First Person

I Thought I Was a Young Invincible. I Was Wrong.

When the Affordable Care Act passed in 2010, I honestly didn’t believe it applied to me. I was young and healthy, and faced other, more pressing concerns at the time, such as pursuing my education.

But all that changed this February when I was sitting on the train on my way to my graduate class and felt my heart race. I wasn’t nervous or stressed, but could feel my pulse thundering throughout my body—the type of feeling you get when your professor is cold-calling students with questions and you haven’t done the reading.

Chastened, I resolved to start running again and cut back on my caffeine. But my palpitations didn’t go away. After two months of diet and exercise (and persistent chiding from my mother), I reluctantly went to the doctor. I didn’t expect much to come out of it. Why would I need to see a doctor? I was young and healthy and heart problems only happened to older people—I was a young invincible.

My first real sense of concern arose when the nurse practitioner put her stethoscope to my chest and her eyes widened. She proceeded to tell me that I had a very clear heart murmur, a whooshing sound indicating turbulent blood around my heart. An echocardiogram later revealed a mitral valve prolapse, and a subsequent test showed significant regurgitation.

I went from being a healthy young adult to one in need of heart surgery.

Put into plain English, one of the valves of my heart doesn’t close properly, allowing blood that should be pumped out of my heart to spill back in. In cases like this, the heart compensates and pumps harder to keep the blood out. My doctor recommended mitral valve repair surgery, an open-heart surgery that will require me to stay in the hospital for at least five days after the operation, followed by four to six weeks’ recuperation.

And so, in a period of three months, I went from being a healthy young adult to one in need of heart surgery. I was shocked, but in some ways I was lucky. I was insured, thanks to the Affordable Care Act.

The ACA helped me when I transferred from a full-time position to a part-time one and lost my employer-provided health insurance. After conversations with multiple people about the risks of forgoing health insurance, I decided to purchase coverage through the New York marketplace.

I am incredibly fortunate that I chose—and was able to afford—the route of subsidized insurance premiums. While the cost for mitral valve repair surgery before insurance is around $30,000, the entire ordeal can cost upwards of $200,000. With that high of a price tag, the surgery would have financially crippled me. But due to my insurance, I will only be responsible for copays and deductibles.

I cannot imagine the stress of knowing I could not afford a surgery that could save my life. But that’s a reality for too many Americans—particularly millennials of color—even though the ACA has resulted in the largest gains in coverage in decades. These gaps are in part due to the fact that 20 states have refused to expand Medicaid, which has meant that 3.1 million otherwise eligible adults fall into what is known as the “coverage gap”—they earn too much for Medicaid but too little to access the subsidies they need to afford insurance. Of that group, nearly half are adults aged 19 to 34.

With that high of a price tag, the surgery would have financially crippled me.

The fact that vulnerable people have been left without insurance doesn’t seem to bother some on the right, including governor-elect Matt Bevin of Kentucky. Although the state has already expanded Medicaid, Bevin has promised to dismantle the state-run Kynect exchange, leaving over 300,000 people that were previously covered through the expansion without affordable health insurance. This disastrous move would undo the immense good that the policy has achieved, including the second largest drop in uninsured rates in the nation.

Furthermore, the Senate recently passed a bill that can only be described as highly destructive. The proposed legislation would nearly double the number of uninsured Americans by dismantling Medicaid expansion for the 30 states, plus the District of Columbia, that have already implemented it. Simultaneously, it would eliminate subsidies that help low-income people purchase coverage.

This proposal represents a callous disregard for the lives of low-income Americans. We should be removing barriers to insurance, not impeding paths to coverage. I hope that our elected officials consider the human costs of their decisions and remember citizens like myself whose lives might depend on accessing that coverage.




Why Achieving the American Dream Depends on Your Zip Code

Today, the state of the American Dream—the ability of anyone to work hard and get ahead—largely depends on one’s zip code. That is more than a little troubling, given that 97 percent of Americans believe everyone should have an equal shot at success.

As President Obama put it earlier this year: “In this country, of all countries, a person’s zip code shouldn’t decide their destiny.”

But what makes this trend even more problematic, as a new Center for American Progress report indicates, is that now—due to a lack of affordable housing and enduring patterns of residential segregation—the zip code where people live is largely determined by income, race, and ethnicity.

The report’s co-authors suggest that if we want to change this unacceptable status quo we need to work on two fronts: reinvest in impoverished neighborhoods so that residents have access to high-quality housing, jobs, good schools, transportation, and other basics; and ensure that families with low-incomes have access to affordable housing in neighborhoods that already offer residents these resources.

For low-income renters, the affordable housing situation is now a crisis. As Housing and Urban Development Secretary Julián Castro said at the release of the report: “This issue of an affordability crisis on the rental market is real, in big cities and in small towns.”

Indeed, half of all renters in the U.S. spend more than 30 percent of their income on housing (above the threshold commonly defined as “affordable”); and more than a quarter spend over 50 percent of their income. On top of that, the housing that is available is increasingly limited to high-poverty, low-opportunity neighborhoods: 13.8 million Americans now live in neighborhoods where more than 40 percent of residents are poor, nearly double the number of people in 2000.

When low-income families are able to move to neighborhoods that foster mobility, the benefits are clear: the children perform much better academically than their peers in high-poverty neighborhoods; their average annual earnings as adults increase by 31 percent; they are more likely to attend college and less likely to become single parents. There is also marked improvement in physical and mental health, particularly for adults and girls.

Quanda Burrell, 30, lives with her 10-year-old daughter and 5-year-old son in Boston where she works full-time as a childcare teacher for infants. She grew up in low-income communities, where there was a lot of drug and gang activity and shootings.

When she was pregnant with her first child, she was couch-surfing with friends and relatives, and briefly lived in two homeless shelters. She then moved to privately-owned, subsidized housing in a mixed-income neighborhood.

“The neighborhood was primarily Caucasian, and quiet,” Burrell said. “That took getting used to.”

Her children haven’t had to face the stressors Burrell dealt with—like how to cross rival gang territories in order to walk to the park; getting robbed at gunpoint when walking home from work during high school; or needing to stay inside of the house “for safety reasons.” Her family has also enjoyed quality childcare and schools, and easy access to services like WIC, a food pantry, and a diaper bank when they have needed help.

“But the number one difference is safety,” she said.

In order to help more low-income families move to high-opportunity neighborhoods, the report recommends establishing a federal law that would prohibit landlords from refusing tenants just because they possess a housing voucher. Additionally, the authors call for the elimination of exclusionary zoning—“ranging from density limits and minimum lot size requirements to community vetoes of new construction”—which limit affordable housing construction and increase racial and economic segregation.

But not every family is going to be able to move to a high-opportunity neighborhood (nor does every family want to relocate), which is why we need to revitalize distressed communities as well.

Secretary Castro and the report’s co-authors point to the Obama Administration’s Promise Zone model as one way to do that. The initiative aims to revitalize high-poverty communities through comprehensive, evidence-based strategies that break siloes—so that people working on issues ranging from housing, transportation, job training, health equity, youth employment, and more—are working collaboratively towards solutions that connect these issues. There is also technical assistance to help the zones access federal funding and other resources.

“I believe that ultimately more local communities [will] put this kind of thinking into action, and challenge the state and federal government to do the same,” said Secretary Castro.

Whether families remain in distressed neighborhoods or move to more affluent ones, a big part of the solution lies in increasing the overall supply of affordable housing. Currently, for every 100 households earning below 30 percent of the area median income, there are just 28 affordable and available units. That adds up to a shortage of 4.5 million units just for those very low-income households.

If our priorities weren’t so skewed to benefit affluent homeowners, an increase in our affordable housing stock might be more easily achieved. As the report notes, “More than 75 percent of federal housing expenditures support homeownership. More than half of these…benefit high-income households earning more than $100,000 per year.” In all, we spend nearly three times more on subsidizing homeownership than we do on rental assistance. It should come as no surprise then that only 1 in 4 households eligible for federal rental assistance actually receives it.

This trend could easily get worse before it gets better.

If our priorities weren’t so skewed to benefit affluent homeowners, an increase in our affordable housing stock might be more easily achieved

According to the authors, 2.1 million units of subsidized affordable housing are at risk over the next 10 years as rent restrictions expire and landlords look to cash in. It is critical that states and cities pass laws that give tenants, local agencies, and non-profits opportunities to purchase these units from private landlords. “Opportunity to purchase” laws have proven most effective where there are entities committed to affordable housing, including “local housing agencies, legal aid clinics…and mission-oriented non-profits that specialize in preservation transactions.”

The report co-authors also suggest that we could do a better job increasing the supply of affordable housing through tax policy. For example, they argue that we need to expand and better target the Low Income Housing Tax Credit (LIHTC), which in the past 30 years has preserved more than 2.7 million affordable units and leveraged more than $100 billion in private capital. The LIHTC program offers significant tax credits to participants who “agree to keep the units affordable to very low-income tenants for a period of at least 30 years.” We also need to allocate these credits based on where the need for affordable housing is greatest, rather than the current approach of making the determination based on a state’s population.

Finally, we need to promote mobility and access to more affordable units by better funding the voucher program. The authors note that “while the share of households that are spending unsustainable portions of the income on rent has grown, the number of households that are receiving rental assistance has remained flat.” In fact, sequestration alone resulted in 70,000 fewer families receiving vouchers.

There is no question that these reforms and the many others outlined in the report would dramatically increase affordable housing in our nation and move us closer to our ideal that “anyone can rise.” The question—and it’s always the question when it comes to poverty and opportunity in America—is how do we create the political will to make it happen?

Burrell believes low-income people speaking out is key.

“A lot of people say that the political leaders in the statehouse don’t care about them,” she said. “But you got to make them care. You got to visit them, speak out. If more low-income folks were talking, I think that would make a difference.”

Secretary Castro seemed to largely agree, adding that the rental crisis is also harming the middle class.

“How do you mobilize folks to impress upon policymakers at all levels about the needs of different communities?” Secretary Castro asked. “I don’t see that conversation right now happening enough.”


First Person

How My Criminal Record Is Punishing My Whole Family

I am a 32-year-old mother of three living in Philadelphia. My children are 14, 8, and 6, and while I support them on my own, it isn’t easy due to a criminal record I have from almost ten years ago.

Back in 2006, I was convicted of disorderly conduct (a third-degree misdemeanor) after a run-in with law enforcement. While I was recording an incident in my neighborhood where a cop was beating up a person on his corner, the officers saw me taping them and told me to stop. They also tried to take my camera phone. I pulled away and a group of cops started running after me and assaulted me. I was hurt pretty badly and sustained multiple injuries, including a fractured hand and bruises all over my body. I still have scars to this day.

And so even though I had done nothing wrong, I was convicted of “disorderly conduct” and sentenced to 6 months of probation. I didn’t do any jail time, but I was left with a criminal record.

It’s been almost 10 years since I paid my debt to society, but I’m still being punished. My whole family is still being punished.

That was hardly the end of my punishment. At the time, I was making enough to support my family as a customer service representative for a health insurance company. I needed to take medical leave after the assault and was told I could come back when I was ready. But when I tried to go back to my job, I was forced to “re-apply.” I had to fill out a job application that asked if I had ever been convicted of a felony or a misdemeanor. I had to check yes, and they refused to take me back.

Even with just a third-degree misdemeanor on my record, I haven’t been able to find a steady job since. I’ve tried to find work in customer service, but I have been told over and over that I need a “clean background” to be hired. And so, to try to make ends meet, I am currently doing part-time work for my brother who owns a small trucking business. The company doesn’t have enough business to pay me even a fraction of what I was earning before. I make just $150 per week, which means I need to turn to food stamps to keep my family afloat.

It’s been almost 10 years since I paid my debt to society, but I’m still being punished. My whole family is still being punished. All I want is to be able to move on and to support my family so that my kids have a chance at a better life.

And I’m far from alone. According to a new study by the Center for American Progress, nearly half of kids in the United States now have a parent with a criminal record.

As policymakers debate fixing the criminal justice system, I hope they hear my story. People like me should be able to earn a clean slate once we’ve paid our debt to society so we can support our families.

And instead of having our resumes thrown in the trash just because we checked the box, we deserve a chance to show employers that we’re worth hiring.

I’m not asking for much—just that people like me get a second chance so that we can be the parents we want to be.



How Congress Wants to Bring Sex Education Back to the Dark Ages

As the deadline for Congress to pass the budget deal—or else shut down the government—looms closer, our elected officials have found themselves embroiled in yet another battle. This time around, an important sex education program that benefits low-income teens and women of color is at stake, as conservatives threaten to gut the Teen Pregnancy Prevention Initiative (TPPI).

Although we have seen a dramatic decrease in the number of teen pregnancies, the United States still experiences higher rates of teen pregnancy and sexually transmitted infections (including HIV) than other Western countries. Despite this fact, current conservative proposals would cut funding for TPPI by nearly 90 percent. This critical program, which represents one of the two major federal funding streams for comprehensive sex education, works to reduce the number of unplanned teen pregnancies through increasing access to medically-accurate and age-appropriate evidence-based programs, contraception, and reproductive health care services. But instead of backing this successful model, Congress would increase funding for Abstinence Only Until Marriage programs (AOUM) by $10 million, despite the fact that states with abstinence-only education have the highest teen birth rates.

Many AOUM programs (also known by the misleading term “Sexual Risk Avoidance” programs) advance deeply problematic gender expectations and generally ignore the needs of LGBTQ youth or stigmatize homosexuality. They also often provide medically inaccurate information, undermining students’ ability to make safe and informed choices.

This misguided effort by conservatives to gut TPPI fails to address the immediate causes of teen pregnancy. The U.S. has high rates of unplanned pregnancy and STIs relative to other nations likely because we have lower rates of contraceptive use. By contrast, comprehensive sex education, which TPPI helps to provide, increases contraception usage and particularly benefits teens, who are disproportionately likely to experience unplanned pregnancies.

Unlike abstinence-only programs, TPPI also works to address racial disparities in access to comprehensive sex education by specifically focusing on the African American and Hispanic communities. These communities are less likely to receive comprehensive sex education—if any at all—and face higher rates of poverty. Economic deprivation is known to make it more difficult for teens of color to access contraception and other sexual health services. The result is that Hispanic and black youth have the highest teen pregnancy rates—more than double that of white youth—and are disproportionately likely to contract STIs.

We have to avoid treating teen pregnancy prevention as a silver-bullet solution to ending poverty.

The facts clearly show that it is counterproductive for Congress to slash funding for evidenced-based programs while pouring more resources into programs that we know are ineffective. Moreover, it is inequitable, as cutting TPPI funds would specifically harm the students who already face limited access to comprehensive sex education and reproductive health care services.

But while the correlations between poverty, race, and teen pregnancy are undeniable, we have to avoid treating teen pregnancy prevention as a silver-bullet solution to ending poverty. A 30-year study from the University of Pennsylvania that followed 300 teen mothers from Baltimore found that teen childbirth was not the major cause of their economic difficulties. This finding has been supported by Melissa Kearney and Phillip Levine who also note that, “teen birth itself does not appear to have much direct economic consequence.” Rather, women who grow up in poverty are likely to live in poverty their entire lives regardless of whether or not they have a baby as a teen or wait until they are older.

But regardless of its effectiveness as an anti-poverty measure, the work of TPPI to reduce the prevalence of STIs and unplanned pregnancy is valuable. The program promotes equality among teenagers and increases students’ agency. Moreover, TPPI is ushering in an important paradigm shift by funding comprehensive sex education aimed at empowering young people to parent when they decide they are ready; this contrasts with the dangerous notion of using contraceptives to reduce the number of poor children, an idea popular among some moderate and conservative politicians that brings to mind a dark history of forced sterilizations and state control over the bodies of low-income women.

Instead of gutting effective programs, our elected leaders should adopt a broad strategy to ensure young people can reach their full potential. While programs like TPPI that fund comprehensive sex education are a central part of this work, the government must also invest in jobs and adopt strong anti-poverty policies in order to bring about more opportunities for social mobility.

The clock is ticking for Congress to act. We need politicians that will fight for the sexual health and empowerment of teenagers, not contest the very existence of the institution they serve.




Minneapolis Shootings Show That Communities Need Resources, Not More Policing

The recent shootings of Black protesters by white vigilantes in Minneapolis—and the ensuing anemic response by local police—are symptoms of a culture of racism that devalues Black lives. It is clear to many of the residents of Minneapolis and beyond that police do not make them safer. We need to reimagine community safety as something very different from policing and mass incarceration.

As members of Minneapolis’ Black community staged a peaceful protest against what one relative of Jamar Clark called his “execution-style” killing by police, a masked man—accompanied by three accomplices—shot five Black Lives Matter protesters outside of a police station.

Activists who were on the scene say that police nearby did nothing to protect the protesters and that it took approximately 15 minutes for ambulances to arrive.

The shooting of peaceful protesters by white vigilantes is terrorism, plain and simple. The victims were shot as they exercised their right to free assembly. The horrific act should have been met with a state response that takes these ongoing threats seriously and did not perpetuate the devaluing of Black life. Instead, the response by the City demonstrates that the policing and criminal justice systems in Minneapolis are irredeemably broken.

The police in Minneapolis were aware of threats to the protesters but took no action to avert this tragedy. All four suspects managed to get away after drawing guns and shooting five protesters only a block away from the Fourth Precinct police station. Activists reported that during the chaos of the shootings, not only did police fail to protect the demonstrators, but they taunted and maced them. In the past week, the Minneapolis Police Department further escalated tensions by using a chemical irritant against protesters.

The shootings in Minneapolis took place on the same week as the one-year anniversary of the shooting of 12-year-old Tamir Rice. They also occurred the week that first-degree murder charges were filed against a Chicago officer in the merciless shooting of 17-year-old Laquan McDonald.  Indeed, Minneapolis is the latest example that our criminal justice and policing systems are not designed to keep Black communities safe. All around the country, Black people are finding that they are as under-protected as they are over-policed.

We must address not only this current crisis but the root causes that created it.

We need to reimagine community safety as something very different from policing and mass incarceration.

We need meaningful community control of police and support for Black communities to address safety concerns. Communities are experts in the type of policing they need and must have the power to set police priorities, determine policing tactics, and make hiring and firing decisions. Police departments in San Francisco and Newark have introduced programs in which local communities have a meaningful say in setting priorities for the department, but there are currently no existing ideal models for community control of local police.

We need to ensure that our communities are protected not only from white vigilantes, but from other forms of violence ignored by the state, including poverty, a dearth of employment opportunities, failing education systems, homelessness, and a lack of mental health services. We know that investments in education, affordable housing, mental health services, restorative justice programs, and higher wages are vital for rebuilding these traumatized communities.

The United States spends $100 billion annually on policing alone—this despite a steady decline in crime rates. Growth in corrections spending has outpaced growth in expenditures in other critical areas. State spending on higher education rose by less than six percent between 1986 and 2013, yet corrections spending jumped by 141 percent.

If all of the energy and resources that go towards policing and incarceration were instead redirected toward these basic needs and opportunities, we would see a kind of safety we have not seen in this country since its original sin.

Legislators and state officials have stripped our communities of basic resources, preyed and profited on our exploitation, and continue to fill prisons while shutting down schools. The killing of Jamar Clark and the terrorist event in Minneapolis are the latest symptoms of our great American tragedy.