issue: Politics

Carolina Postcard: Will Voting Rights Battles Come to NC – Again?

Posted on by The Progressive Policy Institute

For 150 years, North Carolina has been a battleground over Black citizens’ voting rights. Get ready for another battle.

Governor Roy Cooper issued a warning this month:

“I expect Republican leadership in our North Carolina legislature to follow a lot of other state legislatures in using this ‘big lie’ of voter fraud as an excuse for laws that suppress the vote. Let’s just get real about it: These laws are intended to discourage people from voting.”

Legislators in 43 states have proposed more than 250 bills to suppress voting. Georgia just passed one that The New York Times says will have “an outsize impact on Black voters.”

Reporters in Raleigh have speculated that similar bills will be introduced this year – and rushed through the legislature to Governor Cooper’s desk.

Our state has been here before. Resistance began as soon as the Fifteenth Amendment gave Blacks the right to vote after the Civil War.

Blacks helped elect Governor William W. Holden, a Republican, in 1868. In 1870, the Ku Klux Klan used murder and intimidation to suppress Republican votes. Democrats regained control of the legislature. They impeached Holden and removed him from office.

Despite Jim Crow laws and the Klan, Blacks continued to hold elected office in North Carolina during the 19th Century. The last to serve in Congress was George Henry White (1897-1901).

Congressman George H. White

Then white supremacists took over. In 1898, white mobs murdered Black citizens and overthrew the legally elected government of Wilmington. The Democratic Party and The News & Observer, working together, imposed ruthless voter-suppression laws that disenfranchised Blacks for decades.

In the 1960s, Congress passed the Civil Rights Act and Voting Rights Act despite filibusters by Southern Senators, including North Carolina’s Sam Ervin, a Democrat.

The two parties then reversed roles on race. The Democratic Party, once the party of white supremacy, embraced civil rights. Southern whites embraced the Republican Party, once the party of Lincoln.

The News & Observer became a strong voice for civil rights and racial equality.

Republican Senator Jesse Helms, elected in 1972, took up the Southern-resistance banner. He had won fame fulminating on WRAL-TV against the civil rights movement and Dr. Martin Luther King Jr. He held his seat for 30 years; he never changed his views on race.

The U.S. Justice Department accused Helms’ 1990 campaign – against a Black opponent, Harvey Gantt – of intimidating Black voters. The campaign sent 125,000 postcards, mostly to Black voters, falsely claiming they were not eligible and could be prosecuted for voter fraud. Helms’ campaign later signed a consent decree to settle the complaint.

A former Democrat, Helms had been involved in one of the most racist campaigns in North Carolina’s history, Willis Smith’s victory over Frank Porter Graham in the 1950 Senate Democratic primary. Smith’s campaign passed out flyers that said: “White People Wake Up.”

Willis Smith campaign flyer, 1950

Despite Helms, North Carolina earned a reputation in the last decades of the 20th Century as a progressive state on racial issues.

Then, in 2010 – the first midterm after the election of Barack Obama, the first Black President – Republicans won majorities in the state House and Senate.

In 2013, they passed an election law that the Brennan Center for Justice called “possibly the most restrictive” in the nation. It required a photo ID, curtailed early voting, ended same-day registration and ended provisional voting.

A federal court said the law “disproportionately affected” Black voters, targeting them “with almost surgical precision.” Lawsuits tied up many of the law’s provisions.

Now – in the wake of the 2020 election and Donald Trump’s false claims of voter fraud – North Carolina may be in for another battle.

Carolina Postcard: Tracking North Carolina’s “Blue Shift”

Posted on by The Progressive Policy Institute

By Gary Pearce

Looking back, it’s clear that North Carolina took a big step in 2008 toward becoming a Democratic state in presidential elections. It’s not clear whether we’ll keep moving in that direction.

Since 2008, Democrats have confidently predicted that demographic trends – more young voters, minority voters and college-educated voters – would make North Carolina more like Virginia, which is increasingly Democratic, and Georgia, which was surprisingly Democratic in 2020.

Before we explore whether that will happen, let’s be clear about the “blue shift” that already has happened.

From 1980 to 2004, North Carolina was reliably Republican in presidential races. Republican candidates carried the state seven straight times, usually by double digits.

Ronald Reagan beat Jimmy Carter here by 2% in 1980, then swamped Walter Mondale by 24% in 1984; George H. W. Bush beat Michael Dukakis by over 16% in 1988. Bill Clinton made North Carolina competitive again in 1992, losing to Bush by less than 1%, partly because Ross Perot was on the ballot and siphoned votes away from Bush. Bob Dole beat Clinton here by 4.7% in 1996.

In 2000, George W. Bush beat Al Gore in North Carolina by 12.8%; Bush beat John Kerry by 12.4% in 2004, even with former North Carolina Senator John Edwards on the Democratic ticket.

But that pattern changed dramatically in 2008.

The breakthrough didn’t come the way experts expected: with a moderate white candidate from the South, another Carter or Clinton. Instead, it was a Black candidate, an unknown first-term Senator from Illinois with an unlikely name and an unexpected appeal.

Republicans scoffed that year at reports Barack Obama’s campaign was targeting North Carolina. No way, they said, could a Black Democrat win such a safe Republican state.

But Obama did win, by just 0.3%, thanks to a surge of minority voters and young voters. He won white working-class voters who had lost faith in Republican economic policies and lost patience with never-ending wars in the Middle East. John McCain’s pick of Sarah Palin for Vice President cost him women and college-educated voters.

North Carolina turned red again on the electoral maps of 2012, 2016 and 2020. But the margins never returned to pre-2008 levels. Mitt Romney beat Obama here in 2012 by just 2%. Trump beat Hillary Clinton by 3.6% in 2016 and Joe Biden by 1.3% in November.

Democrats here have been inspired by Democrats in Georgia, which went for President Biden and elected two Democratic Senators. Efforts have begun to replicate Georgia Democrats’ voter registration and turnout juggernaut.

But North Carolina isn’t Georgia. We’re more rural. While both states have over 10 million people, Georgia’s rural population is about 1.8 million; North Carolina’s is over 3 million. Georgia has more Black voters – 30% of the total electorate, compared to North Carolina’s 20%.

Three questions will decide the future of North Carolina’s “blue shift.”

First, will Covid and its economic impact put an end to the 40-year reign of Ronald Reagan’s philosophy that “government is the problem”? Some polls suggest Americans today want more from government, not less.

Second, which party’s set of issues matter more to voters? Biden and Democrats are focusing on Covid vaccines, economic relief, climate change, and gender and racial equality. Republicans are focused on abortion, immigration, “reopening” the country and “cancel culture.”

Third, which will prevail: Democrats’ efforts to expand voting or Republicans’ efforts to restrict it?

In a state where presidential elections are decided by 1, 2 or 3%, small actions and small shifts in attitudes can produce big shifts in outcomes.

PPI Applauds Passage of the Biden Administration’s American Rescue Plan Act

Posted on by The Progressive Policy Institute

Washington, D.C. – Today, Congress passed the Biden Administration’s American Rescue Plan Act, a $1.9 trillion emergency pandemic relief package that will help ramp up COVID-19 vaccine production and distribution, support small businesses and workers, and provide the necessary resources to safely reopen schools and communities.

Will Marshall, President of the Progressive Policy Institute (PPI), released the following statement:

“Passage of the American Rescue Plan is a landmark achievement for President Biden and the new Democratic Congress – one that gives us reason to hope our government may not be broken after all.

It’s not a perfect bill, but after a long, grinding year of sickness, economic privation and social isolation, this isn’t the time to make the perfect the enemy of the good. Policy disagreements aside, President Biden has rightly gauged the magnitude of the nation’s health and economic emergency and responded resolutely. His decision to “go big” was right, as was his desire to avoid vilifying his political opponents and deepening the nation’s paralyzing cultural rifts.

That’s the way our democracy is supposed to work.

By clearing his first big hurdle, President Biden has dealt himself a strong political hand for the next one: Winning passage of his coming “Build Back Better” plan for building a more just, clean and resilient U.S. economy.”

The Progressive Policy Institute is a catalyst for policy innovation and political reform based in Washington, D.C. Its mission is to create radically pragmatic ideas for moving America beyond ideological and partisan deadlock. Learn more about PPI by visiting progressivepolicy.org.

Media Contact: Aaron White – awhite@ppionline.org

How to Feed America Better Post-Covid

Posted on by The Progressive Policy Institute

When teachers locked up their classrooms last March, few thought that a year later schools would still be shuttered and that millions of children would lack access to essential services, such as meals, and that millions of jobs would be lost, leaving many individuals and families struggling to put food on the table. America’s hunger crisis is now so acute that a recent analysis found that the number of children not getting enough to eat was ten times higher during the pandemic, while nearly 1 in 6 adults – or close to 24 million Americans – reported that their households did not have enough to eat sometimes or often in the past seven days.

The sharp rise of hunger during the pandemic is yet another woeful legacy of the Trump administration’s mishandling of the Covid crisis, including trying to deny access to food relief by placing unnecessary bureaucratic barriers on states and even attempting to kick nearly 700,000 unemployed people off of food assistance in the midst of a once-in-a-century public health crisis. President Biden has thankfully made quick progress to address the hunger crisis through executive action and proposed legislation, but there is more work to be done to make our federal anti-hunger policy more resilient going forward for the next crisis, and to address the structural barriers to food affordability and access.

In his first week in office, President Biden signed an executive order that will help alleviate the hunger crisis by increasing benefits of the Pandemic-EBT program (P-EBT) and the Supplemental Nutrition Assistance Program (SNAP), as well as calling for the Agriculture Department to modernize the Thrifty Food Plan to better reflect the cost of a market basket of foods upon which SNAP benefits are based. Biden’s American Rescue Plan will also significantly bolster food assistance programs around the country. Collectively, these changes should make food aid more generous and better targeted.

However, many anti-hunger innovations were born of necessity during the pandemic, and these should serve as lessons learned going forward to better prepare for a future crisis. The P-EBT program has been a success at bridging the gap in nutrition for low-income children who used to obtain meals through programs at their schools, but who could no longer do so with schools closed. This program should be studied to see if it can be converted to a Summer EBT option going forward. Furthermore, to stay ahead of a future crisis, researchers at the Center on Budget and Policy Priorities have suggested that Congress “leverage the P-EBT structure to create a permanent authorization for states to issue replacement benefits (similar to P-EBT, and perhaps renamed “emergency-” or E-EBT) in case of lengthy school or child care closures resulting from a future public health emergency or natural disaster.” This would make it easier for states to act quickly and not rely on Congressional action should schools need to close in the future. Finally, Rep. Suzanne Bonamici has introduced a bill that would more effectively allow schools to distribute free meals to students and other community members in need, and to extend meal service for afterschool meals and snack programs. These measures would make our systems nimbler and more responsive should a future disruption, national or local, occur.

America’s hunger crisis did not start with the pandemic, and policymakers should go further to address three key underlying causes and structural barriers to food access and affordability. First, the White House should focus on stricter antitrust enforcement in the food industry. The U.S. food and agriculture industry is concentrated, with a few large firms dominating many markets, which can drive up consumer prices on basic nutrition staples. Second, Congress should enact the HOPE Act, introduced by Reps. Joe Morelle and Jim McGovern and Senator Kirsten Gillibrand (D-NY) which would create online accounts that enable low-income families to apply once for all social programs they qualify for, rather than forcing them to run a bureaucratic gauntlet that makes it difficult for low-income Americans to get public assistance. Third, Congress should take up legislation, such as the bipartisan Healthy Food Access for All Americans (HFAAA) Act put forth by Sens. Mark R. Warner, Jerry Moran, Bob Casey, Shelley Moore Capito, that incentivizes food providers to set up shop in rural and hard-to-reach communities to improve food access for the estimated 40 million Americans living in “food deserts” that lack a nearby grocery store or food pantry or bank.

Food insecurity is not just a moral issue, it also has economic and social costs. Adults who go hungry are less productive and are more likely to suffer from chronic illness. Hungry children are more likely to get sick and fall behind in school. One in five Black and Hispanic households report they are unable to afford food. Poor nutrition and soaring rates of metabolic disease are a drag on the economy and contribute to rising healthcare costs and early deaths in minority and low-income families that are disproportionately more likely to experience poor nutrition and health as a result of food insecurity. And a boost in food assistance programs has even been found to speed economy recovery during a downturn and serve as an “automatic stabilizer”, an added bonus of fighting hunger during the Covid recession.

It’s time for a new national commitment to wiping out hunger and malnutrition in America. The pandemic and the associated hunger crisis have taught us valuable lessons that we should use so that we can be better prepared to face a future crisis and to curb hunger in America.

*Veronica Goodman is the Director of Social Policy at the Progressive Policy Institute. In her role, she develops and analyzes policies designed to help lift more Americans out of poverty and to strengthen the middle class, focusing on social mobility, inequality, labor, and modernizing social services. Veronica earned graduate degrees in economics and public management from Johns Hopkins University, and her undergraduate degree from The George Washington University.

You can find Goodman’s full paper on a comprehensive federal approach to the hunger crisis here.

This piece was published on On Food Law, a forum for food law scholars to discuss ideas and to share work, managed by the Food Law Lab at Harvard Law and the Resnick Center for Food Law & Policy at UCLA Law.

Biden Clears First Big Hurdle

Posted on by The Progressive Policy Institute

Barring some 11th hour drama in the House, President Biden is expected to sign his $1.8 trillion American Rescue Plan into law this week. It’s a landmark achievement that gives us reason to hope our government may not be broken after all. 

Although he’s only been in office 46 days, Biden already has done more to lift the nation’s morale and make the economy work for everyone than his predecessor managed in four turbulent years. In case we’ve forgotten, this is what a real president looks like.

Biden’s plan focuses intently on defeating the coronavirus pandemic that has frozen normal life for a full year. It provides ample money to ramp up vaccinations, enable schools to reopen, help people who have lost their jobs and businesses, keep state and local governments running – all of which will speed economic recovery. 

In shaping and steering the package through Congress, Biden has drawn on a deep reservoir of political experience and cordial relationships. He also has been abetted by qualified and competent White House staff (another contrast with the man he replaced). He has radiated calm and showed impressive discipline in ignoring political distractions and media sideshows to deliver swiftly on his core campaign promise. 

The record will show the relief bill passed with almost zero votes from Republicans. But it will also show that Biden got the job done without vilifying his opponents or deepening the country’s paralyzing cultural rifts.    

Plenty of pragmatic progressives – myself included – have misgivings about parts of the bill. Its cash payments are not well-targeted, and $350 billion appears to be more than state and local governments actually need. Those dollars would be better spent on science and technology, high skills for non-college workers, clean energy infrastructure and other essential public investments. Amid $5-6 trillion deficits and cascading public debt, we could face some difficult fiscal adjustments in the years ahead.

On the other hand, the Biden package is deeply progressive. It throws lifelines to vulnerable Americans who have borne the brunt of the virus and the Covid recession:  the old, low-income workers, poor and minority communities with severe health challenges and hungry families. Through an expanded child tax credit, the bill also would create the equivalent of a child allowance that is expected to cut child poverty in half. 

Policy disagreements aside, Biden correctly gauged the magnitude of the nation’s health and economic emergency. After a long, grinding year of loss, suffering and social isolation, his instinct to go big is right. So is his desire to cultivate national “unity” and reach out to reasonable Republicans, who are beset by extremists in their party. 

This is what governing in a Constitutional democracy is supposed to look like. The public seems to approve, even if Biden’s left-wing detractors don’t. The most recent AP poll shows the president’s approval rating hitting 60 percent. 

By clearing his first big hurdle, Biden has dealt himself a strong political hand for the next one: Winning passage of his coming “Build Back Better” plan for building a more just, clean and resilient U.S. economy. 

This piece was also published on Medium.

Natural Gas and America’s Clean Energy Transition

Posted on by The Progressive Policy Institute

President Biden has set the ambitious, important climate goal of achieving net zero emissions from the nation’s electric power sector by 2035.  Already, natural gas has played a key role in lowering U.S. carbon dioxide emissions in the past 15 years, in part by displacing higher emitting coal. But gas, which still provides more than a third of America’s electricity, must play an even greater part in America’s decarbonization plans going forward.

Right now, gas uniquely supports the expansion of renewable energy by providing an instantly dispatchable source of electricity. Unlike coal and nuclear plants, natural gas power plants turn on and off within minutes, allowing the grid to quickly match supply and demand even when the wind isn’t blowing and the sun isn’t shining. As a U.S. National Renewable Energy Laboratory report has noted, this unique flexibility of natural gas generation thereby facilitates the steady expansion of renewables.

Yet as we move toward decarbonization, maintaining an affordable and reliable grid is becoming more exacting, due to increased frequency of extreme weather events and the rapid growth of intermittent and variable wind and solar power. Retaining sufficient natural gas generation to backstop wind and solar power will reduce costs and increase reliability compared to a grid that relies entirely on renewables, or often more expensive electricity storage. Given these realities, demands to ban shale gas development and fracking are not consistent with an economically balanced approach to decarbonizing the electric grid, as President Biden and other administration officials have repeatedly noted.

Read the full piece by click here.

Carolina Postcard: What is Roy Cooper’s Special Sauce?

Posted on by The Progressive Policy Institute

A national reporter recently wrote a flattering article about Governor Roy Cooper, but seemed flummoxed by Cooper’s political success.

In “What Does This Man Know That Other Democrats Don’t?” in The Atlantic, Edward-Isaac Dovere wrote, “The governor is 16–0 in primary and general elections over the past three and a half decades—in good years and bad years for Democrats, in the North Carolina of his youth and in the very different place his state has become.”

Even after interviewing the Governor, he wrote, “Cooper doesn’t know why he keeps winning in North Carolina while other Democrats keep losing.” He added, “the secret to Cooper’s victories may be hard to replicate.”

Actually, there’s no secret here. Dovere touched on most of the explanations. But he underestimated some of them, and he missed a big one.

Cooper’s first key to success, the article noted, is “Make sure voters can see you running a competent and effective government.” Yep. The Governor’s handling of the Covid pandemic played a big part in his reelection last year.

Dovere mentioned “his identity as a white man (which) may have enabled him to hold on to moderate voters.” It’s more than that; Cooper comes across as what he is: a small-town boy from rural North Carolina who has worked his way up.

The article noted, in a master stroke of understatement, that Cooper has “built up his own fundraising apparatus.” In fact, the Governor raised more than $42 million for his reelection last year. His opponent, Dan Forest, raised about $5 million. Cooper outspent Forest 10-1 on TV. In 2016, Cooper outraised an incumbent Governor – a rare feat.

Dovere said Cooper “also established (and largely funded) a political operation (that) gave him centers of political support around the state.” Actually, he’s been building a network since he was a student at UNC. Through 35 years in politics, Cooper has built a stable and experienced team of governmental and political advisers; some have been with him since he ran for Attorney General in 2000.

The article adds, “Then there’s Cooper’s aggressive messaging.” Again, that’s an understatement. In his one debate with Forest last year, Cooper – unlike most incumbents – hit his opponent hard from his opening to close.

After all that, Dovere missed what may be the biggest factor in Cooper’s success: He has won because he has run against the legislature.

Thanks to a fluke off-year election in 2010 and gerrymandering since, Republicans run the legislature. They’ve cut corporate taxes, cut spending on public schools, pushed private schools, stopped Medicaid expansion, cut unemployment relief and cut health, safety and environmental regulations.

But gerrymandering doesn’t work for a statewide race. North Carolina has elected Democratic governors – with precisely the opposite priorities of our legislature – in seven of eight elections since 1992. The only exception was 2012, when incumbent Governor Beverly Perdue pulled out of the race late and left the door open to Republican Pat McCrory.

McCrory faithfully followed the legislature’s lead on most every issue. He signed the controversial “Bathroom Bill” that cost North Carolina millions of dollars in business. He promptly lost reelection to Cooper, even though Donald Trump carried the state, as he did again in 2020.

Cooper is squarely in the tradition of governors since Terry Sanford (1960-64), including Democrats and Republicans like Jim Holshouser and Jim Martin. They focused on better education as the path to a better future. Cooper has added better health care, racial and gender equity, climate-change action and rural Internet to the agenda.

His secret is that North Carolinians evidently share his priorities.

Link to Article.

 

MAGALand in Orlando

Posted on by The Progressive Policy Institute

Orlando, a hub of fantasy theme parks, was the perfect setting for last weekend’s Conservative Political Action Conference (CPAC). The event showed that Republicans remain stuck in a looking-glass world of upside-down values.

The coronavirus pandemic has killed more Americans than World War II. But not a word of reproach was directed to the ex-president who presided over the nation’s COVID-19 debacle. Instead, conservatives gave South Dakota Gov. Kristi Noem a standing ovation when she jeered at Dr. Anthony Fauci.

Presidents who fail to win reelection usually have the decency to drop from public view and let their successor take the wheel. But in his closing speech to CPAC, Donald Trump pretended that the 2020 campaign never ended. He repeated the “rigged vote” lie that inspired the Jan. 6 assault on Congress and slurred President Biden with a farrago of false claims.

Read the rest of the piece here.

How Biden Can Get Americans Back to Work Better

Posted on by The Progressive Policy Institute

President Biden’s upcoming address to Congress is an opportunity to speak directly to the more than 10 million Americans who find themselves out of a job because of the pandemic recession. On the question of how to help these workers, Biden need look no further than the Build Back Better platform he campaigned on. A key element of the BBB platform is a $50 billion investment in workforce development, including apprenticeships.

Americans, especially young adults, need more pathways to careers that don’t require a traditional four-year college degree. While Millennials are the most educated generation in history, as of 2015, only about a third of Americans ages 25 to 34 were college graduates. That number is even lower for older Americans. Most people don’t go to college, and apprenticeships are an underappreciated way for finding jobs for the millions of job seekers who will have to find work after the pandemic, including those whose pre-Covid jobs might never come back. Compared to other high-income countries, the U.S. lags significantly when it comes to apprenticeships and other “active labor market” policies and it’s time for us to make investments to fill this gap.

Recently, the White House announced several ways that the Biden administration is strengthening registered apprenticeships across the country.

President Biden has endorsed Congressman Bobby Scott’s bipartisan National Apprenticeship Act of 2021, which will “create and expand registered apprenticeships, youth apprenticeships and pre-apprenticeship programs.” This legislation had been passed in the House in November 2020, in the last Congress, but 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. We’ve supported this bipartisan legislation in the past and we look forward to seeing it make its way through Congress.

Additionally, the White House has reversed a harmful Trump-era policy by rescinding the industry-recognized apprenticeship programs (IRAPs), which threatened to undermine registered apprenticeship programs across the country and weakened employer-protections for trainees.

These are important steps, but the White House and Congress should go even further to modernize the current apprenticeship system. First, they should formalize and incentivize intermediaries (public or private) who create “outsourced” apprenticeships programs that get paid for each placement when they hire candidates who meet certain criteria (such as eligibility for Pell grants), provide them with an apprenticeship that pays minimum wage or better, train them, and place them in permanent positions. Second, they should create relationships with high schools to set up apprenticeships and career and technical education programs that begin in the 11th or 12th grade and pair students with local employers. These have shown promise in other high-income countries that employ a high percentage of their younger workers through apprenticeships. And, lastly, they should create public service apprenticeship opportunities and programs at all levels of government, including in industries such as information technology, accounting, and healthcare.

As President Biden crafts his address to Congress in the coming weeks, we hope that he acknowledges that millions of Americans who are out of a job lack a college degree. For them, other pathways to jobs, such as through investing in apprenticeships, will be a critical step forward in regaining their economic footing.

This piece was also published on Medium.

Electric cars are the future. Here’s how to get American drivers interested in them.

Posted on by The Progressive Policy Institute

Major electric vehicle announcements by President Joe Biden and General Motors are being hailed as a turning point in the transition to widespread EV production and deployment in America. This matters greatly, because this crucial technology can both jump-start U.S. manufacturing to ease the economic and jobs crisis, and rapidly reduce emissions that cause climate change.

But there are still serious barriers to EVs. By far the biggest is the lack of American consumer demand for electric vehicles.

EVs, including plug-in electric hybrids, accounted for less than 2% of new U.S. vehicles sold in 2019.

This number is far lower than in other major markets, especially China, which has triple U.S. production and deployment volume.

Just as worrisome, only 14% of Americans say they are considering buying an EV, compared with 73% of Chinese motorists.

Read the full piece here.

Report Calls for New National Commitment, Vigorous Response to Hunger and Malnutrition in America

Posted on by The Progressive Policy Institute

WASHINGTON, D.C. — A new brief released today from the Progressive Policy Institute (PPI) targets the federal response to the hunger crisis resulting from the COVID-19 pandemic and recession.

It discusses the valuable policies contained in President Biden’s recent executive orders and the proposed American Rescue Plan legislation and also identifies additional policies to address hunger, including reducing concentration in the food industry, using modern information technologies to help low-income Americans cut through siloed bureaucratic obstacles, and expanding food aid for low-income children.

Key recommendations from the brief include: 

• Extend the Pandemic EBT program through the pandemic and economic recovery to provide low-income children with free or subsidized meals during weekends, holidays, and summer break. To be better prepared for a future crisis, Congress should also leverage the P-EBT program to create a permanent authorization for states to issue replacement benefits, giving them more flexibility to respond in a crisis.

• Study the success of the P-EBT program with an eye to converting it into a Summer EBT program post-Covid to bridge the gap in nutrition during the summer months and reach more low-income children in rural and underserved communities.

• Pass legislation, such as the Pandemic Child Hunger Prevention Act, in future recovery legislation, to allow all children free access to breakfast, lunch, and after school snack programs either in school or through “grab and go” and delivery options, as well as reduce bureaucratic barriers for schools to deliver meals to kids.

• Focus on stricter antitrust enforcement in the food industry to help consumers facing increasing prices for basic nutrition staples, such as meat and eggs.

• Use information technology to modernize social service delivery and reduce the administrative burden on low-income people. For example, Congress should enact the HOPE Act, which would create online accounts that enable low-income families to apply once for all social programs they qualify for, rather than forcing them to run a bureaucratic gauntlet.

• Pass the bipartisan Healthy Food Access for All Americans (HFAAA) Act, put forth by Sens. Mark R. Warner, Jerry Moran, Bob Casey, Shelley Moore Capito, which provides incentives, including tax credits or grants, to food providers who serve low-access, rural communities. Draft legislation that provides grants to states to fund the establishment and operation of grocery stores in rural and underserved communities.

Veronica Goodman, PPI’s Director of Social Policy, and Crystal Swann, Senior Policy Fellow, are co-authors of the brief, and said this: 

“The Trump administration’s feeble response to America’s hunger crisis was a national disgrace, one of the many ways in which it thoroughly bungled the nation’s response to the Covid pandemic. The contrast with the Biden administration’s sharp focus on hunger and decisive moves to alleviate it couldn’t be more dramatic.

Nonetheless, it should be just the beginning of a new national commitment to wiping out hunger and malnutrition in America. It’s time for a vigorous public response to growing concentration in the food industry, as well as a new push to use modern information technologies to help low-income Americans cut through burdensome bureaucratic obstacles and take charge of their economic security. We’ve also learned lessons during the pandemic for how to provide meals to families outside of the traditional systems, and we should preserve these going forward in the effort to be better prepared for a future crisis and to curb hunger in America.”

Read the full report here.

Hunger in America: A Comprehensive Federal Response

Posted on by The Progressive Policy Institute

EXECUTIVE SUMMARY

This policy brief highlights recent developments in the federal response to the hunger crisis resulting from the Covid pandemic and recession. It discusses the valuable policies contained in President Biden’s recent executive orders and the proposed American Rescue Plan legislation, and also identifies additional policies to address hunger, including reducing concentration in the food industry, using modern information technologies to help low-income Americans cut through siloed bureaucratic obstacles, and expanding food aid for low-income children.

As the pandemic unfolded across the country last spring, one of the first major disruptions was widespread school closures. When teachers locked up their classrooms last March, few thought that a year later schools would still be shuttered. Among the troubling losses to students, especially for the low-income, have been the social services that schools provide, such as meals. Millions of children around the country rely on school for breakfast, lunch, and daytime snacks. In April 2020, as policymakers scrambled to address spiking food insecurity, 35 percent of households with children under 18 said they didn’t have enough to eat, a dramatic rise from already high rates of hunger pre-pandemic. A recent analysis of food insecurity data found that the number of children not getting enough to eat was ten times higher during the pandemic, comparing December 2019 to December 2020.

Food insecurity doesn’t just affect children; adults and the elderly also don’t have enough to eat. Covid relief has certainly helped, but nearly 1 in 6 adults – or close to 24 million Americans – reported that their households did not have enough to eat sometimes or often in the past seven days, according to the latest Census Household Pulse survey in January. Households experiencing food insecurity include close to 5.3 million senior citizens. America’s ongoing hunger crisis requires a forceful response encompassing several different dimensions of public policy.

The sharp rise of hunger during the pandemic is yet another woeful legacy of the Trump administration’s mishandling of the Covid crisis. Last spring, in response to widespread school closures, Congress launched Pandemic Electronic Benefit Transfer, or P-EBT, a program to replace the free and subsidized meals that children would normally get at school. However, the Trump administration placed unnecessary bureaucratic barriers on states which meant that many households eligible for the P-EBT program never received the benefits, even as Congress re-funded the program in September 2020. The Trump administration went so far as to try to kick nearly 700,000 unemployed people off of food assistance late last year in the midst of this public health crisis, but this move was stopped by a federal judge. The consequence of these actions was that while spending for food assistance went up by nearly 50 percent in 2020, some of that aid never reached families in need. 

President Biden’s swift call for legislative and executive action on hunger is a welcome sign that U.S. leaders finally are determined to give this problem the attention it deserves.

During his first week in office, President Biden moved quickly to address the acute hunger crisis afflicting millions of Americans during the Covid pandemic and recession. Unveiling his $1.9 trillion coronavirus relief plan in January, Biden struck an urgent note, decrying a reality in which “…folks are facing eviction or waiting hours in their cars — literally hours in their cars, waiting to be able to feed their children as they drive up to a food bank. It’s the United States of America and they’re waiting to feed their kids… But this is happening today, in America, and this cannot be who we are as a country. These are not the values of our nation. We cannot, will not let people go hungry.”

To meet this emergency, Biden’s American Rescue Plan extends the 15% increase in Supplemental Nutrition Assistance Program (SNAP) benefits and proposes $3 billion in additional funding for the Women, Infant and Children (WIC) program. The plan also includes $350 billion in aid to state and local governments to support their anti-hunger initiatives, including food pantries, senior nutrition, and other nutrition programming.

President Biden is not waiting for Congressional legislation to provide a much-needed increase in food assistance to families. In his first week in office, the President signed an executive order that will alleviate the hunger crisis in three critical ways.

First, Biden’s executive order will increase food benefits for the P-EBT program by 15 percent, which will give a family of three children an additional $100 every two months, according to National Economic Council Director Brian Deese. The P-EBT was created by Congress in 2020 to give benefits to eligible households with children who would have received free and reduced meals under the National School Lunch Act had schools not been closed. Second, the President has directed the USDA to increase the SNAP Emergency Allotments for those at the lowest rung of the income ladder. And lastly, the executive order calls for modernizing the Thrifty Food Plan to better reflect the cost of a market basket of foods upon which SNAP benefits are based. Collectively, these changes should make food assistance more generous and better targeted.

While these are welcome steps, we call on the Administration to go further by addressing the underlying causes and structural barriers to food access and affordability. We focus on three in particular: Growing concentration in the food industry; siloed social service bureaucracies that make it difficult for low-income Americans to get public assistance; and the difficulty in expanding food aid for low-income children in hard-to-reach places. The pandemic has shined a light on the silent nutrition and food insecurity epidemic in our country and our policy brief outlines a comprehensive federal response.

KEY RECOMMENDATIONS: 

  • Extend the Pandemic EBT program through the pandemic and economic recovery to provide low-income children with free or subsidized meals during weekends, holidays, and summer break. To be better prepared for a future crisis, Congress should also leverage the P-EBT program to create a permanent authorization for states to issue replacement benefits, giving them more flexibility to respond in a crisis.
  • Study the success of the P-EBT program with an eye to converting it into a Summer EBT program post-Covid to bridge the gap in nutrition during the summer months and reach more low-income children in rural and underserved communities.
  • Pass legislation, such as the Pandemic Child Hunger Prevention Act, in future recovery legislation, to allow all children free access to breakfast, lunch, and after school snack programs either in school or through “grab and go” and delivery options, as well as reduce bureaucratic barriers for schools to deliver meals to kids.
  • Focus on stricter antitrust enforcement in the food industry to help consumers facing increasing prices for basic nutrition staples, such as meat and eggs. 
  • Use information technology to modernize social service delivery and reduce the administrative burden on low-income people. For example, Congress should enact the HOPE Act, which would create online accounts that enable low-income families to apply once for all social programs they qualify for, rather than forcing them to run a bureaucratic gauntlet. 
  • Pass the bipartisan Healthy Food Access for All Americans (HFAAA) Act, put forth by Sens. Mark R. Warner, Jerry Moran, Bob Casey, Shelley Moore Capito, which provides incentives, including tax credits or grants, to food providers who serve low-access, rural communities. Draft legislation that provides grants to states to fund the establishment and operation of grocery stores in rural and underserved communities.

GO BIG ON HUNGER — FAST

Food insecurity is not just a moral issue, it also has economic and social costs. Adults who go hungry are less productive and are more likely to suffer from chronic illness. The nutrition crisis has been called a “slow epidemic” by Dr. Dariush Mozaffarian, dean of the Freidman School of Nutrition Science and Policy at Tufts University.

The rate of households reporting that they do not have enough to eat is much higher than pre-pandemic levels, especially for families with children. Hungry children are more likely to get sick and fall behind in school. One in five Black and Hispanic households report they are unable to afford food. Poor nutrition and soaring rates of metabolic disease are a drag on the economy and contribute to rising healthcare costs and early deaths in minority and low-income families that are disproportionately more likely to experience poor nutrition and health as a result of food insecurity.

Food assistance spending now can also speed economic recovery. A 2019 report from the U.S. Department of Agriculture quantified the economic impact of SNAP spending during the Great Recession and found that this program can serve as an “automatic stabilizer” during a downturn. The authors analyzed program data and observed that low-income SNAP participants quickly spent the benefits after receiving them and the overall effect was a boost in the economy. Every $1 billion in new SNAP benefits led to “an increase of $1.54 billion in GDP – 54 percent above and beyond the new benefits.” SNAP benefits also generated $32 million in income for the agriculture industry and helped create jobs.

BUILDING RESILIENCE INTO OUR ANTI-HUNGER POLICIES

Despite the pandemic’s many tragic aspects, the disruption of our everyday lives has had some silver linings. Many innovations have been born of necessity, such as pioneering new approaches to feeding children who rely on meals at school despite school closures, and these can inform how we tackle food insecurity going forward. 

The U.S. has a patchwork of programs to feed children, and the efficiency of this system has been sorely tested during the pandemic. The School Breakfast Program and the National School Lunch Program feeds over 22 million children per year who rely on meals provided by their schools as a significant source of nutrition. During a normal schoolyear, the lack of access during weekends, holidays, and summer break can leave kids hungry. During the summer, only 1 in 6 of these children still receive meals through the USDA Summer Food Service Program. In 2011, in response to this gap in nutrition, the USDA launched a pilot called the Summer EBT to provide meals to children during the summer months. The program is aimed at reaching low-income families in rural and hard-to-reach communities where the Summer Food Service Program has not been as successful. Results from the demonstration are promising and, so far, more than 250,000 children have gained access to nutrition as a result of the program. Despite the early successes of the Summer EBT demonstration projects, the Trump administration took the controversial step of closing sites in some places, such as Connecticut and Oregon.

Some researchers have called for expanding the Pandemic-EBT program through the rest of the pandemic and recovery to allow states to provide free or subsidized meals for children during these breaks in the school calendar. Once schools reopen, the Biden administration should explore preserving the systems set up by schools during the pandemic to provide meals to low-income children outside of the usual school day and year, including potentially by expanding Summer EBT. 

Forced to improvise when schools shut down, many school districts have developed more flexible and varied ways to get meals in the hands of hungry families. School meals now are more widely available to children learning at home through “grab and go” distribution centers or meal delivery. School systems should go further to ensure that other family members in low-income households can take away meals during pickup to eat off-site. For example, Rep. Suzanne Bonamici has co-sponsored a bill that would allow schools to distribute meals to students and other community members in need, and to extend meal service for afterschool meals and snack programs. We applaud this bill as temporary and essential pandemic-relief legislation. This flexibility and the waivers aimed at making it easier to serve meals for low-income families in school districts could end up having unintended consequences, such as impacting funding levels as these waivers are used to determine need across districts. Policymakers should remain aware that funding will need to be determined differently during the pandemic as a result of fast-changing policies.

We do not know when the next pandemic or economic crisis may strike, but we can be better prepared. As we’ve learned from Covid, systems that we take for granted, such as schools, can be shut down overnight. In order to stay ahead of a future crisis, researchers at the Center on Budget and Policy Priorities have suggested that Congress “leverage the P-EBT structure to create a permanent authorization for states to issue replacement benefits (similar to P-EBT, and perhaps renamed “emergency-” or E-EBT) in case of lengthy school or child care closures resulting from a future public health emergency or natural disaster.” This will make it easier for states to act quickly and not rely on Congressional action should schools need to close in the future.

Making our food delivery system more resilient against future pandemics or other emergencies should be a national priority. That will require attacking the structural roots of food scarcity in the world’s richest country. 

STRUCTURAL BARRIERS TO FOOD ACCESS AND AFFORDABILITY

Of course, America’s hunger problem did not start with the pandemic. Before Covid, as many as 13.7 million households or 10.5 percent experienced food insecurity. In addition to dealing with the present crisis, the White House should develop new strategies for tackling the structural causes of food access and unaffordability. Three stand out today in particular: a decades-long trend of concentration in the food industry; bureaucratic inertia and dysfunction that discourages enrollment in aid programs; and the stubborn blight of rural hunger. 

As PPI economist Alec Stapp has documented, market concentration in the food industry is driving up prices for basic sources of protein, such as chicken and eggs. A recent antitrust conference at Yale Law School noted that “the country’s four largest pork producers, beef producers, soybean processors, and wet corn processors control over 70 percent of their respective markets. Four companies control 90 percent of the global grain trade. Agrochemical, seed, and many consumer product industries are likewise now controlled by just a few mega-sized firms.” 

Low-income households spend the bulk of their budgets on housing, transportation, and food and, as a share of their household income, these families spend close to a third on food, with meat and eggs being especially pricey. To make food more affordable for all families, the White House should focus on stricter antitrust enforcement in the food industry by appointing leaders to the USDA, the Antitrust Division of the Department of Justice, and the Federal Trade Commission who will make this issue a priority. 

Recent evidence from communities hit especially hard by the pandemic also highlights how formidable bureaucratic barriers deter many eligible households from accessing food aid. Policymakers should use information technology to modernize social service delivery and reduce the administrative burden on people to increase take-up in food assistance programs.

PPI has called for modernizing safety net programs to reduce the high “opportunity costs” of being poor in America. Federal and state governments should adopt modern digital technologies that help low-income families apply once for public benefits without having to run a bureaucratic gauntlet of siloed programs for nutrition, housing, unemployment, job training, mental health services, and more.

“While it’s true that government safety net programs help tens of millions of Americans avoid starvation, homelessness, and other outcomes even more dreadful than everyday poverty, it is also true that, even in ‘normal times,’ government aid for non-wealthy people is generally a major hassle to obtain and to keep,” notes Joel Berg, CEO of Hunger Free America.

“Put yourself in the places of aid applicants for a moment,” Berg added. “You will need to go to one government office or web portal to apply for SNAP, a different government office to apply for housing assistance or UI, a separate WIC clinic to obtain WIC benefits, and a variety of other government offices to apply for other types of help—sometimes traveling long distances by public transportation or on foot to get there—and then once you’ve walked through the door, you are often forced to wait for hours at each office to be served. These administrative burdens fall the greatest on the least wealthy Americans.”

In a 2016 PPI report, Berg proposed the creation of online “HOPE” accounts for families to better manage and access their benefits, and into which they could deposit their public assistance.

This idea is at the heart of the Health, Opportunity, and Personal Empowerment (HOPE Act) introduced by Reps. Joe Morelle (D-NY) and Jim McGovern (D-Mass) and Senator Kirsten Gillibrand (D-NY). The HOPE Act would fund state and local pilot projects setting up online HOPE accounts to make it easier for low-income people to apply for multiple benefits programs with their computer or mobile phone. In addition to saving them time, money, and aggravation, HOPE accounts enable people to manage their benefits – effectively becoming their own “case manager” – and easing their dependence on often inefficient and unresponsive social welfare bureaucracies.

WIC (formally the Special Supplemental Nutrition Program for Women, Infants, and Children) is a concrete example of how bureaucratic barriers can impact program enrollment. Despite increases in funding and strong evidence for its boost in outcomes for mothers and children, the share of eligible household participating in the program has fallen over the past ten years. One significant barrier to uptake is the requirement that families take time off of work to apply in person and bring their children to multiple appointments at clinics. HOPE accounts, if implemented well, could help families by creating an online platform where they can complete an initial application and better manage their benefits.

Policymakers should also make it easier for the elderly and other vulnerable groups to navigate eligibility and participate in SNAP. Researchers recently found that “providing information on eligibility or information plus application assistance” can significantly increase take-up rates among the elderly. Interventions should be designed with the behavioral differences of eligible groups for various social safety net programs, including food assistance.

The third major contributor to food insecurity is geography. According to the USDA, nearly 40 million Americans live in rural communities considered “food deserts” because they lack a nearby grocery store or food pantry or bank. And although rural communities make up 63% of counties in the U.S., they represent 87% of counties with the highest rates of food insecurity. These “food deserts” tend to disproportionately impact the rural poor, Black and Hispanic households, and families with children. To address this disparity, some organizations have launched mobile food pantries and food delivery programs that ship food in bulk to low-income families, but more access is needed to bridge this geographical barrier.

Earlier this month, Senator Mark Warner, along with several senators from both sides of the aisle, introduced the Healthy Food Access for All Americans (HFAAA) Act which provides incentives, including tax credits or grants, to food providers who serve low-access communities and become designated as a “Special Access Food Provider” certification process through the U.S. Treasury Department. This legislation is a crucial way to incentivize food providers to set up shop in rural and hard-to-reach communities.

CONCLUSION

The Trump administration’s feeble response to America’s hunger crisis was a national disgrace, one of the many ways in which it thoroughly bungled the nation’s response to the Covid pandemic. The contrast with the Biden administration’s sharp focus on hunger and decisive moves to alleviate it couldn’t be more dramatic. 

Nonetheless, it should be just the beginning of a new national commitment to wiping out hunger and malnutrition in America. It’s time for a vigorous public response to growing concentration in the food industry, as well as a new push to use modern information technologies to help low-income Americans cut through burdensome bureaucratic obstacles and take charge of their economic security. We’ve also learned lessons during the pandemic for how to provide meals to families outside of the traditional systems, and we should preserve these going forward in the effort to be better prepared for a future crisis and to curb hunger in America.

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

Posted on by The Progressive Policy Institute

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

Posted on by The Progressive Policy Institute

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

Posted on by The Progressive Policy Institute

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.