The Washington Post - USA (2021-10-23)

A4 EZ SU THE WASHINGTON POST.SATURDAY, OCTOBER 23 , 2021

to the pandemic because, as GAO officials wrote, people with chronic ailments are more likel y to be hospitalized or die of covid- 19 than people without them. And the chronic condition of being a person of color means they also are more likely to be hospitalized or die of covid-19 than White Americans. Centers for Disease Control and Prevention data say that compared with the White population, the covid-19 death rate among Black people is two times greater; Hispanic people, 2.3 times; Native Americans, 2. times. A White House fact sheet issued Tuesday credits Biden’s programs with significant progress in closing the racial coronavirus vaccination rate since May. Now Black, Brown and White rates for first injections are all in the 70 percent-plus range. This represents increases of more than 14 percentage points for Black Americans and Hispanics. A federal strategy is needed to improve coordination of diet- related programs that combat chronic conditions, according to GAO, which said certain conditions hit men, Black Americans and people living in

the South particularly hard. Furthermore, GAO added in a paper last month, “implicit biases and misperceptions about people from various racial and ethnic groups, especially for Black women, can exacerbate disparities by race and ethnicity in access to care.” Just like chronic diseases are preventable, so are health inequities. In addition to the coronavirus, the report points to “worse health care outcomes” by race in maternal mortality and among veterans. Of course, the death rate is the most telling health statistic. The life expectancy for White Americans born in 2020 was 78 years; for Black Americans, 72 years, according to the CDC. Despite other adverse indicators, the life expectancy for Hispanic Americans was 79.9 years. A federal strategy to correct systemic inequities needs good data. But GAO and members of Congress say there are holes in the information and other problems that hinder a robust res ponse. There are racial and ethnic data gaps for coronavirus testing rates, cases, hospitalizations,

deaths and vaccinations, GAO’s paper found. The gaps are huge. “Race and ethnicity information sent to CDC was incomplete for almost half of reported COVID- cases (47.2 percent) and for people who received at least one vaccination dose (46.7 percent),” GAO said in March. In 2019, GAO reported “weaknesses in the completeness and accuracy” of Department of Veterans Affairs health records, including “conflicting race and ethnicity information.” GAO concluded the data gap could hinder the government’s ability to identify and combat health disparities. In the case of the coronavirus, GAO suggested giving CDC the authority to require states and localities to report coronavirus cases and deaths by race and ethnicity, a power now absent. GAO urged VA to assess the accuracy of racial and ethnic data in its electronic health records. Agencies across the government are ill-equipped with the data needed to advance racial equity, two Democratic congresswomen told Susan Rice, Biden’s domestic policy council director, and acting Office of

Management and Budget director Shalanda Young. The le tter last week from Reps. Carolyn B. Maloney (N.Y.), chairwoman of the House Committee on Oversight and Reform, and Ayanna Pressley (Mass.) says implementing Biden’s January executive order, which calls for “an ambitious whole-of- government equity agenda,” requires the “collection of data that aligns with an up-to-date understanding of people’s identities and that reflects how diverse groups are differently situated. Most federal agencies do not yet collect this type of data.” Young acknowledged the problem in a r eport to Biden about methods to assess equity. “It is a difficult realization that Federal agencies have not fully delivered value to all of their constituents,” she wrote in July. “It is disheartening when a data scan reveals results that are at odds with organizational intentions and core national values. And yet, it is only through this ethic of learning and a commitment to evidence that governments become truly able to serve their people.” [email protected]

That the coronavirus is an especially vicious killer in Black and Brown communities is well-known. Less evident, but of real concern, is the federal government’s fragmented response to health care, compounded by the need for better data collection. Both hamper improved federal services, including the fight against systemic racism and implicit bias in federal programs, a ba ttle President Biden promised to wage. The opening line in an August government watchdog report is a zinger: “Many chronic health conditions are preventable, yet they are leading causes of death and disability in the United States.” This Government Accountability Office (GAO) study identified 200 federal efforts to improve diets and fight chronic disease and found the programs were “fragmented across 21 agencies.” That problem relates directly

Federal Insider JOE DAVIDSON

L acking data hinders Biden’s push for racial equity in health care

BY MICHAEL SCHERER

Neera Tanden was named the
next White House staff secretary
on Friday morning, putting her
in the nerve center of the build-
ing charged with overseeing the
paper flow for President Biden,
according to a White House
official briefed on the move.
White House Chief of Staff
Ron Klain announced the move
in a morning staff call.
Tanden has been working for
Biden since May and will also
retain her current title of White
House senior adviser, which has
allowed her to advise the presi-
dent on a wide
range of is-
sues, the per-
son said.
Tanden will
replace Jessica
Hertz, a for-
mer Obama
administra-
tion attorney
who worked
more recently
in the government affairs office
of Facebook. White House offi-
cials have praised Hertz as a
highly regarded and well-liked
member of the team.
Hertz will leave the job on
Friday, a planned departure that
was first reported by Politico last
week, and Tanden will start on
Monday, the official said.
The staff secretary, who re-
ports to the chief of staff, tradi-
tionally plays the role of both
traf fic cop and honest broker in
the White House, with control
over the documents that make it
to the president, whether they be
briefing books or decision mem-
os laying out the arguments on
major decisions.
The post of White House staff
secretary has often served as a
steppingstone for other roles in
government. Former White
House counsel Harriet Miers,
Supreme Court Justice Brett M.
Kavanaugh and former White
House chief of staff John D.
Podesta, a mentor for Tanden, all
previously held the job.
“She is uniquely suited to the
role because she is a lawyer,
which is important, she is tough,
and she will discipline important
decision-making inside the
White House,” Podesta said. “You
have to be able to spot that there
is something missing, some per-
spective that wasn’t reflected.”
She is well known in Washing-
ton as a policy wonk and political
strategist. She came to the White
House from the Center for Amer-
ican Progress, the liberal think
tank where she had served most
recently as president and chief
executive and before that as a
deputy to Podesta, who founded
the think tank.
Biden nominated Tanden last
year to become his director of the
Office of Management and Budg-
et, but the White House with-
drew her nomination in March
after it became clear that she
lacked the votes to win Senate
confirmation. Multiple lawmak-
ers, including Joe Manchin III
(D-W.Va.), objected to partisan
comments she had previously
made on social media.
Tanden, who is Indian Ameri-
can, would have been the first
Asian American woman to serve
as director of the Office of Man-
agement and Budget. After her
nomination was withdrawn,
Asian American leaders — who
had already been concerned
Tanden would not be confirmed
— intensified their criticisms
that Biden’s Cabinet would not
have sufficient Asian American
representation, especially in its
secretary-level positions.
Tanden previously served as a
senior adviser for health reform
at the Department of Health and
Human Services and a policy
adviser to the 2008 presidential
campaigns of both Hillary Clin-
ton and Barack Obama.
In the current White House,
Tanden has helped lead the ex-
ternal political effort to pass the
Biden economic agenda. She has
also been overseeing a review of
the U.S. Digital Service, a group
of technologists who design and
maintain the federal govern-
ment’s technology infrastruc-
ture.
[email protected]

Amy Wang contributed to this report.

Tanden is

named sta≠

secretary

for Biden

Onetime OMB nominee gets a key role in White House decision-making

Neera Tanden

sue anyone who helps a woman obtain an abortion after cardiac activity is noted in the embryo, as early as about six weeks. The Texas law was designed to prevent judicial intervention to stop it before it could take effect. The court accepted two cases to determine whether the United States or abortion providers and doctors may bring suit in federal court to prevent S.B. 8 from being enforced. Friday’s decision to keep the law in place but put the cases on a fast-track seemed to be a compro- mise worked out in advance. Be- cause it involves a procedural matter on how to challenge the law, rather than the law’s merits, a resolution could be reached more quickly compared with other cases the court hears. Justice Sonia Sotomayor was the lone dissenter Friday. She agreed the court should expedite review of the law, but said it should have blocked it until the case is decided. She was also on the losing side in the court’s 5 -to-4 order allowing the law to go into effect Sept. 1. “Women seeking abortion care in Texas are entitled to relief from this Court now,” Sotomayor wrote. She said those who became pregnant the day the law went into effects should be considered. “As I write these words, some of those women do not know they are pregnant. When they find out, should they wish to exercise their constitutional right to seek abortion care, they will be unable to do so anywhere in their home State.”

COURT FROM A1 The schedule is extraordinary for the Supreme Court, which nor- mally allows months between accepting a case and scheduling it for argument. John Elwood, a Washington lawyer who tracks the court’s docket, tweeted that it was the “most expedited briefing & argument since Bush v. Gore ,” after the contested 2000 presidential election. Reaction from the political left and abortion advocates was laced with anger. “Texans deserved better than this. The legal limbo is excruciat- ing for both patients and our clin- ic staff,” said Amy Hagstrom Mil- ler, chief executive of Whole Wom- an’s Health, which operates four clinics in Texas. “We’ve had to turn hundreds of patients away since this ban took effect, and this rul- ing means we’ll have to keep deny- ing patients.” Patients who are able to leave Texas have been seeking abortion care in New Mexico, Oklahoma and other surrounding states, where clinics have been booked solid as they try to meet the in- creased demand. Clinics in Texas are still provid- ing abortions before cardiac activity is detected, around the six-week mark. While two out- posts of Planned Parenthood, in Waco and in San Antonio, stopped performing abortions entirely when S.B. 8 took effect, they recently resumed such services. Kimberlyn Schwartz, director of media and communications for Texas Right to Life, said the court’s decision to leave the law in place for now “will continue to save an estimated 100 babies per day.”

The la w’s structure has so far frustrated challengers. Usually, abortion providers sue to stop government officials from enforcing laws that violate constitutional protections. But the Texas law leaves enforcement to private individuals, which the federal government has likened to a “bounty hunter” scheme. Any individual can sue anyone who helps a woman get a prohibit- ed abortion. Successful lawsuits would result in an award of at least $10,000 to the person who filed the complaint. Because they could not sue everyone who might choose to file such a claim, the doctors and clinics brought suit against some individuals to keep them from filing such actions, and against state judges and clerks to keep them from accepting the suits. When the Supreme Court considered the abortion providers’ request to keep the Texas law from going into effect, the majority’s one-paragraph opinion cited the law’s “complex and novel” procedural questions and said it was not clear that abortion providers challenging the law were suing the proper defendants. “Federal courts enjoy the power to enjoin individuals tasked with enforcing laws, not the laws themselves,” the majority wrote in allowing the law to go into effect. Those justices — Clarence Thom- as, Samuel A. Alito Jr. and Presi- dent Donald Trump’s three nomi- nees, Neil M. Gorsuch, Brett M. Kavanaugh and Amy Coney Bar- rett — a dded that the law presented “serious” constitutional ques-

tions. The court’s three liberals — So- tomayor and Justices Stephen G. Breyer and Elena Kagan — said it was clear to them the law was, in Sotomayor’s words, “flagrantly unconstitutional.” She wrote that presented with a law “engineered to prohibit women from exercising their constitutional rights and evade judicial scrutiny, a majority of justices have opted to bury their heads in the sand.” Chief Justice John G. Roberts Jr. provided a fourth vote for blocking the law, saying it re- quired additional judicial scrutiny. “The statutory scheme before the court is not only unusual, but unprecedented,” he wrote. He would have allowed more time for courts to consider “whether a state can avoid responsibility for its laws in such a manner.” After the suit brought by abortion providers was turned away, the Justice Department got in- volved, suing the state of Texas on behalf of those who it said were being denied their constitutional rights. A federal district judge agreed with the government. U.S. District Judge Robert L. Pitman halted the law, writing, “This court will not sanction one more day of this offensive deprivation of such an important right.” Two days later, however, a pan- el of the U.S. Court of Appeals for the 5th Circuit overruled him and reinstated the law. But the abortion providers and the Justice Department asked the Supreme Court not to wait for the

5th Circuit to weigh in. If the law stays in effect, “no decision of this Court is safe,” wrote Acting Solicitor General Brian H. Fletcher. “States need not comply with, or even challenge, precedents with which they disagree. They may simply outlaw the exercise of whatever rights they disfavor.” Texas Attorney General Ken Paxton (R) said the court should stay out of it for now and that challenges to the law should move through state courts. “Federal courts are not ‘roving commissions assigned to pass judgment on the validity of the Nation’s laws,’ ” said Paxton’s filing, quoting a 1973 Supreme Court decision. “Neither is the Department of Justice.” In the case brought by the Jus- tice Department, U.S. v. Texas , the court said it will consider whether the government can sue in federal court to “obtain injunctive or de- claratory relief against the State, state court judges, state court clerks, other state of ficials, or all private parties to prohibit S.B. 8 from being enforced.” In Whole Women’s Health v. Jackson, challengers asked whether “a State can insulate from federal-court review a law that prohibits the exercise of a constitutional right by delegating to the general public the authority to enforce that prohibition through civil actions.” Briefs from all sides are due Wednesday. [email protected]

Caroline Kitchener and Emily Wax- Thibodeaux contributed to this report.

Court won’t block abortion law ahead of review

SERGIO FLORES FOR THE WASHINGTON POST Abortion rights activists protest Texas’s S.B. 8 o utside the state capitol o n Sept. 1 in Austin. The Supreme Court has scheduled an expedited review of the law for Nov. 1.

The Washington Post - USA (2021-10-23)

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