SATURDAY, DECEMBER 25 , 2021. THE WASHINGTON POST EZ RE A
Sentencing Project, believes in a
wait-and-see approach to Biden’s
South Carolina pledge that “this
administration is going to
continue to fight for meaningful
police reform in Congress and
through additional executive
actions.”
The former federal prisoner
had a special perspective when
he joined experienced
professional advocates on the
Zoom meeting that was “short,
but it still was productive.” He
would not have been in such a
gathering a year ago, because he
was incarcerated on drug
charges. Released in January
after 33 years, Underwood, 68,
now fights mass incarceration.
He linked his long imprisonment
to legislation Biden supported as
a senator that included
mandatory minimum sentencing
provisions.
Now, Underwood wants
Biden’s criminal justice efforts to
succeed.
After listening to the high-
level presidential appointees at
the meeting — including
Domestic Policy Council
Director Susan Rice, Public
Engagement Director Cedric L.
Richmond and Counsel to the
President Dana Remus —
Underwood left feeling “hopeful... if they do half of what they
said.”
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for drug offenses despite
previous commitments to end
mandatory minimum sentences”
sets “a dangerous, radical new
precedent... and continues to
promote criminalization rather
than public health recourse.”
l Marijuana: “DOJ must
commit to ending the
prosecution of marijuana
offenses... remove it from the
list of scheduled substances
under the Controlled Substances
Act... as well as push for the
expungement of past and
current marijuana convictions,”
the letter said.
Advocates are also disturbed
by a Government Accountability
Office (GAO) report that warned
of the potential collapse of a
planned FBI database that
would collect information on use
of force data from police
departments. As my colleague
Tom Jackman wrote, “due to
insufficient participation from
law enforcement agencies, the
FBI... may never publish use of
force incident data from the
collection.” Although released
this month, the report looks at
collection efforts from fiscal
2016 through 2020, before Biden
took office. In its response to
GAO, the Justice Department
said “the FBI believes” it will get
the needed data.
William “Bill” Underwood, a
senior fellow with theConference, Justice Action
Network, R Street Institute, the
Sentencing Project and Justice
Roundtable.
Now, Ring says Garland’s
announcement “is excellent
news for thousands of people
and their families to get before
the holidays... and we are very
grateful to the Biden
administration.” Also effusive
was Wade Henderson, interim
Leadership Conference
president and CEO, who
declared Tuesday “a triumphant
day” and a move “toward justice
and racial equity.”
But advocates remain
frustrated by other issues. While
applauding some administration
actions, the letter listed, in some
detail, areas where they would
like quick action, including:
l Death penalty: The groups
said the federal government
“should end the pursuit of
capital punishment in all cases,
and neither seek nor carry out
the death penalty.” Garland
halted federal executions in July
pending a review, but advocates
want a full commitment against
capital punishment.
l Mandatory minimum
sentences: The letter said the
administration’s support for
policies that subject
“disproportionately Black and
Brown individuals, to extreme
mandatory minimum sentencesand the Leadership Conference
on Civil and Human Rights,
which itself represents more
than 230 national groups.
Starting the letter by
reminding Garland that “the
Biden administration has
publicly articulated a
commitment to advancing racial
justice in the federal criminal-
legal system,” the organizations
stressed “the importance of swift
action,” adding that “the Biden
administration and the
Department of Justice must
assert its commitment to
promoting justice and
opportunity for all people in
America.”
Garland moved in that
direction Tuesday, when he
reversed Trump administration
policy and said federal inmates
who had been released from
prison to limit covid-19’s spread
will be allowed to remain home
and “not unnecessarily returned
to prison” if they “have made
rehabilitative progress and
complied with the conditions of
home confinement.”
That was a top issue for Kevin
Ring, president of FAMM
(formerly known as Families
Against Mandatory Minimums),
who was among advocates on
the Zoom meeting who were
irritated by administration
policies. Other organizations at
the meeting were the Leadershipwhich include many women,
African Americans and other
people of color, as well as
lawyers with civil rights and
public defender experience.
But critical issues have
emerged in the past month,
including an inconclusive Nov.
30 Zoom meeting with top
White House officials and the
release of a government
watchdog report warning that a
planned FBI use of force
database is nearing collapse.
Advocacy groups also posted a
pointed 12-page letter that
accused the Justice Department
of being no better on some issues
than it was under former
president Donald Trump — “in
some instances doubling down
on the failed policies of the past
administration instead of
charting a bold new course.”
The Dec. 14 letter to Attorney
General Merrick Garland from
eight organizations complained
about administration decisions
and inaction that “raise concerns
for us about the progress the
Department of Justice is making
on its racial justice priorities.”
Signing the letter were the
NAACP, Amnesty International
USA, American Civil Liberties
Union (ACLU), Drug Policy
Alliance, Federal Public and
Community Defenders, NAACP
Legal Defense and Educational
Fund, the Sentencing ProjectAs President
Biden touts his
criminal justice
reform record
after 11 months in
office, advocates
are thankful, yet
disappointed his
administration
hasn’t done more
to advance
fairness and
equity in law enforcement.
Biden agrees more must be
done.
“On criminal justice reform,”
Biden told a South Carolina
State University commencement
this month, “we need it from top
to bottom.”
He praised the Justice
Department’s ban on police use
of chokeholds, restrictions on
no-knock warrants and body-
cam requirements for federal
officers, while pushing for the
George Floyd Justice in Policing
Act on police abuse and
accountability that remains
stalled in the Senate. Biden
reminded the audience that the
department is ending the use of
private prisons, no longer makes
federal prosecutors seek the
harshest penalties and has
opened police misconduct
investigations in four cities.
Even critics impatient with
administration actions celebrate
Biden’s judicial confirmations,
Biden touts criminal justice record — but advocates want more action quickly
Federal
Insider
JOE
DAVIDSON
Back Better Act, its name drawn
from Biden’s campaign theme,
would allow people below the
poverty line in states not expand-
ing Medicaid to enroll in one of
the private health-care plans sold
on ACA marketplaces. A federal
subsidy would pick up the full
cost of the monthly premium, and
co-payments would be small.
The help would run through
2025, with the net cost about
$57 billion, according to an esti-
mate from Congress’s budget ana-
lysts.
Republican governors and
state lawmakers opposed to ex-
pansion have not spoken out
against this approach because its
reliance on ACA marketplaces
falls within federal control.
“I don’t think anyone is com-
plaining about that,” said one
health policy expert familiar with
state government who spoke on
the condition of anonymity to
describe private discussions.
Less certain is the plan’s fate in
the Senate, when the chamber
considers the spending bill in the
weeks ahead. Senate Majority
Leader Charles E. Schumer
(D-N.Y.) initially said he would
like the chamber to pass it by
Christmas, but that goal was
thwarted by schisms within his
party.
As in the House, Senate Repub-
licans are uniformly against the
legislation. With barely a majori-
ty, Senate Democrats cannot pass
the bill unless every member of
their caucus supports it.
Ideological fissures are already
evident. Sen. Raphael G. Warnock
(D-Ga.) is among the strongest
advocates for the bill, contending
that providing more insurance
coverage to low-income Geor-
gians is crucial to his reelection
next year and perhaps to preserv-
ing his party’s slim Senate majori-
ty.
Warnock favors a permanent
expansion of Medicaid, either by
states or an all-federal public pro-
gram to provide the same cover-
age. Still, the senator worked to
incorporate the temporary ACAapproach — more appealing to
party centrists — into a revised
Build Back Better framework that
Biden issued in October, War-
nock’s office said.
One of those centrists, Sen. Joe
Manchin III (D-W.Va.), has con-
demned the idea of creating a
federal program that would act
like Medicaid to fill the coverage
gap. Manchin says it would be
unfair to states such as his, which
have expanded Medicaid and, as
the ACA requires, are footing
10 percent of the cost. Manchin
does not yet have a position on the
House’s ACA marketplace ap-
proach, his office said.
For states with expanded Med-
icaid, the plan would temporarily
increase the federal share of the
cost from 90 percent to 93 per-
cent. It is unclear whether that
extra help will satisfy Manchin or
other senators with similar reser-
vations.
Despite the bill’s uncertain
prospects for becoming law, advo-
cates in Texas are mobilizing, pre-
paring for a mass education cam-
paign to help the state’s hundreds
of thousands of uninsured people
learn how to sign up for ACA
health-care plans.
People such as Jahnari Ball,
who lives with his grandmother
on Houston’s south side and grew
up on Medicaid. At 22, he is in his
first semester at a community
college, studying to get a real
estate license. And he works part-
time setting up stages for commu-
nity events. He has had no health
insurance for three years, once he
became no longer eligible for Tex-
as’s Medicaid as a child and did
not qualify as a single adult.
In the past year, Ball has begun
to have what he suspects are
mental health issues, worrying
whether his life is in a good lane.
Some nights, he lies awake.
“It depends on how the vibe is
at the moment,” Ball said. “I have
different episodes, as far as the
anxiety coming back.”
He wanted to have this anxiety
checked out. He couldn’t afford it.
So he began searching for how toget insurance, doing Google
searches, asking relatives.
They had suggestions that
would have helped if he were old
or disabled but “nothing for me,”
Ball said. Finally, he discovered
he was in the coverage gap.
Ball said help from Congress
“would be amazing,” especially
“for ones in the gap, who need it
the most.”
If he could get insurance, he
said, he would get a physical. And
he would find a mental health
professional, as he began wanting
to do months ago. “I was just
looking for a sense of peace,” he
said.
More than 200 miles to the
northwest in Dallas, Robinson
remembers being in the hospital
in 1992, diagnosed with HIV.
“They gave me three to five
years to live,” Robinson recalled.
“And I’m 55. I want to keep living.”
Most of those years in between,
she has had insurance. At her last
job, at the Afiya Center focused on
reproductive rights, the nonprofit
group gave her $200 a month to
apply to an ACA health-care plan.
She kept paying the premiums of
about $700 through August, two
months after her job ended. Then
she stopped, unable to keep up
payments on her part-time care-
giver’s income of roughly $900 a
month.
With neither a full-time job nor
health insurance, she can get
medicine and other care for her
HIV through a federally funded
clinic. Still, if the federal govern-
ment helped her back onto an
ACA plan, Robinson said, “I’d be
super excited and very grateful.... I’d make the appointment
with the cardiologist.”
She fears that if the help is not
permanent, some people would
not bother to apply for the cover-
age. For others, she said, a few
years’ insurance “is just long
enough to get you used to it, and
then you lose it.”
Still, she said, “anything, hon-
estly, is better than nothing. It
will be enough until it’s not.”
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BY AMY GOLDSTEIN
Since she was diagnosed with
HIV in the 1990s, Deneen Robin-
son has worked as an advocate,
promoting health, abortion
rights and AIDS education for
other Black women. But it was not
until June, when her job as a
policy director for a Dallas non-
profit organization was eliminat-
ed — leaving her with insurance
premiums she no longer could
pay — that Robinson discovered a
gap she had never known existed.
Unable to find work beyond a
few hours a day as a friend’s
caregiver, Robinson descended
into poverty. In Texas, even that
scanty income is too much for
adults to qualify for Medicaid. But
it is too little to make her eligible
for a subsidized Affordable Care
Act health plan. So with a worsen-
ing endocrine problem, she can-
not afford to see the cardiologist
she needs as her blood pressure
has spiked, threatening her heart.
“The irony is not lost,” Robin-
son said. “Now, I’m fighting to get
the things I advocated for for
everyone else.”
So Robinson has a personal
reason to celebrate a few passages
in the sprawling social spending
plan House Democrats adopted
in November. It would create a
path to health coverage for her
and more than 2 million fellow
uninsured people in Texas and
11 other states that have not ex-
panded Medicaid as the ACA al-
lows.
If the plan survives a political
minefield in the Senate, it would
rely on ACA insurance market-
places to close the coverage gap
temporarily, offering people such
as Robinson a chance for the next
few years to sign up for private
health plans nearly for free.
This approach is considerably
less ambitious than goals for ex-
panding access to health care that
President Biden carried to Wash-
ington from his campaign.
A public insurance option —
something the president and lib-
eral Democrats in Congress have
long espoused — has never been
seriously considered as part of
this legislation. Nor would the
plan create a permanent federal
program similar to Medicaid, the
insurance system for the poor run
jointly by the federal government
and states, in the dozen states
that have resisted expanding the
program.
And the House’s approach is a
tacit admission that the last way
Biden and Congress tried to close
the Medicaid coverage gap has
not worked. As part of a coronavi-
rus relief law passed in March, the
government began offering a nov-
el and generous financial incen-
tive to the holdout states if they
agreed to expand.
A few of the states, led by
Republicans and spread largely
across the South, have talked
about the offer with federal
health officials, although none
have accepted it.
In Texas, an estimated 771,
people fall into the Medicaid gap,
more than in any other state and
roughly one-third of the national
total in the gap. Consumer health
advocates there have concluded
that filling the gap would need to
be done by Washington.
Laura Guerra-Cardus, deputy
director of the Children’s Defense
Fund’s Texas branch, said she is
not exactly happy with the plan to
offer ACA marketplace health in-
surance plans only through 2025
but nevertheless is “in full sup-
port” of it. Given adamant opposi-
tion from Texas Gov. Greg Abbott
(R) and his predecessor to ex-
panding Medicaid, the House’s
temporary approach “represents
the only realistic path forward,”
Guerra-Cardus said.
The Democratic authors of the
ACA did not envision any cover-
age gap when they created the
health-care law that was enacted
in 2010. Originally, the law sought
to widen access to insurance in
two ways. It would expand Medic-
aid nationwide and allow people
to join even if their incomes were
a little above the poverty line. And
for others who lack affordable
health-care benefits through a
job, it offered new federal subsi-
dies to help pay for the monthly
premiums for private health
plans sold through insurance
marketplaces that the law creat-
ed.
But in a challenge to the law
two years later, the Supreme
Court ruled that each state has
the power to decide whether to
expand Medicaid.
Since the high court’s decision,
five legislative sessions have tak-
en place in Texas, where lawmak-
ers convene every other year.
Democrats have introduced bills
to expand Medicaid each time.
With governors’ opposition and a
strong Republican majority in the
legislature, only three of the bills
have even gotten as far as a hear-
ing.
During this year’s session,
grass-roots advocates intensified
their efforts. Dozens of organiza-
tions joined forces to implore
legislators to close the gap. The
state’s AARP chapter called on the
governor to temporarily expand
Medicaid to help poor Texans
during the coronavirus pandem-
ic.
Once again, the expansion bill
did not get a legislative hearing.
As in some other states that
haven’t expanded Medicaid, the
views of Texas political leaders
conflict with public opinion. Two
polls this year showed that nearly
7 in 10 Texans say they favor
Medicaid expansion.
With no sign that Texas politics
will shift to more closely mirror
public sentiment, Guerra-Cardus
said, “at the end of the day, this
country needs to ensure there is a
permanent coverage option for
all people.” In the meantime, she
said, even temporary federal help
is a “lifeline.”
The House version of the BuildUninsured eager
for Congress to
fill coverage gap
House plan to help poor
afford health care faces
uncertain fate in Senate“Anything, honestly, is
better than nothing.”
Deneen Robinson, an uninsured
woman in Texas, speaking about
the House plan to address the
health insurance gap through
the next three years“At the end of the day,
this country needs to
ensure there is a
permanent coverage
option for all people.”
Laura Guerra-Cardus, deputy
director of the Texas branch of the
Children’s Defense FundCOOPER NEILL FOR THE WASHINGTON POST
Deneen Robinson is among more than 2 million uninsured people in a dozen states who fall into a health insurance gap. A social spending
plan passed by the House would address the issue, but it faces resistance from Senate Republicans and some moderate Senate Democrats.