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Tag: Solutions

  • Pros and Cons of Congressional Term Limits

    Pros and Cons of Congressional Term Limits

    Background: What are Congressional Term Limits?

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

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

    Current Attempts to Impose Congressional Term Limits

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

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

    Arguments In Favor of Congressional Term Limits

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

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

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

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

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

    Arguments Against Congressional Term Limits

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

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

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

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

    Conclusion 

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

  • Maternal Mortality Review Committees and the PMDR Reauthorization of 2023: Key Perspectives

    Maternal Mortality Review Committees and the PMDR Reauthorization of 2023: Key Perspectives

    Introduction

    The United States faces a maternal mortality crisis, with maternal death rates significantly higher than other high-income nations. According to the CDC, maternal mortality disproportionately affects Black, Indigenous, and rural communities, with Black women experiencing maternal deaths at 2.6 times the rate of White women. The factors contributing to these disparities are complex and include unequal access to quality healthcare, socioeconomic barriers, and more. Despite advancements in healthcare, 80% of maternal deaths are preventable through timely medical intervention and comprehensive data collection. 

    What are MMRCs?

    State-based Maternal Mortality Review Committees (MMRCs) have been shown to play a pivotal role in analyzing maternal deaths to recommend evidence-based interventions. MMRCs are multidisciplinary teams that examine maternal deaths occurring during pregnancy or within one year postpartum. They utilize comprehensive data sources, including medical records, autopsy reports, and social service information. MMRCs assess preventability and contributing factors, allowing them to identify patterns and propose targeted policy solutions. Their review process centers on critical questions related to medical factors, social determinants, delays in care, and provider bias. By systematically addressing these factors, MMRCs generate insights that inform strategies to reduce preventable maternal deaths, which comprise 20% to 50% of all maternal deaths in the U.S.

    However, MMRCs face inconsistent funding and regulatory barriers, limiting their ability to track and analyze maternal deaths across states. Disparities in data collection methods and access to comprehensive patient records further hinder efforts to address maternal health inequities. Some states lack the authority to access certain medical records, while others experience delays in data sharing, reducing the timeliness and effectiveness of recommendations. Without consistent federal funding, many MMRCs struggle to maintain operations, particularly in rural and underserved areas, where maternal health disparities are often most pronounced. 

    Introduction to the Preventing Maternal Deaths Reauthorization Act

    The Preventing Maternal Deaths Reauthorization Act of 2023 (PMDR) was introduced to the House Committee on Energy and Commerce by Congresswoman Robin Kelly (D-IL) on May 18, 2023. The bill passed out of the Senate Health, Education, Labor, and Pensions (HELP) Committee in Fall 2023 and passed the House with bipartisan support in March 2024. However, the bill failed to pass the Senate before the end of the legislative calendar, rendering the bill “dead”. The reauthorization built upon the original Preventing Maternal Deaths Act of 2018, which helped establish and fund state-based Maternal Mortality Review Committees (MMRCs) to investigate maternal deaths and identify preventable causes. It sought to extend funding for MMRCs, enhance data collection, and address racial disparities in maternal health outcomes through the following provisions:

    1. Extending funding for state-level MMRCs to continue investigating maternal deaths
    2. Authorizing $58 million annually for the CDC to support state-level efforts
    3. Enhancing data collection on factors related to maternal health outcomes, particularly for minority populations
    4. Strengthening community-based interventions to reduce racial and ethnic disparities 
    5. Enhancing coordination among agencies to implement evidence-based solutions
    6. Expanding research on social determinants of maternal health 

    Arguments in Support

    Proponents of the PMDR Act of 2023 argue that the bill provides critical support for tried and true interventions to prevent maternal deaths. They emphasize that scientific literature identifies state-based MMRCs as the “gold standard” for preventing maternal deaths due to their multidisciplinary analysis. However, inconsistent funding threatens the effectiveness of MMRCs, particularly in states with high maternal mortality rates. In a letter to Congress, 125 public health and social services associations urged legislators to treat the PMDR as a top-priority bill, stressing the nation’s consistently high maternal mortality rate. Several national associations, including the American Medical Association, argue that continued federal funding is crucial to preventing maternal deaths. They highlight that past funding gaps resulted in reduced MMRC operations, hospital closures, and increased barriers to care. Supporters contend that the only way to ensure MMRCs can continue their vital work without funding disruptions is to pass the PMDR.

    Proponents of the PMDR Act also highlight its potential to promote health equity. Beyond identifying risk factors, MMRCs are critical in addressing racial, socioeconomic, and geographic disparities in maternal health by filling critical knowledge gaps on the drivers of maternal mortality in underserved populations. The PMDR Act directly supports these efforts by requiring MMRCs to report on disparities in maternal care and propose solutions. Federal support through this bill enables MMRCs to strengthen provider training, expand access to prenatal care, and address structural barriers contributing to maternal deaths. Without reauthorization, proponents argue, efforts to close maternal health gaps would be fragmented, leaving vulnerable populations without necessary protections.

    Arguments in Opposition

    The most prominent critique of the PMDR Act is that it focuses too heavily on MMRCs. Critics voiced concerns about MMRCs’ inconsistency, lack of accountability, and failure to acknowledge all social determinants of health. 

    Opponents highlight that legal and logistical challenges, such as data collection issues and lack of legal protections for participants, can create disparities in MMRC operations. Rural populations, who face higher maternal mortality rates and limited access to care, are often overlooked in MMRCs, further exacerbating disparities. Additionally, bureaucratic barriers and state laws limiting community involvement in MMRCs reduce their effectiveness in addressing maternal health challenges. 

    Others argue that MMRCs lack accountability, particularly regarding inclusivity and equitable decision-making. Advocates contend that MMRCs often exclude community representatives or organizations that challenge the status quo, prioritizing clinical expertise over individuals with lived experience. This exclusion can foster distrust, as community members may feel their knowledge and perspective are undervalued. The lack of compensation for community members to attend all-day MMRC meetings – unlike salaried clinicians – adds another barrier, further entrenching inequalities. Laws that impose burdensome requirements on MMRCs further complicate the process and reduce diversity in ideas. Opponents of the PMDR contend that these factors contribute to a lack of accountability from MMRCs, preventing them from fully creating lasting and inclusive solutions. 

    Finally, critics assert that MMRCs often fail to adequately address the underlying social determinants of health that contribute to maternal mortality. While MMRCs focus on clinical factors, such as healthcare quality and implicit bias, they can lack the frameworks to assess other social determinants like housing instability, food insecurity, or socioeconomic status. Often, these factors are deeply rooted in the broader healthcare system and community environments. Critics argue that the absence of these social factors in MMRC reviews limits the committees’ ability to develop holistic prevention solutions. Reports suggest MMRCs could benefit from incorporating a health equity framework and utilizing socio-spatial measures to address the full spectrum of challenges mothers face. Without this consideration, critics argue that MMRCs fall short of offering effective solutions to reduce maternal deaths and disparities. 

    Due to these critiques of MMRCs, critics of the PMDR argue that the bill should allocate more funding toward alternate interventions 

    Conclusion 

    The Preventing Maternal Deaths Reauthorization Act of 2023 represented an effort to extend investment in evidence-based maternal health interventions. While it received strong bipartisan support in the House, it died before a vote in the Senate, leaving MMRC funding uncertain in the years to come. While the bill was applauded for its potential to expand access to maternal care and fill critical knowledge gaps on maternal mortality factors, critics argued it placed too much emphasis on an intervention that lacked consistency and accountability to marginalized communities. 

    Future Outlook

    The Trump administration has implemented significant changes to the National Institutes of Health (NIH), including halting medical research funding and restructuring the agency, which has led to delays and uncertainties in grant approvals. These actions have raised concerns about the future of critical medical research, including studies on maternal health. Given these developments, the future of the PMDR may depend on an evolving public health funding environment. Advocacy groups and policymakers will need to collaborate to ensure that maternal health research and interventions receive the necessary support, despite the current challenges in the federal funding landscape.