ACE

Category: ACE Research

  • Pros and Cons of the Behavioral Health Information Technology Coordination Act

    Pros and Cons of the Behavioral Health Information Technology Coordination Act

    Despite an unprecedented demand for mental health and substance use services in the U.S., psychiatric hospitals utilize electronic health records (EHRs) at significantly lower rates than general medical practices. EHRs are electronic versions of patient health profiles, and include information such as relevant demographics, past diagnoses and treatments, lab report data, and vaccination history. EHRs are nearly ubiquitous in general medicine due to their ability to facilitate coordination between providers and reduce duplication in testing and treatment. The Behavioral Health Information Technology (BHIT) Coordination Act of 2023 aims to develop standards for mental health EHRs, promoting their adoption nationwide. If passed, the bill would allocate $20 million annually to grant funding for mental health providers over five years beginning in 2024. 

    The Problem

    The U.S. is facing a growing mental health and substance use crisis, with 21% of adults experiencing mental illness and 15% affected by substance use disorders. The pandemic exacerbated this issue, increasing symptoms of anxiety and overdose deaths, yet the demand for mental health services has not fully rebounded. In response, experts emphasize the urgent need for technology infrastructure to support behavioral healthcare and address these escalating issues.

    Research indicates a significant gap in EHR adoption between general and psychiatric hospitals. An analysis of American Hospital Association survey data from 2019 and 2021 found that 86% of general acute care hospitals had adopted a 2015 Edition certified EHR, compared to only 67% of psychiatric hospitals. Outdated privacy laws requiring providers to segregate their health records from others and inconsistent state regulations create challenges for mental health record sharing. According to the National Institutes of Health (NIH), privacy and disclosure laws for mental health records vary widely from state to state. Some states, like Massachusetts and Colorado, require strict consent procedures to share mental health records, while others, like Kansas and Mississippi, allow broader disclosures without patient consent.

    While the HITECH Act of 2009 allocated federal funds to incentivize the use of EHRs in healthcare systems, behavioral health systems were excluded from these incentive payments. Researchers believe this omission was likely due to the difficulty of reconciling national standards with the patchwork of differing state-level mental health privacy laws. 

    The Plan

    Behavioral health integration is becoming an increasingly high priority for both the healthcare industry and the federal government. Leaders at the Office of Policy of the National Coordinator for Health IT (ONC) and the Substance Abuse and Mental Health Services Administration (SAMHSA) are looking to revamp EHR systems to be friendlier to behavioral health needs. Beginning in FY25, the BHIT Coordination Act aims to reach this goal by providing $20 million a year in grant funding. Specifically, under the Act, the ONC must grant awards to behavioral health care providers, including physicians, psychologists, and social workers, to support integration and coordination of services. These grants can be used to purchase or upgrade technology to meet specified federal certification standards for health information technology.

    The Pros 

    Proponents argue that enhanced adoption of Electronic Health Records (EHR) under the BHIT Coordination Act can significantly strengthen behavioral healthcare by improving coordination and expanding access to resources for patients. These systems promote better integration of mental health and addiction treatment, improving the quality of behavioral healthcare overall. Considering the increasing oversight of the behavioral health industry, including financial penalties for underperformance and underreporting, proponents say EHR technology can help create more accountable care models.

    Supporters argue that the integration of services through EHR systems can also bridge the gap between physical and behavioral health, enabling a “no wrong door” approach. This ensures that no matter how patients enter the healthcare system, they will have access to all available services. As Senator Cortez Masto, a strong supporter of the Act, stated, “Mental health is just as important as physical health, and it is essential that behavioral health care providers have the same access to the technology and electronic health records that other practices utilize daily.”

    Proponents also point to research that suggests implementing EHRs helps improve patient safety by reducing errors and streamlining care processes. They hold that coordinated care improves efficiency across the system, which can lead to better outcomes. A study of more than 90 clinical trials found that collaborative care improves access to mental health services and is more effective and cost-efficient than standard treatments for anxiety and depression. Proponents say the BHIT Coordination Act could benefit psychiatric hospitals and residential treatment centers especially, which are crucial parts of the mental healthcare system.

    Another potential benefit of the BHIT Coordination Act is that health IT data can be used to address clinical priorities, improve workflows, and provide technical information that helps better integrate services across behavioral health settings. Proponents emphasize that the data organization capabilities that come with EHRs can be valuable in identifying problems and improving healthcare delivery.

    The Cons

    The implementation of electronic health records (EHRs) and IT tools in behavioral health faces significant privacy and security challenges. As noted by the NIH, while these tools offer great potential to enhance behavioral health, they also create risks, particularly with sensitive data like narrative records which include personal histories and psychiatric diagnoses. This information, when exposed to breaches or misinterpretation, can have serious consequences for both patients and clinicians. If public health authorities disclose intimate information, individuals may suffer embarrassment, stigma and discrimination in employment, insurance and government programs. Although HIPAA privacy and security rules have been applied to protect psychotherapy notes and other behavioral health information, protecting this data remains a complex issue. Keeping records secure is a challenge that doctors, public health officials, and regulators are still working to fully address. Firewalls, antivirus software, and intrusion detection systems are needed to protect data. Employees must also follow strict rules to maintain privacy, such as avoiding sharing their EHR login information, always logging off, and using their own ID to access patient records. Critics of increasing EHR use in mental healthcare argue that providers must go to great lengths to ensure patient information stays confidential, which poses a risk of sensitive data leaks. 

    Distrust for EHRs and health IT technology also stands in the way of being able to integrate these technologies in behavioral health settings. Concerns about unauthorized access are particularly prominent. According to a study, more than half of adults over 30 report being either “very” or “somewhat” concerned that an unauthorized person may access their records. Another study, published by the NIH, found that a majority of mental health clinicians expressed concern over privacy issues that arose after the adoption of EHRs, with 63% expressing low willingness to record confidential information in an EHR, and 83% preferring that the EHR system be modified to limit access to their patients’ psychiatric records. This distrust can lead patients to avoid clinical tests and treatments, withdraw from research, or provide inaccurate or incomplete health information.

    The lack of clarity around health IT standards further complicates EHR implementation. There are still many unknowns regarding how to integrate EHRs in behavioral health settings. Although the BHIT Coordination Act plans to invest in developing EHRs and necessary equipment to enable the exchange of electronic health information, there is a lack of clear guidelines on how to fulfill these goals while ensuring the IT tools meet the needs of behavioral health practices.  

    Conclusion 

    The BHIT  Coordination Act aims to address the significant gap in EHR adoption between behavioral health providers and general medical practices. By providing funding to enhance the development and interoperability of mental health EHRs, the Act strives to improve care coordination for patients with mental health and substance use disorders. However, privacy concerns remain a critical issue; protecting sensitive information is essential to gaining the trust of both providers and patients. Balancing the need for improved data sharing with strong privacy protections will be key to the Act’s success.

  • The Laken Riley Act and Immigration Policy

    The Laken Riley Act and Immigration Policy

    On January 29th, President Trump signed the Laken Rikey Act into law. This law now requires the Department of Homeland Security to detain and deport non-U.S. nationals who are accused, but not yet convicted, of “theft, burglary, assaulting a law enforcement officer, and any crime that causes death or serious bodily injury.” The law has received support from Republicans and some Democrats, with 12 Democratic senators voting in support of the bill in order to send it to the President’s desk to be signed into law.

    Background

    Laken Rikey was a nursing student who was murdered by Jose Ibarra, a man who was initially arrested for illegal entry into the United States in 2022 near El Paso, Texas. Ibarra was temporarily released by immigration officials due to the surge in immigration and was allowed to pursue his case in immigration court. 

    Contents of the Law

    The law aims to immediately deport undocumented immigrants if they are arrested for specific crimes, regardless if they have been convicted of the crime. Trump and his Republican allies have pushed for the passing of the law, arguing that the law gives law enforcement the means to detain illegal immigrants once arrested. Additionally, the law also grants States the power to sue the federal government if it fails to enforce this immigration policy.

    Supporters of the law argue that the law provides the necessary to keep illegal immigrants accused of crime off the streets. The law also aims to enforce border security and mass deportation. They also believe that this law will “prevent situations like what occurred to Laken Riley” as stated by Arizona’s democratic Senator Ruben Gallego.

    Critics of the law argue that it strips migrants of their right to due process of the law as they would be deported without having been found guilty of the accused crime. The law would grant law enforcement the power to arrest, detain, and deport an immigrant even if the police later concluded that he was not involved in the crime. Critics argue that the nation currently lacks the safeguards necessary to ensure that immigrants who have temporarily protected status, such as immigrants under DACA, are protected from the law as they might be accidentally detained and deported before receiving their due process. Additionally, Democrats have criticized the law for failing to allocate funds to support the law’s initiative as the law is estimated to cost $83 billion over the next three years and does not address the root causes of immigration.  

  • Understanding the Accountability for Overprescription Debate

    Understanding the Accountability for Overprescription Debate

    Background: The Opioid Epidemic

    Over the past two decades, the opioid epidemic has emerged as a key public health issue in the United States. The first wave of the epidemic was characterized by an increase in opioid prescriptions in the late 1990s paired with marketing from pharmaceutical companies that ensured that opioids were safe for pain management. In the early 2010s, a second wave arose when individuals who had become dependent on opioids sought out heroin as a cheaper and more accessible alternative for pain management. The third wave, starting in the mid-2010s, saw a rise of synthetic opioids such as fentanyl in illegal drug markets, leading to unprecedented levels of overdoses. 

    Prescription opioids are chemicals, both natural and synthetic, that are prescribed for pain management and include commonly-prescribed drugs such as Hydrocodone (Vicodin),  Oxycodone (Oxycontin, Percocet), and Morphine (Kadian). While prescription drugs are used to treat acute to chronic pain related to surgery, injury, or illness, prescription can come with risks. Side effects of commonly-prescribed opioids include increased sensitivity to pain, increased drug tolerance, and withdrawal post-medication. These side effects can lead the way to opioid misuse and addiction. In 2023, 125 million opioid prescriptions were filled in America, and 8.6 million Americans misused prescription opioids.

    Calls for Accountability

    In recent years, blame for the opioid epidemic has shifted towards pharmaceutical companies that produce the drugs and initially advertised their safety. Specifically, many consumers seek to hold pharmaceutical companies legally accountable using the argument that their deceptive marketing tactics have created a public health crisis and therefore constitute a public nuisance. Between 2014 and 2021, more than 3,000 lawsuits were raised against pharmaceutical corporations based on the public nuisance argument. However, 2021 decisions from California and Oklahoma State Supreme Courts held that false advertising was not enough to constitute a public nuisance, weakening the prospects of accountability arguments in other pending cases. 

    Most recently, the U.S. Supreme Court struck down a bankruptcy plan for Purdue Pharma – a major pharmaceutical company – that would have facilitated an $8 billion settlement to the individuals, states, and local governments that had sued the company over opioid-related deaths. While some praised the Court for its refusal to grant Purdue Pharma the bankruptcy relief it desired, others say the Court failed to hold the company accountable by jeopardizing the $8 billion settlement to victims. Today, avenues for holding major pharmaceutical corporations – collectively referred to as Big Pharma –  accountable are highly debated. 

    The Case for Holding Big Pharma Legally Accountable

    Supporters of holding pharmaceutical companies legally accountable for the opioid epidemic cite the companies’ use of deceptive marketing techniques to sell opioids. For example, Purdue Pharma’s Evolve 2 Excellence initiative aimed to increase the sale of OxyContin by instructing their marketing team to promote higher dosages and target high volume opioid prescribers. In 2003, Purdue Pharma launched a misleading marketing campaign about the effectiveness of their prescription drugs despite a lack of proven efficacy in treating pain. In 2014, the city of Chicago sued Janssen Pharmaceuticals, Cephalon, Purdue Pharma, Endo Health Solutions, and Actavis for “knowingly and aggressively marketing [opioids] as rarely addictive” and contributing to several Chicagoan overdose deaths. 

    Proponents of legal accountability for Big Pharma believe that successful lawsuits against major pharmaceutical companies could set important precedents and ensure that other corporations are held accountable for their public health impacts on the US population. When polled, 57% of Americans believed that pharmaceutical companies should be held legally and financially accountable for the worsening opioid crisis. This belief existed across party and ideological lines. An even larger segment of the U.S. population supports compelling Big Pharma to remedy their contributions to the epidemic in other ways, with 73% stating that they want drug companies to fund opioid addiction treatment and 72% arguing that they should distribute naloxone kits for free. 

    Arguments Against Legal Accountability for Big Pharma

    Critics of legal accountability for pharmaceutical corporations argue that lawsuits are temporary solutions that will not deter pharmaceutical companies from producing and marketing harmful drugs in the long term. They hold that given the massive annual profits of the top five pharmaceutical companies, civil suits act as no more than a slap on the. Critics also emphasize the increasing difficulty of using the public nuisance argument against Big Pharma due to the complexities of state and federal oversight.

    Additionally, some opponents of legal accountability for Big Pharma argue that highly-publicized lawsuits only provide a false sense of closure and ignore other factors that underlie the opioid crisis. Critics believe there are multiple causes of the opioid epidemic such as housing and food insecurity, and thus argue that the social determinants of health framework must be adopted in order to best tackle the crisis. Mimi Walters, former United States Representative, discussed how prioritizing settlements with pharmaceutical companies is illogical if people are not simultaneously addressing unfair federal housing programs that create barriers to housing for those who have substance use disorders. Citing lack of economic opportunity, limited drug treatment, and need for pain management as causes of opioid overuse, some believe taking a holistic approach is the only way to manage the opioid crisis from the grassroots. They contend that legal settlements are simply a bandaid solution.

    Moreover, some argue that overprescribing doctors hold just as much responsibility for the opioid epidemic as the corporations that market the drugs. Patient satisfaction and expectations for pain-free experiences have become central to the healthcare industry, leading some doctors to prescribe strong opioids for slight injury rather than saving them for persistent, chronic pain. Critics believe that this push for patient satisfaction, along with a focus on the monetary value of patients, creates a cycle in which physicians prescribe to make money. Opponents also cite the Food and Drug Administration’s (FDA) lack of regulation as a contributing factor. In 2017, the Presidential Commission on Combating Drug Addiction and the Opioid Crisis found that the epidemic was partially caused by gaps in FDA oversight. In 2002, 8 out of 10 members of an FDA advisory committee on opioid prescription had ties to Big Pharma. The committee advised the FDA against regulating overprescription, causing many to argue that accountability efforts should include government agencies and not just corporations.

    Conclusion

    Efforts to hold pharmaceutical companies legally accountable have gained traction in recent years. In 2023, Michigan became the last state in the nation to repeal its legal immunity for pharmaceutical companies. In October 2024, the U.S. Department of Justice brought charges against several pharmaceutical companies and brokers for their role in the unlawful distribution of nearly 70 million opioid pills. While many applaud these efforts, some see them as short-term solutions and argue they must be part of a larger comprehensive approach to address the far-reaching consequences of the opioid epidemic in the years to come.

  • Pros and Cons of Texas Senate Bill No. 4

    Pros and Cons of Texas Senate Bill No. 4

    Introduction

    Texas Senate Bill No. 4 (SB4), passed in 2023, aims to address illegal border crossings into Texas. The bill created new state-level criminal offenses for unauthorized entry and non-compliance with removal orders, giving local law enforcement the power to detain suspected undocumented individuals. It also provided legal protection for officers who act in accordance with the law. While SB4 is a state-level bill, it sparked national debate on issues of immigration, human rights, and federalism. Supporters of SB4 believe the bill is necessary to protect Texas residents and secure state borders. However, critics argue that the bill could lead to racial profiling and harm immigrant communities, many of whom are fleeing dire circumstances in their home countries. 

    What are SB4’s Main Provisions?

    SB4 gives police officers the power to arrest and detain individuals who are under suspicion of having illegally entered the country. The bill restricts law enforcement from making immigration-related arrests in places that are not designated ports of entry, such as elementary and high schools, hospitals, places of worship, and forensic medical facilities. This provision intends to create safe havens where individuals can seek help without being detained for their suspected status. Arrests on college and university campuses are permitted under SB4.

    Under SB4, judges can also issue orders for non-citizens to return to their home countries under specific conditions. The non-citizen will not receive a criminal charge if they meet the following conditions: have no prior criminal record, are not facing severe charges unrelated to immigration, and are willing to provide biometric measures including fingerprints. The biometric measures will be cross-referenced with local, state, and federal criminal databases.

    SB4 has harsh penalties for those who enter Texas without using official ports of entry and those who re-enter after being deported. Those who refuse to leave the United States under court-ordered returns may face felony charges. Inmates convicted under SB4 have limited eligibility for parole, meaning they are less likely to be released early. 

    SB4 also includes strong legal protections for law enforcement officers and officials involved in immigration enforcement. To give officers the confidence to enforce the bill without fear of being sued, the bill grants officers immunity from lawsuits as long as they act in good faith.  

    Legal Battles

    Texas SB4 is at the heart of an ongoing legal battle, highlighting the tensions between state and federal powers over immigration. Initially passed in 2017, the bill faced pushback from civil rights groups and local governments. After some revisions, Texas reintroduced SB4 in December 2023, but it quickly came under fire again. In January 2023, the U.S. Department of Justice filed a lawsuit, claiming the revised bill violated constitutional rights. By February 2024, the United States District Court for the Western District of Texas issued a ruling temporarily blocking SB4 from going into effect. However, in March 2024, the Supreme Court briefly allowed it to take effect, only for it to be blocked again by the Fifth Circuit Court of Appeals. SB4 remains on hold as the Department of Justice’s lawsuit is pending. The case’s outcome could shape immigration policy nationwide, reflecting the struggle to balance state power with federal oversight. 

    Arguments in Favor of Texas SB4

    For supporters, SB4 is a crucial deterrent against what they see as unchecked illegal immigration that threatens the safety and stability of their communities. Many Texans live in border towns and worry about issues like drug trafficking and crime. They see SB4 as a step toward restoring order. Without SB4, state authorities are only able to arrest migrants for criminal trespass near the border with landowner permission. SB4 would allow them to prosecute illegal entry and reentry without landowner permission. Proponents hold that this provision drastically increases the efficiency of immigration law enforcement.

    Defenders of the bill also point out that it explicitly targets illegal border crossing and does not institute mass deportations. They say SB4 does not apply to those living in Texas without legal status. Instead, it focuses on areas close to the border where illegal entry is most common. Near the border, a magistrate must determine that there is enough evidence to make an arrest, which means the law has a more limited impact on communities further from the border. Supporters also emphasize that legal residents of Texas who are detained will have the opportunity to defend themselves in court. 

    Additionally, proponents of SB4 argue that the bill helps create consistency between state and federal enforcement efforts. They say the current system leaves too many gaps, with federal policies often shifting based on political changes in D.C. They cite the United States Constitution’s Article I, Section 10, which states that states may protect themselves from an “invasion” or imminent danger. For Texans in support of the bill, unauthorized immigration poses an “invasion” and impending threat to their state. According to them, Texas has the constitutional authority to do as it sees fit to protect its constituents in the face of the federal government’s failures. 

    Arguments Against Texas SB4

    According to critics, SB4 has the potential to increase civil rights abuses. They hold that the bill’s broad language and increased powers for local law enforcement open the door to racial profiling, especially against Latino and Hispanic residents, who make up 65% of Texas’s population. By granting extensive authority to local law enforcement to detain individuals based on suspected immigration violations, they say SB4 may lead to biased practices. They argue it will lead to the erosion of trust between Texas’s immigrant community and law enforcement, rendering it more difficult for law enforcement to maintain public safety. 

    Opponents also highlight legal concerns, arguing that SB4 oversteps the bounds of state authority. The Supremacy Clause of the American Constitution establishes that federal laws take precedence over state laws, and immigration enforcement is traditionally a federal responsibility. In the case Arizona v. United States, the Supreme Court ruled against a similar state law, limiting the role states could play in immigration enforcement. Critics argue that SB4 ignores this precedent.

    Critics also emphasize that SB4 will harm vulnerable immigrant populations, including refugees fleeing danger who have the right to seek asylum under U.S. law. SB4 does not create exceptions for these individuals and may lead to the deportation of people who qualify for asylum or other protections. Critics argue that by treating all undocumented individuals as criminals, the bill risks inflicting harm on families and children who are seeking safety. Moreover, critics emphasize that refugees and immigrants contribute positively to Texas’s economy through self-made businesses and taxes like other Americans, and forcing them to leave will cause more economic harm than good. 

    Conclusion

    Texas Senate Bill No. 4 reflects the broader national debate over immigration. Some see SB4 as a necessary step to protect Texas communities from the perceived chaos of border crossings. In contrast, others see it as an overreach that endangers the rights and well-being of immigrants seeking refuge. As the legal battle unfolds, Texas will grapple with balancing the principles of federalism, border control, and human rights. 

  • Understanding AI in Intelligence Gathering and Analysis

    Understanding AI in Intelligence Gathering and Analysis

    What is AI?

    Artificial Intelligence (AI) involves the use of machine learning algorithms and predictive models to process and analyze large datasets. Intelligence gathering, a critical component of national security and defense systems, refers to the collection and analysis of information to identify potential threats. Recently, AI has taken on a bigger role in U.S. intelligence systems, automating data collection and analysis processes that used to be completed manually. While some see this as a step towards more efficient and effective defense systems, others point to the potential for human rights violations and security breaches. 

    The Rise of AI in National Defense

    The strategic competition between the United States and China has elevated AI as a critical factor in national security and defense intelligence capabilities. Both nations are heavily investing in AI, aiming to outpace each other in developing technologies that could offer a decisive advantage in intelligence gathering. At the same time, AI’s role in geospatial intelligence is particularly evident in the ongoing Russo-Ukrainian conflict. AI has become an essential asset for analyzing data from various sensors, systems, and personnel in the field. It gathers data from combat scenarios in real-time and provides actionable intelligence to military operators. 

    The Case for AI in Intelligence Operations 

    Proponents of AI’s increasing role in intelligence and defense cite two key reasons for their support:

    • Enhanced Data Analysis: Proponents of AI in intelligence gathering highlight AI’s ability to process vast amounts of data quickly and with precision. For example, Scylla AI software, designed for security and defense applications, demonstrated threat detection accuracy exceeding 96% and significantly reduced false alarm rates when tested by the U.S Department of Defense. By integrating computer vision and machine learning algorithms, Scylla improved response times in critical defense and security environments. Additionally, supporters cite projects like the U.S. Defense Intelligence Agency’s SABLE SPEAR which successfully employed AI to identify illicit activities that traditional methods overlooked.
    • Complementary Capabilities: Supporters contend that by automating repetitive tasks and providing recommendations based on historical data, AI not only reduces human error, but can serve to complement human decision-making. They argue that AI systems are not completely replacing military operators’ autonomy to make decisions, but rather serving as a partner in decision making that can increase accuracy and decrease collateral damage in military operations.

    Criticisms of AI in Intelligence Operations

    AI’s growing role in intelligence and defense has drawn criticism for three main reasons:

    • The “Black Box” Problem: Critics argue that AI’s lack of transparency in decision-making, often referred to as the “black box effect,” presents a significant challenge. AI systems may behave unpredictably, especially when trained on biased data. Since it is very difficult for operators to discern how and why AI systems reach certain decisions, it is difficult to redirect AI systems after making decisions that are harmful.
    • Human Rights Consequences: Opponents say the “Black Box” problem can lead to errors in critical applications, rendering AI-driven decisions dangerous in combat. A notable example is the U.S. military’s AI-driven drone strike in Kabul on August 29, 2021. The AI system incorrectly identified a civilian vehicle as a threat, resulting in a tragic strike that killed 10 civilians, including 7 children. AI’s reliance on input data quality means that biased or flawed data can produce inaccurate and potentially deadly conclusions. In the context of military operations, these flaws could lead to increased civilian casualties or misidentification of combatants, violating international norms like the Geneva Convention.
    • Security Vulnerabilities: Centralized data analysis systems also increase the risk of cyberattacks. Critics point out that advanced AI systems could be exploited by malicious actors, raising concerns over the security of sensitive information used in intelligence operations.
    • Infrastructure and Cultural Resistance: Finally, critics hold that integrating AI into government systems requires significant resources and organizational overhaul. Transitioning to AI-based intelligence systems requires updates to infrastructure and organizational culture, and may result in layoffs of employees. The U.S. Department of Defense has faced difficulties in standardizing and integrating its vast array of data sources, hindering AI deployment across military branches. Additionally, resistance from personnel concerned about job displacement and AI’s role in decision-making has slowed the integration process.

    Weighing the Benefits and Risks

    The integration of AI into intelligence operations offers the potential for increased efficiency, enhanced data analysis, and improved threat detection. However, it also introduces serious concerns about data security, job security, and the human rights risks of unpredictable combat outcomes. Moving forward, the intelligence community will have to weigh these perks and drawbacks as it continues its push towards AI integration. 

  • Understanding the Investigatory Encryption Backdoors Debate

    Understanding the Investigatory Encryption Backdoors Debate

    Background: Encryption Backdoors in Law Enforcement Investigations

    Encryption is the process of encoding messages so that only authorized individuals can decode and access the content. Organizations rely on encryption to protect sensitive data from unauthorized access. However, an encryption backdoor is any method that allows someone, regardless of authorization, to bypass encryption and access data. Encryption is like a lock that secures messaging data, while encryption backdoors function like master keys, providing access to that data. 

    The debate around encryption backdoors gained popularity after the 2015 San Bernardino terrorist attack in which individuals who had previously pledged loyalty to a leader of ISIS on social media carried out a mass shooting. As part of their investigation, the FBI tried to access data from one perpetrator’s iPhone 5C, believing it could provide critical information. The phone was locked with Apple’s iOS 9, which included a security feature that erases data after several incorrect password attempts. The FBI pressured Apple to create an encryption backdoor to bypass their security features. Apple declined, leading to a court case that was eventually dropped when the FBI accessed the data via a third party. An encryption backdoor, if provided to the U.S. government, would have allowed law enforcement to bypass security barriers and access data on numerous devices. 

    Encryption backdoors are controversial because they are both useful to investigations and vulnerable to exploitation. Efforts have been made to propose safe implementations of encryption backdoors. Some suggest that law enforcement could access encrypted data only with a court-ordered warrant. Under these conditions, encrypted content would remain secure by default, but law enforcement would gain access when a valid warrant is issued.

    Other proposed safeguards include:

    • Abuse Detectability: Systems would create a public audit trail whenever a backdoor is used, allowing independent auditors to monitor and report misuse of backdoors.
    • Global Warrant Standards: Establishing global warrant policies to ensure consistency across legal systems and prevent misuse by courts or law enforcement agencies.
    • Cryptographic Enforcement: Technical solutions could ensure that the master key is unusable if certain conditions—such as an invalid warrant or missing audit trail—are not met.

    Arguments for Encryption Backdoors in Law Enforcement

    Advocates of encryption backdoors for law enforcement support this measure for two main reasons:

    • Law Enforcement Necessity: Proponents argue that encryption backdoors are essential for law enforcement to access digital evidence related to severe crimes, such as terrorism, child abuse, and drug trafficking. Backdoors prevent encrypted messaging spaces from becoming “lawless zones” where criminals can operate without fear of surveillance or investigation.
    • Costly Alternatives: Without backdoors, law enforcement must rely on more expensive and less efficient methods to gather intelligence. Proponents of encryption backdoors argue that these alternatives are not always scalable, and can place a financial burden on taxpayers.

    Concerns Over Encryption Backdoors in Law Enforcement

    The use of encryption backdoors by law enforcement agencies draws criticism for three key reasons:

    • Security Risks to Users: Critics argue that creating a handful of access points to encrypted data through backdoors makes encryption less secure for regular users. If an access point is compromised, it could be exploited by malicious actors, leading to extensive breaches of sensitive information. Additionally, criminals could still use other encryption tools that do not have backdoors, leaving lawful users more vulnerable while criminals remain protected.
    • Law Enforcement Effectiveness: Opponents point out that encryption backdoors might not significantly improve law enforcement’s effectiveness. Federal authorities make arrests in less than one percent of the approximately 350,000 cybercrime incidents reported to the FBI each year. With 1 in 4 American households affected by cybercrime, only a small fraction of victims report these incidents, leading to concerns that backdoors would not meaningfully enhance law enforcement’s ability to combat such crimes.
    • Constitutionality: Foreign Intelligence Surveillance (FISA) Court rulings have found that the FBI’s practices violated the Fourth Amendment due to repeated unauthorized searches and improper queries of Americans’ communications without a warrant, including violations of privacy laws under FISA Section 702. These findings have raised concerns about whether law enforcement agencies’ use of encryption backdoors are constitutional.

    Legislative Responses to the Debate

    The ongoing debate on encryption backdoors has led to legislative proposals such as the Lawful Access to Encrypted Data Act, which seeks to create a balanced approach between law enforcement access and privacy rights. Key provisions of this act include:

    • Promoting Secure Innovation: The bill encourages the development of encryption technologies that support lawful access while safeguarding user privacy and security.
    • Strengthening Public-Private Collaboration: The bill incentivizes cooperation between the government and technology companies to establish frameworks for lawful access to encrypted data during criminal investigations.
    • Maintaining Privacy and Security Balance: The bill proposes policies to address warrant-proof encryption, ensuring a balance between individual privacy rights and law enforcement capabilities in serious crime investigations.

    Conclusion

    The debate around law enforcement agencies’ use of encryption backdoors is ongoing, and revolves around the competing ideals of user privacy and investigatory efficacy. While encryption backdoors might assist ongoing criminal investigations, they can also pose significant risks to user privacy and data security. As legislators continue to address the issue through national policy, the question remains: should law enforcement have the ability to access encrypted data, or should individual privacy come first?

  • The Pros and Cons of the Black Maternal Momnibus Act

    The Pros and Cons of the Black Maternal Momnibus Act

    Background on Black Maternal Health 

    The Centers for Disease Control and Prevention (CDC) estimates that Black women are over three times more likely to die during or after childbirth than white women, often facing life-threatening complications from early pregnancy to postpartum. Unfair treatment and lower quality of care contribute to these disparities, with more than 80% of pregnancy-related deaths among Black women being preventable. For every maternal death, 100 Black women experience near maternal death, highlighting the broader maternal health crisis for Black women in the U.S.

    Structural racism and various social determinants of health (SDOH), such as access to quality healthcare, safe housing, nutrition, and socioeconomic conditions, shape maternal health outcomes. Both implicit and explicit provider biases worsen these disparities. Research suggests the accumulated experiences of interpersonal racial discrimination across life can negatively impact Black women’s pregnancy outcomes, increasing the risk of complications. Further, surveys that sampled more than 2,500 women in the U.S. showed that Black women were more likely than white women respondents to report experiencing discrimination during childbirth, communication barriers with providers, and a lack of emotional support. Additionally, many Black mothers report feeling unheard or pressured into medical decisions, which can sometimes be attributed to providers’ implicit racial biases around pain tolerance and treatment. 

    The Momnibus

    The Black Maternal Health Momnibus Act of 2021, introduced by Congresswoman Lauren Underwood [D-IL], is still in the early stages of the legislative process and has been stuck in committee since April 2021. The bill targets multiple agencies’ efforts to improve maternal healthcare, particularly among ethnic and racial minority groups, veterans, and other vulnerable populations. The bill is a comprehensive package of several individual bills that support investments in: 

    1. Social determinants of health that influence maternal health outcomes 
    2. Expanding WIC eligibility for postpartum and breastfeeding parents
    3. Funding for community-based organizations
    4. Maternal healthcare for veterans and incarcerated moms
    5. Growing and diversifying the perinatal workforce
    6. Improving data collection processes and quality control measures 
    7. Maternal mental health
    8. Digital tools like telehealth and innovative payment methods
    9. Access to maternal vaccinations

    Arguments in Support of the Momnibus

    Proponents of the Black Maternal Health Momnibus Act argue that systemic racism and healthcare inequities drive the higher maternal mortality rates among Black women, and that the Act is a necessary intervention. While racial health disparities were once wrongly attributed to biological differences, research now shows that systemic racism affects social determinants of health (SDOH) – specifically access to nutrition, clean water, and safe housing. These inequalities, along with fewer healthcare facilities, food deserts, and environmental hazards in Black neighborhoods, restrict access to essential prenatal care, proper nutrition, and timely medical interventions. Compounding these issues, Black women often experience gaps in Medicaid coverage and limited access to quality birthing hospitals. Proponents assert that the Momnibus Act’s investments will improve these conditions, thereby supporting better outcomes for Black mothers. 

    Supporters of the Momnibus Act also argue that expanding access to comprehensive prenatal and postpartum care is crucial for addressing disparities that disproportionately affect Black mothers. They contend that programs like extended Women, Infant, and Children (WIC) eligibility for up to two years postpartum ensure consistent access to essential nutritious foods during critical recovery and developmental periods. Advocates highlight that limited prenatal care and late entry into antepartum care often correlate with lower attendance at postpartum visits, which leaves vulnerable Black women without vital health monitoring. They hold that expanding the availability of these services throughout the care spectrum – from preconception to postpartum – is therefore essential to ensure mothers receive the monitoring and support needed for positive health outcomes. 

    Proponents also praise the Momnibus for its provisions to address gaps in the healthcare workforce, arguing that diversifying the perinatal workforce is crucial in addressing the maternal health crisis among Black mothers. Although Black Americans make up 13% of the U.S. population, they represent only 5.7% of physicians, with Black women making up just  2%. Studies show that Black patients experience better health outcomes, including lower infant mortality when treated by Black doctors or culturally competent providers. This may be due to the shared experience of facing racism, which fosters trust and understanding between patients and providers. Supporters of the Momnibus Act praise its investments in measures such as implicit bias and anti-racism training to ensure culturally responsive care, viewing these steps as essential for improving health outcomes for Black mothers.  

    Arguments Against the Momnibus

    Critics argue that while the Momnibus Act brings essential attention to maternal health disparities, it may fall short of fully addressing the root causes of Black maternal health crisis. They argue that the Momnibus will necessitate large-scale government expenditures, increase taxes, and add to the national debt without delivering sustainable solutions. Critics contend that many provisions of the Momnibus do not account for the broader socio-economic factors contributing to Black maternal mortality, such as healthcare deserts, insurance coverage, and institutionalized racism that cannot be eliminated with bias trainings. Research suggests that policies focused on race and maternal health fail to yield positive outcomes without provisions to address institutional racism in areas like housing, employment, and education as well, so critics hold that addressing maternal health alone is insufficient. They argue that broader reforms across these areas are essential and emphasize the need for a robust, structural approach to truly address health disparities. 

    Many opponents specifically question the effectiveness of implicit bias training included in the Momnibus Act, suggesting that implicit bias is deeply ingrained in the healthcare system and cannot be eliminated via occasional trainings. Without robust, systemic reforms – such as building quality healthcare facilities in low-resource communities and providing long-term maternal health support – they believe the Act’s provisions will yield only temporary improvements leaving underlying inequalities largely unchallenged. 

    Conclusion

    The Black Maternal Health Momnibus Act seeks to address racial disparities in maternal health by investing in prenatal and postpartum care, diversifying the perinatal workforce, and investing in social determinants of health. Supporters argue these measures are essential for reducing maternal mortality among Black women, while critics question whether the Act alone can tackle deep-rooted systemic issues. The future success of the bill’s central goal may depend on securing federal support and enacting comprehensive, structural changes beyond healthcare.

  • The TikTok Ban: Overview and New Developments

    The TikTok Ban: Overview and New Developments

    An Overview of TikTok Security Concerns

    In 2016, the Chinese company ByteDance launched Douyin, a social media app focused on short-form content in China. Following the app’s success, ByteDance expanded the app overseas, launching TikTok to the international market in late 2017. TikTok was a major success internationally, amassing two million downloads and 800 about million active users within a few years.

    Despite its massive popularity, TikTok has come under scrutiny for alleged cybersecurity threats. In 2019, the U.S. government sued the company for violating child online privacy laws, leading TikTok to settle for a $5.7 million fine. After reports of alleged censorship suggested that TikTok was working in tandem with Chinese government interests, the Pentagon banned the app on all military devices. In a joint letter to the Director of National Intelligence later that year, Senators Chuck Schumer (D-NY) and Tom Cotton (R-AR) argued that weak Chinese cybersecurity laws might compel ByteDance “to support and cooperate with intelligence work controlled by the Chinese Communist Party” by handing over data to the Chinese government upon its request. However, more recently, security experts argued that China has been collecting personal data from Americans for nearly a decade such that TikTok is not necessarily a novel or unique threat.

    A Brief History of the TikTok Ban

    After TikTok gained widespread attention in 2019 for alleged security concerns, President Trump signed two consecutive executive orders that restricted American business transactions with ByteDance and demanded ByteDance to shift management of TikTok’s U.S. operations. While these orders prompted consideration of a potential sale to Microsoft, the second order was blocked by a federal judge and the Trump administration eventually loosened its deadlines after losing the 2020 election.

    The momentum toward a national TikTok ban slowed for the first few years of the Biden Administration, until a 2023 hearing with TikTok’s CEO drew public attention for lawmakers’ heated interrogations. The same year, a bipartisan “sell-or-ban” bill, which proposed a national TikTok ban if the app was not sold to an American buyer in 270 days, was introduced and gained traction. On April 24, 2024, President Biden signed the “sell-or-ban” bill into law. In response, TikTok sued the U.S. Justice Department, arguing that the ban violated the constitutional right to free speech. The Department of Justice argued that the bill was justified due to pressing national security threats. 

    Recent Developments

    On Friday, January 17th, 2025 – two days before the ban was to go into effect – the Supreme Court ruled against TikTok, holding that the “sell-or-ban” bill was constitutional because it did not target TikTok for the content of the platform’s speech, and was based on sufficient evidence of national security threats. Additionally, the Supreme Court reasoned that the law was not an outright ban because TikTok still had the opportunity to operate if the platform was sold to different management. 

    On Saturday, January 18th, the app went offline for about twelve hours before returning with a message thanking then President-elect Trump for his efforts to restore the app. Before TikTok resumed service on Sunday the 19th, Trump had promised to issue an executive order delaying enforcement of the “sell-or-ban” law after his inauguration the following day. 

    Now, Trump has issued a 75-day delay in enforcing the TikTok ban, ordering that ByteDance either sell the app within that time or reach a deal with Trump in which 50% of ownership of the app would be given to the United States

  • President-Elect Trump’s Day-One Promises

    President-Elect Trump’s Day-One Promises

    President-elect Donald Trump is set to take office Monday, January 20th for his non-consecutive second term. Along the campaign trail, Trump has made several promises that he plans to execute on his first day back in office. Such promises include initiating mass deportations, ending the war in Ukraine, combating inflation, and pardoning those who were charged for their participation in the January 6th insurrection.

    Mass Deportation

    While campaigning, President-elect Trump promised to carry out the country’s largest mass deportation program, stating that America must “make the border strong and powerful.” Trump’s appointed “border czar” Tom Homan explained that the Trump administration would implement a “Remain in Mexico” policy on Trump’s first day in office. This policy would force asylum seekers to remain in Mexico while waiting for their asylum status to be approved. Additionally, Homan expressed plans to deport all illegal immigrants even if their children are United States citizens, arguing, “having a U.S. citizen child doesn’t make you immune from our laws.” It is expected that these policies will be implemented through executive orders.

    Trump’s promised mass deportation program is estimated to cost around $86 billion. Without the guaranteed support of congressional funding, the budgets of executive agencies will need to be reworked in order to allocate enough funding to execute the policy. Given the impending increase in detained immigrants under his policy, the Trump administration is also preparing to work with county jails and private prisons to provide additional space for undocumented immigrants. In his Time Person of the Year interview, the president-elect also noted that he is prepared to call in the National Guard and local sheriffs to execute his deportation policies.

    Ukraine Russia War

    Donald Trump has repeatedly promised to take steps to end the war between Russia and Ukraine during his first days as president. In an interview with Fox news, Trump’s press secretary stated that on day one, Trump would bring “Ukraine and Russia to the negotiating table to end this war.” While Trump has not elaborated on the specifics of his plan to engage both nations in negotiations, his campaign’s communications director has noted that the war is a “top priority” of Trump’s second term and that “Trump believes European nations should be paying more of the cost of the conflict.” Despite Trump’s promises, Russia’s ambassador to the United Nations has argued that the conflict cannot be solved in “one day.”

    Economy and Inflation

    During his campaign for president, Trump promised to increase tariffs on foreign imports with the aim of decreasing costs for American consumers. In late November, Trump announced that he would implement a 25% tariff on all products coming into the United States from Mexico and China on his first day in office. Trump plans to keep the tariffs in place until illegal immigrants stop entering the United States. Moreover, Trump promised that he would leverage an “additional 10% tariff” against China until it stops the flow of drugs, particularly Fentanyl, from entering the U.S.

    China, Canada, and Mexico have all denied their alleged involvement in the flow of drugs across U.S. borders, reiterating their commitment to border security in statements to the press. Mexico’s President Claudia Sheinbaum stated that “neither threats nor tariffs will solve the issue of migration or drug consumption,” arguing that Trump’s proposed day-one tariffs do not address the root issues underlying migration and the drug trade. 

    Despite promising to “bring [grocery] prices way down” during an interview with NBC in early December, Trump has also faced pushback from economists who warn that his proposed tariffs will instead increase the cost of goods for the American consumer. Chief market strategist at Corpay Cross-Border Solutions, Karl Schamotta, argues that the tariffs will “add approximately $272 billion a year to tax burdens, raise goods prices, [and] lift interest rates.” Trump recently backpedaled on his promise to lower grocery prices in his Time Person of the Year interview, stating that it would be “very hard” to bring down grocery prices due to broken supply chains. In the interview, Trump did not clarify his plans to fix the supply chain issue, but stressed that his day-one tariffs would strengthen the economy.

    January 6th Pardons

    On the campaign trail, Trump announced a plan to pardon all individuals charged for their actions related to the capitol insurrection on January 6th, 2021. In mid-December, Trump stated that he plans to issue pardons on a “case-by-case” basis, promising to look over each case within the “first hour that [he] gets into that office” to determine if the insurrectionists “actually caused death and destruction”. In the same interview, Trump claimed that most of the insurrectionists “should not be in jail” and have “suffered greatly.” At least 1,500 people have been charged or plead guilty to the attack on the capitol, and at least 645 people have been sentenced to jail time. 

    As January 20th approaches, critics and supporters alike wait intently to see whether the President-elect will follow through on his day-one policy promises.

  • Understanding China’s Belt and Road Initiative (BRI) in Southeast Asia and the U.S. Response:

    Understanding China’s Belt and Road Initiative (BRI) in Southeast Asia and the U.S. Response:

    Introduction:

    The BRI (Belt and Road Initiative) is a 2013 trade route plan aimed at improving China’s connectivity to the rest of the world. The plan seeks to stimulate China’s economy through investing in infrastructure projects including railways, bridges, and airports abroad. This project also strives to connect countries in the Global South and Eastern Europe to China via land and maritime networks in hopes of increasing trade and economic growth. It is estimated that over 150 countries are partnered with the BRI across six continents.

    The BRI in Southeast Asia

    Southeast Asia is a key region of the BRI. The plan’s extensive funding supports a range of urban development initiatives in Southeast Asian nations, making it difficult to pinpoint its specific effects on local policies. Projects under the BRI encompass everything from infrastructure development to special economic zones to cultural activities.

    In the Philippines, the BRI has led to many large-scale infrastructure projects, but has also been criticized for expanding illicit sectors and selectively benefiting economic elites. Indonesia plans to leverage the BRI to enhance connectivity between Java Island and its eastern regions, fostering cultural interconnectivity and economic opportunities. In Cambodia, BRI-funded transportation projects, like the Phnom Penh-Sihanoukville Expressway, have reduced travel time and improved safety between major cities. For landlocked Laos, the BRI presents a chance to boost its economy and global standing through enhanced transportation infrastructure. Malaysia has seen improvements in human resource development due to the BRI-funded Malaysia-China Kuantan Industrial Park (MCKIP) project.

    While the BRI has contributed to several developments across Southeast Asia, it also raises concerns about debt dependence and disregard for environmental health and safety. Countries borrowing from China for large infrastructure projects risk falling into “debt traps”, which can force them to favor the interests of their donor nation and hinder their ability to invest in local development. Forms of “debt trap diplomacy” such as the BRI have been found to spur long-term economic downturn in beneficiary nations. Environmental impacts are another major concern. In Thailand, a high-speed railway project threatens deforestation and community displacement, particularly near the culturally significant city of Ayutthaya. In Vietnam, the Vinh Tan 2 Thermal Power Plant is discharging excessively hot wastewater into the sea, negatively affecting marine life and local agriculture. There is also a coal ash dump site near Vinh Tan, and local households are complaining about nearby crops dying and withering as a result. In Indonesia, the rapid development at the Morowali Industrial Park (IMIP) poses worker safety risks. These drawbacks have led critics to deem the BRI  “China’s belt and road to nowhere”.

    BRI’s Impact on US Foreign Policy

    Given ongoing criticism that the U.S. has struggled to match China’s vision for economic expansion, the U.S. plans to counter the BRI with a similar project. In 2022, President Joe Biden announced the India-Middle East-Europe Economic Corridor (IMEC) at the G20 Summit. This project has similar goals to the BRI, such as increasing connectivity and economic integration with the rest of the world. While the IMEC is targeted at India, the Middle East, and Europe, China’s project extends mostly to countries in the Global South, especially Southeast Asia. 

    The split between Global North and Global South is relevant to the U.S. and China’s competing policies. While India and Saudi Arabia are the only countries in the IMEC that represent the Global South, China’s BRI puts special emphasis in expanding reach into Global South markets. While this marks a significant opportunity for China to expand its influence in developing nations, it also risks backlash from countries who feel the BRI is doing more harm than good to local economies. Since the IMEC emerged significantly after BRI, the U.S. aims to learn from its shortcomings as it launches a new strategy.

    Conclusion

    In conclusion, the BRI has significantly impacted Southeast Asia, driving infrastructure development and economic growth while also raising concerns about debt dependency and environmental harm. The future of BRI in the region will depend on balancing development with local welfare and environmental considerations. As the U.S. responds with the IMEC, it will aim to learn from these challenges to foster sustainable partnerships in its target regions.