BY NOAH WEXLER, ECONOMIC DEVELOPMENT POLICY BOARD
On September 22nd, members of Roosevelt Institute at GW met with Ed Lazere of the DC Fiscal Policy Institute (DCFPI), a chapter of the Center for Budget and Policy Priorities’ State Policy Project. As the Director of DCFPI, Ed researches the effects of the District of Columbia’s (the District) fiscal decisions and advocates for progressive revenue allocation. Ed graciously offered his time to discuss an overview of the District’s fiscal processes and how politics affects and shapes the municipal policy. He also provided his insight into contentious local policies and issues.
Ed began the conversation by explaining the unique complexity of the District’s fiscal policy process. He noted that the District is a political anomaly in the nation; its City Council and Mayor essentially take on otherwise federal, state, and local duties. Furthering this unique situation, Congress has purview over the District’s fiscal allocations. Ed emphasized that up until two years ago, Congress actively reviewed every piece of legislation that went through the District’s City Council. If Congress did not review a bill, it was tacitly approved.
The spectre of federal involvement still looms large in local fiscal processes. The imposition of a Federal Control Board over the District’s allocation process in response to the District’s fiscal crisis in the 1990s created a stigma against spending. Ed explained that the Chief Financial Officer of the District of Columbia consistently pushes for a budgetary surplus because of a fear of fiscal insolvency. The result: the District consistently generates a multi-million dollar surplus year after year, but the money is seldom invested into local initiatives that benefit low-income citizens.
Ed highlighted how this lack of desire to invest fiscally results in effective programs being underfunded. One effective policy that goes underfunded is the District’s housing voucher program, a policy he feels is a politically palatable solution to the District’s affordable housing crisis. According to Ed, providing more vouchers that fund for rent payments in excess of 30% of residents’ income would effectively ensure accessible housing without angering DC’s politically influential development industry. Ed summed up the entire discussion bluntly and poignantly, saying that when it comes to affordable housing and development, so much would be fixed if “DC just put up the money.”
KATIE ALLISON, INTERNATIONAL AFFAIRS POLICY BOARD
On this day in 1957, the Soviet Union launched the first satellite into orbit, inciting panic into the American public and demanding a response from President Eisenhower. Ignoring what has been learned in the past fifty nine years, there were a variety of policy options available to President Eisenhower at the time of the launch. This post will evaluate the policy options available to the United States government and their effectiveness—as though it were still 1957. Following the policy recommendation is a brief analysis of how this significant event, 59 years ago, still impacts both foreign and space policy today.
Response Options to the Launch of Sputnik I
On October 4, 1957, the Soviet Union became the first nation to successfully launch an object into orbit with their satellite, Sputnik.[i] The United States now faces the issue of determining an appropriate response.
There will be psychological implications to this launch, especially in the United States and those countries currently fighting against Communism.[ii] Plans existed in both countries to put a satellite into orbit as part of the International Geophysical Year (IGY). The United States is now second in this race which will, undoubtedly, damage the nation’s pride and incite some amount of fear in its citizens. The public response will unquestionably ask for an increase in funding for space programs to close any perceived gap in technology. Contrary to public perceptions of a technological gap, the Army’s Redstone program, in September of 1956, successfully launched a Jupiter-C missile to an altitude of 682 miles, and achieved sufficient speed to launch a satellite into orbit, had one been on board.[iii] Therefore, there is only a perceptual gap in technology . The current source of fear is in Soviet military applications of this new missile technology. The USSR has shown no signs of developing a viable reentry vehicle or shield for any warhead, so these fears are, for the moment, baseless.
The United States has multiple agencies tasked with Research and Development (R&D) of space launch and satellite technologies (the Air Force, Navy, Army and the National Advisory Committee for Aeronautics) which are cooperatingcompeting with each other.
The USSR has established the precedent of the “Freedom of Space”, since their satellite went into orbit without backlash from the international community. Scientific satellite launches were agreed to as part of the IGY, therefore the United States will have no issue with the legality of future scientific satellite launches under this precedent. Intelligence gathering satellites may raise objections. Sputnik demonstrated that space is free to all countries because of the lack of objections from the international community over Sputnik’s radio signals differing from those agreed to under the IGY.[iv]
Here are the following policy options for consideration:
Option 1: The President will address the nation publicly and accelerate the planned launch date of the first US satellite by increasing funding to agencies involved in space/launcher R&D.
Option 2: The President should address the nation publicly and inform them that the United States will not be frightened by the actions of another nation, and will launch a scientific satellite by the end of the IGY. The President will create a new committee to increase information sharing between agencies involved in space R&D, so that these agencies begin cooperative efforts.
Option 3: The President will address the nation as he would in option two. He should then create a new government agency that would take over all space related R&D and instruct Congress to move all space-related funding to this agency. He will then instruct the agency to continue working on the Army’s Jupiter-C missile as a launcher.
Seeing that the President has a plan and is calm in the face of crises will have a psychologically beneficial effect on the American public. Addressing the nation is a crucial part of all these options. Options 2 and 3 are the most highly recommended, as the information sharing aspects they create have the greatest potential for increased efficiency of space technology without dramatically increasing the economic costs of these endeavors. Option 3 is preferable to Option 2, as it would concentrate space technology under one agency, making R&D economically feasible and faster in the future and utilize technology that has worked in the past.
Though the launch of Sputnik occurred 59 years ago, its implications are still visible in modern foreign and space policy.
Despite the criticism President Eisenhower received for apparent inaction in response to Sputnik, his ability to maintain a calm demeanor throughout the period of public panic that followed the launch of the satellite is an example of demeanor that future presidents facing crisis should follow. The President resisted pressure to immediately increase the budgets of those working on a launch vehicle for spaceflight (NACA (the predecessor to NASA), the Air Force, the Navy and the Army), despite public and Congressional outcry. He relied on his knowledge of the technical capabilities of the United States and counted on those working on the space programs to meet the set deadline for a United States satellite launch as part of the International Geophysical Year. In the end, everything went according to plan—the United States launched Explorer 1 on January 31, 1958, and Eisenhower set a lasting example of remaining composed under pressure.
The Soviet Union, unaware they incited panic throughout the public of the United States by its satellite launch, settled a legal argument that had been raging within the United States government for months about the freedom of space, which remains a key aspect of space policy to this day. Before the launch of Sputnik, international implications of spaceflight were and any negative repercussions of a satellite obritting above another sovereign nation was unknown. The Soviet Union set a precedent for the freedom of space that still exists today, and gives any sovereign nation the right to utilize outer space in a responsible manner. This precedent has allowed technologies that are now commonplace to be developed. Global Positioning Systems, advanced weather tracking, and satellite television, would be difficult to conceive if the freedom of space had not been established.
[i] Diamond Edwin and Stephen Bates. 1997. "SPUTNIK - Forty years ago this month the Soviet Union orbited a "man-made moon" whose derisive chirp persuaded Americans they'd already lost a race that had barely begun". American Heritage. 48 (6): 84.
[ii] Executive Secretary of the National Security Council. 1955. Note by the Executive Secretary to the National Security Council on U.S. Scientific Satellite Program.
[iii] McDougall, Walter A. 1985. The Heavens and the Earth: A Political History of the Space Age. New York: Basic Books.
[iv] Quarles, Donald. 1957. Memorandum of Conference with the President.
The Inevitability of Yellow Flowers Turning Purple: The Reality Surrounding Those Affected by Alzheimer’s
NORA HENNESSEY, PUBLIC HEALTH PAC
Three thousand walkers, each holding a flower or two that spun in the fierce morning wind, came together recently on the National Mall to memorialize the widespread effects of Alzheimer’s disease. The flowers we held came in four colors: blue flowers were given to those who have Alzheimer’s themselves, yellow for those supporting or caring for someone affected by the disease, purple for those who lost a loved one to the disease, and orange for those who supported the cause and vision of the walk we were participating in—a world without Alzheimer’s.
Lydia and Mia, the two girls with whom I was walking, each held one of these yellow flowers. In this moment it occurred to me that their flowers would eventually match the purple flower I gripped tightly in my hand.
More than five million people are currently diagnosed with Alzheimer’s in the United States. This number is expected to increase greatly over the next ten years, with predictions putting Alzheimer’s patients in the U.S. at 13.8 million by 2050. Alzheimer’s is the sixth-leading cause of death in United States, currently costing the nation $230 billion. These expenses are expected to balloon to $1.1 trillion in 2050. In the District of Columbia alone, around 9,000 patients were diagnosed with Alzheimer’s in 2014, costing caregivers a total of $26 million.
In December 2010, Congress unanimously passed the National Alzheimer's Project Act, which was officially made law a month later with President Obama’s signature . This legislation provided the United States with a much-needed framework for addressing Alzheimer’s and its effects on those with the disease and their caregivers.
The main goals of this legislation are to evaluate the effectiveness and outcomes of federal funding of Alzheimer’s research, care, and facilities, and to create yearly recommendations on how to better the lives of those affected by the disease—both physically and financially. A council created specifically to advise on the issues surrounding Alzheimer’s oversees the implementation of these recommendations, and while the framework has provided a large step forward for the Alzheimer’s community, there is still more to be done. To help bridge the gap between the national outlines and local implementations, many states—including the District of Columbia—have made their own plans using the federal recommendations.
Local policies need to be multifaceted and encourage increased research and medical treatments to address these issues. D.C.’s policy and plan for Alzheimer’s is, for the most part, well thought-out and comprehensive in this aspect.
While the policy tackles Alzheimer’s most pressing issues, the plan is reliant on an inefficient system that lacks incentives for those involved to begin this process. In order for this plan to be properly executed, each goal depends upon roughly ten identified “responsible parties”. These parties take the form of governmental institutions, non-profit organizations, and advisory councils, as well as caregivers and those affected by the disease themselves. These constituents must therefore balance the responsibilities of each of these goals, fulfill their own duties, and hold the other parties responsible for their own roles in the achievement of these goals.
To encourage cooperation, D.C. residents will need to speak out and encourage these organizations to actively engage and work on the implementation of this plan. While we may hope that these stakeholders would do this without prompting, the combination of bureaucracy and the lack of consequences for non-participation makes unlikely that this plan will be fulfilled in its five-year time frame without active incentivization.
These incentives could include direct phone calls to the responsible organizations to encourage action, calls to the D.C. Office on Aging expressing the need for the consistent governmental oversight of the issue, volunteering in committees dedicated to addressing Alzheimer's, contacting local nursing homes and hospitals to convey the need for active research and investment in finding a cure, and encouraging local community and religious organizations to host coordinated group petitions for increased governmental action on the Alzheimer’s agenda.
Alzheimer’s does not yet have a cure. There are only five experimental drugs to fight the illness after it has been diagnosed, and only one experimental treatment has been created to slow or potentially avoid the disease before it takes hold. In Colombia, an extended family with hereditary early-onset Alzheimer’s – one of eleven of its kind in the world – has consented to try the latter drug, but as it is a relatively new undertaking, its effectiveness is still unclear. Across the board, organizations that work on Alzheimer’s express the need for more money and for more patients to become involved in experimental treatments.
Alzheimer’s policy that has been put in place is a step in the right direction if only we can agree to stick to it, to follow through on national recommendations and have our communities reach out to local states to initiate and pursue their own plans.
Amongst a sea of purple flowers, and more that will one day likely be replaced by purple flowers, the orange flower projected more than any other. The orange flower is the hope that one day a an Alzheimer’s diagnosis will not mean inevitable death by dementia. The orange flower is the hope that gives people the strength to fight against the fading of yellow flowers into purple.
We need more orange flowers.
In the words of fellow walker Lydia Igna, “This is when your faith in humanity is restored: when you are in this giant group of people who come out to walk together in this frigid weather to support one another against this disease that affects so many.”
LENA HILLIARD, EQUAL JUSTICE DIRECTOR
Last Monday, the members of the Roosevelt Institute Equal Justice Policy and Advocacy Center traveled to the Transitional Housing Corporation (THC), a non-profit operating in the Washington, DC area. We were greeted by staff at the organization, who took us downstairs into an office room, where we matched up alarming facts and statistics on homelessness in the DC metropolitan area. These statistics made it clear that there is a vital need for organizations such as THC.
As we learned, there has been a 50 percent increase in the number of homeless families in the past 10 years, and the price of living in DC is so high that to afford a market-value, two-bedroom apartment, one needs to work 3.4 minimum wage jobs. After learning these alarming statistics about homelessness, we had a very comprehensive lesson on how the Transitional Housing Corporation is taking action to combat the issue.
Since its founding in 1990, THC has, through support services and housing opportunities, helped to place more than 500 families into stable homes. They utilize four different housing systems: Transitional Housing, Permanent Supportive, Rapid Rehousing, and Affordable Housing.
Transitional Housing is a system that bridges the gap between living in a shelter and living in an owned or rented home. It is a stable place of residence and a support system for families while they become more financially independent. Support is given to help people enter a stable job and receive consistent income. Permanent Supportive Housing moves families into permanent homes with leases in their names and offers comprehensive support as needed. The Rapid Rehousing system provides short term monetary assistance to place families in permanent housing in their names as quickly as the housing market allows. The last system, Affordable Housing, allows families to be placed in the district in a home that is within their means.
THC only works with homeless families in Washington, DC, a group whose number now hovers around 1,231. To qualify as a family, the group must include one adult 18 years or older and one dependent under 18 years old. The organization has struggled in the past with identifying how many homeless families actually exist in the district because less than 15 percent of people are considered chronically homeless -- the most overt form of homelessness, where a person has no roof over their head. Many families stay with relatives and may not identify as homeless.
When asked about how gentrification has affected their cause, THC was undecided. While the city is becoming safer and safer, the organization is finding an even greater need for its services. More and more families can no longer afford the cost of living and are being forced into unfavorable situations. Ultimately, the Transitional Housing Corporation aims to end homelessness in the District of Columbia. “We want to work ourselves out of a job,” said staff member Quinn Miller.
All statistics are courtesy of the Transitional Housing Corporation.
DAWID SKALKOWSKI, INTERNATIONAL AFFAIRS DIRECTOR
The Alexander Hamilton Society at the George Washington University recently hosted a debate between Philip Gordon, of the Council on Foreign Relations, and Mark Dubowitz, Executive Director of the Foundation for Defense of Democracies. Gordon has suggested that history shows it is unlikely for the United States and its partners to negotiate a better agreement than the Joint Comprehensive Plan of Action with Iranian leaders. Dubowitz argued that it is not only possible to acquire a better arms agreement, but that the United States and its partners must do so if they intend to ensure the stability of the region in the long-run.
This post will not examine details of the Joint Comprehensive Plan of Action (more commonly referred to as the Iran Deal); Vox has an in-depth overview of the language within the agreement. Much of the discussion surrounding the agreement has pointed towards the same objective: removing the possibility for Iran to develop industrial-sized centrifuges that can enrich uranium to produce a bomb. Yet critics and proponents alike disregard a crucial component to the discussion: preventing Iran from developing nuclear weapons compounds its desire to acquire them in the long-run.
Mark Dubowitz is correct to point out that the major flaw of the nuclear agreement rests in its ballistic missile restrictions being depleted over a fifteen year period, assuming Iran complies with all components of the agreement. To be sure, no agreement has the potential to prevent Iran from acquiring advanced centrifuges and building an arsenal of intercontinental ballistic missiles.
As Kenneth Waltz has contended, attempts to punish Iran for developing a nuclear program through economic and political sanctions further draw Iranian leaders to pursue the ultimate deterrent. Leaders have proven to the international system that Iran responds to sanctions and incentives like any other state would. Treasury Secretary Jacob J. Lew announced in April that Iran’s economy was fifteen to twenty percent smaller than it would have been had it remained on its pre-2012 growth trajectory.
Clearly, Tehran has taken notice. Critics of an armed Iran often look to discredit the regime by portraying its officials as irrational fanatics who would utilize a nuclear weapon against Israel. Yet, if Iranian leaders were willing to join international negotiations to remove sanctions on its economy—what is to suggest they would accept self-destruction through the promise of Israeli retaliation?
History is on the side of nuclear states that the international community wanted to disarm. North Korea frequently utilizes bellicose rhetoric towards other actors on the international stage, but has not employed use of its ballistic missile technology against another state. A nuclear arms race between the United States and the Soviet Union revealed that the promise of mutually assured destruction has served as the primary deterrent from states utilizing their nuclear programs.
If the United States and its partners find it in their interest to stabilize the region, the foremost consideration to be made is to recognize an Iranian withdrawal from the Nuclear Non-Proliferation Treaty. Next, the United States and the international community should draw back its sanctions against Iran. As Daniel Drezner has indicated, sanctions against Iran have the potential to weigh heavily on Iran’s economy—they do not, however, have the ability to alter Iran’s willingness to concede on arming itself with a nuclear weapon. By some accounts, sanctions make Iranian leaders more likely to perceive an external threat, and provide them with an even greater incentive to pursue a nuclear program.
The United States, and its partners in the region, should take steps towards drafting treaties that prevent the targeting of nuclear facilities—an initiative that was successfully accomplished between India and Pakistan in 1991.
We will have to accept that Iran’s regime will eventually gain nuclear capabilities, and we need to turn the discussion surrounding Iran towards what a world like that will look like, and how the United States and its partners can prepare to accept that reality. In the question of whether or not states should have the potential to pursue nuclear weapons, the international community may attempt to delay the construction of nuclear programs, but ultimately cannot erase the desire for states to defend themselves on the international stage.
Whether or not allowing Iran to develop a nuclear program would make it a more responsible actor on the international stage is a topic for a different discussion. By providing Tehran the assurance it needs to secure itself against opposing powers in the region, the international community would be taking a step towards recognizing and fulfilling greater stability in the region. By gaining a nuclear program, Iran will be joining a community of other nations that have developed nuclear programs against opposition from the international community, and ultimately have been deterred from utilizing them.
DAVID MENI, CHAPTER PRESIDENT
Urban acoustics is much more than a really excellent band name. It’s an emerging field of study that incorporates elements of urban planning and acoustic ecology—the study of sound’s impact on society and human functions. The study of urban sound planning has grown in popularity in parts of Europe but has yet to be holistically addressed in many American cities, even as new trends of mixed-use development make acoustic considerations more important.
While it may at first seem to be a trivial issue, acoustics can have an impact on everything from local economics to human psychology. Because of these intersectional issues, it’s important that cities take seriously those policies having to do with urban acoustics, take efforts to eliminate the socioeconomic disparities of noise pollution, and encourage creative use of sound design in new development projects and urban planning.
Now, before I get labelled as a grumpy “get off my lawn” type that doesn’t like loud noises, let me explain some of the current literature on noise pollution and acoustic ecology and how it impacts life in cities.
The World Health Organization and the EPA have established guidelines for community noise exposure: “Individuals [should] not exceed an 8-hour daily average level of 75 decibels or a 24-hour daily average of 70 decibels over a 40-year exposure period.” Seventy to seventy-five decibels is about as loud as a vacuum cleaner or a busy street; the New York Subway gets as loud as 105 decibels.
The public health impact of noise pollution, particularly in cities, is actually quite surprising. By 2050, there may be as many as 50 million people in the US with hearing impairment; younger generations have a rate of impaired hearing 2 1/2 times higher than that of their parents and grandparents, in large part due to the louder environments they live in. Sustained traffic noise in urban environments has been linked to everything from hypertension to sleep deprivation.
Urban acoustics even has an impact on economics. A Hofstra University study found a striking inverse relationship between noise levels and property value in residential areas, with a decrease in property value of 0.62% per decibel. Highways have an even greater impact; just the adjacent noise of a highway like the SE Freeway in DC can reduce property values 8-10%.
It’s important to note that the point of urban acoustic design is not meant to just make everything quiet. The type of noise is just as important to study as the volume—a coach bus and a crowded coffee shop are around the same decibel level. Good public spaces make use of noise as a cue for activity, and well-planned urban acoustic spaces can even go as far as providing the perfect natural acoustics for street musicians.
Soundscape mapping is an important tool for studying these kinds of relationships, but the practice is underutilized in the United States as a resource for planning. Below is an example of a soundscape map of a neighborhood in Seoul, South Korea, which shows trends of activity over the course of day.The crowd-sourced tool Sound Around You is a fun exploration of natural recordings, from birds chirping to squeaky metro escalators.
There are clear connections between the impacts of noise and the development trends of American cities, particularly as the automobile became ubiquitous in the 20th century. There’s no doubt that noise pollution is partially to blame for the 20th century phenomenon of over-zoning—the practice of so rigidly dividing residential, commercial, and industrial zones that they can no longer reinforce each other or create a sense of community. The desire to separate loud commercial and recreational space from residential areas led to this stark separation of land use seen in development of the last 40-50 years.
This trend introduces a disparity in noise pollution, which the American Public Health Association put the issue quite succinctly:
Even if you live in a city, it’s likely that you want to come home to some peace and quiet. But this tranquility often comes at a cost, and, without proper intervention and planning, can be relegated to a luxury. Low-income and minority communities are often not given a voice when high-noise land use (like a freeway) is placed near (or through) them, posing all the health risks, economic damages, and impediments to community growth mentioned above.
With the recent rise of New Urbanism and trends towards zoning for mixed-use, reduced sprawl, and greater density, urban acoustic design has become more important than ever.
If investments are made to advance urban acoustic planning, developments can more comfortably accommodate increased density.
A great example about how intentional acoustic design can encourage diverse and high-density are the plans for The Wharf development on DC’s Southwest Waterfront. Specifically, one building of the mixed-use plan contains both a 6,000 seat concert hall and residential units (the apartments effectively encase the concert hall). The site developers are working with a team of acoustic engineers to sufficiently soundproof the space—the concert hall can rock on while people upstairs can go about their business in peace.
Currently, there are two clear policy applications for urban acoustic design:
First, municipalities should seek to remedy the existing racial and income disparity in noise pollution. While nearly every locality has a noise ordinance, most are poorly enforced in the areas that need it most. To this end, more state and federal funding should be made available for the study of current urban soundscapes and methods of lessening the impact of noise pollution on public health and community development.
Second, American cities should embrace the range of new possibilities opened up by the continued advancement of acoustic design in built spaces. Developers both public and private can involve acoustic design earlier on in the development process, and acoustic considerations and their impacts on human behavior should be given greater consideration in urban planning.
Robust acoustic design can be an effective tool to fight increased sprawl in new developments and help make our cities more diverse.
Increased attention to the policy and practice of urban acoustic design can go a long way to improve the life of our cities. Well designed acoustic spaces can positively impact public health and local economies, as well as create novel ways to increase density and mixed-use development.
JACK NOLAND, ECONOMIC DEVELOPMENT DIRECTOR
As another session begins, there’s a monumental case before the Supreme Court concerning the Affordable Care Act (ACA), better known as Obamacare. Hold on. Didn’t we settle this a few years ago? Weren’t the streets filled with gleeful liberals and fist-shaking conservatives as the Court upheld the President’s signature piece of legislation? As seems to be the answer to any political question, yes and no.
National Federation of Independent Business v. Sebelius, the case decided in 2012, centered on the law’s individual mandate – the provision that eligible people need to buy health insurance or face a penalty so that there are enough healthy people in the insurance pool to keep everyone’s rates low. Since insurers cannot discriminate based on existing conditions, without the individual mandate, someone could wait until they got sick to purchase insurance, and it would be illegal for insurers to deny the coverage to them. Everyone would pay more, since the insurance pool would be primarily full of people who only purchased a policy once they had fallen ill.
In the end, Chief Justice Roberts joined the more liberal justices of the Court in holding that the individual mandate was indeed constitutional, which cleared the way for the law to be implemented. After a much-maligned rollout, the ACA remains in place. What’s the issue at hand now?
Essentially, King v. Burwell, the most recent case to dispute a component of Obamacare, will be decided over five words in an act running longer than nine hundred pages:
“an Exchange established by the State.”
A little more background: since the ACA mandates insurance coverage, there are potential issues for lower to middle class people who may not be able to afford the policies they are required to have. In thinking about this burden, the law establishes subsidies for these individuals.
The kicker, however, is that these subsidies are only available to those who purchase their insurance policies through a government-run exchange. As of 2011, 59.5 percent of Americans received their health insurance through their employer. To ensure that the remaining citizens were able to get insurance, the federal government encouraged states to establish marketplaces where people could pick the policy that worked for them. However, since the federal government cannot force the states to set up these exchanges, the law also provides for federal marketplaces to be developed in the states that choose not to build their own.
As the plaintiffs in King contend, if an individual purchases their policy in a federal marketplace, they will not be able to receive a subsidy, since the exchange was not “established by the State.” Whether or not this language was designed to restrict subsidies to state-run marketplaces, or rather to refer to the government exchange in a state in general (as opposed to the private marketplace), is up in the air. Should the Supreme Court hold the plaintiff’s interpretation to be correct, there will be massive economic implications.
Last year, five million people purchased insurance on the federal exchanges, and thirty-four states have a federally-facilitated or state partnership marketplace. Without subsidies, many people in these states would be unable to afford health insurance, and the ACA would be effectively kneecapped.
As an Urban Institute report estimates, should the plaintiffs win, the federal government would withhold $340 billion in tax credits over the course of 10 years. This would lead to 8.2 million more uninsured people in the states with federal exchanges, or a seventy-five percent decrease in coverage. Put simply, if your state didn’t vote to implement its own exchange, there’s a good chance you would be unable to afford insurance.
Crucially, there would also be a spillover effect. For many people, the cost of insurance would be more than 8% of their income and they would therefore be exempt from the penalty; in this case, it would be more affordable to forgo insurance entirely. As discussed above, insurance pools maintain low premiums by covering a wide swath of people, both sick and healthy. This loss of buyers into the insurance pool would exert economic pressure on the price of insurance policies, to the tune of thirty-five percent higher premiums for the marketplace.
There are very real expenses for both individuals and institutions here. According to Paula Brussard of the Hospital and Healthsystem Association of Pennsylvania, the cost to hospitals in that state of treating people with insufficient or no insurance increased about 50 percent, to over $1 billion in 2012. Keeping people insured makes clear economic sense.
Such a rate hike would have a profound impact on health insurance in general. Obamacare’s trusted defense rests on the idea that, at least in the long run, it will provide a cheaper alternative to the status-quo market. If premiums shot up, the legislation would lose the credibility it has struggled so hard to attain, as people become increasingly priced out. The number of uninsured individuals would rise, and we would be back to where we started.
This two-tiered system would defeat the purpose of the law: comprehensive coverage for all. The states that opted not to run their own exchanges would essentially be stuck with a higher percentage of uninsured citizens until they decided to implement programs of their own. In truth, this might light a fire under the states to try to set up their own markets, but, as Dan Schuyler of Leavitt Partners notes, this would cost the average state around $40 billion. Additionally, attempts to craft creative solutions in these states would fall flat, for the ACA’s “state innovation waivers” only grant states funding relative to the “amount of tax credits they would otherwise receive.” This is precisely why several of the states with federal exchanges have signed onto an amicus brief arguing against the plaintiff’s interpretation, and that they had received no forewarning that states with this type of marketplace would be denied subsidies.
For those who would have received subsidies and decide to buy insurance anyway, there are very real losses to savings and investment at stake. Instead of forcing people to choose whether high-priced health insurance is worth it for them because their state decided not to set up its own exchange, this comprehensive national reform should be allowed to be just that: comprehensive and national. Creating a system where some states receive benefits and others do not is not only against the spirit of the legislation, it is simply the wrong thing to do.
When the Supreme Court hears arguments on March 4, ignoring questions of plaintiff standing, it is under no obligation to consider economic impact. Nor should it, really.
The argument really comes down to statutory interpretation. In the context of the rest of the law, it is clear that Congress did not intend to create a system of two halves, and the argument that this was a move to try to incentivize states to set up their own exchanges is not compelling to me. If this were the case, there would be more explicit references to such a reform, as it truly would be a monumental division. Either way, this is a ruling whose effects will ripple through the economy.
The Affordable Care Act is an imperfect law, to be sure, and it needs works to best achieve its objectives. A ruling against federal subsidies in King v. Burwell, however, will have massive and negative economic repercussions. Ruling for the plaintiffs here would create an unnecessary two-tiered system outside the scope of the law’s intentions, and prevent millions from getting the health care they need, just as they seem to have secured it.
VALERIE NAUMAN, DIRECTOR OF HEALTHCARE
Mainstream media has purposefully criticized this because of its appeal to Millennials, but this is precisely how to include a generation, often called apathetic, in the political process. Despite their reputations, the interviewers stuck to important and complicated issues, often addressing some elephants in the room. The YouTube creators each took suggestions from their viewers on what topics the interviews should cover. Hank Green begins the interview series with asking topics ranging from the political feasibility of his policies from the State of the Union to drone technology and about US sanctions placed on North Korea. To conclude the first of three interviews, Hank, who has suffered from a chronic condition and greatly benefitted from the Affordable Care Act, asked the president to sign a receipt from his pharmacy where his normally $1100 medication cost $5.
Glozell conducted her interview next, most notably expressing that Fidel Castro “puts dick in dictatorship” when asking how the president justifies relieving sanctions on Cuba. To finish the triad of interviews, 19- year-old Bethany Mota dives into education plans and why people her age should obtain an education. Lastly, Mota asks one of the most important questions, why should young people be interested in politics? President Obama asks viewers to get involved and let their representatives know what issues they care about most to have some positive impact.
Is this the future of social change, and is this how we can get Millennials to become more involved in their world? I hope so. Only 13% of voters between the ages of 18 and 29 participated in the 2014 midterm elections. Hank noted that “Legacy media accuses young people of being apathetic while actively attempting to remove them from the conversation.” Hank’s words ring true. Every day I see a new article about how Millennials are the worst generation yet. Time magazine even named us the “Me Me Me Generation” in a May 2013 issue. So while Millennials try to watch traditional forms of media, that media constantly bombard them with criticism. Legacy media has actively tried to remove Millennials from political conversation in an elitist effort of generational warfare. For a generation that has seen the Great Recession, the longest war in American history, and a 1,120% increase in the cost of secondary education since our parents’ generation, Millennials are doing surprisingly well. Millennials simply don’t watch as much television as their parents but rather find their entertainment with the free internet and the Obama administration has caught onto this. Although many of these YouTubers’ viewers are too young to vote, they eventually will grow to become part of the American electorate and will, hopefully, become more informed because of the way the information is presented to them. Whether their information comes the playful Bethany Mota, the ridiculous Glozel Green, or the hopeful Hank Green, if they can successfully produce a less politically apathetic generation then the White House should absolutely support that.
Despite criticism, the President has made an admirable effort to reach out to a generation often considered lost by their parents. Any effort to reach out to Millennials should be celebrated and these YouTube creators are certainly one way to get the attention of a generation. This isn’t something new to President Obama. He went on Zach Galifianakis's Between Two Ferns in 2010 to promote the launch of healthcare.gov. GW students will recall his appearance on The Colbert Report in December of last year. He also, just this past week, appeared in a hilarious Buzzfeed video that seemed to plug for healthcare.gov. This demonstrates the desire to include Millennials in the national conversation despite the belief that young people can’t care. The government is often criticised for its distance with the public with too many Americans believing they cannot affect change without a sizable change purse. Only 24% of Americans said in 2014 that they trusted the government most or all of the time. A separate 2014 poll showed that “84 per cent of people felt alienated from the political system.” There is an unnecessary amount of pomp and circumstance that has created a remoteness and area of separation around the presidency that some view as too big to influence. In Miss Mota’s interview, she asks the president why Millennials should care about politics and this reflects the apathy by most young people who have simply given up on something that they don’t feel like they have any say in anymore. Restoring the faith that citizens (especially young people) can affect change is crucial to the political process. So is it “beneath the dignity of the office”? Is it beneath the President’s dignity to ensure the country has a well-educated and politically active populace? Is it beneath his duties to ensure the nation is safe in the hands of the next generation? That is exactly what the President should be doing.
The truth is, no one would criticise the president if he had done an interview with a mainstream news organization (some of which should have less credibility than the YouTube interviewers). Both inform the public, but one informs a different generation than the other. As seen with the vlogbrothers’ Project for Awesome by raising $1,279,877 collectively, the young viewers of YouTube are capable of some pretty amazing social change. So is it “beneath the dignity of the office” to reach out to constituents in any way possible? No, and the sooner we realize that YouTube and Facebook and Twitter can be some of the most powerful avenues for social change, the better. By using the internet to connect young people with their political system, we can reduce apathy and hopefully boost political participation for years to come.
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