Summary

To address the massive unemployment caused by the COVID-19 pandemic, the Biden-Harris administration should establish a Digital Work Projects Administration (D-WPA), creating government-funded jobs that people can perform from their own homes or other safe locations. Inspired by the Depression-era Work Projects Administration, or WPA, the modern D-WPA would put millions of unemployed Americans to work serving the public good and speeding the country’s economic recovery.

In the D-WPA, work will be digital instead of physical. Digital tools allow many jobs to be done from anywhere good internet access is available. D-WPA participants could work safely and effectively no matter how long the pandemic limits in-person employment. Working remotely, D-WPA participants could help combat the COVID-19 pandemic and mitigate its economic and societal impacts. At the same time, participants would learn, practice, and improve digital skills of increasing value in the modern workforce.

The D-WPA should be established within the Department of Labor, with sufficient funding to put up to 4 million Americans back to work quickly and safely. Funds for this program should be requested in the next COVID-19 recovery package. In the meantime, existing DOL employment and training programs could be used to support an initial cohort of workers for the D-WPA, demonstrating proof of concept while efforts are underway to secure full funding. The D-WPA should create both public- and private-sector positions supporting the national response to the pandemic’s health and economic impacts.

Summary

The next administration should help local communities reassert control over police use of surveillance technology. It should support legislation requiring that the use of all federally- funded surveillance technology be approved by local elected representatives through a public process, and that this use be constrained by a formal policy delineating the situations in which it will be used, how the data it generates will be handled and secured, and how its effectiveness will be evaluated. If new legislation is not forthcoming, then the next administration should empower local initiatives through a pledge program in which leading local law enforcement authorities voluntarily agree to take these steps.

Today local law enforcement agencies obtain cutting edge — and potentially intrusive — surveillance equipment without the knowledge of elected leaders and the general public, sometimes leading to a rejection of the technology once the public discovers it. In Oakland, for example, following a council review that lasted only two minutes, the city created a data integration center that networked together all of its existing surveillance infrastructure. Once the public learned of the center, protests broke out and council meetings were flooded with angry residents. The backlash was so severe that the city ultimately largely gutted the center, even though millions in federal funding had already been spent on its development.

Federal funding is a major driver of uninformed and undemocratic adoption of surveillance technology at the local level. The Federal Government funds billions of dollars in grants to local law enforcement agencies, money that can then be used to purchase surveillance equipment. But the government does not take steps to ensure that local elected representatives and members of the public are involved in decisions about what technologies are acquired, or that protocols are developed to constrain how the technologies are used.

The Federal Government has a responsibility to intercede to make sure that local elected representatives are aware of and have control over how federally-funded surveillance equipment is used in their communities. Transparency is particularly important for surveillance technology because this equipment is often invisible. People cannot challenge deployment of surveillance technology in court or through public processes if they do not know about it. Moreover, surveillance technologies can be invasive, with potentially harmful effects on civil rights and liberties. Particularly given today’s high level of concern over policing practices, the Federal Government should not be undermining the ability of local communities to assert democratic control over their police departments.

Some cities and counties have passed ordinances requiring that their law enforcement agencies seek approval to deploy surveillance technology, demonstrating the feasibility and desirability of such measures. But with some 18,000 law enforcement agencies nationwide, only the Federal Government can implement a solution at scale.

Summary

American society urgently needs to address structural disparities in the criminal-justice system. One important disparity—which is both easily mitigated and generally unrecognized—is the asymmetry of information access granted to prosecutors and defendants. Prosecutors can easily access digital records that establish guilt. But defendants are far less empowered to access digital records that prove innocence.

Privacy laws are a key source of this disparity. The Stored Communications Act (SCA), for instance, permits law enforcement—but not defense investigators—to access certain evidence from Internet companies. Fortunately, there are two straightforward policy solutions to this problem. First, new federal privacy legislation should include language requiring symmetric information access for defendants. Second, the Department of Justice should adopt a new interpretation of the SCA to protect fairness in criminal proceedings.

Summary

The current Administration has adopted a high-profile approach to space issues. It established a National Space Council, chaired by the Vice President and including various senior members of the Executive Branch. The Council authored multiple Space Policy Directives for Presidential signature on a variety of topics—NASA’s exploration efforts, bolstering the commercial space sector through regulatory streamlining, space traffic management, and the establishment of a Space Force. These efforts were individually laudable but lacked the cohesion of a grand strategy for envisioning America’s future in space.

Several cases illustrate this point:

• A proposal to return to the Moon by 2024 electrified the imagination of many, but if theonly acceptable path to success lies through such inordinately expensive and perennially delayed projects as the Space Launch System or Orion crew vehicle, how could such a challenging schedule goal conceivably be met?
• An ever-increasing population of orbital debris threatens commercial, civil, and defense spacecraft alike, yet the obvious agency choice for dealing with the issue—the Federal Aviation Administration—was passed over in favor of the Commerce Department’s Office of Space Commerce, which has little experience or historical association with the problem.
• While a space-focused arm of the Defense Department can act as an advocate and steward for critical national space priorities, the new U.S. Space Force has focused almost exclusively on operations and protection of legacy satellites and systems at the expense of fielding a new, more resilient space architecture.

Summary

Prevention plays a crucial and underappreciated role in our health system. To improve health outcomes and bring down costs, it will be important to establish a better balance between preventive measures and drug treatments. The next administration should provide incentives to healthcare providers that scale up—and reduce costs of delivering—preventive interventions with demonstrated efficacy. Currently, the U.S. Department of Health and Human Services (HHS) sets broad standards regarding managed care contracts. But states have considerable latitude. States can set income eligibility criteria, define services, and set alternative payment methods with Managed Care Organizations (MCOs). And in just the last few decades, Medicaid programs have been almost fully privatized: MCOs now cover over 85% of the Medicaid population. Because of the existing patchwork of insurance programs and state rules, it is important that regulations set minimum national standards to ensure that health care is accessible and affordable for those who need it the most. Particularly important to this effort are non- distortionary prices and reimbursement policies.

For a few decades, policymakers have, with bi-partisan consensus, moved away from a fee-for-service (FFS) system whereby providers are paid for service delivery and toward capitation and pay for performance (p4p) models. While these models offer significant improvements over FFS models, each involves risks of incentivizing non-optimal care and expenditures if they are not structured carefully. When paying capitation rates, bonuses adjusting for population risk alone should be avoided as this incentivizes an increase in diagnoses without necessarily improving care. Either all health care payments should be p4p, or a p4p component should be added to the capitation base. Pharmacological interventions should also be included in the overall provider reimbursement structure to align reimbursement incentives with health outcomes. Healthcare providers will then determine the right mix of services. Furthermore, while p4p is generally a good idea (i.e., hospitals and MCOs are rewarded for decreasing the number of avoidable hospital readmissions), if this metric is not applied homogeneously across all services, this payment structure significantly hampers the provision of preventive services.

Summary

Everyone hates cookie notifications, click-thrus, and pop-ups. While cookies give the web more functionality, their excessive use and attendant consent system can interfere with user experience and raises serious privacy concerns. The next administration should commit to finally resolving these and related issues by creating a digital privacy task force within the White House Office of Science and Technology Policy (OSTP). The task force would coordinate relevant agencies—including the Federal Trade Commission, Federal Communications Commission, and Department of Commerce—in working with Congress, state actors, and European Union partners to develop meaningful data-privacy protections.

Summary

Artificial intelligence (AI) is transforming our everyday reality, and it has the potential to save or to cost lives. Innovation is advancing at a breakneck pace, with technology developers engaging in de facto policy-setting through their decisions about the use of data and the embedded bias in their algorithms. Policymakers must keep up. Otherwise, by ceding decision-making authority to technology companies, we face the rising threat of becoming a technocracy. Given the potential benefits and threats of AI to US national security, economy, health, and beyond, a comprehensive and independent agency is needed to lead research, anticipate challenges posed by AI, and make policy recommendations in response. The Biden-Harris Administration should create the Fair Artificial Intelligence Research & Regulation (FAIRR) Bureau, which will bring together experts in technology, human behavior, and public policy from all sectors – public, private, nonprofit, and academic – to research and develop policies that enable the United States to leverage AI as a positive force for national security, economic growth, and equity. The FAIRR Bureau will adopt the interdisciplinary, evidence-based approach to AI regulation and policy needed to address this unprecedented challenge.

Summary

From HIPAA to doctor-patient confidentiality, the U.S. healthcare system is replete with provisions designed to ensure patient privacy. Most people are surprised, then, to hear that patients in the United States do not legally own nearly any of their health data: data as diverse as health and medical records, labs, x-rays, genetic information, and even physical specimens such as tissue and blood removed during a procedure.

Providing patients with agency over their health data is necessary for elevating patients as partners in their own health management—as individuals capable of making genuinely informed and even lifesaving decisions regarding treatment options.

The next administration should pursue a two-pronged approach to help do just that. First, the administration should launch a coordinated and comprehensive patient-education and public- awareness campaign. This campaign should designate patient data and tissue rights as a national public-health priority. Second, the administration should expand provisions in the Cures 2.0 Act to ensure that healthcare providers are equally invested in and educated about these critical patient issues. These steps will accelerate a needed shift within the U.S. healthcare system towards a culture that embraces patients as active participants in their own care, improve health- data literacy across diverse patient populations, and build momentum for broader legislative change and around complex and challenging issues of health information and privacy.

Summary

The incoming administration faces complex issues at the intersections of science, technology, and society. As such, the next administration should establish a special unit within the Science and Technology Policy Institute (STPI)—an existing federally funded research and development center (FFRDC)—to provide capacity for Participatory Technology Assessment (pTA) to the White House Office of Science and Technology Policy and across executive branch agencies.

A pTA unit within STPI would provide pTA as a service for the executive branch regarding emerging scientific and technological issues and questions. By integrating public voices alongside expert assessments, the next administration can ensure that federal science and technology decisions provide the greatest benefit to society.

Summary

The next administration should launch national Place-Based Public-Private Partnerships for Innovation (P4I) to supercharge American innovation by leveraging the power of proximity and partnerships, and in so doing, lay the foundation for a new and more inclusive era of American prosperity.

The P4I initiative will catalyze the formation and growth of vibrant Innovation Zones (IZs), creating powerful points of convergence that weave together place-based investments with educational, research, entrepreneurship, and economic supports to advance inclusive economic development from the American heartland to the coasts. IZs will catalyze the public-private development of mixed-use innovation hubs that house and support: training programs to prepare diverse and resilient labor forces; advanced research and development (R&D) activities undertaken by partnerships between universities and industry; and, incubators, accelerators, and investor groups to incubate, grow, and retain high-tech businesses.

P4I should be implemented by an interagency committee convened by the White House Office of Science and Technology Policy (OSTP) under the auspices of the President’s Council of Advisors on Science and Technology (PCAST). An interagency initiative will be critical for success, mobilizing federal agencies that share responsibility for all aspects of innovation and economic development policy, including STEM R&D, formation and growth of U.S. innovation industries (small to large), and innovation-based economic and workforce development.

Summary

While the Veterans Health Administration (VHA) provides telehealth services across the country, current services neglect to respond to the access challenges that constrain veterans, particularly in rural areas. Of the nearly 5 million veterans who live in rural areas, 45% lack access to reliable broadband internet and smart technology. In the absence of available or reliable internet, veterans are often forced to access telehealth services in person at VA Clinical Resource Hubs (CRHs). However, these facilities are limited in number and are typically located far from rural communities. To address digital inequities and constraints posed by infrastructure and geography, the VHA needs to create more ways for veterans to access and fully utilize telehealth. We propose that the VHA partner with federal agencies like the United States Postal Service (USPS) or United States Department of Agriculture (USDA), leveraging their infrastructure to develop telehealth hubs. We further suggest that the VHA develop and lead a federal taskforce to build critical technology infrastructure that will facilitate expansion and use of telehealth for veterans. These interventions will be vital for ensuring that veterans in rural communities have greater access to care and can not only survive but thrive.

Summary

While the United States is a global leader in Artificial Intelligence (AI) research and development (R&D), there has been growing concern that this may not last in the coming decade. China’s massive, state-based tech-investment schemes have catapulted the country to the status of a true competitor over the development and export of AI technologies. In response, there have been repeated calls as well as actions by the Federal Government to step up its funding of fundamental and defense AI research. Yet, maintaining our status as a global leader in AI will require not only a focus on fundamental and defense research. As a matter of domestic policy, we must also attend to the growing chasm that increasingly separates advances in state-of-the-art AI techniques from effective and responsible adoption of AI across American society and economy.

To address this chasm, the Biden-Harris Administration should establish an applied AI research program within the National Institute of Standards and Technology (NIST) to help community-serving organizations tackle the technological and ethical challenges involved in developing AI systems. This new NIST program would fill a key domestic policy gap in our nation’s AI R&D strategy by addressing the growing obstacles and uncertainty confronting AI integration, while broadening the reach of AI as a tool for economic and social betterment nationwide. Program funding would be devoted to research projects co-led by AI researchers and community-based practitioners who would ultimately oversee and operate the AI technology. Research teams would be tasked with co-designing and evaluating an AI system in light of the specific challenges faced by community institutions. Specific areas poised to benefit from this unique multi-stakeholder and cross-sectoral approach development include healthcare, municipal government, and social services.