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The Abstract
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> By Stephanie DiCapua Getman, Arnold Ventures
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AV Executive Vice President of Health Care Mark E. Miller writes this week about Medicare Advantage:
The Medicare Advantage plan industry has been spending millions of dollars on ads — including high-visibility spots during Super Bowl LVII — and dispatching their $18 million CEOs to Capitol Hill to deliver this important message: “We aren’t being paid enough.”
Medicare Advantage plans — alternatives to traditional Medicare coverage that are run by private companies — are paid more than $450 billion annually, financed in part through premiums paid by beneficiaries who are older and have disabilities. Plan payments were increased by more than 8% last year and will increase another 1% this year. And the insurers are characterizing this as a “cut.”
AV is setting the record straight on Medicare Advantage.
There is clear evidence that Medicare Advantage plans are overpaid. Instances of abuse and even fraudulent billing practices have been well documented, and overpayments are projected to cost taxpayers an estimated $27 billion in 2023. More than 30 million people are enrolled in Medicare Advantage plans.
Arnold Ventures sent a comment letter to the Centers for Medicare and Medicaid Services (CMS) that urges the administration to do more to curtail excessive payments to Medicare Advantage plans than it outlined in recent proposed technical changes.
Medicare Advantage plans have claimed that these changes will result in substantial benefit cuts for beneficiaries. That is misleading. Even the CEO of the second-largest Medicare managed care plan says as much: “We found that in years that there’s pressure on the rate notice, we do much better,” said Bruce Broussard, president and CEO of Humana. “I feel that 2024 will be that way.”
The Biden administration should not bend to the pressure of industry-spun narratives.
It must instead follow the evidence and guard against abuse and waste within the Medicare program to preserve and protect it for future generations.
Read the story >
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By Stephanie DiCapua Getman, director and managing editor
“Tár” and “Top Gun: Maverick” could not be more different films, but both are among the 10 Best Picture nominees at this year’s Academy Awards. That’s because the slate of nominees was chosen using ranked-choice voting (RCV), a method increasingly adopted by localities across the country to make election results more fair and representative. Ranked-choice voting will also determine the winner of the Best Picture category Sunday night. (Here’s a video primer on how it works, using movie snacks as a stand-in for films.)
What’s Happening: As AV grantee FairVote reports, the Oscars use multi-winner, proportional ranked-choice voting (PRCV), which is considered the “gold standard” of RCV and the basis of the Fair Representation Act. “It ensures that winners (or in this case, nominees) are chosen in proportion to the share of votes cast, and that nearly all voters will help elect a candidate (nominee) that they support. In other words, ‘PRCV’ is how to make a representative body truly, well… representative,” writes FairVote.
Why it Matters: Just as ranked-choice voting results in Oscar nominees that represent the breadth and depth of a given year’s film canon, when used in political elections, it ensures winners best represent all of the people they are serving.
It also engenders more civility in political races and incentivizes candidates to appeal to a wider swath of voters, rather than just their partisan base. Take the recent Alaska gubernatorial election, in which Democrat Mary Peltola defeated Republican Sarah Palin in a race that employed RCV. As Ryan Williamson of R Street Institute, a free market, limited government think tank, tells Reason Magazine, "RCV leads to less divisiveness, not more. The new system forced candidates to appeal to a broader range of voters in order to win. That's something Peltola did well that Palin did not.”
What’s Next: Momentum for this nonpartisan voting reform is quickly growing. When the Oscars adopted RCV in 2009 (thanks to outcry over Christopher Nolan’s “The Dark Knight” being overlooked), just four cities used it. Today, more than 60 states, counties, and cities use some form of ranked-choice voting. And just this week, voters in Redondo Beach, California, and Burlington, Vermont, voted to adopt or expand RCV in local elections.
No matter which film takes the Oscar home this weekend, the big winner, it seems, is ranked-choice voting.
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Changes to Federal Policy
Could Remove Loan Barriers
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By Michael Freidrich, ArnoldVentures.org contributor
The Small Business Administration (SBA) has begun taking steps to lift restrictions that exclude people with criminal records from borrowing money.
What’s Happening: In June 2020, a change to relax requirements for PPP loans made it easier for applicants with criminal records to access emergency funds during the COVID-19 pandemic. Last year, the SBA removed a “good character” requirement that blocked justice-involved people from participating in another of its programs and now it is soliciting public comment on a proposal to scrap the requirement altogether.
Why it Matters: People with criminal records often start small businesses as a response to discrimination and exclusion by traditional employers. But they face challenges when trying to access capital through the SBA, the federal agency that connects small businesses with lenders. Experts say that entrepreneurship is important to reducing recidivism, that a past criminal record has no proven bearing on whether or not a person repays a loan, and that reducing barriers to borrowing is critical to the economic and social health of local communities.
What’s Next: This year, the SBA is considering a rule change that would do away with “good character” requirements altogether. Advocates consider the SBA's changes an encouraging sign, one that has the potential to affect billions of dollars in loans for small businesses and expand the Biden administration’s commitment to providing second chances for people with criminal records.
Read the story >
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Who's Maximizing Opportunity
for Affordable Housing
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By Evan Mintz, director of communications
Community Housing Capital (CHC) on Wednesday announced a new $34 million fund to increase access to affordable housing for people of color and support developers of color.
What's Happening: The new BIPOC Fund is made possible by a $17 million commitment from Arnold Ventures, with another $17 million from CHC's own capital. This fund will preserve naturally occurring affordable housing and enable the building of new units for families across 12 southern states and Washington, D.C.
Why it Matters: The United States suffers from a wide and persistent racial wealth gap, and housing security and affordability are key to building intergenerational wealth. At the same time, research finds that Black and Latino developers lack access to capital necessary to invest in their communities.
What's Next: The BIPOC Fund will offer pre-development loans, land loans, bridge multi-family acquisition loans, and revolving lines of credit in addition to strategic guidance, prioritizing minority-led nonprofit housing developers.
“We believe that developers of color are an essential partner in closing the affordable housing gap in America — especially in communities of color,” said Chris Hensman, director of new programs at Arnold Ventures.
Read the story >
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Criminal Justice
- The Houston Chronicle editorial board discusses the merits of gun buyback programs and cites AV's Director of Criminal Justice Asheley Van Ness on options that may be more effective at reducing violence.
- Pennsylvania Gov. Josh Shapiro's 2023 budget proposal includes $10 million for public defense, the Pennsylvania Capital-Star reports. Pennsylvania is currently one of only two states in the nation that does not provide any state funding for indigent defense.
- The Crime Report highlights AV-supported research from the Council on Criminal Justice that suggests reducing long sentences by even modest margins could significantly decrease prison populations without harming public safety.
- Seventeen states have recently attempted to pass bills that would strip powers from reform-focused prosecutors, The Intercept reports. The article cites a new report published by the Local Solutions Support Center and the Public Rights Project, an AV grantee.
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The Miami-Herald discusses how Florida’s continuing practice of charging fines and fees to juveniles encountering the justice system is racially and economically inequitable, counterproductive, and inefficient. The article cites AV-supported research conducted by Alex Piquero at the University of Miami.
Health Care
- Dozens of consumer and patient advocates are pressuring the Biden administration to do more to protect Americans from medical bills and debt collectors, KHN reports. (100 million Americans carry medical debt).
- Eli Lilly's insulin cuts have nothing to do with charity and will instead save the company millions of dollars it would have paid in rebates to state Medicaid programs in 2024, policy experts tell Politico.
Higher Education
- AV grantee Preston Cooper of FREOPP released the accountability-focused Aligning Higher Education’s Cost and Value proposal, which describes a comprehensive set of reforms that aim to ensure students and taxpayers receive a return on their investment in higher education.
- AV grantee Public Agenda released a report comparing alumni experiences with online degrees at for-profit and nonprofit colleges. The report finds that more nonprofit online alumni are satisfied with their colleges, think their degree has paid off, feel that their college prioritized students over profit, and felt more supported from college staff, compared to their for-profit counterparts.
- In preparation for the National Advisory Committee on Institutional Quality and Integrity's (NACIQI) first meeting of the year, the Center for American Progress wrote a report on the role the committee plays within the higher education accreditation system.
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Katherine Knott at Inside Higher Ed looks at what happens to the cohort default rate, a school accountability measure, when the default rate goes down thanks to Biden's student loan plan; AV Higher Education Fellow Clare McCann proposes an alternative measure.
Public Finance
- Wendy Edelberg and Melissa S. Kearney at The Hamilton Project outline a plan to simplify and expand the Child Tax Credit.
- William Gale and Kyle Pomerleau explain why the FairTax — a proposal that seeks to replace nearly all federal taxes with a 23% national sales tax — would fall trillions of dollars short from existing revenue expectations in AV grantee the Urban-Brookings Tax Policy Center’s blog.
- Also for the Tax Policy Center blog, C. Eugene Steuerle corrects the record on the structure of Social Security and what needs to be done to restore the program’s solvency.
- In The New York Times, Alicia Parlapiano, Margot Sanger-Katz, and Josh Katz lay out what level of program cuts, tax increases, or both would be required to balance the budget given promises to keep reforms to programs like Social Security and Medicare off-the-table.
Journalism
- The Center for Public Integrity is making data more accessible to journalists through its acquisition of The Accountability Project, a platform that lets reporters comb through 1.8 billion public records.
- Congratulations to AV grantees Kaiser Health News, the Center for Public Integrity, The Markup, Type Media, and the International Consortium of Investigative Journalists for their recognition by the Society for Advancing Business Editing and Writing (SABEW) Best in Business Awards.
Also
- Time profiles AV grantee the Niskanen Center, calling it "a little-known think tank that may be the most interesting institution in D.C."
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- AV grantee Sheena Meade, executive director of the Clean Slate Initiative, hosts an episode of "Our Voice" featuring James Cadogan, executive director of the National Basketball Social Justice Coalition and formerly of AV. They discuss removing barriers to mobility for people seeking a second chance after coming into contact with the criminal legal system.
- Watch a virtual conversation hosted by AV grantee The Urban Institute, "Prison Research Meets Practice: A Conversation on Restrictive Housing," featuring Keramet Reiter, Sara Sullivan, and David Pitts. Restrictive housing isolates an incarcerated person to their cell for all but an hour per day, sometimes for months or years, and research has shown it can result in negative health outcomes.
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- In honor of Women's History Month, check out this playlist "How She Works," highlighting amazing women in diverse careers.
- Octogenarian Delia Barry knitted sweaters for the Oscar-nominated “Banshees of Inisherin.” Now she's gone viral on Instagram and TikTok.
- Elizabeth Smart was rescued from her kidnappers 20 years ago. Today she helps others fight back and heal from trauma.
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Have an evidence-based week,
– Stephanie
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Stephanie DiCapua Getman develops and executes Arnold Ventures' digital communications strategy with a focus on multimedia storytelling and audience engagement and oversees daily editorial operations and design.
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