“Our arithmetic was unique”: The Sheppard-Towner Act and the Constraints of Federalism on Data Collection Before the New Deal

This article reveals how the politics of federalism in the 1920s stifled the U.S. Children’s Bureau’s ability to collect national data on the workings of the Sheppard-Towner Act. The Bureau staff’s reliance on state administrators for data hindered their efforts to collect standardized national statistics on the states’ use of federal dollars. Ultimately, this barrier contributed to Sheppard-Towner’s defeat in 1929. Though the law was short-lived, the problems the Children’s Bureau encountered administering it provide insights into how federal matching grant programs began to shape federal and state relations before the New Deal. As this article shows, Bureau staff learned from their experience administering Sheppard-Towner that they needed to implement more stringent federal oversight over state-level accounting in their administration of Title V of the Social Security Act.

“Based upon New Principles”

This essay examines the early life and work of the Russian American social reformer Abraham Epstein, an advocate for old-age pensions and compulsory social insurance whose work as head of the American Association for Social Security helped lead to the passage of the 1935 Social Security Act. The essay traces a young Epstein’s 1921–22 journey to Russia to study the Soviet government’s radical experiments in social welfare policy. Although Epstein was disillusioned with the Soviet system on the whole, his experiences in Soviet Russia informed his later idea of “social security”: a unified system of social insurance and social assistance to protect the entire population from social risk while functioning as a powerful tool of income redistribution. Epstein’s early interest in Soviet social welfarism adds new insight into the development of the broader concept of “social security,” an important but understudied link between Progressive Era “workingmen’s insurance” and the postwar welfare state.

Save Our Senior Noncitizens: Extending Old Age Assistance to Immigrants in the United States, 1935–71

When do states grant social rights to noncitizens? I explore this question by examining the extension of Old Age Assistance (OAA) to noncitizens after the passage of the 1935 Social Security Act. While the act contained no alienage-based restrictions, states were permitted to bar noncitizens from means-tested programs. In 1939, 31 states had alienage restrictions for OAA. By 1971, when the Supreme Court declared state-level alienage restrictions unconstitutional, only eight states still did. States with more Mexicans and Asians were slower to repeal restriction, however. Using in-depth case studies of New York, California, and Texas, I demonstrate the importance of federal and state institutional arrangements and immigrant political power for the extension of social rights to noncitizens. I also show that to secure access to OAA, immigrant advocates adapted their strategies to match the institutional and political context.

Learning Lessons From Long-Term Care Policy Financing Efforts in the United States

A decades-long policy impasse has crippled our national capacity to finance long-term care (LTC) sufficiently or equitably, leaving large swaths of the US population at risk of going broke paying privately for LTC or having unmet LTC needs, while also draining state and federal budgets. By reviewing past LTC financing policy efforts—from the passage of the Social Security Act and the enactment of Medicaid and Medicare, to the LTC financing proposals advanced by 2020 presidential candidates—the political interplay of budgetary concerns in government spending and social justice concerns regarding access to care emerged as a primary LTC policymaking issue. Establishing national consensus on the prioritization of these fiscal and social justice concerns, and their respective values, could help lawmakers craft policy capable of generating the political will needed to overcome political gridlock. Clarifying how LTC benefits would be paid for appears to be a relatively straightforward technical task in comparison.

Child Welfare Financing: What Do We Fund, How, and What Could Be Improved?

Government efforts toward the prevention, detection, and investigation of child abuse and neglect are carried out through the United States’ child welfare system—a complex web of programs that provide family assistance and promote child safety. Most funding for these activities is split among federal, state, and local governments and comprises specific child welfare–related funding (such as Titles IV-E and IV-B of the Social Security Act) and non–child welfare funding that is spent on programs that support poor and disadvantaged families (Medicaid and TANF). I provide an overview of these funding streams that finance the child welfare system, review the federal legislation since 1970 that has led to the current funding structure, and end with a discussion of how the Family First Prevention Services Act of 2018 has the potential to create better outcomes for children and families by promoting prevention activities and program support with strong evidence of success.

THE PROBLEMS OF PENSION SYSTEMS MODERNIZATION AT THE SECOND–THIRD DECADES (IN US)

The article examines the transformation of US social security trust funds in view of pension benefits guarantees. It is pointed out main approaches to solving the growing gap between the volume of payroll taxes and outlays for each year. According to the Social Security Board of Trustees, the asset reserves are expected to be exhausted in the fourth decade of the current century and future retirees could face problems with retirement benefits. Meanwhile, it’s an important point of each candidate’s agenda before presidential elections. One of the approaches for keeping the financial stability of the Social Security Act till the end of the current century and beyond is raise payroll taxes. But this proposal is not popular among republicans. President D. Trump's position on Social Security is not to increase payroll taxes or the age of retirement, but to stimulate economic growth which make it possible to collect more payroll taxes for Social Security system. At the same time the key priority of D. Trump’s administration in the field of strengthening retirement security in America is development of individual pension plans.

Legal Protection for Patient of Independent National Health Insurance’s Participant: Restriction on Hospitalization Upgrade

The government issued Regulation of the Minister of Health Number 51 of 2018 which regulates the increase in inpatient classes which are difficult to understand. After the issuance of the Minister of Health's regulation regarding the imposition of fees and the difference in costs in the Health Insurance program, causing confusion in the community. This study aims to analyze the legal protection for independent national Health Insurance Participants after the issuance of the Minister of Health Regulation concerning imposition of cost and difference in the health insurance Program. In addition, to analyze the existence of a norm conflict between the Minister of Health Regulation about Imposition of cost and Difference in cost toward the laws and regulations above. This study uses a statutory, conceptual and comparative approach. The type of research used in this study is normative legal research. The results showed that the legal protection of JKN participants independently after the enactment of Permenkes Number 51 of 2018 regarding the Imposition of Costs and Difference in Costs in the Health Insurance Program was unclear and caused legal uncertainty. Besides that, it turns out there has been a norm conflict between the Minister of Health Imposition of Imposition of costs and costs difference in Health Insurance with the Perpres Health Insurance, the National Social Security Act, the Consumer Protection Law and Human Rights. Settlement that can be taken to harmonize the norm conflict is to revoke Article 10 paragraph (5) Permenkes Number 51 of 2018, set aside the Article and conduct a judicial review to the Supreme Court.

The role of emergency institutes in countering the COVID-19 pandemic in the United States

This article deals with the role of emergency institutes in countering the COVID-19 pandemic in the United States. The author examines such types of emergency as Public Health Emergency, National Emergency, Major Disaster Regime and Emergency Regime. The entire layer of emergency legislation is analysed, including National Emergencies Act of 1976, Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1988, Social Security Act of 1935, Public Health Service Act of 1944, Defense Production Act of 1950. Acts of the President of the United States and the Congress adopted directly during the pandemic and aimed at countering COVID-19 and protecting the rights of American citizens are considered as well. In conclusion it’s being argued that the formal availability of federal mechanisms of mobilization of assistance to state and local government in the conditions of emergency (especially in the sphere of public health protection) by itself doesn’t guarantee effective response of the state machine to this situation, adequate and timely funding of the corresponding efforts.

Improving Healthcare Value: COVID-19 Emergency Regulatory Relief and Implications for Post-Acute Skilled Nursing Facility Care

Rarely, if ever, does a national healthcare system experience such rapid and marked change as that seen with the COVID-19 pandemic. In March 2020, the president of the United States declared a national health emergency, enabling the Department of Health & Human Services authority to grant temporary regulatory waivers to facilitate efficient care delivery in a variety of healthcare settings. The statutory requirement that Medicare beneficiaries stay three consecutive inpatient midnights to qualify for post-acute skilled nursing facility coverage is one such waiver. This so-called Three Midnight Rule, dating back to the 1960s as part of the Social Security Act, is being scrutinized more than half a century later given the rise in observation hospital stays. Despite the tragic emergency circumstances prompting waivers, the Centers for Medicare & Medicaid Services and Congress now have a unique opportunity to evaluate potential improvements revealed by COVID-19 regulatory relief and should consider permanent reform of the Three Midnight Rule. Journal of Hospital Medicine 2020;15:XXX-XXX. © 2020 Society of Hospital Medicine