The President’s address to Congress is an opportunity to highlight Covid-19 treatments

The United States broke records with the swift development and distribution of new Covid-19 vaccines, but after the Trump administration’s hydroxychloroquine debacle, the focus on treatments was pushed to the side. President Biden has acknowledged that even with the new vaccines, the Covid-19 pandemic will likely linger throughout the year. To save lives, we’ll need to increase access to evidence-based treatments by educating the public, restructuring treatment facilities to handle Covid-positive patients, and helping patients navigate the health care system. Federal leadership will be essential to meet these goals.

President Biden has spent the first few weeks of his presidency ramping up Covid-19 response efforts. He signed an executive order requiring mask-wearing in all federal buildings, called for a $1.9 trillion economic recovery package, and pushed to increase vaccinations to 1.5 million per day. But one thing he hasn’t drawn a lot of attention to is treating patients with Covid-19 infections.

Even as new cases have plummeted in recent weeks, more than 1,000 Americans per day are dying from Covid-19. And because the country isn’t likely to return to ‘normal’ until the end of the year, it’s important to not lose sight of the important role effective Covid-19 treatments can play in reducing unnecessary deaths. Two drugmakers – Eli Lilly and Regeneron – have developed monoclonal antibody therapies that lessen the effects of Covid-19 on high-risk patients. Increasing access to these treatments will save lives.

Next week at his State of the Union address, President Biden will emphasize his Covid-19 recovery plan. He should use the bully pulpit of the presidency to emphasize that evidence-based therapies are available to people who get infected.

Recent research from Baylor University Medical Center published in the Journal of the American Medical Association found that monoclonal antibodies reduced hospitalizations among high-risk Covid-19 patients. However, to be effective, it was important that these high-risk patients – those over 65 or with obesity or diabetes or immunocompromised – received the therapy early in the course of their illness. This means that doctors need to be aware of and prescribe the treatment and patients need access to infusion facilities since the drugs are delivered intravenously within the first 10 days of symptoms. 

Yet uptake of these effective therapies remains low. There are four main hurdles:

  1. With everchanging clinical guidelines for Covid-19, many physicians aren’t aware of the efficacy of these new treatments and thus aren’t prescribing them to patients
  2. Stand-alone infusion centers require referrals from physicians and may be hesitant to accept Covid-positive patients
  3. Hospitals are overburdened with critically ill Covid-19 patients and vaccination efforts and haven’t set up out-patient infusion centers where patients can easily be treated
  4. It’s difficult to identify and treat patients within the 10-day window from the onset of symptoms

There are steps the new administration can take to improve access to these therapies which will in-turn save lives and lessen the impact of the pandemic. 

First, the Centers for Disease Control and Prevention (CDC) should work with state licensing boards to ensure the timely dissemination of clinical information to providers on the ground. Because guidelines are evolving as we learn more about Covid-19, it’s important that there are clear communication channels to get information to individual providers across all states. While it makes sense for the CDC to act as a central gathering place of information, providers should not have to be checking the CDC website daily in order to stay up to date.

Second, infusion centers need to adapt to Covid-19. Given the importance of receiving treatments within 10 days of the onset of symptoms, infusion centers need to update their practices to expedite the treatment process. That might mean working to build relationships with individual providers so that they know where to refer Covid-positive patients and changing their protocols to accept walk-ins without appointments. They also need to make sure they have the infrastructure needed to treat Covid positive patients and keep them separate from patients receiving other types of infusions. 

Third, as daily cases have dropped, hospitals should shift their focus from treating Covid-19 inpatients patients to helping treat Covid-19 patients in the outpatient setting. Typically, hospital infusion centers are for administering cancer drugs. Restructuring infusion facilities so that they can be safe for Covid-positive patients and cancer patients will be an important step to getting more people treatment.

Finally, contact tracing, testing and diagnosing Covid-19 patients in a timely fashion remains as important as ever. Patients need to know they are Covid-19 positive within a few days in order to be able to benefit from monoclonal antibody therapies. Continued investment in contact tracing and testing will make fast diagnoses possible. But after a patient receives a positive Covid-19 test either from a doctor’s office, public testing site, or a pharmacy, there needs to be a pipeline to a care provider and treatment, if needed. Monoclonal antibody therapies require a prescription and a referral and often patients will have to drive to an infusion site. Making sure the patient is easily transferred between care sites will be vital to timely access to treatment.

There is no question that the pandemic is improving. But with President Biden’s admission that Covid-19 is likely to drag on in the coming months, it is vital that people know more about treatment opportunities. Monoclonal antibody therapies are out there and should be available to everyone — not just the well-informed health care consumer or the elites. The president has made effective use of his bully pulpit to encourage mask-wearing and vaccinations. He should do the same with Covid-19 therapies.

This blog was also published on Medium.

Biden should ease access to key opioid treatment

From May 2019 to May 2020 the CDC reported over 81,000 overdose deaths from opioids in the United States, the biggest annual death toll to date. In a belated effort to mitigate the crisis, the Trump administration changed regulations to make it easier to access the opioid treatment drug buprenorphine in the waning days of his presidency. But the new Biden administration has reversed those changes because of legal concerns over the way the Trump administration implemented the policy.

The Trump changes were released amidst the chaos of the Capitol insurrection. When Elinore McCance-Katz, the health and Human Services (HHS) assistant secretary for mental health and substance use, resigned in the aftermath of the riots, the White House quickly appointed a replacement who greenlighted new “clinical guidelines” that made it easier for physicians to prescribe buprenorphine. McCance-Katz had refused to push these changes forward during her tenure. McCance-Katz had favored more safeguards to prevent buprenorphine from being overprescribed in fear of the drug starting a new epidemic of its own. 

Buprenorphine is one of three pharmacological treatments for opioid use disorders and is considered the easiest tolerated of the options. It has been shown to reduce overdose mortality by 50% and comes in a variety of forms, dissolvable films, and tablets being the most common. But stringent regulations make the drug difficult to get for people seeking opioid treatment. Under current law, doctors are required to complete special training and obtain an “X-waiver” license in order to prescribe buprenorphine. Only 5% of doctors in the country have the necessary waiver to prescribe it, and in rural areas, it’s even less.

The new guidelines allowed any physician with a Drug Enforcement Administration (DEA) prescriber license to prescribe buprenorphine. The drug is a narcotic that diminishes the symptoms of opioid withdrawal and is also safer, less addictive, and less likely to be misused. Despite its safety and efficacy, The federal government crafted these rules over two decades ago before the drug was approved by the Food and Drug Administration (FDA) to treat opioid use disorder in 2002. Ironically, opioids require no special training to be prescribed, unlike buprenorphine.

Many addiction researchers, physicians, and policy experts applauded the change in regulation. In the hasty process, however, the Trump administration did not obtain the necessary approval to change the regulations from the White House Office of Management and Budget (OMB).

Though the Trump administration may not have followed proper procedures, Biden’s decision to reverse its action sparked backlash from many policymakers and physicians who believe quick and drastic measures must be taken to ease the toll of the pandemic for people with substance use disorders. 

Overdose deaths have been steadily rising in the past decades and the pandemic has significantly exacerbated the rate. Synthetic opioids are believed to be the main substance that accelerated the overdose death rate during the pandemic. The CDC reported that two-thirds of opioid overdose deaths involve synthetic opioids. Experts estimate that the total economic burden of the crisis is over $78 million per year.

In addition to limited providers, people with substance use disorders often face other barriers to receiving treatment, especially in disadvantaged communities. These include lack of stable housing, health insurance, and stigma. COVID-19 intensified these problems by limiting in-person support groups, public transportation, and job security while increasing social isolation and stress.

Since buprenorphine is an opioid it does have the potential to be addictive. It is, however, safer and less addictive than the opioids that it is used to treat because of its pharmacological properties. It is also unlikely that the deregulation of this drug will lead to more opioid use disorders since it is only prescribed to treat opioid use disorders– unlike other opioids that are prescribed to alleviate pain. Ultimately the life-saving benefits that buprenorphine offers far outweigh the potential risks. 

Although the legal concerns over the way the Trump Administration removed these regulations are legitimate, the longer it takes the Biden administration to ease the restrictions on buprenorphine – or find an equivalent treatment – the direr the situation will become.

As a part of launching his multifaceted Opioid Crisis plan, President Biden should take executive action to remove X-Waivers in a legally surefire and quick manner. While removing the waivers will not solve the crisis overnight, it is a step in the right direction to treat people with opioid use disorders and prevent the overdose death rate from rising further.

This piece was also published in Medium.

Many Roads to a Living Wage

The Congressional Budget Office has dealt another blow to progressive hopes for swift action to raise the U.S. minimum wage to $15 an hour. It released a new study this week estimating that while the wage hike would lift 900,000 Americans out of poverty, it also would cost 1.4 million workers their jobs.

Liberal economists challenged the job loss figures, calling CBO’s methodology outdated. But the report feeds growing doubts that Senate Democrats will be able to shoehorn the measure into the big relief bill they hope to pass under “reconciliation” rules that allow for a simple majority vote. That means Republicans could filibuster it to death.

These setbacks raise an important tactical question: In a commendable effort to give working Americans a raise, are progressives fixating too narrowly on the minimum wage? After all, there are other policy tools at their disposal that could lift workers’ earnings without sacrificing jobs or harming small businesses. And these policies — essentially rewards for work delivered through the tax system — could be taken up under reconciliation.

It is abundantly clear that progressives, led by Sen. Bernie Sanders, have made several mistakes in their single-minded pursuit of the $15 wage boost. The first was claiming that it could pass through reconciliation. However, CBO had previously found that Sanders’s proposed “Raise the Wage Act” would have a negligible effect on the federal budget.

So Sanders pushed CBO to produce a new score using different methodology that he thought would make a persuasive fiscal case for the increase. Instead, CBO’s new analysis said that raising the minimum wage to $15/hour would kill over one million jobs while adding $70 billion to the federal deficit. As President Biden has noted, it’s unlikely the measure could get around Senate rules that prohibit the inclusion of non-fiscal policies for which the budgetary impacts are “merely incidental” in a reconciliation bill.

Moreover, West Virginia Sen. Joe Manchin already made clear he would oppose a $15 minimum wage because of the impact it would have in his low cost-of-living state, meaning the proposal wouldn’t have the simple majority needed to pass it.

Nonetheless, most Democrats, including Sen. Manchin, are united in their desire to raise the federal minimum wage, now stuck at a paltry $7.25 an hour. And not just Democrats: polls show solid majorities in favor of a $15 wage. Last November, even as Democratic candidates up and down the ticket got shellacked in a reddening Florida, 60 percent of voters backed a referendum to raise the state minimum to $15.

But as with many ideas that are simple and popular in concept, the apparent consensus breaks down when policymakers plunge into the devilish details: How high should the wage go, how quickly, and how uniformly should it be applied? Does it make sense to mandate $15 an hour in all 50 states, or allow for differences in the cost of living? What’s the impact of a big hike on jobs and small businesses in America’s less prosperous places?

Since Democrats evidently lack the votes to pass a $15 minimum wage, they should get what they can from Republicans who favor more modest increases, and look for other ways to make up the difference.

Specifically, they could expand tax credits designed to make work pay. The model here is the federal Earned Income Tax credit, which matches the earnings of low-wage workers dollar for dollar up to a certain threshold, after which it begins to phase out. It’s both an incentive and reward for work that’s become, after Social Security, America’s most successful anti-poverty policy.

What’s needed now is to move this “work bonus” principle up the income scale, with an eye toward raising incomes of non-college educated workers who have seen meager wage gains in recent decades.

For example, Brookings Institution economist Belle Sawhill has proposed giving all U.S. workers a 15 percent raise up to some annual ceiling, phasing out as earnings rise $40,000 a year.

PPI has proposed to absorb the EITC into an expanded Living Wage Credit that reaches deeper into the heart of the working class. The cost of these new credits could be defrayed by taxing the unearned incomes of wealthy Americans.

Such public subsidies for private work would lift wages for lower-skilled workers without pricing them out of labor markets or forcing the small companies that employ them out of business. And, as tax credits, they could be passed under budget reconciliation rules even without Republican support.

The minimum wage is a venerable policy, but progressives don’t need to put all of their eggs in this particular policy basket. Fortunately, there’s more than one road to establishing a genuine living wage in America that honors the dignity of work of all kinds and keeps working families from falling out of the middle class.

This piece was also posted on Medium.

PPI Statement on the National Apprenticeship Act of 2021

Last Friday, the U.S. House of Representatives voted to dramatically expand investment and access to apprenticeships with the passage of the National Apprenticeship Act of 2021 under the leadership of Rep. Bobby Scott. This legislation had been passed in November in the last Congress, however, the Republican Senate Majority failed to take up the bill for a vote. With Democrats now in the majority, there is renewed hope that the country’s underfunded and outdated apprenticeship system can finally be modernized to meet our 21st-century workforce needs.

The reauthorization of The National Apprenticeship Act is estimated to create nearly one million high-quality apprenticeship opportunities and includes provisions that target opportunities for key groups, such as young adults, childcare workers, and veterans. The bill also aims to increase apprenticeships in industries that do not require a four-year degree for well-paid jobs, such as healthcare, IT, and financial services. 

For the more than 10 million workers who have lost jobs or been laid off, there is no guarantee that their jobs will be there once our country returns to normal. Some estimate that at least 3.7 million Americans will not have jobs to return to. Many will have to reinvent themselves and apprenticeships can play a critical role in helping workers get back to work better after the pandemic.

Apprenticeships are an overlooked option to put workers on a path to better employment and the National Apprenticeship Act would remedy this gap. The United States lags behind many other OECD countries in investments to apprenticeships to provide immediate options for laid-off workers. Currently, there are only about 440,000 registered apprentices in the U.S. and often, in states where apprenticeships are available, there are too few slots to meet demand. If the United States were to create as many apprenticeships as a share of our labor force as in Europe that number would be nearly ten times higher

As policymakers consider how to help American workers weather the Covid recession, PPI strongly supports an increase in public investment in apprenticeships and work-based “career pathways” training programs that connect workers, including those laid off during the pandemic, to well-paying careers. We look forward to its progress in the Senate Health Education Labor and Pensions Committee under Senator Patty Murray, and we encourage the Senate to pass this important workforce legislation. 

Biden’s commission on the judiciary must put justice over politics

Some Democrats want to seek political revenge for the Republicans’ unapologetic use of their power over the past decade to engineer a conservative judiciary. Since October, they have been calling on President Biden to expand and pack the Supreme Court and federal judiciary with liberal judges. Biden has wisely resisted these calls and is setting up a commission to provide thoughtful ways to repair the partisan damage done to the courts over the past decade.

When it comes to reforming the courts, Democrats need to tread carefully. Our criminal and civil justice systems are keystones of our economic and political liberty; they keep order and facilitate the peaceful resolution of disputes. Neither system is perfect, but these objectives are unachievable if there is a belief among enough Americans that cases are decided by partisan politics, not justice.

The good news is that Biden has entrusted this effort to two highly respected lawyers, former White House Counsel Bob Bauer and former Deputy Assistant Attorney General Cristina Rodriguez. The persistent guidepost for their work must but ensuring the impartiality of the courts. Their big challenge, therefore, is putting this political genie back in the bottle.

Read here.

PODCAST: Congresswoman Suzan DelBene on “Getting to Yes”

PPI President Will Marshall welcomes Representative Suzan DelBene of Washington State’s First District to this episode of the PPI Podcast. The two discuss the Republican party’s identity crisis, the issue of Marjorie Taylor Greene, and the need for the GOP to come to the table on a broad relief package.

They also talk about DelBene’s involvement in the New Democrat Coalition, the House’s largest ideological caucus focused on a solutions-oriented approach to bipartisan legislation for economic growth and progress. Will Marshall hits on the importance of purple districts like DelBene’s, and she highlights the necessity of proving governance still works.

Biden’s Education secretary must seize the bully pulpit — and quickly

President Biden’s nominee for Education secretary appeared before the Senate’s education committee today. Miguel Cardona was asked about his stance on issues such as federal support for student civil rights and charter schools. The most pressing questions were centered on the pandemic: Under what circumstances should schools reopen? How much federal aid is needed? How should standardized testing be managed after months of lost learning?

Cardona’s answers are critical to families whose schools have been shuttered for nearly a year. But it’s Cardona’s leadership skills that senators should be most focused on. How strongly will Cardona advocate for America’s children, particularly when adult interests such as teacher unions push in the opposite direction? The secretary of Education doesn’t have authority to open or close schools; that falls to states and localities. But he does have a bully pulpit, and he should use it forcefully to support state and local officials struggling to reengage kids in learning.

Previous Education secretaries under Democratic presidents have forcefully used their voices to support education reforms. Richard Riley’s “America Reads Challenge” during the Clinton administration and Arne Duncan’s “Race to the Top” competition during the Obama administration come to mind. The challenges of this moment are even more daunting.

Read the full piece here.

Trump Pollster: Witness for the Prosecution?

Donald Trump reportedly plans to defend himself in the Senate impeachment trial by rehashing his bogus “stolen election” claims. To debunk this noxious myth, the prosecution has a new witness it can call: Trump’s own pollster.

Tony Fabrizio oversaw polling for the former president’s 2020 campaign. He’s just issued an unsparing post-mortem on how Trump actually lost to Joe Biden. The story has nothing to do with fraudulent voting and everything to do with Trump’s compulsive mendacity and inept response to the coronavirus pandemic.

Based on an analysis of exit polls from 10 key battleground states, five that flipped to Biden, and five that held for Trump, Fabrizio found “massive swings against POTUS” among independent voters. “Racially, POTUS suffered his greatest erosion with White voters, particularly White Men in both state groups,” the report says.

In the five states that flipped to Biden (Pennsylvania, Wisconsin, Michigan, Arizona, and Georgia), Trump’s margin among white voters fell from 23 percent in 2016 to 15 percent in 2020, with white men defecting at a higher rate than women. Trump also lost ground with white voters in the five battleground states he won in 2016 (Florida, Iowa, North Carolina, Ohio and Texas), albeit by smaller margins.

Fabrizio’s findings shred Trump’s fantasies about being cheated out of victory by a Democratic-deep state-media conspiracy, especially his allegations of ballot-stuffing in big cities with many black voters. They spotlight the truth that would shatter Trump’s fragile ego if he tried to face it: He blew a winnable race by convincing many white voters that he couldn’t be trusted to tell them the truth and couldn’t competently manage the pandemic.

Ironically, this conclusion also could prove discomfiting to the progressive left. Many activists have convinced themselves Biden won the election thanks to a tsunami of minority turnout. However, Fabrizio’s analysis suggests that wasn’t the decisive factor in these 10 pivotal states. On the contrary, he notes that Trump made double-digit gains with Hispanics while slightly exceeding his 2016 performance with black voters.

In the states that flipped, Trump lost ground (-8 points) among voters over 65, while older voters in the other five states stayed with him. But the ex-president’s most dramatic losses came among college-educated whites, who shifted 14 points toward Biden in the states that flipped and 18 points in those Trump held. So what happened?

The short answer: coronavirus. Voters in all 10 states said combatting the pandemic was a higher priority than handling the economy. Those who picked Covid as their top issue favored Biden by 73–26 in the flipped states and nearly the same margin in the states Trump held.

Conversely, Trump’s strength was the economy, even though the election occurred amid the worst recession since the Depression. Voters gave Trump better marks for handling the economy, 51–47 in the flipped states and 54–43 in the states he held.

In a sign of how badly Trump misjudged the public temper on Covid, mask mandates won overwhelming support (3–1) from voters in all 10 states. And while Trump was in negative territory on handling Covid in all the states, the man he itched to fire — Dr. Anthony Fauci — “garnered nearly a 3–1 positive job approval on the handling of CV overall with Fauci detractors voting overwhelmingly for POTUS while Fauci supporters voted for Biden by wide margins, especially in “Flipped’ states,” according to the report.

After Covid, the issue of character seemed to weigh most on voters’ minds. Asked which candidates were “honest and trustworthy,” they chose Biden by a crushing 18-point margin in the flipped states, while Trump narrowly edged Biden out (52–48) in the five states he won twice. Conservative pundits who dismissed Trump’s constant and well-documented lying as inconsequential or “performative” missed the demoralizing effect it had on a significant chunk of the people they considered his “base.”

Finally, the Fabrizio report makes clear that Trump’s defeat was very much a personal one. It notes that in all 10 states the 2020 electorate was more Republican than in 2016. That’s why Republicans overperformed in Congressional and state contests even as Biden was trouncing Trump nationally by more than seven million votes. Trump probably helped boost Republican turnout, but there is cosmic justice in the fact that he was one of the few Republican candidates who didn’t benefit from it.

We don’t yet know whether Trump has read Fabrizio’s report. That’s another benefit of the ex-president’s exile from Twitter. But it’s another piece of damning evidence, from a source Republicans will find hard to dismiss, that Trump is lying about a stolen election simply to hide his shame over blowing his reelection.

This piece was also shared on Medium.

Why Biden Has The Right Covid Relief Strategy

President Biden met with 10 Republican senators on Monday to discuss their proposed $600 billion alternative to his $1.9 trillion American Rescue Plan. Both the White House and Sen. Susan Collins described the meeting as a productive exchange of ideas and the start of continued talks. But some Democrats believe these discussions are doomed from the start and want Biden to focus on passing his plan through reconciliation – a complicated process that allows budgetary legislation to pass with just 51 votes instead of the 60 required to bypass the filibuster on all other legislation. Although Democrats are right to move forward with reconciliation, there are several reasons why it makes sense for Biden to pursue the talks further and seek common ground beyond just a platonic ideal of “bipartisanship.”

Read the full piece here.

PODCAST: A Better Public Health Approach to Tobacco

For those concerned about nicotine addiction and tobacco consumption, a ban on flavored tobacco might sound like a good idea. But as Nkechi Taifa explains in this week’s PPI Podcast, such bans are going to almost entirely fall onto minority communities.

Several states are considering or have already banned flavored tobacco. Nkechi Taifa agrees with Crystal Swann that in time a time when we are rolling back the war on drugs in favor of a public health approach, we should be doing the same with tobacco.

Tune in here or wherever you get your podcasts.

Moderate Democrats are the key to Biden’s success

Written by Ben Ritz and Will Marshall

It’s been less than a week since President Biden took office, but Washington’s tribal gladiators already are arming for mortal combat. Fortunately, pragmatic Democratic lawmakers are working to help Biden avert a relapse into political paralysis.

Senate Republicans are bewailing Biden’s $1.9 trillion American Rescue Plan to end the pandemic and help jobless workers and small businesses tread water until it’s over. Though few complained when his predecessor broke the trillion-dollar deficit barrier – despite a then surging economy – Republicans now profess to be shocked by the “colossal waste” (Sen. Pat Toomey) of Biden’s “massive spending” package (Sen. Rick Scott).

Such hypocrisy is galling, and it has tripped the progressive left’s hair-trigger outrage alarm. Activists who didn’t support him in the first place fret that Biden is too eager to compromise in the name of the national “unity” he movingly invoked during his inauguration. They insist he waste no time in pressuring Senate leadership to kill the filibuster so Democrats can steamroll Republicans, at least for the next two years.

Everyone should take a deep breath. President Biden is anything but a political naif. Having been on the receiving end of Sen. Mitch McConnell’s deeply unpatriotic strategy of total obstruction for eight years, he doesn’t need lectures from sectarians in his own party about how rabidly partisan the other side can be.

But Biden understands he was elected to save our democracy from an unhinged demagogue, not to join Republicans in fomenting intractable enmity between red and blue America. He also knows from bitter experience that one-party rule is inherently unstable and fuels political paranoia and extremism.

Read the full piece here.

Biden, Congressional Democrats Have Rare Chance to Highlight, Fix America’s Broken Higher Education Financing Model

WASHINGTON, D.C. — A new brief released today from the Progressive Policy Institute (PPI) commends President Biden’s bold vision to ease student debt burdens. The brief calls on the Administration to help borrowers in more meaningful ways by fixing America’s broken financing model for higher education, and investing in non-college pathways to good jobs.

Key highlights from the brief: 

  • More than 1/5 households hold a student loan, up from 1/10 in 1989.
  • Millennials, who are already saddled with lower wages and lingering economic pains from the Great Recession, hold $497.6 billion in outstanding loans.
  • Education debt is a generational/equity crisis. Borrowers are more likely to be lower-income, Black, and less likely to have generational wealth, making them more likely to default, which can lead to further worsening of poverty and the racial wealth gap.
  • Biden has faced calls to cancel $50,000 in education debt for borrowers but the evidence suggests that this could be regressive and benefit many high-income households who don’t need relief.
  • Education debt relief should not be a one-time fix. President Biden and Congress need to meaningfully address America’s broken financing model for higher education and invest in non-college pathways to good jobs.

The policy brief calls for the Biden Administration to take important key steps, including: 

  • Auto-enrollment in income-based repayment as opt-out for new and existing loans.
  • Modernize the Public Service Loan Forgiveness Program to reward national or community service for our public servants and create incentives for public service.
  • Accelerate attainment of credentials by making the process for earning college credit through Advanced Placement (AP), International Baccalaureate (IB) programs, and college courses taken in high school at community colleges, more transparent and accessible.

Veronica Goodman, PPI’s Director of Social Policy and author of the brief, said this:

“President Biden and Congressional Democrats have a rare opportunity to move fixing America’s broken higher education financing model to the center of the nation’s agenda.

They should follow targeted education debt relief with bold progressive reforms aimed at two critical national goals: Lowering college costs and thereby reduce the need for borrowing, and boosting public  investment in the skills and career prospects of the majority of young Americans who do not get college degrees.”

Read the full report here.

Memo to President Biden: The Progressive Way to Ease Student Debt Burdens

Note: In this brief, I use the term education debt, rather than student debt, since most affected borrowers are no longer students, and this category of debt affects a wide swath of society, not just students.          

After his inauguration on January 20, one of President Joe Biden’s first official acts was signing an executive order to extend the pandemic-related pause on student loan payments and interest, as well as to halt collection of student loans in default, through September 30. For millions of young Americans struggling to pay off college loans, the order will be a welcome down payment on Biden’s campaign promise to deliver major debt relief.

While campaigning for the presidency last spring, Biden unveiled a plan to forgive a minimum of $10,000 per borrower. The President’s advisers say the administration will submit a legislative proposal for debt relief to the new Congress. 

The case for relief is strong. Over the past four years, the Trump administration and Republican lawmakers have provided little in the way of help for struggling borrowers beyond the temporary pause on repayments. With young people struggling to keep their heads above water amid the Covid pandemic and recession, it is no surprise that Democratic policymakers are looking for ways to relieve their financial stress.  

In May 2020, House Democrats also called for $10,000 worth of education loan relief for “distressed” borrowers as part of their Health and Economic Recovery Omnibus Emergency Solutions (HEROES) bill. This category of borrowers included those with delinquent or defaulted loans, and others considered “financially distressed.” According to the U.S. Department of Education, as many as 20 percent of education loans are in default. This provision got caught up in partisan wrangling over the size and cost of the HEROES act, and was dropped from the compromise stimulus bill Congress passed in late December 2020. 

Since his victory last November, Biden has faced persistent calls from progressives to forgive education debt for the 45 million Americans who owe close to $1.6 trillion in loans. Sens. Elizabeth Warren and Chuck Schumer dramatically raised the bidding by urging Biden to take executive action to forgive up to $50,000 of federal education debt. Reps. Ayanna Pressley (D-MA), Ilhan Omar (D-MN), Alma Adams (D-NC), and Maxine Waters (D-CA) introduced a companion resolution in the House in December 2020.  

Although popular on the left, such calls to “go big” have drawn a skeptical response from many independent analysts. “In sheer magnitude, canceling $50,000 in student debt would rank among the largest transfer programs in U.S. history,” notes the Brookings Institution’s Adam Looney. “At a cost slightly above $1 trillion, it would equal the total amount spent on cash welfare since 1980. And its largest effect would be to improve the finances of college-educated workers, who have already tended to be winners in an economy marked by ever-rising inequality.” 

President Biden likewise has expressed skepticism about the distributive impact of these proposals. He’s also told Congressional Democrats he would prefer a legislative fix to an easily reversible executive order – something that looks more likely after the January 5 Georgia runoffs flipped control of the Senate to his party.

Digging into the data on the demographics of Americans with education debt, it becomes clear that Biden’s approach isn’t just more affordable, it’s also more progressive and equitable. Approximately 48 percent of outstanding student loans are held by those with graduate degrees; that is double the share of those who owe loans and earned an Associate’s degree or less. In fact, slightly over a third of all education debt is concentrated in the highest income quartile – households making over $97,000 per year.

Without better targeting, debt relief would mostly benefit higher-income households, which hold a third of student loans and have greater ability to pay them back. A 2019 analysis by the Urban Institute finds that “forgiving larger amounts of debt would distribute a larger share of benefits to higher-income households, and reducing the amount of debt forgiven should increase the share of benefits going to lower-income households.” Based on this analysis, the $50,000 proposed by Sens. Warren and Schumer would have regressive effects and distribute relief to households at the top of the income scale. 

In contrast, Biden’s plan aims at lower-income borrowers who need debt relief the most. Relief in the amount of $10,000 per borrower would eliminate all debt for 37 percent of borrowers (16.3 million people) and cut in half debts owed by another 9.3 million borrowers at an estimated cost between $250-300 billion. These borrowers are disproportionately young and low-income, and include veterans, single parents, and those in a minority group. Two-thirds of borrowers that default on their payments owe a comparatively low average amount of $9,625. These borrowers also are less likely to repay their loans because they never completed their college degrees or earned only a certificate.

However, it’s not clear whether President Biden’s plan will include an income-based eligibility test to ensure that relief is concentrated on needy rather than affluent families. PPI recommends that the administration target its plan by phasing out relief for borrowers making over $125,000. This would address concerns that about the regressive nature of untargeted debt relief and substantially reduce the cost of the proposal. 

Perhaps most important, the President’s approach recognizes the limits of debt relief and leaves fiscal space for tackling the fundamental problem: America’s broken financing model for higher education. Over the past two decades, the cost of higher education has approximately doubled and ballooning tuition prices have forced students to borrow more to finance their education.

Although federal subsidies – chiefly grants and loans – tilt heavily toward college-going young people, college is not the only pathway to good jobs for young adults and U.S. workers. It’s true that the average college-educated worker reaps a lifetime premium of higher earnings in the labor market. But most Americans don’t go to college. As of 2019, 70.1 percent of Americans 25 and older had not earned a four-year degree, while just 29.9 percent earned a four-year degree or higher. Given his well-known empathy for the struggles of America’s working-class families, PPI recommends that the President pair debt relief with increased public investment in apprenticeships and work-based “career pathways” training programs that connect workers, including those coming out of high school, to well-paying careers.  

PPI has proposed a suite of ideas for how to expand career pathways to employment for millions of Americans including investments for a 10-fold increase in apprenticeships, creating incentives for partnering public and private programs that focus on transferable skills and credentials, and incentivizing private intermediaries who create “outsourced” apprenticeships programs. Although they are beyond the scope of this memo, PPI believes these and related ideas are crucial to ending the bias in federal policy toward college-bound youth. We hope the Biden administration will give high priority to investing more in building a robust system of work-based learning, career training, and apprenticeships for the majority of young Americans who don’t attend four-year colleges.

Recommendations for the Biden Administration

  • Draft legislation to provide $10,000 in immediate education debt forgiveness for those with an annual income of less than $125,000 per year. This will deliver relief for those at greatest risk of defaulting on their student loans, especially students from low-income and minority families. The estimated cost of President Biden’s plan is $250-300 billion, and it would eliminate all education debt for 37 percent of borrowers (16.3 million people) and cut in half debts owed by another 9.3 million borrowers. Our recommendation of an income-based eligibility test is expected to reduce the overall cost.
  • Continue giving borrowers a break on payments and interest by extending the pause on federal student loan payments for the duration of the pandemic and Covid recession. President Biden has extended the pause through September 30.
  • Make income-based repayment more accessible and generous for borrowers. Switching to a universal IBR system that is opt-out for new and existing loans, and which automatically re-enrolls borrowers, would make payments more manageable and automatically tied to income, decreasing the likelihood of default and missed payments. 
  • Modernize the Public Service Loan Forgiveness Program to reward national or community service for our public servants by offering $10,000 of education debt relief for every year of service up to five years—after which the loan would be forgiven. This would include individuals with up to five years of prior service and automatically enroll workers in schools, government, and other nonprofit organizations. This would encourage workers to pursue careers in public service.
  • Accelerate attainment of credentials by making the process for earning college credit through Advanced Placement (AP), International Baccalaureate (IB) programs, and college courses taken in high school at community colleges, more transparent and accessible, as PPI’s Paul Weinstein has argued.

Education Debt Has Led to a Social Crisis, Which the Pandemic Has Made Worse

Those who have borrowed for degrees are more likely to be lower-income, Black, and less likely to have generational wealth, making them more likely to default, which can lead to further worsening of poverty and the racial wealth gap. To understand why the proposal of $10,000 relief per borrower could have the most impact on lower-income families and those most struggling during the pandemic, it is worth digging into the demographics of who is behind on payments and what groups are holding the most debt:

  • According to the U.S. Department of Education, 20 percent of borrowers are in default, and a million more go into default each year. Two-thirds of borrowers who default never completed their college degrees or earned only a certificate and owe a comparatively low average amount of $9,625. Those who default include veterans, parents, and first-generation college students who are more financially vulnerable to default. Without a credential and with limited access to good jobs, borrowers are forced to default and, in doing so, accrue additional interest and fees on the principal loan. These borrowers are in no position to pay back their defaulted loans.

Default can have catastrophic implications for future access to credit, and result in garnished wages, seized tax refunds, and harm other measures of financial wealth. Given the age at which most of these borrowers took out loans, many begin their adulthood at an economic disadvantage. At this scale, the education debt crisis is not only hurting those who are struggling the most, but it is holding back an entire generation with negative implications for their children’s generation. The financial strain the pandemic has inflicted on workers will make it more difficult for defaulted borrowers to get back on track with payments.

Debt Relief: Down Payment on Reform

As the pandemic rages, and more Americans lose their jobs and businesses, short-term education debt relief can help our most vulnerable borrowers ride out the storm. But we also need longer-term, structural reforms aimed at driving down the tuition costs for both college and post-secondary skills training. 

Short-Term Relief and Considerations

The Trump administration implemented limited short-term relief for education debt by temporarily suspending loan payments through February 2021 on federal educational loans as of March 2020. Further short-term relief is desirable, in line with President Biden’s proposal for $10,000 of forgiveness. As one of his first actions in office, President Biden signed an executive order extending the pause on student loan payments and interest through September 30. Biden should continue to extend the pause as long as the Covid recession continues to place financial strain on borrowers.

Reviewing the data, education debt forgiveness targeted at borrowers with low incomes and the unemployed would have the greatest impact. However, some concerns remain over how policymakers can target relief to those who need it the most. Some experts have suggested that policymakers could isolate undergraduate debt from graduate school debt in order to prioritize these more needy borrowers. This would avoid regressive effects that could give a large portion of relief to those with graduate school debt, such as doctors and lawyers, that are in a better financial position to pay back their loans. At the $10,000 level, however, the Biden plan avoids many of the greatest concerns about the potential for regressive outcomes relevant to higher dollar per borrower proposals. Adding an income cap of $125,000 for borrowers will target relief for households who need it the most.

Following dramatic victories in the Jan. 5 Georgia run-off elections, Democrats have taken control of the Senate. This likely clears the way for legislation to provide debt relief, as President Biden prefers. Citing the need for action during the pandemic and recession, some Democrats have been urging him to use a provision in the Higher Education Act to sidestep legislation and cancel the balances of millions of Americans. That would likely trigger legal challenges, and Biden is right to first seek a legislative fix using budget reconciliation.  

Advisers of President Biden have suggested that education debt relief could be included in anticipated stimulus legislation aimed at pandemic relief. On the other hand, a legislative path for education debt relief could also take longer if additional relief legislation proves difficult to enact in the near term, a worthy consideration given the present economic crisis. 

More difficult to measure are the intangible or second-order benefits that education debt relief would bring to borrowers, especially those who have defaulted. Worries about their debt burdens undoubtedly affect their career choices, such as whether to pursue a public interest job, and their life choices, such as whether and when to buy a house or have a child. Those with significant education debt are more likely to experience depression and anxiety as a direct result of their debt, which can lead to mental health issues down the road. Mental health experts point to Millennials coming of age with slower economic growth than any other generation in history as part of the reason for why their mortality rates, driven by suicides and drug overdoses, have risen sharply since 2008. It is also difficult to capture the effect that education debt relief would have on rates of entrepreneurship in younger generations or how intergenerational wealth might change if millions were no longer in default and saddled with debt.

Long Term Solutions

Targeted education debt relief is only a temporary fix. There are several other policy solutions that would help address the education debt crisis.

Congress should also adopt Biden’s proposal to modernize income-based repayment (IBR), loans. Such programs calculate a borrower’s monthly payment based on their income and other factors, such as family size and location. Currently, borrowers must opt-in to IBR through a lengthy process. Automatically enrolling new borrowers and re-enrolling existing borrowers in IBR and tying their payments to their eligible income would streamline the process, as well as making it easier for existing borrowers to take advantage of the program. By making enrollment automatic for borrowers and the terms much simpler, it is estimated that on-time payments will rise and default rates should decrease on net. 

The Public Service Loan Forgiveness program was introduced in 2007 as a way to reward workers who pursue public service by forgiving their federal student loans after 10 years if they make consistent payments and are an employee of a qualifying public service employer. Like IBR, the unnecessary complexity and difficulty of navigating the program has led to low enrollment and success in rewarding public servants. Automatically enrolling employees of qualifying employers would increase take-up and help reduce debt in a way that rewards work and service. The program should offer $10,000 of education debt relief for every year of service up to five years—with full forgiveness after five years. This would include individuals with up to five years of prior service in schools, government, and other nonprofit organizations.

To get at the root of the education debt problem, as President Biden has acknowledged, we need broad higher education reform and more pathways to good jobs beyond college. Periodic education debt relief should not become a band-aid solution for higher education’s broken financing system. Fully addressing these challenges is beyond the scope of this brief, but below are a few points to consider. 

Since the 1990s, the cost of higher education has approximately doubled and institutions have responded to declining state investment by passing off the cost to students through rising tuition prices. Told repeatedly that a college degree is the best pathway to the middle class, it’s little wonder that young Americans increasingly turned to loans to finance their education. For too many, however, the high price of going to college isn’t leading to jobs with earnings sufficient to propel them into the middle class and allow them to pay off their debts.

When considering how to create lasting reforms to higher education, the Biden administration should develop a plan for a systemic restructuring of higher education consisting of two parts: (a) creative ways to reduce college costs rather than expanding subsidies in an endless game of catchup; and (b) a big public investment in building a robust career ladders infrastructure of work-based learning as an alternative route to middle-income jobs.

Many progressives have been thinking creatively about how to tame the rising price of higher education in the longer term. For example, my PPI colleague Paul Weinstein proposes a set of imaginative reforms including leveraging direct federal spending on higher education to force institutions to cut tuition and fees by reducing “administrative bloat,” requiring faculty to teach more, thereby opening up additional spots for students, increasing tuition revenue, and, lastly, by moving U.S. colleges toward three-year bachelor’s degrees.

Conclusion

President Biden and Congressional Democrats have a rare opportunity to move fixing America’s broken higher education financing model to the center of the nation’s agenda. They should follow targeted education debt relief with bold progressive reforms aimed at two critical national goals: Lowering college costs and thereby reduce the need for borrowing, and boosting public  investment in the skills and career prospects of the majority of young Americans who do not get college degrees. 

A Day of Deliverance and Hope

Presidential inaugurations are usually festive occasions in which Americans celebrate the orderly and peaceful transfer of power to new political leaders. With the coronavirus pandemic raging and thousands of troops on guard to deter violence by deranged followers of Donald Trump, that’s not exactly the mood in Washington today.

Overshadowed by these grotesque legacies of Trump’s presidency, the inauguration of President Joe Biden and Vice President Kamala Harris is a somber affair. Nonetheless, it’s a day of deliverance, and fresh hope, for America.

We are delivered from a pathological liar and demagogue who likely will go down in history as the most deformed character ever to occupy the White House. Our democracy has survived, though by an unnervingly narrow margin.

There will be much talk in the days ahead of healing, as there should be. President Biden wisely resists pressure from within his own party to govern in the same corrosive, zero-sum way that Trump and his Republican enablers have. The last thing America needs is for Democrats to join Republicans in fanning the flames of civil strife. 

But before there can be reconciliation, there must be truth and accountability. 

On Nov. 3, 2020, the American people fired President Trump. Psychologically unable to accept the peoples’ verdict, Trump concocted a myth of massive voter fraud and spent the next two months urging Republican election officials to falsify the election results. His seditious scheming culminated on Jan. 6, when a mob of supporters invaded the Capitol and threatened lawmakers certifying the 2020 vote. Five people died in the Trump riot. 

For this unprecedented assault on U.S. democracy from within, the House rightly impeached Trump for a second time. To drive home the gravity of his crime and uphold the authority of our Constitution, the Senate should swiftly convict him.

This is simple justice, not vengeance. It is a vital act of democratic self-preservation. 

And it’s crucial because if we are delivered today from Trump, we are not yet delivered from Trumpism. Americans should never forget his cowardly and disloyal accomplices, especially the eight Senate Republicans and 146 House Republicans who voted to reject the states’ certification of the electoral college vote. 

Most worrisome are the millions of Trump voters who apparently have swallowed his lies, not to mention the fanatics who subscribe to crackpot theories propagated by QAnon and alt-right sites that peddle hatred and call for armed insurrection. To counteract the online radicalization of the right, Congress should empanel a 9/11-style commission to study the election and its aftermath and report to the public what really happened.  

Ultimately, however, Republican leaders are going to have to rededicate themselves to dealing with facts, evidence and objective reality and purge their own ranks of extremists. We’ve never been fans of GOP Minority Leader Mitch McConnell, but his honesty about the Jan. 6 insurrection is a start. “The mob was fed by lies,” he told the Senate. “They were provoked by the president and other powerful people.”

Finally, we’re grateful today to President Biden and Vice President Harris for making a convincing case to the American people for denying Trump a second term. We’re confident that they will restore experience, reason, honesty and decency to the White House after a ruinous four-year detour into delusional populism. 

And we’re hopeful that the ambitious agenda our new president has outlined – at once progressive and pragmatic – will make our democratic government work again. That’s the best recipe for bringing Americans together. 

PPI Applauds President-Elect Biden’s Ambitious Agenda to Get the Pandemic Under Control

America, it appears we have a real president again.

President-elect Joe Biden yesterday unveiled an ambitious agenda for getting the pandemic under control, helping jobless Americans recover through the Covid recession, throwing a lifeline to millions of small businesses, strengthening the safety net for our most vulnerable citizens, and opening public schools.

PPI applauds the President-elect for stepping boldly into a total vacuum of leadership in Washington. His decision to “go big” with a $1.9 trillion package is just the jolt we need to galvanize national action and spur the sharing of resources to vaccinate Americans faster, protect the vulnerable and speed up economic recovery.

Above all, it’s a welcome sign that experience, honesty and compassion are returning to the White House after a four-year absence. In Joe Biden, Americans will once again have a leader who can make their government work for them.

The details of the Biden plan will be worked out in the weeks ahead. What follows are reactions by PPI policy analysts to its key proposals.

History tells us that Biden’s front-loaded $1.9 trillion fiscal stimulus plan is essential for helping the U.S. economy accelerate out of the Covid Recession and bring jobs back to millions of Americans.  Small businesses, especially, will benefit from the flow of money to poor and middle-class Americans. And if the country has to take on more deficits, this period of low interest rates is the perfect time.

The Biden plan does come with some important risks. We may be facing a weaker dollar down the road, which would lead to rising import prices and higher inflation. Nevertheless, those potential problems are worthwhile given the magnitude of the current crisis. – Dr. Michael Mandel, Chief Economic Strategist 

President-Elect Biden’s proposed $1.9 trillion coronavirus relief plan extends the 15% increase in the Supplemental Nutrition Assistance Program (SNAP) benefits and proposes additional $3 billion in funding for the Women, Infant and Children program, both programs are incredibly essential to supporting the more than 30 million adults and over 12 million children suffering from food insecurity in the United States.  The plan also includes $350 billion in aid to state and local governments which is critically needed during this economic downturn because many cities and local governments use those flexible dollars to support their anti-hunger initiatives including food pantries, senior nutrition and other nutrition programming.  – Crystal Swann, Senior Policy Fellow

The American Rescue Plan is ambitious and boldly prioritizes the needs of working families and those struggling the most during this Covid recession. PPI supports President-elect Biden’s call for an increase in the minimum wage to $15, with a phased approach that takes into account regional differences. The expansions of the Child Tax Credit and Earned Income Tax Credit will reduce child poverty by an estimated 50 percent and alleviate economic hardship for workers without children. The Rescue Plan also has critical support for housing and unemployment, provides funding for childcare, and extends paid family and sick leave for workers affected by the pandemic through September, expanding these benefits to cover an additional 100 million workers. We encourage Congress to move forward swiftly to provide this relief to the American people. – Veronica Goodman, Social Policy Director

It’s refreshing to see the Biden-Harris administration release a policy plan that meets the gravity of this moment. After 20 million Americans have been infected with and almost 400,000 Americans have died from Covid-19, it’s clear that we need policies that will stem the tide of the raging pandemic. A national vaccination effort as proposed by President-elect Joe Biden is the quickest way to get back to normal life and improve the economy.

I am pleased to see the incoming administration prioritize many good policies including increasing surveillance of virus mutations, using the National Guard and the Defense Production Act to support vaccination and testing efforts, and investing $20 billion dollars in the ‘last mile’ of vaccine distribution to get it into more people’s arms faster. While the darkest days of the pandemic may still lie ahead, the plan put forth by the Biden-Harris administration is the quickest way to end this pandemic once and for all. – Arielle Kane, Director of Health Care

President-elect Biden should be commended for offering an ambitious action plan to end the covid pandemic and save the American economy. If even a fraction of these new relief measures were enacted, they would cement the United States’ fiscal response to the pandemic recession as the largest in the world. PPI also applauds the president-elect’s commitment to pursue automatic triggers and stands ready to support those efforts however we can. Lawmakers should enact such mechanisms to provide economic support consistent with the real needs of our economy while preserving fiscal space for the next component of Biden’s recovery agenda. Building back better will require making unprecedented investments in infrastructure and scientific research to mitigate climate change and lay the foundation for long-term growth. – Ben Ritz, Director of the Center for Funding America’s Future

PODCAST: Congressman Conor Lamb Talks Impeachment, Energy with PPI

PPI President Will Marshall welcomes Congressman Conor Lamb of Pennsylvania’s 17th District to the PPI Podcast, just days after Rep. Lamb’s dramatic floor speech following the insurrection in the Capitol, in which he lambasted Republicans for supporting the Trump lies that inspired the assault, plus his thoughts on impeaching the president again.

Rep. Lamb shares how he and Biden won their elections in the crucial swing state of Pennsylvania, and the critical importance in that state of energy issues — including Biden’s opposition to a ban on natural gas drilling and a balanced approach on energy which helped him flip Pennsylvania back to blue.

The conversation shares the need for a new Democratic approach on energy and climate that recognizes that natural gas is speeding the deployment of renewable energy to the grid; and that our goal should be decarbonizing the economy, not abolishing fossil fuels precipitously, which would cost many Pennsylvania and other energy state workers their jobs and damage their economy.

Listen to the podcast here.