Rebuilding Place in the Urban Space

"A community’s physical form, rather than its land uses, is its most intrinsic and enduring characteristic." [Katz, EPA] This blog focuses on place and placemaking and all that makes it work--historic preservation, urban design, transportation, asset-based community development, arts & cultural development, commercial district revitalization, tourism & destination development, and quality of life advocacy--along with doses of civic engagement and good governance watchdogging.

Saturday, July 25, 2020

Equity planning: an update

No, I haven't revised my post, "An outline for integrated equity planning: concepts and programs," from 2017.  I do continue to add items that I come across in the comments thread.

There was a discussion on the pro-urb list that I argued against.  Basically, a planning professor stated that categorically, placemaking investments like bike lanes and trees automatically brought about gentrification, and she implied therefore we shouldn't be making these kinds of investments in community.

I reacted, especially because right now I am reading Palaces for the People: How Social Infrastructure Can Help Fight Inequality, Polarization, and the Decline of Civic Life which is about the importance of "social infrastructure" to community development and health generally but specifically in otherwise less well resourced communities.

The point isn't to invest less, it's to invest more, while also instituting initiatives to limit displacement. And in fact, I came up with my own use of the term "social infrastructure" for this kind of investment c. 2014-2015.

But placemaking investments in "nicer communities" often are denigrated by equity advocates too, as over-investing in the better off.

My response is twofold. First, we need to be making these investments everywhere, but such investments need to be prioritized in impoverished communities.

Second, at the same time, we need to retain higher income residents too, otherwise we won't generate the property tax revenue necessary to fund the operations of the city.  (This was recognized by Hennepin County, Minnesota and justified their community investment program for Minneapolis, the county's largest source of property tax revenue.  See "A County and Its Cities: the Impact of Hennepin Community Works," Journal of Urban Affairs 30:3, 2008).)

This was especially true during the many decades when trends and preferences didn't favor urban living.

For example, while historic preservation is derided in many quarters, the fact is that it was a cheap strategy for a city as it only required some personnel, staff time and a set of laws and regulations. Otherwise the costs were borne by the homeowners. And by improving neighborhoods, it staunched the outmigration of residents, attracted new residents, and stabilized neighborhoods when otherwise the city was declining.

Anyway, especially in the face of the ongoing Black Lives Matter protests, questions of equity and urban planning are being raised more frequently.

1. Louisville police killing as a result of gentrification?  The family of Breonna Taylor' argue that her death in Louisville was the result of gentrification ("Breonna Taylor warrant was part of larger gentrification scheme," New York Daily News).

While I think that's somewhat of a facile argument, it is true that in demographically changing neighborhoods, policing patterns do change, as newer, better connected, higher income residents call the police more and demand public safety improvements.  Yes, people call in complaints on "drug houses."  The tragedy is that Louisville police went to the wrong house.

Pittsburgh.  In Pittsburgh, the neighborhood community development organization East Liberty Development Inc. developed a program targeting nuisance properties, and their successful "curing" of these nuisances led to significant public safety improvements, which in turn spurred economic and community revitalization.  Is that gentrification, or investing in the community and its social infrastructure?

The Pittsburgh Post-Gazette reported ("How did East Liberty become safer? Buying out homes that housed criminals") on this, referencing a study of the program (East Liberty Crime Data Analysis). From the article:
A map of East Liberty in 2008 shows Negley Avenue running down the length of a curious red blotch between Penn Avenue and East Liberty Boulevard.  By 2012, the red blotch had dimmed to yellow. The change signified a 49 percent drop in the incidence of crime. 
The blotch had covered much of the old residential neighborhood, including Hays, North St. Clair, Mellon and Euclid streets. In the mid-2000s, Eric Jester, then the housing development manager for East Liberty Development Inc., said his and nearby streets were “a steady drumbeat of nonsense. Not just gunfire but street fights, people screaming, hookers propositioning your dinner guests.” He said an identifiable number of properties had reduced quality of life to “an existential threat.” 
“We called the police, but as soon as the police left it started up again,” he said. “We tried code enforcement, we tried yelling, we tried shaming. 
“We finally decided it’s probably better if we owned the properties.” The result of ELDI’s strategic purchase of 200 units from slumlords between 2008 and 2012 is the subject of a 23-page report, released recently by the data analysis firm Numeritics, that reframes East Liberty’s narrative of transformation. ... 
Through the 2000s, ELDI was buying, renovating and replacing properties for mixed-income buyers, but it intensified its efforts in 2008, going after property owners who allowed criminal behavior as long as tenants didn’t complain about lax maintenance.
ELDI’s acquisition of both large and small apartment buildings led to renovations and the hiring of effective property managers and off-duty police officers. At the same time, ELDI kept the same racial composition and low rents, Numeritics reported
According to the report, ELDI acquired about 3% of the residential properties, and according to crime hot spot theory, in problem neighborhoods 3% of properties generate 50% of the crime. While the neighborhood is experiencing rising demand for residential properties and increased prices, there is still plenty of affordable housing.

Public safety is key to center city success.  People don't want to live in unsafe places. 

Murder is bad. Getting mugged/robbed sucks. Assault and rape is a really bad thing. Getting your house broken into sucks. Getting your bike or car stolen sucks. (Most of this happened to me/my household at one time or another while living in Washington, DC.)

Yes, crime is a function of social determinants, poverty, bad circumstances. But that is an explanation, not a justification.

This is the conundrum when it comes to "defunding the police" arguments.  The overall point ought to be to refocus community priorities and spending away from "warrior policing" and towards social infrastructure and more appropriate ways to respond to various social problems where police officers generally are not well positioned to be effective.

This recent Post article ("The worst case scenario") seems to be held up to show the value of officers being trained to deal with mental health matters.  Reading the article carefully, it seems more like a fluke that the lady in mental distress was not killed by the police.

2. Flood control measures in Houston/Harris County, Texas.  The New York Time reports in "A Climate Plan in Texas Focuses on Minorities. Not Everyone Likes It.," about how Harris County is changing how it prioritizes new flood control projects.

Graphic: Christine Walsh, Rice University Speed Center.

In response to massive damage resulting from Hurricane Harvey, the County passed a bond issue for these projects, in advance of the 2018 election.

But the election brought a Democratic majority to the County Commission and a progressive "County Judge" (what other places term the political leader of a county the County Executive or County Mayor, in Texas they are called "Judges"), the 29 year old (!!) Hispanic Lina Hidalgo (profile: "Top Houston-area official: 'We've got to fundamentally rethink strategy' in dealing with coronavirus," The Hill), and among the changes was to direct flood control infrastructure to the most vulnerable defined not just in terms of physical threat, but in social and economic terms as well, rather than the previous method that only considered property value--which ended up prioritizing wealthy communities.

From the article:
In Harris County, like elsewhere, the emphasis on prioritizing higher-value property led to different levels of protection not just from big federally funded flood projects, but also basic infrastructure.

Wealthy neighborhoods got sidewalks and curbs with gutters and underground drainage, while poorer areas still rely on open ditches in front of their houses, according to Tracy Stephens, a former project inspector for Houston’s public works department who now works with Ms. Murray at a community development group called Achieving Community Tasks Successfully.

Mr. Stephens recalled crews being sent to upgrade gutters in upscale neighborhoods simply to accommodate the extra runoff as more people installed backyard swimming pools. “That money could have been spent doing jobs everywhere else,” he said.

Environmental policy experts say it makes no sense to decide which people get protection based on which property is more valuable. That approach reinforces historical discrimination, which contributed to minority neighborhoods having lower property values in the first place. And it doesn’t address the deeper question of who needs the most help, or why.
Increasingly, GIS tools are being used to map poverty and infrastructure needs in interesting ways, such as vulnerable areas within watersheds in Harris County.  Also see, "Can a $2.5 Billion Bond Deal Fix Harris County's Inequitable Flood Control," Texas Observer, 2019.

3. Elected officials in Boston call for a equity lens being applied to planning and other government-related decision making on development ("Boston needs to adopt a planning equity standard" and "Amid push for systemic change, city councilor wants equity proof from BPDA," Boston Globe). From the second article:
Amid the push to dismantle systems that have perpetuated racial inequality, a Boston city councilor is demanding proof from the city’s powerful planning agency that it prioritizes racial and economic equity as it shapes the city’s neighborhoods through housing and commercial development.

Councilor Lydia Edwards is asking for documents that show whether staff at the Boston Planning & Development Agency focus on things like equitable development, racial justice, and planning that prevents residents from being displaced by new building projects. She wants to see if the agency conducts an analysis of ethnic impact and racial disparities of proposals before it.

“This is basically a moment in time for BPDA to show the receipts, and that’s what I’m asking for,” said Edwards at this week’s City Council meeting. “This is a time when we need to plan differently and we need to look at how they have been planning.”
I haven't looked into this more deeply. I don't know the extent of the city's "community benefits" requirements in development planning.

Typically, most cities have "matter of right zoning" which sets up what is allowable. Projects that are matter of right have zero community benefits requirements. And that covers the majority of development projects.

But when zoning considerations are required (exceptions, variances, density increases) usually community benefits are triggered.

Communities may have good processes for extracting benefits--Arlington County, Virginia is exemplary on this score when it comes to transportation and cultural benefits in particular; but most do not. I argue this is because as a "Growth Machine" matter, they want to limit the costs to developers.

-- "Community benefits agreements, revised (again)," 2008
-- "What community benefits are supposed to be versus what people think they are about," 2011
-- "(Over)Focusing on community benefits agreements does not substitute for economic revitalization planning: Atlanta; Chicago," 2017

Another way to address this is through "impact fees," although typically such fees cover infrastructure needs in response to increased demand, they don't cover equity-related issues.

Community benefits are tricky. I have come to realize they are more about "buying into a community" in a community ties/anthropological kind of way ("In lower income neighborhoods, are businesses supposed to be "community organizations" first?," 2012).

4.  Trailer parks as affordable housing.  Threats to convert the trailer park properties into higher value housing comes up from time to time.  As demand for housing rises in areas, trailer parks are vulnerable to conversion to higher value uses.

Trailer homes are a much cheaper way to have a home, and are a relatively efficient use of land.  But they are a hybrid form of ownership.  They own the trailer, but rent the land.  As a renter, they have no property rights, but as an owner of the trailer, they aren't treated as tenants in terms of landlord-tenant law, so they have no renters rights either.

A trailer park community in Centerville, Utah currently faces this threat ("Centerville residents facing eviction in the middle of a pandemic, but not without a fight," Salt Lake Tribune).

A similar threat in another community was averted ("A Murray mobile-home park once facing closure is now expanding," SLT) when a firm specializing in this type of property bought  the property with a commitment to continue the use.

I argue that housing plans for communities should address trailer parks, if they are present and the potential for conversion in a proactive manner, to be prepared especially if the community values affordable housing, rather than reactively in response to a threat.

5.  Predatory housing practices.  Other items that should be addressed systematically in housing planning, items which often differentially impact BIPOC include predatory mortgages, land contract house purchases,  ("Why a housing scheme founded in racism is making a resurgence today," Washington Post)  Land Installment Contracts: The Newest Wave of Predatory Home Lending Threatening Communities of Color, Boston Federal Reserve Bank) and underlying ground rent ("Sun series: On shaky ground," Baltimore Sun).

And reverse mortgages ("Seniors face foreclosure in retirement after failed reverse mortgages" and "Advocates push for reverse mortgage reform," USA Today).

6.  Equity in sustainable mobility planning.  Recent initiatives to convert street space to walking and biking uses in communities across the country often has been justified in terms of equity, such as in Oakland, California ("Cities Close Streets to Cars, Opening Space for Social Social Distancing," New York Times), even if more recently similar measures are more about 'increasing spaces of consumption" for restaurant patios.

A few years ago I came across some really pathbreaking analysis in trails planning for Cuyahoga County, Ohio.

They used GIS mapping to show how trails can  provide greater access to activity and employment centers, and parks, alongside equity goals ("County planners seek the public's help in designing Cuyahoga's proposed Eastside Greenway," Cleveland Plain Dealer).

The earlier initiative focused on a single (but long trail), the Eastside Greenway.

More recently, they extended this approach county-wide and regionally. The Cuyahoga Greenways plan proposes 240 miles of new trails, 151 miles of trails focused on eliminating gaps in the current system, and 571 miles of "local," supporting trails and multi-use paths providing connections to an expanded regional system.

-- presentation

bos
It too laid out the proposals in terms of providing access to jobs and a larger proportion of the county's population, along with economic development elements, which I thought was pretty innovative.

They also promote the health aspect of bicycling, although that isn't a new approach (although health is one of the primary reasons I cycle).

While this type of analysis is more common to transit planning, it needs to be extended outward to sustainable mobility planning more generally.

This approach more widely applied could go a long way towards justifying investments in walking and biking infrastructure especially. 

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13 Comments:

At 1:27 PM, Blogger Richard Layman said...

The House DC, program in Anacostia

https://wtop.com/dc/2020/09/d-c-youth-center-helps-at-risk-teens-turn-their-lives-around/

Georgetown University Pivot Program, entrepreneurship program for the formerly incarcerated.

https://pivot.georgetown.edu/

 
At 8:46 AM, Blogger Richard Layman said...

DC Families First centers

https://wtop.com/dc/2020/10/they-help-you-dc-launches-new-centers-to-support-families-in-wards-7-8/

Good step. Although I wonder about the city's capacity in terms of vision and implementation (e.g., how they screwed up summer school for Title I students and then just junked it).

UK had/has a similar program, called Sure Start, focused on low income new families, but mostly junked it as part of austerity.

https://www.independent.co.uk/news/uk/home-news/sure-start-children-centres-hospital-visits-injuries-ifs-closures-early-years-a8942336.html

https://www.theguardian.com/commentisfree/2017/feb/06/sure-start-children-worked-why-theresa-may-out-to-kill-it

https://www.gov.uk/government/collections/evaluation-of-childrens-centres-in-england-ecce

 
At 10:56 AM, Blogger Richard Layman said...

Violence interruption.

https://www.theguardian.com/us-news/2020/jul/20/time-for-a-new-vision-violence-is-a-public-health-issue-that-requires-community-driven-solutions

 
At 2:45 PM, Blogger Richard Layman said...

Value of the Harlem YMCA as a community hub, especially for the Harlem Renaissance.

https://www.nytimes.com/2021/10/15/t-magazine/harlem-ymca-black-culture.html

https://www.nytimes.com/2008/10/25/nyregion/25journal.html

Anthony Bowen YMCA had a comparable role in DC.

https://www.nps.gov/places/twelfth-street-ymca.htm

https://www.afro.com/bowen-ymca-makeover-to-be-unveiled-in-september/

8/7/2013

 
At 9:27 PM, Blogger Richard Layman said...

https://thegrio.com/2021/11/16/black-residents-san-francisco-fillmore-center-city-reparations/

"Black residents demand San Francisco give center as reparations after destroying Fillmore neighborhood"

Fillmore Heritage Center. The city owns it. It's underutilized. The community wants to own and run it.

====
I think they should first come up with a plan to activate the center and operate it, with the building owned by the city.

Frankly, owning the building puts a big financial burden on the operators.

 
At 9:54 AM, Blogger Richard Layman said...

https://www.bostonglobe.com/2021/12/05/metro/nonprofit-launches-black-city-hall-address-gaps-access-critical-services

"Nonprofit launches ‘Black City Hall’ to address gaps in access to critical services"

Boston’s long history of racism means Black Bostonians have more trouble accessing the economic, social, and health support they need, leaving them more vulnerable in times of stress.

Addressing these gaps is the driving force behind the Community Communications Center, a virtual “Black City Hall,” launched by a Boston nonprofit where Black Bostonians can ask for help with securing food assistance, scheduling a COVID-19 booster shot, or repairing their credit.

“My goal is supporting Black people to be able to . . . transition from survival mode to thriving,” said Atyia Martin, the founder and executive director of the nonprofit behind the initiative, Next Leadership Development Corporation, or NextLeads. ...

“People waste a lot of time trying to figure stuff out, and it’s not their fault that a lot of the things we have — whether it’s social services, government services — to navigate every day aren’t the easiest,” Martin said.

National and local policies and practices that have helped working-class people build wealth through education, jobs, and homeownership have historically left out Black residents, creating a wealth deficit that has widened over generations. A 2015 study found that African Americans in Greater Boston have an average net worth of $8, compared with $247,500 for their white counterparts.

“We’ve allowed these systemic structures and issues to fester for a very long time,” said Lee Pelton, CEO and president of The Boston Foundation, one of the nation’s largest and oldest community foundations. “Our communities have been invisible to those who sit at the table.”

=====
This is a general issue. And governments should set up programs like this to better meet the needs of residents in need.

NYC does have a master portal for access to services independent of specific agencies.

https://access.nyc.gov/

But people with needs usually need more help than is typically provided by a computer screen.

 
At 1:31 PM, Blogger Richard Layman said...

https://www.ocregister.com/2021/12/02/project-rebound-community-gives-thanks-for-a-second-chance/

"Project Rebound community gives thanks for a second chance"

With the mission of “supporting the higher education and successful reintegration of the formerly incarcerated,” Project Rebound’s current and former Titans, along with their families and supporters, gathered on a sunny November afternoon in Fullerton to share in a turkey meal, complete with all the trimmings.

Project Rebound got its start in 1967 at San Francisco State University by renowned criminologist John Irwin. While serving five years in prison, Irwin took his first college course, a decision that transformed his life. He went on to earn his bachelor’s degree from UCLA and his doctorate from UC Berkeley.

He then returned to San Francisco State as a faculty member in criminology, and it was there that Irwin made it his goal to create a mechanism for matriculating the formerly incarcerated into the CSU system.

Project Rebound has a great track record, one that is effective in not only providing a path for secondary education for those coming out of the state’s prison system but also for cultivating a community among those with similar life experiences.

 
At 9:03 PM, Blogger Richard Layman said...

This article has lots of good links.

https://www.inquirer.com/opinion/commentary/community-violence-prevention-sustained-support-20220117.html

"Community-based violence prevention works, but it needs sustained support"

 
At 8:33 PM, Blogger Richard Layman said...

NHK's Direct Talk tv program has an episode on the "gang intervention" program Homeboy Industries and founder Father Greg Boyle in Los Angeles.

https://www3.nhk.or.jp/nhkworld/en/tv/directtalk/20210730/2058789/

 
At 2:25 PM, Blogger Richard Layman said...

https://www.nytimes.com/2021/03/09/business/lebron-james-community-development.html

"How LeBron James Uses His Influence to Improve Community Development"

In Akron, Mr. James is building a model for advancing education and social assistance in the West Market Street neighborhood, where he was raised. A new school, three residential buildings and a sports-and-entertainment complex represent more than $20 million in investment by the LeBron James Family Foundation and its partners.

In building projects that serve the public interest, Mr. James has joined an expanding movement of developers around the country who mix new ingredients into the formula for socially responsible development. The term was initially defined by advances in design like energy efficiency, environmental safety and affordability. Developers now construct buildings and neighborhoods that make those assets and others — health care, recreation, good schools, safe streets — accessible to residents in neglected communities.

Examples are numerous. Among them is the East Harlem Center for Living and Learning, a mixed-use project on 104th Street in Manhattan. The $84 million building, completed in 2015, includes 89 affordable housing units, office space and the Dream Charter School for 500 students from kindergarten through the eighth grade. The project also includes a renovated public park. ...

Mo Vaughn, who spent part of his baseball career with the New York Mets, is a co-founder of Omni New York, which specializes in buying and renovating apartment buildings for affordable housing in struggling neighborhoods in and outside the city. ...

Mr. James’s model of development, real estate authorities say, differs from those efforts because it relies on his stature to recruit public and private capital to embrace a suite of social goals, and then build projects to pursue them. The value proposition is to develop projects that help curb family disorder and instill learning, life and work skills so that underperforming children graduate from high school, attend college and have a successful career. The individual pieces, though, are owned and managed by different agencies.

 
At 2:25 PM, Blogger Richard Layman said...

-- continued --


“It’s a promising model for community redevelopment at a holistic level,” said Jeff Levine, a lecturer of economic development and planning at the Massachusetts Institute of Technology. “It delivers high-value development in places where there aren’t resources for people to do it themselves.” ...

The foundation’s latest and largest project is the $2.875 million it paid in December to buy the Tangier, an entertainment and events center in Akron. Renovation of the 60,000-square-foot building, renamed House 330, started in January and is expected to be completed next year.

The project will provide training and jobs for students interested in careers in food service, hospitality, management, maintenance, finance and other professions. It is also the first to develop a revenue stream for the foundation’s work, said Michele Campbell, executive director of the LeBron James Family Foundation. ...

Mr. James’s development career began five years ago when he recruited support from Akron Public Schools to start the I Promise School for underperforming elementary and middle school students. His foundation spent more than $2 million to renovate a former McDonald’s office building for the school. It opened in 2018, serves third through eighth graders and will reach its 720-student capacity in 2023.

https://www.nytimes.com/2019/04/12/education/lebron-james-school-ohio.html

,,, The school inspired Cheryl L. Stephens, chief executive of the East Akron Neighborhood Development Corporation, to get involved with the city and the foundation to build I Promise Housing, a $14.5 million, 50-unit affordable housing project that starts construction in the spring on 1.75 acres the city donated.

I Promise Housing is close to I Promise Village, a 22-unit apartment building that provides temporary housing at no cost to families in crisis. It opened in July and includes space for social services and community events. Graduate Hotels, a Nashville developer, spent $850,000 in 2019 to buy the 98-year-old, four-story brick building. Ben Weprin, the company’s chief executive, then went to work with his staff to recruit suppliers and contractors to donate materials and labor to complete a total renovation and furnish the apartments.

 
At 3:56 PM, Blogger Richard Layman said...

https://www.nytimes.com/2021/02/25/education/susan-feingold-dead.html

Susan Feingold Dies at 95; Helped Give New York Children a Head Start

Her Bloomingdale Family Program provided preschoolers with a haven where there hadn’t been one before. It became a model for similar efforts under Lyndon Johnson’s War on Poverty.

In the 1960s, New York City presented a harsh landscape for its underprivileged children. Parks were dangerous, the courtyards of crumbling housing projects could be hostile zones, and preschools were expensive. But a band of parents in Manhattan resolved to take matters into their own hands, led by a strong-willed woman named Susan Feingold, who had narrowly escaped the Holocaust as a girl.

Their grass-roots effort started off humbly enough, though it later changed the lives of thousands of New York children and became a model for the national Head Start program, an early-childhood federal outreach initiative for low-income families. At the time, Ms. Feingold and her fellow parents were just trying to make things better for their children, and they called their group the Bloomingdale Family Program, named after their sliver of a neighborhood on the Upper West Side.

It began with their creation of an urban oasis — an outdoor preschool classroom — in Riverside Park at West 103rd Street. They repaired a wilting playground and cleaned its bathrooms. They provided gardening classes, athletic programs and reading lessons. Racial divisions loomed large, and Ms. Feingold strove for inclusivity, handing out fliers about Bloomingdale to families on Riverside Drive and throughout the Frederick Douglass housing project nearby. ...

The Parks Department began supporting the group, which eventually moved its operations into church basements and a community center. In 1965, the program received a Ford Foundation grant, and a few years later word about Bloomingdale reached President Lyndon B. Johnson’s administration as it was conceiving Head Start, which became a signature initiative of Johnson’s War on Poverty.

The government planners were reported to have been inspired by Bloomingdale’s success, notably in integrating volunteer parents into the classroom, and they borrowed from the program as they implemented Head Start nationally. In the late 1960s Bloomingdale became a federally funded Head Start program, and Ms. Feingold remained its director for more than 40 years.


"Program's Aimed at Children, But It Also Helps the Mothers", Joan Cook, 10/12/1968

"Recreation Program, Unites Mothers"
https://www.nytimes.com/1964/03/18/archives/recreation-program-unites-mothers.html
3/18/1964

https://bloomingdalefamilyprogram.org/in-memory-of-our-founding-executive-director-susan-feingold/?fbclid=IwAR2jB3uR_V7BmzpwhHcVT5tcCCdPm2s1Muxa2U5Joa0fSeltCE2I7D3nLVg

Documentary

"Shouts of Children Echo Again In Revived Uptown Playground; Once-Deserted Area in Riverside Park Gets a Clean-Up and Police Guard in City-Neighborhood Effort"
8/8/1960
Emma Harrison

https://www.nytimes.com/1960/08/08/archives/shouts-of-children-echo-again-in-revived-uptown-playground.html?url=http%3A%2F%2Ftimesmachine.nytimes.com%2Ftimesmachine%2F1960%2F08%2F08%2F99774875.html%3FpageNumber%3D23

Auerbach, Aline Sophie Buchman, and Sandra Roche. Creating a preschool center: parent development in an integrated neighborhood project. John Wiley & Sons, 1971.

 
At 9:02 AM, Blogger Richard Layman said...

"Why Cash Is Better Than Expanded Health Insurance for the Poor"

Cash transfers go directly to people in need, while health insurance expansions pay mainly for care that the uninsured already receive, an economist says.

https://www.nytimes.com/2021/05/13/business/health-insurance-cash-Biden.html

 

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