Paying the Price for Vice: The Evolving Landscape of Excise Taxes in America

While excise or vice taxes have long been a part of the American tax landscape related to alcohol and cigarettes, the recent invention of vaping and legalization of marijuana and other substances is changing the landscape.

What Are Excise Taxes?

Excise taxes are taxes on specific types of consumable products such as alcohol or tobacco for one of two reasons. First, as vice taxes in order to raise revenue to cover the costs related to consumption; and second, to deter consumption itself. Unlike other types of consumption taxes such as sales tax, these are specific to certain products.

Do They Change Behavior?

Theoretically, when you increase the price of a product such as alcohol through the addition of excise taxes, demand should go down. While this may be a deterrent and limit demand, excise taxes certainly haven’t proven to be a feasible way to eliminate behaviors. A pack of cigarettes can cost upward of $15 in major cities, but there are still people smoking. It’s a similar situation with drinking and gambling.

It’s All About the Benjamins

While we think of excise taxes as vice taxes today in many respects, the main point isn’t to change behavior – it is to raise revenue. Excise taxes pre-date the United States and were one of the main forms of government funding in America before income tax was created. Alcohol taxation goes back to George Washington’s presidency and incited the infamous Whiskey Rebellions. Cigarette taxes were introduced as a way to pay for the Civil War. In the end, it’s about the money generated as there are easier and more effective ways to regulate behavior.

New Products Equal New Taxes

The legalization of marijuana by states raises the issue of excise taxes on this product. Unlike tobacco, where one of the goals is to decrease consumption, the situation here is more one of legalizing something to raise consumption and generate revenue as a result.

Marijuana taxation is more akin to alcohol in the years following prohibition. In both cases, you have large-scale illegal operations and illicit consumption with the aim of moving them to legitimate status. In this sense, it’s different than other vice taxes. 

Initially, at least, the authorized market will have to operate in parallel with the black market for the same product, limiting the amount of taxes that can be raised when there is still an unregulated and untaxed alternative.

Beyond Marijuana

Aside from marijuana, there are other new products that could be taxed and generate revenue, the most notable being vapor products. While vaping products are not really that new, the market is just growing to a substantial size.

Taxing vaping products is more complicated and problematic. Some consider these products to be just as harmful as cigarettes, while others not so much. There is evidence that nicotine consumed via vaping is less harmful than through smoking cigarettes.

Theoretically then, the government should apply less taxes as a result if the harm and therefore cost to society is less.  The problem with this is that less revenue is raised. As noted before, we come back to the issue that vice taxes are often revenue-raising tools disguised as public safety measures.

Too Successful For Its Own Good

Vice taxes can be too successful, with tobacco as the best example. While people may stop buying cigarettes, they don’t stop consuming cigarettes; instead, they buy them elsewhere.

For example, more than 50 percent of cigarettes consumed in New York are purchased out of state. If you push too far, people will react.

Conclusion

Excise and vice taxes are here to stay. While varying arguments can be made that they benefit society by shaping behaviors, it is undeniable that state, local and the federal government are addicted to the revenue generated.

How Will the Biden Administration’s China Policy Impact Markets?

The Obama and Trump administrations couldn’t have had a more different approach when it came to U.S. relations with China. As the Institute for China-America Studies (ICAS) explains, under the Obama administration, the United States favored a trade and investment approach when dealing with China, while the Trump administration had a national security focus. The ICAS believes the Biden administration will address trade and economic imbalances through a modified approach, including reducing tariffs on imported Chinese goods over time to decrease inflation for American consumers. Another example is maintaining pressure on China to cut government subsidies for competing industries, currency games, and exporting products to the United States at artificially low prices.

While the Obama administration engaged China through trade and investments, it didn’t emphasize engaging the country on the national security side. The Trump administration looked to make American industries independent of Chinese production, especially for rare earth metals, pharmaceutical precursors, etc. With the inauguration of President-elect Biden, the incoming administration is expected to maintain the Trump administration’s quest to give many American industries a fighting chance of survival, albeit how it will be accomplished will likely vary.

The Biden administration is projected to lower tariffs on Chinese imports gradually. This is expected to be done to reduce the tension of the existing trade war. It’s also expected to be done to lower the rate of inflation and help businesses that import input materials from China.

Based on statistics according to the American Action Forum, approximately $57 billion was paid by consumers on an annual basis per 2019 import numbers, due to tariffs instituted by President Trump. This action is likely to increase consumer spending and increase companies’ earnings. However, the Biden administration is still expected to keep other forms of trade pressure on what many believe are unfair trade practices by China.

Biden also is expected to raise the same concerns the Trump administration did regarding Chinese trade and commerce, including China subsidizing its industries, flooding the American market with goods to undercut American producers, and requiring so-called forced technology transfers from U.S. companies.  

However, the trade deficit the U.S. has with China isn’t expected to see much attention. This could negatively impact how much China is ultimately expected to import from the United States.

When it comes to colleges and universities, research-based collaboration, and artistic-based areas, relations are expected to be more friendly. However, when it comes to fighting China’s human rights violations, individuals or business entities might be targeted. Based on Vice President-elect Kamala Harris’ proposed Uyghur Human Rights Policy Act of 2020, there’s an expectation the Biden administration will keep the pressure on China.

Beginning in 2017, Biden began to discuss plans for America and how some of America’s crucial industries could be more self-sufficient and less reliant on China. Examples include pharmaceutical products, medical equipment, and rare earth minerals.

Potential actions the Biden administration could implement against China include sanctions; U.S. government-sponsored legal action against Chinese firms; and becoming more involved in the World Trade Organization (WTO) and similar organizations. This is seen by some as the U.S. becoming more in-step with Europe to better pressure China in WTO and related disputes. It might also include courting America’s allies in reducing or prohibiting Chinese investment of domestic industries to make it more difficult for Chinese firms to obtain cutting-edge technology.

While there is no way to accurately predict how the Biden administration will treat China, there will likely be continued pushback on China. How these actions will ultimately impact trade and the markets will be seen in the near future.

What To Know About Filing For Bankruptcy

About one million Americans file for personal bankruptcy each year, with one in 10 households having filed at some point. Given the loss of jobs, reduced income, and the coronavirus recession in 2020, those numbers could increase this year if the economic recovery is not both swift and omnipresent.

There are two main types of personal bankruptcy: Chapter 7 and Chapter 13. Chapter 7, which is the more common option, will liquidate the filer’s assets in order to discharge all or a portion of the outstanding debt. People generally choose this route because they are in way over their heads and do not earn enough income to pay their debts in any type of normal time frame.

Chapter 13, on the other hand, provides some immediate breathing room while helping the filer develop a payment plan based on a reduced percentage of the debt. This percentage is determined by how much he makes and what he can feasibly pay each month. While a Chapter 7 bankruptcy remains on your credit report for 10 years, while Chapter 13 bankruptcy is a bit less punitive staying on record for only seven years. As the filer works to pay down his debt and sticks to his plan, his credit score will gradually improve over time. In some cases, the debtor may be able to apply for an FHA, VA, or USDA home loan a year after his bankruptcy filing, or two to four years if applying for a conventional mortgage.

Bankruptcy can provide immediate relief from creditors calling and threatening to evict, foreclose, repossess, shut off, or garnish wages. However, be prepared for some level of pain, such as the bankruptcy court seizing property to be sold to pay your creditors, and/or your credit cards being canceled.

You may see television ads to get debt relief without having to file bankruptcy. Be aware that while these programs may negotiate a debt settlement to something you can better afford, they will not skirt the wrath of the dreaded credit rating agencies. Any time an entity negotiates a reduction in your debt, this will show up as a negative factor on your credit score, and will likely remain that way for many years. A more recent issue that not everyone is aware of is that some employers have started checking the credit reports of job applicants. This makes it all the more difficult to pay off your debt if you can’t get a job because of your past payment history. Your best option is to secure a reliable income before you work with a debt relief agency or file for bankruptcy.

Before entering any type of debt relief program, it’s a good idea to consult with a qualified, non-profit credit counseling agency for a free debt analysis. Don’t go to just anyone; make sure it is a legitimate resource which, by law, is required to serve your best interest. Shady debt counseling vendors are inclined to recommend a debt solution that works out better for the agency than their clients.

If you do decide to file for bankruptcy, be aware that court fees cost about $300, plus lawyer fees tend to run between $1,000 and $3,000 for a Chapter 7 filing and approximately $3,000 to $6,000 for a Chapter 13 filing.

Deciding if a Roth IRA Conversion is For You

Roth IRAs can be a powerful tax tool, but they are often misunderstood and misused. Investment income in Roth IRAs compound tax-free and most distributions are tax-free as well. Another benefit is that there are no required minimum distributions (RMDs) throughout the original owner’s life. Long-term Roth distributions are tax-free to the beneficiaries who inherit the IRA as long as they fully distribute the Roth within 10 years of inheriting.

As the annual contribution limits are rather small, most Roth IRA contributions are made by converting a traditional IRA to a Roth IRA. The downside to conversion is that you’ll have to pay tax on the gross amount converted. Considering this can require a substantial cash outlay and that all the Roth IRA benefits are backloaded, deciding to make a conversion can be a difficult call.

Most people aren’t sure it will pay off in the long term and don’t like the idea of paying taxes now instead of in the future. Consequently, too often people try to make a conversion decision through intuition instead of objectively considering the important factors.

It’s best to use a spreadsheet to do an analysis or work with a tax advisor because you will need to consider many factors, including assumptions about tax rates, investment returns, how long you’ll own the accounts, how much you will convert, etc.

Generally, a conversion becomes more advantageous if tax rates increase and this impact is compounded by higher investment returns. Finally, remember that you can leave the Roth to your heirs who can take distributions tax-free.

Roth IRA conversions are not the right option for everyone, but where it’s appropriate the benefits can be substantial.

Prosecution for Use of Performance Enhancement Drugs, Modernizing Government Technology, and Enhancements for Veterans and Their Caregivers

Rodchenkov Anti-Doping Act of 2019 (HR 835) – This bill was introduced by Rep. Sheila Jackson Lee (D-TX) on Jan. 29, 2019. The purpose of this legislation is to give U.S. officials the power to prosecute individual athletes who used performance-enhancing drugs at international sports competitions involving American athletes. The legislation has been criticized by the World Anti-Doping Agency (WADA) as undermining the global anti-doping movement based on international cooperation, and because no other nation has extra-territorial jurisdiction in this field. The bill passed in the House in October, the Senate in November, and was signed into law by the president on Dec. 4.

IoT Cybersecurity Improvement Act of 2020 (HR 1668) – This bill requires the Institute of Standards and Technology (NIST) and the Office of Management and Budget (OMB) to establish minimum security standards for Internet of Things devices owned or controlled by the Federal Government. The legislation was introduced by Rep. Robin Kelly (D-IL) on March 11, 2019, passed in both Houses, and was signed into law on Dec. 4.

Information Technology Modernization Centers of Excellence Program Act (HR 5901) – Introduced by Rep. Ro Khanna (D-CA) on Feb. 13, this bill authorizes the establishment of an Information Technology Modernization Centers of Excellence Program. The purpose of the program is to help executive agencies adopt secure modern technology in coordination with the Department of Homeland Security. The program must provide regular reports to Congress. The legislation passed in the House in September, in the Senate in November, and was signed into law by the president on Dec. 3.

Veterans COMPACT Act of 2020 (HR 8247) – Short for Veterans Comprehensive Prevention, Access to Care and Treatment, this bill authorizes a variety of programs, policies, and reports that fall under the Department of Veterans Affairs (VA). Components of the legislation address transition assistance, suicide care, mental health education and treatment, healthcare, and female veteran care. It includes a program to provide education and training for caregivers and family members of veterans with mental health disorders. The bill also establishes a Task Force on Outdoor Recreation for Veterans to recommend public lands or other outdoor spaces to be used for medical treatment and therapy. The bill was introduced by Rep. Mark Takano (D-CA) on Sept. 14. It passed in the House in September, the Senate in November, and was signed by the president on Dec. 5.

Wounded Veterans Recreation Act (S 327) – This bill offers a free lifetime pass to National Parks and Federal Recreational Lands to any U.S. resident who has been medically determined to be permanently disabled (must furnish adequate proof of disability and citizenship or residency), as well as to any veteran with a service-connected disability. It was introduced by Sen. Jeanne Shaheen (D-NH) on Feb. 4, 2019, passed in the Senate in June, the House in November, and was signed into law by the president on Dec. 3.

Transparency and Effective Accountability Measures (TEAM) for Veteran Caregivers Act (S 2216) – Designed to upgrade VA caregiver programs by identifying and formally recognizing caregivers of veterans, and notify them of assistance available under the Program of Comprehensive Assistance for Family Caregivers. The bill also temporarily extends benefits for veterans who are determined to be ineligible for the family caregiver program, including a monthly personal caregiver stipend. This bill was introduced by Sen. Gary Peters (D-MI) on July 23, 2019. It passed in the Senate in November, the House in December, and is currently waiting for enactment by the president.

2021 Social Security Tax and Benefit Increases Announced

The Social Security Administration recently announced 2021 increases to both benefits and the taxable wage base for FICA taxes.

Increases Announced for 2021

Workers are facing a 3.7 percent increase in the taxable wage base subject to Social Security taxes, increasing the amount from $137,700 up to $142,800. This means high earners who make as much as or more than the taxable wage base will pay $8,853.60 of the employee withholding portion or $17,707.20 in total for the self-employed – who pay both employee and employer portions of the tax.

Retirees receiving benefits will only garner a 1.3 percent cost-of-living (COLA) raise in 2021, resulting in a raise of $20 per month for the average single beneficiary and $33 per month for the average retired couple. COLA increases for beneficiaries have been low for a long time, with several years seeing zero increases in the past decade or so. You can see the historic trend of COLA increases in the chart below, going back to 1975.

Historical Social Security COLA Increases1
Year Increase Year Increase
2020 1.3% 1997 2.1%
2019 1.6% 1996 2.9%
2018 2.8% 1995 2.6%
2017 2.0% 1994 2.8%
2016 0.3% 1993 2.6%
2015 0.0% 1992 3.0%
2014 1.7% 1991 3.7%
2013 1.5% 1990 5.4%
2012 1.7% 1989 4.7%
2011 3.6% 1988 4.0%
2010 0.0% 1987 4.2%
2009 0.0% 1986 1.3%
2008 5.8% 1985 3.1%
2007 2.3% 1984 3.5%
2006 3.3% 1983 3.5%
2005 4.1% 1982 7.4%
2004 2.7% 1981 11.2%
2003 2.1% 1980 14.3%
2002 1.4% 1979 9.9%
2001 2.6% 1978 6.5%
2000 3.5% 1977 5.9%
1999 2.5% 1976 6.4%
1998 1.3% 1975 8.0%

Medical Expenses Outpacing COLA increases

Low COLA increases are putting pressure on retirees’ finances as medical expenses are rising at a much faster pace, with some believing they are given too little weight in the COLA calculation. Moreover, retirees need to consider Medicare Part B and Part D premiums.

While the official 2021 premiums are not announced yet, there are estimates out there that Part B premiums (covering doctor and outpatient services) will raise $9 per month, or approximately 6.2% percent, from $144.30 to $153.30. These are just average figures, as there are income-related surcharges that apply to both Part B and Part D drug premiums. During 2020, for example, individuals making more than $87k per year and couples filing jointly making over $174k per year began paying higher premiums for Part B and Part D than other recipients, with those at the top of the surcharge paying almost $1,000 per month for Part B premiums alone.

Income Caps on Working Beneficiaries

Finally, there are new earnings limits for workers below full retirement age (age 66 for people born in 1943 through 1954). In 2021, those who are not at full retirement age will lose $1 in Social Security benefits for every $2 they earn over $1,580 a month ($18,960 per year). After reaching one’s full retirement age, there are no earning thresholds that will impact benefits.

Conclusion

The 2021 COLA increase continues the recent trend of coming in low and putting pressure on retirees’ finances, while medical expenses continue to rise at much faster rates. As a result, retirees will see less disposable income from their benefits, while high-earning workers will see continued tax increases that outpace benefit payouts. This puts pressure on all beneficiaries of the system.

1 Starting in 1975, Social Security benefit increases have been based on cost-of-living adjustments (COLAs). Pre-1975, the benefit increases were set by legislation.

How Businesses Can Adapt, Grow During COVID-19

In order to survive – and even thrive – during these unprecedented times, small businesses have had to find new ways to make money. The UPS Store’s Small Biz Buzz survey found that 41 percent of small businesses in the United States took steps to modify their businesses in hopes of survival. Fifteen percent provided customers with curbside delivery options, 28 percent moved to online sales as their primary source of sales, and 65 percent made a concerted effort to grow their e-commerce capabilities.

More than 50 percent of those polled by a U.S. Census Bureau Small Business Pulse Survey said it would be at least half a year before pre-COVID levels of business come back. Looking at overall economic recovery, and we could be waiting five years or more for things to return to where they were before. When it comes to small businesses, it might take even more time; however, businesses that adapt will be more likely to succeed.

In order to increase the chances of the pivot being successful, Harvard Business Review recommends doing so based on the newly created conditions of the crisis. In the case of the pandemic, it’s created more telecommuting, disrupted supply chains, and required everyone to socially distance for work, leisure, and daily tasks. In light of these circumstances, there are three factors for a pivot to be successful.

Social Distancing Opportunities

With the pandemic demanding less contact, chiefly through social distancing, businesses must find ways to work around the new circumstances. One example is how dating websites have added video dating for users. Other examples include grocery stores limiting in-store customers, requiring workers and customers to wear masks, and adding more and wider delivery areas for groceries and other products.

Building on Original Business Concept

The second recommendation by HBR is that businesses examine how additional and different services or products complement the original business concept.

Let’s consider Airbnb; when travel and resulting bookings collapsed, the platform’s hosts received financial assistance that helped facilitate guest relations virtually. In a shift from its non-hotel lodging option via homeowners and apartment dwellers offering their abode for rent, Airbnb moved to provide hosts with the ability to hold online events, such as cooking classes, art therapy, virtual tours, or other activities.

Looking to the future and building on the opportunity for growth, tourists could learn about new places to travel and things to do and learn while visiting the new destination.

Adapting to Change by Adding Value

The final ingredient of a successful pivot, according to HBR, is that the move demonstrates how well a company can adapt, work through problems and adjust to market forces while proving profitable and resonating as a value in the consumer’s view.

Before the lockdown orders, Spotify placed a sizeable portion of its business model on having primarily free customers stream music on personal devices. Spotify would benefit in two ways – they wouldn’t have to send out Spotify-specific devices, along with relying on receiving advertisers’ income that free users would listen to in exchange for a free Spotify membership. However, when the pandemic hit, Spotify’s advertisers cut their marketing budgets, making this business model difficult for Spotify to sustain.

Spotify’s pivot offered podcasts for users from music artists, talk show hosts, celebrities, etc. By offering premium subscriptions for its podcasts, along with curated, niche programming, Spotify gave customers more control and a better value over previous media offerings.

While the pandemic doesn’t necessarily mean a “going out of business sign” for companies, it could spell the end of the road for those that don’t adapt to the new economy.

Sources

https://www.uschamber.com/co/start/strategy/metlife-us-chamber-small-business-index-covid-19

https://hbr.org/2020/07/how-businesses-have-successfully-pivoted-during-the-pandemic

https://www.uschamber.com/co/start/strategy/pivoting-your-business-to-survive-pandemic

How Will the Biden Administration Influence the Federal Reserve?

With the nation on the precipice of a transition of administrations on Jan. 20, 2021, there will need to be many roles filled both in and out of the White House. With the potential for Janet Yellen to replace Steven Mnuchin as the next treasury secretary, there is much speculation about how the Federal Reserve will be shaped by the Biden administration.

Predicting Changes to the Federal Reserve

When 2022 arrives, Chair of the Federal Reserve Jerome Powell’s term will expire. While presidents have historically given another term to first-term chairs who were appointed by the outgoing administration, there is no indication that Powell will stay on for another year. President Trump deviated from this norm when he appointed Powell to replace then-Chair Janet Yellen. Originally appointed by Obama to the Fed in 2012, Powell was first a Fed governor and a Republican politically.

First Vice Chair Richard Clarida’s term expires in January 2022. Vice-Chair of Banking Supervision Randal Quarles’ term expires in October 2021. Both vice-chairs are expected to be replaced when their terms are up.  

With two Fed board seats still unfilled, and if the Biden administration nominates Fed Governor Lael Brainard to become the next Treasury Secretary, it would create a third Fed board seat opening. Brainard is favored as a strong candidate because many economic experts see a need for the Fed and the U.S. Treasury to work together closely.    

While President Trump attempted to fill one of the empty Fed seats with Judy Shelton, on Nov. 17, the U.S. Senate declined her nomination to sit on the Federal Reserve Board of Governors; Christopher Waller still could be confirmed during the Senate’s post-election session. Assuming he doesn’t get confirmed before Congress adjourns and 2020 closes, the nomination will expire.

What’s Not Expected to Change

When it comes down to how the Fed handles monetary policy, chances are things won’t change much from the current status quo. Since the U.S. economy is still in a malaise due to the harmful effects of the COVID-19 pandemic, the Fed has made a crystal-clear statement that interest rates will remain at “near zero” for the next 36 months, at a minimum.

In August 2020, the Fed announced that it’s recommitting itself to maintain existing rates as the economy emerges from the downturn for a longer period of time, compared to past Federal Reserve efforts to spur economic growth. Then on Nov. 5, the Federal Reserve’s FOMC Statement reinforced that the federal funds rates will stay at 0 percent to ¼ percent, as long as economic growth is threatened.

Promoting Diversity

Part of the Democrats’ legislative agenda is for the Fed to take action to reduce racial inequality. The objective is for this to become part of the Fed’s existing mandate, which currently includes price stability and maximum employment. If President Biden endorses this legislation, it would likely have an even greater impact on the Fed.

Another thing to consider is that Biden is expected to appoint more minorities to the FOMC, which, with the exception of Janet Yellen serving a four-year term, has been all white men.

Many at the Fed already recognize the importance of including all Americans in opportunities to benefit from a robust economy. During August 2020, the Fed announced that it is taking its time boosting interest rates, in contrast to how it handled past economic challenges, in order to produce an economy that favors job seekers, especially minorities.

Chairman Jerome Powell explained to the media that the Fed is ready and able to implement its financial instruments to prop up the economy and ensure that the country’s emergence from COVID-19 will be assisted. Powell has called on Congress to pass more stimulus, especially to help those who lost jobs from the pandemic.

Depending on who is selected and confirmed as treasury secretary, there could be a renewed hope for recently discontinued stimulus programs, some in conjunction with the Fed. In a letter dated Nov. 19, Treasury Secretary Steven Mnuchin indicated to Jerome Powell the following Federal Reserve programs that will cease functioning on Dec. 31, 2020:

  • Program 1: Primary Market Corporate Credit Facility (PMCCF)
  • Program 2: Secondary Market Corporate Credit Facility (SMCCF)
  • Program 3: Municipal Liquidity Facility (MLF)
  • Program 4: Main Street Lending Program (MSLP)
  • Program 5: Term Asset-Back Securities Loan Facility (TALF)

Funded via Congress’ CARES Act, these programs give the Fed the power to loan as much as $4.5 trillion to markets.

Naturally, this move is currently opposed by the Fed because it takes away additional tools that can be deployed to support the economy and its underlying financial systems. Treasury Secretary Mnuchin’s actions will return $429 billion from the Fed to Congress to be re-appropriated.

One program that will be lost is the MSLP, which was recently modified to give loans as small as $100,000 per applicant. With no more access by year-end, this will likely impact smaller businesses.

It is noteworthy that the following programs were extended for an additional 90 days after Dec. 31, 2020. These include Commercial Paper Funding Facility (CPFF), Market Mutual Fund Liquidity Facility (MMLF), Primary Dealer Credit Facility (PDCF), and Paycheck Protection Program Liquidity Facility (PPPLF), used to shore-up money market liquidity. Though, depending on who is the treasury secretary in 2021, there might be a reconsideration of any or all of these programs. 

COVID-19 Vaccine Rollout: Where We Are So Far

While the pandemic is not over, we do have some good news. There are vaccines and they will be available soon. Here’s where we are in terms of an overall plan and where states are with distributing the vaccines.

Operation Warp Speed

The current administration has already purchased hundreds of millions of doses of several vaccine candidates. Two of them are from Moderna and Pfizer and they’ve shown significant efficacy in Phase 3 clinical trials. The incoming Biden administration will take on distribution and has established a COVID-19 Task Force. A limited number of doses may become available as early as December.

The Interim Playbook

This document from the Center for Disease Control and Prevention (CDC) is the roadmap for state, territorial, tribal, and local public health programs and their partners. It focuses on how to plan and operationalize a vaccine response to the pandemic within their jurisdictions. It’s quite comprehensive and is a good reference for the coming months.

Phased Approach

In the Interim Playbook, the CDC has given states a set of planning assumptions by which they can develop their distribution plans and explains how the vaccine will likely be administered in phases.

  • Phase 1 – there is an initial limited supply of vaccine doses that will be prioritized for certain groups. The distribution will be more tightly controlled and a limited number of providers will be administering the vaccine.
  • Phase 2 – supply would increase and access will be expanded to include a broader set of the population, with more providers involved.
  • Phase 3 – there would likely be sufficient supply to meet demand and distribution would be integrated into routine vaccination programs.

Common Themes and Concerns from State Plans

The Kaiser Family Foundation (KFF), a non-profit organization focusing on national health issues, sought to collect plans from all 50 states and DC. As of Nov. 13, they’ve reviewed 47 of these plans and have singled out key areas contained within each plan.

  • Identifying priority populations for vaccination. Each state will determine who will be first in line, initially; however, every plan highlights the following categories as being the priority during Phase 1: healthcare workers, essential workers, and those at high risk (older people and those with pre-disposing health risk factors). A majority of states (25 of 47, or 53 percent) have at least one mention of incorporating racial and/or ethnic minorities or health equity considerations in their targeting of priority populations. 
  • Identifying the network of providers in their state will be responsible for administering vaccines. Even though states are at different points in the process, providers will likely include hospitals and doctors’ offices, pharmacies, health departments, federally qualified health centers, and other clinics that play a role in administering vaccines today. Given the need to quickly vaccinate most residents, additional partners will be needed, such as long-term care facilities, and will (potentially) set up public locations like schools and community centers for mass vaccinations.
  • Developing the data collection and reporting systems needed to track the vaccine distribution progress. Many states are relying on (and often expanding) existing state-level immunization registries, while other states are developing new systems or using those provided by the federal government. To sum it up, each state is at a different stage in this process.
  • Laying out a communications strategy for the period before and during vaccination. The CDC has asked states to design plans that anticipate and respond to different populations and include the need to address misinformation and vaccine hesitancy. Not surprisingly, some of these states’ plans are detailed while some are not.

All of these things are high-level summations of what is planned so far. For a more detailed explanation, check out the Interim Playbook from the CDC. The COVID-19 situation is ever-changing, but the most important takeaway is that steps are being put in place to help protect us all. Stay safe.

Sources

States Are Getting Ready to Distribute COVID-19 Vaccines. What Do Their Plans Tell Us So Far?

https://www.newsweek.com/fauci-optimistic-about-covid-19-vaccine-says-high-risk-could-get-it-december-1546384

https://www.cdc.gov/vaccines/imz-managers/downloads/COVID-19-Vaccination-Program-Interim_Playbook.pdf

A Flush of Protections for Veterans and Native Americans

Veterans’ Compensation Cost-of-Living Adjustment Act of 2020 (HR 6168) – Introduced by Rep. Elaine Luria (D-VA) on March 10, this bill increases Vet compensation benefits by 1.3 percent (the same as for Social Security recipients). The increase impacts veteran disability compensation, compensation for dependents, the clothing allowance for certain disabled veterans, and dependency and indemnity compensation for surviving spouses and children. This bill passed in the House in May and the Senate in September, and was signed into law by the president on Oct. 20.

Veterans’ Care Quality Transparency Act (HR 2372) – Designed to improve mental health care for veterans and reduce suicide rates, this bill was introduced by Rep. Lauren Underwood (D-IL) on April 25, 2019. It requires the Government Accountability Office (GAO) to report on all arrangements between the Department of Veterans Affairs (VA) and non-VA organizations related to suicide prevention and mental health services. The bill passed in the House in May, the Senate in September, and was enacted on Oct. 20.

Improving Safety and Security for Veterans Act of 2019 (S 3147) – This Act was introduced by Sen. Joe Manchin (D-WV) on Dec. 19, 2019. The bill passed in the Senate in December 2019, the House in November, and is waiting to be signed by the president. Following the investigation of events that ended in tragic veteran deaths in 2017 and 2018, this legislation aims to increase VA health center accountability. Specifically, it requires the Department of Veterans Affairs to submit reports to Congress detailing VA policies and procedures relating to patient safety and quality of care. The first report is due within 30 days after the bill is written into law.

Whole Veteran Act (HR 2359) – This bill was introduced by Rep. Connor Lamb (D-PA) on April 25, 2019. The purpose of this legislation is to expand VA Health efforts to deploy a holistic model of care that focuses on patient engagement and total health. It includes integrating non-drug approaches, such as hypnosis and acupuncture, with standard medical treatment. The bill passed in the House in May, the Senate in October, and was signed into law by the president on Oct. 30.

Vet Center Eligibility Expansion Act (HR 1812) – This legislation extends readjustment counseling and related mental health services to non-combat veterans. These benefits are now available to National Guard and Reserve troops whose service includes fighting national disasters and other emergency and crisis situations. Introduced by Rep. Phil Roe (R-TN) on March 18, 2019, this bill passed in the House in May, the Senate in September, and was signed by the president on Oct. 20.

A bill to nullify the Supplemental Treaty Between the United States of America and the Confederated Tribes and Bands of Indians of Middle Oregon, concluded on Nov. 15, 1865 (S 832) – This bill nullifies the supplemental treaty between the United States and this particular tribe in Middle Oregon, which was signed in 1865. The treaty restricted the tribe members from leaving the reservation, among other conditions. The Department of the Interior has stated that the treaty was never enforced by the federal government or Oregon. The legislation was introduced by Sen. Jeff Merkley (D-OR) on March 19, 2019, passed in both Houses, and signed into law on Oct. 20.

Native American Business Incubators Program Act (S 294) – This bill establishes a grant program to provide business incubation and other business services to Native American entrepreneurs and businesses. It was introduced by Sen. Tom Udall (D-NM) on Jan. 31, 2019, passed in both Houses, and signed by the president on Oct. 20.