Briefing for September 7-10, 2021 on COVID-19 and Low-Income Communities

Briefing for September 7-10, 2021 on COVID-19 and Low-Income Communities

We are struck that one of the few certainties about the coronavirus outbreak is that low-income communities and workers in low-income, service sector occupations will be disproportionately impacted — likely in devastating fashion.

One step in combatting this will be to share information about what is happening and what can be done. That’s why we are offering a daily news service summarizing relevant stories, which you can read below.

If you would like to receive a daily briefing, feel free to email schumitz@tfreedmanconsulting.com to subscribe.

Briefing for September 10, 2021



Democrats ready $450 billion package to expand child care, pre-K: The Washington Post reports: “Congressional Democrats this week are set to take their first steps toward adopting a $450 billion plan that could improve child care nationwide, marking an early attempt to lock in a major element of President Biden’s economic agenda at a moment when it is in political peril. The new spending could amount to the largest-ever investment in federally backed child-care programs, with Biden and other Democrats laboring to ease the financial burdens on parents, offer higher wages to caregivers, and ensure all children ages 3 and 4 can enroll in free prekindergarten. But the funds are part of a fluid, still forming $3.5 trillion package that has become the subject of considerable sniping even among Democratic lawmakers in recent days. Democrats envision a broad reimagining of federal health care, education, immigration, and tax laws, even as liberal and moderate lawmakers quarrel over the price tag and scope of their policy ambitions. Amid the squabbling, Democrats have stressed that the new child-care investments are urgent. They say the proposed spending compensates for decades of neglect compounded in severity during the coronavirus pandemic, which forced many child-care centers to shutter — all the while leaving working parents with few options.” 

Could COVID-19 finally end hunger in America? Politico’s Recovery Lab series looks at the potentially transformative long-term impact of safety net programs during the pandemic: “A peculiar thing happened last year during the COVID-19 pandemic: As large swaths of the U.S. economy shut down and unemployment skyrocketed, hunger rates held steady and poverty rates went down. From the pandemic’s earliest days, Washington showed it had learned the lessons of past crises like the 2008 financial collapse, when policymakers responded with too little too late to help people get by and the economic recovery was hampered as a result. So as the country faced a once-in-a-century pandemic and the sharpest economic downturn since the Great Depression, Congress threw trillions at the double disaster, sending unprecedented levels of aid to American families and businesses. Soon, a pattern was evident, thanks in part to real-time monitoring by the U.S. Census Bureau: When Washington doled out federal aid, hardship declined. When Washington let aid expire, hardship ticked back up. In essence, the pandemic triggered a country-wide policy experiment aimed at keeping families fed and financially afloat. There have been big increases in food stamps and unemployment benefits. Three rounds of stimulus checks. Universal free meals at schools and new grocery benefits for kids who are learning virtually, or out of school during the summer. Hundreds of millions of food boxes flooded into churches and other nonprofits. The latest tranche of aid may carry the biggest bang yet: six monthly child tax credit payments that will be dispersed through the end of the year. The first two rounds of payments that went out in July and August fueled a dramatic reduction in the rate of American households with kids who report sometimes or often not having enough to eat in the past week, according to the Census Bureau. All that aid appears to have worked. ‘Lo and behold, if you give people money, they are less poor,’ said Elaine Waxman, an economist and senior fellow at the Urban Institute who has closely monitored how low-income households have fared throughout the crisis.” 

Lessons from a 15,397-mile drive: Hunger Free America CEO Joel Berg writes about what he discovered in a recent cross-country trip to celebrate his 20 years leading an anti-hunger organization. In visiting 37 states and making more than 80 hunger-related site visits, Berg says he found “persistent, systemic, food insecurity — with large numbers of people struggling to afford food — in virtually every rural area, city, and suburb I visited. While some Americans thought hunger was a brand-new phenomenon during the pandemic, that’s far from the truth. In 2019, when the economy was still theoretically strong and COVID-19 had yet to hit the U.S., 35 million Americans were food insecure, according to the USDA. Most were in working families, earning paltry incomes that didn’t fully cover their costs of housing, health care, transportation, utilities, childcare, prescription drugs, and yes, food. Then the pandemic hit, and things went from worse to worser. Tens of millions lost their jobs or had further reductions in their paltry incomes, leaving them with even less money for food. The 29 million U.S. children who relied on school lunches and breakfasts lost them virtually overnight and thousands of senior meals programs nationwide shuttered their doors. As I visited food charities from coast to coast this summer, I learned that two things that were true before the pandemic became truer than ever: one, that while nonprofit groups perform heroic work filling in gaps in the safety net, they can never do anything more than make a dent in the hunger problem, and; two, that the most impactful measures to reduce hunger in America, by far, are those funded by the federal government.” 

Expanded Child Tax Credit would lower child poverty under 10% in nearly all states: Details of a new Urban Institute study from Urban’s Elaine Maag: “The American Rescue Plan’s (ARP) expanded Child Tax Credit (CTC) would reduce child poverty in a typical year below 10% in 47 states — if it is extended beyond 2021. Absent an extension, child poverty in a typical year would be below 10% in just 13 states. A new study by my Urban Institute colleagues Greg Acs and Kevin Werner shows that, in a typical year, the expanded CTC would reduce child poverty from 14.2% to 8.4% nationally — a reduction of over 40%. Child poverty would remain above 10% in only three states — California, Florida, and Texas. In 11 states, it would be reduced by 50% or more. That means 4.3 million fewer children would be in poverty in a typical year.”   

A personal plea for fully funding home care: Be a Hero co-founder Ady Barkan writes in the New York Times about how crucial fully funded home care has been in his battle against A.L.S.: “Home care is literally keeping me alive. But across the country, almost a million children, adults, and seniors with disabilities sit on waiting lists for Medicaid’s home- and community-based care, in danger of being removed from their homes and sent to live in institutions. In his jobs and infrastructure plan introduced this year, President Biden proposed $400 billion for home- and community-based care. That’s what’s needed to clear the 820,000-person waiting list and provide professional caregivers — the majority of whom are women of color — with better wages. Funding for home care would also give new choices to the one-tenth of caregivers — most of whom are women — who were forced to leave their paid jobs or retire early to take care of a loved one. The significantly scaled-back bipartisan version of this plan eliminated the president’s proposal for in-home care funding. Republicans did not support the president’s original proposal, and even some conservative Democrats said we cannot afford it. The fate of the funding now depends on how hard the president, Senate majority leader Chuck Schumer and Speaker Nancy Pelosi fight for that commitment.” 

Briefing for September 9, 2021



Vast expansion in aid kept hunger from getting worse in U.S. last year: From the New York Times: “As 20 million jobs vanished at the start of the coronavirus pandemic and traffic jams formed outside food banks, many experts warned that the twin crises of unemployment and disease would produce soaring rates of hunger. But huge expansions of government aid followed, and data released on Wednesday suggests the extraordinary spending achieved a major goal: Despite shuttered businesses and schools, food insecurity remained unchanged from pre-pandemic levels. That result defied past experience, when recessions caused food hardship to spike. ‘This is huge news — it shows you how much of a buffer we had from an expanded safety net,’ said Elaine Waxman, who researches hunger at the Urban Institute in Washington. ‘There was no scenario in March of 2020 where I thought food insecurity would stay flat for the year. The fact that it did is extraordinary.’ The government found that 10.5% of American households were food insecure, meaning that at some point in the year, they had difficulty providing enough food to all members of the home because of a lack of money. It also found that 3.9% experienced ‘very low food security,’ meaning the lack of resources caused them to reduce their food intake. That was statistically unchanged from the previous year. Food insecurity did rise among some groups, including households with children, households with Black Americans, and households in the South. The gap between Black and white households, which was already large, widened further, with 21.7% of Black households experiencing food insecurity, compared with 7.1% of white households. That is a gap of 14.6 percentage points, up from 11.2 points in 2019, before the pandemic struck. Black households suffered disproportionately from job losses and school closings during the pandemic and had fewer assets with which to buffer a crisis.” 

California set to spend billions to try to end homelessness: Kaiser Health News reports on an ambitious new plan from California’s Med-Cal health insurance program to try to move beyond traditional doctor visits and hospital stays into the realm of social services. Under the program, vulnerable patients will be assigned a personal care manager to coordinate their health care treatments and daily needs like paying bills and buying groceries. “And they will receive services that aren’t typically covered by health insurance plans, such as getting security deposits paid, receiving deliveries of fruits and vegetables, and having toxic mold removed from homes to reduce asthma flare-ups. Over the next five years, California is plowing nearly $6 billion in state and federal money into the plan, which will target just a sliver of the 14 million low-income Californians enrolled in Medi-Cal: homeless people or those at risk of losing their homes; heavy users of hospital emergency rooms; children and seniors with complicated physical and mental health conditions; and people in — or at risk of landing in — expensive institutions like jails, nursing homes, or mental health crisis centers. Gov. Gavin Newsom is trumpeting the first-in-the-nation initiative as the centerpiece of his ambitious health care agenda — and vows it will help fix the mental health and addiction crisis on the streets and get people into housing, all while saving taxpayer money. His top health care advisers have even cast it as an antidote to California’s worsening homelessness crisis.” 

Long-haul COVID prompts calls for new disability investments: One of the many unknowns facing policymakers in the wake of the COVID-19 pandemic is the impact of so-called “long-haul COVID” — patients who suffer long-term, often incapacitating symptoms from the virus. Many disability rights advocates and experts fear long-haul COVID could add millions to the rolls of those needing disability benefits, a system that many feel is already overtaxed and underfunded. Megan Buckles, senior policy analyst for the Disability Justice Initiative at the Center for American Progress, took part in a recent webinar that focused on the issue while also marking the 31st anniversary of the Americans With Disabilities Act. Buckles spoke recently with Spotlight on Poverty and Opportunity about the need for disability aid reforms and the potential impact of long-haul COVID. 

Telehealth’s limits — Battle over state lines and licensing limits patient’s options: From Kaiser Health News: “If you live in one state, does it matter that the doctor treating you online is in another? Surprisingly, the answer is yes, and the ability to conduct certain virtual appointments may be nearing an end. Televisits for medical care took off during the worst days of the pandemic, quickly becoming commonplace. Most states and the Centers for Medicare & Medicaid Services temporarily waived rules requiring licensed clinicians to hold a valid license in the state where their patient is located. Those restrictions don’t keep patients from visiting doctors’ offices in other states, but problems could arise if those same patients used telemedicine. Now states are rolling back many of those pandemic workarounds. Johns Hopkins Medicine in Baltimore, for example, recently scrambled to notify more than 1,000 Virginia patients that their telehealth appointments were ‘no longer feasible,’ said Dr. Brian Hasselfeld, medical director of digital health and telemedicine at Johns Hopkins. Virginia is among the states where the emergency orders are expiring or being rolled back. At least 17 states still have waivers in effect, according to a tracker maintained by the Alliance for Connected Care, a lobbying group representing insurers, tech companies, and pharmacies. As those rules end, ‘it risks increasing barriers’ to care, said Hasselfeld. Johns Hopkins, he added, hosted more than 1 million televisits, serving more than 330,000 unique patients, since the pandemic began. About 10% of those visits were from states where Johns Hopkins does not operate facilities.” 

Classroom time isn’t the only thing students have lost: In an essay for the Atlantic, Baltimore high school English teacher Kelsey Ko writes about the trauma many of her students have endured during the pandemic: “As schools reopen their doors this fall, much of the national-media narrative around education has centered on learning loss. More than 1 million children were not enrolled in school this past year, and many of those children were kindergartners in low-income neighborhoods. The virtual landscape that students have had to navigate over the past year has been particularly challenging for our most vulnerable learners. Students living in historically redlined neighborhoods are the most likely to lack access to adequate technology and broadband connectivity. Here in Baltimore, one in three households doesn’t have access to a computer and 40% of households don’t have wireline internet service. We must address these problems. But as I prepare to welcome more than 100 ninth graders to my classroom this fall, I’m also concerned about the trauma that my students have endured during this pandemic, and how we can help support them as they transition back into school. Many of my incoming ninth graders have not set foot inside a physical school building since seventh grade, and in bringing their full, authentic selves into the classroom, they are also bringing all the emotional and personal difficulties they’ve experienced. Nearly one in five Americans knows someone who has died from COVID-19. For Black Americans, that number is one in three. We also know that COVID-19 can cause stress and trauma. Schools are a place for us to nurture the minds of future generations, and we must continue to help students learn to read and write and think. But we must not ignore the impact that this type of trauma can have on students’ long-term well-being and educational attainment. We must also help our children learn how to process the immense emotional and mental hardships they have experienced.” 

Briefing for September 8, 2021



Health care workers grapple with PTSD: Reuters reports: “The surging Delta variant is heaping on fresh trauma as the United States and other nations begin to study PTSD in health workers. Data already showed that U.S. health workers were in crisis before COVID-19. While PTSD is associated with combat, it can arise among civilians after natural disasters, abuse, or other trauma. Health workers can be reluctant to equate their experience with that of returning soldiers. ‘I feel like a schmuck calling it PTSD,’ [Milwaukee nurse Chris] Prott said. ‘It took me a long time to be able to talk to somebody because I see guys with real PTSD. What I’ve got going on, it’s nothing in comparison, so you feel guilty for thinking that.’ Psychiatrist Dr. Bessel van der Kolk knows better. ‘On the surface, a nurse at your local hospital will not look like a guy coming back from Afghanistan,’ said the author of ‘The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma.’ ‘But underneath it all, we have these core neurobiology-determined functions that are the same.’ Pre-pandemic studies showed that rates of PTSD in front-line health workers varied from 10% to 50%. The suicide rate among doctors was more than twice that of the general public.” 

Rural hospitals can’t find the nurses they need: A Stateline story published by the Daily Yonder finds that across the country, “thousands of hospitals are overwhelmed with critically ill patients, prompting many overburdened nurses to change careers or retire early. The shortages are particularly dire in rural areas, rural health experts say, because of the aging workforce and population, smaller salaries, and intense workload. Rural health care leaders have begun offering sign-on bonuses and benefit packages to combat shortages during the pandemic. But they’ve found that even those perks aren’t enough to keep or attract skilled health professionals. Instead, they say, the focus needs to shift to boosting nursing school enrollment and getting workers into the field faster. ‘It’s just very difficult to compete with some of the size and scale that bigger systems have,’ said Mary Ellen Pratt, CEO of St. James Parish Hospital in rural Lutcher, Louisiana. For decades, hospitals and clinics have struggled to recruit and retain enough doctors, nurses, and administrators. The problem is particularly acute in rural areas. The recent Delta surge has worsened the shortage, pushing some hospitals into crisis. State health officials in Nebraska are so desperate they are trying to recruit unvaccinated nurses from other states and from hospitals that require the vaccine.” 

States have money to spend on mental health, but it may not last: Stateline reports that at least eight states — Colorado, Illinois, Indiana, Maryland, Ohio, Virginia, Vermont, and Washington — have set aside millions of federal dollars for mental health and substance use disorder services, according to the National Academy for State Health Policy, a nonpartisan research organization with offices in Washington, D.C., and Portland, Maine. “Health officials in those states hope the influx of cash will be a game-changer. They’re planning to spend it on everything from mental health awareness campaigns to mobile crisis teams and bonuses for psychiatric hospital staff. But there’s a catch. After the relief funds run out — the money must be spent by the end of 2026 — state leaders will have to find other ways to fund any programs, services, or staffing increases they spend federal dollars on now. State leaders need to make sure they don’t start a successful new program only to get rid of it five years later, said Dr. Brian Hepburn, executive director of the National Association of State Mental Health Program Directors, an Alexandria, Virginia-based membership organization. ‘If it’s just a blip — if this is just a one-time only, and we’re only seeing an improvement over the next couple of years, that’s not very helpful,’ Hepburn said.” 

From cradle to grave, Democrats move to expand social safety net: Jonathan Weisman of the New York Times provides context on the historic, $3.5 trillion reconciliation bill the House takes up this week. “When congressional committees meet this week to begin formally drafting Democrats’ ambitious social policy plan, they will be undertaking the most significant expansion of the nation’s safety net since the war on poverty in the 1960s, devising legislation that would touch virtually every American’s life, from conception to aged infirmity. Passage of the bill, which could spend as much as $3.5 trillion over the next decade, is anything but certain. President Biden, who has staked much of his domestic legacy on the measure’s enactment, will need the vote of every single Democrat in the Senate, and virtually every one in the House, to secure it. And with two Democratic senators, Joe Manchin III of West Virginia and Kyrsten Sinema of Arizona, saying they would not accept such a costly plan, it will challenge Democratic unity like nothing has since the Affordable Care Act. That is largely because the proposed legislation would be so transformative — a cradle-to-grave reweaving of a social safety net frayed by decades of expanding income inequality, stagnating wealth, and depleted governmental resources, capped by the worst public health crisis in a century. The pandemic loosened the reins on federal spending, prompting members of both parties to support showering the economy with aid. It also uncorked decades-old policy desires — like expanding Medicare coverage or paid family and medical leave — that Democrats contend have proved to be necessities as the country has lived through the coronavirus crisis.” 

Modernizing SNAP after the pandemic: TheProgressive Policy Institute’s Director of Social Policy Veronica Goodman, writing for the Regulatory Review, calls for Congress and the Biden administration to take the lessons of the pandemic experience to heart while working to modernize the SNAP program. “U.S. policymakers should use the lessons from the COVID-19 pandemic and the Great Recession to ensure that Americans are better prepared to meet the next national emergency. Programs such as SNAP and unemployment insurance serve as countercyclical income boosts to families during downturns, and this spending also benefits the economy as a whole, staving off some of the worst effects of economic downturns. Throughout the pandemic, nearly 44 million individuals enrolled in SNAP — a more than 20% jump from about 36 million in 2019. Still, hungry families were forced to wait on Congress for relief despite historic levels of food insecurity. Congress should pass the Food for Families in Crisis Actintroduced by U.S. Senator Michael Bennet (D-Colo.), that would reform SNAP by implementing an ‘economic trigger to jumpstart automatic stabilizers’ if the economy meets certain conditions. If these conditions are met, SNAP would automatically increase by 15% until the economy recovers. In addition, the minimum benefit would increase to $30 and work requirements would be suspended for the duration of the crisis. These proposals would help get aid to families quickly, especially to those breadwinners who experience job losses and are unable to find stable employment.” 

Briefing for September 7, 2021



Millions in U.S. lose jobless benefits as aid expires: The New York Times reports: “Expanded unemployment benefits that have kept millions of Americans afloat during the pandemic expired on Monday, setting up an abrupt cutoff of assistance to 7.5 million people as the Delta variant rattles the pandemic recovery. The end of the aid came without objection from President Biden and his top economic advisers, who have become caught in a political fight over the benefits and are now banking on other federal help and an autumn pickup in hiring to keep vulnerable families from foreclosure and food lines. The $1.9 trillion economic aid package Mr. Biden signed in March included extended and expanded benefits for unemployed workers, like a $300-per-week federal supplement to state jobless payments, additional weeks of assistance for the long-term unemployed, and the extension of a special program to provide benefits to so-called gig workers who traditionally do not qualify for unemployment benefits. The expiration date reached on Monday means that 7.5 million people will lose their benefits entirely and another three million will lose the $300 weekly supplement. Republicans and small business owners have assailed efforts to extend the aid, contending that it has held back the economic recovery and fueled a labor shortage by discouraging people from looking for work. Liberal Democrats and progressive groups have pushed for another round of aid, saying millions of Americans remain vulnerable and in need of help.” 

Less than 12% of August job gains went to women: From CNBC: “After solid job growth in July, the economy has slowed, adding just 235,000 positions in August, according to the Bureau of Labor Statistics. That number is a lot smaller than the 720,000 new hires economists had predicted as a surge in COVID-19 cases disrupts economic recovery. Of the 235,000 jobs added, only 11.9% went to women, marking a sharp decline in women’s job growth from July, reports the National Women’s Law Center. There has also been a concerning drop in the number of women working or actively seeking employment. Women’s labor force participation rate decreased to 57.4% from 57.5% in July — before the pandemic, it had not dropped this low since 1988. ‘This was not a good month for jobs, especially right after July, when we saw over a million jobs added,’ Jasmine Tucker, director of research at the NWLC, tells CNBC Make It. ‘But the pandemic has made the market really volatile, so we should expect the economy to change month to month.’ Given the pandemic’s economic toll on women, the NWLC estimates that women would need about nine years of August’s job gains to return to pre-pandemic employment levels. The highly contagious Delta variant has made it even more difficult for working mothers to rejoin the labor force, Tucker explains, as schools shut down and there continues to be a lack of child care.” 

Experts fear Texas abortion law could disproportionately impact low-income women: NBC News reports that Texas pro-choice advocates fear the new state law drastically limiting the right to a legal abortion will disproportionately affect poor people who give birth, especially Black and Latino residents. “People would have to drive 248 miles on average to undergo the procedure out of state, up from 12 miles in state, according to the Guttmacher Institute, a nonprofit organization that researches reproductive rights. People with money could fly out of state to get abortions. But for those with lower incomes, work obligations, lack of transportation, and financial struggles could make it far more difficult to leave Texas. As many as eight out of 10 people who seek abortions could be forced to continue their pregnancies, according to the University of Texas at Austin’s Texas Policy Evaluation Project. Marsha Jones, executive director of the Afiya Center, which partners with abortion centers and provides people with resources to access safe abortion services, said laws like Texas’ only perpetuate poverty for poor and Black and Latino people. ‘When systems are in place that force folks to have children that they cannot take care of and there’s no system in place to assist them with taking care of those children, nothing but a system that penalizes our parenting, you’re creating generational poverty,’ Jones said.” 

Finding day care already was a ‘frustrating maze’ — and the pandemic made it worse: From USA Today: “For parents across the country, the process of finding and signing up for child care — and the government subsidies that help them afford it — has become more overwhelming than ever before. Quality early-learning options are in short supply across the country. Centers are understaffed, and case managers are overextended. Many families lack the time and savvy needed to land a seat at the programs that do exist. First, there’s the hassle of figuring out what’s available: Reliable, go-to directories listing up-to-date openings are rare, as are clear ratings of a program’s quality. Then there’s the time-consuming task of calling or visiting each of those providers to see where there are vacancies, filling out applications, and, sometimes, going through interviews. Then the months- or even years-long waitlists. Preschool admissions can be cutthroat. And for many low- and middle-income parents, there’s the added step of figuring out and applying for financial aid, which typically requires its own mishmash of procedures and paperwork. ‘Given today’s technology, it should be as easy to find child care as it is to make a dinner reservation,’ said Cara Sklar, the deputy director of early and elementary education policy at New America, a Washington, D.C., think tank.” 

New Orleans power failure traps older residents in homes: From the New York Times: “As the massive power failure in Louisiana stretched to its seventh day on Sunday, its disproportionate effect on New Orleans’ older residents was coming into grim focus. The deaths at the eight apartment buildings, where residents live independently, followed the deaths of seven people who had been moved from nursing homes in New Orleans to a warehouse that appeared to lack basic sanitation. More than 100,000 electric customers in New Orleans — about half of the city’s total customers — were still without power on Sunday. Entergy, which provides electricity to New Orleans, said it planned to restore service to most of the city by Wednesday, and utility workers could be seen pulling branches from downed power lines in a mad dash to turn the lights back on. But forecasters warned that New Orleans and other parts of Louisiana could feel as hot as 105 degrees on Sunday, a level deemed ‘dangerous’ by the National Weather Service. And without air-conditioners or fans, many residents were feeling the heat.” 

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