Yes, and Republicans should Use Process Reform to Tackle Them.

most definitely in the details. There seems in general to be common ground between the two sides, but philosophically the parties have notably different reasons for supporting increased spending.

If anything, the divide between the parties has only grown greater in the last few years, as the Democrats have moved substantially to the left. Moderate Democrats are fewer and farther between, while socialist Bernie Sanders is the chairman of the Senate Budget Committee, an important perch from which to influence domestic policy. Many in the party now seek to redefine “infrastructure” as a catchall term for their entire agenda. The expansion of a cradle-to-grave welfare state, from new programs on childcare to an expansion of Medicare, is now “human infrastructure.” The Green New Deal, with its massive transfer of wealth based on magical notions of a carbon-free economy, is likewise now “infrastructure.” And buried deep within the Biden Administration’s infrastructure plan are all kinds of goodies for labor unions and restrictions on what policies states who accept federal dollars can actually accomplish. Destroying federalism is apparently now infrastructure in the Democratic mind. As bipartisan negotiations over an infrastructure package continue this summer, Republicans should be mindful of their bottom line as a coalition. Any bill that

But because most Republicans hopes to have Republican support has to focus on primarily see infrastructure as a physical infrastructure means to economic development, that facilitates regional they see tax increases as a self- integration and above all economic development. That defeating form of financing, as it is why the party supports takes capital out of the private sector, such spending, and it should be its sine qua non in any where it is best directed for growth. negotiations. If Democrats insist on redefining the term “infrastructure” to include their redistributive agenda, Republicans should walk away from the bargaining table and instead take the issue to the voters in 2022. RF Jay Cost is the Gerald R. Ford nonresident senior fellow at the American Enterprise Institute (AEI), where he focuses on elections, politics, and public opinion.

Immunization rates for teens and adults have fallen dramatically during the pandemic...

We must act quickly to stop the spread of vaccine preventable diseases.

Avalere Health compared adolescent and adult vaccine billing patterns in commercial, Medicaid managed care (due to variability across states in billing requirements for vaccines provided through the Vaccines for Children program, this analysis may not fully capture adolescent vaccine utilization in the Managed Medicaid market), Medicare FFS, and MA markets from January-August 2019 to vaccine billing patterns during the same months in 2020 (e.g., March 2019 to March 2020), represented as a percent change between years. Between 2019-2020, aggregate vaccine claims submitted between March-August decreased by 53% (Commercial), 41% (Managed Medicaid), 42% (Medicare Advantage) and 48% (Medicare FFS).

Source: Avalere Health. Aggregate Changes for All Vaccine Products Across Markets. Adolescents and Adults, 2019-2020.

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Funding for this research was provided by GlaxoSmithKline. Avalere Health retained full editorial control.