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The Tax Reform That Just Won't Die and Shouldn't (Article)
Leonard E. Burman

This paper provides an historical overview of tax reform with an eye toward identifying conditions that would make successful reform plausible in the near future. Burman begins by analyzing the environment that led to tax reform in 1986 and posits that successful reform would require strong leadership from the White House, bipartisan support, and a new source that would make possible substantial income tax rate cuts—all of this while addressing the concerns of Republicans that new revenues would fuel a growth in government and of Democrats about progressivity. He argues that the new revenue source should be a value-added tax with proceeds earmarked to pay for government health care. This could slow healthcare spending because the tax would stimulate efforts to find cost savings, would result in a more efficient revenue system, and would go a long way towards addressing our long term budget imbalances.

Posted to Web: April 24, 2014Publication Date: April 24, 2014

Placing Diagnosis Errors on the Policy Agenda (Policy Briefs/Timely Analysis of Health Policy Issues)
Robert A. Berenson, Divvy Upadhyay, Deborah R. Kaye

Between 5 and 15 percent of health care encounters result in a diagnosis error. While misdiagnoses and missed diagnoses can have devastating effects on patients and even result in death, the issue does not receive much attention from health care providers and policy leaders as the major quality and safety issue that it deserves to be. A new brief from the Urban Institute explores the different reasons for diagnosis errors, the challenges of measuring them, and fruitful approaches to reducing their prevalence and harm to patients. The brief offers recommendations for policy-makers on how they can place the issue on the policy agenda.

Posted to Web: April 24, 2014Publication Date: April 24, 2014

Impact of the Great Recession and Beyond (Occasional Paper)
Signe-Mary McKernan, Caroline Ratcliffe, C. Eugene Steuerle, Sisi Zhang

This paper uses over two decades of Survey of Consumer Finances data and a pseudo-panel technique to measure the impact of the Great Recession on wealth relative to the counterfactual of what wealth would have been given wealth accumulation trajectories. Our regression-adjusted synthetic cohort-level models find that the Great Recession reduced the wealth of American families by 28.5 percent—nearly double the magnitude of previous pre-post mean descriptive estimates and double the magnitude of any previous recession since the 1980s. The housing market was only part of the story; all major wealth components fell as a result of the Great Recession.

Posted to Web: April 22, 2014Publication Date: April 22, 2014

Capitol Hill Economist and Data Visualization Expert Jonathan Schwabish to Join Urban Institute (Press Release)
Urban Institute

Jonathan Schwabish, an economist with the Congressional Budget Office, will join the Urban Institute on May 7 as a senior researcher and data visualization expert. A leading voice calling for clarity and accessibility in research, Schwabish will boost the Institute's capabilities in data visualization and conduct research on older workers, people with disabilities, food security, immigration policy, and microsimulation modeling at Urban's Income and Benefits Policy Center.

Posted to Web: April 21, 2014Publication Date: April 21, 2014

Local Government Discretion and Accountability in Sierra Leone (Research Report)
Benjamin Edwards, Serdar Yilmaz, Jameson Boex

Sierra Leone is a small West African country with approximately 6 million people. Since 2002, the nation has made great progress in recovering from a decade-long civil war, in part due to consistent and widespread support for decentralization and equitable service delivery. Three rounds of peaceful elections have strengthened democratic norms, but more work is needed to cement decentralization reforms and strengthen local governments. This paper examines decentralization progress to date and suggests several next steps the government of Sierra Leone can take to overcome the remaining hurdles to full implementation of decentralization and improved local public service delivery.

Posted to Web: April 17, 2014Publication Date: March 01, 2014

Making Sense of Childhood Asthma: Lessons for Building a Better System of Care (Research Report)
Marla McDaniel, Susan J. Popkin, Judy Berman, Paola Barahona, Priya Saxena, Deborah Quint, Stephen J. Teach

This report highlights findings from a qualitative study about asthma care for low-income African American and Latino children ages 4-14 in Washington, DC, where nearly one in five children under age 18 has the condition. We interviewed medical providers, health administrators, policy makers and caregivers whose children had visited the IMPACT DC clinic (located in the emergency department of Children’s National Health System) about the primary barriers, challenges, and opportunities for improving asthma treatment in DC. The stakeholders each felt their school, clinic, agency, or department had a role to play in improving asthma care, and that many challenges were system-related. Three major areas where caregivers and stakeholders described system breakdowns were poor communication among caregivers, providers, and other stakeholders; inadequate access to both the quality and quantity of care needed to manage a child's asthma; and scarce long-term support to address both the social-emotional and financial burdens created by managing a chronic childhood illness.

Posted to Web: April 16, 2014Publication Date: April 16, 2014

Johnson Crapo GSE Discussion Draft (Commentary)
Laurie Goodman, Ellen Seidman

Over the past several years, a consensus has developed on the goals of GSE Reform: preserve the liquidity of the mortgage market while protecting the taxpayer by putting private capital in a first loss position, retain wide access to long-term fixed rate mortgages, provide access and equity for lenders of all sizes, and support affordable housing. Senators Tim Johnson (D-SD) and Mike Crapo (R-ID) released new draft legislation in March 2014 striving to achieve these goals. While this bipartisan proposal is a major step forward for housing finance reform, we suggest improvements in two critical areas: the structure of the private capital in the first loss position and the affordable housing incentive fee provisions. In both cases, the system as proposed has intellectual appeal, but is apt to have unintended and undesirable consequences.

Posted to Web: April 15, 2014Publication Date: April 14, 2014

National Mortgage Settlement (Commentary)
Laurie Goodman, Maia Woluchem

In early 2012, the nation’s five largest mortgage servicers entered into a $25 billion settlement with the Department of Justice, Department of Housing and Urban Development, and 49 state Attorney Generals. This settlement, which addresses questionable servicing practices, was the largest joint state-federal civil settlement in US history. As a result, Bank of America, Citi, JP Morgan Chase, Rescap/Ally and Wells Fargo have since dispersed more than $50 billion in gross relief to over 600,000 families. In this commentary, we examine each servicer’s strategies in providing relief to borrowers, consider how those actions were impacted by the settlement's crediting system, and suggest improvements for future settlements.

Posted to Web: April 15, 2014Publication Date: April 14, 2014

Housing Finance At A Glance: A Monthly Chartbook (Commentary)
Laurie Goodman, Ellen Seidman, Jim Parrott, Jun Zhu, Wei Li, Bing Bai, Pamela Lee, Taz George, Maia Woluchem, Alison Rincon

At A Glance, the Housing Finance Policy Center's monthly chartbook, provides timely metrics on the state of the housing market and examines public policy's role in housing finance. April's issue includes a special quarterly feature on GSE loan performance and new numbers on the Federal Reserve's activity in the mortgage market.

Posted to Web: April 15, 2014Publication Date: April 15, 2014

Ten Years of Language Access in Washington, DC (Research Report)
Hamutal Bernstein, Julia Gelatt, Devlin Hanson, William Monson

This report provides an overview of the implementation of the Language Access Act within the context of the unique demographic and economic characteristics of the District's immigrant community. We describe DC's Language Access Program, its creation, and evolution, profile the city's LEP/NEP population, and identify accomplishments and challenges for each of the three major domains required for ensuring full language access: identifying language needs, serving language needs, and monitoring the provision of those services. We conclude with recommendations for next steps for city government officials and other stakeholders as they continue to strengthen the Language Access Program in the District.

Posted to Web: April 15, 2014Publication Date: April 15, 2014

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