Promises Broken or Promises Kept: Biden’s First 100 Days in Office

During his campaign, President Joe Biden broadcasted a lot of different messages to the public. He was entering the white house during a time of general discomfort with the government and a negative opinion of the previous administration. The country was working to combat high rates of homelessness, unemployment, police brutality, racial injustices, and a worldwide pandemic. All Americans were hoping that his actions would do something to confront this unhealthy atmosphere. 

The Hilltopper chose to look into some of these major campaign promises to determine if Biden had followed through with real change since taking office. We’ve broken it down into four major categories.

COVID-19 Response:

Biden won the 2020 Election well into the COVID-19 pandemic and because of this, much of the media’s attention was on his response to it. He opened with his American Rescue Plan which became an outline for the relief legislation making its way through congress. In this $1.9 trillion package, stimulus checks were provided to those families in need, as well as funding for reopening schools, aiding small businesses, and vaccination infrastructure. The bill passed on March 11. He also set a goal of 100 million COVID-19 vaccines in his first 100 days. He blew that number away in only 59 days and instead upped his numbers to 200 million by his 100th day. On top of this, he also rejoined the World Health Organization in the hopes of a return to normal in the fall of this year.

Civil Rights Protections

Under President Biden we have not seen the end to police violence targeted towards people of color. On the campaign, Biden promised to create a commission to oversee police brutality at the national level but in April the idea was scrapped. However, AG Merrick Garland made an announcement that there would be a civil investigation into the Louisville and Minneapolis police departments. The new administration has put its support behind the George Floyd Justice in Policing Act, passed by the US House in March. 

Biden also promised voters on the trail that he was the candidate to increase diversity and inclusion. He called for the immediate passing of the Equality Act, amending the 1964 Civil Rights Act to include gender identity and sexual orientation. It passed the House in February and now sits in the Senate. Biden himself however has not pushed for any movement from the Senate on this legislation since its passing in the House.

Climate Change

Since Biden’s January 21st inauguration, wildfires have ravaged the California forests, and Texas has practically frozen over. Many grew weary over how the planet was responding to the increase of greenhouse gases in the atmosphere. Biden has kept his promise to make America more “green-minded.” He issued an executive order on day one to kill the Keystone XL pipeline. He also stopped the development of the Arctic National Wildlife Refuge and rejoined the Paris Climate Agreement. Biden’s team also established the Office of Domestic Climate Policy in the White House. In progress, Biden and his administration have a plan to conserve 30 percent of American land and water by 2030 and help curb greenhouse gas emissions.

Voting Rights

Biden promised to update the Voting Rights Act. He also wanted to pass the For the People Act and John Lewis Voting Rights Amendment. These bills are all awaiting their respective hearings in the US Senate where Republicans have been staunchly in opposition of their passage. These motions by the President have not been met with great acceptance across the country either. In Georgia, a law was passed that led to widespread protests, boycotts, and even a withdrawal from the MLB in hosting its All Star Game in Atlanta in 2021.

Progressives go for a Trial By Fire Approach in Special-Election Races

As special election season has begun, spectators from both political parties have taken notice, especially in blue-leaning districts across the country.

It is not a matter of which party will win, but who from the incumbent’s party will- a progressive or a moderate? As members have been appointed to cabinet positions and other roles in President Joe Biden’s White House, a scramble has begun behind the scenes to see who will be their successor. Former Congresswoman and now Housing and Urban Development Secretary Marcia Fudge (D-OH) provides viewers with a great case example. Her seat is one of the bluest in the country, going D+60 in the 2020 election. It is safe to say no Republican is going to be a challenge in this predominantly urban district that encompasses Cleveland and Akron. 

This situation is not uncommon in the United States, particularly at the beginning of a new presidential administration when many elected officials are asked to join the executive branch. Cedric Richmond from Louisiana’s 2nd district who also joined Team Biden as a special advisor is leaving behind a D+48 district back home. These circumstances allow for basically a one-party election to determine who will fulfill the vacancy. As of late, with polarization at an all time high, it’s been progressive Democrats pinned against more moderate candidates, while in heavily red districts its moderate Republicans versus Trump-like opponents. With a Democratic White House, however, there have been more vacancies on the left side of the aisle than the right. 

Enter Bernie Sanders campaign chairwoman Nina Turner. A lifelong progressive from Ohio’s 11th district, Turner has been able to promote her prior experience as a state legislator and credibility as a pro-union and pro-Medicare For Alladvocate on the national scene to gain traction in her home district. She has also been able to get endorsements from local leaders such as Cleveland mayor Frank Jackson and Ohio Senate Democratic Whip Sandra Williams. On the flip side of the coin is moderate Shontel Brown, who has the highly sought-after endorsement of the United Auto Workers Union, something many candidates look to receive when trying to sway working class voters. She also has the  endorsements of Pro-Israel America and Democratic Majority for Israel (DMFI), a Super PAC that has spent vast sums of money on moderate Democratic candidates in the past. Many view this as a proxy battle between progressives and moderates, and with a few months to go before the primary election, expect this race to heat up.

A fall point for Progressives however can be seen in the race to fill Cedric Richmond’s seat in LA-2. Over this past week Troy Carter, a moderate state senator with experience working across the aisle over fellow state senator Karen Carter Peterson, a staunch progressive who ran on a Green New Deal and had the endorsement of Congresswoman Alexandria Ocasio-Cortez (NY-14). Although this endorsement made waves on blue-check Twitter, it was not enough to propel the state senator over her fellow candidates, especially after local teacher unions endorsed Mr. Carter. 

The State of the Union: Trump’s Vision for the Nation

On the evening of February 4, 2020, President Donald J. Trump addressed the nation in his third State of the Union address since he ascended to the presidency in 2016. This address focused on many key factors that the President has actively been working towards since he was elected. He claimed that “The state of our union is stronger than ever before.” These are three major takeaways from the evening’s speech that should be taken into consideration in the upcoming weeks, months, and even year:

  1. President Trump Kept His Campaign Promises

Throughout his speech to the nation, Trump made many remarks about how he has been successful in completing many of the promises he vowed to work towards during his Presidency. He spoke of how the border wall he promised in 2016 is being erected, bragging that over 100 miles of new wall has been built and over 500 miles will soon be constructed. This border wall was a key platform piece of his campaign in 2016, and remains to be in 2020. He is reassuring the American people that he has kept his promise and will continue to do so if elected in 2020.

Trump also praised many border officials and Immigrations and Customs Enforcement (ICE) officers during his speech. This section of the address received audible booing from many Democrats in attendance and an eruption of cheers from Republicans. President Trump offered condolences to Jony Jones, a man whose brother was attacked and killed by an illegal immigrant. He also praised Deputy Chief Raul Ortiz, a Border Patrol Officer whom the President claimed has been vital in protecting our Southern border from immigrants attempting to illegally cross into the country. The president wants the American people to know he has and always will keep his promises.

  1. Impeachment was Never Mentioned

In what was an unexpected contrast to the perceived social media buzz, Donald Trump did not acknowledge his own impeachment even in the midst of a likely vote the following day. Sitting in the audience were the seven House impeachment managers deliberately together to the President’s right. This may be because Donald Trump’s main goal of this address was to prove to the American public that he is worthy of another term in office. Republican colleagues in the audience even began a “four more years” chant as the President entered the House Chamber. 

  1. The 2020 Election will Boil Down to the Economy

The President opened his address by mounting what he claimed to be the “Great American Comeback”. As many have assumed, President Trump is very proud of where the United States’ economy lies. He noted that “The unemployment rate for African-Americans, Hispanic-Americans, and Asian-Americans has reached the lowest levels in history.” Donald Trump continues to tell the American people how successful he has been in helping the middle class as well. He claimed that the nation was in the midst of a “blue-collar boom,” and that wages were increasing. This is true, but the increase isn’t nearly as dramatic as he may have made it sound. Wages on average have risen faster than inflation; however, wage gains have fallen stagnant in recent months.    

Donald Trump adds $10 million to his presidential campaign

Trump also discussed how 7 million new jobs have been created under his presidency and how drastically that counters the “failed growth of the past administration.” The president is avoiding the truth but not explicitly lying. It’s true the rate of job creation and active working fell during Obama’s two terms in office, partly because the population was aging. It has since rebounded this year, but the economy created 11.6 million jobs during Obama’s two terms, and job creation under Trump has increased at a slightly slower rate than Obama’s administration. The President is likely trying to woo voters in the upcoming election.

State of the Union live updates: Trump attacks Democrats ...

One thing is for certain, Donald Trump and the Republicans are not necessarily looking to work with the Democrats in the future to get things done. At the beginning of the address, Speaker Nancy Pelosi offered a handshake to the President prior to his speech which he subtly ignored. Pelosi then ripped the copy of the address she had been given. Both sides seemed to belittle the other regarding how they handled this interaction. Party polarization is on the rise, and the State of the Union Address showcased just how poor the situation has become.

Saint A’s Students Travel to Concord, Boston for Women’s March

Liz Moore ’19 (left), Meg Russo ’19 (right), and Sarah Bentley ’19 (center) attend the Women’s March in Boston. (Photo courtesy of Moore)

The beginning of Donald J. Trump’s presidency spurred a wave of feminism and women-led activism that has been ongoing for over two years. In 2017, the National Women’s March captivated the minds and attention of Americans nationwide, inspiring hundreds of women to run for public office and participate in national elections. The Women’s March on Saturday, January 19, 2019, marked two years of advocating for strong women. It was a fierce declaration to protect and defend their rights, safety, communities, and health. The march aimed to raise awareness and increase understanding of women’s needs in social change and public policy, targeting issues such as health care, which is not equally accessible nor affordable for black, Hispanic, trans*, disabled, and Indigenous women.

The annual event is organized by women who work directly with impacted communities, expanding the Unity Principle established in 2017 to represent marginalized and vulnerable women. Annual marches work to encourage progression in policy priorities in ending violence against women and femmes, ending state violence, LGBTQIA+ rights, immigrant rights, reproductive rights and justice, racial justice, economic justice and worker’s rights, civil rights and liberties, disability rights, and environmental justice.

The #WomensWave swept through cities across the country, including Concord, New Hampshire and Boston, Massachusetts. Several Saint Anselm students participated in the marches, and their support for the cause was overwhelming. When The Hilltopper asked Liz Moore ’19 why she marched in Concord, she answered, “Because women are still afraid to walk alone in a city and because 1 in 5 women will be sexually assaulted in their lifetime. As long as this statistic is this high, we need feminism and we need this march.”

Taylor Head ’19 supported Moore’s reasoning, saying she embraced the atmosphere where “everyone’s opinions [are] respected and celebrated at the march.” She went on to add, “I loved the environment of the women’s march and genuinely do feel like our generation is going make changes for women of those voices silenced long ago.”

When asked why she participated, Moore stated that she personally benefits from the experience: “It’s empowering to see strong, confident women (and men!) standing up for themselves and talking about the problems in our country rather than simply pushing them under the rug.”

How much can a difference can a small demonstration make? Moore answers: “Even though I’m just one person, I’m confident that my participation in the march made a difference. Each person there was just one person, but together we were a unit. A group of people standing in unity and solidarity is impactful and very powerful.”

The national movement has not only garnered intense media attention but has increased its number of supporters. Cassidy Diaz ’19, marched in Concord because of her newfound awareness about the lack of gender equality. Just a few months ago, Cassidy considered herself an “antifeminist”— her views of the world abruptly changed after taking “The History of Feminism Through Literature.” “Professor Holbrook opened my eyes to the many ways women AND men are treated unfairly just because of their gender,” says Diaz, “and this inspired me to attend the Woman’s March because I truly believe that this needs to change.”

Diaz admits she believes her impact is subtle but important nonetheless. While she says many people asked about her participation which spurred great conversation, Diaz says, “I don’t think I am really making a difference by attending these kinds of marches… I’m not usually the person to scream my views and opinions from the rooftops. But, I think the difference these marches make [is] in the people that attend them, like myself. It gave me an opportunity to educate myself further on feminism issues and the actions and lack of actions that are taking place in the world.”

Many agree the marches offer exposure to increase awareness of pressing issues. Moore hoped that by participating in the march she would mindset. “I was able to talk with and listen to women of all walks of life that wanted to make their voices heard, and I was exposed to more issues than I initially thought there were,” she says.

Her sentiment was echoed by Diaz, who said, “These marches are extremely inspiring and [it’s] encouraging to see how many people also care about the same issues you care about.”

When asked what she hopes to communicate to other women, Moore stated strongly, “I hope to communicate to other women that even if you might not feel oppressed or endangered, there are numerous women that are… Girls supporting girls is a powerful thing!” Girls supporting girls is the backbone of the marches, inviting new supporters, such as Diaz, to explore issues that beg attention.

“Even though I’m not your typical feminist and my opinions don’t exactly align with a typical feminist,’” Diaz says, “this march definitely showed me the importance of listening to other people’s opinions even if you don’t agree.” Moore, Diaz, and Head collectively agree they will be participating in future marches.

A fight for women everywhere, the Women’s March is an important part of the modern feminist movement around the country. Raising awareness and increasing representation for all women is a slow and tedious process, though women are steadily and powerfully making their voices heard—one step at a time.

A Year Out, 2020 Campaign Takes Shape

The first votes of the 2020 Presidential Election are going to be cast a little over a year from now, on February 3, in Iowa. New Hampshire will vote about a week later, and then the party really starts. A number of states have taken steps to front-load the primary calendar, giving their state, and its delegates, more sway in selecting the nominee. In 2020, it is possible that the Democratic nominee could surpass the delegate threshold by the end of March. The 2016 nominee, Hillary Clinton, did not do so until June 6.

There are currently four declared major candidates for President running as members of the Democratic Party.

The first to announce, in July of 2017, was former Maryland Congressman John K. Delaney. Delaney, a former business owner, has very low name recognition but, as he said at an event in the Dana Center last year, his hope is that running for so long will give him the opportunity to meet as many voters as possible in as intimate venues as possible in order to push up his name recognition. Congressman Delaney’s platform is broadly centrist, promoting a jobs training program, a shift to clean energy, and a reform to America’s public education program.

Hawaii Congresswoman and former Army National Guard medic Tulsi Gabbard was the second Democrat to throw her hat into the ring. She first rose to prominence in the national dialogue in 2016, when she resigned as a Vice Chair of the Democratic National Committee in support of Senator Bernie Sanders’ upstart presidential campaign.

Rep. Tulsi Gabbard, D-Hawaii, and Democratic presidential candidate Sen. Bernie Sanders wave to supporters during a campaign event in Miami. (Pedro Portal/El Nuevo Herald/TNS via Getty Images)

Congresswoman Gabbard, in her fourth term as a member of Congress, is having trouble getting her campaign off the ground as she is dogged by several controversies from her past. In 2017, she took part in a Congressional fact-finding mission to the warzone in Syria and met with Syrian Dictator Bashar al-Assad, who has been accused of using chemical weapons against his own people and has a long and bloody track record of suppressing dissent in the country. Congresswoman Gabbard has said that she supported al-Assad’s rule and opposed U.S.-led “regime-change.” She has a mixed record on social issues such as abortion and has drawn ire over her archaic positions on same-sex marriage. She once led the campaign in Hawaii for a “Traditional Marriage” constitutional amendment.

Julián Castro, a former Mayor and Housing and Urban Development Secretary, become the third major candidate to announce he was running for President. Secretary Castro has a record as a strong progressive, being an early supporter of same-sex marriage and promoting a Medicare-for-All proposal. At a recent visit to the Hilltop, he put an emphasis on pre-K education and his immigration story. Secretary Castro’s largest base of support comes from the shifting demographics of the United States, as he represents a younger, more progressive, and more inclusive picture of the future.

The only other major Presidential to declare that they are running is California Senator Kamala Harris. A first-term Senator, Harris is the child of immigrants and spent much of her early years in Quebec, where her mother moved after divorcing her father. Senator Harris has made a fast rise through the California political ranks, serving as San Francisco’s District Attorney and California’s Attorney General before being elected to the Senate in 2016. She is the first Senator from Jamaican or Indian heritage and has staked herself out as a progressive voice in Washington, leading the opposition to Supreme Court Justice Brett Kavanaugh, pushing for passage of the DREAM Act, and authoring criminal justice reform legislation.

While only four candidates have formally announced their Democratic campaigns for President, a number have launched Exploratory Committees, a coy political tool enabling someone to look into running for President while fundraising a significant amount of money without having to follow the normal FEC disclosure rules.

U.S. Senator Elizabeth Warren (D-MA) speaks during a campaign rally for Democratic U.S. presidential nominee Hillary Clinton in front of Alumni Hall in 2016. (REUTERS/Carlos Barria)

Senator Elizabeth Warren of Massachusetts, an outspoken Progressive, was the first to do so, followed by New York Senator Kirsten Gillibrand. Senator Gillibrand reached national prominence in 2017, after being appointed to the Senate when Hillary Clinton became Secretary of State in 2009, for her stiff opposition to many Trump Administration nominees as well as leading the campaign to oust Senator Al Franken of Minnesota as his sexual misconduct scandal became public.

Pete Buttigieg, the Mayor of South Bend, Indiana, has made history as the first openly gay person to form an exploratory bid for a major party’s nomination. Before jumping into the presidential race, he conducted an unsuccessful long-shot bid for Chairman of the Democratic National Committee in 2017.

It is likely that several more candidates will join the Democratic field before the end of 2019. Former New York City Mayor Michael Bloomberg has floated the idea of a self-funded campaign and some expect him to use his event at Saint Anselm College’s New Hampshire Institute of Politics next week to launch his campaign.

Washington Governor Jay Inslee has announced he is running for President on the sole issues of addressing climate change but has yet to file with the FEC. Vermont Senator Bernie Sanders is expected to launch his second campaign for the Presidency sometime next week.

Former Vice President Joe Biden, Colorado Senator Michael Bennett, New Jersey Senator Cory Booker, Minnesota Senator Amy Klobuchar, Ohio Senator Sherrod Brown, and former Texas Congressman Beto O’Rourke have all been speculated to be interested in running in 2020, although none have formed exploratory committees or launched campaigns.

Fmr. Ohio Governor John Kasich visiting NHIOP in 2017. He is rumored to be considering a 2020 presidential campaign. (Photo from Saint Anselm College)

As for the Republican side, it is unlikely that a serious, viable challenge to President Trump will emerge. Former Ohio Governor John Kasich and Former Arizona Senator Jeff Flake have been frequently talked about as a potential “Anyone But Trump” candidate, but President Trump’s support among Republicans is very strong, nearly 90%. At the Republican National Committee’s annual winter meetings, held this weekend in New Mexico, the party passed a resolution declaring their support for President Trump’s reelection, essentially giving a stiff finger to any potential challengers.

Maryland Governor Larry Hogan, a popular Governor in a blue state, has recently been floated as a potential candidate, with reports indicating he is in talks to headline a Politics & Eggs at Saint Anselm College in the coming weeks and is planning a trip to Iowa with Never Trump leader Bill Kristol. It is not obvious what potential base of support Governor Hogan has other than the Never Trumpers.

Former Massachusetts Governor Bill Weld, who most recently was the Libertarian Party’s Vice Presidential nominee in 2016, has also held talks with potential staff about a Republican campaign in 2020. Governor Weld has not held office since the Saint Anselm College Class of 2019 was born, leaving the corner office on Beacon Hill in 1997. He will be headlining a Politics & Eggs event in February at the Bedford Village Inn.

Howard Schultz resigned his position as CEO of Starbucks last year to look into running for President. In an interview that will air on Sunday night’s 60 Minutes, Schultz says that he is close to announcing an independent and self-funded campaign for President as the anti-Trump. This has worried many Democrats, including former Senior Advisor to President Obama Dan Pfeifer, who said “[Schultz] will pose an existential threat to a Democrat in what will likely be 2020 race decided by a few votes in a handful of states.”

Early on in the 2020 media cycle, there was a lot of talk of a potential “Unity Party” bid, reminiscent of when Republican President Abraham Lincoln chose Democratic Senator Andrew Johnson as his running mate to unite the country in 1864 during the throes of the Civil War, with Republican Governor Kasich and Democratic Colorado Governor John Hickenlooper. This talk has, largely, died down since the fall, when Governor Hickenlooper told reporters in Colorado that Kasich “didn’t even send me a text” when Governor Kasich formed a new PAC to look into running for President.

Regardless of how big or how crazy the 2020 primary fields are, or even the general election, the Hilltop with surely be at the center of it all.

Julián Castro Outlines Vision at Politics & Eggs Event

Julián Castro (D-TX) spoke at the Politics & Eggs event on campus Wednesday. (Photo by Mary Schwalm of the Associated Press)

Former Secretary of Housing & Urban Development Julián Castro was on campus Wednesday to outline his vision if he wins the presidency. Castro is the most prominent announced candidate for the Democratic nomination, but the field is quickly growing. Congresswoman Tulsi Gabbard (D-HI) has also announced she is running while Senators Kirsten Gillibrand (D-NY) and Elizabeth Warren (D-MA) formally explore potential candidacies. Senator Kamala Harris (D-CA) is also scheduled to announce her entry into the race on or around MLK Day. Speculation continues to swirl around former Vice President Joe Biden (D-DE), Senator Sherrod Brown (D-OH), and former Congressman Beto O’Rourke (D-TX).

Castro is the former Mayor of San Antonio, Texas. In his speech Wednesday, Castro talked about the experience of his grandmother’s immigration to the United States and the opportunities she built for her daughter and grandsons. He has tied this personal narrative into the issues he cares most about.

Castro speaks with a Saint Anselm student while signing eggs. (Photo by Nick Fulchino ’19)

In addition to his personal narrative, Castro spoke about a variety of issues he hopes to address as president. He called for universal pre-kindergarten and talked about when he passed the program in San Antonio, asking his constituents to agree to a sales tax increase to pay for it. His emphasis on early childhood education earned applause from the room.

Castro also spoke about criminal justice reform, climate change, and affordable housing. Questions in the audience centered on how Castro plans to pay for his ambitious agenda, mental health, and veterans’ affairs.

Julianne Plourde ’20, who is a New Hampshire primary voter, reacted positively to most of Castro’s remarks. “It was promising to hear a candidate want to talk about problems that are often ignored, such as our affordable housing issues,” she said before continuing, “He’s definitely someone I want to learn more about after his speech.”

Politics & Eggs is as much a New Hampshire tradition as it is a Saint Anselm one. It is hosted at the New Hampshire Institute of Politics on campus in conjunction with the New England Council. It frequently features top political minds and nearly, if not all, presidential candidates.

Castro Announces Bid, Will Visit Hilltop

Former Sec. of Housing and Urban Development Julián Castro (D-TX) announces his campaign in San Antonio, TX. (Photo from ABC News)

The parade of potential 2020 Presidential candidates continues next week with another stop at the New Hampshire Institute of Politics.

Julián Castro, who most recently served as the Secretary of Housing and Urban Development under President Barack Obama, will keynote the next Politics and Eggs of the New England Council. Castro’s Politics and Eggs visit will be days a rally, on January 12, in his native San Antonio, Texas where Castro formally announced his campaign.

The rally in San Antonio comes after a barnstorming tour of Iowa, which began today, the first state of hold an electoral contest, a few weeks before New Hampshire’s own 2020 Primary.

Before serving in President Obama’s second term cabinet, Castro was the Mayor of San Antonio for three terms and served on the San Antonio City Council before that. Castro was frequently linked to Hillary Clinton’s 2016 vice presidential search before the job was offered to Virginia’s Tim Kaine.

Much of Castro’s appeal centers around his youth and his representation of the growing Hispanic population across the United States, as well as his liberal positions on issues, including a recent pledge of support for the “Medicare for All” proposal. In his announcement speech, Castro affirmed his support for universal healthcare coverage and announced plans for ending cash bail, universal Pre-K, and re-entering the Paris Climate Accord. As Mayor, Castro was a major supporter of same-sex marriage, despite the fact same-sex marriage was illegal in the State of Texas at the time.

Castro has a twin brother name Joaquín, who has been a member of Congress since 2013. Both Castro brothers have hinted at running for higher office but, it seems, they’ve decided that 2020 is Julian’s time. Regardless of which Castro brother is running, it seems that there is a new Kennedy family coming up through the Lone Star State – one more reflective of the shifting demographics and social trends in the country.

Castro will be the fifth potential Presidential candidate to visit the Hilltop in the 2020 Cycle, joining Republicans Jeff Flake and John Kasich and Democrats John Delaney and Andrew Yang.

Timmer Explains Question 1 on MA Ballot

The controversy surrounding the first ballot question on the upcoming ballot has split Massachusetts nurses and residents alike. Before voting on the issue it is important to understand the arguments from each side.

I am not an expert on Question 1, and I am not yet a registered nurse. Many people, however, have approached me and my peers seeking advice on how to vote, hoping that we will have some insight as nursing students or nursing assistants. While I will not tell you how to vote, here is a summary of the research I have done, and the things I have observed in the hospital setting to help you make an informed decision on Tuesday.

Question 1 on the November 6th Massachusetts ballot is proposing a plan to implement safe staffing for nurses by limiting the number of patients in each nursing assignment. The ballot question was added in an effort to improve patient safety by reducing the prevalence of human error in nursing care. Aside from in Intensive Care Units (ICUs), there is currently no set patient limit for nurses in Massachusetts.

There is no question that unsafe staffing is an issue in many hospitals and that nurses are often overwhelmed by their patient assignments. Many argue, however, that a “one size fits all” approach is not the correct way to solve this issue, leading to a confusing and vast controversy.

Arguments in Favor of Question 1:

The argument supporting Question 1 is heavily union-backed, as it’s supported by the Massachusetts Nurses Association (MNA). The MNA argues that mandating a maximum patient quota will improve patient outcomes and decrease readmission rates.

In a survey conducted by the MNA in April, 77 percent of nurses reported being assigned too many patients with an average of 6-8 patients per assignment (with the exception of the ICU). 86 percent of the nurses who completed the survey said that they plan to vote “yes” on Question 1. An article in the Boston Globe, however, states that the survey “appears to have been weighted towards MNA members”.

There is no debate that nurses are overworked and are frequently asked to juggle heavy patient assignments, and many of the nurses questioned stated that they did not have enough time with each patient to provide the best standard of care. Understaffing not only puts patients at risk for error but also increases liability among nurses. While many nurses and the MNA are largely in support of Question 1, the nursing population as a whole seems to be split on the issue.

Arguments Opposing Question 1:

Most nurses would agree that measures need to be taken to improve unsafe staffing issues but many also agree that Question 1 is not the correct solution to the problem. The patient limits set by Question 1 would vary depending on the type of unit and the stability of the patient (an Emergency Room nurse could be assigned one urgent unstable patient OR two urgent stable patients).

The ballot question, however, does not take into account the experience or skill level of each nurse. Those opposed to Question 1 argue that experience and skill level is largely what determines what is a reasonable patient assignment, for example, a recent graduate or novice nurse should not have the same expected patient quota as a nurse with twenty years of experience.

The mandated patient assignments would cause a loss of autonomy among hospitals and individual units to create a staffing plan tailored to their employees.

There is also the issue of cost. According to the Boston Globe, Massachusetts Governor Charlie Baker was undecided on the ballot question until seeing a cost analysis stating that the passing of Question 1 could cost anywhere from $676 and $949 million per year.

The president of Massachusetts General Hospital, Peter L. Slavin, brings to light the additional financial strain that would be put on each hospital in a newsletter to hospital employees that can be found online. Hospitals could be fined up to $25,000 per day for not complying with the necessary ratios, however, the cost of hiring hundreds of new nurses would be an even greater expense.

These increased costs could cause a huge financial burden on small community hospitals, potentially causing closures of certain departments or even the hospital as a whole. This could create a significant barrier to patients who are dependent on these hospitals for long-term care without the financial burdens associated with commuting or relocating.

There is already a significant shortage of mental health facilities and nursing homes in Massachusetts and many argue that the financial impact of Question 1 would only worsen this issue. The financial impact of Question 1 would put these facilities in jeopardy and prevent our society’s most vulnerable populations from receiving care. Slavin also states that there is not a sufficient quantity of new nurses to satisfy these quotas among the many Boston hospitals and community health centers, meaning that the $25,000 per day fine is a likely reality among many organizations.

Those planning to vote “no” state that, while Question 1 could improve some individual errors in the clinical setting, it would create a vast barrier to patient care by limiting the number of available patient beds in all facilities.

Many nurses are still undecided about how they plan to vote on the ballot question tomorrow. Many nurses believe that patient safety risk and overworked nurses is an issue that must be addressed. Others are worried that Question 1 is not the correct way to solve the persistent un-safe staffing issue but they still feel that it is at least a step in the right direction to improve working conditions and patient care.

Many nurses, however, also believe that the potential consequences of the increased costs are too great to risk and that the changes will result in poor access to healthcare among patients who are reliant on community hospitals, mental health facilities, or nursing homes for care. The information above is compiled from a variety of news articles, union statements, hospital newsletters, and issues that I have observed throughout my clinical experience as both a student and a nursing assistant.

For more information on Question 1, there are links articles of varying opinions and the full ballot question below.

The Ballot Question

In Favor: https://safepatientlimits.org/
https://www.bostonmagazine.com/news/2018/10/23/endorsement-question-1-massachusetts/

Opposed: https://www.boston.com/news/politics/2018/10/09/massachusetts-ballot-questions-2018-question-1-nurse-staffing
https://www.massgeneral.org/News/newsarticle.aspx?id=6923#.W7_ms8tOPbg.facebook

Cover image from Don Treeger of The Republican.