As we look back on the year, the communications team has rounded up 23 stories we published that show how Arnold Ventures worked to maximize opportunity and minimize injustice in 2023. We have deep dives into health care policy, bipartisan criminal justice reforms, interviews with new portfolio leaders and more. Take a look at the list below.
Melissa and Ann: Navigating America’s Tangled Health Safety Net
People with complex health care needs often receive health care coverage from two separate and disjointed government programs, Medicare and Medicaid. Follow along for a powerful, first-person look as Melissa and Ann, two so-called “dual-eligible” women living in southern California, navigate the fragmented U.S. health care system in search of care, resources, and support.
New Poll: Majority of Voters Support Aggressive Congressional Action to Lower Hospital Prices
About 40% of U.S. adults say they have delayed or gone without medical care due to cost, and more than 100 million Americans have medical debt. As health care costs continue to rise, new AV polling found nine in 10 voters say it is important for Congress to take action to reduce hospital prices — the primary driver of high health care costs for the privately insured. Further, a large majority of voters support many of the solutions that policymakers at the state and federal level are exploring to address out-of-control prices. These policies included requiring hospitals to publicly disclose their prices, limiting mergers and acquisitions, and limiting outpatient fees to the same price charged by doctors in the community, to name a few.
Why the Left, Right and Center All Agree on Site-Neutral Payments
Where health care services are provided can impact the cost of care. For example, Medicare pays between 106 percent and 217 percent more for services delivered in a hospital outpatient department compared to the same service performed in a physician’s office. Policy experts, stakeholders, and legislators across the spectrum are calling for legislation to expand “site-neutral payments” in Medicare to ultimately reduce health care costs for Medicare beneficiaries and taxpayers.
Site-Neutral Payments Could Mean Big Savings for Patients With Chronic Conditions
The Lower Costs, More Transparency Act is an important step in expanding site-neutral payments in Medicare. New research estimates if the legislation had been in place in 2021, total fee-for-service Medicare costs would have been $161 million lower. It’s estimated the highest need chemotherapy patients could save more than $1,000 per year on cost sharing under the Lower Costs, More Transparency Act. The Lower Costs, More Transparency Act passed in the House in December and will move to the Senate in 2024.
State by State, Lawmakers Aim at Affordable Prescriptions for All
Too many Americans cannot afford the drugs they are prescribed. To reduce what consumers and taxpayers pay for certain high-cost drugs, state legislators and governors across the country are taking action through the establishment of prescription drug affordability boards (PDABs). These independent state government entities have the authority to examine the high cost of prescription drugs and determine how to make them more affordable for residents.
What’s Going on with Medicare Advantage? Arnold Ventures Experts Explain.
On the heels of proposed changes to the way the Medicare program determines payments to Medicare Advantage (MA) plans, Arnold Ventures submitted a comment letter to the Centers for Medicare and Medicaid Services (CMS) outlining specific policy recommendations to strengthen program integrity and curtail excessive payments to MA plans. The letter urged the administration to do more to ensure the program is delivering value to both beneficiaries and taxpayers and reduce opportunities for MA plans to game the system and drive overpayments.
The Facts on New Jersey Bail Reform
New Jersey demonstrates that while concern over elevated levels of crime is legitimate, bail reform should not be made a scapegoat. In fact, our fact sheet shows that since 2015, bail reform has succeeded in dramatically reducing the number of people in jail while maintaining community safety. In particular, the pretrial jail population decreased by 20% between 2015 and 2022. Over roughly the same period, the state saw a decrease in overall crime and a decrease in violent crime steeper than the national average.
New Mexico Continues to Reform and Improve the Criminal Justice System
Despite a challenging political climate, several states passed important, evidence-based criminal justice reforms in 2023. One of these was New Mexico, which passed a series of landmark justice reform bills, including: ending the practice of suspending driver’s licenses due to court debt, failure to pay, or failure to appear; allowing people who received life sentences when they were under 18 to be eligible for parole hearings 15 to 25 years into their sentences (depending on the conviction); expanding and fixing the process for compassionate release; and strengthening the standards to be a licensed law enforcement officer and the grounds for decertification.
With a Broad Coalition, Minnesota Overhauls Its Criminal Justice System
Another state that enacted a wide range of criminal justice reforms this past year was Minnesota. Specifically, the state legislature passed a sweeping criminal justice omnibus bill, SF 2909, that was then signed by Governor Tim Walz. Among other things, the bill: eliminated juvenile life without parole; limited no-knock warrants; restricted probation terms to five years or less; introduced prosecutor-led sentencing; created an Office of Restorative Practices and an Office for Missing and Murdered Black Women and Girls; appropriated funds for free prison phone calls; funded a study of pretrial release practices and bail; and expanded compassionate release.
Of particular concern to many criminal justice advocates and stakeholders is the growing crisis in corrections. Decades of over-incarceration and under-resourcing have intersected with severe staffing shortages to create dangerous conditions within prisons that negatively affect incarcerated people and staff alike. For instance, a new report shows that correctional staff experience violence at a rate 36 times higher than all other American workers, and approximately 35% of incarcerated men reported being physically victimized in the previous six months while in prison. As a result of these and other experiences, many staff and incarcerated people are suffering from post-traumatic stress syndrome, and both officers and incarcerated people have significantly reduced life expectancy.
One state that began the process of addressing the corrections crisis in 2023 was Arizona. Motivated by reports that the state’s prison system is beset by crumbling infrastructure, poor health care, and pervasive violence, Gov. Katie Hobbs signed an executive order creating an independent prison oversight commission. The commission including public officials alongside representatives from various stakeholder groups, including corrections officers and incarcerated people. Advocates in the state hope that the executive order and the commission’s subsequent recommendations will spur policymakers in the legislature to enact further reforms.
One of the organizations involved in the effort to create a prison oversight commission in Arizona was FAMM. In the summer of 2023, FAMM’s former president Kevin Ring joined Arnold Ventures as our new vice president of criminal justice advocacy. In an interview after his arrival, Ring discussed his belief that we can create a more equitable and humane justice system while at the same time improving community safety and well-being. He also revealed how two books, The Blank Slate by Steven Pinker and Non-Zero by Robert Wright, changed the way he saw the world.
One of Ring’s priorities was to continue AV’s relationship with criminal justice advocacy partners from across the political spectrum. This includes conservative organizations and policymakers who are willing to challenge traditional, failed “tough-on-crime” approaches and advance evidence-based solutions. In 2023, numerous conservative organizations and lawmakers were on the cutting edge of criminal justice reform across the country. This includes groups like Conservatives for Criminal Justice Reform in North Carolina, R Street Institute, Americans for Prosperity, the American Conservative Union, the American Legislative Exchange Council, Right on Crime, and many others.
In May, AV interviewed Jillian Snider, R Street’s policy director of the criminal justice and civil liberties team and a former NYPD police officer. Snider discussed how R Street advocates for police accountability and improved police community relations by supporting citizens review boards, data collection, alternative crisis response models, and better police officer training, among others. She also discussed how recruitment and retention of police officers is a pressing issue, and part of the solution is to pay better attention to the mental health needs of officers.
Alternative crisis response models, like those mentioned by Snider, gained traction in several cities and states during 2023. For instance, a cohort of cities in North and South Carolina have started using data to understand and improve their 911 systems. They have found that a large proportion of 911 calls were unrelated to criminal activity, and responding to them cost police departments thousands of hours of officers’ time that could be used elsewhere. The goal of these efforts is to ultimately design new 911 responses that would reduce unnecessary police involvement and deliver better outcomes for individual and community safety and health. This can include dispatching mental health professionals to certain calls, partnering clinicians with traditional law enforcement responders, and offering other supportive services to people who are experiencing a crisis.
The desire to make policing more effective, fair, and accountable is an issue that connects academics and activists, police union leaders and politicians, Republicans and Democrats. And it was a priority for Arnold Ventures in 2023. In addition to alternative crisis response models, other areas of interest for AV this past year included Place Network Investigations (PNIs), which is a process of interrogating why crime occurs in certain areas and then working with an array of stakeholders including, but not limited to, law enforcement to develop a specific strategy to address it. Another was procedural justice and de-escalation training, which has been shown to result in fewer arrests, less crime, and more positive interactions between police officers and the community. And a third was finding ways to help law enforcement improve clearance rates (the percentage of reported crimes that result in an arrest).
Celebrating Innovative Supervision Leaders During PPPS Week
All of AV’s criminal justice portfolios, including policing, are built on the understanding that the vast majority of the people who work in the criminal justice system are dedicated public servants – many of whom are the the loudest and most authoritative voices for reform. For instance, in the community supervision system (probation and parole), there are numerous departments and department leaders who are implementing evidence-based practices that use jail sparingly, support people on community supervision, and uphold community safety.
One of Arnold Ventures’ higher education policy goals is to help students avoid low-quality, low-value schools that deliver junk degrees and unpayable debt. But how do you measure the value of an education? We interviewed Stephanie Cellini, a researcher and professor in the Trachtenberg School of Public Policy and Public Administration at George Washington University, about the different ways that the Department of Education can identify low-value programs and make that information available to students and families.
After the U.S. Supreme Court rejected the Biden administration’s attempt at broad-based student debt forgiveness and the White House began to pursue other tracks, Arnold Ventures CEO Kelli Rhee weighed in with an alternative idea — tackle the causes of the student debt crisis rather than just the symptoms. “By instead focusing on holding colleges accountable for their value and ensuring borrowers have the support they need, it could make a meaningful and tangible difference in the lives of students and borrowers — improvements that will endure well beyond Joe Biden’s tenure as president,” Rhee wrote in a CNN op-ed. Her opinion piece followed one published by Laura Arnold, AV co-founder and co-chair, which ran on CNBC.com.
In a striking mix of personal essay and policy deep-dive, R.J. Wicks, a higher education intern, shared the story of a classmate who landed a spot at her dream college only to face struggles beyond the expected academic challenges. Financial and emotional burdens, combined with tuition and living costs, eventually led her to drop out. As Wicks explains, evidence-based student success programs like the City University of New York’s (CUNY) Accelerated Study in Associate Programs (ASAP) initiative can help prevent students from slipping through the cracks and help them complete their college journeys.
Arnold Ventures officially launched our infrastructure portfolio this year, and we kicked off that announcement via a Q&A with Charlie Anderson, our new executive vice president of infrastructure. In the fun and engaging interview, Charlie talked about how AV could help the country build faster, at lower cost, and better by expanding the evidence base about what works and what doesn’t and enacting policy changes in housing, clean energy, transportation, and other infrastructure-related fields.
International tax law got the spotlight at the Supreme Court this year, where a case on the validity of a $15,000 tax bill has the potential to upend a third of the U.S. tax code. Executive Vice President George Callas, who worked on the 2017 tax code central to the case, was tapped by publications across the country to weigh in. Read his insight on the case in The Washington Post, Bloomberg, and elsewhere.
Meet Justin Milner, Arnold Ventures’ new executive vice president of evidence and evaluation. With a diverse background leading both five-year-olds and policy wonks, Milner has worked with research via multiple avenues. Find out more about his vision for the department and the evolving world of evidence.