting a single-day record for the seventh time in 11 days.

JULY 10 – Hong Kong shuts down its school systems, reporting more than 1,400 cases and seven deaths.

JULY 11 – Disney World reopens its gates in Orlando, Florida.

JULY 11 – President Trump appears with a face mask for the first time in public, five months after administration officials recommended that all Americans wear face masks in public.

JULY 12 – Florida reports a record 15,300 new coronavirus cases, by far the most any state has experienced in a single day.

JULY 13 – The media reports that at least 5.4 million Americans have lost their health insurance during the pandemic. 

JULY 13 – In an apparent attempt to undermine Dr. Fauci’s credibility, a White House official releases a statement saying that “several White House officials are concerned about the number of times Dr. Fauci has been wrong on things.”

JULY 17 – India reports one million coronavirus cases and 25,000 deaths. Researchers at MIT estimate that by the end of 2021, India could have the world’s worst outbreak.

JULY 17 – Israeli Prime Minister Benjamin Netanyahu announces new restrictions on gyms, restaurants and beaches. 

JULY 19 – During a Fox News interview, President Trump again asserts COVID-19 is going to disappear, “I think we’re gonna be very good with the coronavirus. I think that at some point that’s going to sort of just disappear.”

JULY 20 – U.K.’s Oxford University COVID-19 vaccine shows positive results in first phase of human trials.

JULY 21 – European Union leaders agree on a $857 billion spending package to rescue their economies from ravages of COVID-19. 

JULY 21– At his first coronavirus-related news conference in weeks, President Trump admits that COVID-19, “will probably, unfortunately, get worse before it gets better. Something I don’t like saying about things, but that’s the way it is.” 

JULY 23 – U.S. surpasses 4 million reported coronavirus cases

JULY 23 – Trump cancels Republican convention activities in Jacksonville. 

JULY 30 – Second-quarter GDP plunges by worst-ever 32.9% amid virus-induced shutdown.

JULY 30 – Herman Cain succumbs to COVID-19.

 

AUGUST

AUGUST 3 – Trump criticizes Deborah Birx after she warns the U.S. that the coronavirus outbreaks are “extraordinarily widespread.”

AUGUST 5 – Twitter temporarily restricts the Trump campaign’s ability to tweet false COVID-19 claims.

AUGUST 6 – U.S. records more than 52,000 new COVID-19 cases and 1,388 virus-related fatalities.

AUGUST 6 – Ohio Gov. Mike DeWine tests positive for the coronavirus.

AUGUST 26 – Under pressure from the White House, the CDC issues new guidance saying that people who do not exhibit symptoms after being exposed to someone with coronavirus, “do not necessarily need a test.” 

 

SEPTEMBER

SEPTEMBER 9 – Media reports revelations from Bob Woodward’s new book Rage that President Trump purposely minimized the dangers posed by the coronavirus: “I wanted to play it down. I still like playing it down because I don’t like to create panic,” Trump told Woodward.

SEPTEMBER 9 – “The president never downplayed the virus,” White House press secretary Kayleigh McEnany tells the media. 

SEPTEMBER 12 – Media reports that Michael Caputo and Paul Alexander, Trump-appointed officials at the Health and Human Services Department, pressured CDC to “revise, delay and even scuttle weekly reports on the coronavirus that they believed were unflattering to President Trump.”

SEPTEMBER 16 – Caputo takes a leave of absence from HHS after posting a Facebook video accusing government scientists of working to defeat President Trump. Alexander announces his departure from HHS.

SEPTEMBER 18 – Olivia Troye, a top adviser to Vice President Pence and member of the White House coronavirus task force, says the task force recognized by mid-February  that the virus posed a big threat to the United States. “But the President didn’t want to hear that, because his biggest concern was that we were in an election year.”

SEPTEMBER 18 – CDC reverses its August 26 guidance and encourages people exposed to someone with coronavirus to get tested, whether they show symptoms or not. 

SEPTEMBER 22 – The U.S. COVID-19 death toll passes 200,000, accounting for 21% of global deaths.

SEPTEMBER 25 – The number of confirmed U.S. cases passes seven million.

SEPTEMBER 28 – Twenty-one states report increases in cases as health experts warn of a surge in fall pandemic surge.

SEPTEMBER 29 – Seven former commissioners of the federal Food and Drug Administration accuse the Trump administration of distorting science and “eroding public confidence” in the agency. 

SEPTEMBER 30 – Olivia Troye tells NPR that CDC Director Robert Redfield has faced “very challenging dynamics, at times when you’re changing the wording and guidances to fit a narrative, to play down the severity of the virus or cases.”

SEPTEMBER 30 – In the same interview, Troye says President Trump’s refusal to wear a mask in the White House sets the tone for staff: “Even in the West Wing, …you were looked down upon when you would walk by with a mask.”

 

OCTOBER

OCTOBER 1 – White House communications director Hope Hicks tests positive for the coronavirus.

OCTOBER 1 – President Trump hosts a post-debate fundraiser at his golf club, where few attendees wear masks.

OCTOBER 2 – President Trump and First Lady Melania Trump test positive for COVID-19. Later that day the president is taken to Walter Reed National Military Medical Center. 

OCTOBER 2 – Media reports that the official U.S. unemployment rate fell to 7.9% in September. However, the labor force participation was 61.3%, two points lower than in February. 

OCTOBER 4 – President Trump temporarily leaves Walter Reed Hospital for a car ride by supporters stationed outside the hospital.  

OCTOBER 5 – Several Secret Service agents anonymously criticize the president’s “joyride,” saying it exposed members of his security disease to the virus. “He’s not even pretending to care now” said one agent. Said another, “That should never have happened. The frustration with how we’re treated when it comes to decisions on this illness goes back before this though. We’re not disposable.”

OCTOBER 5 – President Trump’s medical team confirms that he will be returning to the White House this afternoon. “Feeling really good! Don’t be afraid of Covid,” the president tweets.

OCTOBER 5 – A Cornell University study identifies President Trump’s Twitter feed as the “single largest” transmitter of false information about COVID-19. Graham Brookie, Director of the Atlantic Council’s Digital Forensic Research Lab, reaches a similar conclusion: “There is no doubt that Donald Trump is by far the largest spreader of specific and important types of misinformation today.” 

OCTOBER 6 – Stephen Miller, President Trump’s top immigration policy adviser, tests positive for COVID-19. 

OCTOBER 6 – The stock market plunges after President Trump tweets that he has instructed his representatives to cease negotiations with Democrats on a new COVID-19 relief and stimulus bill. 

OCTOBER 6 – NIH scientist Rick Bright resigns in protest over President Trump’s handling of the pandemic. “In this Administration, the work of scientists is ignored or denigrated to meet political goals and to advance President Trump’s re-election aspirations,” Bright charges.

OCTOBER 6 – In the Vice Presidential debate, Democratic nominee Kamala Harris says of President Trump’s handling of the pandemic, “The American people have witnessed what is the greatest failure of any presidential administration in the history of our country.” Vice President Pence responds by crediting Trump with “The greatest national mobilization since World War II.”

OCTOBER 7 – In a scathing letter, former CDC director Bill Foege – called the “Babe Ruth of public health” – calls on CDC Director Robert Redfield to publicly acknowledge the administration’s failure to level with the American people over COVID-19. “Don’t shy away from the fact this has been an unacceptable toll on our country. It is a slaughter and not just a political dispute.”

OCTOBER 8 – Senate Majority Leader Mitch McConnell admits he hasn’t been to the White House since August 6th, “because my impression was their approach to how to handle this was different than mine and what I insisted that we do in the Senate, which is to wear a mask and practice social distancing.”

OCTOBER 10 – The government reports a third consecutive day with over 50,000 coronavirus cases, the most since August. 

OCTOBER 11 – On NBC’s Meet the Press, Bill Gates says, “We are running the worst testing system, in terms of who gets access to it, of any country.”

OCTOBER 12 – Dr. Fauci warns COVID-19 is “on a trajectory of getting worse.” The latest data shows infections increasing in 31 states. 

OCTOBER 15 – The New York Times reports show that the autumn coronavirus surge is hitting the Midwest, mountain states and rural communities especially hard. “Of the 100 counties with the worst per-capita outbreaks in the last seven days, more than half are home to fewer than 10,000 people.”

OCTOBER 16 – More than 70,000 new cases of the coronavirus were reported today, the highest single-day increase since July. At least nine states set single-day case records, with Midwest and Mountain West states driving the surge. 

OCTOBER 19 – The Washington Post reports on Dr. Scott Atlas’s attempts to hijack the White House coronavirus task force. “Atlas shot down attempts to expand testing. He advanced fringe theories, such as that social distancing and mask-wearing were meaningless and would not have changed the course of the virus in several hard-hit areas. And he advocated allowing infections to spread naturally among most of the population while protecting the most vulnerable and those in nursing homes until the United States reaches herd immunity, which experts say would cause excess deaths, according to three current and former senior administration officials.” 

OCTOBER 19 – A new Yahoo News/YouGov poll shows that Joe Biden has a built a 19-point lead over President Trump on who would do a better job of handling COVID-19. 

OCTOBER 19 – In a call with campaign staff, President Trump asserts that voters no longer want to hear what U.S. health officials have to say about the pandemic. “People are tired of hearing Fauci and all these idiots,” said. “Every time he goes on television, there’s always a bomb, but there’s a bigger bomb if you fire him. But Fauci is a disaster.”

OCTOBER 20 – Dr. Francis Collins, director of the National Institutes of Health, defends Fauci in an NPR interview. “Tony Fauci is probably the most highly respected infectious disease expert in the world – he’s also a terrific communicator – and I think the public has actually been greatly benefitted by hearing his unvarnished, unflinching descriptions of what’s happening with this pandemic.”

OCTOBER 26 – More than half of US states report their highest single day of new cases in October.

OCTOBER 30 – US surpasses 9 million coronavirus cases, only two weeks after hitting the 8 million case milestone.

 

NOVEMBER

NOVEMBER 6 – White House Chief of Staff Mark Meadows tests positive for coronavirus.

NOVEMBER 7 – Joe Biden is projected to win the electoral college by all major news organizations, but Trump refuses to concede.

NOVEMBER 9 – Pfizer announces vaccine candidate is 90 percent effective in early trials.

NOVEMBER 16 – Early data shows Moderna vaccine candidate is 94.5 percent effective.

NOVEMBER 20 – Biden coronavirus advisory board member says lack of shared information between Trump and Biden’s team is ‘dangerous,’ as Trump continues to block the Biden transition process.

NOVEMBER 20 – Donald Trump, Jr. tests positive for the coronavirus.

NOVEMBER 23 – The General Services Administration officially designates Joe Biden as the president-elect, beginning the formal transition of power.

 

DECEMBER

DECEMBER 1 – US closes out a record-breaking month for coronavirus cases and hospitalizations.

DECEMBER 7 – President Trump’s personal lawyer Rudy Giuliani is hospitalized after testing positive for coronavirus. The 76-year-old has spent the past month traveling around the country as part of his legal efforts to challenge the November election.

 

PODCAST: Scoring a Better Future — Getting Facts on Credit Scores & How They Work

Posted on by The Progressive Policy Institute

Join Paul Weinstein, Jr., Senior Fellow at the Progressive Policy Institute in Washington, D.C., and Joanne Gaskin, Vice President of Scores and Analytics at FICO, for a discussion on the changes FICO has made to its models, and how they may impact credit scores, particularly for millennials and GenZ.

Or listen to the full audio here without a Spotify account:

PODCAST: Scoring a Better Future — Getting Facts on Credit Scores & How They Work

Posted on by The Progressive Policy Institute

Join Paul Weinstein, Jr., Senior Fellow at the Progressive Policy Institute in Washington, D.C., and Joanne Gaskin, Vice President of Scores and Analytics at FICO, for a discussion on the changes FICO has made to its models, and how they may impact credit scores, particularly for millennials and GenZ.

Or listen to the full audio here without a Spotify account:

Looking Back: The Worst Business Cycle Ever For U.S. Manufacturing

Posted on by The Progressive Policy Institute

The 2007-2019 business cycle is now in the books, and even before the pandemic it was objectively terrible for domestic manufacturing. What do we have to do to dig ourselves out, and can policy help?

Economists usually measure business cycles from peak to peak. While the arbiters of business cycles—Business Cycle Dating Committee of the National Bureau of Economic Research—just identified February 2020 as the monthly peak, the peak year is clearly 2019. The previous peak was 2007, just before the financial crisis.

Unfortunately, domestic manufacturers basically staggered through the past 12 years, as measured by output, productivity, and employment. Let’s start with output first. As measured by the Federal Reserve’s industrial production index, manufacturing output fell by 1.3% from 2007 to 2019. To put this in perspective, that’s a worse performance than the Great Depression of the 1930s, when factory output actually rose from the 1929 peak to the next peak in 1937.

Read more here.

Forget the ‘veepstakes’ — Biden should make history with finance picks

Posted on by The Progressive Policy Institute

As COVID-19 takes its toll across a divided nation, bad economic news is pouring in from every corner of the country. Vice President Biden has been here before. He campaigned with President Obama in 2008 as the U.S. economy and Wall Street collapsed. This time, however, it’s Biden’s turn to pick a running mate.

Should he claim victory in November, Biden has pledged to build a top-notch Cabinet that “will look like the country.” That’s important, as diverse voices produce better policy outcomes for everyone.

After promising last month to pick a woman to be his running mate, the former VP has recently gone further, saying he ”would consider announcing some Cabinet members before the election.” While naming actual nominees now would be politically fraught, he should instead pledge to fill some of the high-ranking economic and financial posts – for the first time – with minorities.

The list of high-ranking administration jobs that have yet to see an African American, Latino, Asian or Native American includes secretary of the Treasury, as well as the chairs of the National Economic Council (NEC) or the Council of Economic Advisors (CEA). Most influential of all is chair of the Federal Reserve System, which has been occupied by a woman, Janet Yellen, but never a person of color. Nearly every demographic has been confirmed in some or all of the above-mentioned jobs — men, women, old, young, rich, poor, rural, urban and white. That leaves one glaring exception.

Why is this important, beyond making history and breaking barriers?

First is to acknowledge the reality of demographics. With families of color soon to constitute the majority of the U.S. population, having a Cabinet that better reflects society is a no-brainer. Additionally, while global chronic wealth and income inequality have become a defining issue of our times, and the current crisis is sure to exacerbate it, the truth is, race defines inequality in the United States.

According to the Urban Institute, “In 1963, the average wealth of white families was $121,000 higher than the average wealth of nonwhite families. By 2016, the average wealth of white families ($919,000) was over $700,000 higher than the average wealth of black families ($140,000) and of Hispanic families ($192,000).”

Next is policy. While the agenda will ultimately be the president’s to set, the economic and political actualities of 2021 will most likely entail stimulus schemes and a re-boot of Trump’s tax bill that favored the wealthy and big business. This reality would heighten the importance of having minority representation in the executive posts whose most important function is counseling and devising new policies.

From homeownership and access to capital to retirement, history is rife with well-meaning policy efforts that had unintended consequences because policymakers failed to fully consider how people of all backgrounds would ultimately be impacted.

Prosperity Now (formerly CFED) finds that “more than half of the $400 billion provided annually in federal asset-building subsidies…flow to the wealthiest 5 percent of taxpaying households. Meanwhile, the bottom 60 percent of taxpayers receive only 4 percent of these benefits and the bottom 20 percent of taxpayers receive almost nothing. Black and Latino households are disproportionately among those receiving little or no benefit. Unless key policies are restructured, the racial wealth gap—and wealth inequality in general—will continue to grow.”

As the old saying goes, “personnel is policy.”

Finally, in this day and age, despite any semblance of parity, there are simply too many experienced, successful and knowledgeable women and men of color spread across banking, finance and academia for this streak to continue. To think otherwise is to be ill informed. We simply need the will to make change a priority.

Amid the coronavirus outbreak, the Biden campaign can’t lose focus of the bigger picture. A commitment to an inclusive Cabinet would reflect the spirit of Biden’s campaign. Pledging to start addressing economic justice with the top decision makers at one or two of the top economic and financial policy setting institutions makes sense. The fact that these top tier (and most influential) posts have never been led by a minority is a shame. Pledging to nominate minorities to these positions is an idea whose time has come.

This piece was originally published on The Hill. 

Lawsuits threaten to derail economic recovery

Posted on by The Progressive Policy Institute

As governors start lifting stay-at-home orders, businesses, schools, non-profits and houses of worship are trying to figure out how to reopen safely. A driving concern for many employers has been the fear of getting slapped with lawsuits if their workers or customers contract COVID-19.

It’s a reasonable fear; the pandemic is already inflaming America’s legendary litigiousness. Hundreds of COVID-19 lawsuits have already been filed. Law firms tout their “Coronavirus Litigation Task Force” as they troll for clients. Employees and customers who do not have COVID-19 have sued businesses because they feared they were at risk of catching it. Even some factories deemed “essential” have been labeled “public nuisances” for asking courts to determine the safety measures businesses must take.

Judges are not qualified to make these calls; government health experts are. But we’re in uncharted territory. America has never experienced anything like this pandemic or virus-induced freeze on economic and social activity. The experience over the past three months has been that federal and state public health guidance is vague, variable and sometimes contradictory.

Read the full article here

How a Startup Tax Credit Can Spur Re-Employment

Posted on by The Progressive Policy Institute

As federal and state governments outline plans for reopening the economy, lawmakers will have to grapple with the challenge of getting tens of millions of Americans back to work as quickly as possible.

More than 47 million Americans have filed for unemployment since the pandemic began, with the unemployment rate at 13.3 percent in May.

The economic damage has been inflicted on both the employer and worker sides of the labor market. A mass of businesses have filed for bankruptcy as a result of the lockdown, with the American Bankruptcy Institute finding a 48 percent increase in commercial Chapter 11 filings in May compared to last year.

And many laid off workers will not be able to return to their former jobs. As many as 25 percent of jobs may never come back, Joseph Brusuelas, chief economist at consulting firm RSM, recently told Politico.

Part of the problem is that even businesses that survive the downturn are going to be wary about expanding to fill the market gaps left by their defunct peers. Small businesses, which are naturally less risk-tolerant than their large counterparts and have access to fewer resources, will be especially cautious about growth.

That’s why simply “reopening the economy” won’t put everyone back to work. We also need a strategy for incentivizing existing small businesses to swiftly scale up and make room for rehiring the unemployed.

U.S. policymakers need new tools for revitalizing entrepreneurship and leveraging its potent job-creating abilities. To that end, the Progressive Policy Institute (PPI) has proposed a new Startup Tax Credit that incentivizes entrepreneurs to quickly increase employment at their small companies, giving even existing companies a startup-like boost.

Modeled on the Earned Income Tax Credit, the Startup Tax Credit would be a refundable tax credit tied to the number of employees and payroll at a small business.

Read more here.

COVID-19’s Impact on Communities of Color Sheds Light on Health Care Disparities, Need for Action

Posted on by The Progressive Policy Institute

This week has been a turning point in the United States. I want to make sure you see PPI President and Founder Will Marshall’s statement on the killing of George Floyd, and the commitment PPI is taking to come up with new ideas to fight systemic racism in the United States.

The coronavirus pandemic has had a disproportionate impact on communities of color. Essential workers — in direct care, grocery stores and delivery — are disproportionately Black. Essential workers are more likely to get the virus because their jobs don’t lend themselves to social distancing and working from home. Further compounding the damage the virus has caused, people who have lost their jobs are also more likely to be Black, particularly hurt are Black women of whom almost 19 percent lost their job since February.

The virus has also laid bare disparities in health status by race in the United States. Black Americans are 3.5 times as likely to die from Covid-19 than white Americans. This is partly because the virus is more lethal to people with underlying health conditions and people of color are 1.5 to 2 times more likely than white Americans to have chronic diseases, like type 2 diabetes and obesity because of systemic barriers to housing, income and education which all affect health status.

Solving racial discrimination in medicine is not an easy task. It is built upon years of systemic racism, reasonable distrust, and unconscious biases of medical practitioners.

But there are some policy levers that could help.

Make health insurance more affordable. Cost is the main reason people remain uninsured. Even before the Covid-19 pandemic, Black workers were 60 percent more likely than white workers to be uninsured. By focusing on ways to bring down health care costs — such as introducing a price cap on medical care and increasing subsidies for Affordable Care Act health plans — insurance will be more affordable for all Americans.

Address social determinants of health. Insurance coverage is a first step but it will not by itself address racial disparities in health. Health status is a product of more than medical care — things like safety, housing, education, transportation, and nutrition all impact a person’s health. Federal agencies like the departments of education, health, and housing should collaborate to create new programs to ensure that people get not just health care, but also the housing, education, and other things that health outcomes depend on. To have additional funding for these types of programs, it is paramount to lower overall health care spending. States should also have greater flexibility to spend Medicaid dollars on housing and other social determinants that can reduce health care expenditures.

Address bias in medicine. Health care workers need to better understand the ways in which implicit and explicit bias can affect the care they provide in order to counteract centuries of racism. Sen. Kamala Harris’s Maternal CARE Act, and the accompanying House version, would authorize $150 million to programs that seek to help medical professionals identify high-risk pregnancies and establish implicit-bias training curriculum for medical schools. This type of training should be taught across all disciplines.

Make health care workers more reflective of the population. A more diverse workforce can improve outcomes for Black Americans. Using existing programs like the National Health Service Corps, which provides loan forgiveness and scholarships to workers who practice in underserved areas, the federal government could recruit more medical and nursing students from minority communities. Additionally, boosting funding to medical schools at historically black colleges and universities could increase the number of Black physicians and nurses.

Make scientific research more inclusive. In 2009, the NIH changed its grant review process in an effort to make it more racially equitable yet a new study finds that between 2014–2016, only 10 percent of Black applicants got NIH funding, compared to around 19 percent of white applicants. On the flip side, Black Americans are overrepresented in clinical trials that don’t require informed consent and underrepresented in cancer clinical trials. Undoing these racial disparities in scientific research will help improve the practice of medicine.

Read the full article here

Tackle unemployment, trade, manufacturing and environment: Invest in green infrastructure

Posted on by The Progressive Policy Institute

More than 42 million workers have filed unemployment claims during the coronavirus pandemic, the jobless rate is over 13% and minorities are bearing a disproportionate share of the economic pain, just as people have taken to the streets to protest racial injustice — but there’s a clear path forward for America. We must create millions of new jobs by investing in an infrastructure-led recovery through federal legislation.

Just as we did in the 1930s New Deal and the 1950s Interstate Highway System, in the 1960s through NASA and in the 2009 American Recovery and Reinvestment Act, we can rebuild the foundation of America’s economic future while creating millions of jobs today.

To be most effective at helping workers, such economic recovery and infrastructure legislation should include large investments in clean manufacturing, which will be the fastest growing manufacturing sector in coming years, attracting $10 trillion in investment globally by 2050. A new report from the Progressive Policy Institute finds that means putting Americans to work building tens of millions of new electric vehicles, charging stations, and creating advanced electric grids, as well as upgrading our roads, bridges, high-speed internet, ports, and public transport.

Read the full article here

Guest Column: America’s Top Colleges Are Karens

Posted on by The Progressive Policy Institute

This is a guest column by Ryan Craig.

My stepsister is a lovely person, but she has the great misfortune of being named Karen. When she was born back in 1971, Karen was the 15th most popular name for girls. No one’s exactly sure when the name Karen began to go downhill – my guess is Lorraine Bracco’s portrayal of entitled mob wife Karen in Goodfellas – but in the fast-moving world of social media and memes, Karen has become the insult of choice for entitled people who demand to speak to the manager to sustain their privilege. It’s no longer cool to be a Karen and I’ve taken it upon myself to send examples to my stepsister. Her response is generally one of befuddlement, most recently “what is this baloney?” (an American processed meat popular around the same time as the name Karen).

The Karen-ization of Karen reached its apex two weeks ago when a white woman called the police on an African-American birder in Central Park. Even though the privileged perpetrator’s name is Amy, “Central Park Karen” began trending. Karen has now become shorthand not only for blatant assertions of privilege, but also reinforcing social inequality and racism, as underscored by the tragic death of George Floyd and the resulting national explosion of frustration and anger. In response, a friend tweeted that his bumper sticker for the remainder of 2020 would be: A Little More Carin’, A Little Less Karen. I told him if he produced it, I’d give one to my stepsister.

Last month Washington Monthly reported that elite and wealthy business schools like Northwestern, MIT, Columbia, and Cornell are refusing to grant deferrals to international students concerned about paying full price for what could very well be an online MBA, and also refusing to return deposits to students who withdraw. And just as the University of Southern California was making scandalous national news (again) as Full House’s Aunt Becky and her designer husband admitted committing fraud to get their two daughters in, USC announced it was raising tuition 3.4% for next year and, simultaneously, that it would not provide any discounts if classes are held online. I read this while wearing my favorite new T-shirt (You can’t spell “suck” without USC), and a question crossed my mind: are America’s top universities becoming Karens?

When I wrote A New U: Faster + Cheaper Alternatives to College, I was worked up about the poor employment outcomes of recent graduates and predicted that non-selective colleges and universities that continued to ask students to take on unaffordable levels of debt to pay for tuition, fees, and living expenses were in for a rude enrollment awakening. As Kevin Carey pointed out last week, Covid-19 has thrown gasoline on this dumpster fire and most leaders at mere mortal institutions recognize the world has changed. But even in a faster + cheaper world, F. Scott Fitzgerald informed my view: “Let me tell you about the very rich [universities]. They are different from you and me.” Elite colleges and universities would innovate at the margins, perhaps playing with integrated experiential learning and digital credentials, but remain largely unchanged – a monument to America’s isomorphic college ideal, continuing to attract the most talented and promising students to gothic parklands. But no one anticipated a faster + cheaper + Covid world.

***

Prior to Covid, top universities were already braving unprecedented headwinds. The perception that elite universities were less engines of socioeconomic mobility than brakes gave rise to candidate Bloomberg’s plan to ban legacy admissions (a position also supported by Tony Carnevale in his upcoming book), and to New America’s proposal to mandate lottery-based admissions. Recrimination from left and right coalesced in the first ever endowment tax – a 1.4% annual excise tax on colleges and universities that is costing Stanford $43M and Harvard $38M annually.

Now Covid is shining a blazing spotlight on inequality and racism. The economic and racial gap between haves – who can work remotely and who’ve only experienced inconvenience – and have-nots – who have been risking their lives by showing up at work to keep the country running, and getting sick, and showing up at hospitals, and dying – has never been more stark; it is now clear that social distancing is a luxury much of America cannot afford. Selective schools have made some progress increasing enrollment of low income Pell-eligible students, but no elite college or university has put forth a compelling narrative as to why it – in its current form – should be considered a solution rather than a Karen flaunting exclusivity and perpetuating inequality. It’s a tricky argument for elite institutions to make. But, like Karen, they haven’t really tried. 60% of students at selective colleges come from top quartile income families ($115k+ annually). In recent years, legacies have constituted more than one-third of each class at Ivy League schools; Harvard’s Class of 2022 is over 36% legacy. Carnevale calls it “an inequity machine that raises and perpetuates class and race hierarchies and sinks the lower classes.” As young Americans have always had a knack for spotting and rebelling against insincerity, the more Covid reveals elitism’s dark underbelly (i.e., inequality), the harder it will become for top universities to continue to attract the best talent.

The privileged insincerity of our top universities is equally clear in their immediate response to Covid. If Harvard were put on trial for continuing to charge full tuition for Zoom U. in March, April, and May, a clever lawyer would force America’s richest university to admit that either: (1) the last three months did not constitute an education worthy of the Harvard name; or (2) Harvard could easily scale enrollment by a factor of 10. Re: #1, the quality of Zoom courses was apparently pretty good. According to an internal Yale survey, 80% of Yale College faculty said their remote courses were good, very good, or excellent after only the first week. And whether correctly, or out of pride or greed, none of the richest colleges and universities that could have afforded to provide discounts offered to do so.

Re: option #2, I argued just ahead of Covid’s arrival that top universities had a moral responsibility to expand geometrically rather than linearly at $625,000 per seat (or in Harvard’s case not at all). Zoom U. demonstrated it’s possible. According to the Yale Alumni Magazine, as Jay Gitlin’s course Quebec and Canada from 1791 to the Present neared the end of a long and winding road, a student’s grandfather popped into the frame to say that, as the course was now available here, there and everywhere in this helter skelter world, he was very grateful to be able to get back several times a week and attend alongside his grandson. The grandfather was none other than Sir Paul McCartney, proving America’s top universities have the capacity to teach many more students, knighted and benighted alike.

***

Elite universities purport to provide students with a bundle of education/skills, college experience, and a branded credential that helps them stand out in the labor market. Not long ago, this bundle commanded unrivaled respect, like Karen at the country club in the 1970s and 80s. But no longer.

One reason is that digitization of the economy, entry-level employment, and the hiring process make it increasingly likely that program of study is a more powerful lever for future employment and income than attending an elite university, particularly ones that fail to prioritize STEM and digital skills; a new AEI study from Joe Fuller and Frederick Hess shows that four years after graduation, median salaries aren’t materially higher for graduates from top schools. A second is that at least for the foreseeable future, the elite college experience will be constrained by social distancing and grab-and-go meals (and a concomitant volume of plastic waste that will be hard for students to swallow). And reductions in campus dining and housing will most significantly impact lower income and underrepresented minority students, further hindering equality on campus. But the biggest challenge may be that thousands of brands are capable of signaling talent and prestige in a less Karen-like manner. A recent survey revealed that to launch a successful career, 60% of Americans would opt for a Google internship over a Harvard degree.

NYU celebrity prof Scott Galloway has gotten a lot of digital ink predicting MIT will partner with Google to launch a category killer STEM degree. While this would go a long way to combatting Karen-ization, no one has ever gone broke betting against the pace of change in higher education. And I’m pretty sure no one has ever lost a single bet betting against change at elite institutions. Outside of the forward-thinking (but not rich) London School of Economics, real online credentials with partners like 2U – distinct from the asynchronous safety and plausible deniability of Coursera and edX courses – remain limited to select graduate and professional degrees (and with limited enrollment). Meanwhile, the Karens of higher education view the current Zoom school experiment as perhaps a decade’s worth of innovation. As a result, with few exceptions (most notably Davidson College President Carol Quillen’s plea to “dramatically expand capacity using every tool we have to reach many more people at dramatically lower cost”), the focus of current leadership is how quickly they can return to their cloistered campuses.

So I fear @profgalloway is wrong about MIT@Google, iStanford, and HarvardxFacebook, just as he’s wrong in believing that the missing link is a multi-year degree program, and wrong in resurrecting that old chestnut that star professors (or in Galloway’s parlance, the 6-12 “ringers” at each university “who are worth it” – presumably he’s one) “will see their compensation rise as much as 10x over the next decade” as a result of online delivery. (He’s probably also wrong to identify himself on LinkedIn as a “Clinical Professor of Marketing.” I’m not sure what clinical marketing is, but if he’s not joking, I’ll dream of a future NYU appointment as Clinical Professor of Private Equity.)

What @profgalloway isn’t wrong about is that Google has a powerful brand, perhaps more powerful than any of higher education’s Karens when it comes to the things today’s students care most about – first and foremost, a clear pathway to a good first job. Ironically, @profgalloway could look closer to home for a working model. NYU has already launched faster + cheaper pathways to careers in the music industry (in partnership with Billboard Magazine, a highly relevant brand) and in the sports industry. These programs guide students through the core elements of the industry – in the case of music, production, performance, business, and technology – and give them a better chance to begin making a living doing what they love than most multi-year degrees, at a tiny fraction of the time and cost. The programs are orchestrated by Yellowbrick, which also offers last-mile training in beauty (FIT, Allure, Bobby Brown, L’Oreal), sneakers (FIT + Complex Media), streetwear (Parsons + Complex Media), and other industries with other brands.

While USC and other top schools may look at what NYU is doing and ask to speak to the manager, NYU is demonstrating that elite doesn’t have to be inconsistent with access and equality. In a post-Covid world, NYU is on the right track. You’re either dramatically expanding capacity using every tool you have to reach many more people – especially black and brown Americans – at dramatically lower cost, or you’re a Karen. And the Karens of higher education should steel themselves for staggering penalties from not-too-distant-future governments, as well as from the market. Because no one wants to enroll at Karen U., even one with a $40 billion endowment.–

Reality bites Trump back

Posted on by The Progressive Policy Institute

Donald Trump is a wretched president but a master illusionist. His greatest skill isn’t solving real-world problems. It is concocting “alternative facts” that allow his supporters to evade unpleasant realities.

Now, however, the president is beset by three intractable realities even he can’t disguise or spin: a deadly virus, an inert economy with mass unemployment, and public outrage over racist cops.

His bungling of the coronavirus pandemic has cost tens of thousands of American lives and prolonged a job-killing economic freeze. These painful realities have penetrated the make-believe world of Trumpistan, in which an infallible Trump valiantly battles the forces of darkness: the media, the “deep state,” immigrants, Democrats, socialists, faithless allies, etc.

Reality has bitten back, and Trump is flailing. His path to reelection this fall has suddenly become much steeper, and he is desperately looking for a political lifeline. Trump imagines he has found it in the vandalism and looting that have accompanied nationwide protests over the killings of George Floyd and other black Americans by police.

Read the full article here

Medicaid Will Be Crucial Safety Net in COVID-19 Crisis

Posted on by The Progressive Policy Institute

Introduction

The coronavirus pandemic has not deterred President Trump and Republicans from trying to kill the Affordable Care Act (ACA), which would strip millions of Americans of health care coverage at the worst possible time. However, Medicaid — significantly strengthened in the ACA — will be a lifeline for the country during this crisis.

The pandemic and the related economic downturn have already led over 40 million people to file jobless claims. Estimates of the number of Americans who may be joining the ranks of the uninsured range from 18 million (1) to 25 million (2) to as high as 45 million. (3)

This is in addition to the 28 million people who were uninsured prior to the COVID-19 pandemic. In a new survey from the Kaiser Family Foundation on the impact of the current crisis, “55 percent of Americans say Medicaid is personally important to them and their families and about one in four adults (23%) who are not currently on Medicaid say it is likely they or a family member will turn to Medicaid for health insurance in the next year.”(4)

However, the safety net provided by Medicaid will differ dramatically depending on where you live. People who live in states that embraced the ACA’s Medicaid expansion will be a lot better off than those who don’t. Since the Supreme Court made Medicaid expansion optional in 2012, 36 states and the District of Columbia have accepted the expansion. (5)

Before the pandemic struck, states that expanded Medicaid covered over 35 percent of unemployed adults compared to just 16 percent in non-expansion states.” (6) Now, the Urban Institute and the Robert Wood Johnson Foundation estimate that about 47 percent of those who have lost their job-based insurance will receive coverage from Medicaid. (7)

The Kaiser Family Foundation estimated a similar 50 percent. (8) Drilling down more specifically, in expansion states, 53 percent of those losing employer insurance are expected to turn to Medicaid, while 23 percent will remain uninsured (the rest will be eligible to purchase insurance on the ACA exchanges). (9) In non-expansion states, just 33 percent will receive Medicaid and 40 percent will likely wind up  uninsured. (10)

In Texas alone, the largest state that declined to expand Medicaid, an estimated 1.6 million individuals have lost their employer-provided health insurance. About half of them will wind up without health care coverage because they will earn too much income to join Texas’ Medicaid program and too little income to be eligible for ACA subsidies for the exchanges. For the country as a whole, over one-quarter of individuals falling into that coverage gap will be in Texas. (11)

The Urban Institute estimated the state by state effects of different unemployment scenarios on insurance coverage. (12) Taking two states from this analysis, New York and Florida, allows us to more clearly understand the fate of people who lose their jobs and employer-provided health care insurance in expansion states vs. those in non-expansion states.

Under a projection of 20 percent unemployment, New York (an expansion state) and Florida (a non-expansion state) are both estimated to see around 1.5 million people lose their job-based coverage. In New York, 923,000 are projected to gain Medicaid coverage (61 percent) with 282,000 left uninsured (19 percent). In Florida, only 475,000 would gain coverage (31 percent) with 581,000 (38 percent) left uninsured. (13) (See Figure 1)

 

MEDICAID EXPANSION UNDER THE ACA

Medicaid has always been a crucial backstop for low-income families with children. In addition, Medicaid spending goes up when the economy turns down, making it an important part of the government’s suite of countercyclical tools for mitigating recessions. Before the coronavirus pandemic appeared, Medicaid provided insurance for one in five Americans and about 40 percent of children.

Prior to expansion in 2013, Medicaid targeted coverage to children in low-income families and some low-income parents. The expansion in the ACA included childless adults, making Medicaid a true safety net program for low-income Americans. The program now largely covers anyone with annual income below 138 percent of the federal poverty line (in 2020 that is $17,236 for an individual). About 13 million people have received Medicaid coverage in the expansion states. Since 2013, 21 of these states saw increases in Medicaid enrollment of at least 25 percent. (14) In non- expansion states, says the Kaiser Family Foundation, “eligibility levels for parents remain very low, often below half of poverty, and, with the exception of Wisconsin, other adults are not eligible regardless of their incomes.” (15)

The best way to mitigate a Covid-19 induced explosion of uninsured Americans would be for the 14 outlier states to expand their Medicare programs under the ACA. Unfortunately, this is unlikely to happen since the reasons for not expanding up until this point have been partisan and ideological, not related to the underlying levels of uninsured in the states or state budget problems.

In fact, Medicaid expansion is a good deal for the states, since the federal government picks up 90 percent of the costs. And it’s worth recalling how shortsighted the 14 states were in rejecting expansion initially given the desperate need now — especially considering the federal government promised to pay for 100 percent of costs for the first three years.

It is true that the remaining 10 percent contribution would now be a difficult lift given the pandemic-induced fiscal crises in most states. Congressional Democrats should thus propose returning to the 100 percent inducement for expansion in upcoming negotiations over further federal aid. (16)

STATE BUDGETS NEED HELP

The amount of economic suffering in general, and availability of Medicaid as a comprehensive safety net specifically, will also depend on whether national leaders enact further economic relief legislation. The Congressional Budget Office (CBO) projects that if Congress fails to pass additional economic support, even by the end of 2021 there would still be 10 million more unemployed than before the crisis.

The nation’s leaders must take further action and their top priority should be aid to state and local governments. With most businesses closed, state sales tax revenues are falling off a cliff even as costs for unemployment insurance and health care are exploding. PPI estimates that state and local governments will need between $445 and $835 billion in additional federal support between now and the end of 2021. (17)

Without that support they will be forced, by state balanced budget requirements, to cut employees and services, and to raise taxes — both of which would prolong the economic downturn. That, in turn, would mean many more people will lose their jobs and the ranks of the uninsured will swell.

And, it means pressure on Medicaid — often the largest and fastest growing expense in a state’s budget (in 2019, estimated at 30 percent of total state spending across all states). (18) States have reported the near certainty of Medicaid budget shortfalls and some have already begun cutting by hundreds of millions of dollars. (19)

Given the centrality of Medicaid as a comprehensive health care safety net for those with low incomes and those who have lost their employer-provided health insurance, states’ abilities to administer and maintain robust programs will be incredibly important for people for as long as the Covid-19 crisis lasts.

House Democrats have passed a $3 trillion relief bill, the HEROES Act, that whatever its flaws, (20) includes around $900 billion for state and local governments. The Trump administration and Senate Republicans, however, are balking at providing further aid.

It is worth noting that in the “Families First Coronavirus Response Act,” the second piece of emergency legislation passed so far, there was a small and restricted increase in aid-to-states funneled through the federal government’s Medicaid funding system. Importantly, this funding included Medicaid  maintenance of effort” requirements. In exchange for taking the funding, states had to agree to not cut people already from the state’s Medicaid rolls or impose new restrictions on who is eligible to receive benefits. States are then bound by these requirements for as long as the health emergency lasts. (21)

Making sure those requirements are not watered down or eliminated in future relief bills will be essential. Nonetheless, given the enormous funding challenges states face, and the amount of jobless people now requiring health care insurance, Medicaid beneficiaries will still be at risk over the longer term. Studying the effects of the Great Recession, Rice University researchers found that, despite maintenance of effort requirements,

“On average, states suffered a $222 per capita negative revenue swing in 2009, which in the long term led to a $64 cut in Medicaid spending per child beneficiary, a 1 percent reduction in the number of elderly people enrolled in Medicaid and an $82 per capita cut in long-run state education spending. Such cuts are sobering, given that other economists have found that Medicaid coverage is effective in reducing infant and child mortality.” (22)

What’s more, the Trump administration and Republican state leaders in recent years have been probing the edges of legality to cut their Medicaid rolls, impose new restrictions on eligibility, and to cut Medicaid benefits. (23) So there is always a threat to this crucial safety net program – especially in the Republican-led states who have yet to expand their programs.

CONCLUSION

The Covid-19 crisis is far from over. Thanks to the ACA’s expansion of Medicaid, the program is poised to provide a crucial backstop for millions of Americans who have lost their jobs and their health coverage. For those who happen to live in the 14 Republican-dominated states that did not expand Medicaid, however, the picture looks bleak.

Medicaid expansion started out as the less-flashy, sometimes forgotten achievement of the ACA. It was originally projected to insure substantially less people than the ACA’s insurance exchanges and it built on an existing program, so it didn’t suffer from a website meltdown or a new, broadly unpopular “mandate” — which were certainly attention grabbing. But, there was also the fact that it focused support on low-income, childless individuals – a class of Americans often overlooked by national policymakers.

More attention was paid to the expansion’s success when Republican bills to “repeal and replace” the ACA were debated and failed — in part, because even Republicans had a hard time swallowing the huge numbers of people who would lose Medicaid coverage in their states. (24)

Ultimately, during the decade since passage of the ACA, those with insurance from the Medicaid expansion have outnumbered those getting insurance through the private market insurance exchanges. (25) As both ramped up during the 2013-2016 period, they insured roughly the same amount annually (reaching 13 million each by 2016). Since 2017, Medicaid expansion has maintained enrollment, while enrollment in the exchanges has shrunk by about 3 million people (largely due to Trump Administration
sabotage). (26)

The ACA’s Medicaid expansion is a sterling example of a federal government program accomplishing what it set out to accomplish. Now, progressive supporters of the ACA should focus on two critical goals. The first is passing federal aid to state and local governments, which will relieve pressure for cutting back on Medicaid during the pandemic. This step is supported by bipartisan majorities, who are also specifically averse to cutting Medicaid as a means of addressing upcoming budget shortfalls. (27) The second goal should be to build public pressure on the 14 recalcitrant states to put the needs of their citizens for health coverage over partisan enmity.

Authored by Josh Gordon, Ph.D., Senior Health Care Policy Fellow

PPI_Medicaid-Will-Be-Crucial-Safety-Net-in-Covid-Crisis

References

1 University of Minnesota, “As many as 18.4 million Americans face disruption, loss of health insurance in pandemic,” MedicalXpress, April 28, 2020. https://medicalxpress.com/news/2020-04-million-americans-disruption-loss-health.html

2 Garrett, Bowen and Anuj Gangopadhyaya, “How the COVID-19 Recession Could Affect Health Insurance Coverage,” Urban Institute and Robert Wood Johnson Foundation, May 4, 2020.
https://www.urban.org/research/publication/how-covid-19-recession-could-affect-health-insurance-coverage

3 Urban/RWJF projected the amount of uninsured at different levels of the unemployment rate and developed a baseline and high scenario for each. In this paper, I used their 20 percent unemployment rate analysis and their baseline (25 million) scenario not their high (45 million) scenario.

4 KFF Health Tracking Poll – May 2020. Published May 27, 2020. https://www.kff.org/report-section/kff-health-tracking-poll-may-2020-health-and-economic-impacts/

5 Nebraska, one of the 36 states, has adopted the expansion but isn’t scheduled to implement until October 1, 2020. See also the AdvisoryBoard, “Where the states stand on Medicaid expansion,” January 13, 2020, https://www.advisory.com/daily-briefing/resources/primers/medicaidmap

6 Center on Budget and Policy Priorities, “Larger, Longer-Lasting Increases in Federal Medicaid Funding Needed to Protect Coverage,” May 5, 2020. https://www.cbpp.org/research/health/larger-longer-lasting-increases-in-federal-medicaid-funding-needed-to-protect. And Anuj Gangopadhyaya and Bowen Garrett, “Unemployment, Health Insurance, and the COVID-19 Recession,” Urban Institute, April 2020.

7 Garrett, Bowen and Anuj Gangopadhyaya, “How the COVID-19 Recession Could Affect Health Insurance Coverage,” Urban Institute and Robert Wood Johnson Foundation, May 4, 2020. https://www.urban.org/research/publication/how-covid-19-recession-could-affect-health-insurance-coverage

8 Garfield, Rachel, et. al. “Eligibility for ACA Health Coverage Following Job Loss,” Kaiser Family Foundation, May 13, 2020. https://www.kff.org/coronavirus-covid-19/issue-brief/eligibility-for-aca-health-coverage-following-job-loss/

9 Park, Edwin, “New Urban Institute State-Level Health Coverage Estimates as Unemployment Rises,” Georgetown University Health Policy Institute Center for Children & Families (CCF), May 5, 2020. https://ccf.georgetown.edu/2020/05/05/new-urban-institute-state-level-health-coverage-estimates-as-unemployment-rises/

10 ibid.

11 Johnson, Kim and Dallas Williams, “1.6M Texans Lost Employer-Sponsored Health Insurance Because Of The Pandemic,” Texas Public Radio, May 26, 2020. https://www.tpr.org/post/16m-texans-lost-employer-sponsored-health-insurance-because-pandemic

12 Garrett, Bowen and Anuj Gangopadhyaya, “How the COVID-19 Recession Could Affect Health Insurance Coverage,” Urban Institute and Robert Wood Johnson Foundation, May 4, 2020.

13 ibid. Author calculations based on study.

14 The Medicaid and CHIP Payment and Access Commission, “Medicaid enrollment changes following the ACA,” Accessed on February 24, 2020, https://www.macpac.gov/subtopic/medicaid-enrollment-changes-following-the-aca/

15 Artiga, Samantha, Robin Rudowitz and MaryBeth Musumeci, “How Can Medicaid Enhance State Capacity to Respond to COVID-19?,” Kaiser Family Foundation, March 17, 2020. https://www.kff.org/medicaid/issue-brief/how-can-medicaid-enhance-state-capacity-to-respond-to-covid-19/

16 The SAME Act from Democratic Senators Doug Jones (AL), Mark Warner and Tim Kaine (VA) is one ready-to-go option. https://www.modernhealthcare.com/government/senate-bill-wants-sweeten-deal-states-expand-medicaid

17 McDermott, Brendan, Interactive Calculator: How Much Federal Support Do State and Local Governments Need?,” Progressive Policy Institute, May 7, 2020. https://www.progressivepolicy.org/publications/interactive-calculator-how-much-federal-support-do-state-and-local-governments-need/

18 National Association of State Budget Officers, “State Expenditure Report,” https://www.nasbo.org/reports-data/state-expenditure-report

19 Zeballos-Roig, Joseph, “3 cash-strapped states are making deep cuts to Medicaid as coronavirus devastates their budgets — and millions of jobless people lack health insurance,” Business Insider, May 6, 2020. https://www.businessinsider.com/states-medicaid-cuts-coronavirus-devastates-economy-budgets-ohio-dewine-2020-5

20 Ritz, Ben. “House HEROES Act Gets The Trade-Offs Wrong,” Progressive Policy Institute, May 15, 2020. https://www.progressivepolicy.org/projects/center-for-funding-americas-future/house-heroes-act-gets-the-trade-offs-wrong/

21 Aron-Dine, Aviva, “Medicaid ‘Maintenance of Effort’ Protections Crucial to Preserving Coverage,” Center on Budget and Policy Priorities, May 13, 2020. https://www.cbpp.org/blog/medicaid-maintenance-of-effort-protections-crucial-to-preserving-coverage

22 Rice University, “State revenue declines lead to cuts in children’s Medicaid benefits, education spending, Rice experts say,” May 11, 2020. https://news.rice.edu/2020/05/11/state-revenue-declines-lead-to-cuts-in-childrens-medicaid-benefits-education-spending-rice-experts-say/

23 See Gordon, Joshua, “Getting Back to Basics on Health Care,” Progressive Policy Institute, March 2020. https://www.progressivepolicy.org/publications/getting-back-to-basics-on-health-care/

24 ibid.

25 Author’s calculations based on the regularly updated Congressional Budget Office report “Federal Subsidies for Health Insurance.”

26 ibid.

27 KFF Health Tracking Poll – May 2020. Published May 27, 2020. https://www.kff.org/report-section/kff-health-tracking-poll-may-2020-health-and-economic-impacts/

Statement by PPI President Will Marshall

Posted on by The Progressive Policy Institute

As someone who grew up in the Jim Crow South, I know that progress toward racial justice and concord is possible in America. I’ve seen it happen. I also know that social progress is neither linear nor inevitable. Progress stalls, people backslide, old prejudices find new ways to express themselves. Even well-intentioned Americans lose focus, become complacent and stop grappling with the legacy and persistence of racism in our country.

The depraved killings of George Floyd, Ahmaud Arbery, Breonna Taylor and too many more black Americans remind us that we can never stop struggling for racial justice. The PPI community is aggrieved and sickened by these deaths, and by the despicable conduct of a president who stokes racial fear and animosity for political gain. Our hearts go out to the families of the victims, and to all African-American citizens who worry with reason about their safety and that of their families.

In coming weeks, PPI will work to develop new ideas for tackling the systemic racism that seems so stubbornly embedded in the nation’s institutions. 

We also encourage you to read these heartfelt words by former President Bill Clinton, who has never lost faith in America’s ability to keep moving forward towards racial justice and reconciliation.