Category: ACE Research

Understanding Trump v. Hawaii: Travel Bans and Executive Power

The 2018 Supreme Court decision in Trump v. Hawaii upheld the third iteration of President Donald Trump’s 2017 travel ban, officially known as Presidential Proclamation 9645, affirming the executive branch’s broad authority over immigration and national security. The ruling raised questions about the balance between national security and constitutional protections, as well as the extent of executive power in shaping immigration policy.

Context and Court Decision

In 2017, the Trump administration issued a series of executive actions restricting immigration from predominantly Muslim-majority countries, citing national security concerns. The initial order, Executive Order (EO) 13769, faced legal challenges over its broad scope and alleged religious bias, leading to EO 13780, which removed Iraq from the list but remained contested. Following a Department of Homeland Security review, Proclamation 9645 was issued, targeting eight countries—five of which were Muslim-majority—based on security considerations.

The State of Hawaii, the Muslim Association of Hawaii, and three individuals challenged Proclamation 9645. The plaintiffs argued the proclamation exceeded the president’s authority under 8 U.S.C. §1182(f) — a statute that grants the president power to suspend entry of foreign nationals deemed “detrimental” to U.S. interests. The plaintiffs also argued that the proclamation violated the Establishment Clause, a section of the U.S. Constitution that forbids the government from favoring one religion over another, because it disproportionately targeted Muslim-majority nations.

In a 5-4 decision, the Supreme Court upheld the travel ban. Chief Justice John Roberts applied the rational basis test—a judicial standard requiring that a policy must advance the nation’s best interest in order to be constitutional—and ruled that the policy had a valid national security justification. The majority emphasized that the judicial branch must defer to executive authority in immigration matters. In dissent, Justice Sonia Sotomayor argued that the Court failed to scrutinize potential discriminatory intent behind the executive orders.

Historically, the Supreme Court has upheld immigration restrictions based on national security and executive power. In Chae Chan Ping v. United States (1889), the Court affirmed Congress’s plenary power to regulate immigration based on nationality. This precedent was reinforced in United States v. Thind (1923), which upheld racial classifications in immigration law, and Korematsu v. United States (1944), which ruled that national security concerns could justify executive actions, including the internment of Japanese Americans.

Arguments in Favor

Supporters of the decision argued that the travel ban was necessary for national security, asserting that it was based on an objective review of foreign governments’ vetting capabilities rather than religious bias. Given that Proclamation 9645 references certain nations that failed to meet U.S. standards for identity management, information sharing, and risk factor screening, supporters of the Trump v. Hawaii decision negate the plaintiffs’ argument that Proclamation 9645 targets nations based on religion.

Another key argument concerns the president’s authority under 8 U.S.C. §1182(f), which permits suspending the entry of foreign nationals when necessary for national security or public health reasons. The executive branch has traditionally been granted broad discretion in immigration matters, particularly concerning national security, a precedent supporters say was simply reaffirmed by the Court in Trump v. Hawaii. Supporters of the Court’s decision argue that courts should not second-guess executive branch decisions regarding national security.

Arguments in Opposition

Critics contended that the ruling in Trump v. Hawaii set a dangerous precedent by granting excessive deference to executive authority, allowing presidents to impose broad immigration restrictions with minimal judicial oversight. They hold that the 2018 ruling is indicative of a broader trend in which courts “hide behind national security” to avoid ruling against the executive branch. Opponents feared Trump v. Hawaii and similar cases would add to “rule of law backsliding”, in which policies that violate human rights avoid judicial scrutiny and remain in effect. After the majority decision was published, critics feared the ruling could enable future administrations to justify exclusionary policies under the guise of national security.

Another primary concern was the disregard for evidence of religious discrimination. Critics pointed to Trump’s campaign remarks advocating a “Muslim ban,” arguing that these statements demonstrated clear discriminatory intent. Lower courts had previously considered these remarks substantial indicators of unconstitutional religious bias, yet the Supreme Court focused on the text of the proclamation rather than its underlying motivations.

The ruling also raised constitutional concerns. Critics argued that by prioritizing national security justifications over potential Establishment Clause violations, the Trump v. Hawaii decision suggested that religious exclusion could be legitimized if framed as necessary to national security.

Conclusion

Trump v. Hawaii reaffirmed the executive branch’s broad authority over immigration and national security, prompting critical questions: Does the decision set a precedent for unchecked presidential authority, or does it safeguard national security? How should courts balance deference to the executive with safeguarding individual rights? These unresolved issues ensure that Trump v. Hawaii will remain a key reference point in future debates over executive power and immigration law.

April 22, 2025
Pros and Cons of S.5446: The Electrifying Rural Transportation Act of 2024

Background
Electric vehicles (EVs) have gained significant traction in recent decades due to advances in battery technology, electric motor design, and increasing public receptivity. In the United States, EV sales rose from fewer than 160,000 units in 2016 to more than 1.39 million units in 2023. This surge has been driven largely by declining technology costs, making EVs more accessible to a broader population—including rural communities, which face unique transportation challenges such as long travel distances and low population density.

S.5446 Key Provisions

Introduced in December 2024 by Senator Peter Welch (D-VT), S.5446—the Electrifying Rural Transportation Act of 2024—sought to apply the benefits of EVs to address transportation and microtransit issues in rural areas. The bill’s primary objective was to allocate federal funds to rural communities that want to strengthen their transportation infrastructure with electric vehicles. The bill was referred to the Senate Committee on Commerce, Science, and Transportation, and failed to pass out of committee before the close of the 118th Congress.

S.5446 aimed to address rural transportation challenges through microtransit, a transportation system seen as a middle ground between private vehicles and mass public transportation. The bill text defined microtransit as a “technology-enabled public transportation model” allowing users to “request on-demand rides within a defined service area”. One example of microtransit is the St. Louis Metro’s partnership with Via, which allows commuters to hail buses for on-demand rides within a designated route. Typically, microtransit systems use smaller-capacity vehicles, such as minibuses, which are better suited to rural areas with lower ridership and greater distances between users. Given that microtransit systems are already being piloted across small towns to address transportation deserts and safety issues, the Act sought to incentivize the use of electric vehicles in such programs.

In accordance with the Department of Transportation’s Formula Grants for Rural Areas program, State lands with populations of under 50,000 people or Indian Tribes would have been eligible for Electrifying Rural Transportation funding if the bill had passed. Under S.5446, three categories of projects were eligible for federal funding: (1) the purchase of electric buses, other electric vehicles, and related charging infrastructure; (2) upgrades or renovations to existing facilities to support EV charging; and (3) certain operational costs, including online platforms for scheduling and driver retraining programs.

Arguments Against S.5446
Despite the bill’s clear objectives, several challenges merit consideration. Chief among them are the costs associated with purchasing electric buses, constructing charging stations, and hiring qualified drivers. Furthermore, given that S.5446 was not written in complete language and did not receive mark-ups in committee, one is left to speculate on the proportion of the spending between federal and state contributors. The standard formula for federal grant matching of “capital projects” with similar scope and intent to S.5446 stipulates a 20% contribution by the state to match the 80% provided by the federal government. Thus, even with federal contributions, a substantial expenditure would still fall to the states seeking to implement an EV microtransit scheme.

Another concern is the capacity of local electrical grids. EVs require direct current fast-charging (DCFC) stations to charge efficiently, which can put a substantial strain on power grids. In many rural areas, existing power grids are aging and susceptible to disruption from extreme weather, compounding the challenge.

Beyond infrastructure, implementation involves navigating zoning laws and permitting processes, especially for constructing structures with high energy needs such as DCFC stations and vehicle depots. Rural areas may span multiple jurisdictions, including local governments and tribal lands, requiring coordination among various stakeholders. Additionally, community attitudes may present obstacles. Rural residents, who often depend heavily on gasoline-powered vehicles due to long travel distances, may be reluctant to adopt new technologies. For instance, while only 4% of the U.S. population lives in rural areas, they consume approximately 13% of the nation’s gasoline. The reliance on gasoline also supports local economies, including car repair shops that cater to vehicles subject to harsher road conditions. Studies show that this longstanding environment of gasoline consumption has substantially decreased the likelihood for EV adoption in rural areas, raising questions about the feasibility of S.5446.

Arguments for S.5446
While the bill’s provisions face challenges, S.5446 also offers numerous potential benefits. EVs are more energy-efficient than internal combustion engine vehicles, consuming between 2.6 and 4.8 times less energy per mile. In rural settings, where larger vehicles are common and travel distances are longer, this translates into cost savings. Rural drivers currently spend about 44% more on gasoline than their urban counterparts. Maintenance costs are also lower for EVs, which have fewer moving parts and do not rely on combustible fuels; studies indicate maintenance costs for EVs are approximately 50% less than for traditional vehicles.

In addition, EVs create no emissions as a by-product of their operation. Currently, the transportation sector contributes about 28% of U.S. greenhouse gas emissions, with ground vehicles accounting for over 80% of that total. Expanding EV usage, even in rural areas with small populations, could help reduce these emissions meaningfully.

Beyond operational efficiencies and environmental gains, S.5446 addresses longstanding gaps in rural transportation. Traditional public transit systems are often financially unviable in rural settings due to low ridership and dispersed populations. Microtransit, especially when paired with EVs, offers a cost-effective alternative. This is particularly important for older, lower-income residents or those in zero-car households—populations found disproportionately in rural areas—who often lack access to any form of personal transportation. One relevant example is the METGo! program in Wise County, Virginia. METGo! is a publicly funded microtransit initiative that mirrors S.5446’s microtransit objectives, though it does not currently use EVs. Since its launch, METGo! has more than doubled rural transit ridership, highlighting the potential impact of such services.

Last, public opinion on adopting EVs in rural communities has been steadily uptrending despite these populations’ longtime reliance on gasoline-powered vehicles. In the general population, EV use is rising exponentially. Proponents of S.5446 argue that any step towards electrifying transit aligns with this trend in public opinion.

Conclusion
The Electrifying Rural Transportation Act of 2024 represents a comprehensive legislative effort to extend EV benefits to rural communities through enhanced microtransit systems. By enabling access to federal funding for EV acquisition, charging infrastructure, facility upgrades, and operational support, S.5446 lays the groundwork for a new model of rural transit. While the bill faces logistical, financial, and public opinion-related hurdles, its potential to address efficiency, equity, and environmental concerns makes it a notable proposal in the evolving landscape of transportation policy. The bill has yet to be reintroduced in the current Congress, but it is likely that attempts to engineer solutions for rural transportation will remain at the forefront of related legislation for decades.

April 22, 2025
A Third Trump Term?: Debate and Future Prospects

In an interview with NBC on March 30th, 2025, President Donald Trump conveyed interest in pursuing a third term, stating he was “not joking” at the prospect and that “a lot of people want [him] to do it”. When questioned about how he planned to go about seeking a third term, Trump admitted that he could see a method in which current Vice President J.D. Vance would run for President with Trump as Vice President and then pass the role onto Trump. President Trump did not identify other potential methods of seeking a third term.

What Does the Constitution Say?

The twenty-second amendment of the U.S. Constitution imposes a two term limit on the Presidency. Additionally, the twelfth amendment of the Constitution states that people who are constitutionally ineligible to run for President are also ineligible to run for Vice President. Since Trump has already reached his two-term limit, he is ineligible to serve as President and thus ineligible to run for Vice President under the Constitution. In sum, it would be unconstitutional for President Trump to run for Vice President or for a third term as President.

A Third Term: What Would it Take?

Article V of the Constitution specifies that the Constitution can only be amended by either a two-thirds vote from both chambers of Congress or a constitutional convention called by two-thirds of all states that ratifies an amendment with a three-fourths majority vote. While 11,000 constitutional amendments have been proposed in U.S. history, only 27 have been ratified. The overwhelming majority required to achieve a Constitutional Amendment makes it highly unlikely that President Trump will be able to achieve a third term through these means.

Reactions and Controversy

In reaction to President Trump’s statements, prominent Republican politicians have attempted to downplay Trump’s intentions of running for a third term. Attorney General Pam Bondi stated that President Trump is likely “going to be finished” when his term ends in 2029. Additionally, Speaker of the House Mike Johnson admitted that running for a third term would be a “high bar” and that there would be “constitutional limitations.”

Some Democrats caution against interpreting President Trump’s statements about a third term as hyperbole, with former Representative Tim Ryan (D-OH) stating, “[Seeking a third term] is a serious thing and he is capable of doing it.” Representative Dan Goldman (D-NY)—who has introduced and reintroduced resolutions to affirm the twenty-second amendment’s two-term limit—went farther in his condemnation of Trump’s suggestions. He stated, “Republicans are waging an all-out attack on the Judiciary to clear the way for Trump to serve a third term.”

However, some lawmakers advocate for a third presidential term. On January 25, 2023, Representative Andy Ogles (R-TN) introduced a joint resolution to extend the Presidency to a three-term limit, arguing it would allow President Trump to “sustain the bold leadership our nation so desperately needs.”

As the debate continues, only time will tell whether President Trump intends to act on his controversial statements about pursuing a third term.

April 22, 2025
Understanding the Freedom of Information Act (FOIA)
Background

In November 2024, Elon Musk posted on social media, “There should be no need for [Freedom of Information Act] requests. All government data should be default public for maximum transparency.” His statement reignited discussions on the Freedom of Information Act, or FOIA, a federal law enacted in 1966 that requires federal executive branch agencies to disclose information in specific ways. Since its original passage in 1966, FOIA has been updated three times to tighten agency compliance, account for digital records, and allow citizens to request records online. Under FOIA, government agencies must disclose information by:
- Publishing procedural rules in the Federal Register
- Electronically disclosing certain frequently requested records
- Disclosing all covered records not already available upon request
FOIA includes nine exemptions to protect against harms that might result from divulging certain records; these exemptions include cases like invasion of personal privacy, information related to national security, and information that would interfere with law enforcement proceedings.

History of FOIA

Concerns over government secrecy grew in the aftermath of the Cold War. In response, Representative John Moss, a Democrat from California, introduced FOIA in 1955 with support from the journalism community. Despite opposition from President Lyndon B. Johnson and every federal agency, the House of Representatives passed the bill with a vote of 307–0. When Johnson signed the legislation in 1966, he included a signing statement emphasizing that the law allowed room for interpretation and exemptions related to national security.

Over the decades, several amendments refined FOIA to make it what it is today. Most notably, the Privacy Act of 1974 was created in response to concerns about individual privacy rights In 1996, President Bill Clinton signed the Electronic Freedom of Information Act Amendments, which required agencies to make documents available electronically. The OPEN Government Act of 2007, signed by President George W. Bush, expanded the definition of “journalist” to include web-based reporters and bloggers. It also established the Office of Government Information Services to oversee FOIA compliance. President Barack Obama further reformed the law with the FOIA Improvement Act of 2016, which required agencies to update their FOIA regulations and create a centralized online portal for requests. The FOIA Improvement Act also introduced the “foreseeable harm” standard, which prohibits agencies from denying FOIA requests unless they can sufficiently prove that disclosure of the requested records would lead to a specific harm.

The FOIA Request Process

FOIA requests are open to anyone, regardless of citizenship status. Requesters must submit their inquiries either electronically or in paper form to the appropriate federal agency. Upon submission, the agency provides a tracking number and begins searching for relevant records. If the requested documents contain sensitive information, agencies redact sections in accordance with the nine exemptions before releasing them to the requester.

The processing time for a FOIA request depends on the complexity of the information sought. Simple requests are generally fulfilled more quickly, while those requiring extensive searches or redactions take longer. In certain circumstances, requests may qualify for expedited processing, particularly if a delay would threaten someone’s safety or if there is an urgent need to inform the public about government activities. While there is no initial fee to file a request, agencies may charge for search time beyond two hours or for duplicating more than 100 pages, depending on the requesting party. If a request is denied, the requester has the right to file an appeal at no cost.

FOIA in the 21st Century

As digital technology has advanced, FOIA has become a tool for journalists and advocacy organizations to uncover government behaviors and potential wrongdoings. Some FOIA requests eventually turn into lawsuits. For example, in 2008, the American Civil Liberties Union filed a lawsuit for the Department of Justice to turn over records on the government’s use of individual cell phones as tracking devices. In 2016, Color of Change and the Center for Constitutional Rights sued the Federal Bureau of Investigation for not responding to their FOIA requests, which they had submitted that same year for records about federal surveillance of Black Lives Matter protests.

During the Trump administration, FOIA requests were frequently used to fact-check government statements, investigate the COVID-19 response, and examine financial conflicts of interest. In 2017, federal agencies redacted or withheld 78 percent of requested records, the highest rate in a decade. That same year, FOIA lawsuits rose by 26 percent, marking a 70 percent increase from 2012.

Under the Biden administration, FOIA request processing remained similarly restrictive. In fiscal year 2023, over two-thirds of requests were either redacted, withheld, or denied on the basis that no relevant records were found. Agencies received nearly 1.2 million FOIA requests that year, setting a new record. Approximately 40 percent of requests were only partially fulfilled, a rate comparable to the final year of the Trump administration. Meanwhile, the number of requests fully granted dropped from 21 percent in 2020 to 16 percent in 2023.

Arguments in Favor of FOIA

Supporters of FOIA argue that the law promotes public transparency and holds government officials accountable for fraud, waste, and abuse. In a democratic society, access to government information is essential for maintaining trust between the public and its government. Proponents argue that government transparency is especially important in the post-9/11 era, as government agencies have expanded their data collection efforts while often keeping these activities secret.

In addition to promoting the democratic ideal of an informed citizenry, supporters argue that FOIA is especially useful to potential voters. FOIA gives Americans access to in-depth knowledge about their political representatives, allowing them to make more informed choices at the polls.

Finally, supporters argue that FOIA allows advocacy organizations to amplify and seek justice for government wrongdoing that would otherwise remain secret. They point to instances where FOIA requests have led to the discovery of misinformation campaigns, coordinated use of excessive force against protesters, and surveillance. In some cases, such as the aforementioned 2008 and 2016 lawsuits, FOIA requests can provide a foundation for victims of injustice to seek accountability.

Although FOIA initially faced challenges such as bureaucratic delays and inconsistent enforcement, proponents contend that amendments over the years have made the process more accessible. The rise of digital technology has also made it easier for agencies to share information with the public.

Criticisms of FOIA

Opponents argue that FOIA places an excessive burden on federal agencies by requiring them to respond to requests within a short time frame despite limited resources and funding. They also argue that FOIA contributes to an overburdened judicial system, as courts must handle cases involving delayed or incomplete responses to FOIA requests. Another concern is that FOIA allows too many requests driven by personal curiosity rather than legitimate public interest, further straining agency resources.

On the other hand, some criticize FOIA’s broad exemptions, arguing that agencies frequently overuse them to withhold information. Exemption 5, which protects privileged communications between agencies, is particularly controversial. In 2013 alone, it was cited more than 81,000 times to deny FOIA requests.

Another longstanding issue is the excessive delay in releasing certain records. The FBI, for example, took nearly 25 years to release files on musician John Lennon following an ACLU request. The agency withheld the final 10 documents until 2006, citing concerns about “foreign diplomatic, economic, and military retaliation” against the United States. However, when the documents were finally disclosed, they contained only well-known information about Lennon’s connections to antiwar groups. ACLU legal director Mark Rosenbaum described the prolonged secrecy as “government paranoia at a pathological level.”

Proposed Reforms

To address some of these concerns, several reforms have been proposed to improve FOIA while balancing the government’s need for confidentiality. One suggestion is to limit the duration that records can be withheld under Exemption 5. Proponents of this reform suggest that setting a maximum withholding period of 12 years—the same limit applied to presidential records involving deliberative processes—could help prevent excessive secrecy while still protecting sensitive government deliberations. Another proposed reform is to implement a “balancing test” that requires agencies to weigh the government’s interest in confidentiality against the public’s right to access records.

Conclusion

FOIA is a landmark law that changed the landscape of government transparency. While it has undergone reforms to improve public access to records, challenges such as delayed processing times and resource constraints hinder its effectiveness. Ongoing debates about FOIA reflect broader tensions regarding national security, government efficiency, and the public’s right to information.
April 17, 2025
Understanding the Debate on AI in Electronic Health Records

Background

Artificial Intelligence (AI) refers to the use of computer algorithms to process data and make decisions, ultimately streamlining administrative processes. In healthcare, AI is being increasingly integrated with Electronic Health Records (EHRs)—digital systems that store and manage patient health information, such as medical history and diagnoses. By 2021, almost 80% of office-based physicians and virtually all non-federal acute care hospitals had implemented an EHR system. As part of this widespread adoption, various AI applications in EHRs are beginning to emerge. So far, the main functions of AI in EHRs include managing datasets of patient health information, identifying patterns in health data, and using these patterns to predict health outcomes and recommend pathways for treatment.

Arguments in Favor of AI in EHRs

The use of AI in EHRs presents opportunities to improve healthcare by increasing efficiency as well as supplying administrative support. Supporters of AI integration argue that it can significantly improve diagnostic accuracy. AI-integrated EHR systems can analyze vast amounts of patient data, flagging potential issues that might otherwise be overlooked by human clinicians. Machine learning algorithms can identify patterns across multiple cases and recommend diagnoses or treatments based on evidence from similar cases. Proponents contend that by reducing human error and providing real-time insights, AI could support doctors in making more accurate and quick decisions, leading to better patient outcomes.

Proponents of AI in EHRs also argue that AI has the potential to significantly reduce healthcare inequities by providing better access and more personalized care for underserved populations. AI-powered tools can identify at-risk patients early by analyzing complex data, including demographic and behavioral factors, and help prioritize interventions for those who need it most. Additionally, AI can bridge communication gaps for patients facing language barriers or low health literacy, ensuring they receive clear and relevant information about their health. Supporters also suggest that AI’s ability to reduce human biases in clinical decision-making, such as disparities in pain assessment or treatment recommendations, could lead to fairer, more equitable healthcare outcomes for all.

From the workforce perspective, supporters argue that AI integration in EHRs has the ability to significantly reduce physician burnout by streamlining the documentation process. With the increasing time spent on EHR tasks, AI-driven tools like voice-to-text transcription, automated note generation, and data entry can cut down the time physicians devote to administrative duties. For instance, one 2023 study reported that AI integration in health records led to a 72% reduction in documentation time, equating to approximately 3.3 hours saved per week per clinician. This allows doctors to spend more time on direct patient care and less on paperwork, which supporters contend will improve job satisfaction and reduce stress.

Arguments Against AI in EHRs

While some argue that AI in EHRs will lead to more accurate and equitable healthcare, others raise concerns regarding data bias, privacy, and transparency. Critics of AI integration argue that modern legal frameworks lack adequate safeguards for individuals’ health data, leaving sensitive information vulnerable to breaches. For example, data collected by AI tools may be hacked or gathered without consent for marketing purposes. Additionally, certain genetics testing companies that operate without sufficient legal oversight may sell customer data to pharmaceutical and biotechnology companies.

Moreover, some critics share concerns about whether AI integration in EHRs aligns with standards for informed consent. Informed consent is a key ethical principle that ensures patients are fully informed and in control of decisions regarding their healthcare. It includes elements such as the patient’s ability to understand and make decisions about their diagnoses, treatment options, and any risks involved. Ethical responsibility dictates that consent should be specific, voluntary, and clear. The rise of AI in healthcare applications has increased concerns about whether patients are fully aware of how their data is used, the risks of procedures, and potential errors in AI-driven treatments. Autonomy principles state that patients have the right to be informed about their treatment process, the privacy of their data, and the potential risks of AI-related procedures, such as errors in programming. Critics say that patients must be more informed about how AI is integrated into health records systems in order for them to truly provide informed consent.

Another significant ethical concern in the use of AI and machine learning (ML) in healthcare is algorithmic bias, which can manifest in racial, gender, and socioeconomic disparities due to flaws in algorithm design. Such biases may lead to misdiagnosis or delayed treatments for underrepresented groups and exacerbate inequities in access to care. To address this, advocates push for the prioritization of diverse training data that reflects demographic factors. They hold that regular evaluations are necessary to ensure that AI models consistently remain fair over time, upholding the principles of justice and equity.

Future Outlook

Building on the potential of AI in healthcare, H.R. 238, introduced on January 7, 2025, proposes that AI systems be authorized to prescribe medications if they are approved by the Food and Drug Administration (FDA) and if the state where they operate permits their use for prescribing. This bill represents a significant step in integrating AI into clinical practices, going beyond data management to reshape how medications are prescribed and managed. The arguments for and against H.R. 238 mirror the debate around AI integration in EHRs; while proponents of the bill argue that AI could enhance patient safety, reduce errors, and alleviate clinician burnout, critics highlight concerns regarding the loss of human judgment, data privacy, and the potential for AI to reinforce biases in healthcare. As AI continues to play a central role in healthcare, bills like H.R. 238 spark important discussions about AI’s ethical, practical, and legal implications in clinical decision-making.

Summary

In conclusion, the integration of AI into EHRs has forced medical stakeholders to balance a need for improvements in accuracy and efficiency with a concern for medical ethics and patient privacy. On one hand, AI can support more accurate diagnoses, enhance patient care, and help reduce the burnout faced by healthcare providers. Additionally, AI may contribute to reducing healthcare inequities by providing better access and more personalized care, especially for underserved populations. However, the implementation of AI also raises concerns regarding data privacy, algorithmic bias, and informed consent, suggesting a need for more careful implementation and oversight. As AI’s presence in healthcare settings continues to expand, addressing these concerns will be key to ensuring it benefits patients and healthcare providers alike.

April 15, 2025
Understanding the Connected MOM Act: Federal Intervention in State Maternal Health Medicaid Coverage
Introduction to Medicaid and Maternal Health Coverage

Medicaid is a healthcare program designed to cover specific medical costs for individuals with lower incomes and limited resources. While the federal government sets baseline regulations and retains oversight authority over Medicaid programs, states maintain primary responsibility for program administration, which leads to variation in Medicaid coverage across the nation. Many state Medicaid programs offer insurance coverage for pregnant individuals through mechanisms such as presumptive eligibility. Presumptive eligibility allows certain vulnerable populations to receive coverage before their application for Medicaid is fully processed. For example, Iowa’s presumptive Medicaid coverage extends Medicaid benefits to all pregnant applicants while their eligibility is being determined, regardless of the final outcome.

Maternal health remains a critical concern in the United States, where indicators such as preterm births and maternal mortality have continued to rise despite targeted policy interventions. A key factor in improving maternal health outcomes is access to high-quality prenatal care, yet adequate access to prenatal care is declining. A significant reason that many people cannot access adequate prenatal care is a lack of insurance coverage or sporadic insurance coverage during their pregnancy. Research emphasizes that increasing insurance coverage for pregnant people can improve access to prenatal care, which can improve maternal health outcomes.

While federal regulations mandate certain Medicaid services, including maternal healthcare, the specifics of maternal health coverage are left largely to the discretion of individual states. For instance, Iowa’s presumptive eligibility for pregnant people continues until the applicant receives a determination of full Medicaid eligibility. In contrast, Minnesota’s hospital-based presumptive coverage for pregnant people only lasts for a month.

S.141 and the Scope of Federal Intervention

Introduced on January 16, 2025, S.141—or the Connected MOM Act—aims to identify and address barriers to Medicaid coverage of health monitoring devices in an effort to improve maternal health outcomes. Given that health monitoring devices can expand access to prenatal care by allowing physicians to remotely monitor health metrics, the bill aims to explore how pregnant people might face challenges in obtaining these devices. The bill proposes investigating state-level obstacles to coverage of remote physiologic devices, which include:
- Blood pressure cuffs (used to monitor blood pressure)
- Glucometers (used to assess blood glucose levels)
- Pulse oximeters (used to measure blood oxygen saturation)
- Thermometers (used to track body temperature)
These devices enable at-home monitoring of key health metrics, facilitating earlier intervention for dangerous pregnancy-related conditions. According to legal experts, such investigative efforts generate data that can inform and support future policy development. S.B. 141, which has received bipartisan support, is currently under review by the Senate Finance Committee.

Perspectives on S.B. 141 and Federal Medicaid Interventions

Investigative legislation like the Connected MOM Act allocates funding for evidence-gathering to guide future policy decisions. In this case, the bill aims to collect information on how states manage Medicaid coverage for remote physiologic devices that are critical during pregnancy, with the long-term goal of shaping federal Medicaid policies. While supporters of the Connected MOM Act argue that it will provide necessary insights to catalyze Medicaid expansion for pregnant people, others point to the rules and regulations of Medicaid which make it difficult for the federal government to intervene broadly in state Medicaid programs. Given the structural limits on federal influence over state-run Medicaid programs, broad national reforms are often considered too costly or unlikely to yield systemic change. This dynamic was evident in the fate of H.R. 3055—the Black Maternal Health Momnibus Act—which failed to advance beyond the committee stage. Supporters of the Connected MOM Act argue that its incremental, investigative approach will help justify future reforms without being perceived as broad federal overreach.

Conclusion

Each state administers its own Medicaid program, resulting in variations in coverage for certain medical devices, including remote health monitoring devices. Given the importance of these devices in expanding access to prenatal care, S.B. 141 seeks to investigate the best course of action for improving coverage of them across the nation. As it moves through committee, S.B. 141 may give insights on how policymakers can strategically navigate limits on federal power over state health programs.
April 15, 2025
Understanding Title 42: The Intersection of Public Health and Immigration

What is Title 42?

Title 42, established under the Public Health Service Act of 1944, grants the U.S. government authority to expel individuals recently present in a country with a communicable disease. Section 362 of the act allows the Surgeon General to halt the “introduction of persons or property” to prevent the spread of disease. While rarely used in modern history, Title 42 became a key immigration enforcement tool during the first Trump administration.

The first recorded use of Title 42 occurred in 1929 to restrict entry from China and the Philippines during a meningitis outbreak. Decades later, on March 20, 2020, the Centers for Disease Control and Prevention (CDC) invoked the policy to limit the spread of COVID-19 across state and national borders.

Implementation and Impact

During the first two years of its enforcement, Title 42 was used around 2.5 million times to deport migrants entering the U.S. It gave border control agents the authority to expel migrants without offering the opportunity for them to seek asylum, although families and children traveling alone were exempt from this provision. Beginning in January 2023, migrants coming from Mexico could request a Title 42 exemption through the CBP One app if they met vulnerability criteria.

In April 2022, the CDC announced that Title 42 was no longer necessary and would be terminated in May 2022, citing increased vaccination rates and improved treatments for COVID-19. However, several Republican-led states challenged this decision, and the case went to the Supreme Court. While the Court allowed continued enforcement of Title 42 before it heard arguments, it dismissed the case the following year. Title 42 expired in May 2023.

Arguments in Favor of Title 42

Supporters of Title 42, including the Trump administration, argued that the policy was necessary to limit the spread of COVID-19 in detention centers and, by extension, within the United States. In a 2020 briefing, President Trump stated that his actions to secure the northern and southern border under Title 42 would “save countless lives.” The Trump administration’s declaration of a COVID-19 national emergency on March 18th, 2020, framed stricter immigration policy as a matter of public health.

Some states also supported Title 42 to prevent a surge in migration that could overwhelm their border facilities. Texas, for example, argued that lifting the policy would place an undue burden on the state, leading it to implement Operation Lone Star, which allocated state resources to border security.

The policy also received occasional bipartisan support, and was willfully enforced by the Biden administration until the CDC attempted to terminate Title 42 in April 2022. In early 2022, at least nine Democrats argued that Title 42 should be extended. President Biden also debated whether or not the policy should end. In January 2023, he expanded the scope of Title 42 to include migrants originating from Cuba, Nicaragua, Haiti, and Venezuela.

Arguments Against Title 42

Critics of Title 42 argue that it violates international norms, particularly Article 14 of the Universal Declaration of Human Rights, which recognizes the right to seek asylum. While the U.S. did not ratify the declaration, it played a key role in its creation and remains a signatory. Additionally, since 1980, U.S. law has recognized the right to seek asylum, rendering Title 42’s restrictions controversial in the context of global and domestic asylum norms.

Public health experts also questioned the policy’s effectiveness in controlling COVID-19. There is no statistical evidence linking Title 42 expulsions to a reduction in COVID-19 cases. Instead, critics suggest that overcrowding in detention centers may have worsened public health conditions. One migrant described being held in “crowded conditions” for days without COVID-19 testing before being transported in similarly congested vehicles. Additionally, a senior advisor to the Trump administration pushed for the use of Title 42 before COVID-19, raising concerns about whether the policy was implemented for genuine public health reasons.

Opponents also contend that Title 42 subjected migrants to precarious conditions. Doctors Without Borders emphasized that mass expulsions left individuals without access to shelter, food, medical care, or legal representation. A fire in a migrant detention center, which killed 39 people, underscored these risks; surveillance footage showed detainees trapped in locked cells while guards failed to intervene. Critics also argue that the policy’s implementation often resulted in asylum seekers being detained in poor conditions and returned to the dangers they had fled.

Future Prospects

While Title 42 was invoked as a measure to protect public health, its effectiveness in achieving those goals remains debated. Proponents argue it was an effective solution that addressed co-occurring public health and immigration crises, while opponents argue it invited human rights violations and had a counterproductive impact on public health. Internal documents collected from the Trump administration in February 2025 suggest that President Trump aims to reinstate Title 42 policies, labeling unauthorized migrants as “public health risks” that “could spread communicable diseases like tuberculosis.” The Trump administration previously shut down the CBP One app, which assisted migrants in requesting Title 42 exemptions. The policy continues to evoke mixed reactions, and if reintroduced, past experiences may provide insights into its potential impact.

April 15, 2025
Pros and Cons of Congressional Term Limits

Background: What are Congressional Term Limits?

While members of the U.S. House of Representatives serve two-year terms and U.S. Senators serve six-year terms, all Congresspeople are eligible for re-election indefinitely. As of 2023, U.S. Representatives served an average term of 8.5 years, while U.S. Senators served an average term of 11.2 years.

Congressional term limits are a proposed constitutional amendment that would limit the number of terms a member of Congress can legally serve. Under Article V, the Constitution can be amended by either (1) a two-thirds vote of support in both chambers of Congress, or (2) a constitutional convention called by two-thirds of all states and ratified by three-fourths of all states. Term limits reached their highest level of political salience in the 1990s. In 1992, Arkansas voters attempted to impose term limits on their state’s federal congresspeople via an amendment to their state constitution. In U.S. Term Limits, Inc. v. Thornton, the Supreme Court decided that this amendment was unconstitutional and that states cannot impose term limits on their own federal delegation; the only way to impose congressional term limits is to amend the U.S. Constitution.

Current Attempts to Impose Congressional Term Limits

In 2024, Representative Ralph Norman (R-SC) introduced a joint resolution to amend the Constitution and enact a three-term limit for Representatives and a two-term limit for Senators. The resolution died in committee. In January 2025, Senators Ted Cruz (R-TX) and Katie Britt (R-AL) introduced a resolution with the same provisions. Their proposed amendment was co-sponsored by 17 senators, all of whom are Republicans.

While the constitution has never been amended through a constitutional convention, some states are also taking that approach to impose congressional term limits due to limited success of prior joint resolutions in Congress. Indiana’s State Senate recently voted to approve a resolution calling for a convention to consider term limits. If the Indiana House passes the resolution, Indiana will become the tenth state to call for a constitutional convention, joining Alabama, Florida, Louisiana, Missouri, North Carolina, Oklahoma, Tennessee, West Virginia, and Wisconsin.

Arguments In Favor of Congressional Term Limits

The case for congressional term limits centers on the following arguments: (1) Term limits motivate politicians to get more done while in office, (2) Congressional turnover eliminates the incumbent funding advantage, (3) Term limits reduce careerism in politics, and (4) Congressional term limits have widespread support.

One common argument in favor of congressional term limits is that the policy will incentivize politicians to act more efficiently and effectively during their term given the knowledge that they cannot serve indefinitely. Some argue that today, legislators avoid taking immediate action on hot-button issues like immigration and healthcare because they know those issues drive voters to the polls. These proponents argue that congressional term limits would help shift lawmakers’ core objective from winning re-election to creating effective, long-term policy solutions.

Advocates for congressional term limits also express concern that members of Congress are unrepresentative of their constituents, especially in terms of economic status. They highlight that funding has become a barrier to becoming an elected official and that incumbency is often linked with disproportionately high campaign funds, making it difficult for newcomer candidates to win against an incumbent. Proponents of term limits say the policy would reduce this incumbent advantage, leveling the funding playing field every two or three terms so that candidates have more of an equal financial footing heading into their race. Supporters also suggest that term limits could indirectly decrease the role of corporate funders in politics by deterring companies from making major investments in lawmakers who will only hold power for a short period.

Other proponents of congressional term limits argue that the policy would limit careerism in Congress by making room for people with more real-world expertise to service. They highlight that the average duration of time served in Congress has been steadily increasing from 8.9 years to 11 years, arguing this demonstrates that congressional office is viewed as a career plan instead of a post of service. In the absence of indefinite congressional roles, proponents argue, everyday Americans with more recent connections to the job market would have more opportunities than career politicians who are “insulated from the communities they represent.”

Finally, proponents of congressional term limits highlight that the majority of Americans support the policy. A 2023 Pew Research Center study found that 87% of respondents favored limiting the number of terms one person can serve in congress. A different 2023 study from the Maryland School of Public Policy found support for congressional term limits transcended political party, with 86% of Republicans, 80% of Democrats, and 84% of Independents in favor of the policy.

Arguments Against Congressional Term Limits

The arguments against congressional term limits are primarily built around the three subarguments: (1) Term limits fail to address political corruption, (2) Term limits ignore the value of the incumbency and institutional knowledge, and (3) Frequent congressional turnover shifts power away from the legislative branch.

Some opponents argue that congressional term limits fail to curtail political corruption, and may even worsen the problem. They hold that imposing term limits will cause lawmakers to work more closely with lobbyists for two reasons. First, given that term limits will cause a sharp increase in the number of “freshmen” lawmakers with limited legislative experience, critics argue that more politicians will rely more closely on lobbyists and special interest groups to write or recommend laws to “fill [lawmakers’] own informational and policy gaps.” Second, critics warn that term limits will only exacerbate the “revolving door” phenomenon in which retired legislators seek to maintain political influence by securing careers as lobbyists or private sector government affairs consultants. They cite a 2023 study that found that state governments with term limits saw an increase in the frequency of political corruption events. The study observed a “penultimate effect”, where state legislators under a term limitation devoted more of their last term to securing their personal power than to passing policy. Given that the frequency of last terms will increase significantly under term limit policy, opponents worry about an accompanying increase in political corruption.

Opponents of term limits also argue that the values of political incumbency in the legislative process are taken for granted. They argue that policymaking is a specialized skill that must be developed over time, highlighting examples of how bills with loopholes and contradictions – the result of unskilled policymaking – harm the American public. They hold that incumbency’s value is its ability to maintain legislative efficiency and institutional knowledge. Given that federal policymaking is a skill that can only be learned on-the-job, critics say incumbency gives lawmakers the opportunity to become the specialized professionals their constituents deserve. They also argue that bipartisan partnerships among lawmakers take years to cultivate, and that term limits would hinder cross-party collaboration.

The third core criticism of term limits is that the policy would shift power to the executive and the private sector at the detriment of democracy. As lawmakers are denied longer tenures, opponents argue, lobbyists and staffers become the primary voice of experience in the legislature. Additionally, critics suggest that a decrease in experienced legislators with cross-aisle relationships will further hinder Congress’ ability to efficiently pass legislation, catalyzing an increase in executive orders and other executive branch actions. This will create hurdles to the traditional system of checks and balances.

Conclusion

The debate over congressional term limits is longstanding and complex. While proponents argue that the policy will increase legislative efficacy, decrease corruption, and represent the will of the people, critics worry that it could have a counteractive effect. As the debate continues, countless questions linger. How much do we value incumbency? How are money and careerism intertwined? Is the legislature representative enough? Is legislative efficiency worth risking? After all of those questions have been asked, there is only one question left: Should Americans be for or against congressional term limits?

April 15, 2025
Perspectives on the California Privacy Rights Act: America’s Strictest Data Privacy Law
Background and Key Provisions

The California Privacy Rights Act (CPRA), also known as Proposition 24, is a recently enacted law aimed at strengthening corporate regulations on data collection and processing in California. It acts as an addendum to the California Consumer Privacy Act (CCPA), a voter-initiated measure designed to enhance oversight of corporate data practices. The CPRA seeks to increase public trust in corporations and improve transparency regarding targeted advertising and cookie usage. Cookies are small files containing user information that websites create and store on users’ devices to tailor their website experience. The CPRA aims to align California’s data privacy practices with the General Data Protection Regulation (GDPR), a European Union data privacy law regarded as the most comprehensive in the world.

The CPRA was introduced as a referendum by California voters for the November 2020 general election. It passed with the support of 56.2% of voters in 2020, but did not go into effect until January 1st, 2023. The law builds off of the preexisting CCPA’s protections for user data through the following key provisions:
- Establishes the California Privacy Protection Agency (CPPA), a government agency responsible for investigating violations, imposing fines, and educating the public on digital privacy rights.
- Clarifies CCPA definitions of personal data, creating specific categories for financial, biometric, and health data. Adds a new category of sensitive personal information, which will be regulated more heavily than personal information.
- Implements privacy protections for minors. Under the CPRA, companies must request permission to buy or sell data from minors, and can be fined for the intentional or unintentional misuse of minors’ data. Minors ages 13 to 16 must explicitly opt into data sharing, while minors ages 16 through 18 can opt out of data sharing.
- Expands consumer rights by prohibiting companies from charging fees or refusing services to users who opt out of data sharing. Building on the CCPA’s universal right to opt out of data sharing, the CPRA gives consumers a right to correct or limit the use of the data they share. Consumers can also sue companies that violate the CPRA, even if their personal data was not involved in a security breach.
- Modifies the CCPA’s definition of a covered business to exclude most small businesses and include any business that generates significant income from the sale of user data.
Perspectives on CPRA Data Collection Regulations

One of the most contentious aspects of the CPRA is the regulation of personal data collection. Supporters contend that increased regulation will enhance consumer trust by preventing corporations from over-collecting and misusing personal data. Many California voters worry that businesses are gathering and selling personal information without consumers’ knowledge. Whether or not these fears are justified, they have driven strong public support for stricter data processing guidelines under both the CCPA and CPRA. Additionally, supporters of the CPRA argue that its impact on corporate data will be minimal, given that studies suggest less than 1% of Californians take advantage of opt-out options for data sharing.

Opponents argue that restricting data collection could lead to inaccuracies if a large number of consumers choose to opt out. Without access to a broad dataset, companies may face higher costs to clean and verify the data they collect. Currently, many businesses rely on cookies and tracking technologies to analyze consumer behavior. If these methods become less effective, companies may need to invest in alternative, more expensive market research techniques or expand their workforce to ensure data accuracy.

The opt-out mechanism has been a focal point of debate. Supporters view it as a balanced compromise, allowing Californians to protect their personal information without significantly disrupting corporate data operations. However, some argue that an opt-in model—requiring companies to obtain explicit consent before collecting data—would provide stronger privacy protections. Critics believe that many consumers simply accept default data collection policies because opting out can be confusing or time-consuming, ultimately limiting the effectiveness of the CPRA’s protections.

Financial Considerations

Beyond concerns about data collection, the financial impact of the CPRA has also been widely debated. While the CPRA exempts small businesses from its regulations, larger businesses had already invested heavily in CCPA compliance and were reluctant to incur additional costs to meet new, potentially stricter regulations under the CPRA. Additionally, implementing the CPRA was estimated to cost the State of California approximately $55 billion due to the creation of a new regulatory agency and the need for updated data practices. Critics argued that these funds could have been allocated more effectively, while supporters viewed the investment as essential for ensuring corporate accountability.

Future Prospects for California’s Privacy Policy

Since the CPRA is an addendum to the CCPA, California data privacy law remains open to further modifications. Future updates will likely center on three key areas: greater alignment with European Union standards, increased consumer education, and clearer guidelines on business-vendor responsibility.

The General Data Protection Regulation (GDPR), the European Union’s comprehensive data privacy law, already shares similarities with the CPRA, particularly in restricting data collection and processing. However, a major distinction is that the GDPR applies to all companies operating within its jurisdiction, regardless of revenue. Additionally, the GDPR requires companies to obtain explicit opt-in consent for data collection, while the CPRA relies on an opt-out system. Some supporters of the CPRA believe it does not go far enough, and may consider advocating for GDPR-style opt-in requirements in the future.

Others argue that many individuals are unaware of how their data is collected, processed, and sold, no matter how many regulations the state implements. This lack of knowledge can lead to passive compliance rather than informed consent under laws like the CPRA. In the future, advocacy organizations may push for California privacy law to include stronger provisions for community education programs on data collection and privacy options.

Another area for potential reform is business-vendor responsibility. Currently, both website operators and third-party vendors are responsible for complying with CPRA regulations, which some argue leads to redundancy and confusion. If accountability is not clearly assigned, businesses may assume that the other party is handling compliance, increasing the risk of regulatory lapses. Clarifying these responsibilities might be a target for legislators or voters who are concerned about streamlining the enforcement of privacy law.

Conclusion

With laws like the CCPA and the CPRA, California maintains the strongest data privacy protections in the nation. Some view these strict regulations as necessary safeguards against the misuse of consumer data that align the state with global privacy norms. Others see laws like CPRA as excessive impositions on business resources. Still, others argue that California law does not go far enough, advocating for a universal opt-in standard rather than an opt-out standard for data sharing. As debates around CPRA continue, California is likely to provide a model for other state and federal data privacy regulations across the U.S.
April 15, 2025
Journalist Accidentally Added to Military Planning Chat: What You Need to Know

On March 13, The Atlantic Editor-in-Chief Jeffrey Goldberg was inadvertently added to a Signal group chat that included senior Trump administration officials, including Vice President J.D. Vance and Secretary of Defense Pete Hegseth. The group chat—titled “Houthi PC small group”—contained sensitive information about U.S. military operations. Two days after Goldberg was added to the chat, Hegseth sent details about upcoming airstrikes on Yemen, including specifics about weapon type, timing, and human targets. About two hours after Hegseth’s chat, the first of the air strikes began to fall on Yemen, killing at least 53 people.

After the strikes were confirmed, Goldberg determined that the group chat was legitimate. He subsequently left the chat due to concern about the highly classified nature of the information being shared. Goldberg noted that the members of the group chat did not seem to notice that he had been added to the group chat or that he had left, despite the group’s creator being notified of Goldberg’s departure.

Concerns and Controversy

The existence of the group chat has raised concerns regarding national security and potential violations of federal law. National security and legal experts say that Michael Waltz, Trump’s national security advisor, may have breached the Espionage Act by creating the Signal group chat and communicating classified war planning information. The Espionage Act prohibits unauthorized access to or distribution of sensitive national defense information.

While Signal is commonly used by government officials for logistical coordination, it is generally not employed for classified military communications. Instead, the federal government maintains secure communication channels specifically for such discussions. Experts warn that classified messages on Signal could be vulnerable to leaks in the event of a cybersecurity breach or the theft of an official’s device.

Beyond security risks, the use of disappearing messages in discussions of official acts raises concerns about compliance with federal records retention laws. Under these laws, official communications related to government actions must be preserved as part of the public record. Some messages in the Signal chat, however, were reportedly set to be automatically deleted after a few weeks.

Trump Administration Response

The Trump administration has denied that the group chat contained classified information or “war plans.” White House Press Secretary Katherine Levitt dismissed Goldberg’s report as a “hoax written by a Trump-hater.” When asked about the leak on March 24, President Trump denied knowledge of the situation and downplayed the controversy, stating that The Atlantic was “not much of a magazine.”

Officials in the administration have continued to assert that the group chat did not involve sensitive military details. Hegseth maintained that “nobody was texting war plans,” while Waltz took responsibility for accidentally adding Goldberg to the group chat, stating that the journalist’s number was listed under someone else’s name.

Full Transcript Released

In response to the Trump administration’s denial, The Atlantic published the full transcript of Hegseth’s attack plans on Yemen. These texts include information such as the types of aircraft being used in the strike and the timing of the strikes. In response to the release of the full transcript, the Trump administration and senior officials such as Secretary of State Marco Rubio have maintained that no classified information was leaked, nor would the leaked information have “put in danger anyone’s life or the mission.”

April 10, 2025