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21. State Regulatory Compliance Processes: Lessons Learned From COVID-19

Author:
Neil Kerwin, Aretha Ferrell-Benavides, Stan Meiburg, Shelley Metzenbaum, and Courtney Phillips
Publication Date:
12-2022
Content Type:
Special Report
Institution:
The National Academy of Public Administration (NAPA)
Abstract:
Over the past 18 months, the nation’s economy and society have been upended by the COVID-19 pandemic. To protect public health while minimizing economic disruption, state and local governments took action to improve the regulatory compliance process, such as: Utilized additional online mechanisms for some regulatory compliance processes; Addressed business pain points and concerns about timeliness; and Improved sequencing and routing of regulatory approvals (for example, by allowing offices to do concurrent reviews) Supported by a grant from the Pew Charitable Trusts, the Academy's Center for Intergovernmental Partnerships analyzed states' actions related to their regulatory standards. The report discovered several main steps state governments took regarding: Simplified permitting paved the way for business start-ups; New permissions allowed bars and restaurants to resume operations; Streamlined licensing allowed healthcare professionals to continue to practice; and The authorization of telehealth allowed millions of people to receive remote healthcare services. The report noted several important implications along these investigative lines and detailed additional opportunities for research into lessons learned and preparations for future crises. See Chapter 5 of the report to read the complete conclusions and recommendations.
Topic:
Regulation, Public Health, COVID-19, Compliance, and Public Administration
Political Geography:
North America and United States of America

22. Reality Injection: Beyond Masks and Quarantine The True Cost of COVID-19

Author:
Eric D. Achtmann, Raquel Bono, Anita Goel, Margaret A. Hanson-Muse, and Steven M. Jones
Publication Date:
01-2022
Content Type:
Journal Article
Journal:
PRISM
Institution:
Institute for National Strategic Studies (INSS), National Defense University
Abstract:
COVID-19 has had a profound economic and social impact on America, taking over a half million lives—more than all American deaths in World War I, World War II, and Vietnam, combined.1 This article seeks to examine primary and secondary consequences of the pandemic in practical terms for the average citizen and taxpayer, whose personal exposure exceeds 2.5 years of net income based on predictions of a $16 to $35 trillion cost to the nation by 2025. Further, we offer insight into the pandemic’s collateral effects on our citizens and workforce (including often overlooked key stakeholders such as women, children, and minorities), as well as more overt aspects of our national security. History will measure the pandemic’s tragic and overwhelming impact on the world—and our country—in terms of infections, hospitalizations, vaccinations, and deaths. Yet, as COVID-19 extends our quasi-lockdown into its 18th month, we are scarcely beginning to comprehend its profound economic impact. A December 2020 Congressional Budget Office (CBO) report estimates Americans’ costs at nearly $16 trillioni or double its May 2020 projections.2 To a layperson, $16 trillion is the wealth of 16 million millionaires or $110k for each U.S. taxpayer. Analysts expect this number to reach $35 trillion by 20253—a sum that easily exceeds the initiatives Congress has fought over for yearsii. Another study conducted by the Journal of the American Medical Association reached a similar conclusion. “About half of the price tag, $8.6 trillion (about $26,000 per person in the United States), is driven by the long-term health implications and costs for those who contract COVID-19, as well as the statistical estimates for the loss of life.”4 Robert Frost’s words aptly depict society’s effort to overcome the pandemic’s effects, “…miles to go before [we] sleep.” The stock market crash of 1929, in hindsight a predictable occurrence, unleashed a 10-year Great Depression. Likewise, the COVID-19 contagion, an equally predictable event, portends a similar trend. Long term, it compels society to address its socio-economic impact, acknowledge its lack of preparedness, and formulate a realistic action plan for protection against this and future pandemics, as well as potential biowarfare attacks. A similar event is inevitable, whether through malfeasance, rapidly increasing population density, environmental stress, biowarfare attack, or simply bad luck. So is society’s realization of two things: our economy and civilization will struggle to survive another pandemic in the near term, and that “an ounce of prevention is worth a pound of cure.” While one can theoretically shut down the engines and glide a plane to safety in an emergency, there is no substitute for proper planning, operations, and maintenance. Society needs a more proactive and anticipatory approach to national and global security, biodefense, and pandemic prevention and mitigation.5 Leaders need a strategy that leverages the resources of both the public and private sectors, as well as academic and individual initiative. Failure to do this is not an option—it is too costly and could lead to the collapse of entire economies and societies.
Topic:
Economy, Public Health, Pandemic, and COVID-19
Political Geography:
North America and United States of America

23. Barber Licensing in Arkansas: Public Health or Private Gain?

Author:
Tanner Corley and Marcus M. Witcher
Publication Date:
01-2021
Content Type:
Journal Article
Journal:
The Cato Journal
Institution:
The Cato Institute
Abstract:
In Arkansas, the barber profession has been regulated and licensed for more than 80 years, and until recently, the issue was mostly absent from the political debate. During a regular session of Arkansas’s 92nd General Assembly in 2019, however, state Sen. John Cooper presented a bill to “repeal the [1937] Arkansas Barber Law” and to “abolish the State Board of Barber Examiners” (Briggs 2019). The average Arkansan probably was not aware of the bill, but occupational licensing reformers saw this as a great opportunity for Arkansas to pave the way for other states to reform their own license laws. If Cooper’s bill had passed, Arkansas’s economy would have likely benefited (Timmons and Thornton 2010, 2018). By removing restrictive requirements to becoming a barber, the bill would have allowed more Arkansans to enter the profession. This reform would have ­provided people with more economic opportunities, increased competition, and benefited consumers.
Topic:
Regulation, Business, Public Health, and Licensing
Political Geography:
North America and United States of America

24. ASPI NOTES for the Biden Administration

Author:
Wendy Cutler, Anubhav Gupta, Nathan Levine, Richard Maude, Elina Noor, Jing Qian, Alistair Ritchie, Kevin Rudd, Daniel R. Russel, and Thom Woodroofe
Publication Date:
01-2021
Content Type:
Policy Brief
Institution:
Asia Society
Abstract:
The Asia Society Policy Institute (ASPI) Notes for the Biden Administration is designed to offer creative and practical ideas for how the United States might re-engage in the Asia Pacific, particularly in the critical first six months of the new administration. The administration will immediately face a range of challenges and opportunities in this important region, including on climate change, public health, and the global economy. President-elect Biden and his team have signaled the need for the United States to lean into and deepen its engagement with friends and allies. This will mean leveraging the Asia Pacific’s multilateral architecture as well as using global forums such as the G20 and international organizations. Trade policy will also figure importantly in any effort to renew and expand America’s engagement. Additionally, the U.S.-China relationship will loom large from the outset. Tensions with China will surely linger, whether in the South China Sea or the Taiwan Strait, complicating the task of establishing a new framework of “managed strategic competition” – a combination of each side's "red lines," continued competition, plus agreement on areas of mutually beneficial cooperation. ASPI Notes for the Biden Administration provides a diverse package of 20 actionable proposals to address specific risks or objectives in reconnecting with the Asia Pacific. These notes carefully reflect the views, perspectives, and expectations of the region itself – a hallmark of ASPI’s approach.
Topic:
Foreign Policy, Climate Change, Economy, Trade, Public Health, and Joe Biden
Political Geography:
China, Taiwan, Asia, Asia-Pacific, and United States of America

25. Impacts of the Affordable Care Act Medicaid Expansion in California

Author:
Natalie Schwehr, Giovann Alarcon, and Lacey Hartman
Publication Date:
01-2021
Content Type:
Journal Article
Journal:
California Journal of Politics and Policy
Institution:
Institute of Governmental Studies, UC Berkeley
Abstract:
We examined the impact of the Affordable Care Act (ACA) on healthcare coverage, access, health status, and affordability, as well as disparities in these outcomes by race/ethnicity among low-income Californians. We used nationally representative survey data from the Behavioral Risk Factor Surveillance Survey 2011-2019 and a difference-in-differences approach that compared California with nonexpansion states. We examined the impact of Medicaid expansion on health insurance coverage, having a usual source of care, self-reported health status, frequent (≥14) unhealthy days in the past month (physical, mental, and both), and foregone care due to cost. The sample population included low-income Californians (<100% of the federal poverty guidelines) aged 19-64 and low-income childless adults. Low-income adults, childless adults, and white childless adults in California saw post-ACA gains in six of seven outcomes, including a 7.7 percentage point increase in having a usual source of care for all low-income adults (CI: 0.051 to 0.104). Childless adult people of color (POC) reported significant improvements in three measures, with a 6.6 percentage point increase in having a usual source of care (CI: 0.013 to 0.120). All of the groups we examined had coverage gains, ranging from 3.9 percentage points for all low-income adults (CI: 0.013 0.066) to 8.4 percentage points for white childless adults (CI: 0.025 to 0.143). Additionally, all groups reported improved mental health, including an 8.2 percentage point decrease in frequent mental distress for childless adults (CI: -0.120 to -0.044). These findings indicate that the ACA coverage expansion benefitted the targeted population of low-income Californians. Additionally, the disparity between white and non-white Californians decreased for the unadjusted mean rate of having a usual source of care. However, unadjusted means showed that white low-income adults remained more likely to have health insurance coverage and a usual source of care compared with POC in both California and nonexpansion states.
Topic:
Health, Minorities, Health Care Policy, Public Health, Medicaid, and Medicine
Political Geography:
North America and United States of America

26. COVID-19 and California’s Detained Youth: Vulnerable and Overlooked

Author:
Sue Burrell and Shannan Wilber
Publication Date:
01-2021
Content Type:
Journal Article
Journal:
California Journal of Politics and Policy
Institution:
Institute of Governmental Studies, UC Berkeley
Abstract:
The COVID-19 pandemic is an unprecedented and ongoing calamity, laying bare the vulnerabilities of California’s public health and emergency response systems. Although youth confined in juvenile detention facilities are among those at highest risk of suffering from the effects of the virus, the plight of these young people has been largely invisible to the public and overlooked by the state. This article describes the unique dangers posed by the coronavirus to youth incarcerated in county-run detention facilities in California. It summarizes the policies and procedures necessary to protect the health and well-being of detained youth based on the recommendations of public health officials and youth justice stakeholders nationally. It then describes the county and state agencies whose coordinated action is essential to respond to COVID-19, the efforts of the authors and other California advocates to urge these government stakeholders to implement essential health and safety protocols, and the obstacles and challenges encountered. Those efforts met with a range of responses ranging from lack of certainty about authority to act to non-responsiveness. As a result, California failed to provide systematic guidelines for releasing youth from custody, proactively oversee conditions in detention facilities, report data in meaningful ways, or respond to concerns and complaints from youth and families. The article, finally, draws on the experiences of the past year and a half to offer recommendations for the systemic changes necessary to prepare for the next pandemic or similar public health emergency.
Topic:
Governance, Youth, Public Health, Pandemic, and COVID-19
Political Geography:
North America and United States of America

27. Vaccinating America

Author:
Committee for Economic Development of the Conference Board
Publication Date:
04-2021
Content Type:
Policy Brief
Institution:
The Conference Board
Abstract:
In December 2020, one year after the COVID-19 virus had been reported in China, the Food and Drug Administration (FDA) granted emergency use authorization in back-to-back announcements for the Pfizer/BioNTech and Moderna/NIAID vaccines. This was by far the fastest vaccine development in history. A typical vaccine took 10 years to develop, with the most rapid previous development being the four years it had taken for the mumps vaccine in 1967.1 And these two vaccines were of a new type, utilizing messenger RNA (mRNA). While mRNA had been studied for years, the unique spike protein of the coronavirus that causes COVID-19 provided a first opportunity to respond with an mRNA vaccine.2 The ensuing technological and scientific success could not have been accomplished without the collaboration of the private and public sectors. The distribution of the vaccine nationally could not have been accomplished without the major delivery companies stepping up to meet the challenges of on-time distribution of the vaccines, which required very cold storage. The research, development, and nationwide distribution of the vaccines has evoked comparisons to the private-public sector collaboration during WWII that led to the Manhattan Project’s rapid and dramatic scientific breakthroughs.3 After death tolls climbed into the hundreds of thousands, the vaccine announcements provided hope that there may be light at the end of the very dark COVID-19 tunnel. By the end of May, the United States is expected to have sufficient vaccine supply for the entire adult American population. But the challenge to manufacture, distribute, and administer the vaccinations quickly, efficiently, and fairly, in a race against continued infection and the emergence of variants of the virus here and all around the world, requires continued collaboration between the public and private sectors. The US and the world must win that race between vaccination and mutation to achieve “herd immunity” and return to normality in daily life and the economy. The stakes are high for both the current crisis and the inevitable pandemics of the future. For this reason, the following analysis offers a diagnosis of the current episode, and recommendations for today and tomorrow.
Topic:
Public Health, Vaccine, and COVID-19
Political Geography:
North America and United States of America

28. Containing the Pandemic Public Debt

Author:
Committee for Economic Development of the Conference Board
Publication Date:
05-2021
Content Type:
Policy Brief
Institution:
The Conference Board
Abstract:
In early 2020, the COVID-19 pandemic presented the entire world with its worst public health threat in at least a century. The precise seriousness of the pandemic, of course, could not be known at the outset; and in fact, the pandemic is not yet vanquished as this statement is written. The extent of the damage the virus and its mutations will ultimately cause is not yet fully known. But the near-miraculous efforts to develop vaccines, contain the infection, and treat the infected provide much-needed hope that a return to “normal” is not out of reach. The pandemic had economic consequences as well. And like the public health impact, the shock to the economy was large but impossible to assess accurately at its outset. And like the damage to public health, the economic fallout is still impossible to assess today with complete accuracy. For the first time in 100 years, stay-at-home orders to protect the public health spurred an economic downturn and dramatic job losses—leaving a wide swath of businesses in hospitality, travel, leisure, dining, and retail nearly shut down, with entire occupations, such as personal service workers, facing extended layoffs or even permanent job loss. The fates of these businesses and workers are unpredictable, depending on the uncertain course of the pandemic itself. Another similarity between the public health and the economic threats is that prudent public policy required strong and immediate responses. With the ultimate extent of the damage unknown but potentially catastrophic, executive and congressional policymakers deemed it essential that government react swiftly and robustly. Policymakers and commentators repeated often that the nation should err on the side of action—that it would be better to do too much rather than too little.
Topic:
Debt, Economy, Public Health, Pandemic, and COVID-19
Political Geography:
North America and United States of America

29. Religious Identities and the Race Against the Virus: Engaging Faith Communities on COVID-19 Vaccination

Author:
PRRI Staff
Publication Date:
04-2021
Content Type:
Special Report
Institution:
PRRI: Public Religion Research Institute
Abstract:
As the U.S. navigates evolving dynamics related to COVID-19 vaccine hesitancy and access, there has been a dearth of hard data to understand the cultural dynamics of this problem, and even less rigorous data available to understand how faith-based interventions might mitigate vaccine hesitancy and resistance. The PRRI–IFYC Religion and the Vaccine Survey, the largest study conducted to date in this area, reveals that faith-based approaches supporting vaccine uptake can influence members of key hesitant groups to get vaccinated and thus can be a vital tool for the public health community as we work toward herd immunity. Faith-based approaches are influential among vaccine hesitant communities. More than one in four (26%) Americans who are hesitant to get a COVID-19 vaccine, and even 8% of those who are resistant to getting a vaccine, report that at least one of six faith-based approaches supporting vaccinations would make them more likely to get vaccinated.
Topic:
Religion, Public Health, Vaccine, Pandemic, and COVID-19
Political Geography:
North America and United States of America

30. Back to School: Parents, Religion, and COVID-19 Vaccination

Author:
PRRI Staff
Publication Date:
08-2021
Content Type:
Special Report
Institution:
PRRI: Public Religion Research Institute
Abstract:
Parents and guardians of children under the age of 18 are less likely to be vaccine accepters than those without children under 18 in their households, according to data from the latest PRRI-IFYC vaccine report.[1]About six in ten parents (61%) say they have gotten or will get a vaccine, 21% are hesitant, and 17% say they will not get a COVID-19 vaccine. By contrast, Americans without children under 18 in their households are more likely to be acceptant (76%) and less likely to be hesitant (13%) or refusers (10%).
Topic:
Public Health, Vaccine, Pandemic, COVID-19, and Parenting
Political Geography:
North America and United States of America