Category: ACE Research

  • Historical Context for U.S. Housing Policy Part 4: Section 8 Vouchers

    Historical Context for U.S. Housing Policy Part 4: Section 8 Vouchers

    Nixon’s 1973 moratorium on the production of public housing marked the beginnings of a new consensus in U.S. housing policy: insufficient incomes and rising costs—e.g., affordability—constituted the major problem, rather than a physical shortage of units. This conviction, though not unchallenged at the time, led the federal government to fully commit to a demand-side approach with the Housing and Community Development Act of 1974. 

    What has come to be known as Section 8 vouchers found its roots gradually, through a patchwork of policy initiatives and experiments. Ultimately, Section 8 has taken over as the dominant mode of federally subsidized housing, with over two-thirds of the Section 8 growth deriving from transfers from public housing. Vouchers operate by providing recipients with a subsidy to close the gap between 30% of their income and the cost of renting a unit on the private market. The options for rental have been constrained by various algorithms over the course of the program, but there are generally three conditions

    1. Voucher holders must find an apartment on the lower-end of the price-spectrum as calculated by the Fair Market Rent (FMR) of the surrounding area;
    2. The rental unit must comply with standards for physical adequacy;
    3. The owner of the unit must agree to participate in the program, incentivized by the federal subsidy which ensures reliable payment. 

    Vouchers were initially championed by conservatives under President Nixon and struck progressives as a retreat from the era of strong federal influence in the housing market. Section 8 enjoyed support from the housing market lobby in Washington DC—most notably the National Association of Real Estate Boards, or the NAREB—because it generated an influx of reliable renters who could afford moderate pricing. On the other hand, most affordable housing advocates at that time supported public housing because they did not trust the private market. Over time Section 8 gained widespread support, particularly from social welfare-minded constituencies which hoped it could operate as a tool for economic and racial integration. 

    The court-ordered Gautreaux program, located in Chicago in the 1990s, provides a good case study of how and whether vouchers can work to deconcentrate poverty. The Gautreaux program created a lottery to select a set of Black households, which were given Vouchers accompanied by individualized counseling on the available affordable units and the benefits of living in affluent neighborhoods. 75% of the participants were relocated to suburbs, while the rest settled in primarily White urban neighborhoods. The results were dramatic, especially with regards to the suburban/urban divide. 27% of the children relocated to suburban areas ended up attending a four-year college, compared to only 4% of city children. While it is debatable whether it is a good thing for urban Black families to move away from neighborhoods where they have strong community and cultural ties, the Gautreaux program illustrates how suburban living improves various measures of well-being. It is important to note, however, that many scholars have questioned how generalizable these results are, given that the program is likely self-selected for more enterprising families. 

    Inspired by Gautreaux, the federal government launched Move to Opportunity, or MTO, in 1993. Unlike Gautreaux which took an explicitly race-based affirmative action approach, MTO focused on income. It was implemented in five metropolitan areas: Baltimore, Boston, Chicago, Los Angeles, and New York City. The results were far less encouraging. Many participants remained in the city, often opting to attend the same school in the same high-poverty neighborhood. While the families expressed higher satisfaction with their home and were exposed to less violence, there was little if any improvement in education or economic flourishing. 

    While many journalists note that the main divergence between Gautreaux and MTO was the requirement in Gautreaux that participants relocate in suburbs, there is understandable reluctance from many urban residents to do so. Following the implementation of MTO, White, working-class suburban residents organized in fierce opposition, expressing race-tinged fear that public housing residents would enter their neighborhood.

    Despite resistance to Section 8-driven economic and racial integration, many advocates continue to extol vouchers for their ability to move program participants to areas of higher opportunity. Pragmatic progressive critics, however, note that Section 8 is insufficient to solve the problem of low-income housing. Section 8 has failed to break out of its original form, which was crafted under the fiscally conservative leadership regimes of Reagan, Bush, and Clinton. Unlike other federal programs such as Medicaid and SNAP, Section 8 funding is capped at a set amount. Currently, only one in four eligible parties receive vouchers, and every locality harbors lengthy waiting lists. 
    In recent years, concerns over landlords’ amenability to vouchers have joined concerns over underfunding. From 2010 to 2016, over 10,000 landlords have backed out of the Section 8 program, and have fought successive laws to outlaw this practice under the rationale of unfettered choice. In a 2018 study conducted by the Urban Institute, two-thirds of landlords in five major cities said they would refuse to accept vouchers. While Section 8 vouchers are widely considered an effective tool, both historically and for the future, their success depends on other aspects of housing policy to provide affordable units.

  • Historical Context for U.S. Housing Policy Part 3: The Fair Housing Act

    Historical Context for U.S. Housing Policy Part 3: The Fair Housing Act

    The Civil Rights movement of the 1960s cast light on the various sites of racism and discrimination imposed on Black Americans. Housing was no exception. The Fair Housing Act of 1968 was a turning point in the battle to ensure equal provision of housing benefits for all. From a legal standpoint, The Fair Housing Act prohibited housing discrimination in sales and rentals, outlawed Blockbusting, and enlisted the newly-created Department of Housing and Urban Development, or HUD, in the task of enforcing these rules. The United States’ sprawling Federalist system of local, state-level, and federal government—along with poor design—meant that the Fair Housing Act had relatively weak enforcement mechanisms, but it played an important role in elevating housing to a level of moral and legal concern, which opened the door for more federal intervention in the future.

    The Fair Housing Act bloomed out of the Committee to Rebuild America’s Slums which was established by President Lyndon B. Johnson in 1967 and aimed to eliminate substandard housing. It set a high production goal—the production or rehabilitation of 26 million over the next ten years—but fell into conflict over whether the housing would be provided through public or private means. The compromise that followed created Section 235 of the National Housing Act, which enabled HUD to pay private lenders of the FHA-insured loans the difference between 20% of the home buyer’s monthly income and the monthly mortgage payment. 

    The Fair Housing Act also lowered underwriting standards to combat redlining. This policy led to some improvements in African American’s ability to attain mortgages outside of the inner city, but this left further concentrated poverty in its wake. In addition, Section 236 enlisted the facilities of the private market in constructing low-income rental housing, mostly of the multi-family variety. HUD lowered the interest rates for the involved private companies to 1% on construction loans, and in exchange, the owner of the buildings agreed only to rent to households with incomes at or below 80% of the area median income and to subject the rent charged to HUD approval. 

    The Fair Housing Act also created legal standards to combat exclusionary housing policies. Most notably, in the court-ordered Gautreaux program (1981-1996) in Chicago, federal judges determined that the location of public housing projects constituted intentional segregation. In more than ten other cities across the country, including Los Angeles, Philadelphia, Memphis, Minneapolis and Omaha, lawsuits levied by the local NAACP organizations resulted in changes to single-family zoning ordinances. None, though, were as successful or prominent as the Gautreaux program. 
    The legacy of the 1968 Fair Housing Act lies mostly in policies that it spawned, and in the broadened effort to address racial discrimination in housing. Politicians have repeatedly affirmed and strengthened the law, such as President Obama’s 2015 Affirmatively Furthering Fair Housing rule, which commits to “meaningful actions to overcome historic patterns of segregation, promote fair housing choice, and foster inclusive communities that are free from discrimination.” However, federal judicial regimes have thus far refrained from using the law to consistently address local segregation.

  • Euromaidan: What Came Before, What Came After

    Euromaidan: What Came Before, What Came After

    Also known as the ‘Revolution of Dignity’ in Ukraine, Euromaidan began in November 2013 with civil protests in Kyiv demanding closer integration with Europe, and culminated in February 2014 with the ousting of President Yanukovych and the creation of a new government. The effects of the revolution are still felt in the region and globally today, particularly in relations between Russia and the West.

    Key Events

    Protests began when Ukrainian President Yanukovych suddenly and unexpectedly refused to sign a European Union Association Agreement due to Russian pressure. Ukraine and the EU had worked on the agreement for several years. Protests began because citizens demanded increased integration with Europe, but they soon shifted to call out corruption in the country. Ukraine ranked 144th globally in the Corruption Perceptions Index in 2013. The Yanukovych government was unable to discourage protesters, only making them more angry through the use of violence and anti-protest laws.

    Euromaidan came to an end when Yanukovych fled the country for Russia. This allowed a new government to take over, with Petro Poroshenko elected as the new president in May 2014. Shortly after Yanukovych fled and was officially removed from his position, Russia used demonstrations against the new Ukrainian government, along with the significant ethnic Russian population in the region, as justification to annex Crimea.

    Aftermath of Euromaidan

    Russian Annexation: since the beginning of the conflict in eastern Ukraine began, there have been more than 13,000 casualties, including over 3,000 civilians. Recent escalations of tensions between Russia and Ukraine, as well as the West, do not indicate that this conflict is likely to come to an end soon.

    EU Integration: the government that came into power following Euromaidan signed the EU Association Agreement in June 2014, and it came fully into force in September 2017. Many Ukrainians are optimistic that Ukraine will join the EU in the future.

    Russia, Ukraine, and the West: the two Ukrianian presidents since the revolution, Poroshenko and Zelensky, have weaker ties to Russia than past Ukrainian presidents. Both expressed future hopes that Ukraine will join the EU and NATO in the future. This has brought Ukraine and Russia, neighbors and longtime allies, into opposition. The conflict between Russia has also caused significant damage to relations between Russia and the West at a time when tensions are already high.

    Images from Euromaidan

    Photo source

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  • Historical Context for U.S. Housing Policy Part 2: Public Housing

    Historical Context for U.S. Housing Policy Part 2: Public Housing

    The US public housing program originated in 1937, as one of the last pieces of legislation included in the New Deal. Like the HOLC and the FHA, public housing was initially aimed at solving the problem of widespread homelessness and housing insecurity created by the Great Depression. Public housing had the additional virtue of allowing for large-scale construction in a single place, and was therefore wielded as a tool for infrastructure growth and jobs creation. For this reason, many of the initial public housing developments were located near, and in service of, major construction projects. Public housing projects were managed and run by local housing authorities but funded entirely through federal capital grants. Rent collections from tenants were expected to cover operating expenses and future maintenance. 

    From the outset, political compromise and concessions created challenges for public housing. Rigorous lobbying from real estate interests and their conservative constituencies—mostly Southern Democrats—led to the agreement that public housing must be markedly inferior to private developments, both aesthetically and functionally. To ensure that these public developments would not compete in the private market, the federal government set low ceilings on construction costs. Additionally, public housing projects were blatantly segregated based on race; developments preserved for White people were located closer to job sites and were given more funding to attract skilled workers. The Public Housing Authorities (PHAs) in White developments enforced strict standards for residents, ensuring that they maintained orderly living spaces and stayed out of trouble with the law. For White people, the early years of public housing, though not luxurious, were a far cry from the current perception of derelict high-rises, ridden with crime. 

    Following the end of World War II, and the gains in White, middle-class homeownership generated by the G.I. bill, Congress commenced a period of accelerated public housing construction—set into action by the Housing Act of 1949. As generous mortgages and federal subsidies built the suburbs, low-income Americans faced a shortage of affordable housing in urban areas. To address this problem, the 1949 Act authorized the construction of 810,000 public housing units over the next six years. It was during this time that many of the high-rise developments—such as the infamous Pruit-Igoe in St. Louis—were built. These buildings are famously deficient: devoid of decoration or amenity; set back from the streetscape; shoddy construction and dull architecture. Many current advocates argue, however, that the widespread publicization of public housing failures presented an inaccurate and grossly exaggerated account. They further argue that many developed units were smaller—mostly row houses and smaller apartments—and that the image of unsightly high-rises contributes to a stigma against public housing. 

    Stigmas aside, public housing has never been socially desirable. With the growth of FHA-insured mortgages, those who could afford to move did so (except for Black Americans), often to suburban developments. This meant that public housing residents gradually became poorer and less White. The median income of tenants fell consistently in the decades after public housing’s conception. The promulgation of upper income limits and the eviction of middle-class tenants meant that by 1970, most tenants earned less than 20% of the national median. Public housing gradually became synonymous with lower-class, harboring pockets of concentrated poverty. In addition, a Circuit Court of Appeals had ruled in 1935 that the federal government does not have the power to acquire local property through eminent domain. A lack of federal control afforded localities ample room to keep public housing out of desirable areas—whether that be by opting-out of funding for construction altogether, choosing construction sites near environmental hazards, or strategically locating sites in accordance with racial segregation.

    In 1973, President Nixon issued a moratorium on the construction of new public housing, calling it “monstrous, depressing places–rundown, overcrowded, crime-ridden”. Nixon effectively declared public housing a policy failure, prompting Congress to refuse to provide sufficient funding for upkeep and modernization.

    This top-down declaration quickly morphed into consensus. In 1993, the federal government launched the HOPE VI to demolish and redevelop more than 150,000 public housing units. HOPE VI rode a wave of changes to the policing system known as the “broken windows theory” which argues that higher quality living environments, in which amenities are durable and repairs are made promptly (repairing broken windows, for example) reduce crime and engender socially-positive behaviors. In this vein, HOPE VI sought to replace distressed public housing with mixed-income developments with more aesthetically minded features designed to blend in with surrounding developments. Additionally, HOPE VI buildings had shallower subsidies and stricter tenant eligibility that took into consideration poor credit histories, the existence of a criminal record, and other applicant characteristics. HOPE VI marked the end of highly-concentrated public developments. 
    There are a few enduring themes to keep in mind when considering the history of the public housing program. The first is the question of concentrated poverty and its externalities. Even though the central aim of the public housing program has always been to serve low-income and housing-insecure Americans, it has long been understood that homogeneously low-income developments are harmful to the interest of residents. Concentrated poverty gives rise to more violence, poorly maintained facilities, and other negative forces that are endemic to poverty. The tension for policymakers is therefore between prioritizing the neediest citizens and improving life-outcomes for those served. A second and related tension has to do with a leniency in tenant behavior. While leniency—poor behavior and late payments—strikes many as the morally charitable stance, it can also give rise to harsher conditions. Public housing has operated, in effect, as a safety net for low-income Americans, and thus has had to tolerate many of the adverse behaviors that come with living in entrenched poverty. If unruly residents were given the boot, as would be needed to maintain an orderly environment, where would they go?

  • Housing Policy in the United Kingdom

    Housing Policy in the United Kingdom

    Why Compare the United States with the United Kingdom?

    The United Kingdom is currently experiencing many of the same housing challenges as the United States, such as similar trends in homeownership among generations currently coming of age, unaffordable rents, and a lack of available housing supply. The government of the United Kingdom is actively working on building policies to address the same issues that the United States government is also concerned about.

    Additionally, the United Kingdom has a similar political system when compared to the United States. The United Kingdom is also a democracy that elects its leaders, though it is a parliamentary democracy rather than a democratic republic like the U.S. This means that whichever party elects the most candidates get to choose the leader and will make the policies. In the United States, our system elects the leader separately, so the common situation of Congress and the President disagreeing and having to compromise on policy does not happen in the UK. It is easier to get policy passed and enacted in the United Kingdom and thus there is little motivation for elected officials to compromise on the design of policy and programs, whereas U.S. housing policy is often a product of political compromise. The United Kingdom has a developed post-industrial economy like the United States. While it has more social welfare policies to assist citizens who experience poverty, it still has an expansive, powerful private market.. 

    The UK also executes its housing policy in a similar way as the United States in that they are mainly administered at the local level. Local governments have a strong influence on housing policy in both countries. British cities also have strict zoning regulations like most American cities, and these uncompromising laws can limit the amount of housing that can be built.

    Housing History and Policies in the United Kingdom

    Like the United States, the United Kingdom experienced a housing boom after World War II, though for different reasons. The United States government provided low interest and guaranteed mortgage loans for returning soldiers that made homeownership accessible for the first time for millions of Americans. The United Kingdom instead focused on rebuilding the housing that had been destroyed during the war. Given the rise in popularity of socialist policies in post-war Britain, such as establishing a national healthcare system and the nationalization of important industries, the post-war government ultimately built over four million publicly owned housing units. These housing units had reduced rent rates for residents and, in the decades following the war, were referred to as “social housing” or “council housing.” The UK built a diverse range of housing types, while the United States focused on high rise building for social housing. At its peak in the 1970s, 33% of United Kingdom citizens lived in social housing.

    When Margaret Thatcher assumed the role of prime minister in 1979, her more ideologically conservative government began privatizing many of the post-war government-controlled industries. Her government implemented a policy referred to as “right-to-buy” for Britain’s social housing. If a household rented a social housing unit for two years, they would then be able to purchase the unit at a steep discount. While it provided an easy transition to homeownership on affordable terms for low income households, the government has not been replacing the social housing at the same rate that units are being purchased. This policy has remained in place since its implementation by the Thatcher government and while it has helped raise the homeownership rate in the United Kingdom, it has also limited the amount of social housing units available for rent for today’s low-income households.

    Modern housing policy in the United Kingdom has focused on increasing demand for housing rather than policies that increase the supply of housing. In 2013, the UK government under David Cameron created homeownership loan programs that offered favorable mortgage terms. While the goal of this policy was to encourage private developers to build more housing and increase the overall homeownership rate, there ultimately was no increase in home construction but an increase in the price of housing as more households were demanding housing as homeownership became more attainable through these programs. The current government, led by Boris Johnson, has targeted the strict zoning regulations in the UK as a reason for the declining homeownership rate and the increasingly unaffordable price of housing. His government has loosened government regulations on local planning and zoning, but the effects have yet to be seen. 

    What can the United States learn from Housing Policy in the United Kingdom?

    The United Kingdom has historically had a larger government presence in the housing markets through the construction of abundant social housing following World War II. While many social housing units are now privately owned, 17% of British households live in social housing today. Comparatively, less than 1% of Americans live in public housing today. Even with this amount of regulated rent units, there is still a thriving private market for housing. The United Kingdom currently has a 70% homeownership rate, higher than the United States’ rate of 65%. The current state of housing in the United Kingdom suggests that a developed country can have a significant amount of government owned and regulated housing units for low-income households while still having a large amount of private real estate. 

    Additionally, the United States could consider the policies of diversifying the types of public housing available, loosening zoning restrictions to allow for the construction of more housing, and implementing a version of a “right-to-buy” policy for public housing residents. Americans considering changes in national housing policy should also consider whether the government influencing the supply of housing or the government influencing the demand for housing will be more successful. While supply-based housing policies, such as the UK’s social housing program, are historically more effective, they are usually more costly than policies that affect the demand for housing. United States housing policy has focused on influencing the demand for housing, with millions of families being able to purchase homes with favorable mortgage loans from the US government and with Section 8 vouchers but could consider beginning to favor supply-based housing policies, such as increasing the amount of public housing units available or increasing the funds available for private developers of affordable housing. 

  • Historical Context for U.S. Housing Policy Part 1: The New Deal Era

    Historical Context for U.S. Housing Policy Part 1: The New Deal Era

    The HOLC and the FHA

    The core pieces of legislation that make up current American housing policy began in the New Deal era. The wreckage wrought by the Great Depression led to widespread poverty and foreclosures. The moment was right for major steps to alleviate suffering. President Franklin Delano Roosevelt entered office on a tide of Democratic power, spawned by widespread agreement that the Hoover administration was to blame for the regulatory mistakes which caused the Depression. In 1933, the Home Owners Loan Corporation (HOLC) was established to bail out defaulting home buyers by trading government bonds for delinquent mortgages. 

    The HOLC was accompanied by a set of federal agencies which were created to stimulate the housing market, the foremost of which was the Federal Housing Administration (FHA). Created in 1934, the FHA provides mortgage insurance for loans that adhere to an established set of requirements, effectively protecting against default, encouraging longer terms, larger sums of money, lower interest rates, and stricter construction standards. The FHA joined and was bolstered by the mortgage interest deduction, or the MID, which came into being in 1913, not to spur homeownership but as part of a general policy allowing businesses to deduct interest payments from loans. 

    With the introduction of “mass tax” in the mid-1930s, the MID began to make an enormous impact. Joined by the HOLC and the FHA, it allowed homeowners to deduct vast amounts of money from their taxed income—money that they were pouring into expensive new mortgages. Without federal insurance, it would make little financial sense for banks to offer loans on such a scale because of the high costs of developing and maintaining housing. Additionally, the MID allowed homeowners to accumulate vast amounts of equity on their homes over the 25 years or so that they committed to pay off their mortgage. Moreover, homeowners could refinance their mortgage to extract equity to finance further purchases, thus operating as a forced savings mechanism that accelerated wealth at unprecedented rates. 

    When speaking of “generational wealth” in this country, the MID is the key mechanism at work. However, the benefits of the three-pronged support provided by the MID, the FHA, and the HOLC were not enjoyed by everyone. Numerous historians have documented the myriad ways in which a combination of FHA policy (which has come to be known as “redlining”) and localized racism excluded Black Americans from good mortgages in up and coming neighborhoods. Under the ostensibly profit-driven justification that Black Americans were uniformly at “higher risk of default,” the FHA maintained mortgage underwriting standards that described “the infiltration of inharmonious racial or nationality groups” as a central factor in creating unstable neighborhoods.

    The MID is currently by far the largest government subsidy directed at homeowners. It is also highly popular and enjoys support from a wide constituency, particularly business class elites and people who hold political sway. This is not surprising, as the subsidy applies only to homeowners who itemize their deductions, which is primarily middle- and high-income households; thus, rich families accrue the majority of the subsidy. Many advocates for the MID argue that it encourages homeownership, which has been shown to have numerous positive “spillover effects” through its creation of stable neighborhoods of consistent socioeconomic status. 

    G.I. Bill

    As the MID and FHA programs began to gain traction with the American public, a second major policy initiative developed in Congress. The G.I. Bill of 1948 welcomed World War II veterans home from war with a sweetened version of the mortgage subsidy offered to other Americans. There was widespread consensus among policymakers that veterans returning home should receive political priority. The American Legion, a conservative and patriotic organization, introduced a set of proposals to Congress which included medical care, unemployment insurance, four-year college education, furlough pay, and home, and farm mortgages.

    Once passed, the G.I. Bill enabled lengthy mortgages with even smaller interest rates and no down payments. The program ultimately fell under the jurisdiction of the Veterans Administration (VA), which, with veterans’ interests in mind, instituted broad safety nets for default and foreclosure. Each year from 1950 to 1960, an average of 200,000 first time homebuyers were financed through the GI bill, which exceeded the number financed by the booming FHA program. The GI bill helped to create a stable and well-housed middle class, primarily located in suburbs and in urban neighborhoods composed of predominantly single-family homes. The policies were also friendly to banks and developers who were able to proceed with reckless abandon—buoyed by the sturdy backing of the federal policies. Absent a racial lens, the GI bill registers as a resounding note of success. However, recent attention has been given to racially discriminatory policies in the bill. Black Americans returning home from Europe were systematically denied entrance into the mortgage program—a move which is often contextualized as a necessary compromise with stingy Southern Democrats in Congress. While operating to improve the quality of life for many Americans, the GI Bill further expanded the gap between White and Black Americans by denying Black Americans a valuable wealth building tool. 

  • Nursing and Residential Care in the United States One Pager

    Nursing and Residential Care in the United States One Pager

      

    Nursing and residential care consists of services that are utilized by people who require medical and/or custodial assistance and who will potentially move to a care facility that provides more support than caregivers can give. There are two types of care facilities: assisted living facilities and nursing homes. Assisted living facilities are for individuals who need some daily care, and can range in population from 25 to 120 residents. Individuals pay for higher levels of care depending on their needs and reside in single rooms or apartments, while sharing common rooms. In contrast, nursing homes are skilled nursing facilities that provide a greater range of health and personal care in comparison to assisted living facilities. They focus on medical care and rehabilitation services for individuals who can no longer care for themselves. Some residents live there permanently because they have ongoing physical or mental conditions that require more supervision.

    There are approximately 15,600 nursing homes in the United States. On average a patient receives around 4 hours of nursing care per day. The Centers for Medicare and Medicaid Services (CMS) created a quality rating for nursing homes to help families evaluate facility performance based on three areas:

    1. Health Inspections: based on the number, scope, and severity of deficiencies identified during the two most recent annual inspection surveys, as well as substantiated findings from complaint investigations
    2. Staffing: defined by the number of hours of care provided on average to each resident each day by nursing staff, subject to the needs to residents in the nursing homes
    3. Quality Measures (QMs): 15 different physical and clinical measures for nursing home residents to identify how well nursing homes are caring for their residents’ physical and clinical needs

    There are many ways to pay for nursing and residential home care depending on the services required. Care is divided into two sectors: custodial care and high-level inpatient medical care. Custodial care is for people who can no longer care for themselves entirely and need long-term residence and non-medical assistance with the activities of daily living such as bathing, eating, walking, and dressing. This care and the services required are often not covered by Medicare. High-Level inpatient medical care consists of skilled nursing or rehabilitation care and covered by Medicare Part A for a limited time. Skilled Nursing Facility Care is covered by Medicare but for only limited periods of inpatient care and can pay for short, costly rehabilitation. A benefit period begins on the day that an individual is admitted as an inpatient in a hospital or a skilled nursing facility and it ends when no care has been administered for sixty days in a row. Medicare Part A covers days 1-20 for $0 for each benefit period, day 21-100 covers $185.50 coinsurance per day of each benefit period, and for days 101 and beyond: all costs are covered by the individual. 

    There are four conditions for nursing home coverage to be covered by Medicare:

    1. Prior Hospital Stay – nursing home stay must begin within 30 days of an inpatient hospital stay of at least three days in length 
    2. Necessity for skilled nursing or rehabilitation – need for services every day
    3. Medicare-approved facility
    4. Improving condition – coverage only as long as the patient is improving, once stabilized, coverage is no longer available

    Medicare Part C/Medicare Advantage Plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). Medicaid has different eligibility requirements by states for various levels of income but residents are able to receive services from any level nursing home that is certified by Medicaid and accepts Medicaid payments. For eligible beneficiaries, Medicaid pays the full cost of room and board in a nursing facility plus any regular therapies and custodial care. There are no copayments and no time limit on Medicaid nursing home coverage. 

    Program of All-Inclusive Care for the Elderly (PACE) is a program for individuals eligible for Medicare and Medicaid benefits at the same time. This enables individuals to remain in their homes and communities, rather than receive care in a nursing or residential home. When individuals enroll in the program, it becomes the sole source of Medicaid and Medicare for PACE participants. Individuals can join PACE if they meet four criteria: 

    1. Age 55 or older
    2. Live in the service area of a PACE organization
    3. Eligible for nursing home care
    4. Be able to live safely in the community

    Health Savings Accounts (HSA) are options available for individuals who have or previously had high-deductible health plans. With an HSA, deductibles can be paid with pre-tax dollars. Individuals can add pre-tax dollars to the account and money in HSAs carries over each year to accumulate in total. However, once an individual is enrolled in Medicare, they can no longer add to a HSA. These accounts can be used to pay for qualified medical expenses such as long-term care services and premiums up to the maximum annual tax-free amount based on age.

    Through long-term care insurance, premium rates are much lower for people who are in good health when they purchase their policy. Some life insurance policies that cover long-term benefits are pricier than standard life insurance. 

  • Russian State Action Against Political Opponents

    Russian State Action Against Political Opponents

    There have been several opponents and critics of the Russian state whose deaths are believed to be connected to the Russian state. Russia tends to deny responsibility for actions against their political opponents, despite there often being a large amount of evidence linking them to the events. Their refusal to acknowledge responsibility makes it difficult to make a definitive statement as to what happened, and gives the Russian state plausible deniability on the world stage. It also allows for a lack of remorse – if no one can say for sure that they did something, then why should they apologize for it? The following examples are significant because they speak to the Russian Federation’s commitment to a leadership strategy which is entirely at odds with the United States and the rules-based international order. Dissidents and whistleblowers vanish and the government acts with impunity. The Russian Federation is not the only state to implement this strategy, but brazenly abducting political opponents, combined with Russia’s attacks on democracy in other countries, indicate the type of world and systems Russia aims to create.

    Here are a few significant examples of presumed Russian state action against political opponents:

    Anna Politkovskaya

    Anna Politkovskaya was a journalist who made much of her career reporting on Chechnya and was critical of the Putin regime. A 1980 graduate of the Moscow State University journalism school, Politkovskaya worked for several papers before she began to write for Novaya Gazeta in 1999—a newspaper known for its investigative reporting and criticism of the post-Soviet regime. 

    While writing for Novaya Gazeta, Politkovskaya conducted a series of trips into the warzone in Chechnya, and her reporting on the conflict angered the authorities, leading to her detention and expulsion from the region in 2001. Despite her arrest and the threats to her life, Politkovskaya continued to write on both Chechnya and the Putin regime, publishing articles in Novaya Gazeta, as well as multiple books, and receiving many awards for her work. 

    In September 2004, she believed herself to have been poisoned while on a flight to help with a hostage negotiation in North Ossetia. On October 7, 2006, she was found dead in the elevator of her apartment block in Moscow, having been shot repeatedly at point-blank range. There was widespread international outrage following her murder. 

    Multiple arrests have been made in the years since her death, but her former colleagues at Novaya Gazeta believe her case is not solved and the culprits have not been brought to justice. (Here is the original Russian article and video.)

    Alexander Litvinenko

    Alexander Litvinenko was a former FSB (successor agency to the KGB, approximately comparable to the American FBI) officer who was critical of the Putin regime. Originally an officer in the MVD (Internal Troops of the Ministry of Internal Affairs) beginning in 1980, Litvinenko was later recruited to join the KGB, and then became a part of the FSB.

    In late 1998, Boris Berezovsky (an oligarch and another suspected victim of Russian state action) accused several senior FSB officers of ordering his assassination. Litvinenko, along with four other officers, held a press conference in support of this claim a few days later. He was the only one to show his face. Following the press conference, he was dismissed from the FSB.

    In October 2000, Litvinenko fled to London, disregarding orders not to travel, in order to seek asylum, which he received on humanitarian grounds. He was convicted in absentia while in Britain on charges of corruption and sentenced to 3 ½ years in jail, but instead spent his time writing and cooperating with non-Russian security services (allegations he made included an accusation that Putin ordered the assassination of Politkovskaya).

    On November 1, 2006, Litvinenko fell suddenly ill after meeting with two former KGB agents. On November 3, he was admitted to a hospital, and his illness was later attributed to polonium-210 poisoning. He died on November 23. 

    In a statement released posthumously the next day, he accused Putin of being behind his poisoning. His widow also accused Moscow of orchestrating the poisoning, although she did not believe Putin was directly behind the order. A British investigation into his death, released in 2016, found that Putin had ‘probably approved’ the poisoning, and that the Russian state was involved, contrasting the Russian media belief that the murder was linked to Berezovsky, the oligarch.

    Sergei Skripal

    Sergei Skripal was a part of the GRU (Russian military intelligence agency) and a double agent for British intelligence in the 1990s and 2000s. He first served in the Soviet Airborne Troops before becoming a GRU military intelligence officer in the early 1990s. 

    While traveling for work in Spain in 1995, Skripal was recruited by British intelligence as a double agent. At this time he began to pass information to the British government, including, allegedly, the identities of over three hundred Russian agents. He was arrested in December 2004, convicted, and sentenced to thirteen years in a high-security facility.

    In July 2010, Skripal was released as part of a spy swap. He moved to the UK, from where he continued to provide assistance and information to various Western intelligence agencies.

    On March 4, 2018, Skripal and his daughter Yulia were found on a park bench slipping in and out of consciousness. It was found that they had been poisoned by a Novichok nerve agent. Both Skripals survived the poisoning, though they were in critical condition for a significant amount of time.

    It has been reported that they are now in New Zealand under new identities, although this rumor is unconfirmed. When asked about the situation, Putin states that Skripal’s situation has been blown out of proportion, and that less attention should be focused on a traitor.

    Others

    These are not the only people believed to have been targeted by the Russian state. The most recent, widely publicized case is that of Alexei Navalny, who was poisoned in August 2020 – his case will be discussed in a separate brief. If you are interested in reading more, there are a few lists of other suspicious deaths and poisonings that many attribute to the Russian state.

  • Introduction to U.S.-Venezuela Relations

    Introduction to U.S.-Venezuela Relations

    • Capital: Caracas
    • Population: 28.43 million (2019)
    • Government type: Federal Presidential Republic
    • President: Disputed between Nicolás Maduro and Juan Guaidó since January 2019
    • GDP per Capita: 1,739 US dollars (2020)
    • Majority Language/s: Spanish
    • Majority Religion/s: Roman Catholic
    • Global Freedom Score: 14 (not free)

    History of Relationship with the US

    Venezuelan relations with the United States began at the same time as Colombia within the united political entity Gran Colombia and, like Colombia, continued after secession from the block. From 1902 to 1903 European powers implemented a naval blockade against Venezuela due to outstanding debts that the government refused to pay back. Despite statements made by President James Monroe that maintained US intolerance for European intervention in Latin America, the United States did not choose to intervene or to aid Venezuela in this crisis. 

    In 1948, a military leader by the name of Pérez Jiménez staged a coup and took control of the Venezuelan government. Following the coup, foreign investment grew from US oil companies with support from Jimenez’s administration. Even though the US had a positive diplomatic relationship with this regime, the dictatorship was also responsible for the torture and disappearance of thousands of Venezuelans.

    Hugo Chavez’s presidency began in 1999 and he quickly became one of Latin America’s most notable leaders in the early 21st century. His presidency was of foreign policy interest (and concern) to the United States due to his socialist policies that were incompatible with US foreign policy goals in Latin America. His government assumed control of Venezuela’s oil fields from foreign corporations and implemented policies including raising royalties for foreign firms. These actions challenged US economic interests in Venezuela. Much to the US’ dismay, Chavez also formed a public friendship with Cuba, further distancing the US and Venezuela diplomatically. Chavez kept the United States at an arm’s length, even refusing military and economic aid at times. Relations with Chavez worsened following a brief coup in 2002 which allegedly received US support. Despite a tense and distrustful diplomatic relationship between Chavez and the acting US presidents, economic relations continued between the two countries, and the US continually bought Venezuelan oil throughout the 2000s and early 2010s. However, tensions worsened still under the Maduro presidency and since 2014 the United States has imposed strict sanctions against Venezuela, ceasing any oil trade between the two countries.

    Key US Foreign Policy Considerations

    Venezuela is in political, economic, and humanitarian disarray.  Thus, many US foreign policy concerns address this multidimensional crisis.

    In the late 2010s, the acting Maduro government made efforts to consolidate power, ultimately creating a contested political system with both Maduro and Juan Guaidó, leader of the opposition, laying claim to the presidency. The US, concerned with Maduro’s authoritarian leanings and human rights abuses, has supported Juan Guaidó as interim president in an effort to promote the return of free and fair elections in Venezuela. The political crisis in Venezuela has led to generalized violence and humanitarian disaster throughout the country. As a strong opponent to the actions taken by Maduro and his administration, the United States has also implemented a series of unilateral sanctions against those within the administration benefitting from US trade. Most notably, the US has implemented strict sanctions on the state-owned oil company which in the past has made up around 90% of Venezuela’s total revenue. Sanctions have not succeeded in pressuring Maduro’s government to give up control. US sanctions have also garnered widespread criticism due to their illegality per international law. According to Chapter 7 of the UN Charter, sanctions are only to be implemented under UN Security Council decisions. There have also been concerns about the human impacts of these sanctions, which has further exacerbated the economic crisis within the country.

    However, the United States has also provided monetary assistance to aid Venezuelans experiencing the devastating effects of the ongoing humanitarian crisis. The humanitarian conditions in Venezuela are characterized by human rights violations (including alleged crimes against humanity perpetrated by Maduro and his supporters), a health crisis (collapse of the healthcare system and shortages in critical supplies), food insecurity, lack of access to fuel and electricity, and high rates of crime and insecurity. The United States government has allocated more than $1 billion dollars of aid to help Venezuelans both within the country and those living elsewhere as migrants. The US has provided monetary aid in order to fund programs geared toward improving quality of life for Venezuelans. Such programs involve improvements in access to basic necessities, such as food, water, and healthcare.

    As a result of the ongoing generalized violence and humanitarian crisis, Venezuela has been experiencing a mass exodus of its population as millions of Venezuelans flee to neighboring countries. Colombia and Brazil have been major destinations for many Venezuelans, due to their proximity as well as relatively open immigration policies, which also recognize most Venezuelans as refugees. The US has also seen an increase of Venezuelan migrants, which has also garnered controversy and criticism in terms of policies or lack thereof to provide refuge to Venezuelans who cannot return to their homes. President Trump refused to implement any sort of special protective status for migrants from Venezuela for the majority of his presidency, only implementing a Deferred Enforced Departure program for Venezuelans January 20th, 2021, the final day of his presidential term. The protections under DED were expanded by President Biden with the creation of Temporary Protected Status for Venezuelans already residing in the United States. This status, a measure taken in response to the ongoing humanitarian crisis in Venezuela, further protects Venezuelans residing in the US from deportation and permits them to get employment authorization in the United States. Unfortunately, this status does not apply to Venezuelan asylum seekers who still experience immense difficulties in immigrating to the US.

  • Introduction to the United States Prison System

    Introduction to the United States Prison System

    Historical Roots of Incarceration

    Prior to the American Revolution, a majority of colonies used confinement in prison dungeons and jails to house individuals awaiting trial. Once a verdict was delivered, a person found guilty was punished in one of the following ways: fine, public shaming, public chastisement, or death. In 1790, the Pennsylvanian Quakers established the first American prison, Walnut Street, which became used as a form of punishment rather than temporary confinement. Due to the success of the Walnut Street prison, New York reduced capital crimes and built the Auburn prison. While the Walnut Street prison prohibited inmate interaction, the Auburn prison congregate system allowed inmates to work alongside one another silently during the day and confined them to solitary confinement at night. Critics of both prison systems argued against the lack of inmate interaction. This caused prisons to revoke the ban on speaking by the 1850s

    ​​
    After the ratification of the Thirteenth Amendment, the 1860s saw a disproportionate number of black people incarcerated in the south. Newly freed slaves became victims of convict leasing, a legal way to arrest individuals, sentence them to labor, and then lease that labor to private establishments. In the 1871 case, Ruffin v. Commonwealth, the Virginia Supreme Court declared an inmate a “slave of the state” with rights only given to them by the state. Convict leasing was outlawed in 1928. 

    Until the late 19th century, prisons were run solely by state governments. However, after the Three Prisons Act of 1891, the United States authorized three federal prisons to run with limited oversight by the Department of Justice. In 1930, the Bureau of Prisons was created to “assume oversight, management, and administration” of all federal prisons at the time. They now operate 122 federal prisons

    Alternatives to Incarceration

    Known as the “Irish system,” indeterminate sentences provide a range of imprisonment for certain criminal offenses. In the 1800s, inmates who maintained good behavior and hard work were released sooner and those who did not had prolonged sentences. In 1907, New York established the concept of parole after indeterminate sentences proved to be successful in decreasing crime. In the current system, an inmate may be released under the supervision of a parole officer if they have observed the rules of the prison, are not a danger to the public, and are unlikely to commit future offenses. The creation of parole established more alternatives to incarceration: 

    1. Probation releases a defendant into society with restrictions set forth by the court, and under the supervision of a probation officer, in place of imprisonment. If the individual violates their probation, they may be sentenced to imprisonment.
    2. Community service is unpaid work designed to benefit the community that has been harmed by the individual’s actions. Community service is commonly sentenced alongside other forms of punishment. 
    3. Home Confinement, commonly known as house arrest, requires people found guilty to wear an ankle monitor that ensures they remain at home and in certain pre-approved areas for the duration of their sentence. 
    4. Fines require the defendant to pay a fee depending on income and seriousness of the offense while restitution requires the defendant to pay for a victim’s costs as a result of the crime. 
    5. Treatment programs are court-supervised health programs that provide services relating to mental health and drug dependency. People who committed sex offenses are commonly placed on probation and ordered to complete sex offender treatment. 

    War on Drugs

    After Nixon declared a “war on drugs” in 1971, many reform acts were established in order to reduce illegal drug use and trade. The 1984 Sentencing Reform Act abolished federal parole, reduced good time, and established determinate sentences. The 1986 Anti Drug Abuse Act established minimum sentences for criminal drug offenses and raised funding for drug enforcement. As a result of the “war on drugs” reform acts, the incarcerated population ballooned, leading to higher costs and overcrowding. To solve the overcrowding problem private prisons were created in the 1980s. Now, the United States has begun to pass reform acts to reverse the effects of the late 20th century “war on drugs.” The Fair Sentencing Act of 2010 reduces the penalties for crack cocaine offenses. The First Step Act of 2018 shortens the mandatory sentences for minor drug offenses and requires the federal “three strike rule” to impose a 25-year sentence instead of a life sentence after three convictions.