Part II of the 2015 Brown Center Report on American Education

Over the next several years, policy analysts will evaluate the impact of the Common Core State Standards (CCSS) on U.S. education.  The task promises to be challenging.  The question most analysts will focus on is whether the CCSS is good or bad policy.  This section of the Brown Center Report (BCR) tackles a set of seemingly innocuous questions compared to the hot-button question of whether Common Core is wise or foolish.  The questions all have to do with when Common Core actually started, or more precisely, when the Common Core started having an effect on student learning.  And if it hasn’t yet had an effect, how will we know that CCSS has started to influence student achievement? 

The analysis below probes this issue empirically, hopefully persuading readers that deciding when a policy begins is elemental to evaluating its effects.  The question of a policy’s starting point is not always easy to answer.  Yet the answer has consequences.  You can’t figure out whether a policy worked or not unless you know when it began.^[i] 

The analysis uses surveys of state implementation to model different CCSS starting points for states and produces a second early report card on how CCSS is doing.  The first report card, focusing on math, was presented in last year’s BCR.  The current study updates state implementation ratings that were presented in that report and extends the analysis to achievement in reading.  The goal is not only to estimate CCSS’s early impact, but also to lay out a fair approach for establishing when the Common Core’s impact began—and to do it now before data are generated that either critics or supporters can use to bolster their arguments.  The experience of No Child Left Behind (NCLB) illustrates this necessity.

After the 2008 National Assessment of Educational Progress (NAEP) scores were released, former Secretary of Education Margaret Spellings claimed that the new scores showed “we are on the right track.”^[ii] She pointed out that NAEP gains in the previous decade, 1999-2009, were much larger than in prior decades.  Mark Schneider of the American Institutes of Research (and a former Commissioner of the National Center for Education Statistics [NCES]) reached a different conclusion. He compared NAEP gains from 1996-2003 to 2003-2009 and declared NCLB’s impact disappointing.  “The pre-NCLB gains were greater than the post-NCLB gains.”^[iii]  It is important to highlight that Schneider used the 2003 NAEP scores as the starting point for assessing NCLB.  A report from FairTest on the tenth anniversary of NCLB used the same demarcation for pre- and post-NCLB time frames.^[iv]  FairTest is an advocacy group critical of high stakes testing—and harshly critical of NCLB—but if the 2003 starting point for NAEP is accepted, its conclusion is indisputable, “NAEP score improvement slowed or stopped in both reading and math after NCLB was implemented.” 

Choosing 2003 as NCLB’s starting date is intuitively appealing.  The law was introduced, debated, and passed by Congress in 2001.  President Bush signed NCLB into law on January 8, 2002.  It takes time to implement any law.  The 2003 NAEP is arguably the first chance that the assessment had to register NCLB’s effects. 

Selecting 2003 is consequential, however.  Some of the largest gains in NAEP’s history were registered between 2000 and 2003.  Once 2003 is established as a starting point (or baseline), pre-2003 gains become “pre-NCLB.”  But what if the 2003 NAEP scores were influenced by NCLB? Experiments evaluating the effects of new drugs collect baseline data from subjects before treatment, not after the treatment has begun.   Similarly, evaluating the effects of public policies require that baseline data are not influenced by the policies under evaluation.   

Avoiding such problems is particularly difficult when state or local policies are adopted nationally.  The federal effort to establish a speed limit of 55 miles per hour in the 1970s is a good example.  Several states already had speed limits of 55 mph or lower prior to the federal law’s enactment.  Moreover, a few states lowered speed limits in anticipation of the federal limit while the bill was debated in Congress.  On the day President Nixon signed the bill into law—January 2, 1974—the Associated Press reported that only 29 states would be required to lower speed limits.  Evaluating the effects of the 1974 law with national data but neglecting to adjust for what states were already doing would obviously yield tainted baseline data.

There are comparable reasons for questioning 2003 as a good baseline for evaluating NCLB’s effects.  The key components of NCLB’s accountability provisions—testing students, publicizing the results, and holding schools accountable for results—were already in place in nearly half the states.  In some states they had been in place for several years.  The 1999 iteration of Quality Counts, Education Week’s annual report on state-level efforts to improve public education, entitled Rewarding Results, Punishing Failure, was devoted to state accountability systems and the assessments underpinning them. Testing and accountability are especially important because they have drawn fire from critics of NCLB, a law that wasn’t passed until years later.

The Congressional debate of NCLB legislation took all of 2001, allowing states to pass anticipatory policies.  Derek Neal and Diane Whitmore Schanzenbach reported that “with the passage of NCLB lurking on the horizon,” Illinois placed hundreds of schools on a watch list and declared that future state testing would be high stakes.^[v] In the summer and fall of 2002, with NCLB now the law of the land, state after state released lists of schools falling short of NCLB’s requirements.  Then the 2002-2003 school year began, during which the 2003 NAEP was administered.  Using 2003 as a NAEP baseline assumes that none of these activities—previous accountability systems, public lists of schools in need of improvement, anticipatory policy shifts—influenced achievement.  That is unlikely.^[vi]

Unlike NCLB, there was no “pre-CCSS” state version of Common Core.  States vary in how quickly and aggressively they have implemented CCSS.  For the BCR analyses, two indexes were constructed to model CCSS implementation.  They are based on surveys of state education agencies and named for the two years that the surveys were conducted.  The 2011 survey reported the number of programs (e.g., professional development, new materials) on which states reported spending federal funds to implement CCSS.  Strong implementers spent money on more activities.  The 2011 index was used to investigate eighth grade math achievement in the 2014 BCR.  A new implementation index was created for this year’s study of reading achievement.  The 2013 index is based on a survey asking states when they planned to complete full implementation of CCSS in classrooms.  Strong states aimed for full implementation by 2012-2013 or earlier.      

Fourth grade NAEP reading scores serve as the achievement measure.  Why fourth grade and not eighth?  Reading instruction is a key activity of elementary classrooms but by eighth grade has all but disappeared.  What remains of “reading” as an independent subject, which has typically morphed into the study of literature, is subsumed under the English-Language Arts curriculum, a catchall term that also includes writing, vocabulary, listening, and public speaking.  Most students in fourth grade are in self-contained classes; they receive instruction in all subjects from one teacher.  The impact of CCSS on reading instruction—the recommendation that non-fiction take a larger role in reading materials is a good example—will be concentrated in the activities of a single teacher in elementary schools. The burden for meeting CCSS’s press for non-fiction, on the other hand, is expected to be shared by all middle and high school teachers.^[vii] 

Table 2-1 displays NAEP gains using the 2011 implementation index.  The four year period between 2009 and 2013 is broken down into two parts: 2009-2011 and 2011-2013.  Nineteen states are categorized as “strong” implementers of CCSS on the 2011 index, and from 2009-2013, they outscored the four states that did not adopt CCSS by a little more than one scale score point (0.87 vs. -0.24 for a 1.11 difference).  The non-adopters are the logical control group for CCSS, but with only four states in that category—Alaska, Nebraska, Texas, and Virginia—it is sensitive to big changes in one or two states.  Alaska and Texas both experienced a decline in fourth grade reading scores from 2009-2013.

The 1.11 point advantage in reading gains for strong CCSS implementers is similar to the 1.27 point advantage reported last year for eighth grade math.  Both are small.  The reading difference in favor of CCSS is equal to approximately 0.03 standard deviations of the 2009 baseline reading score.  Also note that the differences were greater in 2009-2011 than in 2011-2013 and that the “medium” implementers performed as well as or better than the strong implementers over the entire four year period (gain of 0.99).

Table 2-2 displays calculations using the 2013 implementation index.  Twelve states are rated as strong CCSS implementers, seven fewer than on the 2011 index.^[viii]  Data for the non-adopters are the same as in the previous table.  In 2009-2013, the strong implementers gained 1.27 NAEP points compared to -0.24 among the non-adopters, a difference of 1.51 points.  The thirty-four states rated as medium implementers gained 0.82.  The strong implementers on this index are states that reported full implementation of CCSS-ELA by 2013.  Their larger gain in 2011-2013 (1.08 points) distinguishes them from the strong implementers in the previous table.  The overall advantage of 1.51 points over non-adopters represents about 0.04 standard deviations of the 2009 NAEP reading score, not a difference with real world significance.  Taken together, the 2011 and 2013 indexes estimate that NAEP reading gains from 2009-2013 were one to one and one-half scale score points larger in the strong CCSS implementation states compared to the states that did not adopt CCSS.

As noted above, the 2013 implementation index is based on when states scheduled full implementation of CCSS in classrooms.  Other than reading achievement, does the index seem to reflect changes in any other classroom variable believed to be related to CCSS implementation?  If the answer is “yes,” that would bolster confidence that the index is measuring changes related to CCSS implementation. 

Let’s examine the types of literature that students encounter during instruction.  Perhaps the most controversial recommendation in the CCSS-ELA standards is the call for teachers to shift the content of reading materials away from stories and other fictional forms of literature in favor of more non-fiction.  NAEP asks fourth grade teachers the extent to which they teach fiction and non-fiction over the course of the school year (see Figure 2-1). 

Historically, fiction dominates fourth grade reading instruction.  It still does.  The percentage of teachers reporting that they teach fiction to a “large extent” exceeded the percentage answering “large extent” for non-fiction by 23 points in 2009 and 25 points in 2011.  In 2013, the difference narrowed to only 15 percentage points, primarily because of non-fiction’s increased use.  Fiction still dominated in 2013, but not by as much as in 2009.

The differences reported in Table 2-3 are national indicators of fiction’s declining prominence in fourth grade reading instruction.  What about the states?  We know that they were involved to varying degrees with the implementation of Common Core from 2009-2013.  Is there evidence that fiction’s prominence was more likely to weaken in states most aggressively pursuing CCSS implementation? 

Table 2-3 displays the data tackling that question.  Fourth grade teachers in strong implementation states decisively favored the use of fiction over non-fiction in 2009 and 2011.  But the prominence of fiction in those states experienced a large decline in 2013 (-12.4 percentage points).  The decline for the entire four year period, 2009-2013, was larger in the strong implementation states (-10.8) than in the medium implementation (-7.5) or non-adoption states (-9.8).  

This section of the Brown Center Report analyzed NAEP data and two indexes of CCSS implementation, one based on data collected in 2011, the second from data collected in 2013.  NAEP scores for 2009-2013 were examined.  Fourth grade reading scores improved by 1.11 scale score points in states with strong implementation of CCSS compared to states that did not adopt CCSS.  A similar comparison in last year’s BCR found a 1.27 point difference on NAEP’s eighth grade math test, also in favor of states with strong implementation of CCSS.  These differences, although certainly encouraging to CCSS supporters, are quite small, amounting to (at most) 0.04 standard deviations (SD) on the NAEP scale.  A threshold of 0.20 SD—five times larger—is often invoked as the minimum size for a test score change to be regarded as noticeable.  The current study’s findings are also merely statistical associations and cannot be used to make causal claims.  Perhaps other factors are driving test score changes, unmeasured by NAEP or the other sources of data analyzed here. 

The analysis also found that fourth grade teachers in strong implementation states are more likely to be shifting reading instruction from fiction to non-fiction texts.  That trend should be monitored closely to see if it continues.  Other events to keep an eye on as the Common Core unfolds include the following:

1.  The 2015 NAEP scores, typically released in the late fall, will be important for the Common Core.  In most states, the first CCSS-aligned state tests will be given in the spring of 2015.  Based on the earlier experiences of Kentucky and New York, results are expected to be disappointing.  Common Core supporters can respond by explaining that assessments given for the first time often produce disappointing results.  They will also claim that the tests are more rigorous than previous state assessments.  But it will be difficult to explain stagnant or falling NAEP scores in an era when implementing CCSS commands so much attention.   

2.  Assessment will become an important implementation variable in 2015 and subsequent years.  For analysts, the strategy employed here, modeling different indicators based on information collected at different stages of implementation, should become even more useful.  Some states are planning to use Smarter Balanced Assessments, others are using the Partnership for Assessment of Readiness for College and Careers (PARCC), and still others are using their own homegrown tests.   To capture variation among the states on this important dimension of implementation, analysts will need to use indicators that are up-to-date.

3.  The politics of Common Core injects a dynamic element into implementation.  The status of implementation is constantly changing.  States may choose to suspend, to delay, or to abandon CCSS.  That will require analysts to regularly re-configure which states are considered “in” Common Core and which states are “out.”  To further complicate matters, states may be “in” some years and “out” in others.

A final word.  When the 2014 BCR was released, many CCSS supporters commented that it is too early to tell the effects of Common Core.  The point that states may need more time operating under CCSS to realize its full effects certainly has merit.  But that does not discount everything states have done so far—including professional development, purchasing new textbooks and other instructional materials, designing new assessments, buying and installing computer systems, and conducting hearings and public outreach—as part of implementing the standards.  Some states are in their fifth year of implementation.  It could be that states need more time, but innovations can also produce their biggest “pop” earlier in implementation rather than later.  Kentucky was one of the earliest states to adopt and implement CCSS.  That state’s NAEP fourth grade reading score declined in both 2009-2011 and 2011-2013.  The optimism of CCSS supporters is understandable, but a one and a half point NAEP gain might be as good as it gets for CCSS.

Downloads

• Download the report

This is part two of my analysis of instruction and Common Core’s implementation.  I dubbed the three-part examination of instruction “The Good, The Bad, and the Ugly.”  Having discussed “the “good” in part one, I now turn to “the bad.”  One particular aspect of the Common Core math standards—the treatment of standard algorithms in whole number arithmetic—will lead some teachers to waste instructional time.

In 1963, psychologist John B. Carroll published a short essay, “A Model of School Learning” in Teachers College Record.  Carroll proposed a parsimonious model of learning that expressed the degree of learning (or what today is commonly called achievement) as a function of the ratio of time spent on learning to the time needed to learn.     

The numerator, time spent learning, has also been given the term opportunity to learn.  The denominator, time needed to learn, is synonymous with student aptitude.  By expressing aptitude as time needed to learn, Carroll refreshingly broke through his era’s debate about the origins of intelligence (nature vs. nurture) and the vocabulary that labels students as having more or less intelligence. He also spoke directly to a primary challenge of teaching: how to effectively produce learning in classrooms populated by students needing vastly different amounts of time to learn the exact same content.^[i] 

The source of that variation is largely irrelevant to the constraints placed on instructional decisions.  Teachers obviously have limited control over the denominator of the ratio (they must take kids as they are) and less than one might think over the numerator.  Teachers allot time to instruction only after educational authorities have decided the number of hours in the school day, the number of days in the school year, the number of minutes in class periods in middle and high schools, and the amount of time set aside for lunch, recess, passing periods, various pull-out programs, pep rallies, and the like.  There are also announcements over the PA system, stray dogs that may wander into the classroom, and other unscheduled encroachments on instructional time.

The model has had a profound influence on educational thought.  As of July 5, 2015, Google Scholar reported 2,931 citations of Carroll’s article.  Benjamin Bloom’s “mastery learning” was deeply influenced by Carroll.  It is predicated on the idea that optimal learning occurs when time spent on learning—rather than content—is allowed to vary, providing to each student the individual amount of time he or she needs to learn a common curriculum.  This is often referred to as “students working at their own pace,” and progress is measured by mastery of content rather than seat time. David C. Berliner’s 1990 discussion of time includes an analysis of mediating variables in the numerator of Carroll’s model, including the amount of time students are willing to spend on learning.  Carroll called this persistence, and Berliner links the construct to student engagement and time on task—topics of keen interest to researchers today.  Berliner notes that although both are typically described in terms of motivation, they can be measured empirically in increments of time.     

Most applications of Carroll’s model have been interested in what happens when insufficient time is provided for learning—in other words, when the numerator of the ratio is significantly less than the denominator.  When that happens, students don’t have an adequate opportunity to learn.  They need more time. 

As applied to Common Core and instruction, one should also be aware of problems that arise from the inefficient distribution of time.  Time is a limited resource that teachers deploy in the production of learning.  Below I discuss instances when the CCSS-M may lead to the numerator in Carroll’s model being significantly larger than the denominator—when teachers spend more time teaching a concept or skill than is necessary.  Because time is limited and fixed, wasted time on one topic will shorten the amount of time available to teach other topics.  Excessive instructional time may also negatively affect student engagement.  Students who have fully learned content that continues to be taught may become bored; they must endure instruction that they do not need.

Jason Zimba, one of the lead authors of the Common Core Math standards, and Barry Garelick, a critic of the standards, had a recent, interesting exchange about when standard algorithms are called for in the CCSS-M.  A standard algorithm is a series of steps designed to compute accurately and quickly.  In the U.S., students are typically taught the standard algorithms of addition, subtraction, multiplication, and division with whole numbers.  Most readers of this post will recognize the standard algorithm for addition.  It involves lining up two or more multi-digit numbers according to place-value, with one number written over the other, and adding the columns from right to left with “carrying” (or regrouping) as needed.

The standard algorithm is the only algorithm required for students to learn, although others are mentioned beginning with the first grade standards.  Curiously, though, CCSS-M doesn’t require students to know the standard algorithms for addition and subtraction until fourth grade.  This opens the door for a lot of wasted time.  Garelick questioned the wisdom of teaching several alternative strategies for addition.  He asked whether, under the Common Core, only the standard algorithm could be taught—or at least, could it be taught first. As he explains:

Delaying teaching of the standard algorithm until fourth grade and relying on place value “strategies” and drawings to add numbers is thought to provide students with the conceptual understanding of adding and subtracting multi-digit numbers. What happens, instead, is that the means to help learn, explain or memorize the procedure become a procedure unto itself and students are required to use inefficient cumbersome methods for two years. This is done in the belief that the alternative approaches confer understanding, so are superior to the standard algorithm. To teach the standard algorithm first would in reformers’ minds be rote learning. Reformers believe that by having students using strategies in lieu of the standard algorithm, students are still learning “skills” (albeit inefficient and confusing ones), and these skills support understanding of the standard algorithm. Students are left with a panoply of methods (praised as a good thing because students should have more than one way to solve problems), that confuse more than enlighten. 

Zimba responded that the standard algorithm could, indeed, be the only method taught because it meets a crucial test: reinforcing knowledge of place value and the properties of operations.  He goes on to say that other algorithms also may be taught that are consistent with the standards, but that the decision to do so is left in the hands of local educators and curriculum designers:

In short, the Common Core requires the standard algorithm; additional algorithms aren’t named, and they aren’t required…Standards can’t settle every disagreement—nor should they. As this discussion of just a single slice of the math curriculum illustrates, teachers and curriculum authors following the standards still may, and still must, make an enormous range of decisions.

Zimba defends delaying mastery of the standard algorithm until fourth grade, referring to it as a “culminating” standard that he would, if he were teaching, introduce in earlier grades.  Zimba illustrates the curricular progression he would employ in a table, showing that he would introduce the standard algorithm for addition late in first grade (with two-digit addends) and then extend the complexity of its use and provide practice towards fluency until reaching the culminating standard in fourth grade. Zimba would introduce the subtraction algorithm in second grade and similarly ramp up its complexity until fourth grade.

It is important to note that in CCSS-M the word “algorithm” appears for the first time (in plural form) in the third grade standards:

3.NBT.2  Fluently add and subtract within 1000 using strategies and algorithms based on place value, properties of operations, and/or the relationship between addition and subtraction.

The term “strategies and algorithms” is curious.  Zimba explains, “It is true that the word ‘algorithms’ here is plural, but that could be read as simply leaving more choice in the hands of the teacher about which algorithm(s) to teach—not as a requirement for each student to learn two or more general algorithms for each operation!” 

I have described before the “dog whistles” embedded in the Common Core, signals to educational progressives—in this case, math reformers—that  despite these being standards, the CCSS-M will allow them great latitude.  Using the plural “algorithms” in this third grade standard and not specifying the standard algorithm until fourth grade is a perfect example of such a dog whistle.

It appears that the Common Core authors wanted to reach a political compromise on standard algorithms. 

Standard algorithms were a key point of contention in the “Math Wars” of the 1990s.   The 1997 California Framework for Mathematics required that students know the standard algorithms for all four operations—addition, subtraction, multiplication, and division—by the end of fourth grade.^[ii]  The 2000 Massachusetts Mathematics Curriculum Framework called for learning the standard algorithms for addition and subtraction by the end of second grade and for multiplication and division by the end of fourth grade.  These two frameworks were heavily influenced by mathematicians (from Stanford in California and Harvard in Massachusetts) and quickly became favorites of math traditionalists.  In both states’ frameworks, the standard algorithm requirements were in direct opposition to the reform-oriented frameworks that preceded them—in which standard algorithms were barely mentioned and alternative algorithms or “strategies” were encouraged. 

Now that the CCSS-M has replaced these two frameworks, the requirement for knowing the standard algorithms in California and Massachusetts slips from third or fourth grade all the way to sixth grade.  That’s what reformers get in the compromise.  They are given a green light to continue teaching alternative algorithms, as long as the algorithms are consistent with teaching place value and properties of arithmetic.  But the standard algorithm is the only one students are required to learn.  And that exclusivity is intended to please the traditionalists.

I agree with Garelick that the compromise leads to problems.  In a 2013 Chalkboard post, I described a first grade math program in which parents were explicitly requested not to teach the standard algorithm for addition when helping their children at home.  The students were being taught how to represent addition with drawings that clustered objects into groups of ten.  The exercises were both time consuming and tedious.  When the parents met with the school principal to discuss the matter, the principal told them that the math program was following the Common Core by promoting deeper learning.  The parents withdrew their child from the school and enrolled him in private school.

The value of standard algorithms is that they are efficient and packed with mathematics.  Once students have mastered single-digit operations and the meaning of place value, the standard algorithms reveal to students that they can take procedures that they already know work well with one- and two-digit numbers, and by applying them over and over again, solve problems with large numbers.  Traditionalists and reformers have different goals.  Reformers believe exposure to several algorithms encourages flexible thinking and the ability to draw on multiple strategies for solving problems.  Traditionalists believe that a bigger problem than students learning too few algorithms is that too few students learn even one algorithm.

I have been a critic of the math reform movement since I taught in the 1980s.  But some of their complaints have merit.  All too often, instruction on standard algorithms has left out meaning.  As Karen C. Fuson and Sybilla Beckmann point out, “an unfortunate dichotomy” emerged in math instruction: teachers taught “strategies” that implied understanding and “algorithms” that implied procedural steps that were to be memorized.  Michael Battista’s research has provided many instances of students clinging to algorithms without understanding.  He gives an example of a student who has not quite mastered the standard algorithm for addition and makes numerous errors on a worksheet.  On one item, for example, the student forgets to carry and calculates that 19 + 6 = 15.  In a post-worksheet interview, the student counts 6 units from 19 and arrives at 25.  Despite the obvious discrepancy—(25 is not 15, the student agrees)—he declares that his answers on the worksheet must be correct because the algorithm he used “always works.”^[iii] 

Math reformers rightfully argue that blind faith in procedure has no place in a thinking mathematical classroom. Who can disagree with that?  Students should be able to evaluate the validity of answers, regardless of the procedures used, and propose alternative solutions.  Standard algorithms are tools to help them do that, but students must be able to apply them, not in a robotic way, but with understanding.

Let’s return to Carroll’s model of time and learning.  I conclude by making two points—one about curriculum and instruction, the other about implementation.

In the study of numbers, a coherent K-12 math curriculum, similar to that of the previous California and Massachusetts frameworks, can be sketched in a few short sentences.  Addition with whole numbers (including the standard algorithm) is taught in first grade, subtraction in second grade, multiplication in third grade, and division in fourth grade.  Thus, the study of whole number arithmetic is completed by the end of fourth grade.  Grades five through seven focus on rational numbers (fractions, decimals, percentages), and grades eight through twelve study advanced mathematics.  Proficiency is sought along three dimensions:  1) fluency with calculations, 2) conceptual understanding, 3) ability to solve problems.

Placing the CCSS-M standard for knowing the standard algorithms of addition and subtraction in fourth grade delays this progression by two years.  Placing the standard for the division algorithm in sixth grade continues the two-year delay.   For many fourth graders, time spent working on addition and subtraction will be wasted time.  They already have a firm understanding of addition and subtraction.  The same thing for many sixth graders—time devoted to the division algorithm will be wasted time that should be devoted to the study of rational numbers.  The numerator in Carroll’s instructional time model will be greater than the denominator, indicating the inefficient allocation of time to instruction.

As Jason Zimba points out, not everyone agrees on when the standard algorithms should be taught, the alternative algorithms that should be taught, the manner in which any algorithm should be taught, or the amount of instructional time that should be spent on computational procedures.  Such decisions are made by local educators.  Variation in these decisions will introduce variation in the implementation of the math standards.  It is true that standards, any standards, cannot control implementation, especially the twists and turns in how they are interpreted by educators and brought to life in classroom instruction.  But in this case, the standards themselves are responsible for the myriad approaches, many unproductive, that we are sure to see as schools teach various algorithms under the Common Core.

Earlier this month, the College Board released SAT scores for the high school graduating class of 2015. Both math and reading scores declined from 2014, continuing a steady downward trend that has been in place for the past decade. Pundits of contrasting political stripes seized on the scores to bolster their political agendas. Michael Petrilli of the Fordham Foundation argued that falling SAT scores show that high schools need more reform, presumably those his organization supports, in particular, charter schools and accountability.* For Carol Burris of the Network for Public Education, the declining scores were evidence of the failure of polices her organization opposes, namely, Common Core, No Child Left Behind, and accountability.

Petrilli and Burris are both misusing SAT scores. The SAT is not designed to measure national achievement; the score losses from 2014 were miniscule; and most of the declines are probably the result of demographic changes in the SAT population. Let’s examine each of these points in greater detail.

It never was. The SAT was originally meant to measure a student’s aptitude for college independent of that student’s exposure to a particular curriculum. The test’s founders believed that gauging aptitude, rather than achievement, would serve the cause of fairness. A bright student from a high school in rural Nebraska or the mountains of West Virginia, they held, should have the same shot at attending elite universities as a student from an Eastern prep school, despite not having been exposed to the great literature and higher mathematics taught at prep schools. The SAT would measure reasoning and analytical skills, not the mastery of any particular body of knowledge. Its scores would level the playing field in terms of curricular exposure while providing a reasonable estimate of an individual’s probability of success in college.

Note that even in this capacity, the scores never suffice alone; they are only used to make admissions decisions by colleges and universities, including such luminaries as Harvard and Stanford, in combination with a lot of other information—grade point averages, curricular resumes, essays, reference letters, extra-curricular activities—all of which constitute a student’s complete application.

Today’s SAT has moved towards being a content-oriented test, but not entirely. Next year, the College Board will introduce a revised SAT to more closely reflect high school curricula. Even then, SAT scores should not be used to make judgements about U.S. high school performance, whether it’s a single high school, a state’s high schools, or all of the high schools in the country. The SAT sample is self-selected. In 2015, it only included about one-half of the nation’s high school graduates: 1.7 million out of approximately 3.3 million total. And that’s about one-ninth of approximately 16 million high school students.  Generalizing SAT scores to these larger populations violates a basic rule of social science. The College Board issues a warning when it releases SAT scores: “Since the population of test takers is self-selected, using aggregate SAT scores to compare or evaluate teachers, schools, districts, states, or other educational units is not valid, and the College Board strongly discourages such uses.”  

TIME’s coverage of the SAT release included a statement by Andrew Ho of Harvard University, who succinctly makes the point: “I think SAT and ACT are tests with important purposes, but measuring overall national educational progress is not one of them.”

SAT scores changed very little from 2014 to 2015. Reading scores dropped from 497 to 495. Math scores also fell two points, from 513 to 511. Both declines are equal to about 0.017 standard deviations (SD).^[i] To illustrate how small these changes truly are, let’s examine a metric I have used previously in discussing test scores. The average American male is 5’10” in height with a SD of about 3 inches. A 0.017 SD change in height is equal to about 1/20 of an inch (0.051). Do you really think you’d notice a difference in the height of two men standing next to each other if they only differed by 1/20^th of an inch? You wouldn’t. Similarly, the change in SAT scores from 2014 to 2015 is trivial.^[ii]

A more serious concern is the SAT trend over the past decade. Since 2005, reading scores are down 13 points, from 508 to 495, and math scores are down nine points, from 520 to 511. These are equivalent to declines of 0.12 SD for reading and 0.08 SD for math.^[iii] Representing changes that have accumulated over a decade, these losses are still quite small. In the Washington Post, Michael Petrilli asked “why is education reform hitting a brick wall in high school?” He also stated that “you see this in all kinds of evidence.”

You do not see a decline in the best evidence, the National Assessment of Educational Progress (NAEP). Contrary to the SAT, NAEP is designed to monitor national achievement. Its test scores are based on a random sampling design, meaning that the scores can be construed as representative of U.S. students. NAEP administers two different tests to high school age students, the long term trend (LTT NAEP), given to 17-year-olds, and the main NAEP, given to twelfth graders.

Table 1 compares the past ten years’ change in test scores of the SAT with changes in NAEP.^[iv] The long term trend NAEP was not administered in 2005 or 2015, so the closest years it was given are shown. The NAEP tests show high school students making small gains over the past decade. They do not confirm the losses on the SAT.

Table 1. Comparison of changes in SAT, Main NAEP (12^th grade), and LTT NAEP (17-year-olds) scores. Changes expressed as SD units of base year.

 *p<.05

Petrilli raised another concern related to NAEP scores by examining cohort trends in NAEP scores. The trend for the 17-year-old cohort of 2012, for example, can be constructed by using the scores of 13-year-olds in 2008 and 9-year-olds in 2004. By tracking NAEP changes over time in this manner, one can get a rough idea of a particular cohort’s achievement as students grow older and proceed through the school system. Examining three cohorts, Fordham’s analysis shows that the gains between ages 13 and 17 are about half as large as those registered between ages nine and 13. Kids gain more on NAEP when they are younger than when they are older.

There is nothing new here. NAEP scholars have been aware of this phenomenon for a long time. Fordham points to particular elements of education reform that it favors—charter schools, vouchers, and accountability—as the probable cause. It is true that those reforms more likely target elementary and middle schools than high schools. But the research literature on age discrepancies in NAEP gains (which is not cited in the Fordham analysis) renders doubtful the thesis that education policies are responsible for the phenomenon.^[v]

Whether high school age students try as hard as they could on NAEP has been pointed to as one explanation. A 1996 analysis of NAEP answer sheets found that 25-to-30 percent of twelfth graders displayed off-task test behaviors—doodling, leaving items blank—compared to 13 percent of eighth graders and six percent of fourth graders. A 2004 national commission on the twelfth grade NAEP recommended incentives (scholarships, certificates, letters of recognition from the President) to boost high school students’ motivation to do well on NAEP. Why would high school seniors or juniors take NAEP seriously when this low stakes test is taken in the midst of taking SAT or ACT tests for college admission, end of course exams that affect high school GPA, AP tests that can affect placement in college courses, state accountability tests that can lead to their schools being deemed a success or failure, and high school exit exams that must be passed to graduate?^[vi]

Other possible explanations for the phenomenon are: 1) differences in the scales between the ages tested on LTT NAEP (in other words, a one-point gain on the scale between ages nine and 13 may not represent the same amount of learning as a one-point gain between ages 13 and 17); 2) different rates of participation in NAEP among elementary, middle, and high schools;^[vii] and 3) social trends that affect all high school students, not just those in public schools. The third possibility can be explored by analyzing trends for students attending private schools. If Fordham had disaggregated the NAEP data by public and private schools (the scores of Catholic school students are available), it would have found that the pattern among private school students is similar—younger students gain more than older students on NAEP. That similarity casts doubt on the notion that policies governing public schools are responsible for the smaller gains among older students.^[viii]

Writing in the Washington Post, Carol Burris addresses the question of whether demographic changes have influenced the decline in SAT scores. She concludes that they have not, and in particular, she concludes that the growing proportion of students receiving exam fee waivers has probably not affected scores. She bases that conclusion on an analysis of SAT participation disaggregated by level of family income. Burris notes that the percentage of SAT takers has been stable across income groups in recent years. That criterion is not trustworthy. About 39 percent of students in 2015 declined to provide information on family income. The 61 percent that answered the family income question are probably skewed against low-income students who are on fee waivers (the assumption being that they may feel uncomfortable answering a question about family income).^[ix] Don’t forget that the SAT population as a whole is a self-selected sample. A self-selected subsample from a self-selected sample tells us even less than the original sample, which told us almost nothing.

The fee waiver share of SAT takers increased from 21 percent in 2011 to 25 percent in 2015. The simple fact that fee waivers serve low-income families, whose children tend to be lower-scoring SAT takers, is important, but not the whole story here. Students from disadvantaged families have always taken the SAT. But they paid for it themselves. If an additional increment of disadvantaged families take the SAT because they don’t have to pay for it, it is important to consider whether the new entrants to the pool of SAT test takers possess unmeasured characteristics that correlate with achievement—beyond the effect already attributed to socioeconomic status.

Robert Kelchen, an assistant professor of higher education at Seton Hall University, calculated the effect on national SAT scores of just three jurisdictions (Washington, DC, Delaware, and Idaho) adopting policies of mandatory SAT testing paid for by the state. He estimated that these policies explain about 21 percent of the nationwide decline in test scores between 2011 and 2015. He also notes that a more thorough analysis, incorporating fee waivers of other states and districts, would surely boost that figure. Fee waivers in two dozen Texas school districts, for example, are granted to all juniors and seniors in high school. And all students in those districts (including Dallas and Fort Worth) are required to take the SAT beginning in the junior year. Such universal testing policies can increase access and serve the cause of equity, but they will also, at least for a while, lead to a decline in SAT scores.

Here, I offer my own back of the envelope calculation of the relationship of demographic changes with SAT scores. The College Board reports test scores and participation rates for nine racial and ethnic groups.^[x] These data are preferable to family income because a) almost all students answer the race/ethnicity question (only four percent are non-responses versus 39 percent for family income), and b) it seems a safe assumption that students are more likely to know their race or ethnicity compared to their family’s income.

The question tackled in Table 2 is this: how much would the national SAT scores have changed from 2005 to 2015 if the scores of each racial/ethnic group stayed exactly the same as in 2005, but each group’s proportion of the total population were allowed to vary? In other words, the scores are fixed at the 2005 level for each group—no change. The SAT national scores are then recalculated using the 2015 proportions that each group represented in the national population.

Table 2. SAT Scores and Demographic Changes in the SAT Population (2005-2015)

The data suggest that two-thirds to three-quarters of the SAT score decline from 2005 to 2015 is associated with demographic changes in the test-taking population. The analysis is admittedly crude. The relationships are correlational, not causal. The race/ethnicity categories are surely serving as proxies for a bundle of other characteristics affecting SAT scores, some unobserved and others (e.g., family income, parental education, language status, class rank) that are included in the SAT questionnaire but produce data difficult to interpret.

Using an annual decline in SAT scores to indict high schools is bogus. The SAT should not be used to measure national achievement. SAT changes from 2014-2015 are tiny. The downward trend over the past decade represents a larger decline in SAT scores, but one that is still small in magnitude and correlated with changes in the SAT test-taking population.

In contrast to SAT scores, NAEP scores, which are designed to monitor national achievement, report slight gains for 17-year-olds over the past ten years. It is true that LTT NAEP gains are larger among students from ages nine to 13 than from ages 13 to 17, but research has uncovered several plausible explanations for why that occurs. The public should exercise great caution in accepting the findings of test score analyses. Test scores are often misinterpreted to promote political agendas, and much of the alarmist rhetoric provoked by small declines in scores is unjustified.

The release of 2015 NAEP scores showed national achievement stalling out or falling in reading and mathematics.  The poor results triggered speculation about the effect of Common Core State Standards (CCSS), the controversial set of standards adopted by more than 40 states since 2010.  Critics of Common Core tended to blame the standards for the disappointing scores.  Its defenders said it was too early to assess CCSS’s impact and that implementation would take many years to unfold. William J. Bushaw, executive director of the National assessment Governing Board, cited “curricular uncertainty” as the culprit.  Secretary of Education Arne Duncan argued that new standards typically experience an “implementation dip” in the early days of teachers actually trying to implement them in classrooms.

In the rush to argue whether CCSS has positively or negatively affected American education, these speculations are vague as to how the standards boosted or depressed learning.  They don’t provide a description of the mechanisms, the connective tissue, linking standards to learning.  Bushaw and Duncan come the closest, arguing that the newness of CCSS has created curriculum confusion, but the explanation falls flat for a couple of reasons.  Curriculum in the three states that adopted the standards, rescinded them, then adopted something else should be extremely confused.  But the 2013-2015 NAEP changes for Indiana, Oklahoma, and South Carolina were a little bit better than the national figures, not worse.[i]  In addition, surveys of math teachers conducted in the first year or two after the standards were adopted found that:  a) most teachers liked them, and b) most teachers said they were already teaching in a manner consistent with CCSS.[ii]  They didn’t mention uncertainty.  Recent polls, however, show those positive sentiments eroding. Mr. Bushaw might be mistaking disenchantment for uncertainty.[iii] 

For teachers, the novelty of CCSS should be dissipating.  Common Core’s advocates placed great faith in professional development to implement the standards.  Well, there’s been a lot of it.  Over the past few years, millions of teacher-hours have been devoted to CCSS training.  Whether all that activity had a lasting impact is questionable.  Randomized control trials have been conducted of two large-scale professional development programs.  Interestingly, although they pre-date CCSS, both programs attempted to promote the kind of “instructional shifts” championed by CCSS advocates. The studies found that if teacher behaviors change from such training—and that’s not a certainty—the changes fade after a year or two.  Indeed, that’s a pattern evident in many studies of educational change: a pop at the beginning, followed by fade out.  

My own work analyzing NAEP scores in 2011 and 2013 led me to conclude that the early implementation of CCSS was producing small, positive changes in NAEP.[iv]  I warned that those gains “may be as good as it gets” for CCSS.[v]  Advocates of the standards hope that CCSS will eventually produce long term positive effects as educators learn how to use them.  That’s a reasonable hypothesis.  But it should now be apparent that a counter-hypothesis has equal standing: any positive effect of adopting Common Core may have already occurred.  To be precise, the proposition is this: any effects from adopting new standards and attempting to change curriculum and instruction to conform to those standards occur early and are small in magnitude.   Policymakers still have a couple of arrows left in the implementation quiver, accountability being the most powerful.  Accountability systems have essentially been put on hold as NCLB sputtered to an end and new CCSS tests appeared on the scene.  So the CCSS story isn’t over.  Both hypotheses remain plausible. 

Reading Instruction in 4^th and 8^th Grades

Back to the mechanisms, the connective tissue binding standards to classrooms.  The 2015 Brown Center Report introduced one possible classroom effect that is showing up in NAEP data: the relative emphasis teachers place on fiction and nonfiction in reading instruction.  The ink was still drying on new Common Core textbooks when a heated debate broke out about CCSS’s recommendation that informational reading should receive greater attention in classrooms.[vi] 

Fiction has long dominated reading instruction.  That dominance appears to be waning.

After 2011, something seems to have happened.  I am more persuaded that Common Core influenced the recent shift towards nonfiction than I am that Common Core has significantly affected student achievement—for either good or ill.   But causality is difficult to confirm or to reject with NAEP data, and trustworthy efforts to do so require a more sophisticated analysis than presented here.

Four lessons from previous education reforms

Nevertheless, the figures above reinforce important lessons that have been learned from previous top-down reforms.  Let’s conclude with four:

1.  There seems to be evidence that CCSS is having an impact on the content of reading instruction, moving from the dominance of fiction over nonfiction to near parity in emphasis.  Unfortunately, as Mark Bauerlein and Sandra Stotsky have pointed out, there is scant evidence that such a shift improves children’s reading.[vii]

2.  Reading more nonfiction does not necessarily mean that students will be reading higher quality texts, even if the materials are aligned with CCSS.   The Core Knowledge Foundation and the Partnership for 21^st Century Learning, both supporters of Common Core, have very different ideas on the texts schools should use with the CCSS.[viii] The two organizations advocate for curricula having almost nothing in common.

3.  When it comes to the study of implementing education reforms, analysts tend to focus on the formal channels of implementation and the standard tools of public administration—for example, intergovernmental hand-offs (federal to state to district to school), alignment of curriculum, assessment and other components of the reform, professional development, getting incentives right, and accountability mechanisms.  Analysts often ignore informal channels, and some of those avenues funnel directly into schools and classrooms.[ix]  Politics and the media are often overlooked.  Principals and teachers are aware of the politics swirling around K-12 school reform.  Many educators undoubtedly formed their own opinions on CCSS and the fiction vs. nonfiction debate before the standard managerial efforts touched them.

4.  Local educators whose jobs are related to curriculum almost certainly have ideas about what constitutes good curriculum.  It’s part of the profession.  Major top-down reforms such as CCSS provide local proponents with political cover to pursue curricular and instructional changes that may be politically unpopular in the local jurisdiction.  Anyone who believes nonfiction should have a more prominent role in the K-12 curriculum was handed a lever for promoting his or her beliefs by CCSS. I’ve previously called these the “dog whistles” of top-down curriculum reform, subtle signals that give local advocates license to promote unpopular positions on controversial issues.

The 2016 Brown Center Report (BCR), which was published last week, presented a study of Common Core State Standards (CCSS).   In this post, I’d like to elaborate on a topic touched upon but deserving further attention: what to expect in Common Core’s immediate political future. I discuss four key challenges that CCSS will face between now and the end of the year.

Let’s set the stage for the discussion.  The BCR study produced two major findings.  First, several changes that CCSS promotes in curriculum and instruction appear to be taking place at the school level.  Second, states that adopted CCSS and have been implementing the standards have registered about the same gains and losses on NAEP as states that either adopted and rescinded CCSS or never adopted CCSS in the first place.  These are merely associations and cannot be interpreted as saying anything about CCSS’s causal impact.  Politically, that doesn’t really matter. The big story is that NAEP scores have been flat for six years, an unprecedented stagnation in national achievement that states have experienced regardless of their stance on CCSS.  Yes, it’s unfair, but CCSS is paying a political price for those disappointing NAEP scores.  No clear NAEP differences have emerged between CCSS adopters and non-adopters to reverse that political dynamic.

"Yes, it’s unfair, but CCSS is paying a political price for those disappointing NAEP scores. No clear NAEP differences have emerged between CCSS adopters and non-adopters to reverse that political dynamic."

TIMSS and PISA scores in November-December

NAEP has two separate test programs.  The scores released in 2015 were for the main NAEP, which began in 1990.  The long term trend (LTT) NAEP, a different test that was first given in 1969, has not been administered since 2012.  It was scheduled to be given in 2016, but was cancelled due to budgetary constraints.  It was next scheduled for 2020, but last fall officials cancelled that round of testing as well, meaning that the LTT NAEP won’t be given again until 2024.  

With the LTT NAEP on hold, only two international assessments will soon offer estimates of U.S. achievement that, like the two NAEP tests, are based on scientific sampling:  PISA and TIMSS.  Both tests were administered in 2015, and the new scores will be released around the Thanksgiving-Christmas period of 2016.  If PISA and TIMSS confirm the stagnant trend in U.S. achievement, expect CCSS to take another political hit.  America’s performance on international tests engenders a lot of hand wringing anyway, so the reaction to disappointing PISA or TIMSS scores may be even more pronounced than what the disappointing NAEP scores generated.

Is teacher support still declining?

Watch Education Next’s survey on Common Core (usually released in August/September) and pay close attention to teacher support for CCSS.  The trend line has been heading steadily south. In 2013, 76 percent of teachers said they supported CCSS and only 12 percent were opposed.  In 2014, teacher support fell to 43 percent and opposition grew to 37 percent.  In 2015, opponents outnumbered supporters for the first time, 50 percent to 37 percent.  Further erosion of teacher support will indicate that Common Core’s implementation is in trouble at the ground level.  Don’t forget: teachers are the final implementers of standards.

An effort by Common Core supporters to change NAEP

The 2015 NAEP math scores were disappointing.  Watch for an attempt by Common Core supporters to change the NAEP math tests. Michael Cohen, President of Achieve, a prominent pro-CCSS organization, released a statement about the 2015 NAEP scores that included the following: "The National Assessment Governing Board, which oversees NAEP, should carefully review its frameworks and assessments in order to ensure that NAEP is in step with the leadership of the states. It appears that there is a mismatch between NAEP and all states' math standards, no matter if they are common standards or not.” 

Reviewing and potentially revising the NAEP math framework is long overdue.  The last adoption was in 2004.  The argument for changing NAEP to place greater emphasis on number and operations, revisions that would bring NAEP into closer alignment with Common Core, also has merit.  I have a longstanding position on the NAEP math framework. In 2001, I urged the National Assessment Governing Board (NAGB) to reject the draft 2004 framework because it was weak on numbers and operations—and especially weak on assessing student proficiency with whole numbers, fractions, decimals, and percentages.  

Common Core’s math standards are right in line with my 2001 complaint.  Despite my sympathy for Common Core advocates’ position, a change in NAEP should not be made because of Common Core.  In that 2001 testimony, I urged NAGB to end the marriage of NAEP with the 1989 standards of the National Council of Teachers of Mathematics, the math reform document that had guided the main NAEP since its inception.  Reform movements come and go, I argued.  NAGB’s job is to keep NAEP rigorously neutral.  The assessment’s integrity depends upon it.  NAEP was originally intended to function as a measuring stick, not as a PR device for one reform or another.  If NAEP is changed it must be done very carefully and should be rooted in the mathematics children must learn.  The political consequences of it appearing that powerful groups in Washington, DC are changing “The Nation’s Report Card” in order for Common Core to look better will hurt both Common Core and NAEP.

Will Opt Out grow?

Watch the Opt Out movement.  In 2015, several organized groups of parents refused to allow their children to take Common Core tests.  In New York state alone, about 60,000 opted out in 2014, skyrocketing to 200,000 in 2015.  Common Core testing for 2016 begins now and goes through May.  It will be important to see whether Opt Out can expand to other states, grow in numbers, and branch out beyond middle- and upper-income neighborhoods.

Conclusion

Common Core is now several years into implementation.  Supporters have had a difficult time persuading skeptics that any positive results have occurred. The best evidence has been mixed on that question.  CCSS advocates say it is too early to tell, and we’ll just have to wait to see the benefits.  That defense won’t work much longer.  Time is running out.  The political challenges that Common Core faces the remainder of this year may determine whether it survives.

On May 16, I got into a Twitter argument with Campbell Brown of The 74, an education website.  She released a video on Slate giving advice to the next president.  The video begins: “Without question, to me, the issue is education. Two out of three eighth graders in this country cannot read or do math at grade level.”  I study student achievement and was curious.  I know of no valid evidence to make the claim that two out of three eighth graders are below grade level in reading and math.  No evidence was cited in the video.  I asked Brown for the evidentiary basis of the assertion.  She cited the National Assessment of Educational Progress (NAEP).

NAEP does not report the percentage of students performing at grade level.  NAEP reports the percentage of students reaching a “proficient” level of performance.  Here’s the problem. That’s not grade level. 

In this post, I hope to convince readers of two things:

1.  Proficient on NAEP does not mean grade level performance.  It’s significantly above that.
2.  Using NAEP’s proficient level as a basis for education policy is a bad idea.

Before going any further, let’s look at some history.

NAEP history 

NAEP was launched nearly five decades ago.  The first NAEP test was given in science in 1969, followed by a reading test in 1971 and math in 1973.  For the first time, Americans were able to track the academic progress of the nation’s students.  That set of assessments, which periodically tests students 9, 13, and 17 years old and was last given in 2012, is now known as the Long Term Trend (LTT) NAEP. 

It was joined by another set of NAEP tests in the 1990s.  The Main NAEP assesses students by grade level (fourth, eighth, and twelfth) and, unlike the LTT, produces not only national but also state scores.  The two tests, LTT and main, continue on parallel tracks today, and they are often confounded by casual NAEP observers.  The main NAEP, which was last administered in 2015, is the test relevant to this post and will be the only one discussed hereafter.  The NAEP governing board was concerned that the conventional metric for reporting results (scale scores) was meaningless to the public, so achievement standards (also known as performance standards) were introduced.  The percentage of students scoring at advanced, proficient, basic, and below basic levels are reported each time the main NAEP is given.

Does NAEP proficient mean grade level? 

The National Center for Education Statistics (NCES) states emphatically, “Proficient is not synonymous with grade level performance.” The National Assessment Governing Board has a brochure with information on NAEP, including a section devoted to myths and facts.  There, you will find this:

Myth: The NAEP Proficient level is like being on grade level.

Fact: Proficient on NAEP means competency over challenging subject matter.  This is not the same thing as being “on grade level,” which refers to performance on local curriculum and standards. NAEP is a general assessment of knowledge and skills in a particular subject.

Equating NAEP proficiency with grade level is bogus.  Indeed, the validity of the achievement levels themselves is questionable.  They immediately came under fire in reviews by the U.S. Government Accountability Office, the National Academy of Sciences, and the National Academy of Education.[1]  The National Academy of Sciences report was particularly scathing, labeling NAEP’s achievement levels as “fundamentally flawed.”

Despite warnings of NAEP authorities and critical reviews from scholars, some commentators, typically from advocacy groups, continue to confound NAEP proficient with grade level.  Organizations that support school reform, such as Achieve Inc. and Students First, prominently misuse the term on their websites.  Achieve presses states to adopt cut points aligned with NAEP proficient as part of new Common Core-based accountability systems.  Achieve argues that this will inform parents whether children “can do grade level work.” No, it will not.  That claim is misleading.

How unrealistic is NAEP proficient? 

Shortly after NCLB was signed into law, Robert Linn, one of the most prominent psychometricians of the past several decades, called ”the target of 100% proficient or above according to the NAEP standards more like wishful thinking than a realistic possibility.”  History is on the side of that argument.  When the first main NAEP in mathematics was given in 1990, only 13 % of eighth graders scored proficient and 2 % scored advanced.  Imagine using “proficient” as synonymous with grade level—85 % scored below grade level! 

The 1990 national average in eighth grade scale scores was 263 (see Table 1).  In 2015, the average was 282, a gain of 19 scale score points.

Table 1.  Main NAEP Eighth Grade Math Score, by achievement levels, 1990-2015

That’s an impressive gain.  Analysts who study NAEP often use 10 points on the NAEP scale as a back of the envelope estimate of one year’s worth of learning.  Eighth graders have gained almost two years.  The percentage of students scoring below basic has dropped from 48%  in 1990 to 29% in 2015.  The percentage of students scoring proficient or above has more than doubled, from 15% to 33%.  That’s not bad news; it’s good news.

But the cut point for NAEP proficient is 299.  By that standard, two-thirds of eighth graders are still falling short.  Even students in private schools, despite hailing from more socioeconomically advantaged homes and in some cases being selectively admitted by schools, fail miserably at attaining NAEP proficiency.  More than half (53 percent) are below proficient. 

Today’s eighth graders have made it about half-way to NAEP proficient in 25 years, but they still need to gain almost two more years of math learning (17 points) to reach that level.  And, don’t forget, that’s just the national average, so even when that lofty goal is achieved, half of the nation’s students will still fall short of proficient.  Advocates of the NAEP proficient standard want it to be for all students.  That is ridiculous.  Another way to think about it: proficient for today’s eighth graders reflects approximately what the average twelfth grader knew in mathematics in 1990.   Someday the average eighth grader may be able to do that level of mathematics.  But it won’t be soon, and it won’t be every student.

In the 2007 Brown Center Report on American Education, I questioned whether NAEP proficient is a reasonable achievement standard.[2]  That year, a study by Gary Phillips of American Institutes for Research was published that projected the 2007 TIMSS scores on the NAEP scale.  Phillips posed the question: based on TIMSS, how many students in other countries would score proficient or better on NAEP?  The study’s methodology only produces approximations, but they are eye-popping.

Here are just a few countries:

Table 2.  Projected Percent NAEP Proficient, Eighth Grade Math

Singapore was the top scoring nation on TIMSS that year, but even there, more than a quarter of students fail to reach NAEP proficient.  Japan is not usually considered a slouch on international math assessments, but 43% of its eighth graders fall short.  The U.S. looks weak, with only 26% of students proficient.  But England, Israel, and Italy are even weaker.  Norway, a wealthy nation with per capita GDP almost twice that of the U.S., can only get 9 out of 100 eighth graders to NAEP proficient.

Finland isn’t shown in the table because it didn’t participate in the 2007 TIMSS.  But it did in 2011, with Finland and the U.S. scoring about the same in eighth grade math.  Had Finland’s eighth graders taken NAEP in 2011, it’s a good bet that the proportion scoring below NAEP proficient would have been similar to that in the U.S.  And yet articles such as “Why Finland Has the Best Schools,” appear regularly in the U.S. press.[3]

Why it matters

The National Center for Education Statistics warns that federal law requires that NAEP achievement levels be used on a trial basis until the Commissioner of Education Statistics determines that the achievement levels are “reasonable, valid, and informative to the public.”  As the NCES website states, “So far, no Commissioner has made such a determination, and the achievement levels remain in a trial status.  The achievement levels should continue to be interpreted and used with caution.”

Confounding NAEP proficient with grade-level is uninformed.  Designating NAEP proficient as the achievement benchmark for accountability systems is certainly not cautious use.  If high school students are required to meet NAEP proficient to graduate from high school, large numbers will fail. If middle and elementary school students are forced to repeat grades because they fall short of a standard anchored to NAEP proficient, vast numbers will repeat grades.    

On NAEP, students are asked the highest level math course they’ve taken.  On the 2015 twelfth grade NAEP, 19% of students said they either were taking or had taken calculus.   These are the nation’s best and the brightest, the crème-de la crème of math students.  Only one in five students work their way that high up the hierarchy of American math courses.  If you are over 45 years old and reading this, the proportion who took calculus in high school is less than one out of ten.  In the graduating class of 1990, for instance, only 7% of students had taken calculus.[4] 

Unsurprisingly, calculus students are also typically taught by the nation’s most knowledgeable math teachers.  The nation’s elite math students paired with the nation’s elite math teachers: if any group can prove NAEP proficient a reasonable goal and succeed in getting all students over the NAEP proficiency bar, this is the group. 

But they don’t.  A whopping 30% score below proficient on NAEP.  For black and Hispanic calculus students, the figures are staggering.  Two-thirds of black calculus students score below NAEP proficient.  For Hispanics, the figure is 52%.  The nation’s pre-calculus students also fair poorly (69% below proficient). Then the success rate falls off a cliff.  In the class of 2015, more than nine out of ten students whose highest math course was Trigonometry or Algebra II fail to meet the NAEP proficient standard.

Table 3.  2015 NAEP Twelfth Grade Math, Proficient by Highest Math Course Taken

Source: NAEP Data Explorer

These data defy reason; they also refute common sense.  For years, educators have urged students to take the toughest courses they can possibly take.  Taken at face value, the data in Table 3 rip the heart out of that advice.  These are the toughest courses, and yet huge numbers of the nation’s star students, by any standard aligned with NAEP proficient, would be told that they have failed.  Some parents, misled by the confounding of proficient with grade level, might even mistakenly believe that their kids don’t know grade level math.

Conclusion 

NAEP proficient is not synonymous with grade level.  NAEP officials urge that proficient not be interpreted as reflecting grade level work.  It is a standard set much higher than that.  Scholarly panels have reviewed the NAEP achievement standards and found them flawed.  The highest scoring nations of the world would appear to be mediocre or poor performers if judged by the NAEP proficient standard.  Even large numbers of U.S. calculus students fall short.

As states consider building benchmarks for student performance into accountability systems, they should not use NAEP proficient—or any standard aligned with NAEP proficient—as a benchmark.  It is an unreasonable expectation, one that ill serves America’s students, parents, and teachers--and the effort to improve America’s schools.

Hypocrisy is not scarce in the world of politics. But the current House and Senate budget resolutions set new lows. Each proposes to cut about $5 trillion from government spending over the next decade in pursuit of a balanced budget. Whatever one may think of putting the goal of reducing spending when the ratio of the debt-to-GDP is projected to be stable above investing in the nation’s future, you would think that deficit-reduction hawks wouldn’t cut spending that has been proven to lower the deficit.

Yes, there are expenditures that actually lower the deficit, typically by many dollars for each dollar spent. In this category are outlays on ‘program integrity’ to find and punish fraud, tax evasion, and plain old bureaucratic mistakes. You might suppose that those outlays would be spared. Guess again. Consider the following:

Medicare. Roughly 10% of Medicare’s $600 billion budget goes for what officials delicately call ‘improper payments, according to the 2014 financial report of the Department of Health and Human Services. Some are improper merely because providers ‘up-code’ legitimate services to boost their incomes. Some payments go for services that serve no valid purpose. And some go for phantom services that were never provided. Whatever the cause, approximately $60 billion of improper payments is not ‘chump change.’

Medicare tries to root out these improper payments, but it lacks sufficient staff to do the job. What it does spend on ‘program integrity’ yields an estimated $14.40? for each dollar spent, about $10 billion a year in total. That number counts only directly measurable savings, such as recoveries and claim denials. A full reckoning of savings would add in the hard-to-measure ‘policeman on the beat’ effect that discourages violations by would-be cheats.

Fat targets remain. A recent report from the Institute of Medicine presented findings that veritably scream ‘fraud.’ Per person spending on durable medical equipment and home health care is ten times higher in Miami-Dade County, Florida than the national average. Such equipment and home health accounts for nearly three-quarters of the geographical variation in per person Medicare spending. Yet, only 4% of current recoveries of improper payments come from audits of these two items and little from the highest spending locations.

Why doesn’t Medicare spend more and go after the remaining overpayments, you may wonder? The simple answer is that Congress gives Medicare too little money for administration. Direct overhead expenses of Medicare amount to only about 1.5% of program outlays—6% if one includes the internal administrative costs of private health plans that serve Medicare enrollees. Medicare doesn’t need to spend as much on administration as the average of 19% spent by private insurers, because for example, Medicare need not pay dividends to private shareholders or advertise.

But spending more on Medicare administration would both pay for itself—$2 for each added dollar spent, according to the conservative estimate in the President’s most recent budget—and improve the quality of care. With more staff, Medicare could stop more improper payments and reduce the use of approved therapies in unapproved ways that do no good and may cause harm.

Taxes. Compare two numbers: $540 billion and $468 billion. The first number is the amount of taxes owed but not paid. The second number is the projected federal budget deficit for 2015, according to the Congressional Budget Office.

Collecting all taxes legally owed but not paid is an impossibility. It just isn’t worth going after every violation. But current enforcement falls far short of practical limits. Expenditures on enforcement directly yields $4 to $6 for each dollar spent on enforcement. Indirect savings are many times larger—the cop-on-the-beat effect again. So, in an era of ostentatious concern about budget deficits, you would expect fiscal fretting in Congress to lead to increased efforts to collect what the law says people owe in taxes.

Wrong again. Between 2010 and 2014, the IRS budget was cut in real terms by 20%. At the same time, the agency had to shoulder new tasks under health reform, as well as process an avalanche of applications for tax exemptions unleashed by the 2010 Supreme Court decision in the Citizens United case. With less money to spend and more to do, enforcement staff dropped by 15% and inflation adjusted collections dropped 13%.

One should acknowledge that enforcement will not do away with most avoidance and evasion. Needlessly complex tax laws are the root cause of most tax underpayment. Tax reform would do even more than improved administration to increase the ratio of taxes paid to taxes due. But until that glorious day when Congress finds the wit and will to make the tax system simpler and fairer, it would behoove a nation trying to make ends meet to spend $2 billion to $3 billion more each year to directly collect $10 billion to 15 billion a year more of legally owed taxes and, almost certainly, raise far more than that by frightening borderline scoff-laws.

Disability Insurance. Thirteen million people with disabling conditions who are judged incapable of engaging in substantial gainful activity received $161 billion in disability insurance in 2013. If the disabling conditions improve enough so that beneficiaries can return to work, benefits are supposed to be stopped. Such improvement is rare. But when administrators believe that there is some chance, the law requires them to check. They may ask beneficiaries to fill out a questionnaire or, in some cases, undergo a new medical exam at government expense. Each dollar spent in these ways generated an estimated $16 in savings in 2013.

Still, the Social Security Administration is so understaffed that SSA has a backlog of 1.3 million disability reviews. Current estimates indicate that spending a little over $1 billion a year more on such reviews over the next decade would save $43 billion. Rather than giving Social Security the staff and spending authority to work down this backlog and realize those savings, Congress has been cutting the agency’s administrative budget and sequestration threatens further cuts.

Claiming that better administration will balance the budget would be wrong. But it would help. And it would stop some people from shirking their legal responsibilities and lighten the burdens of those who shoulder theirs. The failure of Congress to provide enough staff to run programs costing hundreds of billions of dollars a year as efficiently and honestly as possible is about as good a definition of criminal negligence as one can find.

Editor's note: This post originally appeared in the New England Journal of Medicine's Perspective online series on April 22, 2015.

Congress has finally euthanized the sustainable growth rate formula (SGR). Enacted in 1997 and intended to hold down growth of Medicare spending on physician services, the formula initially worked more or less as intended. Then it began to call for progressively larger and more unrealistic fee cuts — nearly 30% in some years, 21% in 2015. Aware that such cuts would be devastating, Congress repeatedly postponed them, and most observers understood that such cuts would never be implemented. Still, many physicians fretted that the unthinkable might happen.

Now Congress has scrapped the SGR, replacing it with still-embryonic but promising incentives that could catalyze increased efficiency and greater cost control than the old, flawed formula could ever really have done, in a law that includes many other important provisions. How did such a radical change occur?  And why now?

The “how” was logrolling — the trading of votes by legislators in order to pass legislation of interest to each of them. Logrolling has become a dirty word, a much-reviled political practice. But the Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act (MACRA), negotiated by House leaders John Boehner (R-OH) and Nancy Pelosi (D-CA) and their staffs, is a reminder that old-time political horse trading has much to be said for it.

The answer to “why now?” can be found in the technicalities of budget scoring. Under the SGR, Medicare’s physician fees were tied through a complex formula to a target based on caseloads, practice costs, and the gross domestic product. When current spending on physician services exceeded the targets, the formula called for fee cuts to be applied prospectively. Fee cuts that were not implemented were carried forward and added to any future cuts the formula might generate. Because Congress repeatedly deferred cuts, a backlog developed. By 2012, this backlog combined with assumed rapid future growth in Medicare spending caused the Congressional Budget Office (CBO) to estimate the 10-year cost of repealing the SGR at a stunning $316 billion.

For many years, Congress looked the costs of repealing the SGR squarely in the eye — and blinked. The cost of a 1-year delay, as estimated by the CBO, was a tiny fraction of the cost of repeal. So Congress delayed — which is hardly surprising.

But then, something genuinely surprising did happen. The growth of overall health care spending slowed, causing the CBO to slash its estimates of the long-term cost of repealing the SGR. By 2015, the 10-year price of repeal had fallen to $136 billion. Even this number was a figment of budget accounting, since the chance that the fee cuts would ever have been imposed was minuscule. But the smaller number made possible the all-too-rare bipartisan collaboration that produced the legislation that President Barack Obama has just signed.

The core of the law is repeal of the SGR and abandonment of the 21% cut in Medicare physician fees it called for this year. In its place is a new method of paying physicians under Medicare. Some elements are specified in law; some are to be introduced later. The hard-wired elements include annual physician fee updates of 0.5% per year through 2019 and 0% from 2020 through 2025, along with a “merit-based incentive payment system” (MIPS) that will replace current incentive programs that terminate in 2018. The new program will assess performance in four categories: quality of care, resource use, meaningful use of electronic health records, and clinical practice improvement activities. Bonuses and penalties, ranging from +12% to –4% in 2020, and increasing to +27% to –9% for 2022 and later, will be triggered by performance scores in these four areas. The exact content of the MIPS will be specified in rules that the secretary of health and human services is to develop after consultation with physicians and other health care providers.

Higher fees will be available to professionals who work in “alternative payment organizations” that typically will move away from fee-for-service payment, cover multiple services, show that they can limit the growth of spending, and use performance-based methods of compensation. These and other provisions will ramp up pressure on physicians and other providers to move from traditional individual or small-group fee-for-service practices into risk-based multi-specialty settings that are subject to management and oversight more intense than that to which most practitioners are yet accustomed.

Both parties wanted to bury the SGR. But MACRA contains other provisions, unrelated to the SGR, that appeal to discrete segments of each party. Democrats had been seeking a 4-year extension of CHIP, which serves 8 million children and pregnant women. They were running into stiff head winds from conservatives who wanted to scale back the program. MACRA extends CHIP with no cuts but does so for only 2 years.  It also includes a number of other provisions sought by Democrats: a 2-year extension of the Maternal, Infant, and Early Childhood Home Visiting program, plus permanent extensions of the Qualified Individual program, which pays Part B Medicare premiums for people with incomes just over the federal poverty thresholds, and transitional medical assistance, which preserves Medicaid eligibility for up to 1 year after a beneficiary gets a job.

The law also facilitates access to health benefits. MACRA extends for two years states’ authority to enroll applicants for health benefits on the basis of data on income, household size, and other factors gathered when people enroll in other programs such as the Supplemental Nutrition Assistance Program, the National School Lunch Program, Temporary Assistance to Needy Families (“welfare”), or Head Start. It also provides $7.2 billion over the next two years to support community health centers, extending funding established in the Affordable Care Act.

Elements of each party, concerned about budget deficits, wanted provisions to pay for the increased spending. They got some of what they wanted, but not enough to prevent some conservative Republicans in both the Senate and the House from opposing final passage. Many conservatives have long sought to increase the proportion of Medicare Part B costs that are covered by premiums. Most Medicare beneficiaries pay Part B premiums covering 25% of the program’s actuarial value. Relatively high-income beneficiaries pay premiums that cover 35, 50, 65, or 80% of that value, depending on their income. Starting in 2018, MACRA will raise the 50% and 65% premiums to 65% and 80%, respectively, affecting about 2% of Medicare beneficiaries. No single person with an income (in 2015 dollars) below $133,501 or couple with income below $267,001 would be affected initially. MACRA freezes these thresholds through 2019, after which they are indexed for inflation. Under previous law, the thresholds were to have been greatly increased in 2019, reducing the number of high-income Medicare beneficiaries to whom these higher premiums would have applied. (For reference, half of all Medicare beneficiaries currently have incomes below $26,000 a year.)

A second provision bars Medigap plans from covering the Part B deductible, which is now $147. By exposing more people to deductibles, this provision will cause some reduction in Part B spending. Everyone who buys such plans will see reduced premiums; some will face increased out-of-pocket costs. The financial effects either way will be small.

Inflexible adherence to principle contributes to the political gridlock that has plunged rates of public approval of Congress to subfreezing lows. MACRA is a reminder of the virtues of compromise and quiet negotiation. A small group of congressional leaders and their staffs crafted a law that gives something to most members of both parties. Today’s appalling norm of poisonously polarized politics make this instance of political horse trading seem nothing short of miraculous.

The addition of Medicare in 1965 completed a suite of federal programs designed to protect the wealth and health of people reaching older ages in the United States, starting with the Committee on Economic Security of 1934—known today as Social Security. While few would deny Medicare’s important role in improving older and disabled Americans’ financial security and health, many worry about sustaining and strengthening Medicare to finance high-quality, affordable health care for coming generations.

In 1965, average life expectancy for a 65-year-old man and woman was another 13 years and 16 years, respectively. Now, life expectancy for 65-year-olds is 18 years for men and 20 years for women—effectively a four- to five-year increase.

In 2011, the first of 75-million-plus baby boomers became eligible for Medicare. And by 2029, when all of the baby boomers will be 65 or older, the U.S. Census Bureau predicts 20 percent of the U.S. population will be older than 65. Just by virtue of the sheer size of the aging population, Medicare spending growth will accelerate sharply in the coming years.

Event Information

In its 50th year, the Medicare program currently provides health insurance coverage for more than 49 million Americans and accounts for $600 billion in federal spending. With those numbers expected to rise as the baby boomer generation ages, many policy experts consider this impending expansion a major threat to the nation’s economic future and question how it might affect the quality and value of health care for Medicare beneficiaries.

On June 5, the Center for Health Policy at Brookings and the USC Leonard D. Schaeffer Center for Health Policy and Economics hosted a half-day forum on the future of Medicare. Instead of reflecting on historical accomplishments, the event looked ahead to 2030—a time when the youngest Baby Boomers will be Medicare-eligible—and explore the changing demographics, health care needs, medical technology costs, and financial resources available to beneficiaries. The panels focused on modernizing Medicare's infrastructure, benefit design, marketplace competition, and payment mechanisms. The event also included the release of five policy papers from featured panelists.

Please note that presentation slides from USC's Dana Goldman will not be available for download. For more information on findings from his presentation download the working paper available on this page or watch the event video.

Video

• Challenges and opportunities facing Medicare in 2030
• Eligibility, benefit design, and financial support
• Could improving choice and competition in Medicare Advantage be the future of Medicare?
• Improving provider payment in Medicare

Audio

• Strengthening Medicare for 2030

Transcript

• Uncorrected Transcript (.pdf)

Event Materials

• Burtless Slides
• 20150605_medicare_2030_transcript

The eurozone has three problems: national debt obligations that cannot be met, medium-term imbalances in trade competitiveness, and long-term structural flaws.

The short-run problem requires more of the monetary easing that Germany has, with appalling shortsightedness, been resisting, and less of the near-term fiscal restraint that Germany has, with equally appalling shortsightedness, been seeking. To insist that Greece meet all of its near-term current debt service obligations makes about as much sense as did French and British insistence that Germany honor its reparations obligations after World War I. The latter could not be and were not honored. The former cannot and will not be honored either.

The medium-term problem is that, given a single currency, labor costs are too high in Greece and too low in Germany and some other northern European countries. Because adjustments in currency values cannot correct these imbalances, differences in growth of wages must do the job—either wage deflation and continued depression in Greece and other peripheral countries, wage inflation in Germany, or both. The former is a recipe for intense and sustained misery. The latter, however politically improbable it may now seem, is the better alternative.

The long-term problem is that the eurozone lacks the fiscal transfer mechanisms necessary to soften the effects of competitiveness imbalances while other forms of adjustment take effect. This lack places extraordinary demands on the willingness of individual nations to undertake internal policies to reduce such imbalances. Until such fiscal transfer mechanisms are created, crises such as the current one are bound to recur.

Present circumstances call for a combination of short-term expansionary policies that have to be led or accepted by the surplus nations, notably Germany, who will also have to recognize and accept that not all Greek debts will be paid or that debt service payments will not be made on time and at originally negotiated interest rates. The price for those concessions will be a current and credible commitment eventually to restore and maintain fiscal balance by the peripheral countries, notably Greece.

The Supreme Court today decided that Congress meant what it said when it enacted the Affordable Care Act (ACA). The ACA requires people in all 50 states to carry health insurance and provided tax credits to help them afford it. To have offered such credits only in the dozen states that set up their own exchanges would have been cruel and unsustainable because premiums for many people would have been unaffordable.

But the law said that such credits could be paid in exchanges ‘established by a state,’ which led some to claim that the credits could not be paid to people enrolled by the federally operated exchange. In his opinion, Chief Justice Roberts euphemistically calls that wording ‘inartful.’ Six Supreme Court justices decided that, read in its entirety, the law provides tax credits in every state, whether the state manages the exchange itself or lets the federal government do it for them.

That decision is unsurprising. More surprising is that the Court agreed to hear the case. When it did so, cases on the same issue were making their ways through four federal circuits. In only one of the four circuits was there a standing decision, and it found that tax credits were available everywhere. It is customary for the Supreme Court to wait to take a case until action in lower courts is complete or two circuits have disagreed. In this situation, the justices, eyeing the electoral calendar, may have preferred to hear the case sooner rather than later to avoid confronting it in the middle of a presidential election.

Whatever the Court’s motives for taking the case, their willingness to hear the case caused supporters of the Affordable Care Act enormous unease. Were the more conservative members of the Court poised to accept an interpretation of the law that ACA supporters found ridiculous but that inartful legislative drafting gave the gloss of plausibility? Judicial demeanor at oral argument was not comforting. A 5-4 decision disallowing payment of tax credits seemed ominously plausible.

The Court’s 6-3 decision ended those fears. The existential threat to health reform from litigation is over. But efforts to undo the Affordable Care Act are not at an end. They will continue in the political sphere. And that is where they should be. ACA opponents know that there is little chance for them to roll back the Affordable Care Act in any fundamental way as long as a Democrat is in the White House. To dismantle the law, they must win the presidency in 2016.

But winning the presidency will not be enough. It would be mid 2017 before ACA opponents could draft and enact legislation to curb the Affordable Care Act and months more before it could take effect. To borrow a metaphor from the military, even if those opposed to the ACA win the presidency, they will have to deal with ‘facts on the ground.’

Medicare Hospital Insurance and Social Security would not add to deficits because they can’t spend money they don’t have.

The dog days of August have given way to something much worse. Congress returned to session this week, and the rest of the year promises to be nightmarish. The House and Senate passed budget resolutions earlier this year calling for nearly $5 trillion in spending cuts by 2025. More than two-thirds of those cuts would come from programs that help people with low-and moderate-incomes. Health care spending would be halved. If such cuts are enacted, the president will likely veto them. At best, another partisan budget war will ensue after which the veto is sustained. At worst, the cuts become law.

The putative justification for these cuts is that the nation faces insupportable increases in public debt because of expanding budget deficits. Even if the projections were valid, it would be prudent to enact some tax increases in order to preserve needed public spending. But the projections of explosively growing debt are not valid. They are fantasy.

Wait! you say. The Congressional Budget Office has been telling us for years about the prospect of rising deficit and exploding debt. They repeated those warnings just two months ago. Private organizations of both the left and right agree with the CBO’s projections, in general if not in detail. How can any sane person deny that the nation faces a serious long-term budget deficit problem?

The answer is simple: The CBO and private organizations use a convention in preparing their projections that is at odds with established policy and law. If, instead, projections are based on actual current law, as they claim to be, the specter of an increasing debt burden vanishes. What is that convention? Why is it wrong? Why did CBO adopt it, and why have others kept it?

CBO’s budget projections cover the next 75 years. Its baseline projections claim to be based on current law and policy. (CBO also presents an ‘alternative scenario’ based on assumed changes in law and policy). Within that period, Social Security (OASDI) and Medicare Hospital Insurance (HI) expenditures are certain to exceed revenues earmarked to pay for them. Both are financed through trust funds. Both funds have sizeable reserves — government securities — that can be used to cover short falls for a while. But when those reserves are exhausted, expenditures cannot exceed current revenues. Trust fund financing means that neither Social Security nor Medicare Hospital Insurance can run deficits. Nor can they add to the public debt.

Nonetheless, CBO and other organizations assume that Social Security and Medicare Hospital Insurance can and will spend money they don’t have and that current law bars them from spending.

One of the reasons why trust fund financing was used, first for Social Security and then for Medicare Hospital Insurance, was to create a framework that disciplined Congress earmarked to earmark sufficient revenues to pay for benefits it might award. Successive presidents and Congresses, both Republican and Democratic, have repeatedly acted to prevent either program’s cumulative spending from exceeding cumulative revenues. In 1983, for example, faced with an impending trust fund shortfall, Congress cut benefits and raised taxes enough to turn prospective cash flow trust fund deficits into cash flow surpluses. And President Reagan signed the bill. In so doing, they have reaffirmed the discipline imposed by trust fund financing.

Trust fund accounting explains why people now are worrying about the adequacy of funding for Social Security and Medicare. They recognize that the trust funds will be depleted in a couple of decades. They understand that between now and then Congress must either raise earmarked taxes or fashion benefit cuts. If it doesn’t raise taxes, benefits will be cut across the board. Either way, the deficits that CBO and other organizations have built into their budget projections will not materialize.

The implications for projected debt of CBO’s inclusion in its projections of deficits that current law and established policy do not allow are enormous, as the graph below shows.

If one excludes deficits in Social Security and Medicare Hospital Insurance that cannot occur under current law and established policy, the ratio of national debt to gross domestic product will fall, not rise, as CBO budget projections indicate. In other words, the claim that drastic cuts in government spending are necessary to avoid calamitous budget deficits is bogus.

It might seem puzzling that CBO, an agency known for is professionalism and scrupulous avoidance of political bias, would adopt a convention so at odds with law and policy. The answer is straightforward—Congress makes them do it. Section 257 of the Balanced Budget and Emergency Deficit Control Act of 1985 requires CBO to assume that the trust funds can spend money although legislation governing trust fund operations bars such expenditures. CBO is obeying the law.

No similar explanation exonerates the statement of the Committee for a Responsible Federal Budget, which on August 25, 2015 cited, with approval, the conclusion that ‘debt continues to grow unsustainably,’ or that of the Bipartisan Policy Center, which wrote on the same day that ‘America’s debt continues to grow on an unsustainable path.’ Both statements are wrong.

To be sure, the dire budget future anticipated in the CBO projections could materialize. Large deficits could result from an economic calamity or war. Congress could abandon the principle that Social Security and Medicare Hospital Insurance should be financed within trust funds. It could enact other fiscally rash policies. But such deficits do not flow from current law or reflect the trust fund discipline endorsed by both parties over the last 80 years. And it is current law and policy that are supposed to underlie budget projections. Slashing spending because a thirty-year old law requires CBO to assume that Congress will do something it has shown no sign of doing—overturn decades of bipartisan prudence requiring that the major social insurance programs spend only money specifically earmarked for them, and not a penny more—would impose enormous hardship on vulnerable populations in the name of a fiscal fantasy.

Editor's Note: This post originally appeared in Fortune Magazine.

As government funding for disability insurance is expected to run out next year, Congress should re-evaluate the costs of the program.

Nine million people in America today are receiving Social Security Disability Insurance, double the number in 1995 and six times the number in 1970. With statistics like that, it’s hardly surprising to see some in Congress worry that more will enroll in the program and costs would continue to rise, especially since government funding for disability insurance is expected to run out by the end of next year. If Congress does nothing, benefits would fall by 19% immediately following next year’s presidential election. So, Congress will likely do something. But what exactly should it do?

Funding for disability insurance has nearly run out of money before. Each time, Congress has simply increased the share of the Social Security payroll tax that goes for disability insurance. This time, however, many members of Congress oppose such a shift unless it is linked to changes that curb eligibility and promote return to work. They fear that rolls will keep growing and costs would keep rising, but findings from a report by a government panel conclude that disability insurance rolls have stopped rising and will likely shrink. The report, authored by a panel of the Social Security Advisory Board, is important in that many of the factors that caused disability insurance to rise, particularly during the Great Recession, have ended.

• Baby-boomers, who added to the rolls as they reached the disability-prone middle age years, are aging out of disability benefits and into retirement benefits. 


• The decades-long flood of women increased the pool of people with the work histories needed to be eligible for disability insurance. But women’s labor force participation has fallen a bit from pre-Great Recession peaks, and is not expected again to rise materially. 


• The Great Recession, which led many who lost jobs and couldn’t find work to apply for disability insurance, is over and applications are down. A recession as large as that of 2008 is improbable any time soon. 


• Approval rates by administrative law judges, who for many years were suspected of being too ready to approve applications, have been falling. Whatever the cause, this stringency augurs a fall in the disability insurance rolls.

Led by presidential candidate Bernie Sanders, one-time supporters of ‘single-payer’ health reform are rekindling their romance with a health reform idea that was, is, and will remain a dream.  Single-payer health reform is a dream because, as the old joke goes, ‘you can’t get there from here.

Let’s be clear: opposing a proposal only because one believes it cannot be passed is usually a dodge.One should judge the merits. Strong leaders prove their skill by persuading people to embrace their visions. But single-payer is different. It is radical in a way that no legislation has ever been in the United States.

Not so, you may be thinking. Remember such transformative laws as the Social Security Act, Medicare, the Homestead Act, and the Interstate Highway Act. And, yes, remember the Affordable Care Act. Those and many other inspired legislative acts seemed revolutionary enough at the time. But none really was. None overturned entrenched and valued contractual and legislative arrangements. None reshuffled trillions—or in less inflated days, billions—of dollars devoted to the same general purpose as the new legislation. All either extended services previously available to only a few, or created wholly new arrangements.

To understand the difference between those past achievements and the idea of replacing current health insurance arrangements with a single-payer system, compare the Affordable Care Act with Sanders’ single-payer proposal.

Criticized by some for alleged radicalism, the ACA is actually stunningly incremental. Most of the ACA’s expanded coverage comes through extension of Medicaid, an existing public program that serves more than 60 million people. The rest comes through purchase of private insurance in “exchanges,” which embody the conservative ideal of a market that promotes competition among private venders, or through regulations that extended the ability of adult offspring to remain covered under parental plans. The ACA minimally altered insurance coverage for the 170 million people covered through employment-based health insurance. The ACA added a few small benefits to Medicare but left it otherwise untouched. It left unaltered the tax breaks that support group insurance coverage for most working age Americans and their families. It also left alone the military health programs serving 14 million people. Private nonprofit and for-profit hospitals, other vendors, and privately employed professionals continue to deliver most care.

In contrast, Senator Sanders’ plan, like the earlier proposal sponsored by Representative John Conyers (D-Michigan) which Sanders co-sponsored, would scrap all of those arrangements. Instead, people would simply go to the medical care provider of their choice and bills would be paid from a national trust fund. That sounds simple and attractive, but it raises vexatious questions.

• How much would it cost the federal government? Where would the money to cover the costs come from?
• What would happen to the $700 billion that employers now spend on health insurance?
• How would the $600 billion a year reductions in total health spending that Sanders says his plan would generate come from?
• What would happen to special facilities for veterans and families of members of the armed services?

Sanders has answers for some of these questions, but not for others. Both the answers and non-answers show why single payer is unlike past major social legislation.

The answer to the question of how much single payer would cost the federal government is simple: $4.1 trillion a year, or $1.4 trillion more than the federal government now spends on programs that the Sanders plan would replace. The money would come from new taxes. Half the added revenue would come from doubling the payroll tax that employers now pay for Social Security. This tax approximates what employers now collectively spend on health insurance for their employees...if they provide health insurance. But many don’t. Some employers would face large tax increases. Others would reap windfall gains.

The cost question is particularly knotty, as Sanders assumes a 20 percent cut in spending averaged over ten years, even as roughly 30 million currently uninsured people would gain coverage. Those savings, even if actually realized, would start slowly, which means cuts of 30 percent or more by Year 10. Where would they come from? Savings from reduced red-tape associated with individual insurance would cover a small fraction of this target. The major source would have to be fewer services or reduced prices. Who would determine which of the services physicians regard as desirable -- and patients have come to expect -- are no longer ‘needed’? How would those be achieved without massive bankruptcies among hospitals, as columnist Ezra Klein has suggested, and would follow such spending cuts? What would be the reaction to the prospect of drastic cuts in salaries of health care personnel – would we have a shortage of doctors and nurses? Would patients tolerate a reduction in services? If people thought that services under the Sanders plan were inadequate, would they be allowed to ‘top up’ with private insurance? If so, what happens to simplicity? If not, why not?

Let me be clear: we know that high quality health care can be delivered at much lower cost than is the U.S. norm. We know because other countries do it. In fact, some of them have plans not unlike the one Senator Sanders is proposing. We know that single-payer mechanisms work in some countries. But those systems evolved over decades, based on gradual and incremental change from what existed before. That is the way that public policy is made in democracies. Radical change may occur after a catastrophic economic collapse or a major war. But in normal times, democracies do not tolerate radical discontinuity. If you doubt me, consider the tumult precipitated by the really quite conservative Affordable Care Act.

Editor's note: This piece originally appeared in Newsweek.

The American people deserve to have a federal government that is both responsive and effective. That simply isn’t the case for more than 1 million people who are awaiting the adjudication of their applications for disability benefits from the Social Security Administration.

Washington can and must do better. This gridlock harms applicants either by depriving them of much-needed support or effectively barring them from work while their cases are resolved because having any significant earnings would immediately render them ineligible. This is unacceptable.

Within the next month, the Government Accountability Office, the nonpartisan congressional watchdog, will launch a study on the issue. More policymakers should follow GAO’s lead. A solution to this problem is long overdue. Here’s how the government can do it.

Congress does not need to look far for an example of how to reduce the SSA backlog. In 2013, the Veterans Administration cut its 600,000-case backlog by 84 percent and reduced waiting times by nearly two-thirds, all within two years. It’s an impressive result.

Why have federal officials dealt aggressively and effectively with that backlog, but not the one at SSA? One obvious answer is that the American people and their representatives recognize a debt to those who served in the armed forces. Allowing veterans to languish while a sluggish bureaucracy dithers is unconscionable. Public and congressional outrage helped light a fire under the bureaucracy. Administrators improved services the old-fashioned way — more staff time. VA employees had to work at least 20 hours overtime per month.

Things are a bit more complicated at SSA, unfortunately. Roughly three quarters of applicants for disability benefits have their cases decided within about nine months and, if denied, decide not to appeal. But those whose applications are denied are legally entitled to ask for a hearing before an administrative law judge — and that is where the real bottleneck begins.

There are too few ALJs to hear the cases. Even in the best of times, maintaining an adequate cadre of ALJs is difficult because normal attrition means that SSA has to hire at least 100 ALJs a year to stay even. When unemployment increases, however, so does the number of applications for disability benefits. After exhausting unemployment benefits, people who believe they are impaired often turn to the disability programs. So, when the Great Recession hit, SSA knew it had to hire many more ALJs. It tried to do so, but SSA cannot act without the help of the Office of Personnel Management, which must provide lists of qualified candidates before agencies can hire them. SSA employs 85 percent of all ALJs and for several years has paid OPM approximately $2 million annually to administer the requisite tests and interviews to establish a register of qualified candidates. Nonetheless, OPM has persistently refused to employ legally trained people to vet ALJ candidates or to update registers. And when SSA sought to ramp up ALJ hiring to cope with the recession challenge, OPM was slow to respond.

In 2009, for example, OPM promised to supply a new register containing names of ALJ candidates. Five years passed before it actually delivered the new list of names. For a time, the number of ALJs deciding cases actually fell. The situation got so bad that the president’s January 2015 budget created a work group headed by the Office of Management and Budget and the Administrative Conference of the United States to try to break the logjam. OPM promised a list for 2015, but insisted it could not change procedures. Not trusting OPM to mend its ways, Congress in October 2015 enacted legislation that explicitly required OPM to administer a new round of tests within the succeeding six months.

These stopgap measures are inadequate to the challenge. Both applicants and taxpayers deserve prompt adjudication of the merits of claims. The million-person backlog and the two-year average waits are bad enough. Many applicants wait far longer. Meanwhile, they are strongly discouraged from working, as anything more than minimal earnings will cause their applications automatically to be denied. Throughout this waiting period, applicants have no means of self-support. Any skills applicants retain atrophy.

The shortage of ALJs is not the only problem. The quality and consistency of adjudication by some ALJs has been called into question. For example, differences in approval rates are so large that differences among applicants cannot plausibly explain them. Some ALJs have processed so many cases that they could not possibly have applied proper standards. In recognition of both problems, SSA has increased oversight and beefed up training. The numbers have improved. But large and troubling variations in workloads and approval rates persist.

For now, political polarization blocks agreement on whether and how to modify eligibility rules and improve incentives to encourage work by those able to work. But there is bipartisan agreement that dragging out the application process benefits no one. While completely eliminating hearing delays is impossible, adequate administrative funding and more, better trained hearing officers would help reduce them. Even if OPM’s past record were better than it is, OPM is now a beleaguered agency, struggling to cope with the fallout from a security breach that jeopardizes the security of the nation and the privacy of millions of current and past federal employees and federal contractors. Mending this breach and establishing new procedures will — and should — be OPM’s top priority.

That’s why, for the sake of everyone concerned, responsibility for screening candidates for administrative law judge positions should be moved, at least temporarily, to another agency, such as the Administrative Conference of the United States. Shortening the period that applicants for disability benefits now spend waiting for a final answer is an achievable goal that can and should be addressed. Our nation’s disabled and its taxpayers deserve better.

Editor's note: This piece originally appeared in Politico.

One cannot help feeling a bit silly taking seriously the policy proposals of a person who seems not to take policy seriously himself. Donald Trump's policy positions have evolved faster over the years than a teenager's moods. He was for a woman's right to choose; now he is against it. He was for a wealth tax to pay off the national debt before proposing a tax plan that would enrich the wealthy and balloon the national debt. He was for universal health care but opposed to any practical way to achieve it.

Based on his previous flexibility, Trump's here-today proposals may well be gone tomorrow. As a sometime-Democrat, sometime-Republican, sometime-independent, who is now the leading candidate for the Republican presidential nomination, Trump has just issued his latest pronouncements on health care policy. So, what the hell, let's give them more respect than he has given his own past policy statements.

Perhaps unsurprisingly, those earlier pronouncements are notable for their detachment from fact and lack of internal logic. The one-time supporter of universal health care now joins other candidates in his newly-embraced party in calling for repeal of the only serious legislative attempt in American history to move toward universal coverage, the Affordable Care Act. Among his stated reasons for repeal, he alleges that the act has "resulted in runaway costs," promoted health care rationing, reduced competition and narrowed choice.

Each of these statements is clearly and demonstrably false. Health care spending per person has grown less rapidly in the six years since the Affordable Care Act was enacted than in any corresponding period in the last four decades. There is now less health care rationing than at any time in living memory, if the term rationing includes denial of care because it is unaffordable. Rationing because of unaffordability is certainly down for the more than 20 million people who are newly insured because of the Affordable Care Act. Hospital re-admissions, a standard indicator of low quality, are down, and the health care exchanges that Trump now says he would abolish, but that resemble the "health marts" he once espoused, have brought more choice to individual shoppers than private employers now offer or ever offered their workers.

Trump's proposed alternative to the Affordable Care Act is even worse than his criticism of it. He would retain the highly popular provision in the act that bars insurance companies from denying people coverage because of preexisting conditions, a practice all too common in the years before the health care law. But he would do away with two other provisions of the Affordable Care Act that are essential to make that reform sustainable: the mandate that people carry insurance and the financial assistance to make that requirement feasible for people of modest means.

Without those last two provisions, barring insurers from using preexisting conditions to jack up premiums or deny coverage would destroy the insurance market. Why? Because without the mandate and the financial aid, people would have powerful financial incentives to wait until they were seriously ill to buy insurance. They could safely do so, confident that some insurer would have to sell them coverage as soon as they became ill. Insurers that set affordable prices would go broke. If insurers set prices high enough to cover costs, few customers could afford them.

In simple terms, Trump's promise to bar insurers from using preexisting conditions to screen customers but simultaneously to scrap the companion provisions that make the bar feasible is either the fraudulent offer of a huckster who takes voters for fools, or clear evidence of stunning ignorance about how insurance works. Take your pick.

Unfortunately, none of the other Republican candidates offers a plan demonstrably superior to Trump's. All begin by calling for repeal and replacement of the Affordable Care Act. But none has yet advanced a well-crafted replacement.

It is not that the Affordable Care Act is perfect legislation. It isn't. But, as the old saying goes, you can't beat something with nothing. And so far as health care reform is concerned, nothing is what the Republican candidates now have on offer.

Editor's note: This piece originally appeared in U.S. News and World Report.

Editor’s note: The remarks below were delivered to the Committee for a Responsible Federal Budget on release of their report on the SSDI Solutions Initiative. 

I want to thank Marc Goldwein for inviting me to join you for today’s event. We all owe thanks to Jim McCrery and Earl Pomeroy for devoting themselves to the SSDI Solutions Initiative, to the staff of CFRB who backed them up, and most of all to the scholars and practitioners who wrote the many papers that comprise this effort. This is the sort of practical, problem-solving enterprise that this town needs more of. So, to all involved in this effort, ‘hats off’ and ‘please, don’t stop now.’

The challenge of improving how public policy helps people with disabilities seemed urgent last year. Depletion of the Social Security Disability Insurance trust loomed. Fears of exploding DI benefit rolls were widespread and intense.

Congress has now taken steps that delay projected depletion until 2022. Meticulous work by Jeffrey Liebman suggests that Disability Insurance rolls have peaked and will start falling. The Technical Panel appointed by the Social Security Advisory Board, concurred in its 2015 report. With such ‘good’ news, it is all too easy to let attention drift to other seemingly more pressing items.

But trust fund depletion and growing beneficiary rolls are not the most important reasons why policymakers should be focusing on these programs.

The primary reason is that the design and administration of disability programs can be improved with benefit to taxpayers and to people with disabilities alike. And while 2022 seems a long time off, doing the research called for in the SSDI Solutions Initiative will take all of that time and more. So, it is time to get to work, not to relax.

Before going any further, I must make a disclaimer. I was invited to talk here as chair of the Social Security Advisory Board. Everything I am going to say from now on will reflect only my personal views, not those of the other members or staff of the SSAB except where the Board has spoken as a group. The same disclaimer applies to the trustees, officers, and other staff of the Brookings Institution. Blame me, not them.

Let me start with an analogy. We economists like indices. Years ago, the late Arthur Okun came up with an index to measure how much pain the economy was inflicting on people. It was a simple index, just the sum of inflation and the unemployment rate. Okun called it the ‘misery index.’

I suggest a ‘policy misery index’—a measure of the grief that a policy problem causes us. It is the sum of a problem’s importance and difficulty. Never mind that neither ‘importance’ nor ‘difficulty’ is quantifiable. Designing and administering interventions intended to improve the lives of people with disabilities has to be at or near the top of the policy misery index.

Those who have worked on disability know what I mean. Programs for people with disabilities are hugely important and miserably hard to design and administer well. That would be true even if legislators were writing afresh on a blank legislative sheet. That they must cope with a deeply entrenched program about which analysts disagree and on which many people depend makes the problems many times more challenging.

I’m going to run through some of the reasons why designing and administering benefits for people determined to be disabled is so difficult. Some may be obvious, even banal, to the highly informed group here today. And you will doubtless think of reasons I omit.

First, the concept of disability, in the sense of a diminished capacity to work, has no clear meaning, the SSA definition of disability notwithstanding. We can define impairments. Some are so severe that work or, indeed, any other form of self-support seems impossible. But even among those with severe impairments, some people work for pay, and some don’t.

That doesn’t mean that if someone with a given impairment works, everyone with that same impairment could work if they tried hard enough. It means that physical or mental impairments incompletely identify those for whom work is not a reasonable expectation. The possibility of work depends on the availability of jobs, of services to support work effort, and of a host of personal characteristics, including functional capacities, intelligence, and grit.

That is not how the current disability determination process works. It considers the availability of jobs in the national, not the local, economy. It ignores the availability of work supports or accommodations by potential employers.

Whatever eligibility criteria one may establish for benefits, some people who really can’t work, or can’t earn enough to support themselves, will be denied benefits. And some will be awarded benefits who could work.

Good program design helps keep those numbers down. Good administration helps at least as much as, and maybe more than, program design. But there is no way to reduce the number of improper awards and improper denials to zero.

Second, the causes of disability are many and varied. Again, this observation is obvious, almost banal. Genetic inheritance, accidents and injuries, wear and tear from hard physical labor, and normal aging all create different needs for assistance.

These facts mean that people deemed unable to work have different needs. They constitute distinct interest groups, each seeking support, but not necessarily of the same kind. These groups sometimes compete with each other for always-limited resources. And that competition means that the politics of disability benefits are, shall we say, interesting.

Third, the design of programs to help people deemed unable to work is important and difficult. Moral hazard is endemic. Providing needed support and services is an act of compassion and decency. The goal is to provide such support and services while preserving incentives to work and to controlling costs borne by taxpayers.

But preserving work incentives is only part of the challenge. The capacity to work is continuous, not binary. Training and a wide and diverse range of services can help people perform activities of daily living and work.

Because resources are scarce, policy makers and administrators have to sort out who should get those services. Should it be those who are neediest? Those who are most likely to recover full capacities? Triage is inescapable. It is technically difficult. And it is always ethically fraught.

Designing disability benefit programs is hard. But administering them well is just as important and at least as difficult.

These statements may also be obvious to those who here today. But recent legislation and administrative appropriations raise doubts about whether they are obvious to or accepted by some members of Congress.

Let’s start with program design. We can all agree, I think, that incentives matter. If benefits ceased at the first dollar earned, few who come on the rolls would ever try to work.

So, Congress, for many years, has allowed beneficiaries to earn any amount for a brief period and small amounts indefinitely without losing eligibility. Under current law, there is a benefit cliff. If—after a trial work period—beneficiaries earn even $1 more than what is called substantial gainful activity, $1,130 in 2016, their benefit checks stop. They retain eligibility for health coverage for a while even after they leave the rolls. And for an extended period they may regain cash and health benefits without delay if their earnings decline.

Members of Congress have long been interested in whether a more gradual phase-out of benefits as earnings rise might encourage work. Various aspects of the current Disability Insurance program reflect Congress’s desire to encourage work.

The so-called Benefit Offset National Demonstration—or BOND—was designed to test the impact on labor supply by DI beneficiaries of one formula—replacing the “cliff” with a gradual reduction in benefits: $1 of benefit last for each $2 of earnings above the Substantial Gainful Activity level.

Alas, there were problems with that demonstration. It tested only one offset scenario – one starting point and one rate. So, there could be no way of knowing whether a 2-for-1 offset was the best way to encourage work.

And then there was the uncomfortable fact that, at the time of the last evaluation, out of 79,440 study participants only 21 experienced the offset. So there was no way of telling much of anything, other than that few people had worked enough to experience the offset.

Nor was the cause of non-response obvious. It is not clear how many demonstration participants even understood what was on offer.

Unsurprisingly, members of Congress interested in promoting work among DI recipients asked SSA to revisit the issue. The 2015 DI legislation mandates a new demonstration, christened the Promoting Opportunity Demonstration, or POD. POD uses the same 2 for 1 offset rate that BOND did, but the offset starts at an earnings level at or below earnings of $810 a month in 2016—which is well below the earnings at which the BOND phase-out began.

Unfortunately, as Kathleen Romig has pointed out in an excellent paper for the Center on Budget and Policy Priorities, this demonstration is unlikely to yield useful results. Only a very few atypical DI beneficiaries are likely to find it in their interest to participate in the demonstration, fewer even than in the BOND. That is because the POD offset begins at lower earnings than the BOND offset did. In addition, participants in POD sacrifice the right under current law that permits people receiving disability benefits to earn any amount for 9 months of working without losing any benefits.

Furthermore, the 2015 law stipulated that no Disability Insurance beneficiary could be required to participate in the demonstration or, having agreed to participate, forced to remain in the demonstration. Thus, few people are likely to respond to the POD or to remain in it.

There is a small group to whom POD will be very attractive—those few DI recipients who retain a lot of earning capacity. The POD will allow them to retain DI coverage until their earnings are quite high. For example, a person receiving a $2,000 monthly benefit—well above the average, to be sure, but well below the maximum—would remain eligible for some benefits until his or her annual earnings exceeded $57,700. I don’t know about you, but I doubt that Congress would favorably consider permanent law of this sort.

Not only would those participating be a thin and quite unrepresentative sample of DI beneficiaries in general, or even of those with some earning capacity, but selection bias resulting from the opportunity to opt out at any time would destroy the external validity of any statistical results.

Let me be clear. My comments on POD, the demonstration mandated in the 2015 legislation, are not meant to denigrate the need for, or the importance of, research on how to encourage work by DI recipients, especially those for whom financial independence is plausible. On the contrary, as I said at the outset, research is desperately needed on this issue, as well as many others. It is not yet too late to authorize a research design with a better chance of producing useful results.

But it will be too late soon. Fielding demonstrations takes time:

• to solicit bids from contractors,
• for contractors to formulate bids,
• for government boards to select the best one,
• for contractors to enroll participants,
• for contractors to administer the demonstration,
• and for analysts to process the data generated by the demonstrations.

That process will take all the time available between now and 2021 or 2022 when the DI trust fund will again demand attention. It will take a good deal more time than that to address the formidable and intriguing research agenda of SSDI Solutions Initiative.

I should like to conclude with plugs for two initiatives to which the Social Security Advisory Board has been giving some attention.

It takes too long for disability insurance applicants to have their cases decided. Perhaps the whole determination process should be redesigned. One of the CFRB papers proposes just that. But until that happens, it is vital to shorten the unconscionable delays separating initial denials and reconsideration from hearings before administrative law judges to which applicants are legally entitled. Procedural reforms in the hearing process might help. More ALJs surely will.

The 2015 budget act requires the Office of Personnel Management to take steps that will help increase the number of ALJs hired. I believe that the new director, Beth Colbert, is committed to reforms. But it is very hard to change legal interpretations that have hampered hiring for years and the sluggish bureaucratic culture that fostered them.

So, the jury is out on whether OPM can deliver. In a recent op-ed in Politico, Lanhee Chen, a Republican member of the SSAB, and I jointly endorsed urged Congress to be ready, if OPM fails to deliver on more and better lists of ALJ candidates and streamlined procedures for their appointment, to move the ALJ examination authority to another federal organization, such as the Administrative Conference of the United States.

Lastly, there is a facet of income support policy that we on the SSAB all agree merits much more attention than it has received. Just last month, the SSAB released a paper entitled Representative Payees: A Call to Action. More than eight million beneficiaries have been deemed incapable of managing $77 billion in benefits that the Social Security Administration provided them in 2014.

We believe that serious concern is warranted about all aspects of the representative payee program—how this infringement of personal autonomy is found to be necessary, how payees are selected, and how payee performance is monitored.

Management of representative payees is a particular challenge for the Social Security Administration. Its primary job is to pay cash benefits in the right amount to the right person at the right time. SSA does that job at rock-bottom costs and with remarkable accuracy. It is handing rapidly rising workloads with budgets that have barely risen. SSA is neither designed nor staffed to provide social services. Yet determining the need for, selecting, and monitoring representative payees is a social service function.

As the Baby Boom ages, the number of people needing help in administering cash benefits from the Social Security Administration—and from other agencies such as the Veterans Administration—will grow. So will the number needing help in making informed choices under Medicare and Medicaid.

The SSAB is determined to look into this challenge and to make constructive suggestions. We are just beginning and invite others to join in studying what I have called “the most important problem the public has never heard of.”

Living with disabilities today is markedly different from what it was in 1956 when the Disability Insurance program began. Yet, the DI program has changed little. Beneficiaries and taxpayers are pay heavily the failure of public policy to apply what has been learned over the past six decades about health, disability, function, and work.

I hope that SSA and Congress will use well the time until it next must legislate on Disability Insurance. The DI rolls are stabilizing. The economy has grown steadily since the Great Recession. Congress has reinstated demonstration authority. With adequate funding for research and testing, the SSA can rebuild its research capability. Along with the external research community, it can identify what works and help Congress improve the DI program for beneficiaries and taxpayers alike. The SSDI Solutions Initiative is a fine roadmap.

Health reform (aka Obamacare) is entering a new stage. The recent announcement by United Health Care that it will stop selling insurance to individuals and families through most health insurance exchanges marks the transition. In the next stage, federal and state policy makers must decide how to use broad regulatory powers they have under the Affordable Care Act (ACA) to stabilize, expand, and diversify risk pools, improve local market competition, encourage insurers to compete on product quality rather than premium alone, and promote effective risk management. In addition, insurance companies must master rate setting, plan design, and network management and effectively manage the health risk of their enrollees in order to stay profitable, and consumers must learn how to choose and use the best plan for their circumstances.

Six months ago, United Health Care (UHC) announced that it was thinking about pulling out of the ACA exchanges. Now, they are pulling out of all but a “handful” of marketplaces. UHC is the largest private vendor of health insurance in the nation. Nonetheless, the impact on people who buy insurance through the ACA exchanges will be modest, according to careful analyses from the Kaiser Family Foundation and the Urban Institute. The effect is modest for three reasons. One is that in some states UHC focuses on group insurance, not on insurance sold to individuals, where they are not always a major presence. Secondly, premiums of UHC products in individual markets are relatively high. Third, in most states and counties ACA purchasers will still have a choice of two or more other options. In addition, UHC’s departure may coincide with or actually cause the entry of other insurers, as seems to be happening in Iowa.

The announcement by UHC is noteworthy, however. It signals the beginning for ACA exchanges of a new stage in their development, with challenges and opportunities different from and in many ways more important than those they faced during the first three years of operation, when the challenge was just to get up and running. From the time when HealthCare.Gov and the various state exchanges opened their doors until now, administrators grappled non-stop with administrative challenges—how to enroll people, helping them make an informed choice among insurance offerings, computing the right amount of assistance each individual or family should receive, modifying plans when income or family circumstances change, and performing various ‘back office’ tasks such as transferring data to and from insurance companies. The chaotic first weeks after the exchanges opened on October 1, 2013 have been well documented, not least by critics of the ACA. Less well known are the countless behind-the-scenes crises, patches, and work-arounds that harried exchange administrators used for years afterwards to keep the exchanges open and functioning.

The ACA forced not just exchange administrators but also insurers to cope with a new system and with new enrollees. Many new exchange customers were uninsured prior to signing up for marketplace coverage. Insurers had little or no information on what their use of health care would be. That meant that insurers could not be sure where to set premiums or how aggressively to try to control costs, for example by limiting networks of physicians and hospitals enrollees could use. Some did the job well or got lucky. Some didn’t. United seems to have fallen in the second category. United could have stayed in the 30 or so state markets they are leaving and tried to figure out ways to compete more effectively, but since their marketplace premiums were often not competitive and most of their business was with large groups, management decided to focus on that highly profitable segment of the insurance market. Some insurers, are seeking sizeable premium increases for insurance year 2017, in part because of unexpectedly high usage of health care by new exchange enrollees.

United is not alone in having a rough time in the exchanges. So did most of the cooperative plans that were set up under the ACA. Of the 23 cooperative plans that were established, more than half have gone out of business and more may follow. These developments do not signal the end of the ACA or even indicate a crisis. They do mark the end of an initial period when exchanges were learning how best to cope with clerical challenges posed by a quite complicated law and when insurance companies were breaking into new markets. In the next phase of ACA implementation, federal and state policy makers will face different challenges: how to stabilize, expand, and diversify marketplace risk pools, promote local market competition, and encourage insurers to compete on product quality rather than premium alone. Insurance company executives will have to figure out how to master rate setting, plan design, and network management and manage risk for customers with different characteristics than those to which they have become accustomed.

Achieving these goals will require state and federal authorities to go beyond the core implementation decisions that have absorbed most of their attention to date and exercise powers the ACA gives them. For example, section 1332 of the ACA authorizes states to apply for waivers starting in 2017 under which they can seek to achieve the goals of the 2010 law in ways different from those specified in the original legislation. Along quite different lines, efforts are already underway in many state-based marketplaces, such as the District of Columbia, to expand and diversify the individual market risk pool by expanding marketing efforts to enroll new consumers, especially young adults. Minnesota’s Health Care Task Force recently recommended options to stabilize marketplace premiums, including reinsurance, maximum limits on the excess capital reserves or surpluses of health plans, and the merger of individual and small group markets, as Massachusetts and Vermont have done.

In normal markets, prices must cover costs, and while some companies prosper, some do not. In that respect, ACA markets are quite normal. Some regional and national insurers, along with a number of new entrants, have experienced losses in their marketplace business in 2016. One reason seems to be that insurers priced their plans aggressively in 2014 and 2015 to gain customers and then held steady in 2016. Now, many are proposing significant premium hikes for 2017.

Others, like United, are withdrawing from some states. ACA exchange administrators and state insurance officials must now take steps to encourage continued or new insurer participation, including by new entrants such as Medicaid managed care organizations (MCOs). For example, in New Mexico, where in 2016 Blue Cross Blue Shield withdrew from the state exchange, state officials now need to work with that insurer to ensure a smooth transition as it re-enters the New Mexico marketplace and to encourage other insurers to join it. In addition, state insurance regulators can use their rate review authority to benefit enrollees by promoting fair and competitive pricing among marketplace insurers. During the rate review process, which sometimes evolves into a bargaining process, insurance regulators often have the ability to put downward pressure on rates, although they must be careful to avoid the risk of underpricing of marketplace plans which could compromise the financial viability of insurers and cause them to withdraw from the market. Exchanges have an important role in the affordability of marketplace plans too. For example ACA marketplace officials in the District of Columbia and Connecticut work closely with state regulators during the rate review process in an effort to keep rates affordable and adequate to assure insurers a fair rate of return.

Several studies now indicate that in selecting among health insurance plans people tend to give disproportionate weight to premium price, and insufficient attention to other cost provisions—deductibles and cost sharing—and to quality of service and care. A core objective of the ACA is to encourage insurance customers to evaluate plans comprehensively. This objective will be hard to achieve, as health insurance is perhaps the most complicated product most people buy. But it will be next to impossible unless customers have tools that help them take account of the cost implications of all plan features and report accurately and understandably on plan quality and service. HealthCare.gov and state-based marketplaces, to varying degrees, are already offering consumers access to a number of decision support tools, such as total cost calculators, integrated provider directories, and formulary look-ups, along with tools that indicate provider network size. These should be refined over time. In addition, efforts are now underway at the federal and state level to provide more data to consumers so that they can make quality-driven plan choices. In 2018, the marketplaces will be required to display federally developed quality ratings and enrollee satisfaction information. The District of Columbia is examining the possibility of adding additional measures. California has proposed that starting in 2018 plans may only contract with providers and hospitals that have met state-specified metrics of quality care and promote safety of enrollees at a reasonable price. Such efforts will proliferate, even if not all succeed.

Beyond regulatory efforts noted above, insurance companies themselves have a critical role to play in contributing to the continued success of the ACA. As insurers come to understand the risk profiles of marketplace enrollees, they will be better able to set rates, design plans, and manage networks and thereby stay profitable. In addition, insurers are best positioned to maintain the stability of their individual market risk pools by developing and financing marketing plans to increase the volume and diversity of their exchange enrollments. It is important, in addition, that insurers, such as UHC, stop creaming off good risks from the ACA marketplaces by marketing limited coverage insurance products, such as dread disease policies and short term plans. If they do not do so voluntarily, state insurance regulators and the exchanges should join in stopping them from doing so.

Most of the attention paid to the ACA to date has focused on efforts to extend health coverage to the previously uninsured and to the administrative stumbles associated with that effort. While insurance coverage will broaden further, the period of rapid growth in coverage is at an end. And while administrative challenges remain, the basics are now in place. Now, the exchanges face the hard work of promoting vigorous and sustainable competition among insurers and of providing their customers with information so that insurers compete on what matters: cost, service, and quality of health care.

Editor's note: This piece originally appeared in Real Clear Markets. Kevin Lucia and Justin Giovannelli contributed to this article with generous support from The Commonwealth Fund.

Only days before her retirement at age 71, Kathleen Elliott Yinug succumbed to a recurrence of cancer, which had been in remission for fifteen years. Over a Brookings career spanning four decades, she not only assisted several members of the Brookings community, but also became their valued friend. A woman of intelligence and liberal values, she elicited, demanded, and merited the respect of all with whom she worked.

After college, she joined the Peace Corps and was sent to the island of Yap. There she met her husband to be and there her son, Falan, was born. The family returned to the United States so that her husband could attend law school. Kathleen came to work at Brookings, helping to support her husband's law school training. When he returned to Yap, Kathleen assumed all parental responsibility. Her son has grown into a man of character, a devoted husband and father of two daughters. He and his wife, Louise, with compassion and generosity, made their home Kathleen's refuge during her final illness. Over extended periods, she held second jobs to supplement her Brookings income.

Her personal warmth, openness, and personal integrity made her a natural confidante of senior fellows, staff assistants, and research assistants, alike. She demanded and received respect from all. Her judgment on those who did not meet her standards was blunt and final; on one occasion, she 'fired'—that is, flatly refused to work with—one senior staff member whose behavior and values she rightly deplored.

With retirement approaching, Kathleen bought a condominium in Maine, a place she had come to love after numerous visits with her long-time friend, Lois Rice. After additional visits, her affection for Maine residents and the community she had chosen deepened. She spoke with intense yearning for the post-retirement time when she could take up life in her new home. That she was denied that time is a cruel caprice of life and only deepens the sense of loss of those who knew and loved her.

SUMMARY:
With the U.S. poverty rate stuck at around 15 percent for years, it’s clear that something needs to change, and candidates need to focus on three pillars of economic advancement-- education, work, family -- to increase economic mobility, according to Brookings Senior Fellow Isabel Sawhill and Senior Research Assistant Edward Rodrigue.

“Economic success requires people’s initiative, but it also requires us, as a society, to untangle the web of disadvantages that make following the sequence difficult for some Americans. There are no silver bullets. Government cannot do this alone. But government has a role to play in motivating individuals and facilitating their climb up the economic ladder,” they write.

The pillar of work is the most urgent, they assert, with every candidate needing to have concrete jobs proposals. Closing the jobs gap (the difference in work rates between lower and higher income households) has a huge effect on the number of people in poverty, even if the new workers hold low-wage jobs. Work connects people to mainstream institutions, helps them learn new skills, provides structure to their lives, and provides a sense of self-sufficiency and self-respect, while at the aggregate level, it is one of the most important engines of economic growth. Specifically, the authors advocate for making work pay (EITC), a second-earner deduction, childcare assistance and paid leave, and transitional job programs. On the education front, they suggest investment in children at all stages of life: home visiting, early childhood education, new efforts in the primary grades, new kinds of high schools, and fresh policies aimed at helping students from poor families attend and graduate from post-secondary institutions. And for the third prong, stable families, Sawhill and Rodrique suggest changing social norms around the importance of responsible, two-person parenthood, as well as making the most effective forms of birth control (IUDs and implants) more widely available at no cost to women.

“Many of our proposals would not only improve the life prospects of less advantaged children; they would pay for themselves in higher taxes and less social spending. The candidates may have their own blend of responses, but we need to hear less rhetoric and more substantive proposals from all of them,” they conclude.

Downloads

• Download the paper

We can be sure that the 2016 presidential candidates, whoever they are, will be in favor of promoting opportunity and cutting poverty. The question is: how? In our contribution to a new volume published today, “Campaign 2016: Eight big issues the presidential candidates should address,” we show that people who clear three hurdles—graduating high school, working full-time, and delaying parenthood until they in a stable, two-parent family—are very much more likely to climb to middle class than fall into poverty:

But what specific policies would help people achieve these three benchmarks of success?  Our paper contains a number of ideas that candidates might want to adopt. Here are a few examples: 

1. To improve high school graduation rates, expand “Small Schools of Choice,” a program in New York City, which replaced large, existing schools with more numerous, smaller schools that had a theme or focus (like STEM or the arts). The program increased graduation rates by about 10 percentage points and also led to higher college enrollment with no increase in costs.

2. To support work, make the Child and Dependent Care Tax Credit (CDCTC) refundable and cap it at $100,000 in household income. Because the credit is currently non-refundable, low-income families receive little or no benefit, while those with incomes above $100,000 receive generous tax deductions. This proposal would make the program more equitable and facilitate low-income parents’ labor force participation, at no additional cost.

3. To strengthen families, make the most effective forms of birth control (IUDs and implants) more widely available at no cost to women, along with good counselling and a choice of all FDA-approved methods. Programs that have done this in selected cities and states have reduced unplanned pregnancies, saved money, and given women better ability to delay parenthood until they and their partners are ready to be parents. Delayed childbearing reduces poverty rates and leads to better prospects for the children in these families.

These are just a few examples of good ideas, based on the evidence, of what a candidate might want to propose and implement if elected. Additional ideas and analysis will be found in our longer paper on this topic.

In their recent blog for Social Mobility Memos, Brad Wilcox, Robert Lerman, and Joseph Price make a convincing case that a stable family structure is an important factor in increased social mobility, higher economic growth, and less poverty over time.

The interesting question is: what lies behind this relationship? Why is a rise (or a smaller decline) in the proportion of married families associated, for example, with higher growth in average family incomes or a decline in poverty? The authors suggest a number of reasons, including the positive effects of marriage for children, less crime, men’s engagement in work, and income pooling. Of these, however, income pooling is by far the most important. Individual earnings have increased very little, if at all, over the past three or four decades, so the only way for families to get ahead was to add a second earner to the household. This is only possible within marriage or some other type of income pooling arrangement like cohabitation. Marriage here is the means: income pooling is the end.

How do we encourage more people to share incomes and expenses? There are no easy answers. Wilcox and his co-authors favor reducing marriage penalties in tax and benefit programs, expanding training and apprenticeship programs, limiting divorces in cases where reconciliation is still possible, and civic efforts to convince young people to follow what I and others have called the “success sequence.” All of these ideas are fine in principle. The question is how much difference they can make in practice. Previous efforts have had at best modest results, as a number of articles in the recent issue of the Brookings-Princeton journal The Future of Children point out.      

Our success sequence, which Wilcox wants to use as the basis for a pro-marriage civic campaign, requires teens and young adults to complete their education, get established in a job, and to delay childbearing until after they are married. The message is the right one.

The problem is that many young adults are having children before marriage. Why? Early marriage is not compatible, in their view, with the need for extended education and training. They also want to spend longer finding the best life partner. These are good reasons to delay marriage. But pregnancies and births still occur, with or without marriage. For better or worse, our culture now tolerates, and often glamorizes, multiple relationships, including premarital sex and unwed parenting. This makes bringing back the success sequence difficult.

Our best bet is to help teens and young adults avoid having a child until they have completed their education, found a steady job, and most importantly, a stable partner with whom they want to raise children, and with whom they can pool their income. In many cases this means marriage; but not in all. The bottom line: teens and young adults need more access and better education and counselling on birth control, especially little-used but highly effective forms as the IUD and the implant. Contraception, not marriage, is where we should be focusing our attention.

If you’re reading this article, chances are you know people who are still getting married. But it’s getting rarer, especially among the youngest generation and those who are less educated. We used to assume people would marry before having children. But marriage is no longer the norm. Half of all children born to women under 30 are born out of wedlock. The proportion is even higher among those without a college degree.

What’s going on here? Most of today’s young adults don’t feel ready to marry in their early 20s. Many have not completed their educations; others are trying to get established in a career; and many grew up with parents who divorced and are reluctant to make a commitment or take the risks associated with a legally binding tie.

But these young people are still involved in romantic relationships. And yes, they are having sex. Any stigma associated with premarital sex disappeared a long time ago, and with sex freely available, there’s even less reason to bother with tying the knot. The result: a lot of drifting into unplanned pregnancies and births to unmarried women and their partners with the biggest problems now concentrated among those in their 20s rather than in their teens. (The teen birth rate has actually declined since the early 1990s.)

Does all of this matter? In a word, yes.

These trends are not good for the young people involved and they are especially problematic for the many children being born outside marriage. The parents may be living together at the time of the child’s birth but these cohabiting relationships are highly unstable. Most will have split before the child is age 5.

Social scientists who have studied the resulting growth of single-parent families have shown that the children in these families don’t fare as well as children raised in two-parent families. They are four or five times as likely to be poor; they do less well in school; and they are more likely to engage in risky behaviors as adolescents. Taxpayers end up footing the bill for the social assistance that many of these families need.

Is there any way to restore marriage to its formerly privileged position as the best way to raise children? No one knows. The fact that well-educated young adults are still marrying is a positive sign and a reason for hope. On the other hand, the decline in marriage and rise in single parenthood has been dramatic and the economic and cultural transformations behind these trends may be difficult to reverse.

Women are no longer economically dependent on men, jobs have dried up for working-class men, and unwed parenthood is no longer especially stigmatized. The proportion of children raised in single-parent homes has, as a consequence, risen from 5 percent in 1960 to about 30 percent now.

Conservatives have called for the restoration of marriage as the best way to reduce poverty and other social ills. However, they have not figured out how to do this.

The George W. Bush administration funded a series of marriage education programs that failed to move the needle in any significant way. The Clinton administration reformed welfare to require work and thus reduced any incentive welfare might have had in encouraging unwed childbearing. The retreat from marriage has continued despite these efforts. We are stuck with a problem that has no clear governmental solution, although religious and civic organizations can still play a positive role.

But perhaps the issue isn’t just marriage. What may matter even more than marriage is creating stable and committed relationships between two mature adults who want and are ready to be parents before having children. That means reducing the very large fraction of births to young unmarried adults that occur before these young people say they are ready for parenthood.

Among single women under the age of 30, 73 percent of all pregnancies are, according to the woman herself, either unwanted or badly mistimed. Some of these women will go on to have an abortion but 60 percent of all of the babies born to this group are unplanned.

As I argue in my book, “Generation Unbound,” we need to combine new cultural messages about the importance of committed relationships and purposeful childbearing with new ways of helping young adults avoid accidental pregnancies. The good news here is that new forms of long-acting but fully reversible contraception, such as the IUD and the implant, when made available to young women at no cost and with good counseling on their effectiveness and safety, have led to dramatic declines in unplanned pregnancies. Initiatives in the states of Colorado and Iowa, and in St. Louis have shown what can be accomplished on this front.

Would greater access to the most effective forms of birth control move the needle on marriage? Quite possibly. Unencumbered with children from prior relationships and with greater education and earning ability, young women and men would be in a better position to marry. And even if they fail to marry, they will be better parents.

My conclusion: marriage is in trouble and, however desirable, will be difficult to restore. But we can at least ensure that casual relationships outside of marriage don’t produce children before their biological parents are ready to take on one of the most difficult social tasks any of us ever undertakes: raising a child. Accidents happen; a child shouldn’t be one of them.

The injustices faced by African Americans are high on the nation’s agenda. “Black Lives Matter” has become a rallying cry that has elicited intense feelings among both supporters and detractors. As William Julius Wilson has pointed out on this blog, the focus on policing and criminal justice is necessary but not sufficient. Concerted action is required to tackle systematic racial gaps in everything from income and wealth to employment rates, poverty rates, and educational achievement.

Ta-Nehisi Coates argues that financial reparations should be paid to all those who have suffered directly or indirectly from slavery and its aftermath, including present day injustices such as the targeting of subprime mortgages to minorities. The moral case is compelling, and Coates notes that there have been other instances in U.S. history when reparations have been paid—such as to some Native American tribes and to the Japanese-Americans thrown into internment camps during World War II.

Even if the moral argument for reparations is won, there are formidable obstacles in terms of policy, politics, and law. How would reparations work in practice? To be fair, Coates does support the bill from Congressman John Conyers establishing a commission to examine precisely these questions. Even if a workable policy can be found, the political opposition would, to put it mildly, be formidable. There are also doubts about constitutional legality. However, these are certainly questions worthy of better answers than the ones currently being made.

Reparations are a stark example of a race-based policy: targeting resources or an intervention at an explicitly-defined racial group. At the other extreme are “race-blind” policies, applied with no regard to race (at least in theory). But there is a middle ground, consisting of what might be labeled ‘race-conscious’ policies. These policies would be designed to close racial gaps without targeting racial groups.

What might race-conscious policies look like? Here are some ideas:

1. Professors William Darity at Duke and Darrick Hamilton of The New School propose to tackle race gaps in wealth by providing “baby bonds” to children born to families with limited wealth. In 2013, median net worth was $11,000 for black households compared to $141,900 for whites. Darity and Hamilton are supporters of reparations in principle, but are alert to policy and political feasibility. Their specific proposal is that every baby born into a family with below-median wealth receives a “baby bond” or trust fund. These would be worth $50,000 to $60,000 on average, but scaled according to the level of the family’s wealth. The money would be available at the age of 18 for certain expenditures such as paying for college or buying a home. This is a good example of a race-conscious policy. It is not explicitly targeted on race but it would have its greatest impact on African American families.
2. While racial wealth gaps are large and troubling, the disappearance of almost half of unskilled, young black men from the labor force may be an even greater problem in the long run. A comprehensive approach on jobs could include raising the minimum wage, expanding the EITC, and providing subsidized jobs in either the public or private sector for those unable to find jobs on their own. The job subsidies might be targeted on young adults from high-poverty neighborhoods where joblessness is endemic. The subsidized jobs would help people of all races, but especially African Americans. A jobs-based program is also likely to find greater political support than straightforward wealth redistribution. Granted, such jobs programs are hard to administer, but we now have a large number of workers whose job prospects are slim to nonexistent in a technologically-oriented and service-based economy.
3. An enhanced EITC could also help to increase wealth (or lower indebtedness). As Kathryn Edin and her colleagues note in It’s Not Like I’m Poor, the EITC is normally received as a lump sum refund at the end of the year. As a form of forced saving, it enables poor families to repay debt and make mobility enhancing investments in themselves or their children. According to Edin, recipients like the fact that, unlike welfare, the tax credit links them socially and psychologically to other Americans who receive tax refunds. A more generous EITC could therefore help on the wealth as well as income side, and narrow racial gaps in both.
4. A final example of a race-conscious policy is the Texas “top 10” law, which guarantees admission to any public university in the state for students in the top 10 percent of their high school class. This plan could be expanded to other states.

The “Black Lives Matter” movement has refocused the nation’s attention on mass incarceration and related injustices in the criminal justice system. But this problem exists side by side with racial inequalities in income, wealth, education, and employment. There are no easy answers to America’s stubborn race gaps. But jobs and wages seem to us to be of paramount importance. Implemented in a race-conscious way (by targeting them to areas suffering from high rates of poverty and joblessness), employment policy might be the most powerful instrument of all for race equality.

Tomorrow, President Obama unveils his last budget, and we’re sure to see plenty of proposals for spending on education and skills. In the past, the Administration has focused on investments in early childhood education, community colleges, and infrastructure and research. From a budgetary standpoint, the problem with these investments is how to capture their benefits as well as their costs.

First step: find out what works. The Obama Administration has been emphatic about the need for solid evidence in deciding what to fund. The good news is that we now have quite a lot of it, showing that investing in human capital from early education through college can make a difference. Not all programs are successful, of course, and we are still learning what works and what doesn’t. But we know enough to conclude that investing in a variety of health, education, and mobility programs can positively affect education, employment, and earnings in adulthood.

For example:

1. Young, low-income children whose families move to better neighborhoods using housing vouchers see a 31 percent increase in earnings;

2. Quality early childhood and school reform programs can raise lifetime income per child by an average of about $200,000, for at an upfront cost of about $20,000;

3. Boosting college completion rates, for instance via the Accelerated Study in Associate Programs (ASAP) in the City University of New York, leads to higher earnings.

If such estimates are correct (and we recognize there are uncertainties), policymakers are probably underinvesting in such programs because they are looking at the short-term costs but not at longer-term benefits and budget savings.

First, the CBO’s standard practice is to use a 10-year budget window, which means long-range effects are often ignored. Second, although the CBO does try to take into account behavioral responses, such as increased take-up rates of a program, or improved productivity and earnings, it often lacks the research needed to make such estimates. Third, the usual assumption is that the rate of return on public investments in human capital is less than that for private investment. This is now questionable, especially given low interest rates.

A hot topic in budget politics right now is so-called “dynamic scoring.” This means incorporating macroeconomic effects, such as an increase in the labor force or productivity gains, into cost estimates. In 2015, the House adopted a rule requiring such scoring, when practicable, for major legislation. But appropriations bills are excluded, and quantitative analyses are restricted to the existing 10-year budget window.

The interest in dynamic scoring is currently strongest among politicians pushing major tax bills, on the grounds that tax cuts could boost growth. But the principles behind dynamic scoring apply equally to improvements in productivity that could result from proposals to subsidize college education, for example—as proposed by both Senator Sanders and Secretary Clinton. Of course, it is tough to estimate the value of these potential benefits. But it is worth asking whether current budget rules lead to myopia in our assessments of what such investments might accomplish, and thus to an over-statement of their “true” cost.

We have known for some time that children who grow up in single parent-families do not fare as well as those with two parents – especially two biological parents.  In recent years, some scholars have argued that the consequences are especially serious for boys.  Not only do boys need fathers, presumably to learn how to become men and how to control their often unruly temperaments, but less obviously, and almost counterintuitively, it turns out that boys are more sensitive or less resilient than girls. Parenting seems to affect the development of boys more than it affects the development of girls.  Specifically, their home environment is more likely to affect behavior and performance in school.

Up until now, these speculations have been based on limited evidence.  But new research from Harvard professor Raj Chetty and a team of colleagues shows that the effects of single parenthood are indeed real for all boys, regardless of family income, but especially for boys living in high-poverty, largely minority neighborhoods.

When they become adults, boys from low-income, single-parent families are less likely to work, to earn a decent income, and to go to college: not just in absolute terms, but compared to their sisters or other girls who grew up in similar circumstances.  These effects are largest when the families live in metropolitan areas (commuting zones) with a high fraction of black residents, high levels of racial and income segregation, and lots of single-parent families.  In short, it is not just the boy’s own family situation that matters but also the kind of neighborhood he grows up in.  Exposure to high rates of crime, and other potentially toxic peer influences without the constraining influence of adult males within these families, seems to set these boys on a very different course than other boys and, perhaps more surprisingly, on a different course from their sisters.

The focus of a great deal of attention recently has been on police practices in low-income minority neighborhoods.  Without in any way excusing police brutality where it has occurred, what this research suggests is that the challenge for police is heightened by the absence of male authority figures in low-income black neighborhoods.  In his gripping account of his own coming of age in West Baltimore, journalist Ta-Nehisi Coates recounts being severely punished by his father for some adolescent infraction.  When his mother protested, Ta-Nehisi’s father replied that it was better that this discipline come from within the family than be left to the police.  But Coates’ family was one of the few in his neighborhood where a father still existed.

Repairing families is difficult at best.  Most single-parent families are initially formed as the result of an unplanned birth to an unmarried young woman in these same communities.  Perhaps girls and young women simply suffer in a different way.  Instead of becoming involved in crime and ending up in prison or the informal economy, they are more likely to drift into early motherhood.  With family responsibilities at an early age, and less welfare assistance than in the past, they are also more likely to have to work.  But in the longer run, providing more education and a different future for these young women may actually be just as important as helping their brothers if we don’t want to perpetuate the father absence that caused these problems in the first place.  They are going to need both the motivation (access to education and decent jobs) and the means (access to better forms of contraception) if we are to achieve this goal.

Editor's note: This piece originally appeared in Real Clear Markets. 

Far too many people reach their advanced years without planning for how they want their lives to end. The result too often is needless suffering, reduced dignity and autonomy, and agonizing decisions for family members.

Addressing these end-of-life issues is difficult. Most of us don’t want to confront them for ourselves or our family members. And until recently, many people resisted the idea of reimbursing doctors for end-of-life counselling sessions. In 2009, Sarah Palin labelled such sessions as the first step in establishing “death panels.” Although no such thing was contemplated when Representative Earl Blumenauer (D- Oregon) proposed such reimbursement, the majority of the public believed that death panels and euthanasia were just around the corner. Even the Obama Administration subsequently backed away from efforts to allow such reimbursement.

Fortunately, this is now history. In the past year or two the tenor of the debate has shifted toward greater acceptance of the need to deal openly with these issues. At least three developments illustrate the shift.

First, talk of “death panels” has receded, and new regulations, approved in late 2015 to take effect in January of this year, now allow Medicare reimbursement for end of life counselling. The comment period leading up to this decision was, according to most accounts, relatively free of the divisive rhetoric characterizing earlier debates. Both the American Medical Association and the American Hospital Association have signaled their support.

Second, physicians are increasingly recognizing that the objective of extending life must be balanced against the expressed priorities of their patients which often include the quality and not just the length of remaining life. Atal Gwande’s best-selling book, Being Mortal, beautifully illustrates the challenges for both doctors and patients. With well-grounded and persuasive logic, Gwande speaks of the need to de-medicalize death and dying.

The third development is perhaps the most surprising. It is a bold proposal advanced by Governor Jeb Bush before he bowed out of the Presidential race, suggesting that eligibility for Medicare be conditioned on having an advanced directive. His interest in these issues goes back to the time when as governor of Florida he became embroiled in a dispute about the removal of a feeding tube from a comatose Terry Schiavo. Ms. Schiavo’s husband and parents were at odds about what to do, her husband favoring removal and her parents wishing to sustain life. In the end, although the Governor sided with the parents, the courts decided in favor of the husband and allowed her to die. If an advanced directive had existed, the family disagreement along with a long and contentious court battle could have been avoided.

The point of such directives is not to pressure people into choosing one option over another but simply to insure that they consider their own preferences while they are still able. Making this a requirement for receipt of Medicare would almost surely encourage more people to think seriously about the type of care they would like toward the end of life and to talk with both their doctors and their family about these views. However, for many others, it would be a step too far and might reverse the new openness to advanced planning. A softer version nudging Medicare applicants to address these issues might be more acceptable. They would be asked to review several advance directive protocols, to choose one (or substitute their own). If they felt strongly that such planning was inappropriate, they could opt out of the process entirely and still receive their benefits.

Advanced care planning should not be linked only to Medicare. We should encourage people to make these decisions earlier in their lives and provide opportunities for them to revisit their initial decisions. This could be accomplished by implementing a similar nudge-like process for Medicaid recipients and those covered by private insurance.

Right now too few people are well informed about their end-of-life options, have talked to their doctors or their family members, or have created the necessary documents. Only about half of all of those who have reached the age of 60 have an advanced directive such as a living will or a power of attorney specifying their wishes. Individual preferences will naturally vary. Some will want every possible treatment to forestall death even if it comes with some suffering and only a small hope of recovery; others will want to avoid this by being allowed to die sooner or in greater comfort. Research suggests that when given a choice, most people will choose comfort care over extended life.

In the absence of advance planning, the choice of how one dies is often left to doctors, hospitals, and relatives whose wishes may or may not represent the preferences of the individual in their care. For example, most people would prefer to die at home but the majority do not. Physicians are committed to saving lives and relatives often feel guilty about letting a loved one “go.”

The costs of prolonging life when there is little point in doing so can be high. The average Medicare patient in their last year of life costs the government $33,000 with spending in that final year accounting for 25 percent of all Medicare spending. Granted no one knows in advance which year is “their last” so these data exaggerate the savings that better advance planning might yield, but even if it is 10% that represents over $50 billion a year. Dr. Ezekiel Emanuel, an expert in this area, notes that hospice care can reduce costs by 10 to 20 percent for cancer patients but warns that little or no savings have accompanied palliative care for heart failure or emphysema patients, for example. This could reflect the late use of palliative care in such cases or the fact that palliative care is more expensive than assumed.

In the end, Dr. Emanuel concludes, and I heartily agree, that a call for better advance planning should not be based primarily on its potential cost savings but rather on the respect it affords the individual to die in dignity and in accordance with their own preferences.

Editor's note: This piece originally appeared in Inside Sources.

Throughout the past year, we have heard paid leave debated in state houses and on the campaign trail. I am all in favor of paid leave. As I have argued elsewhere, it would enable more people, especially those in lower-paid jobs, to take time off to deal with a serious illness or the care of another family member, including a newborn child. But we shouldn’t stop with paid leave. We should also consider shortening the standard work week. Such a step would be gender neutral and would not discriminate between the very different kinds of time pressures faced by adults. It might even help to create more jobs.

The standard work week is 40 hours -- 8 hours a day for five days a week. It’s been that way for a long time. Back in 1900, the typical factory worker spent 53 hours on the job, more than a third more hours than we spend today. The Fair Labor Standards Act was passed in 1938, and set maximum hours at 40 per week. Amazingly, more than three quarters of a century after passage of the FLSA, there has been no further decline in the standard work week. Not only has the legal standard remained unchanged, but 40 hours has become the social and cultural norm.

What’s going on here? Economists predicted that as we became more prosperous we would choose to work fewer hours. That hasn’t happened. Instead we have kept on working at about the same pace as we did earlier in our history, but have poured all of the gains from productivity growth into ever-higher levels of consumption – bigger houses, more electronic gadgets, fancier cars. With increased prosperity, people are buying more and more stuff, but they don’t have any more time to enjoy it. A reduction in the standard work week would improve the quality of life, especially for those in hourly jobs who have benefitted hardly at all from economic growth in recent decades.

Two-earner couples would also benefit. Among couples between the ages of 25 and 54, the number of hours worked increased by 20 percent between 1969 and 2000, from 56 hours to 67 hours (for both husband and wife combined). As Heather Boushey notes in her new book, Finding Time, we no longer live in a world where there is a “the silent partner” in every business enterprise, the iconic “American Wife,” who takes care of the children and the millions of details of daily living. With a shorter work week, both men and women would have more time for everything from cutting the grass to cooking dinner with no presumption about who does what. Although much of the debate this year has been about work-family balance, empty nesters or singles without young children might also welcome a shorter work week. For them it would provide the chance to follow their dream of becoming an artist, a boat builder, or the creator of their own small business.

Shorter hours could have another benefit and that is more jobs for workers who would otherwise be left behind by technological change. Many economists believe that as existing jobs are replaced by machines and artificial intelligence, new jobs will be created in technical, management, and service fields. But will this happen fast enough or at sufficient scale to reemploy all those who now find themselves without decent-paying work? I doubt it. A shorter work week might help to spread the available jobs around. Germany and other European countries, along with a few U.S. states used this strategy during the Great Recession. It kept more people on the job but at shorter hours and reduced unemployment. Using a similar strategy to deal with automation and long-term joblessness, although controversial, should not be dismissed out of hand.

Of course, shorter hours can mean lower total pay. But in one typical survey published in the Monthly Labor Review, 28 percent of the respondents said they would give up a day’s pay for one fewer day of work per week. Any new movement to reduce the work week would need to be phased in slowly, with flexibility for both employers and employees to negotiate adjustments around the standard. Yet if done correctly, the transition could be accomplished with little or no reduction in wages, just smaller raises as a bigger slice of any productivity improvement was invested in more free time. When Henry Ford reduced the work week from 6 to 5 days in 1926, he did not cut wages; he assumed that both productivity and consumption would rise, and his example encouraged other employers to follow suit.

I am not talking about reducing hours for those of us who want to spend long hours at work because we enjoy it. We would still be free to work 24/7, tied to our electronic devices, and no longer knowing exactly when work begins and ends. A new hours standard would primarily affect hourly (nonexempt) employees. These are the people in the less glamourous jobs at the bottom of the ladder, many of them single parents. Right now they finish work exhausted only to come home to a “second shift” that may be equally exhausting. A reduction in the standard workweek would almost certainly improve the quality of life for these hard-pressed and overworked Americans.

By all means, let’s enact a paid leave policy, but let’s also debate some even bigger ideas – ones that could lead to greater work-life balance now, and more job opportunities in the longer run.

Editor's note: This piece originally appeared on The Washington Post's In Theory Blog.

Senior Fellows Ron Haskins and Isabel Sawhill are the first joint recipients of the Daniel Patrick Moynihan Prize from the American Academy of Political and Social Science (AAPSS). The prize is awarded each year to a leading policymaker, social scientist, or public intellectual whose career focuses on advancing the public good through social science. It was named after the late senator from New York and renowned sociologist Daniel Patrick Moynihan. The pair accepted the award May 12 at a ceremony in Washington, DC. 

In their joint lecture delivered at the ceremony, Haskins and Sawhill emphasized the importance of evidence-based public policy, highlighting Sawhill’s latest work in her book, Generation Unbound (Brookings, 2014). Watch their entire speech here:

“Marriage is disappearing and more and more babies are born outside marriage,” Sawhill said during the lecture. “Right now, the proportion born outside of marriage is about 40 percent. It’s higher than that among African Americans and lower than that among the well-educated. But it’s no longer an issue that just affects the poor or minority groups.”

Download Sawhill's slides » | Download Ron Haskins' slides »

The power of evidence-based policy is finally being recognized, Haskins added. “One of the prime motivating factors of the current evidence-based movement,” he said, “is the understanding, now widespread, that most social programs either have not been well evaluated or they don’t work.” Haskins continued:

Perhaps the most important social function of social science is to find and test programs that will reduce the nation’s social problems. The exploding movement of evidence-based policy and the many roots the movement is now planting, offer the best chance of fulfilling this vital mission of social science, of achieving, in other words, exactly the outcomes Moynihan had hoped for.

He pointed toward the executive branch, state governments, and non-profits implementing policies that could make substantial progress against the nation’s social problems.

Richard Reeves, a senior fellow at Brookings and co-director, with Haskins, of the Center on Children and Families (CCF), acknowledged Haskins and Sawhill’s “powerful and unique intellectual partnership” and their world-class work on families, poverty, opportunity, evidence, parenting, work, and education.

Haskins and Sawhill were the first to be awarded jointly by the AAPSS, which recognizes their 15-year collaboration at Brookings and the Center on Children and Families, which they established. In addition to their work at CCF, the two co-wrote Creating an Opportunity Society (Brookings 2009) and serve as co-editors of The Future of Children, a policy journal that tackles issues that have an impact on children and families.

Haskins and Sawhill join the ranks of both current and past Brookings scholars who have received the Moynihan Prize, including Alice Rivlin (recipient of the inaugural prize), Rebecca Blank, and William Julius Wilson along with other distinguished scholars and public servants.

Want to learn more about the award’s namesake? Read Governance Studies Senior Fellow and historian Steve Hess’s account of Daniel Patrick Moynihan’s time in the Nixon White House in his book The Professor and the President (Brookings, 2014).

Employment among lower-income men has declined by 11 percent since 1980 and has remained flat among lower-income women. Men and women in the top and middle of the income distribution, on the other hand, have been working as much or more since 1980, creating a growing “work gap” in labor market income between haves and have-nots.   

This paper simulates the effect of five labor market interventions (higher high school graduation rate, minimum wage increases, maintaining full employment, seeing all household heads work full time, and virtual marriages between single mothers and unattached men) on the average incomes of the poorest one-third of American households. They find that the most effective way to increase average incomes of the poorest Americans would be for household heads to work full time, whereas the least effective intervention would be increasing education.

In terms of actual impact on incomes, the simulation of all household heads working full time at their expected wage increased average household earnings by 54 percent from a baseline of $12,415 to $19,163. The research also suggests that even if all household heads worked just some—at expected wages or hours—average earnings would still increase by 16 percent.

The least effective simulation was increasing the high school graduation rate to 90 percent and having half of those “newly” graduated go on to receive some form of post-secondary education. The authors note that the low impact of increasing education on mobility is likely because only one in six of bottom-third adults live in a household in which someone gains a high school degree via the intervention.

Because single parents are disproportionately represented among low-income families, Sawhill and coauthors also explored the impact of adding a second earner to single-parent families through a simulation that pairs low-income, single-mother household heads with demographically similar but unrelated men. That simulation increased the average household earnings of the bottom-third only modestly, by $508, or about 4 percent.

Efforts to increase employment among heads of the poorest households must take into consideration why those household heads aren’t working, they note. According to data from the 2015 Census, the most cited reason for women not working is “taking care of home and family” and for men it is being “ill or disabled.”  

Downloads

• Download "One third of a nation: Strategies for helping working families"

The idea of a universal basic income (UBI) is certainly an intriguing one, and has been gaining traction. Swiss voters just turned it down. But it is still alive in Finland, in the Netherlands, in Alaska, in Oakland, CA, and in parts of Canada. 

Advocates of a UBI include Charles Murray on the right and Anthony Atkinson on the left. This surprising alliance alone makes it interesting, and it is a reasonable response to a growing pool of Americans made jobless by the march of technology and a safety net that is overly complex and bureaucratic. A comprehensive and excellent analysis in The Economist points out that while fears about technological unemployment have previously proved misleading, “the past is not always a good guide to the future.”

Robert Greenstein argues, however, that a UBI would actually hurt the poor by reallocating support up the income scale. His logic is inescapable: either we have to spend additional trillions providing income grants to all Americans or we have to limit assistance to those who need it most. 

One option is to provide unconditional payments along the lines of a UBI, but to phase it out as income rises. Libertarians like this approach since it gets rid of bureaucracies and leaves the poor free to spend the money on whatever they choose, rather than providing specific funds for particular needs. Liberals fear that such unconditional assistance would be unpopular and would be an easy target for elimination in the face of budget pressures. Right now most of our social programs are conditional. With the exception of the aged and the disabled, assistance is tied to work or to the consumption of necessities such as food, housing, or medical care, and our two largest means-tested programs are Food Stamps and the Earned Income Tax Credit.

Liberals have been less willing to openly acknowledge that a little paternalism in social policy may not be such a bad thing. In fact, progressives and libertarians alike are loath to admit that many of the poor and jobless are lacking more than just cash. They may be addicted to drugs or alcohol, suffer from mental health issues, have criminal records, or have difficulty functioning in a complex society. Money may be needed but money by itself does not cure such ills. 

A humane and wealthy society should provide the disadvantaged with adequate services and support. But there is nothing wrong with making assistance conditional on individuals fulfilling some obligation whether it is work, training, getting treatment, or living in a supportive but supervised environment.

In the end, the biggest problem with a universal basic income may not be its costs or its distributive implications, but the flawed assumption that money cures all ills.