Recalling the Biggest Social Policy Developments of 2014

 

As 2014 comes to a close, some of Heller’s faculty and researchers are looking back at the biggest developments, good or bad, in their respective areas of focus. There are a variety of issues and items covered, but they all had—or promise to have—a notable impact on social policy and practice.

Thomas McLaughlin, Adjunct Lecturer

I work a lot with Massachusetts human service organizations, and I think the biggest story for that field in 2014 was the election of Charlie Baker. He was well known to these organizations because of his prior government work and, to a lesser extent, his CEO role at Harvard Pilgrim. The significance of his election is that he is a classic Massachusetts Republican, meaning that he would be viewed more as a conservative Democrat in other states.

This is the only Massachusetts gubernatorial election that I can remember in which the nonprofit community (especially the executives) was overwhelmingly in favor of the Republican. By the time his first term is up, he will have presided over the initial wave of baby boomer retirements in the field, and possibly another recession (they seem to come about every seven years lately). His decisions will affect Heller School graduates, faculty, and potential students, even though we won’t necessarily be aware of it at the time. 

Michael Doonan, PhD'02, Associate Professor and Director, Heller MPP Program

Obamacare was a big winner in 2014. The health care sky did not fall. The administration reversed the debacle of Healthcare.gov and a less-than-auspicious program rollout. The number of uninsured is down by 11 million or 25 percent. Forbes reported that employers saw the smallest increase in health insurance premiums in 15 years. The Kaiser Family Foundation reported that health care costs rose at the modest rate of 2.8 percent, which is far lower than the recent double digit increases. Kaiser also reported that over 75 percent of Americans favor major components of the law: marketplaces, subsidies to individuals, and the Medicaid expansion. An increasing number of Republican-led states are expanding their Medicaid programs and covering increasing numbers of the least advantaged.

However, the program is not out of the woods yet, and challenges in 2015 could be steep. First, the Supreme Court will rule on whether the federal government can provide subsidies in states that choose not to create their own health insurance marketplaces. A negative ruling would take insurance subsidies away from many and hobble the law. Second, the Republican-controlled Congress could begin to defund parts of the law in a series of mini and major fights with the administration.

Laurence Simon, Professor of International Development

Brandeis established the Center for Global Development and Sustainability at the Heller School. The Center, which brings together experts from around the university to work on problems of vulnerability in developing countries, is led by myself, with principal investigators Dr. Joseph Assan, Dr. Rajesh Sampath, and Dr. Ricardo Godoy.

The Center launched an Applied Knowledge Network for sharing research and implementation strategies for helping community-based livelihoods adapt to climate change. The first meeting of the network was held in November at the Blaustein Institutes for Desert Research (Ben Gurion University) in Israel. Network representatives came from organizations in West and East Africa, Mongolia and India—all countries experiencing desertification. One member organization, the Ethiopia-based Horn of Africa Environment Center and Network, represents over 400 cooperatives in eight countries of East Africa. In addition, researchers from Oxford University and the University of Liverpool were represented.

Constance Horgan, Professor and Director, Institute for Behavioral Health and Dominic Hodgkin, Professor

In January 2014, major aspects of the Patient Protection and Affordable Care Act of 2010 (ACA) were implemented, including coverage expansion and patient protections with respect to pre-existing conditions and annual limits. The ACA is having a profound impact on all aspects of health care delivery in the U.S. In particular, the ACA, combined with previous federal parity mental health and addiction legislation, is of benefit to individuals with behavioral health conditions because of provisions to increase access, improve quality, and enhance integration with medical care. The ACA goals are accomplished through two major forces: coverage expansion and delivery system reform. Coverage expansion includes both people and services: individuals who were previously uninsured, and mental health and addiction services inclusion as an essential health benefit to be covered no more restrictively than medical services. Delivery system reform includes the encouragement of both new delivery approaches that enhance coordination and integrate care across types and levels, and new payment strategies that reward performance. Several projects within the Institute for Behavioral Health focus on how federal health reform and parity legislation may aid in improving access to and quality of behavioral health care through delivery and payment system reform.

Robert Tannenwald, Adjunct Lecturer

To me, the most significant development in the field of state and local taxation in 2014 was the spread and intensification of the "Heartland Rebellion," the use of "supply-side" tax cuts to combat high unemployment and sluggish economic growth. Especially in the Mid-West, many states have cut their personal income tax rates, even in the face of large structural state deficits, on the theory that the resulting incentive to work and entrepreneurship will give their economy a large, quick boost. In Kansas, the poster child for this supply-side approach, large deficits have developed directly as result of such tax cuts, forcing significant reductions in vital public services, including K-12 education. The Heartland Rebellion reflects the large political gains made by extreme fiscal conservatives over the past four years at the state level. It will be interesting to see if their supply-side growth formula works and, if not, how their political fortunes might change.

Margie Lachman, Minnie and Harold Fierman Professor of Psychology

Brandeis was recently notified of a $1.5 million grant from the National Institute on Aging (NIA) for an Edward R. Roybal Center for Translational Research on Aging. The Roybal Centers are intended to stimulate broadly based multidisciplinary research that improves the health, wellbeing, and productivity of older adults. The overarching goal of the Roybal Centers is the translation of research into practical applications that can be moved quickly into practice and policy.

The Boston Roybal Center for Active Lifestyle Interventions (BRC), based at Brandeis, represents a consortium of five universities in the Boston area: Brandeis, Boston University, Boston College, Hebrew Senior Life (HSL), and Northeastern University. As the principal investigator for the Center, I feel fortunate to be able to work with a stellar interdisciplinary team of investigators who bring the extensive combined resources of multiple universities and professional perspectives to the Center.

We will use the Center resources to develop novel, evidence-based strategies to motivate and support active and engaged lifestyles especially with vulnerable populations at risk for poor aging outcomes. This will involve changing attitudes, teaching skills, reducing sedentary time, and changing environmental supports at work, home, and in the community. We hope to work together with corporations, industries, community agencies, and government to develop effective tools and practices to facilitate active lifestyles throughout adulthood.  We will apply what we learn from the Center research projects to develop programs and policies that improve physical, cognitive and psychological health by incorporating activity into daily lives.

Peter Kreiner, Senior Scientist, and Thomas Clark, Senior Research Associate

At the request of Massachusetts Governor Deval Patrick, Brandeis’ Prescription Drug Monitoring Program Center of Excellence (COE) hosted the kick-off meeting of the New England Regional Opioid Initiative in June. The regional initiative, spearheaded by Governor Patrick and Governor Peter Shumlin of Vermont, is intended to coordinate individual states’ efforts to address opioid overdoses and opioid overdose deaths, which have become a major, shared problem in New England. A follow-up, daylong working meeting of state health commissioners, substance abuse prevention and treatment heads, and law enforcement leaders, expanded to include New York in what has been renamed the Northeast Regional Opioid Initiative, also took place at Brandeis in August. The COE, entering its sixth year funded by the Department of Justice, Bureau of Justice Assistance, provides a clearinghouse of information on prescription drug abuse and state prescription drug monitoring programs (PDMPs), identifies and studies PDMP best practices, and develops methods and tools for evaluating PDMP effectiveness.

Rajesh Sampath, Assistant Professor

In April, the U.S. Supreme Court upheld Michigan’s 2006 state amendment banning the use of race-based preferences in the undergraduate admissions process for public universities (Schuette v. Coalition to Defend Affirmative Action). In essence, the justices’ decision said it is not for the Federal Constitution, the courts, and their precedents to decide whether a state should implement race-based preferences in its public universities’ admissions process. This should be left up to the people at the ballot box or their elected legislatures. 

Assuming that many educational benefits ensue from more diverse student body populations, which then impact issues of opportunity, equity and success later in life, there are many social policy questions at the intersection of race, justice, equality and the law. The key issue for social justice matters is whether these state constitutional bans will create stark differences in which some racial groups will enjoy future positions of power, prestige, wealth, and influence, while other major minority groups, which are increasing their percentage of the overall population, will be systematically excluded from such opportunities.

In light of the recent tragic events in America, which have brought racial injustice once again to the forefront of our society’s deepest concerns, we should take heed about these momentous decisions flowing from today’s Supreme Court. Does preserving the Constitution’s sanctity—by balancing states’ autonomy and the people’s self-determination with the judiciary’s power to question state laws—supersede all other social matters of urgent concern? Do we run the risk of creating two societies of a privileged few and an underprivileged majority in which the latter will be disempowered based on current judicial decisions? The solutions to these questions will hinge on to what extent the Supreme Court can strike a balance between attempting to interpret the letter of the Constitution, which is its historic mission, and recognizing the consequences of certain decisions that have the utmost significance for deciding supra-legal matters of race, equality and justice in a society as complex as American society.