Student writes a letter in support of the ELEVATE act to end long-term unemployment

To Whom It May Concern,

I am writing to you today to inform you about the “Economic Ladders to End Volatility and Advance Training and Employment,” or ELEVATE Act. This is a very crucial act that works to lower the unemployment rate by creating jobs through the help of federal funding which allows for states, “to provide eligible individuals with employment, training, and supportive services” (Hammond). It is also a new title to the Social Security Act for states to fund and implement subsidized employment programs. It was created with built-in guardrails that ensure that states pursue re-employment and retraining programs with a strong evidence base and low overhead, thus significantly lowering the chances of states using the federal money for other purposes. Funding through this act is also conditioned on states’ quarterly unemployment rates to create aggressive and fast-acting “automatic stabilizers”. In addition, it includes a demonstration project to identify “pro-worker employers” to ensure subsidized job placements don’t erode job quality, and a national self-employment benefit for recently unemployed workers to pursue entrepreneurship. Lastly, it consists of a national relocation assistance program to reimburse eligible individuals for the expenses associated with “moving to opportunity.”

This Act was created with a wide range of eligibility so that more citizens have access to the benefits of the program, therefore making it more profitable for business owners involved as well. Those who the program is aimed to help are the long-term unemployed; current and former recipients of public assistance programs like SNAP and TANF; those who are eligible for public assistance but not enrolled; noncustodial parents under a child support order; adults who were in foster care; and the formerly incarcerated. This allows for a wide range of those making up the unemployment rates to have a chance at getting the job training and access they so desperately lack and need. This then results in less people on the streets, more people working to increase production of businesses, and more people with money to invest back in the economy. 

The reason for writing you today is not only to inform you about this very important Act, but to also ask for your support towards this Act. As can be seen from the brief description above, it is a very important act that is needed in our society today in order to improve the lives of our citizens. However, it needs your support as well in order to be implemented and started within our states. I look forward to gaining your support for pushing this Act forward, and I thank you in advance for your support and effort. 

Best regards,

Student's name

References

https://www.niskanencenter.org/the-elevate-act-explained-a-job-guarantee-that-can-work/

This article follows the actual and typical style of most advocacy letters.  In essence, you found a source, paraphrased and quoted from the source, and added a personalized introduction and conclusion to make it appropriate as a letter to someone.

Given that I expected you to put about 10 hours into this assignment, here are things I think you could have done and have not done that would have made it stronger:

1. Look up the actual bill number and write about the specific bill. This is S.1920 Long-Term Unemployment Elimination Act of 2019.
2. Find out where in the process it is and ask for help getting it through.  It was introduced and read twice in the Senate and has been referred to the Committee on Health, Education, Labor, and Pensions.
3. Made some assessment as to whether this policy is bi-partisan or has the potential to be so, or whether it is “Republican” or “Democratic” legislation, in which case, since it is a Senate Bill, it’s odds of passage depend upon it being a Republican Bill without strong opposition from the Democratic Senators or else a Democratic Bill with the real potential of gaining some support from Republicans.  Making that assessment, you should have made your request to someone in the context of what sort of bill this is in terms of partisan politics and ideologies.  In fact, this bill is a Democratic Bill, and the co-sponsors seem to be thinking that this bill is a sort of trial run for similar legislation they might be able to pass if the Democrats take the White House and the Senate next year.  As both your Senators are Democrats, it might be worthwhile seeing whether they might find some Republican colleagues who could support the bill, or even persuade the Republicans to pass this sort of bill into law "for the good of the country" right away.
4. You have addressed your work to “To Whom It May Concern” when this is a Senate Bill.  The correct target for your letter is either of your senators, Duckworth or Durbin.  Alternatively, you could have written a letter to the Chair of the Committee on Health, Education, Labor and Pensions (Republican Lamar Alexander of Tennessee) or the ranking minority member (Democrat Patty Murray of Washington).  Even better, you might have found some Republican Senators on the committee that needs to hear this before it goes to the Senate floor for a vote, and tried to make a case that would be persuasive to a Republican (a conservative) in favor of the bill. 
5. You could have chosen another one or two or three sources to provide you with arguments for why this is a good bill. You have relied entirely on Samuel Hammond’s article in the Niskanen Center (a good source that relies on authentic experts and offers a mix of moderate conservative and liberal ideologies in its biases). That is actually the best source I could find, and even the $2 a Day website links to it. Given the idea that you ought to spend a couple hours at least in researching a paper, you might have also considered these sources I turned up with a Google Search using "long term unemployment" and "senate":
   
   The summary of the bill made by one of the sponsors of it: https://www.vanhollen.senate.gov/imo/media/doc/Van_Hollen_Long_Term_Unemployment_Pen_and_Pad.pdf
   
   The article praising the bill (authors are Mark Paul and Dean Baker, and Dean Baker is one of the best economists I know of): https://www.counterpunch.org/2019/07/01/how-to-put-an-end-to-long-term-unemployment/
   
   Or this article and the sources to which it links: https://nationalinitiatives.wordpress.com/2019/06/24/the-long-term-unemployment-elimination-act-creating-access-to-employment-equity-opportunity/ 
6. You could have done a bit more writing in your own voice instead of the high level of paraphrasing and quoting you used.  In an actual letter, I think the staff person (or the actual senator) who reads your letter can tell the difference between the “voice” of a constituent and the “voice” of a lobbyist who tells constituents what to say.  You will be more persuasive if you study what the proponents or opponents of a bill have to say, and then write your own argument using your own understanding.  The second best strategy is to offer a series of direct quotations or a longer block quotation and then offer your own paragraph summarizing and interpreting the implications of what you have just quoted.
7. You might have thought of reasons people would oppose the bill, given a fair representation of arguments against it, and then explained why those anticipated arguments were not strong enough to overwhelm your case.

A student feels radicalized by the policy class

The number of things I have learned in this class so far is immense. I have come to an understanding, especially during our Wednesday nights class discussions, that various ways of taking in information can lead to multiple perspectives,. Articles, class discussions, and documentaries in this course are a great source of information and have helped me analyze poverty. Poverty, in my eyes, is America's number one enemy. Drugs, violence, prostitution, homeless, and welfare problems all correlate with poverty. Deep down inside, I don't think America can ever beat poverty. However, we can put bandages on the problems it exacerbates. After learning some of the challenges of poverty in this course, it’s clear that our country isn’t waging a serious war on poverty.

Consequently, poverty itself is a tool used in a war on the people who are surviving on the. margins. The welfare system, according to $2.00 A Day, is designed to blame those in poverty for their unfortunate circumstances. The people who write the welfare policies also believe in welfare dependency as a large problem and a general characteristic of those who seek assistance. That is why so little is given to help anyone truly rise out of poverty; just enough is given to prevent starvation or help a person continue through life making just enough to move slightly above or fall slightly below the poverty line. I look at poverty like millions of people stuck in narrow and deep pit grave trying to figure a way out. Meanwhile, the government throws shovels down to them expecting the people to find their way out the grave holes they are in. This is to say, our policies offer tools and opportunities, but they are inadequate and not even always useful given the actual circumstances that condemn people to the situation in which they are trapped.  I'm quite upset at how the governments' welfare to work program has failed millions of Americans in poverty. I am even more upset at having to watch my relatives, coworkers, strangers, and children live on almost nothing in America, and the government stands by, doing the bare minimum with public policy that will help those in poverty rise out of it. 

This course has been an eye opener for many. I would like to see a welfare system that works for single mothers, that works for the homeless, that works for any and everyone struggling and living on almost nothing in America. Persons with chronic health problems or mental health problems or developmental disabilities need a reasonable degree of material security and reasonable access to helpful services. Persons with few skills and poor job prospects need training and employment where they can work in a respectful environment and become productive, and win a decent quality of living if they are honest and hard-working. Persons facing temporary set-backs in life or downturns in the business cycle need support to get them back on their way to achieving material security and some sort of rewarding occupation. The perpetuation of poverty and precarious life is unnecessary, and it only gives advantages to a small segment of the population, while the majority of us suffer. This class has convinced me to advocate for change, so we have better welfare programs and increased access to effective services.

A student asks Senator Duckworth to improve law and funding for developmental disabilities services

Dear Honorable Senator Tammy Duckworth

       I am from Springfield, IL, and have lived here since I was three years old. I graduated from Springfield Public School District 186, and am currently attending the University of Illinois, Springfield. I am a social work student, and I am hoping to provide change and support to the community that gave and taught me so much. 

      The reason I am writing to you is because of the lack of Transition options for Illinois students with disabilities. I work as a paraprofessional in Springfield Public Schools and am placed in a school with a high disabled population. That school is Edwin A. Lee Elementary School. According to the Illinois Report Card, 57% of Edwin A Lee Elementary student population has IEPs, 28% have a developmental delay, 33% have a speech and language impairment, 3% have autism, and 2% have multiple disabilities. Working alongside these students and trying to help them succeed, I have witnessed the lack of transition options for our students after they graduate from Lee. 

At Lee, our students with learning and developmental disabilities can attend to the age of 22. We provide them with an education that focuses on independence and workplace competence. Our hope and aim are that when our students graduate, they can get a job and be as independent as possible. After graduation, though, the lack of programs and initiatives available to our students is hindering that dream. The goal of a more inclusive society where these persons can be more independent is tragically thwarted by the cost of at-home health care, the price of adequate and safe group homes, the lack of government activities that help them get jobs, and the low number of organizations willing to employ the disabled. Some of our students graduate and get in contact with a job counselor, but the waiting list is so long it sometimes takes over a year for them to get in touch. Over that period, their skills and abilities can turn rusty and even become lost though disuse, and that can further inhibit them from getting a job. My wish is that the Individuals with Disabilities Education Act gets expanded and that the result is our community offers more services. We should not “throw away” these people, and I fear that our failing to assist their transition from school to adulthood is doing just that. These persons have valuable contributions to make to their communities. What is best about our society is our concern that we help everyone develop their full potential and live with as much self-sufficiency and autonomy as possible. We are needlessly falling short when it comes to the practical help we give to persons with developmental disabilities as they transition from school to adult life.

I hope that through the act, more coordinators and transition heads are placed in every county in the state. I wish more job coaches positions are made, so that way, the waiting list can be shortened, and more individuals can be helped and not put on a waiting list. I also hope that schools with a high disabled population get their transition coach who focuses on confirming that the students get the help they need when they graduate. Through the act as well, I hope that the individuals who are not able to get a job are provided more assistance so they can go to a safe group home and not have to compromise safety for cost. I also hope that home health care costs paid by the developmentally disabled persons and their families goes down as well, to help the families who are taking care of their loved ones with disabilities. The school district should help with transition planning, so they are not leaving students in the dust where they are not able to fend for themselves. Focusing on transitioning not only helps the schools, but it improves the students. 

I know that assistance like this is at a cost, and I believe one way we can pay for is a property tax and fees that every student has to pay for public education. I am willing to pay a little more in taxes for the betterment of our disabled citizens so they can have the same opportunities. Making sure every citizen has an equal opportunity is significant. I believe that improvements to the laws and increases in tax revenue could be made attractive to voters and taxpayers if we: 1) show them the direct costs in terms of dollars per month they would be paying to help persons with developmental disabilities; and 2) show them exactly where that sort of money goes; and 3) explain the evidence that the services are efficiently helping persons with developmental disabilities and their families. 

Thank you for your time, 

Student suggests after Community Eligibility Provision is eliminated, Springfield ought to continue making lunches free for all students in District 186

Dear Mayor Jim Langfelder,

I appreciate that you are taking the time to read my proposal and I promise that you will not be disappointed with what I have to say. Currently, I am a junior Social Work major at the University of Illinois Springfield, with plans to get my MSW and become a DCFS Investigator in Illinois. I am very passionate about this subject, and after reading this, I hope you are too. 

For years I have lived with the gnawing feeling of guilt that there are hundreds and hundreds of children in Springfield that do not receive adequate meals every day. These children live in a world where going without a meal or two every single day is normal, but just because it is normal for them, does not mean it is right. We live in one of the most developed countries in the world, yet we allow our children to go hungry. Thinking about this issue in that context makes it feel like an impossible feat to conquer, and that is why I am writing you this letter today. 

Even though we cannot change the entire country’s hunger crisis, we can take steps to change our cities. That is why I am proposing the policy of Free Universal School Lunch for all children attending public schools throughout Springfield, Illinois. The children that already get free or reduced lunches are forced to be ridiculed by peers (and sometimes staff) every single day because of their qualification for free lunches, and the ones that have lunch debt, that their parents cannot pay, are oftentimes made to eat nothing but a cold sandwich and a milk. 

After reading the article “America’s New School Lunch Policy: Punishing Hungry Students for Their Parents Poverty,” Steven Singer elaborates on a few ideas policymakers have had to punish poor parents for their child’s lunch debt. One policy was created by the Trump Administration and was “a plan to tighten eligibility requirements for the Supplemental Nutrition Assistance Program (SNAP) that could result in hundreds of thousands of the poorest children losing automatic eligibility for free school lunches,” which makes no sense because, although it is punishing parents, this will only create more families with lunch debt. Another ridiculous idea is forcing children whose parents cannot pay their lunch debt to be put in foster homes (Steven Singer describes how school officials in Wyoming Valley West school district in Pennsylvania warned parents that they could be taken to dependency court if they did not pay school lunch debts, and threatened that a plausible result could be having their children placed in foster care). As if our country does not already have a serious enough issue with too many children in the foster care system. Finally, “the [Pennsylvania] state legislature even voted in June to reinstate lunch shaming—the practice of denying lunch or providing low-cost meals to students with unpaid lunch bills’ (Singer). That just proves how little Pennsylvania cares for its children, the literal future of this country. But, I hope Illinois is different.  

So, why should you consider consider implementing healthy Universal Free School Lunches in the city of Springfield, Illinois?

For many children, school lunch is the only nutrition they receive. Yet just recently, the Trump Administration posed to “...lower nutrition standards for the National School Lunch Program...” which only hinders the “...13 million or more children living in food-insecure households” that may only get their school lunch as a meal in any given day (M. Carney). The idea that our children matter so little to this administration that they will take away nutritious meals to save a buck is absolutely beyond my comprehension. It proves where their priorities lie, which is not in humanity, but rather in the economy. I’m glad that you are not like them.

Implementing Universal Free School Lunch in Springfield would not only improve the “health and nutrition” of our children but would also save us from the issues of student lunch debt and humiliating children whose parents cannot afford to pay for their lunches (M. Carney). It probably comes as no surprise that schools segregate the children who have free or reduced lunches from their peers. I myself experienced this segregation. When I was growing up, I received free lunches, and I remember my peers being aware of this because the kids that had free or reduced lunches were forced to stand at the back of the line. I am still unaware as to why my school did this, but sometimes I feel as if they were somehow punishing us for our parent’s poverty. As I got older, we began scanning our fingers to get our lunches, and all the kids who had free lunches did not have to scan their fingers – again reiterating the fact that we were poor. On top of this humiliation, I had to watch my mother struggle to put adequate meals on the table for my sister and me while she oftentimes had to go without. So, the fact that my school was humiliating me for poverty that was beyond my control while I also had to watch my family struggle to make ends meet, showed me how little the adults running the system care about children. These experiences I had as a child are why I am so passionate about providing a system that not only provides adequate and healthy meals for its children but also saves families the burden and embarrassment of applying for free or reduced lunches.

On top of saving families from these burdens, Universal Free School Lunches benefit the schools as well. This may not seem true because the money for these lunches must come from somewhere and people automatically assume it would be coming out of the school districts pocket. According to the article “Universal Free School Meals: Comparing Funding Options to Create Hunger-Free Schools,” there are three different school meal funding options that would provide healthy and free meals for all children (Universal 1). In other words, there are options that provide the funding schools need for this, at no cost to them, with other benefits included. Some of these benefits are reduced or eliminated stigma, elimination of the financial barrier of paying for school meals, reduction in paperwork for school nutrition staff, streamlined meal service operations, elimination of the hassle of dealing with unpaid meal debt, and fewer students turned away due to inability to pay (Universal 1). This funding not only directly helps the kids and their families, but also helps save the schools from the immense burden of the free and reduced lunch system. 

The first funding, according to this article, is the Community Eligibility Provision (CEP), which gives “high-poverty schools... when the identified student percentage is at least 40%...” the funding to feed the students both breakfast and lunch for free (Universal 1). This would help in Springfield because in school district 186 we have 55.4% of our children described as low-income (see the School Report Card from the IBSE at https://www.illinoisreportcard.com/district.aspx?districtid=51084186025&source=studentcharacteristics&source2=lowincome). CEP would also make it easier on the school itself because they would no longer have to worry about lunch debt and free/reduced lunch paperwork. There is no impact on education funds because 

“Schools are federally reimbursed based on the Identified Student Percentage (ISP). The ISP is multiplied by 1.6 to determine the percentage of meals served that will be reimbursed at the federal free meal rate. The remainder of meals served will be reimbursed at the federal paid meal rate. A group of schools using CEP receives school meal reimbursements based on the total enrollment and total ISPs of all schools in the group” (Universal 2).

In other words, all of the money used on the meals will be fully reimbursed at no cost to the school. This is a viable option, the only problem being that not every school in Springfield would apply, just the schools where over 40% of the student body is living in poverty.

Here are the percentages of low-income students at the middle schools and high schools in District 186:

19%   Iles Elementary (which has a middle school program): 32%  Springfield High School 48% Franklin Middle School (541 students) 56% Springfield Southeast High School63% Lanphier High School 61% Grant Middle School 71% Springfield Learning Academy73% Jefferson Middle School 74% Washington Middle School

The second funding, called Provision 2, allows all school districts to be eligible to give their students free breakfast and/or lunch (Universal 1). This is obviously different from CEP because it does not exclude any district. Again, schools would no longer have to worry about the tedious paperwork of free and reduced lunch. This is a good option because there could be a lot of children in districts that CEP excludes that need the free lunches even if majority of their peers do not. There is no impact on education funding because

“In the first/base year, schools count the meals served by fee category (free, reduced-price, or paid) and determine the percentage of meals served in each fee category. All meals are offered at no cost to all students during the first/base year. In years 2-4, schools receive reimbursement based on the percentage of meals served in each fee category during the base year” (Universal 2).

In other words, these schools are reimbursed for the free lunches offered to all students regardless of whether they are free, reduced, or paid. Again, this option is different from CEP because it offers funding to any school district that wants it, rather than solely on the districts that are “-high-poverty" (Universal 2).

The third provision, called Non-Pricing, allows any school district eligibility to offer its students free breakfast and/or lunch (Universal 1). This is different from CEP but the same as Provision 2. Like the other two, schools would no longer have to worry about student lunch debt and free/reduced lunch paperwork. Schools are federally reimbursed for meals “... based on the number of meals served in each of the fee categories (free, reduced-price, and paid). No fees are collected from students” (Universal 2). In other words, the schools will be reimbursed for the meals, regardless of whether the student falls into the category of free, reduced, or paid lunches. The only issue with Non-Pricing is that there is a possibility that it could potentially impact education funding. 

Without a doubt, there are provisions that schools can use in order to provide their students with free meals at school, at no cost to the school. On top of this no-cost for the school, it helps erase the burden lunch debt has on schools and eliminates the extra-work of paperwork dietary staff must deal with. Students would no longer have to be humiliated if they received free or reduced lunches, and kids that somehow do not qualify that need to qualify, would no longer have the burden of receiving inadequate meals (cold sandwich and milk) because their parent cannot afford to pay their lunch fines.

This is a policy that I would very much like you to consider because, unlike our federal government, you can choose to care more about the people than ‘the money.’ Students, regardless of their parent’s poverty, should be provided adequate and nutritious meals. Rather than having ridiculous guidelines on free or reduced lunch eligibility, that some students who need it do not receive because guidelines are so strict, we should be providing all students with universal free school lunch. It is obvious that there is immense poverty riddled throughout Springfield, and this is one step we can take to release some burden off of parent’s shoulders. 

Thank you so much for your time and consideration of this policy,

Here are some more numbers to think concretely about this issue.

Springfield’s District has 14,063 students, and 55% of those are low income students (from households with income low enough to receive free meals or reduced-price 40¢ meals). The income threshold for free meals is 130% of poverty, and the threshold for 40¢ meals is 185% of poverty.  For a single parent with one child in school, the thresholds in 2020 would be $1,828 per month for free lunches and $2,658 per month for reduced price lunches. Assuming those single parents were working full time, for 155 hours per month, their hourly wages would be below $12.05 per hour to get free lunches and below $17.15 per hour to get the reduced priced lunches for their child.

  https://www.fdacs.gov/Food-Nutrition/Nutrition-Programs/National-School-Lunch-Program/Financial-Management/Reimbursement-Rates 

Currently, the Federal government supports school lunches with about $3.42 per child who gets a free lunch, $3.02 for children who get reduced-priced lunches, and $0.33 for students who pay for their own school lunches (the kids making fun of those who got free lunches didn’t really know that the government was paying over 30¢ to keep their lunch costs down, did they?)  Assume that the 55% of students in 186 are divided with 91% of those getting free lunches and 9% getting reduced priced lunches, (that estimate is based on the fact that nationally there are 20.2 million free lunches and 1.8 million reduced price lunches and 7.7 million full price lunches, for which the government is subsidizing about 32¢ per meal, served each day in the USA (https://schoolnutrition.org/aboutschoolmeals/schoolmealtrendsstats/) 

That would mean each day 7,102 students are getting free lunches and 633 are getting reduced-price lunches. Assume 3/4 of the remaining children buy school lunches at full price (and others bring lunches from home instead of buying school lunches), and that means 4,726 buy “full price” lunches at $3.42 per meal and 1,582 bring meals made at home.  So, we get this:

	children	Feds pay	Kids pay	Actual cost to district for providing meals	Net to school per meal	School District income each meal
Free	7102	$3.42	$0.00	$3.00	$0.42	$2,982.84
40¢	633	$3.02	$0.40	$3.00	$0.42	$265.86
Full Price	4726	$0.32	$2.75	$3.00	$0.07	$330.82
From Home	1582	$0.00	$0.00	$0.00	$0.00	$0.00

If we provided free meals to everyone without participating in the CEP:

	children	Feds pay	Kids pay	Actual cost to district for providing meals	Net to school per meal	School District income each meal
Free	7102	$3.42	$0.00	$3.00	$0.42	$2,982.84
40¢	633	$3.02	$0.00	$3.00	$0.02	$12.66
Full Price	4726	$0.32	$0.00	$3.00	-$2.68	-$12,665.68
From Home	1582	$0.00	$0.00	$0.00	$0.00	$0.00

So, if there were no other sources of income, and meals cost the District $3.00 per child per meal, the district would be losing $9,670 per day to cover the cost of giving everyone a free lunch (assuming there were still about 1,600 kids who didn’t come to school that day or came and brought their own lunches). With 175 days in a school year (https://www.illinoisreportcard.com/District.aspx?source=environment&source2=numberschooldays&Districtid=51084186025) we multiply $9,670 by 175 to see that offering free lunches to all students will cost about $1,692,000 per year.  There would also be cost savings associated with having no personnel collecting money for the free lunches, but on the other hand, the district would probably charge for treats and extra drinks and other things not on the regular lunch menu, so the total cost savings on labor are perhaps in the order of only about 4,000 labor hours per year, which might bring the net cost down to $1,650,000.  District 186 has a budget of $130 million, but the state estimates that it needs $190 million to adequately fulfill its mission of educating all the children.  A shift of resources from where the district had been earning $626,000 per year on the school lunch system, to one where it was spending $1.65 million would reallocate about 2% of the school district’s resources from its education mission to its health & nutrition mission.  If we could increase the school’s overall budget through contributions from city and county governments, or raise taxes slightly, maybe we could raise 3% or 4% of the funding for our school, and then that would cover the free lunches and give us a little left over to help get from our current $130 million toward the desired (needed) $190 million.

Raising the money to cover the free lunches after the federal government stops paying for this would require about $2 million in additional revenue.  That would work out to something like $60 per household (that is a very approximate and rough estimate). Each household in Springfield would pay about $5.00 per month in additional taxes to feed the children in Springfield. Landlords would raise rents by an additional $5 per month.  I think if you explained the benefits to this, and how it helps us create the sort of society we want, you might get people to look at that extra cost in their taxes and decide it is a worthwhile investment, and you could pass a tax increase to cover this.

Looking at the District 186 website, it seems that in school year 2018-19 the school was participating in CEP, and lunches were free for everyone in District 186. 

Community Eligibility Provision (CEP)All schools in District #186 are part of the Community Eligibility Provision (CEP) through the National School Lunch and Breakfast Program. CEP will be providing all students a healthy breakfast and lunch each day at no charge to the students for the school year 2018-2019. Although students receive a meal at no cost, they will still be able to purchase extra items (extra milk, juice, water, etc.) at a nominal cost.

References

Chaney, M. (2018, December 14). Making Healthy School Lunches Free for All Should Be a National Priority. Civil Eats. https://civileats.com/2018/12/14/making-healthy-school-lunches-free-for-all-should-be-a-national-priority/

Universal Free School Meals: Comparing Funding Options to Create Hunger-Free Schools. No Kid Hungry. Retrieved February 20, 2020, from http://bestpractices.nokidhungry.org/sites/default/files/providing-universal-free-school-meals_0.pdf

Singer, S. (2019, July 24). America’s New School Lunch Policy: Punishing Hungry Students for Their Parent’s Poverty. Common Dreams. https://www.commondreams.org/views/2019/07/24/americas-new-school-lunch-policy-punishing-hungry-students-their-parents-poverty

Student asks Rep. LaHood to support Insulin Price Controls

Dear Honorable Representative Darin LaHood,

Today I am writing to you about a bill to lower the price of insulin that has recently been introduced in the United States: I am referring to the Insulin Price Reduction Act. (H.R. 4906, introduced this past October by Rep. Diana DeGette of Colorado). You serve on the Ways and Means Committee, and back in October this bill was referred to the Subcommittee on Health, where it has not yet been passed.  This is a bill that will help many Americans, myself included. I have been a Type One Diabetic for going on sixteen years. I have been around diabetics and insulin my whole life as my mother is also diabetic. I have seen insulin prices sky rocket in the past sixteen years, and it still to this day does not make sense to me. Why should a life saving drug be so hard to afford? I know I am not the only one that feels this way, but I want to make sure that I make an effort to have my voice heard. 

Do you know how much it costs per day, on average, to take insulin to make up for the fact that we persons with Diabetes Type 1 don’t have a functioning pancreas? In India it costs about 150 Rupees per day, or about $2; or about $60 per month. In America the average cost of $6,000 per year to treat a person with Type 1 Diabetes works out to about $500 per month, or $16 per day. That’s the average, not the lowest, nor the highest. The cheapest brands of insulin, such as Novocain R and Novocain N cost over $90 per vial (about 9¢ per unit), and a person who weighs about 140 pounds must use 30 to 50 units per day ($2.85 to $4.55 per day), if they are using those least expensive vials of insulin. But today most people are using rapid-acting insulins such as insulin lisper (18¢ to 24¢ per unit, or $5.70 to $12 per day, $175 to $350 per month for a person weighing about 140 pounds). The least expensive pens for injecting quick acting insulin (like the Humalog KwikPen) cost about 33¢ per unit, so that’s more like something between $312 and $500 per month for that. These are the very cheapest on the market, but there are other insulins; one that you can inhale called Afrezza costs a little over $1 per unit.  Can you imagine working full-time at a wage of $15 per hour, earning about $2,000 per month, and having to spend $400 to $500 to stay alive with insulin, plus $800 for housing, $200 for food, $400 for maintaining and driving a car with insurance, and so forth? It doesn’t leave much for living expenses. People with diabetes who live in places where housing is more expensive, or who live in places where you can still be paid $8 or $9 per hour for working, are really not able to afford insulin on top of their other expenses. 

Senators Jeanne Shaheen, Tom Carper, Kevin Cramer, and Susan Collins have all proposed a legislation to help keep new insulin prices more affordable. This is an effort to lower the price of insulin back to a price no higher than the 2006 price (adjusted for the inflation in the consumer price index). This bill has also been endorsed by JDRF and the American Diabetes Association. The ADA has stated that pharmacy benefit managers (PBMs) have increased rebates (PBMs get a cut of the rebate) as a percentage of the list price. These increasing rebates increase the list price for the insulin, thus resulting in higher out-of-pocket price for individuals needing insulin. Just with Medicare alone, these out-of-pocket prices have more than quadrupled since 2007. 

The goal of the Insulin Price Reduction Act is plain and simple:  lower the price of insulin to become more affordable to those who depend on it. The bill is an attempt to reduce the use of middlemen (PBMs) to reduce the use of rebates for any insulin product to make the price no higher that in 2006. This could result in more than a 75% decrease in price for the drug. Future price increases would only be related to medical inflation. This bill also aims to cut the list prices by restricting rebates that go to the PBMs. The competition within the insulin market has led to higher list prices because higher prices mean higher rebates which mean more of a cut for the PBMs. What this bill is attempting to achieve is to make the price an insurer pays for a drug closer to what an uninsured individual may pay. This more or so means that the patients with high deductible health plans would be able to obtain insulin at a standard copay rather than paying the full price until they meet their deductible. JDRF has stated “This bill would take several significant steps to make insulin affordable. Prescription drug rebates currently make up about 70 percent of the list price of insulin.” Insulin is a large money maker for PBMs because these companies know that people need this drug to stay alive, therefore people will pay what they have to in order to obtain the drug. 

As I was doing research on the Insulin Price Reduction Act, I came across some statistics that should affect any individual, diabetic or not. There have been an immense amount of cases resulting in death related to insulin rationing. In July of 2019, a 21-year-old died as a result of rationing insulin. In June of 2019, a 24-year-old died after a week-long hospital visit to treat DKA because of her skipping insulin doses. In 2017 three individuals died after they could no longer afford insulin and had to begin rationing their insulin. These individuals should not have had to ration their life saving drug because they could not afford to take care of themselves. The rising price of insulin has to stop otherwise who knows how many deaths are going to occur in 2020 because of rationing. 

I believe that a large portion of the United States could benefit from the Insulin Price Reduction Act. This population could benefit from this Act because I am sure that almost everyone knows someone who’s life depends on insulin. There are about 1.25 million Americans with Type One Diabetes, but each of us has several family members and many friends, so Diabetes touches the lives of many tens of millions of Americans. There are so many Type One Diabetics and even some Type Two Diabetics who can not afford to take care of themselves because of the price of insulin. Therefore individuals with diabetes live shorter lives or are slowly killing themselves because they may have to make the decision between paying rent or their medication. Many times I personally have had to ration my insulin so that I could wait until the next paycheck to get my month’s supply of insulin. There are so many other prescriptions and necessities that diabetics need as well. The price of insulin is just another burden that these individuals face. I think that this Act should draw more attention to this problem, as it may help save the lives of many individuals who unfortunately live with this disease. All I am asking is that you encourage that health subcommittee of the your Ways and Means committee to get working on passing this bill, and I hope that you will vote for it the it comes up for a vote in your committee, and then vote for it on the House floor vote. I am beginning to fear for my own health as well as the health of those who suffer from diabetes along with me. If this doesn’t get passed, I’m afraid the suffering and grief for many of us who have Type One Diabetes will be impossible to measure.

Links to Articles Containing Information I used:

https://beyondtype1.org/insulin-price-reduction-act/

https://myglu.org/articles/the-senate-s-insulin-price-reduction-act-what-you-need-to-know

http://gabionline.net/Policies-Legislation/Bill-introduced-in-US-to-cut-insulin-prices

https://www.healthline.com/health/diabetes/facts-statistics-infographic#1 

http://www.diabeticretinopathy.org.uk/prevention/insulindoseinsulin.htm 

https://www.goodrx.com/blog/how-much-does-insulin-cost-compare-brands/ 

https://www.quora.com/How-much-does-insulin-cost-per-day-for-a-Type-1-diabetic-in-India-on-average