In April 2020, the Trump Administration halted funding for the World Health Organization (WHO), an agency of the United Nations, while it reviewed the agency’s response to the COVID-19 pandemic. One month later, President Trump announced that the U.S. would officially withdraw from the WHO, and in July the U.S. initiated a formal withdrawal. Because the WHO requires a one-year notification and all debts paid for a withdrawal process to be completed, the U.S. will not officially cease being a member until July 2021.
The U.S. withdrawal notification was the culmination of months of mounting tensions between the Trump administration and the WHO, which the administration accused of failing to disclose timely COVID-19 case data and mortality information, providing faulty theories on transmission mechanisms, opposing travel restrictions, and accepting at face value inaccurate statements made by the Chinese government early into the pandemic.
The Trump administration’s swift decision to cut ties and funding to the World Health Organization was criticized by Democrats and Republicans. Senator Lamar Alexander (R-TN), the Chairman of the Senate Health Committee, said that “certainly there needs to be a good, hard look at mistakes the World Health Organization might have made in connection with coronavirus, but the time to do that is after the crisis has been dealt with, not in the middle of it.” And on Twitter, House Speaker Nancy Pelosi (D-CA) said that “with millions of lives at risk, the President is crippling the international effort to defeat the virus.”
|How Does a U.S. Withdrawal Affect the World Health Organization’s Revenue?|
According to the Congressional Research Service, U.S. contributions to the United Nations and its various agencies, including the World Health Organization, are not technically “foreign assistance” because they are dues to multilateral organizations. But the United States contributed about $10 billion to the United Nations in 2018, making it the largest contributor to the system as it accounts for about 17% of total revenue collected from all member states. While the U.S. is not threatening to withdraw from the United Nations itself, it has begun the official withdrawal process from the WHO. Should the U.S. withdraw in 2021, the WHO stands to lose $407.5 million in assessed and voluntary contributions from the United States—14% of its total budget.
Yet, the decision to withdraw is consistent with the Trump administration’s skepticism of the need and efficacy of foreign aid. But are they right to be skeptical? This New Center issue brief seeks to provide a primer on U.S. foreign aid policy, what the public thinks of it, and what role it should play in our relations with the world now and in the future.
U.S. Foreign Aid Policy: A Primer
Most U.S. foreign aid is delivered through authority created under the Foreign Assistance Act of 1961. When signing the FAA into law, President John F. Kennedy remarked that “the long-term commitment of development funds, which the bill authorizes, will assist the under-developed countries of the world to take the critical steps essential to economic and social progress.”
Since that time, other legislation has been enacted that both amends and adjusts the original Foreign Assistance Act. This includes the Arms Export Control Act, International Security Assistance Act, and the International Finance Corporation Act, among many others.
The Foreign Assistance Act and accompanying bills authorize over 20 U.S. government agencies to disperse aid funds. Agencies with the highest portions of obligated aid dollars include the U.S. Agency for International Development (USAID), various military agencies and armed services, the Department of State, Department of Health and Human Services, and the Millenium Challenge Corporation.
ForeignAssistance.gov divides foreign assistance into the following categories:
- Humanitarian assistance
- Program management
- Multi-sector (meaning it cross-cuts several categories)
- Peace and security
- Democracy, human rights, and governance
- Education and social services
- Economic development
According to the Congressional Research Service, today’s foreign aid is primarily in the form of grants as opposed to loans (by FY2001, loans accounted for under one percent of total aid appropriations), which is done “so as not to increase the heavy debt burden carried by many developing countries.”
Sources: ForeignAssistance.gov, USASpending.gov, Kaiser Family Foundation
Is Foreign Aid Actually Effective?
Despite the fact that foreign aid makes up less than one percent of federal spending, much of the American public still believes the U.S. should cut back its spending abroad. In a 2017 Chicago Council Survey, when asked what federal government spending should be expanded, cut back, or kept about the same, about 50% of Americans believed that military and economic aid to other nations should be cut back while domestic social security, education, healthcare, and defense spending should be expanded.
Americans have a right to be skeptical of where and how their taxpayer dollars are spent, and this is especially true of U.S. contributions to the United Nations, an organization which has faced long-standing criticism over its effectiveness.
A prime example of this is the United Nations Human Rights Council (UNHRC), whose membership has in the past consisted of flagrant human rights violators like Saudi Arabia who in turn used the council to advance their own agenda against other countries. For example, The Conversation notes that “there have been more special sessions convened on Israel than any other country, even Syria. And in total, Israel has received more of the council’s attention than the Democratic Republic of Congo (where millions of people have been killed or displaced in recent years), Darfur and Sri Lanka (where genocides were perpetrated), North Korea, and Yemen. And this is not just more than each of those countries—but more than all of them combined.”
High-profile cases like the UNHRC might mar the public’s perception on the effectiveness of foreign assistance and contributions to international organizations. But foreign aid has historically provided tremendous benefits—not just to the recipients—but to America’s economic and national security.
In 2014, USAID (in partnership with the Latin American Public Opinion Project and Vanderbilt University) released a report on the impact of USAID’s community-based crime and violence prevention approach in Central America. Central American countries in the Northern Triangle region, which include Guatemala, El Salvador, and Honduras, are considered some of the most dangerous nations in the world. The report found that “USAID’s crime prevention programs in Central America have been a success. The outcomes in the treatment communities improved more (or declined less) than they would have if USAID’s programs had not been administered.” Specific outcomes include a 51% decline in reported murders, a 51% decline in reported extortion, a 35% decline in ‘reports of avoiding walking through dangerous areas,’ and a 25% decline in reported sales of illegal drugs.
U.S. foreign aid stretches far beyond crime prevention in the Americas to tackle food insecurity, health disparities, and education gaps. The results of U.S. involvement in the aforementioned areas are included in the USAID Investing in Our Shared Future report from 2017:
- Feed the Future, founded in 2010, is the U.S. government’s global food security initiative. In areas where Feed the Future operates, extreme poverty dropped between seven percent and 36%, and participating countries have increased domestic spending on agriculture by 85% on average between 2009 and 2014.
- Between 2010 and 2017, USAID’s efforts in global health reduced preventable child and maternal deaths by 4.6 million and 200,000, respectively.
- USAID’s education initiatives have provided 150 million textbooks to children and repaired 11,000 classrooms since 2011 to assist in improving learning outcomes.
These benefits to foreign countries provide direct economic and security benefits to the United States. According to a 2018 USAID report, “over the past 10 years, almost two-thirds of the growth in U.S. goods exports was to major USAID partners. This strong export growth was critical to pulling the U.S. out of the most recent [2008-2009] recession.” And in 2013, former U.S. Defense Secretary James Mattis, testifying before Congress, explained why investments in diplomacy and foreign aid are so crucial. He said:
“If you don’t fund the State Department fully, then I need to buy more ammunition ultimately. It’s a cost-benefit ratio. The more that we put into the State Department’s diplomacy, hopefully the less we have to put into a military budget.”
Given the immense benefit to U.S. national security, foreign aid shouldn’t be viewed as a luxury cost to shed, but an essential investment to keep America safe.
The far left and right in the United States have long presented the American people with a false choice: ignore climate change, or radically disrupt virtually every part of America’s economy and society to fight it. Neither of these approaches makes sense.
The right’s relentless and indefensible climate denial contributes to the already snowballing costs that fossil fuels impose on our economy and environment. In October 2019, The Brookings Institution’s Hamilton Project and the Stanford Institute for Economic Policy Research published a report on climate change which found that not only would a global temperature increase as large as 4°C be accompanied by a two percent GDP decrease, but that “the bottom fifth of counties [in the United States] ranked by economic vitality would experience the largest [economic] damages.”
These conclusions build on previous, more comprehensive studies, such as the Fourth National Climate Assessment—published in 2018 and representing the consensus views of 13 different government agencies—which stated that “climate change creates new risks and exacerbates existing vulnerabilities in communities across the United States, presenting growing challenges to human health and safety, quality of life, and the rate of economic growth.”
On the other hand, implementing many of the provisions in the far left’s Green New Deal could turn out to be more disruptive than its advocates suggest. If done hastily, it could be bad for both the economy and the environment given the plethora of issues still facing renewables, namely their intermittency, low storage capabilities, large-scale land requirements, and reliance on rare earth minerals.
That’s why it’s time for an old energy innovation to become new again in America. As this New Center paper explains, an expansion of next-generation nuclear power may provide the best and most realistic path for America to protect our environment, expand our use of low-carbon energy, and sustain our economy in the years ahead.
What Happened to the Atomic Age?
“Nuclear energy is incomparably greater than the molecular energy which we use today… What is lacking is the match to set the bonfire alight.” —Winston Churchill, 1931
Writing for Strand Magazine in 1931, British Prime Minister Winston Churchill predicted the revolutionary nature of nuclear energy while its development was still in infancy. Fourteen years later, the United States dropped atomic bombs on the Japanese cities of Hiroshima and Nagasaki in 1945 during World War II, leading to a quick Japanese surrender and revealing to the world the destructive power of nuclear energy.
But it also led to the advent of the Atomic Age, during which public interest and policy initiatives spurred the rapid innovation and deployment of nuclear as a source of energy. An analysis from Management Information Services, Inc. of federal expenditures for energy development from 1950 to 2016 shows that “prior to 1976, the primary focus of federal R&D funding was nuclear energy, with an emphasis specifically on research on commercial applications of light water reactors and development of breeder reactors.” This targeted R&D funding, as well as changes to the Atomic Energy Act permitting civilian use, allowed for the further development and deployment of nuclear power over three decades. Data from the International Atomic Energy Agency (IAEA) shows that by 1960, there were 17 nuclear power reactors operating within four countries; by 1970, there were 90 reactors in 15 countries; and by 1980, there were 253 plants in 22 countries, motivated in part by the oil crisis of the 1970s. Nuclear was expanding rapidly around the world, but this growth would soon come to a grinding halt.
For one, building nuclear power plants became increasingly expensive. A nuclear plant that cost between around $600/kW and $900/kW (meaning one dollar for every kilowatt of capacity) in the late 1960s ended up costing between around $1,800/kW to $2,500/kW in the early 1970s. Second, there were growing questions and uncertainties over how to manage radioactive nuclear waste. Third, and most importantly, public perception and support for nuclear power plummeted following the nuclear plant accident at Three Mile Island (1979) in Pennsylvania and the Chernobyl meltdown in the former Soviet Union (1986).
The narrative around nuclear energy changed from that of unbridled promise in the 1950s. Yet, there is no denying that many of the benefits that made nuclear so popular to begin with remain. The question for industry experts and policymakers is how to bring about a new age of nuclear development by harnessing nuclear’s benefits while tackling the roadblocks to its advancement.
The Benefits of Nuclear Energy
High Capacity Factor
According to the No Labels Ultimate Guide to the 2020 Election, “Every electric utility in America has one mandate above all: always keep the lights on. To do it, they need something called ‘baseload’ power, which means power that will always be there when they need it, like for hot days when energy usage spikes because everyone is blasting their air conditioner. The best measurement for an energy source’s ability to meet this standard is capacity factor, which measures how long an energy source can deliver maximum power over a given period.”
In 1975, the capacity factor of the average nuclear plant was at about 55.9%; by 1990, it had grown to 66%, and only five years later it reached 77%. At the turn of the 21st century, nuclear plants in the U.S. reached a capacity factor plateau point, hovering at an average of 90% since then. 2018 data from the U.S. Department of Energy’s Office of Nuclear Energy shows that despite this plateau, nuclear energy still far outpaces natural gas, coal, hydropower, wind, and solar PV in capacity factor, producing maximum power 92.6% of the time throughout the year.
|The Limitations of Renewables: Why Are Their Capacity Factors So Low?|
|Compared to nuclear, wind and solar PV have lower capacity factors, partly because they are intermittent or variable energy sources reliant on wind and the sun, respectively. While northeastern states such as New Jersey and Massachusetts have the lowest capacity factors for their solar energy, states like Arizona, Utah, and California with greater direct normal solar irradiance rank among the highest. As for wind, although there have been improvements to wind farms and wind turbines—such as taller turbines and longer blades—varied wind conditions can make energy derived from wind very unpredictable. An example of this was the “Wind Drought of 2015,” during which the United States suffered record-low windiness not experienced since 1979. That year, U.S. wind generation grew by only 5.1%, the smallest annual increase since 1999.|
High Electricity Generation
In 2019, nuclear energy contributed 20% of total U.S. electricity generation behind natural gas (38%) and coal (23%). After the first nuclear generating plant opened in the U.S. in 1950, nuclear energy grew in the coming decades to account for a significant share of U.S. electrical output. However, the U.S. Energy Information Administration’s Annual Energy Outlook for 2019 projects that nuclear’s share of electricity generation will decrease to 12% by the year 2050 due to the planned retirement of nuclear plants, while electricity generation from natural gas and renewables will increase.
Role in Emission Reductions
The nuclear fission process involves splitting uranium atoms to produce heat and steam which spins a turbine connected to a generator, therefore creating electricity. The fission process itself does not produce greenhouse gases, which is why nuclear energy is touted as an emissions-free source of energy. However, it is important to take into consideration all of the stages of a nuclear cycle, as some of them do in fact produce emissions. According to The Conversation— an independent network of global newsrooms—these include “uranium mining, uranium milling, conversion of uranium ore to uranium hexafluoride, uranium enrichment, fuel fabrication, reactor construction, reactor decommissioning, fuel reprocessing, nuclear waste disposal, mine site rehabilitation, and transport throughout all stages.”
A more holistic analysis of energy source emissions is referred to as a lifecycle greenhouse gas emissions assessment, which the Intergovernmental Panel on Climate Change (IPCC) undertook in its “Special Report on Renewable Energy Sources and Climate Change Mitigation.” The report compared the lifecycle greenhouse gas emissions of both renewable resources and nonrenewable resources and found that even the “maximum” estimates for nuclear energy life cycle emissions are still much less than the estimated greenhouse gases produced by fossil fuels like natural gas, oil, and coal. And when it comes to renewables, wind and solar power both have very similar median estimates to nuclear energy for median life cycle greenhouse gas emissions.
Less Intensive Land Use
As global energy demands rise, greater swaths of land will be devoted to various electricity sources to meet these needs, with some occupying more area than others. In a study conducted by Strata Policy, solar and wind energy were found to be much more land-intensive than coal, natural gas, and nuclear energy. Nuclear energy turned out to be the least land-intensive out of the direct carbon-free emission energy sources and hydropower was the most land-intensive energy source.
The Problems with Nuclear Energy
Market Competition and Subsidies for Competing Energy Sources
According to the U.S. Energy Information Administration, in FY2016, total direct federal financial interventions and subsidies in energy amounted to about $15 billion. Nuclear energy only accounted for about two percent of these subsidies, while renewables occupied a 45% share.
|Looking Back: Historical Trends in Government Energy Subsidies|
|Although it may seem like renewable energy sources are receiving preferential treatment from the federal government, for a long time fossil fuels dominated federal subsidy and support spending. In fact, according to Management Information Services, Inc., between 1950 and 2016, oil and gas received 54% of all federal spending, while wind, solar, and geothermal only accounted for 17% of spending. During this time period, tax concessions were the largest type of incentive, accounting for 47% of all incentives. Oil and gas received 70% of them.|
Amidst renewables occupying a larger and larger share of total federal energy subsidies, there is a question of whether these subsidies still serve their intended purpose. Several studies, including a comprehensive energy source cost analysis conducted by financial advisory firm Lazard, have concluded that renewables, sans subsidies, can be cost-competitive and even less expensive than traditional energy sources such as nuclear.
But a roadblock to further adoption of both nuclear and renewable energy is the advent of increasingly produced cheap natural gas. The Energy Information Administration predicts that average prices for natural gas will decline by nine percent in 2020. If natural gas prices continue to plummet, the EIA predicts that total national nuclear capacity will fall to 55 GW by 2050 from 99 GW today. Even if natural gas prices end up being higher, nuclear capacity will still fall by 2050, but only down to 83 GW.
Out of four potential cases explored by the EIA that could affect nuclear capacity, only two resulted in increased versus decreased capacity: (1) a situation where natural gas prices are higher and nuclear operating costs are low; and (2) the implementation of a carbon tax.
Americans are directionally in favor of an expansion of clean energy sources. According to polling from the Green Advocacy Project, 65% of all voters agree with the statement “in the future, we should produce electricity using 100% clean energy sources such as solar and wind, nuclear, and carbon recapture from fossil fuels,” versus 21% believing that this endeavor would be “costly and unnecessary.” While Americans have warmed up to renewable energy over time, nuclear energy struggled to capture strong support in recent years. For example, results from Gallup’s 2019 annual Environmental Poll show that the American public is split on nuclear energy, with 49% in favor of its use and 49% opposed. This is a 13% decline from a high of 62% support just nine years earlier.
|Nuclear Safety: What is the Real Story?|
|High profile disasters at Chernobyl and Fukushima have led to the public perception that nuclear energy is the most dangerous energy source. However, according to an analysis published by Markandya and Wilkinson in The Lancet in 2007, nuclear energy is responsible for fewer short-term deaths than brown coal, coal, oil, biomass, and gas. This, however, does not account for later deaths brought on by radiation exposure and psychological stress. Researchers at Our World in Data note that according to a wide range of published estimates, deaths resulting from the Chernobyl and Fukushima disasters spanned between thousands of deaths to tens of thousands of deaths, at least. Still, this is “far fewer than the millions who die every year from impacts of other conventional energy sources.” Next generation nuclear reactor designs currently in development are expected to be even safer, thanks to the greater incorporation of passive safety measures that don’t require an active power source or action from a plant operator.|
Disposal of Nuclear Waste
Though a multitude of federal agencies have oversight over radioactive materials, the U.S. Nuclear Regulatory Commission (NRC), Environmental Protection Agency (EPA), and the Department of Energy (DOE) are primarily responsible for overseeing the disposal of nuclear waste. The U.S. Nuclear Regulatory Commission identifies four distinct types of regulated waste:
- Low-Level Waste (LLW): Includes radioactively contaminated protective clothing, tools, filters, rags, medical tubes, and many other items.
- Waste Incidental to Reprocessing (WIR): Refers to certain waste byproducts that result from reprocessing spent nuclear fuel, which the U.S. Department of Energy (DOE) has distinguished from high-level waste. At the discretion of the DOE, WIR can be treated as either LLW or HLW depending on whether it meets certain criteria.
- High-level waste (HLW): “Irradiated” or used nuclear reactor fuel.
- Uranium Mill Tailings: Residues remaining after the processing of natural ore to extract uranium and thorium.
Low-level waste accounts for about 90% of all radioactive waste types. It has a relatively straightforward disposal method: waste is stored on-site (where it undergoes a decaying process), after which it may be transported in bulk to one of four low-level waste disposal facilities in the United States located in South Carolina, Washington State, Utah, and Texas. The Department of Energy reported that in 2017, 5.1 million cubic feet of low-level waste was transported to disposal sites. Low-level waste is divided into four classes—A, B, C, and GTTC (Greater Than Class C)—of which only A, B, and C are permitted to be stored in shallow land burial facilities. The United States currently does not have a permanent solution for GTCC low-level waste storage.
Meanwhile, high-level waste disposal has been the subject of a four-decade political fight with no end in sight. Unlike low-level waste, which can be disposed of near-surface or below ground level, high-level waste requires long-term, deep geological disposal due to the danger its radioactivity poses to communities and the environment. The Government Accountability Office (GAO) notes that right now, there are over 90,000 metric tons of high-level nuclear waste—both from the commercial and defense sectors—that are in need of permanent disposal. Because a disposal site has yet to be approved, this high-level radioactive waste is instead stored at the 80 nuclear sites across the country where it was generated.
38 Years of Nuclear Waste Gridlock
The Nuclear Waste Policy Act of 1982 directed the DOE to find a suitable deep geologic repository to house high-level nuclear waste and spent fuel. It concurrently tasked the EPA with implementing environmental protection standards relating to the material in this repository and gave the NRC authority to license DOE to operate said repository only if it met environmental protection standards and requirements. The Nuclear Waste Policy Act was subsequently amended in 1987, after Yucca Mountain in Nevada was identified by the Department of Energy as a potential repository site. Yucca Mountain was considered a suitable repository site because of its isolated location, natural characteristics that provide safety barriers, and because the nuclear waste would be stored about 1,000 feet below the surface, amongst other reasons.Since then, this decision has faced significant opposition from multiple stakeholders. The current Nevada Attorney General, for example, notes that beyond just the danger of storing waste at Yucca mountain because it is “seismically and volcanically active,” it also simply does not have the capacity to house all the nation’s nuclear waste. Indigenous peoples have also been active in opposing the Yucca Mountain designation, as Yucca Mountain is on historically tribal land. Today, there is little support for the Yucca Mountain project amongst legislators and 2020 presidential candidates. President Trump, who had early in his administration expressed support for Yucca Mountain licensing review, appears to have backpedaled; there is no funding for licensing included in his 2021 budget request. Former Vice President Joe Biden, Trump’s contender on the 2020 Democratic ticket, has also opposed the Yucca Mountain project but has voiced support for the development of small modular nuclear reactors.
Giving Up on Nuclear Energy: What are the Risks?
One of the most prominent arguments for preserving the nuclear energy industry is the impact that nuclear can have on the fight against climate change, and how its erasure would lead to higher GHG emissions. According to a study conducted by the Union of Concerned Scientists, “without new policies and with low natural gas prices, early nuclear retirements are replaced primarily with natural gas and coal. Closing the at-risk plants early could result in a cumulative 4 percent to 6 percent increase in U.S. power sector carbon emissions by 2035 from burning more natural gas and coal.”
This analysis is not theoretical; in fact, in the United States and around the world, the consequences of nuclear plant shutdowns are playing out in real time. In 2016, the U.S. Energy Information Administration reported on the five most recent nuclear plant closures, and what energy sources replaced them. In all but one case (Vermont), in-state electricity generation from nuclear was largely replaced by coal-fired and natural gas-fired generation and supplemented by hydro and non-hydro renewables.
The effects of nuclear plant retirements can be seen beyond America’s borders. In Japan, nuclear plants across the country closed in response to anti-nuclear sentiment in the wake of the 2011 Fukushima nuclear disaster. As plants closed, nuclear energy was mostly replaced by coal and natural gas, with growth in solar energy as well.
Beyond environmental considerations, a weakened U.S. nuclear industry has implications for American influence abroad. While the United States has been grappling with obstacles to nuclear development at home, Russia and China have been establishing themselves as global nuclear export powerhouses. According to The Economist, Russia had 39 foreign nuclear projects under construction or in planning stages as of July 2018. China follows far behind in second with 15 projects. The United States only has two.
How have Russia and China been able to achieve so much success abroad compared to the United States? For one, they have taken concrete steps to make nuclear technology deployment a key component of their strategies for greater economic and diplomatic influence. Russian state-owned corporation Rosatom receives significant financial backing from the state to undertake nuclear construction projects around the world and has installed Rosatom representatives in Russian embassies and trade missions. For Beijing, nuclear exports are integral to the Belt and Road Initiative, an extensive multi-country infrastructure project being undertaken by the Chinese government in order to further ingratiate themselves in the global economy.
This close-knit relationship with government allows the nuclear industries and China and Russia to underbid competitors (in the case of Rosatom by 20-50% at times), cover a majority of construction costs for turnkey production, and even provide government loans to countries who would otherwise be unable to pay for development. As Madison Freeman wrote for Defense One, “U.S. nuclear companies find it nearly impossible to compete against government-backed competitors motivated by political goals more than profit.”
New Center Solutions
For all the promise and progress of renewable energy sources like wind and solar, they still only account for 17% of America’s electricity generation due to their intermittency, low storage capabilities, land requirements, and reliance on rare earth minerals. Nuclear power remains the one low-carbon power source capable of producing massive quantities of energy to complement other renewable sources, and it deserves attention and action from Congress.
Increased Funding for Research and Development
In the 21st century fight against climate change, outdated nuclear technology will simply not cut it. Today, the U.S. Department of Energy is undertaking initiatives to develop breakthrough reactor technologies (such as small modular reactors), safer and more sustainable fuel cycle technologies, and advanced sensors and instrumentation, among other projects. These initiatives, which are critical for the future deployment of safer, more reliable, and less costly nuclear technology, will require increased and targeted research and development funding.
Some existing Congressional bills advocate for increased support for nuclear innovation R&D. In March 2020, Rep. Conor Lamb (D-PA) and Rep. Dan Newhouse (R-WA) introduced the bipartisan Nuclear Energy Research and Development Act. For FY2021, the bill recommends $162.5 million in appropriations for reactor concepts research, development, and demonstration; $255.25 million for fuel cycle research and development; and $525 million for advanced nuclear reactor research, development, and demonstration programs, among other appropriations.
Shaping the Market through a Price on Carbon
According to data modeling from the Energy Information Administration, one of the ways in which America’s nuclear capacity can be preserved, and even increased, is through the implementation of a carbon tax. A price on carbon would send a powerful signal to the private and public sector that clean energy technologies like nuclear are a worthy investment, and would likewise send a signal to polluters that their emissions come with a price tag. To achieve revenue neutrality and bolster support from the American people, Congress could distribute a dividend to American households and communities dependent on fossil fuels to offset rising prices associated with the tax. Alternatively, Congress could employ a tax shift and reduce certain federal taxes (e.g.., income taxes and payroll taxes).
Safely Taking America’s Nuclear Strategy Global
Advancing nuclear energy cannot stop at our country’s borders, and neither should our commitment to cutting global emissions. While undertaking more contracted nuclear construction projects will provide the U.S. with an edge against an increasingly competitive Russia and China, exporting nuclear power will also help other countries contribute to the global goal of necessary emissions reductions.
One venue through which to do so is the U.S. International Development Finance Corporation, an independent U.S. government agency that offers equity financing, debt financing, political risk assurance, and technical development for private development projects abroad. In July 2020, the agency announced that it would be lifting its standing categorical prohibition on the “production of or trade in radioactive materials, including nuclear reactors and components thereof.”
While the removal of the prohibition is an important step in the right direction, the agency has yet to establish policies for nuclear development projects. Congress should require the implementation of strong and clear guidelines before any nuclear project is funded, given the potential national security and safety issues. Important areas for consideration should include:
- The political and military structure of the region and country in which the nuclear energy project is being developed to minimize the risk of nuclear militarization
- How a strong safety and inspections regime will be maintained in the candidate country, as well as how environmental considerations will be implemented
- The economic strength of the candidate country, which will determine whether it can assume the financial burden of nuclear power
Nuclear Waste Disposal: It’s Time to Start from Scratch
Yucca Mountain has been mired in controversy and politics ever since it was designated as a repository candidate for the nation’s high-level nuclear waste 38 years ago. As the void between stakeholders and legislators continues to grow on this issue, the threat of not having a permanent solution for storing nuclear waste becomes more acute. Given this reality, it is time to move on from Yucca Mountain.
A 2013 report from the Blue Ribbon Commission on America’s Nuclear Future proposed several legislative changes to America’s nuclear waste program, namely the amendment of the Nuclear Waste Policy Act of 1987 to move away from evaluating only Yucca Mountain to authorizing “a new consent-based process to be used for selecting and evaluating sites and licensing consolidated storage and disposal facilities in the future.”Amending the Nuclear Waste Policy Act is a necessary step to address the gridlock on nuclear waste management, and it has bipartisan support in Congress. In April 2019, Sen. Lisa Murkowski (R-AK) introduced the Nuclear Waste Administration Act which calls for establishing “a new organization to manage nuclear waste” and a “consensual process for siting nuclear waste facilities.” The legislation, for which hearings have been held in the Committee on Energy and Natural Resources, is cosponsored by Sen. Lamar Alexander (R-TN) and Sen. Dianne Feinstein (D-CA).
In 2019, the United Nations Environment Programme (UNEP) reported that “unless global greenhouse gas emissions fall by 7.6 percent each year between 2020 and 2030, the world will miss the opportunity to get on track towards the 1.5°C temperature goal of the Paris Agreement.”
It used to be difficult to conceptualize what kind of global commitment was necessary to achieve these emissions reductions. But in the age of COVID-19, the scale of this commitment has become clear. In fact, according to the International Energy Agency (IEA), 2020 emissions are expected to fall by eight percent compared to 2019.
In other words, it took a worldwide economic lockdown to achieve the scale of emissions reductions that the U.N. says are needed for the next decade. However, as noted by foreign policy academic Walter Russell Mead in a recent Wall Street Journal column, “most of the measures that led to the drop in emissions aren’t economically sustainable.”
So what might an economically sustainable approach to emissions reduction look like? This New Center issue brief has some ideas on where to start, and explores how environmental and energy policy and politics are shifting during this historic pandemic.
GHG Emissions: Historic Decline, Quick Recovery
The U.S. Environmental Protection Agency (EPA) considers various human activities to be “responsible for almost all of the increase in greenhouse gases in the atmosphere over the last 150 years.” According to ClimateWatch data from the World Resources Institute, this ever-increasing human activity emitted 49.8 billion metric tonnes of greenhouse gases (GHG) into the atmosphere in 2016. GHGs include carbon dioxide (CO2), methane (CH4), nitrous oxide (N2O), and fluorinated gases (F-gases). Sectors that contributed the most to total GHG emissions in 2016 were electricity and heat (30%), transportation (15%), and manufacturing and construction (12%). These sectors, in turn, were the most heavily affected when governments instituted lockdowns in early 2020 to battle the COVID-19 pandemic.
While lockdown measures vary by country, they generally constitute some combination of stay-at-home orders, travel restrictions, and business closures (with exceptions made for those providing essential services). According to the International Energy Agency’s (IEA) Global Energy Review 2020, in Q1 2020, global road transport activity declined by 50% and global aviation activity declined by 60%, compared to the 2019 average. Electricity demand also took a hit, with a 20% decrease during full lockdowns.
According to the IEA, its projection of an eight percent emissions decline in 2020 “would be the largest ever, six times larger than the previous record reduction of 0.4 Gt in 2009 due to the financial crisis and twice as large as the combined total of all previous reductions since the end of World War II.”
In the United States, emissions were nine percent lower in Q1 2020 than they were in Q1 2019. In its June 2020 Short-Term Energy Outlook, the U.S. Energy Information Administration (EIA) predicts that U.S. energy-related carbon dioxide (CO2) emissions will decrease by 14% in 2020, compared to a 2.8% decrease in 2019.
These reductions are not expected to last long, however; the EIA predicts that energy-related CO2 emissions will increase again by five percent in 2021. And according to a May 2020 study in Nature, global emissions will soon start rising once again too.
Reductions in Electricity Demand and Consumption
On average, the IEA found that “every month of full lockdown reduced [electricity] demand by 20% on average, or over 1.5% on an annual basis.” Italy, which experienced one of the deadliest COVID-19 outbreaks in Europe, experienced close to a 30% reduction in electricity demand just 30 days into their full lockdown. Overall, the IEA predicts that by the end of the year, global electricity demand will have decreased by five percent.
In the United States, electricity consumption will have decreased by 5.7% in 2020 compared to 2019 consumption levels, according to EIA estimates. The commercial sector is expected to experience the highest decline (9.1%) followed by the industrial sector (6.7%) and residential sector (1.5%). The summer months in particular are expected to feature historic declines in consumption, with the EIA predicting “U.S. electricity demand to total 998 billion kilowatthours this summer (June through August), the lowest level of summer electricity consumption in the United States since 2009 and 5% less than last summer.” Before the COVID-19 crisis, natural gas and renewables accounted for a growing share of American energy consumption at the expense of coal and nuclear. The EIA expects this trend to continue in 2020.
Relaxing of Environmental Rules and Regulations
In recent months, the Trump administration has loosened or eliminated several environmental rules and regulations, which it believes necessary to help companies and industries recover from COVID-19 lockdown measures.
On March 26, the Environmental Protection Agency (EPA) announced it will stop seeking penalties for facilities that are unable to comply with the agency’s emissions enforcement, monitoring, and reporting requirements. Facilities seeking this enforcement discretion will need to meet certain general conditions, including making good-faith efforts to comply with existing environmental regulations.
If they cannot comply, they must do their best to minimize their environmental impact, document noncompliance, and take steps to return to compliance as soon as possible. The enforcement discretion policy does not apply to criminal violations of the law, nor does it apply to activities carried out under Superfund programs, RCRA Corrective Action Cleanup Enforcement, or pesticide product imports. The EPA has no set end date for the policy, but emphasizes that facilities are expected to return to full compliance once the policy is no longer in effect.
In response to the EPA’s COVID-19 enforcement discretion policy, nine states—New York, California, Illinois, Maryland, Michigan, Minnesota, Oregon, Vermont, and Virginia—filed a complaint against the EPA in the United States District Court for the Southern District of New York. In the complaint, states claim that the policy: (a) exceeds EPA’s authority; (b) was adopted arbitrarily and capriciously without regard for public health; (c) runs contrary to EPA’s responsibility as a primary enforcement authority; and (d) was issued without a usual notice-and-comment review period.
On June 4, 2020, President Trump signed an Executive Order giving federal agencies leeway to make alternative arrangements with the White House Council on Environmental Quality (CEQ) to comply with the National Environmental Policy Act (NEPA) when “emergency circumstances make it necessary to take actions with significant environmental impacts without observing the regulations.”
While the Trump administration has described laws like NEPA as causing “unnecessary regulatory delays,” previous New Center publications have noted that there is little evidence to support or reject this claim. A Government Accountability Office (GAO) report from April 2014 determined that there was minimal data available from federal agencies on how many NEPA analyses—including what different types—are being conducted, as well as the costs and benefits of completing them.
ESG Investing: A Changing Tide?
ESG (Environmental, Social, Governance) investing describes an investing approach that evaluates an asset’s ability to both generate financial returns and enhance several broader measures of societal well-being.
According to a 2019 survey from financial services firm Morgan Stanley, 85% of the general population was interested in sustainable investing, up from 71% in 2015. Among millennial investors, interest is even higher; in 2019, 95% were interested in sustainable investing. But this same survey found actual adoption of sustainable investing lags behind interest. In 2019, only 52% of the general population took “part in at least one sustainable investing activity,” compared to 67% of millennial investors.
This imbalance is reflected in macro-level global energy investment trends. According to the IEA, in the years running up to 2015, global investments in clean energy and efficiency were on the rise. Since then, they have hit a plateau, and are expected to take a hit in 2020 as total global energy investment is projected to decline by 20% compared to 2019 levels. Stagnant trends in investment, now exacerbated by a global pandemic, led the EIA to conclude: “a flat trend of spending since 2015 is far from enough to bring a lasting reduction in emissions.”
Where Do We Go From Here?
Although the world will reach the U.N. emissions reduction targets for 2020, it will do so through economically ruinous lockdown measures that no one hopes we have to repeat in the decade ahead. How, then, could the United States contribute its share of global emissions reductions? The only answer is through investing in, innovating, and deploying diverse technologies that contribute to a cleaner energy system.
Federal R&D Funding for Breakthrough Energy Technologies
In 2018, the Department of Energy received $15 billion for energy research and development (R&D) and related activities. These funds went toward advancing work on nuclear energy technologies, reactor concepts, renewable energy resources, carbon capture, advanced energy systems, and electricity efficiency. Of that $15 billion, ARPA-E (the Advanced Research Projects Agency-Energy)—which funds some of the most ambitious and cutting-edge energy research—only received $353 million. The American Energy Innovation Council—a project of the Bipartisan Policy Center—recommended that the budget for ARPA-E should be at least tripled to over $1 billion per year.
Although this would represent a significant funding increase, it would still pale in comparison to the amount the U.S. government spends on defense R&D. In 2018, the Department of Defense spent $805 billion, $93.5 billion of which was for RDT&E (research, development, test, and evaluation).
With increased funding, the Department of Energy would be able to explore and invest in several possible breakthrough energy technologies, like carbon capture and storage, energy and battery storage, and next generation and modular nuclear reactors.
Carbon Tax and Dividend
The COVID-19 outbreak has America mired in the worst economic and employment crisis since the Great Depression, which makes any effort to raise taxes even harder politically than usual. But it remains the case that putting a price on carbon could send a powerful market signal to entrepreneurs and innovators that clean energy technologies are a worthy investment, and would likewise send a signal to polluters that their emissions come with a price tag.
To achieve revenue neutrality, Congress could distribute a dividend to American households and communities dependent on fossil fuels to offset rising prices associated with the tax. Alternatively, Congress could employ a tax shift and reduce certain federal taxes (i.e., income taxes and payroll taxes).
Technology-Neutral Clean Energy Tax Credits
Rather than prolonging or increasing tax credits that benefit only specific clean energy technologies like solar and wind, next-generation tax credits should be designed to favor promising, emerging technologies over maturing ones. By developing a system where tax credits are awarded based on whether they work towards the goal of achieving a low carbon power system, any clean energy technology that meets certain functional goals of decarbonization would be eligible to receive the credit.
Developing and Deploying Nuclear Energy
For all the promise and progress of renewable energy sources like wind and solar, they still only account for 17% of America’s electricity generation due to their intermittency, low storage capabilities, land requirements, and reliance on rare earth minerals. Nuclear power remains the one low-carbon power source capable of producing massive quantities of energy to complement other renewable sources, and it deserves attention and action from Congress.
A price on carbon, for example, would make market conditions conducive to preserving America’s current nuclear fleet while opening the door to further development with a focus on deploying small modular reactors. Increased investments in Department of Energy projects and initiatives such as the “Advanced SMR R&D Program,” the “U.S. Industry Opportunities for Advanced Nuclear Technology Development”, and other programs could spur technological innovations that could make nuclear energy even more safe, reliable, and profitable, such as advanced reactors and fuels.
But advancing nuclear energy cannot stop at our country’s borders, and neither should our commitment to cutting global emissions. While undertaking more contracted nuclear construction projects will provide the U.S. with an edge against an increasingly competitive Russia and China, exporting nuclear power will also help other countries contribute to the global goal of necessary emissions reductions.
Although there is so much we still do not know about COVID-19, public health officials and doctors were sharing the same urgent message from the beginning of the outbreak in early 2020: The older you are, the more likely you are to die if you contract the disease.
And yet, somehow, America allowed its nursing homes to become the epicenter of the worst COVID-19 outbreak in the world. According to data analysis from The Foundation for Research on Equal Opportunity, over 40% of those who have died in the U.S. from COVID-19 have been residents or workers in nursing homes or long-term care facilities. On this episode of Centering on Coronavirus, Policy Analyst Aleksandra Srdanovic interviews Gregg Girvan, a Health Care Policy Expert at the FREOPP, on how the high death toll amongst nursing home residents has profound implications for the way we’ve managed the coronavirus pandemic.
For more insights on the impact of COVID-19 on nursing homes, you can read The New Center’s issue brief “COVID-19 in Nursing Homes: How Could We Let This Happen?”
Gregg Girvan: My name is Gregg Girvan. I am the research fellow at the Foundation For Research on Equal Opportunity. I perform a lot of the data analysis that we do, especially on the healthcare side. We had several projects going on even before the coronavirus came onto the scene. Essentially, I dive deep into the different issues with a lot of different aspects of healthcare policy. We’ve been working quite a bit on doing a country by country comparison of healthcare systems. It’s been an ongoing project we’ve been working on for quite a while now, but obviously when the coronavirus hit, we definitely pivoted toward that. And that’s been what we’ve been talking about.
A lot of people are now familiar with our work, given that they’ve seen our comprehensive plan on reopening the economy. Even despite the coronavirus pandemic and this sort of FREOPP plan that we have that has gotten a lot of attention, we were really the first ones to ask the question, if we don’t have an effective treatment, if a vaccine doesn’t come on the scene anytime soon, if at all, and if we have trouble with other things like scaling up testing, what do we do then? Do we just remain locked down, or do we find in the data and what we know about the virus, a way or ways to selectively reopen in certain ways so that we can get as many people as possible back to school, back to work, and still protect those who are most vulnerable.
Out of that plan that we’ve been talking about for a couple of months now, it began to emerge in the data that the nursing home crisis was really starting to become a real problem. When you discover that well over 40% of people have died from the virus so far are nursing home and assisted living residents, and yet they only comprise 0.6% of the population, that gives you a very clear indication that this is an extraordinary problem within nursing homes, but it also informs how we reopened the rest of the economy. It tells us that maybe sort of the optimistic view here is that the fact that so much of the problem is concentrated in nursing homes means that it may not be the same danger or threat to those outside of nursing homes, including those who are elderly, as we perhaps thought before.
Aleksandra Srdanovic: On the topic of nursing homes, you’ve brought up that statistic of these nursing home and assisted living facility residents accounting for over 40% of deaths. We knew pretty early on into the pandemic that the disease would be particularly deadly for older people with underlying health issues, which of course describes a lot of people who live in nursing homes. I’m wondering if you think local or federal government entities acted too late to protect them. Or do you think that they took action, but it was just inevitable?
Gregg Girvan: Well, there is certainly the thought out there that these particular places were vulnerable prior to the pandemic. And we look at just the hundreds of thousands of people, nursing home residents, who are affected every year by any number of different bacterial or viral pathogens. And this is a pretty common problem just outside of there being the coronavirus. There’s certainly the thought out there that this was a vulnerable population to begin with.
That being said, what we kept hearing as this became a larger and larger problem in the United States was that we have to institute these lockdowns and we have to engage in social distancing and all these other different pandemic tactics that were from this previous playbook for influenza type viruses, where we needed to shut things down in order to prevent our hospitals from being overrun. That was really the main focus was to make sure that hospitals were able to handle the influx of patients that were going to come in, that we’re going to have to take up those ICU beds.
When the original plans were being drawn up by federal state, local governments to deal with the crisis, the focus was completely on hospitals. And unfortunately, that meant that these other areas like nursing homes and assisted living facilities did not get prioritized like our hospitals did. And there was good reason to prioritize the hospitals. And certainly in certain urban areas like New York City, where there was a huge spike in the number of patients and the number of hospitalizations. But it’s become clear looking back that this was an area where really all levels of government, federal, state, local government did not measure up in terms of being able to protect those who truly are the most vulnerable.
You have to think if you look at the people that are in nursing homes and their levels of need, you talked about the comorbidities that these people had. These are people that need a tremendous amount of help. They have a high prevalence of cardiovascular disease, diabetes. You can imagine among this pandemic with people who, for instance, are diabetic and they need to leave their nursing home to have dialysis. You think about the danger that presents for that individual with the coronavirus and this increased likelihood that they would become infected simply because they have to leave the nursing home and undergo dialysis.
And then you look the other way where you have a lot of these healthcare workers in nursing homes that don’t live at the facility obviously, they have lives outside of the facility and oftentimes they would get infected, they’d be asymptomatic and they’d bring the virus right into the nursing home where, because of the congregate nature of nursing homes, where oftentimes residents are sharing a room, sometimes there’s even up to four in one large room, or up to four that are sharing a bathroom, for instance.
And then combine that with the fact that these facilities have had difficulties in the past with infection control and then layer on top of that, the fact that you have an elderly population that has a lot of these comorbidities. It was really a perfect storm for widespread infections and a high fatality rate. This is obviously something that we’re going to have to reckon with as the pandemic one day eventually dies down and we’re looking back and assessing all of this. It’s pretty clear that our model for protecting really the most vulnerable among us, pretty much failed. And we’ve got to make some major changes in order to protect residents from the next pandemic.
Aleksandra Srdanovic: I think that the general perspective on how the federal government states approached the nursing home has been negative. But do you think that there’s any states whose policies have been particularly successful at preventing the spread? Have you found some states that have lower rates of cases and deaths in nursing homes or that have been particularly unsuccessful, or do you think it’s pretty much the same across the board?
Gregg Girvan: Well, for sure, there have been problems with this particular population since the pandemic began pretty much across the United States with certain exceptions. There are a few states, for example, the ones that come to my mind are states like Alaska and Hawaii that haven’t had really any fatalities, or they’ve only had some in the single digits. A part of that simply has to do with the fact that those are populations that are more remote, they’re more removed from where the epicenters of the virus have been.
Contrast that with essentially New England, if you look really far along the I-95 corridor from basically Maryland up through Massachusetts, you’ve had a really high rate of infection and high fatality rates, especially in nursing homes. And part of that simply has to do with the fact that that’s where the epicenter of the virus has been, and the population is more dense there, so you’re going to have more nursing homes there. And on top of that, you’re just going to have the people in closer proximity to one another, so there’s that factor.
If you look at other states though, that do have higher levels of population, for instance, you have a state like Texas or Florida, those couple states have done a reasonably better job of keeping the virus out of their nursing homes. Part of that has to do with the fact that very early on, they made a conscious decision to not send those residents [who had gone to hospitals] back to the nursing home before they were completely clear of the virus.
Then you look at other States like New York, under Governor Cuomo’s orders, you look at a state like Michigan that is still doing this. They are still taking patients that were in nursing homes, they’re treating them in the hospital, and then out of fear that their hospitals would be overrun, that they would not have enough beds, they’re sending these individuals back to the nursing home before they’ve been completely clear to the virus, before they’ve fully recovered. And it’s pretty clear that that has yet another way that the virus has spread throughout these facilities.
A lot of these state governments that have had these orders in the past, or still have them in place now, will say, “We have procedures in place to separate those individuals and to keep them separate from the rest of the nursing home population.” But the fact is there are a lot of nursing homes that were not even equipped to do that and yet they were still being forced to take these patients back into nursing homes.
Really, the first thing that has to be done in order to address the crisis in nursing homes is these orders need to be rescinded. It’s very clear looking at the data that the rate of hospitalizations has for the most part across the country, been on the decline. There are a few states, a few localities where there’s an uptick as testing has increased as the states have opened up. But for the most part, the rates of hospitalizations have been on the decline and there is plenty of capacity in hospitals. These orders need to be rescinded, and that’s first and foremost.
States like Texas and Florida never had those orders in place, and rightly so in order to prevent the infections from starting from those individuals being returned to the nursing home. It’s policies like that that have helped states like Texas and Florida. As I said, going forward, these orders need to be rescinded, but on top of that, there needs to be better protocols put in place for infection control. We need to ensure that these facilities have adequate personal protective equipment for the staff as well. That’s something that, again, we prioritized for hospitals and made sure that we ramped up PPE capacity for hospitals, but nursing homes really became an afterthought. And there are plenty of nursing homes, according to the data that we’ve seen, that either don’t have enough PPE right now, or they don’t have enough to handle a surge in cases within their facilities. Those are some of the things that state and local governments really need to focus on.
Aleksandra Srdanovic: It seems like those reforms are very COVID focused, like providing PPE and making sure that they have these infection protocols in place. But a lot of the issues that the states have had with their COVID-19 policies, it seems like have been exacerbated by a lot of underlying and longstanding issues in how nursing homes are run and regulated, namely underfunding, and it seems like there’s lapses in state inspections and there’s inadequate training for staff. So I’m wondering, what are some of the broader and long term reforms that you feel like are necessary to ensure that these nursing home residents have better living conditions once COVID-19 has passed?
Gregg Girvan: Sure. Aleksandra, you bring up a really good point here. And that is that the problems that we’re seeing in nursing homes in relation to the coronavirus and really in relation to any major disease outbreak is the fact that this has been a longstanding problem and a structural problem that has really been multiple decades in the making. This is also something that I’ve written about recently, where really, you look at the business model of nursing homes, and it really lends itself to the problems that you’re seeing right now, especially in terms of understaffing and in terms of not having adequate infection controls and PPE storage.
What you have to understand is: what is the business model? How are these nursing homes really being run? The idea is to follow the money, as with so many other things. That it’s really about where the money is coming from in order for these nursing homes to operate. Really in this country, most people don’t realize that the oversize role that Medicaid plays in paying for residents in nursing homes.
For nursing home residents, you basically have two subsets of populations. One is those who are going to nursing homes for a specified shorter duration of time in order to recover from a major surgical procedure, say a hip replacement. These people are in there for post-acute care as they call it. These individuals, when they’re elderly, age 65 or older, Medicare is paying for those individuals. And Medicare pays at a much higher reimbursement rate than Medicaid does.
Contrast that with the second subpopulation, and these are the individuals that are in long term care facilities and nursing homes for a longer period of time or indefinitely. And these are individuals that are not necessarily there because they’ve had a surgical procedure or something to that effect, they’re there because they need assistance with what we call activities of daily living or ADLs. And these are things that we often take for granted in our normal, everyday life. But they’re things like walking, dressing, eating, getting in and out of bed, so what they call transferring. These particular individuals need assistance with those kinds of activities, they can’t do them on their own anymore.
These individuals typically are in these facilities fees and are being paid for by Medicaid. And this really has a lot to do with just the way that the Medicaid law has been written over time. And what we find is when nursing homes or when long term care was originally made part of a Medicaid, or it being a service reimbursed by Medicaid, they were just for nursing homes. That was the only thing Medicaid would reimburse for back in the early 1970s. There became what we call institutional bias, where people were getting long term care services and nursing homes only in, really in what we call institutional settings. These are settings that are higher levels of care, and they look a lot more like hospitals, if you look at just the way they’re structured physically.
The thing to remember is that with Medicaid, they’re getting paid at a much lower reimbursement rate. What these nursing facilities often have to do is they have to increase their mix of Medicare patients or patients who are paying through long term care insurance, or simply paying out of pocket in order to cover the residents that are paying through Medicaid, because the Medicaid reimbursement rates often don’t even cover their cost of care.
Nursing homes, because they have such a high level of Medicaid patients on average, 62% of nursing home residents are on Medicaid. When you look at that fact, you could see how they operate on pretty razor thin margins. Then if you layer on top of that the coronavirus pandemic and how that’s affected that case mix, you still have a lot of these people in there who are on Medicaid, but because the hospitals have been closed to non-elective procedures, the number of residents that are paying through Medicare that are just there for post-acute care has decreased rapidly because nobody’s having those surgical procedures done with the hospitals being closed down. They’re only starting to reopen in certain places now. So that’s a major revenue stream that the nursing homes have also lost out on, on top of the fact that nobody wants to live in a nursing home right now. Understandably so, given the crisis that’s been going on.
Prior to the pandemic, you have a very tenuous and very shaky business model to begin with that has just been blown apart by the pandemic. Going forward, what is this going to look like? What is long term care going to look like? And the answer is we don’t know for sure, but looking at how things are breaking down right now, it’s pretty clear that the demand for living in a nursing home is going to go down even further. The problem again, is that there are certain ways in which the Medicaid Laws are written that’s still biased toward placing people in nursing homes.
They’ve done quite a number of things over the years with Medicaid waivers to try to encourage people to receive these kinds of services in their home or in the community and in a lower impact settings so that they could still receive these services in the community, but not be as intense. But that being said, a lot of those waivers have waiting lists, and there just isn’t enough room for a lot of those people to pull down those services in Medicaid so they still end up in a nursing home anyway, and looking forward, we really have to deal with that. That’s going to be a structural problem that has to be dealt with and reformed one way or another.
We definitely need to introduce more flexibility into the Medicaid programs so that these individuals, at least for now, can seek long term care services in other settings, other than nursing homes. We don’t even know how many nursing homes are going to be around really after the pandemic sort of fizzles out. We just don’t know how many are going to survive, there’s probably going to be a lot of consolidation in the industry as well.
Really, what we need to do is we need to be thinking more holistically and from a 30,000 foot view and say, “How are we going to provide these services to individuals and how are we going to pay for it?” Because clearly the model that we have now is not sustainable. We need to find ways to encourage people to save for this, to increase their uptake of long term care insurance. It’s easier said than done because of the market power so to say that Medicaid has in long term care, but that is going to have to change because of what’s going on on the ground.
Aleksandra Srdanovic: That’s a really fascinating point that you make about the funding structure. I think a lot of people probably don’t know how much of an impact that has on how these nursing homes are run. Thank you for diving deep into that. I think those are all the big points that I wanted to cover with you on my end, unless you think that there’s anything that we missed that you thought was really insightful or important to bring up?
Gregg Girvan: The last thing that I would mention is the fact that throughout this whole thing, it’s been very difficult to obtain data as somebody who works with this on a daily basis. It’s been difficult to find what’s been going on in certain states and even in States like Michigan, where again, they still have these orders in place to send recovering patients back to nursing homes, and yet, you can’t even get accurate numbers from the state in terms of how many people are infected, how many fatalities have happened in these different facilities.
Now, CMS is really trying to obtain this data. And in early May, they put that into place where all the nursing homes that we’re receiving either Medicare or Medicaid funding were required to report to CMS on data points, such as the ones I’ve mentioned. And the thing to remember about that is that that rollout has been shaky. It’s been… The data that they have out right now is not accurate, or at least that the level of accuracy that we want to see. We’ve been diving into this data, and for instance, there have been nursing homes that somehow reported that they had five, six, 700 fatalities in their nursing homes. And yet these are nursing homes that may only have a hundred or 150 that’s to begin with.
Some of the data has not been released to the public properly, so we just have to wait for that and wait for those corrections in order for us to give a better idea, or at least for that comprehensive nationwide reporting to give us some clearer pictures, but we should be getting better updates in the coming weeks as we go.
That being said, again, at the Foundation for Research on Equal Opportunity, we’ve been going really state by state and finding this data. And again, most underappreciated fact or statistics in this whole pandemic is the fact that again, over 40%… according to our calculations, over 42% of people who have died from the virus have died in nursing homes, and they only make up 0.6% of the entire US population. And because of that, we know that we can take steps to reopen the economy, to reopen schools, because it’s a much less significant threat to those populations than it is to say folks in nursing homes.
This is really the most under-appreciated statistic, and once people really understand that it will help to inform the policy decisions that we make going forward so that we can still protect the most vulnerable without completely wrecking the economy with tens of millions of that are unemployed. These are things that we can prevent to begin to repair the country.
Aleksandra Srdanovic: Right. Thank you so much, Gregg. I really appreciate you taking the time. This has been really insightful.
Gregg Girvan: Absolutely. Well, it was my pleasure. Thank you for having me.
This transcript has been edited for length and clarity.
In the wake of the brutal killing of George Floyd in Minneapolis, Americans across the country and across the political spectrum are calling for reforms that combat racial bias in our justice system and change the way we police our communities. Although many cities have already announced significant reforms to the rules governing their local police forces, the U.S. Congress is still debating a variety of proposals.
The New Center’s Criminal Justice Reform Tracker will keep a running tally of the various criminal justice and police reform bills and resolutions that are being introduced, and most importantly which are garnering bipartisan support.
With Republicans controlling the Senate and Democrats controlling the House, votes from both parties will be needed to turn any of these ideas into law.
Update: In the month following calls for action after the killing of George Floyd, Congress introduced 61 bills specifically related to changes to the U.S. criminal justice system. Only 16% of bills (10 bills) garnered bipartisan support, meaning they have both Republican and Democratic co-sponsors. 97% of the bills that have been introduced are stuck in committee.
The only successful House bill, the George Floyd Justice in Policing Act of 2020 introduced by Representative Karen Bass, has been placed on the Senate Legislative Calendar, while the Senate has so far voted against opening debate on the JUSTICE Act originally introduced in the Senate by Senator Tim Scott.
|Action||Date Introduced||Sponsor||Status||Summary||Bipartisan Support|
|S.4142||07/01/2020||Sen. Edward Markey (D-MA)||Read twice and referred to the Committee on the Judiciary||A bill to amend the Revised Statutes to remove the defense of qualified immunity in the case of any action under section 1979, and for other purposes.||No|
|H.R.7384||06/26/2020||Rep. Steve Chabot (R-OH)||Referred to the House Committee on the Judiciary.||To reform policing, and for other purposes.||No|
|S.4064||06/24/2020||Sen. John Cornyn (R-TX)||Read twice and referred to the Committee on the Judiciary.||bill to amend the Omnibus Crime Control and Safe Streets Act of 1968 to provide for training on alternatives to use of force, de-escalation, and behavioral health crisis.||No|
|H.R.7315||06/24/2020||Rep. Ilhan Omar (D-MN)||Referred to the House Committee on the Judiciary.||To amend title 18, United States Code, to clarify the penalty for use of force, and for other purposes.||No|
|S.4036||06/23/2020||Sen. Mike Braun (R-IN)||Read twice and referred to the Committee on the Judiciary||A bill to amend the Revised Statutes to reform the defense of qualified immunity in the case of any action under section 1979, and for other purposes.||No|
|S.4051||06/23/2020||Sen. Lindsey Graham (R-SC)||Read twice and referred to the Committee on the Judiciary.||A bill to improve the ability of law enforcement agencies to access encrypted data, and for other purposes.||No|
|S.4036||06/23/2020||Sen. Mike Braun (R-IN)||Read twice and referred to the Committee on the Judiciary.||A bill to amend the Revised Statutes to reform the defense of qualified immunity in the case of any action under section 1979, and for other purposes.||No|
|S.4000||06/18/2020||Sen. Elizabeth Warren (D-MA)||Read twice and referred to the Committee on the Judiciary.||A bill to require Federal law enforcement and prison officials to obtain or provide immediate medical attention to individuals in custody who display medical distress.||No|
|H.R.7268||06/18/2020||Rep. Ayanna Presley (D-MA)||Referred to the House Committee on the Judiciary.||To require Federal law enforcement and prison officials to obtain or provide immediate medical attention to individuals in custody who display medical distress.||No|
|H.R.7252||06/18/2020||Rep. Eddie Bernice Johnson (D-TX)||Referred to the Committee on Science, Space, and Technology, and in addition to the Committees on Homeland Security, and the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.||To provide for research to examine law enforcement policies and practices, including the causes, consequences, and mitigation of excessive use of force, and for other purposes.||No|
|H.R.7284||06/18/2020||Rep. Debbie Wasserman Schultz (D-FL)||Referred to the House Committee on the Judiciary.||To authorize the Attorney General to make grants to improve the relationship between the police and the communities they serve, and for other purposes.||No|
|H.R.7281||06/18/2020||Rep. Rashida Tlaib (D-MI)||Referred to the House Committee on the Judiciary.||To require States and units of local government to certify a commitment to release certain individuals from jails and prisons, and for other purposes.||No|
|H.R.7278||06/18/2020||Rep. Pete Stauber (R-MN)||Referred to the Committee on the Judiciary, and in addition to the Committees on House Administration, and the Budget, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.||To improve and reform policing practices, accountability and transparency.||No|
|S.3987||06/17/2020||Sen. Gary Peters (D-MI)||Read twice and referred to the Committee on the Judiciary.||A bill to amend the Omnibus Crime Control and Safe Streets Act of 1968 to provide that COPS grant funds may be used for local law enforcement recruits to attend schools or academics if the recruits agree to serve in precincts of law enforcement agencies in their communities.||Yes|
|S.3985||06/17/2020||Sen. Tim Scott (R-SC)||Motion by Senator McConnell to reconsider the vote by which cloture on the motion to proceed to the measure was not invoked (Record Vote No. 126) entered in Senate.||JUSTICE Act||No|
|S.3968||06/16/2020||Sen. Tom Cotton (R-AR)||Read twice and referred to the Committee on the Judiciary.||A bill to create an award for law enforcement officers who exemplify best practices to reduce the excessive use of force or improve community policing, and for other purposes.||No|
|H.R.7221||06/15/2020||Rep. Alexandria Ocasio-Cortez (D-NY)||Referred to the House Committee on the Judiciary.||To prohibit law enforcement officers from using chemical weapons in the course of policing activities, and for other purposes.||No|
|H.R.7206||06/15/2020||Rep. Adriano Espaillat (D-NY)||Referred to the House Committee on the Judiciary.||To amend title 18, United States Code, to prohibit the use of excessive force under color of law by law enforcement and correctional officers, and for other purposes.||No|
|H.R.7199||06/15/2020||Rep. Ted Budd (R-NC)||Referred to the House Committee on the Judiciary.||To provide grants to law enforcement agencies for de-escalation training and community outreach, and for other purposes.||No|
|H.R.7196||06/15/2020||Rep. Alma Adams (D-NC)||Referred to the House Committee on the Judiciary.||To amend title 18, United States Code, to provide that certain uses of riot control agents constitute civil rights violations, and for other purposes.||No|
|H.R.7153||06/11/2020||Rep. Donald Beyer (D-VA)||Referred to the Committee on the Judiciary, and in addition to the Committee on Armed Services||To require Federal law enforcement officers, including contract employees, and members of the armed forces engaged in crowd control, riot control, or arrest or detainment of individuals engaged in civil disobedience, demonstrations, protests, or riots to visibly display identifying information.||No|
|H.R.7150||06/11/2020||Rep. Greg Stanton (D-AZ)||Referred to the House Committee on the Judiciary.||To require the use of body cameras for law enforcement officers as a condition of eligibility for COPS ON THE BEAT grants, and for other purposes.||No|
|S.3956||06/11/2020||Sen. Amy Klobuchar (D-MN)||Read twice and referred to the Committee on the Judiciary.||A bill to incentivize banning of chokeholds and carotid holds, and for other purposes.||No|
|S.3955||06/11/2020||Sen. Rand Paul (R-KY)||Read twice and referred to the Committee on the Judiciary.||A bill to prohibit no-knock warrants, and for other purposes.||No|
|H.R.7194||06/11/2020||Rep. Maxine Waters (D-CA)||Referred to the Committee on the Judiciary, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.||To eliminate mandatory minimum sentences for all drug offenses.||No|
|H.R.7193||06/11/2020||Rep. Maxine Waters (D-CA)||Referred to the House Committee on the Judiciary.||To amend title 28, United States Code, to adjust the penalty for unjust conviction and imprisonment, and for other purposes.||No|
|H.R.7191||06/11/2020||Rep. David Trone (D-MD)||Referred to the House Committee on the Judiciary.||To amend the Omnibus Crime Control and Safe Streets Act of 1968 to condition eligibility for grants under the Edward Byrne Memorial Justice Assistance Grant Program, and for other purposes.||No|
|H.R.7188||06/11/2020||Rep. William Timmons (R-SC)||Referred to the House Committee on the Judiciary||To require law enforcement agencies to report the use of lethal force, and for other purposes.||Yes|
|H.R.7174||06/11/2020||Rep. Ro Khanna (D-CA)||Referred to the House Committee on Armed Services.||To enhance protections of civilians during United States military operations, and for other purposes.||No|
|S.3931||06/10/2020||Sen. Rand Paul (R-KY)||Read twice and referred to the Committee on Armed Services.||A bill to prevent the militarization of Federal, State, and local law enforcement by Federal excess property transfers and grant programs.||Yes|
|S.3909||06/08/2020||Sen. Christopher Murphy (D-CT)||Read twice and referred to the Committee on the Judiciary.||A bill to require Federal law enforcement officers, including contract employees, and members of the armed forces engaged in crowd control, riot control, or arrest or detainment of individuals engaged in civil disobedience, demonstrations, protests, or riots to visibly display identifying information.||No|
|S.3912||06/08/2020||Sen. Cory A. Booker (D-NJ)||Read twice and referred to the Committee on the Judiciary.||A bill to hold law enforcement accountable for misconduct in court, improve transparency through data collection, and reform police training and policies.||No|
|H.R.7120||06/08/2020||Rep. Karen Bass (D-CA)||Passed House. Placed on Senate Legislative Calendar under Read the First Time.||George Floyd Justice in Policing Act of 2020||No|
|H.R.7124||06/08/2020||Rep. Anthony G. Brown (D-MD)||Referred to the House Committee on Armed Services||To amend title 10, United States Code, to provide for additional requirements for the use of authority under the Insurrection Act, and for other purposes.||No|
|H.R.7129||06/08/2020||Rep. David N. Cicilline (D-RI)||Referred to the House Committee on Armed Services||To amend title 10, United States Code, to limit the authority of the President to use the militia or Armed Forces to enforce Federal authority or to provide Federal aid to State governments, and for other purposes.||No|
|H.R.7131||06/08/2020||Rep. Adriano Espaillat (D-NY)||Referred to the House Committee on the Judiciary||To amend title 18, United States Code, to prohibit deprivation of rights under color of law by law enforcement and correctional officers, and for other purposes.||No|
|H.R. 7133||06/08/2020||Rep. Debra A. Haaland (D-MN)||Referred to the Committee on the Judiciary, and in addition to the Committee on Armed Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.||To encourage State and local demilitarization by incentivizing the return of purchases made through the LESO program, and for other purposes.||No|
|H.R. 7134||06/08/2020||Rep. Joseph P. Kennedy III (D-MA)||Referred to the House Committee on the Judiciary||To amend title 18, United States Code, to lower the mens rea standard to reckless for the offense related to depriving persons of their rights under the color of law, and for other purposes.||No|
|H.R. 7135||06/08/2020||Rep. Ilhan Omar (D-MN)||Referred to the Committee on Armed Services, and in addition to the Committee on Rules, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.||To amend the Insurrection Act to curtail violations against the civil liberties of the people of the United States, and for other purposes.||No|
|H.R. 7136||06/08/2020||Rep. Mark Pocan (D-WI)||Referred to the House Committee on the Judiciary||To require the creation and adoption of national minimum training requirements for law enforcement personnel.||No|
|H.R. 7137||06/08/2020||Rep. Cedric L. Richmond (D-LA)||Referred to the House Committee on the Judiciary||To prohibit the receipt of funds under the Edward Byrne Memorial State and Local Law Enforcement Assistance Program and associated grant programs by State and local government units that have failed to adopt use of force policies and other policies that meet minimum standards; require State and local government units that operate law enforcement training programs funded by the Byrne program and associated grant programs to train officers in de-escalation and mental health crisis intervention and to publicly disseminate use-of-force policies; to require the promulgation of protocols for the investigation and reporting of instances of the use of deadly force by Federal law enforcement officers; to provide for grants to community supervision offices for training in de-escalation techniques and to other personnel; and for other purposes.||No|
|H.R. 7144||06/08/2020||Rep. Nydia Velazquez (D-NY)||Referred to the House Committee on the Judiciary||To amend title 18, United States Code, to prohibit the reckless use of excessive force under the color of law, and for other purposes.||No|
|H.R. 7100||06/04/2020||Rep. Sheila Jackson Lee (D-TX)||Referred to the House Committee on the Judiciary||To encourage greater community accountability of law enforcement agencies, and for other purposes.||No|
|H.R. 7089||06/04/2020||Rep. Joaquin Castro (D-TX)||Referred to the House Committee on the Judiciary||To reform law enforcement practices, and for other purposes.||No|
|H.R. 7087||06/04/2020||Rep. Ted Budd (R-NC)||Referred to the House Committee on the Judiciary||To amend title 18, United States Code, to increase the penalty for rioting, and for other purposes.||No|
|H.R.7085||06/04/2020||Rep. Justin Amash (L-MI)||Referred to the House Committee on the Judiciary||To amend the Revised Statutes to remove the defense of qualified immunity in the case of any action under section 1979, and for other purposes.||Yes|
|S.3902||06/04/2020||Sen. Richard Blumenthal (D-CT)||Read twice and referred to the Committee on Armed Services||A bill to amend the Insurrection Act to curtail violations against the civil liberties of the people of the United States, and for other purposes.||No|
|S.3895||06/04/2020||Sen. Kirsten Gillibrand, Kirsten (D-NY)||Read twice and referred to the Committee on the Judiciary||A bill to amend section 242 of title 18, United States Code, to include the use of chokeholds and carotid holds as a deprivation of rights and as a punishment, pain, or penalty, and for other purposes.||No|
|S.3873||06/03/2020||Sen. Tim Scott (R-SC)||Read twice and referred to the Committee on the Judiciary||A bill to require law enforcement agencies to report the use of lethal force, and for other purposes.||No|
|S.3852||06/01/2020||Sen. Elizabeth Warren (D-MA)||Read twice and referred to the Committee on Armed Services||A bill to enhance protections of civilians during United States military operations, and for other purposes.||No|
|Action||Date Introduced||Sponsor||Status||Summary||Bipartisan Support|
|H.Res.1027||06/26/2020||Rep. Bonnie Watson Coleman (D-NJ)||Referred to the House Committee on the Judiciary.||Expressing the sense of the House of Representatives that the wrongs and hardships of Black women are often equal to those experienced by Black men yet receive less attention and justice, and that any legislation passed in the House of Representatives to remedy racial inequities in the United States, especially those present in the criminal justice system, must include reforms to address concerns for Black women.||No|
|H.Res.1023||06/25/2020||Rep. Gregory Steube (R-FL)||Referred to the House Committee on the Judiciary.||Calling for justice for George Floyd and others, and condemning violence and rioting.||No|
|H.Res.1013||06/22/2020||Rep. Russ Fulcher (R-ID)||Referred to the House Committee on the Judiciary.||Resolving that jurisdictions seeking to dismantle or reduce funding for the jurisdiction's police force should not unduly burden residents who seek to defend themselves.||No|
|S.Res.631||06/18/2020||Rep. Josh Hawley (R-MO)||Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent.||A resolution honoring the life and service of David Dorn and expressing condolences to the family of David Dorn.||Yes|
|H.Res.1010||06/18/2020||Rep. Marc Veasey (D-TX)||Referred to the House Committee on House Administration.||Commemorating Juneteenth by calling for the implementation of safeguards to protect the integrity of United States elections and end voter suppression.||No|
|H.Res.1009||06/18/2020||Rep. Mary Gay Scanlon (D-PA)||Referred to the House Committee on the Judiciary.||Recognizing the threats to press freedom in the United States in the wake of protests following the killing of George Floyd, an unarmed Black man, by police in Minneapolis on May 25, 2020, reaffirming the centrality of a free and independent press to the health of democracy, and reaffirming freedom of the press as a priority of the United States in promoting democracy, human rights, and good governance.||No|
|H.Res.1007||06/15/2020||Rep. Gregory Steube (R-FL)||Referred to the House Committee on the Judiciary.||Calling for justice for George Floyd and opposing efforts to defund the police.||No|
|H.Res.1002||06/15/2020||Rep. Michael Guest||Referred to the House Committee on the Judiciary.||Strongly condemning the recent acts of violence, riots, and looting in the United States.||No|
|H.Res.1001||06/15/2020||Rep. Sheila Jackson Lee (D-TX)||Referred to the House Committee on Oversight and Reform.||Recognizing June 19, 2020, as this year's observance of the historical significance of Juneteenth Independence Day.||Yes|
|S.Res.620||06/15/2020||Sen. John Cornyn (R-TX)||Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent.||"A resolution designating June 19, 2020, as ""Juneteenth Independence Day"" in recognition of June 19, 1865, the date on which news of the end of slavery reached the slaves in the Southwestern States.|
116th Congress (2019-2020) | Get alerts"
|H.Res.999||06/11/2020||Rep. Mary Gay Scanlon (D-PA)||Referred to the House Committee on the Judiciary.||Recognizing the threats to press freedom in the United States in the wake of protests following the killing of George Floyd, an unarmed Black man, by police in Minneapolis on May 25, 2020, reaffirming the centrality of a free and independent press to the health of democracy, and reaffirming freedom of the press as a priority of the United States in promoting democracy, human rights, and good governance.||No|
|S.Res.613||06/10/2020||Sen. Tom Cotton (R-AR)||Referred to the Committee on the Judiciary||A resolution calling for justice for George Floyd and opposing calls to defund the police.||No|
|S.Res.612||06/09/2020||Sen. Kelly Loeffler (R-GA)||Referred to the Committee on the Judiciary||A resolution expressing the sense of the Senate that the tragic death of George Floyd was unjust and the perpetrators must stand trial and be brought to justice, the First Amendment of the Constitution guarantees individuals the right to peaceably assemble and protest, groups like Antifa and the individuals who took over peaceful protests with violence, chaos, looting, and destruction should be held accountable for their actions, the attacks on law enforcement, individuals, small businesses, and communities are causing death, injury and millions of dollars in damage, the vast majority of men and women in law enforcement work tirelessly and risk their lives to protect the people of the United States without prejudice, police departments are the cornerstone for maintaining a society of order, calls to defund the police threaten the safety and security of the people of the United States, Congress will continue to appropriate funding to local law enforcement agencies that bolster police efforts, and the Nation must come together in healing, reconciliation, and prayer to reaffirm that every life is sacred, our society must strive for equality, and that we will work to ensure a tragedy like George Floyd's never happens again in the United States.||No|
|H.Con.Res.100||06/04/2020||Rep. Barbara Lee (D-CA)||Referred to the House Committee on the Judiciary||Urging the establishment of a United States Commission on Truth, Racial Healing, and Transformation.||No|
|H.Res.993||06/04/2020||Rep. Eleanor Holmes Norton (D-DC-At-Large)||Referred to the House Committee on the Judiciary||Expressing support for the designation of June 2020 as "National Gun Violence Awareness Month", and calling on Congress to address gun violence.||No|
|H.Res.992||06/04/2020||Rep. Eleanor Holmes Norton (D-DC-At-Large)||Referred to the House Committee on the Judiciary||Declaring unconditional war on racism and invidious discrimination and providing for the establishment of a Cabinet-level Department of Reconciliation charged with eliminating racism and invidious discrimination.||No|
|H.Res.990||06/04/2020||Rep. Joyce Beatty (D-OH)||Referred to the Committee on the Judiciary, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.||Declaring unconditional war on racism and invidious discrimination and providing for the establishment of a Cabinet-level Department of Reconciliation charged with eliminating racism and invidious discrimination.||No|
|S.Con.Res.39||06/04/2020||Sen. Charles Schumer (D-NY)||Referred to the Committee on the Judiciary||A concurrent resolution expressing the Sense of Congress that the constitutional rights of Americans to peaceably assemble, exercise freedom of speech, and petition the government for redress of grievances must be respected; that violence and looting are unlawful, unacceptable and contrary to the purpose of peaceful protests; and that Congress condemns the President of the United States for ordering Federal officers to use gas and rubber bullets against the Americans who were peaceably protesting in Lafayette Square in Washington, DC on the night of June 1, 2020, thereby violating the constitutional rights of those peaceful protestors.||No|
|S.Res.602||06/02/2020||Sen. Edward Markey (D-MA)||Referred to the Committee on the Judiciary||A resolution recognizing that the murder of George Floyd by officers of the Minneapolis Police Department is the result of pervasive and systemic racism that cannot be dismantled without, among other things, proper redress in the courts.||No|
|S.Res.601||06/02/2020||Sen. Mitch McConnell (R-KY)||Referred to the Committee on the Judiciary||A resolution expressing the sense of the Senate that order must be immediately restored to the cities of the United States so that citizens may have peace and the legitimate grievances of peaceful protestors may be heard and considered.||No|
|H.Res.988||06/01/2020||Rep. Ayanna Pressley (D-MA)||Referred to the House Committee on the Judiciary||Condemning all acts of police brutality, racial profiling, and the use of excessive and militarized force throughout the country.||No|
Last updated on July 06, 2020
On this episode of Centering on Coronavirus, The New Center interviewed Greg Burel, the former Director of the Division of the Strategic National Stockpile. Mr. Burel served in this capacity for 12 years, from March 2007 up until his retirement this January. Today, he serves as president at Hamilton Grace, a consulting firm focused on preparedness and response.
Aleksandra Srdanovic: So I thought to frame the discussion, it’d be worthwhile to address the current narrative around the Stockpile. Since the onset of the pandemic, there’s been criticism of the shortages of supplies in the stockpile and its inability to meet requested needs from states. So I’m wondering, given this criticism, what exactly is the Stockpile’s role in a crisis like this, and how would you rate its performance in carrying out that mission?
Greg Burel: So I’ve actually published quite a bit on this that you might want to go take a look at, the most recent was an op-ed in The Hill. But, the Strategic National Stockpile was established a little over 20 years ago now with a mission to be able to respond to chemical, biological, radiological and nuclear events that were either tied to individually acting terrorists or terrorist cells, all the way to a state actor.
The primary purpose is to store the drugs and materials that you need to respond to even large scale terrorist events, but more focused on sort of a regional response. So we think about the theoretical bioterror attack on, maybe, Washington, D.C., New York City, and some other city at the same time, and we’re prepared to respond to those with a variety of materials that nobody else could move as quickly as we could to the area to cover all the people that might need to be taken care of, and in many cases to move the material from us to those locations where there is no other source for that kind of material, because it’s very unique in terms of drug product and so on. There is no commercial market for most of the things that one stocks to deal with bio-terror events, or chemical nerve agent attacks, or large scale radiation releases, or in the worst case, a nuclear detonation.
In 2005 or 2006, the Bush administration was trying to get better prepared for potential pandemic influenza events. So there were some supplemental appropriations from Congress that allowed us to build some stock of antivirals and personal protective equipment designed to respond to a pandemic influenza event. When we looked at models that suggested what we would need to deal with a 1918-type event in today’s United States population, the numbers of things that you might have to have are staggering. And there would really be no way even with almost unlimited funds to stock those and manage that material.
So, we used most of the material that we purchased for pandemic influenza in fighting the 2009 H1N1 pandemic influenza. Congress never gave us additional funds to revive that material. So, what I would say in terms of narrowing this down for you, the Stockpile was intended to respond to chemical, biological, radiological, and nuclear events. Over time, because it’s clear that one of the most capable medical logistics institutions around, we’re saying what we call at this point mission gallup. So, we went from a plan to be able to respond to CBRN in multiple cities simultaneously based on data that can’t be disclosed, to being asked to be engaged in a response to natural events, to being asked to be engaged in response to emerging infectious disease, and we’ve never seen a commensurate increase in funds to do that.
So, based on all of those factors, I think that what the Strategic National Stockpile had, at the beginning of this, was a limited quantity of specific material that could be used to respond to a pandemic or any other emerging infectious disease. Our plan has been always, because we’ve not been able to secure additional funding from the Congress, to get really ready in those areas as we would like-to be able to draw from the private sector supply chain at the time of an event. We’ve done that very successfully as well, for example, when we had to prepare on the fly for Ebola. But the reality is, the money is not there to be prepared as we should be for pandemic emerging infectious disease.
I would say that the Stockpile’s response has been outstanding based on what it has and the funds it’s received to be prepared for this. But I think what this raises is, if the nation expects the Strategic National Stockpile to continue to grow its mission, and it expects it to be prepared for these kinds of events, then it’s going to have to fund it to be able to do that.
AS: You suggested that [the Strategic National Stockpile] had some mission creep and it expanded into other areas aside from chemical, biological, nuclear incidents. So, would you say that it’s more of an issue of, the SNS just really needs more funding from Congress, or do you think that it would be better suited to have a more contracted mission or to have some internal reorganization?
GB: Congress has to fund it. SNS is fully capable of executing the mission that it needs to execute, whether it’s where the mission currently sits, really built around CBRN, or if you really want to expand it and make it do all of these other things. SNS is fully capable of doing that. And I would say it’s more capable than any other organization, not just because I worked there, but other government people will tell me, “SNS can do things that nobody else can do.” People look to us from, even, DOD to help support their mission requirements in many spaces. And the Strategic National Stockpile is the envy of the world. People are routinely coming to the SNS asking us, “How do you do this? How would we set this up in another country?” And so on. I don’t think there’s any benefit really from reorganization.
It needs more funds, and it would be nice if there were some additional authorities. So, for example, the issue here is not necessarily that the SNS didn’t have what it needed, although we would love to have seen the SNS have more material. But the reality is, the normal operating medical supply chain in the United States runs on a very lean, just-in-time paradigm. And while that does a great job of optimizing for the best value, the best profitability, the least funding that’s needed to do that, what it does is it sub optimizes that entire system to be prepared for anything. So if we have just enough of, let’s say, whatever drug it is in the supply chain, all the way from the manufacturer to the point that it would be dispensed to someone to cover a 30-day requirement for the entire United States, you can see there’s no flexibility.
Let’s exacerbate that a little bit. Probably 90% or [more] pharmaceuticals and a similar range of medical surgical supplies like gloves, gowns, face shields and so on, are made outside the United States. Any geopolitical problem can disrupt that supply chain. A number of years back, there was a longshoreman strike on the West Coast, and there were many container ships sitting off the coast with gloves, gowns, and they couldn’t make port and drop those off. So, it’s a combination of factors and to fix this problem.
First, the normal operating supply chain is going to have to create some flexibility in itself. Because it shouldn’t have been necessary with four or five cases in Washington state for Washington state to come ask the federal government for help.
Secondly, states and locals, well, primarily state public health, has to be better funded. Because state public health needs to be prepared to respond to it’s piece of this. The Strategic National Stockpile, even when we think about it in terms of CBRN, was always instead intended to supplement and resupply states just like the rest of the disaster response mechanisms in the United States are. The federal government is never supposed to be the first responder. The problem is, because there isn’t funding for public health as it should exist at the state and local level, they’re not prepared to be the first responder and the second responder either. So when you get back to the Strategic National Stockpile, it has to be funded if you want it to do this. But realistically, if we said that to respond to a 1918 type flu, you would need 3.7 billion N95 masks in stock, and that’s not realistic.
So everybody has to give a little in this. The supply chain has to be more flexible. We’d have to encourage manufacturing to come back into the United States so that we’re not reliant on easily disrupted supply chains from other nations. And I wouldn’t say everything, but there has to be a higher manufacturing capability in the US. And then, those government agencies that are responsible really, and they should be the fall back, on this kind of thing, have to be funded in such a way that they can have a valid way to deal with these things.
AS: Do you have any thoughts on how Washington could ensure that we augment some of these supply chains so we’re making more of these products at home, or just making importing it easier? A followup to that being, in the wake of a lot of previous pandemics, the American public and Congress became really focused on public health preparedness, but obviously as these threats recede, so too does the attention and the funding. Do you have any strategies or ways do you think that we could prevent that from happening again? Or making public health preparedness more conscious in people’s minds?
GB: I think the only way that you’re going to get manufacturing to increase in the United States is if you see, at least initially, some government incentives to bring that manufacturing back. The reality is that the cost to manufacture these products in the US is significantly higher than it is to manufacture them in foreign nations. You can get into all of the why’s and wherefores and politics and goods and bads about that whole thing. But, in reality, it costs more to make these in the US. A company that attempts to make product like this solely in the United States is, on price, always going to compete poorly with somebody that’s bringing in most of those from foreign sources. There are actual real examples of this out there; there is a company in Texas that has a great desire to make a lot of N95s, and they do have a number of customers and they make N95s. But the reality is, their product is significantly higher priced than their nearest competitor’s.
So if people are buying on price alone, which tends to be the case with this kind of thing, then they’re going to be driven away from that higher priced product, simply because it’s higher priced. Not because it’s a better product, but only because it’s made in the US. There’s going to have to be some kind of government incentive somewhere to bring that manufacturing back on shore, or at least a bit of it. Maybe that takes the form of tax incentives, maybe it takes the form of some relaxation of whatever stricture is causing some of the additional costs. There are risks associated with that as well. But, another thing that could be done is to fund the Strategic National Stockpile with, say, a special reserve fund that’s just designed to say, “We want to be able to have another 5 million masks a day manufactured in the United States.” So we put out a contract that we’re not really buying masks, but were buying capacity, and funding the cost to build that capacity. So, there are some potentials to think about there.
To your second question, I think that your articulation of the problem is very clear, and I would’ve said it the same way. Public health has often been, and frankly, much emergency response in general has been a matter of, if there is an event, we throw tons of money at that event. Typically, it’s too late at that point for that money to make a difference in that event. But we beat our chest and say, “This will make a difference in the future.” But the reality is, as we move further away from that event and it recedes in the mind, less and less money is available.
When I look at the supplemental funds that have been awarded under CARES [the Cares Act of 2020] and that we expect to see more of under other acts, the reality is that money is good to get a start on what you need for the future. If you don’t make that a regular investment, you’re going to have the same problem we have here. You’re going to buy this stuff, and it’s going to be used for an event, and you’re going to have no way to replace it. Or you’re going to buy this stuff, and it’s going to sit on the shelf for five or six years until the next event pops up, and then we’re going to get complaints because, “the mask is out of date” or “the drug is out of date” or whatever it is. Well, if you’ve got no money to rotate it after that initial investment to buy it, it was potentially a huge waste.
So, I think that’s a problem, but it’s a problem that affects the state and local level as well. After 9/11, a huge amount of money got poured into public health preparedness as well as other emergency preparedness across the country. And then you can look at the funds that were provided in subsequent years, and the further you moved away, those funds were diminished. This is something that has got to be at the forefront of the mind for forever. To suggest how to change that, I think, is difficult, because this has been the pattern of emergency response and public health preparedness in the United States for hundreds of years.
Hon. Cindy Hyde-Smith, Chairman
Hon. Chris Murphy, Ranking Member
U.S. Senate, Committee on Appropriations, Subcommittee on the Legislative Branch
Room S-128, The Capitol
Washington, DC 20510
Re: Strengthening Legislative Branch Capacity on Science and Technology
Dear Chairman Hyde-Smith, Ranking Member Murphy, and Members of the Committee:
On behalf of the undersigned organizations and individuals, we write to express our concern that Congress does not have sufficient capacity to tackle 21st century science and technology policy challenges. Accordingly, we urge you to prioritize efforts to augment this institutional capacity, including providing funding for the Office of Technology Assessment (OTA), as part of the fiscal year 2020 Legislative Branch Appropriations bill.
The Senate has played a leading institutional role in promoting science and technology capacity in Congress. We note with favor the recently created Science, Technology Assessment and Analytics (STAA) team inside the Government Accountability Office, and its expanding capabilities to serve Members of Congress with expert advice and analysis. We also look forward to the forthcoming report from the National Academy of Public Administration later this year.
But OTA and STAA have different comparative advantages: the former in foresight and emerging technologies, and the latter in oversight and evaluating federal government programs and expenditures. Congress must have both these capabilities to meet the ever-increasing demands on its oversight and legislative responsibilities.
We thank you for the opportunity to express our support for the reestablishment of the Office of Technology Assessment and welcome the opportunity to discuss this further. Please contact: Zach Graves, Head of Policy at Lincoln Network, at firstname.lastname@example.org or 202-733-8976; and Daniel Schuman, Policy Director at Demand Progress, at email@example.com or 240-237-3930.
R Street Institute
American Principles Project
Stand Up Republic
Log Cabin Republicans
Federation of American Scientists
Union of Concerned Scientists
Code for America
Information Technology and Innovation Foundation
American Library Association
American Civil Liberties Union
Center for Democracy & Technology
Center for Humane Technology
Open Markets Institute
Project On Government Oversight
Campaign for Accountability
Government Accountability Project
Joseph Rainey Center for Public Policy
The New Center
Future of Life Institute
Defending Rights & Dissent
Government Information Watch
Latino Tech Policy Initiative
Senior Executives Association
Vint Cerf, Internet Pioneer
Craig Newmark, Founder of Craigslist and Craig Newmark Philanthropies
Douglas W. Elmendorf, Dean and Don K. Price Professor of Public Policy, Harvard Kennedy School
Adam Keiper, Co-Founder and Senior Editor, The New Atlantis
Tim O’Reilly, Founder and CEO, O’Reilly Media
Allison Berke, Executive Director, Stanford Cyber Initiative
Jerry Taylor, President, Niskanen Center
Alan Davidson, VP of Global Policy, Trust, and Security at Mozilla Corporation
Mike Godwin, Board of Trustees, The Internet Society
Bruce Schneier, Lecturer in Public Policy, Harvard Kennedy School
Jon Peha, Professor of Electrical Engineering and Public Policy, Carnegie Mellon University
Daniel Sarewitz, Consortium for Science, Policy and Outcomes, Arizona State University
Robert Cook-Deegan, Consortium for Science, Policy and Outcomes, Arizona State University
Robert Friedman, VP for Policy, J. Craig Venter Institute
Daniel J. Chenok, Executive Director, IBM Center for The Business of Government
Ryan Calo, Co-Director, Tech Policy Lab, University of Washington
Robert Seamans, Professor, NYU Stern School of Business
William A. Galston, Senior Fellow, The Brookings Institution
Jason Schultz, NYU School of Law
Eric Goldman, Professor, Santa Clara University School of Law
David Eaves, Digital HKS, Harvard Kennedy School
Joan D. Winston, former CRS, OTA, and GAO analyst
Matthew Might, Director and Professor, Hugh Kaul Precision Medicine Institute, University of Alabama at Birmingham
John Leary, CEO, DotGov.com
Gladys B. White, Ph.D. Georgetown University, School for Continuing Studies
Gigi Sohn, Distinguished Fellow, Georgetown Law Institute for Technology Law & Policy
Rodney Sobin, Senior Program Director, National Association of State Energy Officials
Benedicte Callan, Clinical Professor, Arizona State University
DJ Patil, Former U.S. Chief Data Scientist
Sean Tunis, Principal, Rubix Health
Nick Sinai, Adjunct Faculty, Harvard Kennedy School
Austin Brown, Executive Director, UC Davis Policy Institute for Energy, Environment, and the Economy
Jillian Grennan, Assistant Professor, Duke University, Fuqua School of Business
Richard Forno, Senior Lecturer, University of Maryland, Baltimore County
Lorelei Kelly, Fellow, Resilient Democracy Lead, Beeck Center for Social Impact + Innovation at Georgetown University
Kathy Hill, Director Center of Advanced Governmental Studies, Johns Hopkins University
Christopher T. Hill, Prof. Emeritus of Public Policy and Technology, George Mason University
Annemarie Bridy, Allan G. Shepard Professor of Law, University of Idaho
Renee DiResta, Mozilla Fellow
Colleen Chien, Visiting Professor, Columbia Law School; Professor, Santa Clara Law School
Rebecca Williams, DC Legal Hackers
Alexander Howard, Founder, e-PluribusUnum.org
Ryan Khurana, Executive Director, Institute for Advancing Prosperity
Andy Lee Roth, Associate Director, Project Censored
Steve Plotkin, Argonne Associate, Argonne National Laboratory
Henry Kelly, University of Michigan
Grant Tudor, Harvard University
Justin Warner, Harvard University
Ross Dakin, New Jersey Office of Innovation
Adam Bly, Former VP Data at Spotify
Caroline S. Wagner, Wolf Chair in International Affairs, Ohio State University
Michael Stebbins, President, Science Advisors, LLC
*Affiliation listed for identification purposes only.
 “GAO Science, Technology Assessment, and Analytics Team: Initial Plan and Considerations Moving Forward,” GAO, April 10, 2019. https://www.gao.gov/pdfs/about/GAOScienceTechPlan-2019-04-10.pdf.
On Thursday, April 25th, North Korean leader Kim Jong Un and Russian President Vladimir Putin held their first joint summit in Vladivostok, Russia.
During a news conference following the summit, Putin stated that he and Kim had “a conversation on all items on our agenda and discussed them in various aspects, including bilateral relations, sanctions, United Nations, relations with the United States and, of course, the denuclearisation of the Korean Peninsula.”
Toward that end Kremlin spokesman Dmitry Peskov hinted at a restart of the “six party talks,” noting that “there are no other efficient international mechanisms at the moment.”
What are the six party talks?
The six party talks were a series of meetings held between the United States, North Korea, South Korea, Japan, China, and Russia between 2003 and 2009, the purpose of which was to address security concerns relating to North Korea’s nuclear weapons program.
The talks were held in six rounds but suspended when North Korea launched the Kwangmyŏngsŏng-2 rocket, believed to be a test for future ICBM launches.
The six party talks failed to yield any long-lasting results. This was in part due to the unpredictable nature of the North Korean regime coupled with a lack of a unified front from the other five parties, with the United States and Japan typically pushing for a more aggressive approach against North Korea than did China, Russia, and South Korea.
Despite continuity during the six party talks, U.S. policy in Korea has ebbed and flowed from administration to administration.
Bill Clinton emphasized diplomacy and conciliation while George W. Bush took a hard-line approach and categorized North Korea as part of the “axis of evil.” Barack Obama counseled “strategic patience,” which featured minimal dialogue or interaction with the North Korean regime.
None of these approaches yielded long-lasting results.
President Trump has alternated between postures of maximum pressure and engagement. Months after threatening the North Koreans with “fire and fury the like the world has never seen,” he managed to bring the North Korean leadership to the table for the 2018 Singapore Summit, after which a joint document was signed stating “new U.S.-DPRK relations will contribute to the peace and prosperity of the Korean Peninsula and of the world, and … mutual confidence building can promote the denuclearization of the Korean Peninsula.”
The second summit held from February 27-28 in Hanoi was not as successful. It was cut short because the North Korean leadership requested an end to all sanctions, a deal President Trump was unwilling to make.
The fallout from the Hanoi summit has left U.S.-North Korean relations at a standstill, with neither party willing to make concessions, and the North Korean regime looking to exploit tense relations by meeting with President Putin.
What does this mean for the United States?
Many in the U.S. foreign policy community worry about the implications of a budding Kim-Putin relationship. For Kim, this summit could be a way to show the United States and the broader international community that he is not, in fact, isolated, and that allies exist who will support his country. Putin could be using the summit to position Russia as a global peacemaker.
But Russia can’t offer North Korea much in the way of safety guarantees. And this could all simply be Kim’s drawn-out attempt to play international actors off against each other, in the hopes that the United States will eventually either renew talks or make concessions on North Korea’s nuclear capabilities.
The underlying motives are unclear. But it does appear as if North Korea will continue to frustrate the Trump administration, just as it has its predecessors.
Aleksandra Srdanovic is a policy analyst for The New Center, which aims to establish the intellectual basis for a viable political center in today’s America.