Andrea Flynn

Roosevelt Institute Fellow
 

Recent Posts by Andrea Flynn

  • The GOP Is Taking the Texas Women's Health Crisis National

    Sep 1, 2015Andrea Flynn

    As of today, nearly three thousand low-income women in Texas will need to find a new place to get their breast and cervical cancer screenings, thanks to a decision by lawmakers to oust Planned Parenthood from the program that subsidized care for uninsured women. The new rule is just the latest reminder that reproductive health services that were once off-limits are now fair game in the GOP’s long and tireless battle against abortion.

    As of today, nearly three thousand low-income women in Texas will need to find a new place to get their breast and cervical cancer screenings, thanks to a decision by lawmakers to oust Planned Parenthood from the program that subsidized care for uninsured women. The new rule is just the latest reminder that reproductive health services that were once off-limits are now fair game in the GOP’s long and tireless battle against abortion.

    Wendy Davis launched Texas into the national spotlight in the summer of 2013 when she filibustered HB2, a law that placed sweeping restrictions on abortion providers and quickly closed 17 of the state’s 41 clinics that offered the procedure. In November the Supreme Court will decide if it will hear the case, and if it rules the law constitutional, seven more will close.

    Many of the restrictions included in HB2 have also been implemented in other states, reducing access to birth control, pap smears, breast exams, pregnancy tests, and abortion.

    But long before HB2 turned national attention to Texas, lawmakers had been busy dismantling the state’s reproductive health infrastructure. Between 2011 and 2013, they cut the state’s family planning budget by nearly two-thirds and established a tiered system that prioritized primary care centers, health department providers, and "crisis pregnancy centers,” leaving little to no funding for family planning clinics—the very entities for which the funding is intended. The state violated federal regulations by banning Planned Parenthood from its Medicaid Women’s Health Program (WHP) and forfeited the federal government’s 9:1 funding match. Governor Perry insisted the state could operate the program without federal support, but the results have proven otherwise: in 2013 the new WHP served almost 30,000 fewer women—and received more than 100,000 fewer claims for birth control—than it did in 2011 (before it lost Medicaid funding). In the wake of these vast changes, 82 family planning clinics closed, 49 more reduced hours, and 54 percent fewer clients were served. In response to public outcry, lawmakers increased funding in 2013, but many women remain left out.

    In a recent survey of providers in Texas, respondents reported that “they did not know what had happened to their former clients but suspected that they simply were not seeking reproductive health care.”

    Despite the mounting challenges to accessing care, Texas lawmakers added yet another barrier. For 20 years Planned Parenthood participated in the state’s Breast and Cervical Cancer Screening (BCCS) Program, and last year served 10 percent of the state’s patients who receive the subsidized services. Lawmakers intent on routing abortion—and Planned Parenthood—out of their state argued that clinics receiving BCCS funding “should not be facilities for performing abortions.” Texas lawmakers insist women can simply receive their care elsewhere, but that’s simply not the case, and it’s particularly troublesome given that the incidence of cervical cancer among Texas women is 17 percent higher than the national average. According to a new report from the National Latina Institute for Reproductive Health, Texas Latinas experience a higher incidence rate of cervical cancer than their white or Black peers, and those living in counties near the Texas–Mexico border—among the worst impacted by the regulations of the last four years—are 31 percent more likely to die of cervical cancer compared to women living in non-border counties.

    Aimee Arrambide, Director of Policy and Advocacy for the Texas Women’s Healthcare Coalition, said it’s hard to predict where the women who relied on Planned Parenthood for their cancer screenings will now go. “Even after the 2013 Texas Legislature restored funding to the Texas women's healthcare programs, the safety net of providers was already so devastated by the 2011 cuts and the exclusion of the most active providers, like Planned Parenthood, that it did not recover.” Rebuilding clinics and getting patients back into the fold is a long and complicated process, especially when new restrictions keep cropping up.

    Lawmakers in other states have followed the lead of their Texas colleagues in extending the battle against abortion access to a broad range of reproductive health services. Today Ohio and Michigan have developed tiered systems similar to that of Texas. Oklahoma and Kansas prohibit private family planning providers from receiving state and federal funding and seven other states prevent organizations that also provide abortion services from receiving funding.

    Republicans at the federal level have followed suit. In 2011 the GOP proposed eliminating Title X, the national family planning program started in 1970 by President Nixon and then-Congressman George H.W. Bush (marking the first of such efforts in the program’s 40-year history). Today funding for Title X is 70 percent lower 1980 levels (accounting for inflation), and House Republicans again proposed eliminating Title X in June of this year, while Senate Republicans proposed further funding cuts. The GOP has voted 55 times to overturn the Affordable Care Act—which has dramatically improved reproductive health coverage—and it shut down the government in opposition to the law’s requirement that employers and insurers cover all FDA-approved methods of contraception. In recent weeks Republicans have lined up to decry the heavily doctored Planned Parenthood videos and demand the organization be stripped of its federal funding. Last week Jeb Bush, a GOP presidential hopeful, argued that Planned Parenthood is not “actually doing women’s health issues.” 

    Texas lawmakers might have blazed the trail in steamrolling reproductive health access, ignoring the cost to the health and lives of their constituents, but it’s clear that others are eager to follow the same path, methodically whittling away at the reproductive health infrastructures on which so many individuals have long relied – particularly poor women, women of color, young men and women, and members of the LGBT community.

    Texas governor Greg Abbott said in his inaugural speech. “As goes Texas, so goes America.” Unfortunately for women and families, that certainly seems to ring true.

    Andrea Flynn is a fellow at the Roosevelt Instittue, where she researches and writes about health and economic issues that impact women and families. Follow her on twitter at @dreaflynn.

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  • Bush Didn't Misspeak: The GOP Wants to Dismantle Reproductive Health Programs

    Aug 5, 2015Andrea Flynn

    Last night Jeb Bush made a slip of the tongue that let us know just where he stands on reproductive health. “I’m not sure we need half a billion dollars for women’s health issues,” he said at an event in Nashville. In a way, he’s right: We actually need much more than half a billion dollars to fully meet the need for publicly funded reproductive health services.

    Last night Jeb Bush made a slip of the tongue that let us know just where he stands on reproductive health. “I’m not sure we need half a billion dollars for women’s health issues,” he said at an event in Nashville. In a way, he’s right: We actually need much more than half a billion dollars to fully meet the need for publicly funded reproductive health services. Bush has since backtracked on his comment, which came on the heels of Senate Republicans’ failed attempt to defund Planned Parenthood, but we should not be fooled. His remarks and the recent furor that led to said defunding attempt are a clear illustration of the resentment GOP lawmakers and candidates have for our nation’s reproductive health programs, and reflect their resolve to diminish them.

    It’s important to consider Bush’s remarks and the attacks on Planned Parenthood in the political context of the past four years. As Elizabeth Warren indicated in her impassioned speech before the Senate this week, over the past five years Republican state lawmakers have passed nearly 300 new restrictions on reproductive health access. In the first quarter of 2015, lawmakers in 43 states introduced a total of 332 provisions to restrict abortion access, which is increasingly out of reach for women throughout the country. Republicans have voted more than 50 times to repeal the Affordable Care Act (ACA), which has dramatically improved women’s health coverage and access. In the fall of 2013, the party orchestrated a costly government shutdown motivated by their opposition to the ACA’s contraceptive mandate. And in June, House Republicans proposed eliminating funding for Title X, the federal family planning program.

    When conservatives talk about “women’s health” funding, they aren’t talking about funding for abortion. Federal law already prohibits public dollars from being spent on abortion or abortion-related care. They’re talking about funding for family planning and other reproductive health services (pregnancy counseling, cancer screenings, STD treatment, etc.), which mainly comes through Medicaid and Title X, two programs that are consistently in conservative crosshairs.

    There are no two ways about it: Funding for public reproductive health programs is far below where it should be. Today funding for Title X is 70 percent lower than it was in 1980 (accounting for inflation). If funding for this program had kept up with inflation over the last 35 years, the current funding level would be $941.5 million. In 2015, Congress appropriated $286.5 million for Title X (down from $317 million in 2010).

    Congress approved these funding decreases (and Republican senators have proposed even further cuts while their House colleagues have proposed complete elimination of Title X) despite a growing need for services. The Guttmacher Institute reports that between 2000 and 2010, the number of women who needed publicly funded contraceptive services and supplies grew by 17 percent and by 2013 had grown by an additional 5 percent (an additional 918,000 women). Guttmacher attributes this to an increase in the proportion of adult women who are poor or low-income; the current U.S. public family planning program is only able to serve approximately 42 percent of those in need. Turns out “half a billion” isn’t quite enough.

    "Title X-funded health centers provide essential preventive care to millions of women and men across the country and are often the only source of health care they receive all year," said Clare Coleman, President and CEO of the National Family Planning & Reproductive Health Association. "The network of publicly funded family planning providers has long been underfunded despite a growing need for these vital services."

    Title X-funded clinics—of which some, but not all, are Planned Parenthood providers—are the backbone of the nation’s reproductive health care system, ensuring that low-income individuals, young people, immigrants, and women of color are able to access affordable, quality reproductive health services. Every year, nearly 5 million individuals rely on these providers for birth control, breast and cervical cancer screenings, pregnancy testing, and a range of other preventive services. In 2012, Title X clinics helped women avert 1.1 million unintended pregnancies that would have otherwise resulted in 527,000 unplanned births and 363,000 abortions. In addition to the extraordinary health benefits, Title X is smart economics. It’s estimated that every dollar invested in family planning yields a taxpayer savings of $7.09, and that Title X-funded clinics save more than $5 billion annually in pubic spending.  

    Conservative lawmakers have spent much more time in recent years finding ways to restrict access basic health care than they have solving the actual problems that plague women and families like pay inequity, low wages, weak worker protections, and a lack of work–family benefits. If recent events are any indication, they’re not going to veer from that course now. Jeb Bush’s recent remarks, the hoopla over Planned Parenthood, and the relentless assault on reproductive health and rights is a clear reminder of where issues central to women and families fall on the priority list of conservative lawmakers: dead last.

    Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter at @dreaflynn.

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  • Planned Parenthood Vote Highlights the GOP's Broken Moral Compass

    Aug 4, 2015Andrea Flynn

    Senate Republicans failed yesterday to advance a bill that would have defunded Planned Parenthood, but their crusade against the organization and others like it is far from over.

    Senate Republicans failed yesterday to advance a bill that would have defunded Planned Parenthood, but their crusade against the organization and others like it is far from over. Speaking in support of the legislation she sponsored, Iowa Senator Joni Ernst said the Planned Parenthood videos have “shaken the moral compass of our country." But given that members of the “pro-life” party are willing to shut down the government over reproductive health access even as they ignore and exacerbate the actual crises that threaten our families and communities, we must question the alignment of the compass they’re following.

    The video saga has now been proven to be complete nonsense. Two state investigations have cleared Planned Parenthood of any wrongdoing. Planned Parenthood is not, as the video’s editors portrayed, harvesting fetal tissue for profit, and their donation of such tissue and their compensation for related costs is, it turns out, perfectly legal. In fact, some of the senators leading this crusade (including Mitch McConnell) signed the very piece of 1993 legislation that legalized tissue donation. There are a number of issues shaking the moral compass of this country, but Planned Parenthood is not one of them.

    Child poverty should shake our moral compass. Today, 22 percent of all children live in poverty, including 40 percent of Black children, and almost half live in low-income families. The U.S. child poverty rate is higher than all but one other OECD country. Poor children are more likely to drop out and perform poorly in school, to have developmental delays, and to experience behavioral, physical, and socioemotional problems. Yet conservatives still love to hate on the safety net programs that help keep these kids and their families afloat. In recent years, they have threated to cut funding for SNAP (food stamps) and WIC (the supplemental nutrition program that serves nearly 10 million low-income women and children) and have opposed legislation that would make it more affordable for low-income kids to go to college.

    Maternal mortality should shake our moral compass. Today, more U.S. women die in childbirth and from pregnancy-related causes than at almost any point in the last 25 years, and the U.S. is one of only seven countries to see its maternal mortality rate increase over the last decade. Black women are three to four times more likely to die from pregnancy-related causes than white women, and in some communities experience a maternal mortality rate equal to that in some Sub-Saharan African countries. But instead of expanding access to quality, affordable, and comprehensive health care, conservatives are busy closing clinics that predominantly serve women of color, low-income women, and young women. They remain steadfast in their refusal to participate in Medicaid expansion under the Affordable Care Act (ACA), which would extend coverage and care to millions more low-income women. And they are still intent on repealing the ACA in its entirety, despite the fact that it has brought coverage to more than 16 million individuals.

    Structural racism should shake our moral compass. The conservatives accusing Planned Parenthood of devaluing human life have been pretty quiet on the systemic violence and discrimination against communities of color. Where’s the outrage over Sandra Bland, Freddie Gray, Trayvon Martin, and the countless others who have died at the hands of law enforcement? Where’s the outrage from the supposed “pro-family” party over the school-to-prison pipeline that has torn apart families and communities across the country? Where’s the outrage over our imbalanced and unjust criminal justice system? Where is the space for these lives under the conservative pro-life umbrella?

    Pay inequity should shake our moral compass. The gender pay gap in the United States is alive and well, with women still making 78 percent of the earnings of white men (Black and Latina women make 64 and 56 percent, respectively). This gap results in a significant loss of income for women and their families over the life cycle and contributes to the high rates of poverty among women and single mothers as well as children. If equal pay were realized, it would mean a raise for nearly 60 percent of U.S. women and two-thirds of single mothers. The increase in earnings would expand access to health care, food and housing security, and educational opportunities, and would have countless long-term benefits for children. But GOP senators have voted four times since 2012 to block the Paycheck Fairness Act, which would make it easier for employees to identify and address pay inequities. They are also consistently opposed to raising the minimum wage, a move that would benefit more than one-fifth of all children in the United States.

    Income inequality—today greater than at any point since the Great Depression—should shake our moral compass. Thanks to our broken economic rules, the incomes of the top 1 percent increased by as much as 200 percent over the past 30 years while the net worth of the poorest Americans has decreased and stagnant wages and increased debt have pushed more middle-class families into poverty. After the 2008 recession, millions of Americans lost their homes, their jobs and their health care, and they are still struggling to regain their footing. The vast majority of Americans now believe a middle-class lifestyle is well beyond their reach. Yet conservatives continue to support the very policies that got us here in the first place: tax cuts for the wealthy; the erosion of unions and labor protections; and corporate structures that encourage a short-term focus on stock prices instead of long-term investments in growth and innovation.

    The inability of individuals to access basic health services should shake our moral compass. Conservatives insist their efforts would not actually impact health access, because Planned Parenthood’s funding would simply be reallocated to other providers. But there are not actually enough providers to fill the void that would be left by Planned Parenthood. As Senator Patty Murray said, “you can’t pour a bucket of water into a cup.” Even with Planned Parenthood and the gains of the ACA, conservative laws have left women across this country reeling. We need more Planned Parenthoods and more of their sister clinics, not fewer.

    Conservatives insist they care about the health of women and their families, but their actions indicate otherwise. They have proposed the elimination of Title X, the nation’s only program dedicated to providing family planning care and services. They are threatening—for the third time in four years—to shut down the federal government over reproductive health funding. They continue to support legislation that is closing clinics across the country, cutting access not only to abortion but also to basic preventive health services. The list goes on. This party is more interested in advancing its antiquated, harmful agenda than it is in the health of women—and men, young people, immigrants, trans folks, and low-income families—who rely on Planned Parenthood and other such providers. Their moral compass needs a good shaking up. 

    Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter at @dreaflynn.

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  • Hillary Clinton's Economic Agenda is Good for Women, But Should Be Even Bolder

    Jul 16, 2015Andrea Flynn

    Hillary Clinton gave her first major economic policy address earlier this week and outlined her goals for lifting wages for the middle class, expanding social services, and addressing growing economic inequality. She said that an important ingredient to strong economic growth is women’s workforce participation, and promised to knock down many of the barriers that hold women—and our economy—back.

    Hillary Clinton gave her first major economic policy address earlier this week and outlined her goals for lifting wages for the middle class, expanding social services, and addressing growing economic inequality. She said that an important ingredient to strong economic growth is women’s workforce participation, and promised to knock down many of the barriers that hold women—and our economy—back. But she failed to mention one issue that is critical to the economic wellbeing of women and their families: access to reproductive health care. 

    It was encouraging to hear Clinton acknowledge the important role that women play in the U.S. economy. After all, women’s entrance into the workforce in the 1970s and 1980s is credited with driving a fifth of GDP growth. But over the past 15 years, their participation in the labor market has declined from 60 to 57 percent, not a major decline but certainly a trend in the wrong direction. The U.S. now ranks 19th out of 24 advanced countries on this measure. America’s dismal status can be blamed in large part on the lack of generous and sensible work and family polices we see in other OECD countries. These include paid sick leave, paid family leave, and affordable child care. Another factor is the stubborn wage gap that disadvantages women—and particularly women of color—throughout their working lives and beyond. Clinton indicated that addressing these inequities is a primary focus of her economic agenda. Doing so would significantly improve the lives millions of women and their families. 

    But we must do all that and more. Without access to comprehensive, quality, and affordable health care, including the full spectrum of reproductive health care—maternal health care, family planning, and abortion care—women and their families will not be able to take full advantage of the economic opportunities available to them.

    I’m not worried that Hillary isn’t going to be a strong supporter of reproductive rights. In her Roosevelt Island campaign launch, she called out Republicans who “shame and blame women, rather than respect our right to make our own reproductive health decisions.” Her campaign sharply criticized House Republicans for passing a 20-week abortion ban earlier this year, saying, "Politicians should not interfere with personal medical decisions, which should be left to a woman, her family and her faith, in consultation with her doctor or health care provider." Historically, she has been an advocate for reproductive rights in both domestic and international policy.

    But it would be powerful if she could also articulate reproductive health as a critical component of economic security, as we at the Roosevelt Institute did in our recent blueprint for reversing economic inequality. Voters understand reproductive health as an economic issue. New polling from Virginia shows that 64 percent of voters there believe that a woman’s financial stability is dependent on her ability to control whether and when she has children, and 68 percent believe laws that make it harder to access abortion can have a negative impact on woman’s financial security. Polling conducted in New York and Pennsylvania showed similar results.

    This isn’t just a matter of opinion; the evidence illustrates that reproductive health access has economic benefits for families. Studies have shown links between family planning access and greater educational and professional opportunities for women, as well as increased earnings over women’s lifetimes. Women report that using birth control has allowed them to better take care of themselves and their families, to stay in school, to support themselves financially, and to get or keep a job and pursue a career. And when women don’t have access to reproductive health care, they are economically disadvantaged. Take the results of the recent Turnaway Study, which has shown that women who seek but are denied an abortion are three times as likely as those who access the procedure to end up below the federal poverty line two years later.

    In light of these findings, a progressive economic agenda will be incomplete if it does not include access to comprehensive reproductive health care. Lack of access to those services has significant health and economic costs. Women of color, immigrant women, and poor women all experience higher rates of chronic disease, unintended pregnancy, and lower life expectancy than women with higher incomes. U.S. women of color are 3–4 times more likely than white women to die of pregnancy-related causes, and infants born to those women are 2.4 times more likely than those born to white women to die in their first year of life. In some regions of the United States, the maternal mortality rate among Black women is comparable to that in some Sub-Saharan African countries. These disparities impact women’s quality of life. They inhibit these women’s ability to care for themselves and their families, to play an active role in their communities, and to participate in the workforce and achieve economic security. There is no more important time than now to advocate for a broader progressive agenda. Attacks on reproductive health access are at an all-time high and access to basic health services is being rolled back at a rapid rate.

    The right and ability to make decisions about our bodies is a fundamental building block of our social and economic wellbeing. We can’t expect people to separate the physical, social, and economic demands and stresses they experience. Are women supposed to worry about their need for an abortion without worrying about the job they might lose if they take a day off to get one? Do they stress over needing to put food on the table for their kids without also worrying about how they will pay for birth control, student loans, and rent? No. For the vast majority of people in this country, life is messy and complicated and overwhelming, and everyday families have no choice but to juggle each of these issues simultaneously.

    Progressives know that. Now is the time for them to put forth an economic agenda that will address all aspects of our economic wellbeing—not just those that have historically been politically palatable. 

    Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter at @dreaflynn.

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  • Once Again, the ACA Survived SCOTUS -- But the Fight Isn't Over Yet

    Jun 25, 2015Andrea Flynn

    Today the Supreme Court decided in favor of the government and the more than 6 million individuals who now have health coverage thanks to the Affordable Care Act’s subsidies. The 6–3 King v. Burwell decision—which determined that individuals in all states, not just those that established their own health exchanges, could be eligible for federal subsidies—is a win for President Obama, for the law more broadly, and for the health and economic security of millions of women and their families.

    Today the Supreme Court decided in favor of the government and the more than 6 million individuals who now have health coverage thanks to the Affordable Care Act’s subsidies. The 6–3 King v. Burwell decision—which determined that individuals in all states, not just those that established their own health exchanges, could be eligible for federal subsidies—is a win for President Obama, for the law more broadly, and for the health and economic security of millions of women and their families. As I described in my recent policy note, the ACA has expanded women’s access to care, improved the quality of their coverage, and in the process increased women’s economic security. Today’s decision ensures that—for the time being—the law will continue to do all of those things and more.

    The ACA expanded coverage to 16.5 million people and elevated the floor of coverage for women. Since 2010, 8.7 million women have gained maternity coverage; 48.5 million women with private insurance can access preventive services with no cost-sharing; and as many as 65 million women are no longer charged higher premiums based on pre-existing conditions. In 2013, the number of women who filled their birth control prescriptions without co-pays grew from 1.3 million to 5.1 million, and the share of women who had access to birth control with no out-of-pocket costs grew from 14 percent to 56 percent. This has been a significant improvement over the pre-ACA system in which women had to pay out of pocket for preventive services like pap smears and breast exams, were routinely charged more than men, and many couldn’t afford maternity coverage during pregnancy.

    Over the past five years the ACA has begun to ease the financial burdens of health coverage and care for women, who are more likely than men to live in poverty. Today more than two-thirds of low-wage workers are women—half of them women of color—and many work long hours with no health benefits. Wage inequality causes Black and Latina women to lose approximately $19,000 and $23,279 a year, respectively. A loss of subsidies would have been especially harmful to women of color, who represent nearly half of all uninsured women eligible for tax credits in states using the federal exchange. Those subsidies are the only path to insurance for 1.1 million Black women, approximately 2 million Latinas, nearly a quarter-million Asian women, and more than 100,000 Native American women. Many of those women live in one of three states: Florida, Georgia, or Texas.

    When women have good coverage and access to care, they are better able to make decisions about the timing and size of their families. They are able to prevent illnesses that cause them to miss work force them to lose a paycheck, and threaten their employment. They have healthier babies and children. Fewer out-of-pocket medical costs free up more money for food, childcare, education, housing, transportation, and savings. Health coverage won’t singlehandedly solve the serious challenges facing low-income women and families. Indeed, our country’s soaring inequality and persistent injustices demand sweeping social and economic reforms. But without the very basic ability to care for their bodies, visit a doctor, plan the timing and size of their families, and make independent reproductive health decisions, women will never be able to take full advantage of other economic opportunities.

    Today’s decision is especially important for women considering conservative lawmakers’ relentless attempts to roll back access to reproductive health care. Consider that just yesterday House Republicans voted to completely eliminate Title X (the federal family planning program), to expand religious exemptions allowing employers and insurers to opt out of covering anything they find morally or religiously objectionable, to implement new abortion restrictions with no exception for the life or health of pregnant women, and to renew the Hyde Amendment, which prohibits Medicaid coverage of abortion.

    So the ACA is safe for now, and the Supreme Court’s ruling will allow the law to become even more ingrained in our social and political fabric. However, we can be sure the vitriolic political opposition is not over. The GOP presidential hopefuls didn’t waste any time letting their constituents know today’s decision wouldn’t stop their attempts to undermine the law. And conservative lawmakers on the Hill will continue to push budget proposals that would unravel the law’s most important components and reduce funding for social programs critical to the wellbeing of low-income families. We should celebrate the King v. Burwell decision, but we must not stop making the case that for women and families, comprehensive, affordable health coverage—and by extension, care—is as much a matter of health as it is economic security.

    Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter at @dreaflynn.

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