CRS Reports

FY2019 Funding for CCS and Other DOE Fossil Energy R&D

Jul 2, 2018

Partisan Gerrymandering: Supreme Court Provides Guidance on Standing and Maintains Legal Status Quo

Jul 2, 2018

Section 232 of the Trade Expansion Act of 1962

Jun 29, 2018

Cyber Supply Chain Risk Management: An Introduction

Jun 29, 2018

Hospital Charity Care and Related Reporting Requirements Under Medicare and the Internal Revenue Code

Jun 28, 2018

Trade Deficits and U.S. Trade Policy

The economic effects of the U.S. trade deficit have been a topic of long-standing congressional interest. The U.S. Constitution grants authority to Congress to regulate commerce with foreign nations and to lay and collect duties, and Congress exercises this authority in numerous ways. These include oversight of trade policy and consideration of legislation to implement trade agreements and to authorize trade programs. In some cases, Congress has delegated certain authorities over trade policy to the Executive Branch: for example, to facilitate trade negotiations. As part of efforts to examine U.S. trade policy and key trading relationships, Congress and previous Administrations have focused on the trade deficit at times, but generally have not implemented specific measures to lower the trade deficit. Nor has reducing bilateral trade deficits been a major objective in evaluating or negotiating U.S. free trade agreements (FTAs) and implementing trade laws. Previous Administrations rarely linked trade deficits and import tariffs with U.S. national security. The Trump Administration, however, is using the U.S. trade deficit as a barometer for evaluating the success or failure of the global trading system, U.S. trade policy, and bilateral trade relations with various countries. It also characterizes the trade deficit as harming the performance and national security of the U.S. economy. The Trump Administration’s approach contrasts with the views of most economists, who argue that the overall U.S. trade deficit stems from U.S. macroeconomic policies that create a savings and investment imbalance in which domestic sources of capital are not sufficient to meet domestic capital demands. As such, attempting to alter the trade deficit without addressing the underlying macroeconomic issues will likely be counterproductive and create distortions in the economy. Some analysts argue that trade agreements play an important role in the U.S. trade deficit; they contend the agreements have failed to provide U.S. exporters with reciprocal treatment or have exposed U.S. producers to increased competition. Most economists, however, question both the role that trade agreements play in determining the trade deficit and the position that the trade deficit is substantially the product of unfair treatment. The Trump Administration’s approach does not rule out the possibility that some countries may not be fully abiding by international trade agreements and rules, or may be maintaining certain trade barriers. Such actions may distort market performance and erode public support for the international trade system. As a result, addressing these issues and continuing to negotiate new agreements to remove trade barriers are likely to have benefits by improving efficiency and creating a level playing field in the global trading system. Nevertheless, given the macroeconomic origins of the trade deficit, as is generally accepted, addressing such distortions may alter the composition of U.S. trade among trading partners and commodities, but would be unlikely to affect the overall U.S. trade deficit. Most economists also question the role the trade deficit plays in affecting jobs, wages, and the distribution of income in the U.S. economy. One concern expressed by economists and others is the debt accumulation associated with sustained trade deficits. They argue that the long-term impact on the U.S. economy of borrowing to finance imports depends on whether those funds are used for greater investments in productive capital with high returns that raise future standards of living, or whether they are used for current consumption. These concerns and the various policy approaches that have been used to alter the savings-investment imbalance in the economy are beyond the scope of this report. Most economists generally contend that from the perspective of the economy as a whole, both consumers and producers benefit from liberalized trade and that the gains for the economy as a whole outweigh the costs, irrespective of the bilateral trade deficit or surplus. Most economists argue that the economy as a whole operates more efficiently as a result of competition through international trade and that consumers and producers who may use imported inputs throughout the economy experience a wider variety of goods and services at varying levels of quality and price than would be possible in an economy closed to international trade. They also contend that trade may have a long-term positive dynamic effect on an economy that enhances both production and employment. Standard economic theory also recognizes that some workers and producers in the economy may experience a disproportionate share of the short-term adjustment costs that are associated with shifts in resources stemming from greater international competition. Although the attendant adjustment costs for businesses and labor are difficult to measure, some estimates suggest they may be significant over the short run and can entail dislocations for some segments of the labor force, companies, and communities. Policymakers generally have aimed to address such dislocations through specific training and other readjustment assistance programs, among other trade-related measures.

Jun 28, 2018

Health Resources and Services Administration (HRSA) FY2019 Budget Request and Funding History: Fact Sheet

The Health Resources and Services Administration (HRSA) within the Department of Health and Human Services (HHS) provides health care to individuals who are geographically isolated and/or economically or medically vulnerable. The agency’s programs target specific populations including pregnant women and their children and individuals with HIV/AIDs. HRSA is organized into five bureaus: (1) Primary Care; (2) Health Workforce; (3) Maternal and Child Health; (4) HIV/AIDS; and (5) Healthcare Systems. In addition to these bureaus, HRSA has 11 offices. Some offices focus on specific populations or health care issues (e.g., Office of Women’s Health, Federal Office of Rural Health Policy), while others provide agency-wide support or technical assistance to HRSA’s regional offices (e.g., Office of Planning, Analysis and Evaluation; Office of Regional Operations). This fact sheet focuses on the agency’s funding; a number of specific HRSA programs are described in more detail in other CRS reports.

Jun 28, 2018

U.S. Intelligence Community Establishment Provisions

Jun 27, 2018

Federal Assistance for Wildfire Response and Recovery

Jun 27, 2018

Legislative Actions to Modify the Affordable Care Act in the 111th-115th Congresses

The Patient Protection and Affordable Care Act (ACA; P.L. 111-148) was signed into law on March 23, 2010. The law comprises numerous provisions in 10 titles. The provisions in Titles I-VIII largely relate to how health care in the United States is financed, organized, and delivered. Title IX contains revenue provisions. Title X reauthorizes the Indian Health Care Improvement Act, establishes some new programs and requirements, and amends provisions included in the other nine titles of the ACA. On March 30, 2010, the Health Care and Education Reconciliation Act (HCERA; P.L. 111-152) was signed into law, which included new provisions and amended several ACA provisions. Since enactment of the ACA and HCERA, lawmakers have repeatedly debated the laws’ implementation and considered bills to repeal, defund, or otherwise amend them. This report summarizes legislative actions taken during the 111th-115th Congresses to modify the health care-related provisions of the ACA and HCERA. The first part of the report provides a brief overview of the laws’ core provisions and their impact on federal spending and health insurance coverage as context for the other material presented in the report. The second part of the report includes Table 2, which summarizes laws enacted during the 111th-115th Congresses that modified ACA or HCERA provisions. The third part of the report lists bills passed in the House or the Senate during the 111th-115th Congresses that would have modified ACA or HCERA provisions, had they been enacted. Identifying legislation that modifies the ACA and HCERA has become increasingly difficult over the years. This is because of the vast number of ACA and HCERA provisions, their complexity, and the fact that these provisions are codified in many different parts of the U.S. Code. As a result, the legislation presented in this report’s tables may not include all enacted legislation that modifies the ACA or HCERA, or all House- or Senate-passed legislation that would have modified the ACA or HCERA, had it been enacted. Due to the increasing complexity of tracking such legislation and concerns about the ability to do so authoritatively, the Congressional Research Service (CRS) does not intend to update this report.

Jun 27, 2018

TRICARE Modernization: Eligibility for the Federal Employee Dental and Vision Insurance Program

In an effort to improve TRICARE dental and vision coverage through “enhanced benefits,” in 2016 Congress expanded (P.L. 114-328) eligibility for the Federal Employees Dental and Vision Insurance Program (FEDVIP) to certain TRICARE beneficiaries. FEDVIP is a dental and vision benefit program for federal employees and annuitants. Uniformed services retirees and their family members are to be eligible to enroll in FEDVIP in November 2018, with coverage beginning on January 1, 2019. Non-active duty TRICARE beneficiaries (i.e., family members of uniformed service members, reserve component members, and survivors) enrolled in a TRICARE health plan are to be eligible to enroll in only a FEDVIP vision plan. What is FEDVIP? FEDVIP is a supplemental dental and vision benefit program managed by the Office of Personnel Management (OPM) and administered through contracts with various dental and vision insurers. In general, federal employees, U.S. Postal Service employees, federal retirees, and their family members are eligible for FEDVIP. Enrollees pay the entire cost of the premium, as well as associated cost sharing, such as deductibles, copayments, and coinsurance. FEDVIP dental plans typically include the following benefits: 100% coverage of in-network preventive services, no deductibles when using in-network dentists, no waiting periods for major dental procedures (e.g., crowns, bridges, dentures, implants, etc.), and orthodontic coverage without a 12-month waiting period or age limit (select plans). FEDVIP vision plans typically include the following benefits: routine eye exams and vision correction without referral requirements, low vision exams and aids, eyeglass frames, lenses, and contact lenses, lens options (e.g., special coatings, tinting, etc.), and discounts on laser eye surgery. What dental and vision benefits do TRICARE beneficiaries currently receive? Uniformed services retirees and their family members are eligible for the TRICARE Retiree Dental Program (TRDP). TRDP is a premium-based dental plan with 1.6 million enrollees and is managed by the Defense Health Agency (DHA) through a contract with Delta Dental. For active duty service members and their families, dental benefits are provided by military treatment facilities (MTFs) or through separate TRICARE dental contracts managed by the DHA. Reserve component members and their families are also eligible to purchase a premium-based TRICARE dental plan. The Active Duty Dental Program (which is contracted for active duty service members) and the TRICARE Dental Program (which is contracted for active duty family members and reserve component members and their families) are both administered by United Concordia. Vision services for active duty service members are provided at certain MTFs, or through TRICARE. Non-active duty TRICARE beneficiaries may receive vision services at MTFs on a space-available basis. TRICARE vision coverage is a limited benefit with cost shares varying by health plan. Which TRICARE beneficiaries will be eligible for FEDVIP? The TRDP contract for uniformed services retirees and their family members ends on December 31, 2018. Dental insurance coverage beyond 2018 for these individuals is to be available through FEDVIP. Non-active duty TRICARE beneficiaries enrolled in a TRICARE health plan (i.e., TRICARE Prime, TRICARE Select, TRICARE Reserve Select, TRICARE Retired Reserve, or TRICARE for Life) are to be eligible to enroll in FEDVIP vision plans only. How many FEDVIP plans will be available to eligible TRICARE beneficiaries? OPM is scheduled to announce available 2019 FEDVIP plans in October 2018. While FEDVIP benefits are available worldwide, some dental and vision plans may only be available in region-specific locations. For calendar year 2018, FEDVIP offered 10 dental plans: Aetna Dental, Delta Dental, Dominion Dental, EmblemHealth, FEP BlueDental, GEHA, Humana, Metlife, Triple-S Salud, and United Concordia. In 2018, FEDVIP offered four vision plans: Aetna Vision, FEP BlueVision, United Healthcare Vision, and VSP Vision Care. Will interested TRICARE beneficiaries need to enroll in FEDVIP? FEDVIP is a voluntary benefit. Eligible TRICARE beneficiaries (including current TRDP participants) interested in participating must enroll during the annual open enrollment season and pay a premium. Open enrollment is scheduled take place from November 12 to December 10, 2018, for coverage beginning on January 1, 2019. Eligible TRICARE beneficiaries may also enroll in FEDVIP or change their plan within 90 days of a Qualifying Life Event. What is the cost to the federal government for extending FEDVIP eligibility to certain TRICARE beneficiaries? The Congressional Budget Office estimates a cost savings of $14 million (discretionary spending) and $21 million (direct spending) over the FY2018-FY2026 period. Implementation costs to the Department of Defense or OPM have not been calculated; Congress may evaluate the transition of benefits administration from one agency to another. What is the cost to TRICARE beneficiaries participating in FEDVIP? TRICARE beneficiaries enrolling in FEDVIP are to continue to pay full premium costs and associated cost sharing, such as deductibles, copayments, and coinsurance. DHA and OPM are scheduled to announce individual FEDVIP plan details and costs in October 2018. Uniformed services retirees may continue to pay premiums through a post-tax allotment of their base or retirement pay. How are active duty service members impacted by FEDVIP? Active duty service members are not impacted by the expanded eligibility for FEDVIP and are to continue to have priority access to care at MTFs or through TRICARE. How are current TRICARE beneficiaries who are FEDVIP enrollees impacted? TRICARE beneficiaries currently eligible or enrolled in a FEDVIP plan are not to be impacted. Eligible beneficiaries may change their enrollment status or plan during the open enrollment season. Are members of the Reserve Component eligible to participate in FEDVIP? Reserve Component members enrolled in TRICARE Reserve Select are to be eligible to participate in a FEDVIP vision plan. Dental coverage may be purchased through the TRICARE Dental Program.

Jun 27, 2018

Tip Credit and Tip Pooling Provisions of the Fair Labor Standards Act

Jun 27, 2018

Private Flood Insurance and the National Flood Insurance Program

The National Flood Insurance Program (NFIP) is the main source of primary flood insurance coverage in the United States, collecting $3.5 billion in premiums for over five million flood insurance policies. This is in contrast to the majority of other property and casualty risks, such as damage from fire or accidents, which are covered by a broad array of private insurance companies. One of the primary reasons behind the creation of the NFIP in 1968 was the withdrawal by private insurers from providing flood insurance coverage, leaving flood victims largely reliant on federal disaster assistance to recover after a flood. While private insurers have taken on relatively little flood risk, they have been involved in the administration of the NFIP through sales and servicing of policies and claims. In recent years, private insurers have expressed increased interest in providing flood coverage. Advances in the analytics and data used to quantify flood risk along with increases in capital market capacities may allow private insurers to take on flood risks that they shunned in the past. Private flood insurance may offer some advantages over the NFIP, including more flexible flood polices, integrated coverage with homeowners insurance, or lower cost coverage for some consumers. Private marketing might also increase the overall amount of flood coverage purchased, reducing the amount of extraordinary disaster assistance necessary to be provided by the federal government. Increased private coverage could reduce the overall financial risk to the NFIP, reducing the amount of NFIP borrowing necessary after major disasters. Increasing private insurance, however, may have some downsides compared to the NFIP. Private coverage would not be guaranteed to be available to all floodplain residents, unlike the NFIP, and consumer protections could vary in different states. The role of the NFIP has historically been broader than just providing insurance. As currently authorized, the NFIP also encompasses social goals to provide flood insurance in flood-prone areas to property owners who otherwise would not be able to obtain it, and to reduce government’s cost after floods. Through flood mapping and mitigation efforts, the NFIP has tried to reduce the future impact of floods, and it is unclear how effectively the NFIP could play this broader role if private insurance became a large part of the flood marketplace. Increased private insurance could also have an impact on the subsidies that are provided for some consumers through the NFIP. The 2012 reauthorization of the NFIP (Title II of P.L. 112-141) included provisions encouraging private flood insurance; however, various barriers have remained. Legislation passed the House in the 114th Congress (H.R. 2901) which was intended to loosen requirements on private flood insurance, but it was not taken up by the Senate before the end of the 114th Congress. The NFIP is currently operating under a short-term reauthorization until July 31, 2018. A bill for longer term reauthorization (H.R. 2874) passed the House in November 2017. Three bills (S. 1313, S. 1368, and S. 1571) have been introduced in the Senate, but none have been acted on by the full Senate. H.R. 2874 includes several provisions intended to promote private flood insurance. S. 1313 mirrors some of these provisions, while the other Senate bills have fewer provisions promoting private flood insurance. This report describes the current role of private insurers in U.S. flood insurance, and discusses barriers to expanding private sector involvement. The report considers potential effects of increased private sector involvement in the U.S. flood market, both for the NFIP and for consumers. Finally, the report outlines the provisions relevant to private flood insurance in the House and Senate NFIP reauthorization bills.

Jun 26, 2018

The Special Registration for Telemedicine: In Brief

Suppress: In response to the concerns about the opioid epidemic, the Trump Administration proposed expanding access to telemedicine services such as for the prescribing of medicine used for substance abuse or mental health treatment. Telemedicine is the electronic delivery of a clinical health care service via a technological method. Section 311(h)(1) of the Controlled Substance Act (CSA), which was added by Section 3 of the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (Ryan Haight Act; P.L. 110-425), authorized the special registration for telemedicine with the goal of increasing patients’ access to practitioners that can prescribe controlled substances via telemedicine in limited circumstances. Section 802(21) of Title 21, U.S.C. defines a practitioner as a physician, dentist, veterinarian, scientific investigator, pharmacy, hospital, or other person licensed, registered, or otherwise permitted, by the United States or the jurisdiction in which he practices or does research, to distribute, dispense, conduct research with respect to, administer, or use in teaching or chemical analysis, a controlled substance in the course of professional practice or research. The registration would enable a practitioner to deliver, distribute, dispense, or prescribe via telemedicine a controlled substance to a patient who has not been medically examined in-person by the prescribing practitioner. For example in the event of an opioid overdose, a patient might need a prescription for an opioid antagonist such as naloxone from a practitioner who has never examined the patient in-person prior to the telemedicine encounter. While the CSA authorized the special registration for telemedicine, practitioners have not been able to apply for this special registration. The Drug Enforcement Administration (DEA) has yet to finalize a rule on the registration’s application process and procedures and the limited circumstances that warrant it. As a result, Congress is considering the Special Registration for Telemedicine Clarification Act of 2018 (H.R. 5483). H.R. 5483 would require the DEA, in a joint effort with the Secretary of the Department of Health and Human Services (HHS), to issue a rule on the special registration for telemedicine within one year of the enactment of the bill (as amended). On June 12, 2018, the House passed H.R. 5483 under suspension of the rules. On June 13, 2018, the Senate referred the bill to the Senate Health, Education, Labor, and Pensions Committee.

Jun 26, 2018

Trinidad and Tobago

Jun 26, 2018

Lebanese Hezbollah

Jun 22, 2018

FEMA and SBA Disaster Assistance for Individuals and Households: Application Process, Determinations, and Appeals

The Federal Emergency Management Agency’s (FEMA) Individual Assistance (IA) program and the Small Business Administration’s (SBA’s) Disaster Loan Program are the federal government’s two primary sources of financial assistance to help individuals and households recover and rebuild from a major disaster. In many cases, disaster survivors find that they need assistance from both of these programs in addition to other sources of assistance including private insurance, state and local government assistance, and assistance from private voluntary organizations. Though FEMA IA and the SBA Disaster Loan Program are separate programs administered by different agencies, in many ways they are interconnected. SBA and FEMA share real-time data on disaster grant and loan approvals to identify potential duplication of benefits while providing individuals and households with federal assistance that can be used in conjunction with each other to meet recovery needs. The two programs are also interconnected in the way they are administered to determine loan and grant eligibility. Furthermore, eligibility and assistance from one source can affect eligibility and assistance from the other source. It could be argued the overlap between the two programs provides an effective means to identify duplication and provide federal assistance; however, the overlap also causes some confusion. Some in Congress are concerned that elements of the application process are not entirely known. For instance, it is unclear to some what criteria are used to determine assistance eligibility as well as how decisions are made with respect to whether an applicant should be provided a grant or a loan (or both). It is also unclear whether FEMA and SBA determine eligibility on a case-by-case basis, or if eligibility criteria are applied uniformly. This report provides an overview of the two programs including discussions about: how declarations put the programs into effect; the application process for both programs; the criteria used by FEMA and the SBA to determine assistance; and the FEMA and SBA appeal processes. The report concludes with policy observations and considerations for Congress.

Jun 22, 2018

Jamaica

Jun 21, 2018

Overview of FY2019 Appropriations for Commerce, Justice, Science, and Related Agencies (CJS)

This report describes actions taken by the Trump Administration and Congress to provide FY2019 funding for Commerce, Justice, Science, and Related Agencies (CJS) accounts. It also provides an overview of enacted FY2018 funding for agencies and bureaus funded as part of annual CJS appropriations acts. For FY2018, Congress and the President provided a total of $72.119 billion in funding for CJS. This included $70.921 billion in regular funding provided in the Consolidated Appropriations Act, 2018 (P.L. 115-141) and $1.198 billion in emergency-designated funding provided in the Further Additional Supplemental Appropriations for Disaster Relief Requirements Act, 2018 (P.L. 115-123). The Administration requests $66.555 billion for CJS for FY2019, which is 7.7% less than total FY2018 funding and 6.2% less than regular FY2018 funding (which excludes emergency-designated funding). The Administration requests $9.797 billion for the Department of Commerce, $28.835 billion for the Department of Justice, $27.372 billion for the science agencies, and $551 million for the related agencies. The Administration’s budget proposes eliminating funding for several CJS agencies and accounts, including the Economic Development Administration and the Legal Services Corporation. The Administration’s budget proposes moving funding for the High Intensity Drug Trafficking Areas program from the Office of National Drug Control Policy to the Drug Enforcement Administration, closing the Community Oriented Policing Services (COPS) Office and moving its responsibilities to the Office of Justice Programs (OJP), and a new account structure for the National Aeronautics and Space Administration. The bill reported by the House Committee on Appropriations (H.R. 5952) would provide a total of $73.923 billion for CJS for FY2019, an amount that is 4.2% greater than regular FY2018 funding (which excludes emergency-designated funding) and 11.1% greater than the Administration’s request. The bill would provide $12.106 billion for the Department of Commerce, $31.113 billion for the Department of Justice, $29.728 billion for the science agencies, and $976 million for the related agencies. The committee largely declined to adopt many of the Administration’s proposals to eliminate funding for several CJS agencies and accounts, though the committee-reported bill would move funding for the COPS program to OJP and it includes the Administration’s proposed account structure for NASA. The bill reported by the Senate Committee on Appropriations (S. 3072) would provide a total of $72.648 billion for CJS for FY2019, an amount that is 2.4% more than regular FY2018 funding (which excludes emergency-designated funding) and 9.2% more than the Administration’s request. The bill would provide $11.572 billion for the Department of Commerce, $30.699 billion for the Department of Justice, $29.400 billion for the science agencies, and $977 million for the related agencies. The Senate Committee on Appropriations largely declined to adopt many of the proposals put forth by the Administration in its FY2019 budget. Unlike the House committee-reported bill, S. 3072 would fund the COPS program through its own account and the committee did not include the Administration’s new account structure for NASA.

Jun 20, 2018

Cambodian Elections

Cambodian National Assembly elections, scheduled for July 29, 2018, are expected to be a setback for the country’s prospects for democratization. The ruling political party, the Cambodian People’s Party (CPP), banned the largest opposition party in 2017 and will run virtually unopposed. Steps taken by the Trump Administration and Congress to respond to the Cambodian government’s “anti-democratic” actions have been met with defiance by the Cambodian leader, Hun Sen. Political History Between 1975 and 1991, Cambodia endured the four-year reign of the Communist Party of Kampuchea, also known as the Khmer Rouge, during which an estimated two million Cambodians died, as well as Vietnamese invasion and occupation, and civil war. The Paris Peace Agreement, signed by Cambodia and 18 other nations pledging to support the country’s sovereignty and reconstruction on October 23, 1991, ended the conflict. It also established a “liberal democracy” with “periodic and genuine elections.” Since the United Nations administered the first post-war national elections in 1993, the Kingdom of Cambodia has made fitful progress in its political and social development, including the conduct of elections and growth of civil society. Official Development Assistance (ODA), which totaled more than $10 billion between 1995 and 2016 (according to OECD data), helped restore and develop Cambodian political, social, and economic institutions, most of which were destroyed under the Khmer Rouge (1975-1979). In recent years, assistance from China has roughly matched total annual ODA flows from OECD member countries, and it appears that Prime Minister Hun Sen has embraced Chinese assistance as an alternative to Western aid, which often comes with conditions for democratic governance. Recent Political Developments The Cambodian National Rescue Party (CNRP), a union of two opposition parties led by Sam Rainsy and Kem Sokha, made significant gains in the 2013 parliamentary elections and 2017 local elections. The CNRP’s strength reflected a younger and more globalized electorate that is less focused on Cambodia’s past turbulence, more concerned about corruption and inequality, and more demanding about government accountability and performance. Cambodia also has been under pressure to improve the quality of its elections, with many Western governments, including the United States, providing assistance to increase participation, improve transparency, and ensure polls are free and fair. The threat of a CNRP victory in 2018 appears to have compelled Hun Sen, who often has employed undemocratic means to stay in power, to crack down on the opposition. In November 2017, the Supreme Court of Cambodia made a ruling that dissolved the CNRP for “conspiring with the United States to overthrow the government.” U.S. Ambassador to Cambodia William Heidt said Hun Sen’s accusations that the U.S. government is attempting to overthrow his government are “inaccurate, misleading, and baseless.” Since 2008, former CNRP president Sam Rainsy has faced several defamation charges regarded by many observers as politically motivated, and has spent most of his time in exile. In December 2017, Sam was charged with treason for posting a video on social media urging security personnel not to “obey orders from any dictators if they order you to shoot and kill innocent people.” He has called upon Cambodians to boycott the 2018 elections. Former CNRP vice-president Kem Sokha has been detained since September 2017 awaiting trial for treason, or conspiracy with a foreign power, allegedly for collaborating with the United States to foment a popular overthrow of the CPP. The Cambodian government has placed increasing restrictions on political and social activism, civil society, free speech, and foreign-funded democracy programs. Since late 2015, more than 25 opposition Members and government critics have been arrested. In 2017, the government ordered the Cambodia Daily, known as an opposition newspaper, to shut down, ostensibly for failing to pay taxes. In 2017, the Cambodian Foreign Ministry expelled the National Democratic Institute (NDI), which receives U.S. funding and was engaged in democracy programs in Cambodia, on the grounds that the U.S.-based organization was not registered with the government. In 2017, the government closed more than one dozen Cambodian radio stations that sold air time to Voice of America (VOA) and Radio Free Asia (RFA). RFA, facing political and economic pressure from the government, closed its Phnom Penh office. In May 2018, the government made its first arrest under a lèse-majesté law, passed by the National Assembly in February 2018, which makes insulting the monarch a crime. U.S. Policy Responses U.S. relations with Cambodia have become strained in recent years in light of Hun Sen’s suppression of political opponents and growing embrace of China. The Trump Administration announced in December 2017 that the U.S. government would “restrict entry into the United States of those individuals involved in undermining democracy in Cambodia.” Pursuant to Executive Order 13818, which implemented the Global Magnitsky Human Rights Accountability Act (Section 1261 of P.L. 114-328), in June 2018 the U.S. Department of the Treasury sanctioned Cambodian General Hing Bun Hieng, commander of Hun Sen’s bodyguard unit, “for being the leader of an entity involved in serious human rights abuses.” Sanctioned individuals are denied entry into the United States, and any assets that they hold in the United States are blocked. The Consolidated Appropriations Act, 2018 (P.L. 115-141) imposes democracy-related and other conditions upon U.S. assistance to the government of Cambodia, as would S. 2412, the Cambodia Accountability and Return on Investment Act of 2018, which is pending in the Senate. H.R. 5754, the Cambodia Democracy Act of 2018, which is pending in the House, would impose visa restrictions and block assets of senior government officials who have undermined democracy or committed serious human rights violations. S.Res. 279, passed by the Senate on November 16, 2017, urges the Department of the Treasury to consider placing all senior Cambodian government officials implicated in the suppression of democracy and human rights abuses on the Specially Designated Nationals (SDN) list; calls on the Cambodian government to release opposition leader Kem Sokha; and supports free and fair elections in 2018 monitored by international observers. A similar resolution, H.Res. 661, is pending in the House.

Jun 20, 2018

Agriculture and Related Agencies: FY2019 Appropriations

The Agriculture appropriations bill funds the U.S. Department of Agriculture (USDA) except for the Forest Service. It also funds the Food and Drug Administration (FDA) and—in even-numbered fiscal years—the Commodity Futures Trading Commission (CFTC). Agriculture appropriations include both mandatory and discretionary spending. Discretionary amounts, though, are the primary focus during the bill’s development, since mandatory amounts are generally set by authorizing laws such as the farm bill. The largest discretionary spending items are the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); agricultural research; FDA; rural development; foreign food aid and trade; farm assistance programs; food safety inspection; conservation; and animal and plant health programs. The main mandatory spending items are the Supplemental Nutrition Assistance Program (SNAP), child nutrition, crop insurance, and the farm commodity and conservation programs paid by the Commodity Credit Corporation. For FY2019, both the House and Senate Appropriations Committees reported Agriculture appropriations bills (H.R. 5961, S. 2976) in May 2018. Neither bill has gone to the floor. The Trump Administration requested $17 billion for discretionary-funded accounts within the jurisdiction of Agriculture appropriations, which would be a reduction of $6.2 billion from FY2018 (-27%). In general, both the House-reported and Senate-reported bills reject most of the Administration’s proposed reductions. The discretionary total of the House-reported bill is $23.23 billion, which would be $14 million less than enacted in FY2018 (-0.1%). The discretionary total of the Senate-reported bill is also $23.23 billion. However, the Senate bill’s total would be $229 million more than enacted in FY2018 (+1%) on a comparable basis that excludes the CFTC. The Senate-reported bill would provide about $250 million more than the House-passed bill on a comparable basis. The primary changes at the agency level that comprise the differences between the bills and from FY2018 include the following: Both the House and Senate bills would increase FDA appropriations (+$308 million in the House bill; +$159 million in the Senate bill), though neither continues extra funding for the opioid crisis that was in the FY2018 appropriation. Both bills increase appropriations for animal and plant health programs (+$16 million to +$19 million). The House bill would provide more base funding for rural water and waste disposal (+$81 million), but none of the extra money that was provided separately in FY2018. The Senate bill would not change the base funding for rural water but continues $400 million of the extra funding from last year. For rural broadband, both the House and Senate bills would continue extra funding from a FY2018 pilot ($550 million in the House bill; $425 million in the Senate bill). The House bill would increase appropriations for agricultural research (+$79 million), and the Senate bill would increase Agricultural Research Service programming (+98 million) but would not provide any money for construction (-$141 million). Both bills provide less for WIC (-$175 million in the House bill, and -$25 million in the Senate bill), though the Senate bill has a larger rescission from prior-year WIC funds than does the House bill. The House bill would reduce base funding for the international Food for Peace program (-$100 million) and does not renew extra funding provided last year (-$116 million), while the Senate bill would keep it constant overall. The appropriations also carries mandatory spending—largely determined in separate authorizing laws—that would total $122 billion. Thus, the overall total of the both bills is about $145 billion. Both bills contain policy provisions affecting disaster programs, rural definitions, industrial hemp, animal products, nutrition programs, dietary guidelines, CFTC, and tobacco products.

Jun 18, 2018

Railroad Retirement Board: Retirement, Survivor, Disability, Unemployment, and Sickness Benefits

Jun 18, 2018

Human Rights and Anti-Corruption Sanctions: The Global Magnitsky Human Rights Accountability Act

Jun 15, 2018

FY2020 Foreign Operations Appropriations: Targeting Foreign Corruption and Human Rights Violations

Jun 14, 2018

Social Security Overview

Jun 13, 2018

The June 12 Trump-Kim Jong-un Summit

On June 12, 2018, President Donald Trump and North Korean leader Kim Jong-un met in Singapore to discuss North Korea’s nuclear program, building a peace regime on the Korean Peninsula, and the future of U.S. relations with North Korea (known officially as the Democratic People’s Republic of Korea, or DPRK). During their summit, the first-ever meeting between leaders of the two countries, Trump and Kim issued a brief joint statement in which Trump “committed to provide security guarantees to the DPRK,” and Kim “reaffirmed his firm and unwavering commitment to complete denuclearization of the Korean Peninsula.” The Singapore document is shorter on details than previous nuclear agreements with North Korea and acts as a statement of principles in four areas Normalization: The two sides “commit to establish” new bilateral relations. Peace: The United States and DPRK agree to work to build “a lasting and stable peace regime.” Denuclearization: North Korea “commits to work toward complete denuclearization of the Korean Peninsula,” as was also promised in an April 2018 summit between Kim and South Korean leader Moon Jae-in. POW/MIA remains: The two sides will work to recover the remains of thousands of U.S. troops unaccounted for during the Korean War. Speaking at a press conference without Kim after the summit, Trump said U.S.-DPRK denuclearization negotiations would continue and resume at an early date; Kim pledged to destroy a “major missile engine testing site”; He will invite Kim to the White House; He raised human rights issues with Kim, though “relatively briefly compared to denuclearization.” Trump appeared to downplay the state of DPRK human rights by saying that human rights conditions are also “rough in a lot of places”; The United States would suspend annual U.S.-South Korea military exercises, which Trump called “war games” and “provocative,” during nuclear negotiations. He said the move, which was not accompanied by any apparent commensurate move by Pyongyang and reportedly surprised South Korea and U.S. military commanders, would save “a tremendous amount of money.” Trump also expressed a hope of eventually withdrawing the approximately 30,000 U.S. troops stationed in South Korea. Postsummit remarks by the Administration created confusion about whether all exercises or only some types will be suspended. Notable items not present in the statement or Trump’s remarks include details about a timeframe or verification protocols for denuclearization, and a commitment by Kim to dismantle the DPRK’s ballistic missile program. Outcomes The summit highlighted the change from 2017, when escalating tensions between North Korea and the United States led to increasingly tight U.S. and international sanctions and fears of a military conflict. In addition to the reduction of tensions, both sides can point to specific gains that have occurred since early 2018. U.S. gains include Kim Jong-un’s public statements committing to begin a process of negotiating complete denuclearization; North Korea’s moratorium on nuclear and missile testing while dialogue continues; North Korea’s apparent destruction in May of its Pyunggye-ri nuclear test site before international journalists; Kim’s statement that he would destroy a missile test site; and North Korea’s release of three U.S. detainees and agreement to restart the POW/MIA recovery program, which the United States suspended in 2005. DPRK gains include Breaking free from its diplomatic isolation. Following Trump’s March 2018 announcement that he would hold a summit, Kim has re-established friendly relations with China and Russia, and held two summits with South Korean President Moon; Boosting Kim’s legitimacy and prestige by using nuclear and missile advancements to obtain a meeting with the U.S. President as an equal; Loosening enforcement of sanctions against the DPRK economy; An expectation of future foreign investment and economic and energy assistance if it denuclearizes; A U.S. promise to provide “security guarantees”; and Trump’s announcement of a unilateral cessation of U.S.-South Korean military exercises and his statement that he hopes to withdraw all U.S. forces from South Korea. Questions The summit meeting raises numerous questions, including Did North Korea promise to abandon its nuclear weapons? What specific steps are needed to realize the DPRK’s commitment “to work toward complete denuclearization?” [emphasis added] Should a timeline be set? Will this be subject to international verification? Some Korea-watchers worry Kim will use a prolonged negotiation, dismantlement, and verification process as a delaying tactic while sanctions pressure eases. What does “denuclearization of the Korean Peninsula” mean? Does this mean the same thing to both countries? Does this phrasing have implications for the U.S. alliance with South Korea? How will talks about denuclearization, a possible peace declaration, and U.S.-DPRK normalization be sequenced and/or linked, if at all? Will the Trump Administration link these talks to inter-Korean talks, and vice versa? Will the United States be able to maintain a global pressure coalition while engaging with North Korea? Although Trump Administration officials have said international pressure against North Korea will continue until North Korea either denuclearizes or takes concrete and irreversible steps (as yet undefined) to denuclearize, the incentives for countries to maintain the intensity of the pressure campaign, and scrutiny of countries’ implementation of sanctions, arguably have diminished. What are the implications for U.S. alliances, especially with South Korea? Combined with his apparent lack of prior consultation with Seoul, Trump’s statements on U.S. troops in South Korea are likely to weaken U.S. allies’ confidence in the durability of U.S. security commitments and provide China and Russia with an argument against future U.S. exercises with allies. Should negotiations include North Korea’s other objectionable practices and programs, like the DPRK’s human rights record, cyberattacks, chemical and biological weapons, and sizeable conventional forces? What will Congress’s role be? Congress could play a direct role in several aspects of an evolving U.S.-DPRK relationship. In addition to approving funding to implement various U.S. commitments and new U.S. diplomatic offices in North Korea, Secretary of State Mike Pompeo has testified that a U.S.-DPRK nuclear agreement would be submitted to the Senate as a treaty. Congress could also support or oppose moves not to enforce or lift sanctions. Congress may also weigh in on moves that affect U.S. alliances with South Korea and Japan.

Jun 12, 2018

International Narcotics Trafficking Sanctions: An Overview

Jun 12, 2018

Science, Technology, Engineering, and Mathematics (STEM) Education: An Overview

The term STEM education refers to teaching and learning in the fields of science, technology, engineering, and mathematics. It typically includes educational activities across all grade levels—from pre-school to post-doctorate—in both formal (e.g., classrooms) and informal (e.g., afterschool programs) settings. Federal policymakers have an active and enduring interest in STEM education, and the topic is frequently raised in federal science, education, workforce, national security, and immigration policy debates. Various attempts to assess the federal STEM education effort have produced different estimates of its scope and scale. These efforts have identified between 105 and 254 STEM education programs and activities at 13 to 15 federal agencies. Annual federal appropriations for STEM education are typically in the range of $2.8 billion to $3.4 billion. All published inventories identify the Department of Education, National Science Foundation, and the Department of Health and Human Services as key agencies in the federal effort. Over half of federal STEM education funding is intended to serve the needs of postsecondary schools and students; the remainder goes to efforts at the K-12 educational level. Much of the funding for postsecondary students is in the form of financial aid, including fellowships and grants. It is often suggested that the United States performs poorly in STEM education, but the data paint a complex picture. By some measures, U.S. students appear to be doing quite well. For example, overall graduate student enrollments in science and engineering (S&E) grew 15% over the last decade. Further, S&E degree attainment for groups traditionally underrepresented in STEM majors—such as Hispanic/Latino, African American, and female students—grew by 122%, 35%, and 37%, respectively. On the other hand, concerns remain about persistent academic achievement gaps between various demographic groups, STEM teacher quality, the rankings of U.S. students on international STEM assessments, foreign student enrollments and increased educational attainment in other countries, and the ability of the U.S. STEM education system to meet domestic demand for STEM labor. Federal STEM education policy concerns center on broad issues—such as governance of the federal effort and broadening participation of underrepresented populations—as well as those that are specific to STEM education at the elementary, secondary, and postsecondary levels. Governance concerns focus on perceived duplication and lack of coordination in the federal effort; broadening participation concerns tend to highlight achievement and participation gaps between various demographic groups. A variety of policy options have garnered attention in recent years, relating to elementary, secondary, and postsecondary STEM education. At the K-12 level, these include proposals to address educational accountability, standards, and teacher quality. At the postsecondary level, proposals center on efforts to remediate and retain students in STEM majors. This report is intended to serve as a primer on existing STEM education policy issues and programs. It covers the federal STEM education effort and the condition of STEM education in the United States, and examines selected policy issues central to the contemporary federal conversation about STEM education. It also provides a history of major federal legislative efforts impacting STEM education.

Jun 12, 2018

Costa Rica: An Overview

Jun 11, 2018

CIA Ethics Education: Background and Perspectives

Jun 11, 2018

Capital Markets, Securities Offerings, and Related Policy Issues

U.S. capital markets are the largest and considered to be the most efficient in the world. Companies rely heavily on capital access to fund growth and create jobs. As the principal regulator of U.S. capital markets, the Securities and Exchange Commission (SEC) requires that offers and sales of securities either be registered with the SEC or be undertaken with an exemption from registration. Registered securities offerings, often called public offerings, are available to all types of investors and have more rigorous disclosure requirements. By contrast, securities offerings that are exempt from SEC registration are referred to as private offerings and are mainly available to more sophisticated investors. Some policymakers have concluded that changes in market trends require updated regulations governing capital access. Specifically, the number of publicly listed U.S. companies has declined by half over the last two decades, and small- to medium-sized companies are said to have more difficulty accessing capital relative to larger companies. Additionally, new capital access tools not previously part of the SEC regulatory regime, such as crowdfunding and initial coin offerings, have emerged. These new tools are especially helpful for small businesses and startups. The bipartisan Jumpstart Our Business Startups Act of 2012 (JOBS Act; P.L. 112-106) scaled regulation for smaller companies and reduced regulations in general for certain types of capital formation. It established a number of new options to expand capital access through both public and private offerings, including a new provision for crowdfunding. Following enactment of the JOBS Act, the public and private offering dichotomy has started to blur, and securities regulation has become increasingly tailored to suit companies of different sizes and with different needs. However, concerns over capital formation have persisted, given that the number of IPOs remained at far below long-term average levels post-JOBS Act and smaller businesses continue to face capital access pressure. To address these concerns, Congress has considered numerous legislative proposals to further expand the scaled approach, with some proposals building on existing JOBS Act provisions. The policy debate surrounding these proposals often focuses on expanding capital access and protecting investors, two of the SEC’s core missions. Expanding capital access promotes capital formation and “democratizes” capital markets by allowing for greater access of investment opportunities for more investors. Investor protection is considered to be important for healthy and efficient capital markets because many investors would be more willing to provide capital, and even at a lower cost, if they could expect enforceable contracts for their investments through a transparent process. At times, expanding capital access can come at the expense of investor protection. For example, proposals that reduce the registration and disclosures that a company must make can decrease the company’s compliance costs and increase the speed and efficiency of capital formation. But the reduced disclosures may expose a company’s investors to additional risks if they are not receiving information that is important to making informed investment decisions. This report analyzes legislative proposals that would generally affect the terms and amounts of capital provided to companies by investors. It analyzes a number of current legislative proposals and agency actions to expand both public and private securities offerings through amendments to program design, investor access, and disclosure requirements, among other provisions.

Jun 8, 2018

UPDATE: Termination of Temporary Protected Status for Sudan, Nicaragua, Haiti, and El Salvador: Key Takeaways and Analysis

Jun 8, 2018

Potential Hydrofluorocarbon Phase Down: Issues for Congress

Jun 7, 2018

Forest Service Assistance Programs

The U.S. Department of Agriculture (USDA) has numerous programs to support the management of state and private forests. These programs are under the jurisdiction of the House and Senate Agriculture Committees and are often examined in the periodic legislation to reauthorize agricultural programs, commonly known as farm bills. For example, the 2014 farm bill repealed, reauthorized, or modified many of these programs. The House version of the 2018 farm bill, the Agriculture and Nutrition Act of 2018 (H.R. 2), contains a forestry title (Title VIII) that would reauthorize, modify, and establish new forestry assistance programs. Forestry-specific assistance programs (in contrast to agriculture conservation programs that include forestry activities) are primarily administered by the USDA Forest Service (FS), with permanent authorization of funding as needed. Some programs have been combined through the appropriations process or for administration purposes. These programs generally provide technical and educational assistance such as information, advice, and aid on specific projects. Other programs provide financial assistance, usually through grants (with or without matching contributions from recipients) or cost-sharing (typically through state agencies, with varying levels of contributions from recipients). Many programs provide both technical and financial assistance. Some of the assistance programs provide support for planning and implementing forestry and related land management practices (e.g., Forest Stewardship, Urban and Community Forestry). Other programs provide assistance for forest restoration projects that involve more than one jurisdiction and address regional or national priorities (e.g., Landscape Scale Restoration). Other programs provide support for protecting forestlands from wildfires, insects and diseases, and from converting forestland to nonforest uses (e.g., Community Forest and Open Space Conservation, Forest Legacy). The Forest Health program provides support for protecting both federal and nonfederal forests from continuing threats, although most of the funding goes to federal forests. Programs also exist to enhance state and rural wildfire management capabilities (e.g., State Fire Assistance and Volunteer Fire Assistance) and to promote the use of forest products (e.g., Wood Innovation). International Forestry is often included as a forestry assistance program, because it provides technical forestry help and because it is funded through the FS appropriations account for forestry assistance programs (State and Private Forestry). Most of the programs provide assistance to state partner agencies. The state agencies can use the aid on state forestlands or to assist local governments or private landowners. How the states use the resources is largely at the discretion of the states, within the authorization of each program and consistent with the national priorities for state assistance established by Congress in the 2008 farm bill. Overall funding for the Forest Service’s forestry assistance programs in FY2018 was $355.1 million, an 8% increase over FY2017 funding of $328.9 million. The Trump Administration requested $197.4 million in funding for FY2019. Overall funding has declined over the past 15 years, however, in both real and constant dollars. Over that time, funding for forestry assistance programs has ranged between 5% and 9% of the total annual Forest Service discretionary appropriation.

Jun 7, 2018

Endangered Species Considerations in Pesticide Use Restrictions: Background and Legislation

Jun 7, 2018

Background Information on Health Coverage Options Addressed in Executive Order 13813

On October 12, 2017, President Trump issued Executive Order (E.O.) 13813, entitled “Promoting Healthcare Choice and Competition Across the United States.” E.O. 13813 directs specified agencies to consider regulatory or sub-regulatory approaches to expand access to three unrelated, private-sector health coverage options: association health plans (AHPs); short-term, limited-duration insurance (STLDI); and health reimbursement arrangements (HRAs). This report answers frequently asked questions (FAQs) about E.O. 13813 and subsequent rulemaking and provides background information about AHPs, STLDI, and HRAs. Association health plan is an umbrella term that represents a spectrum of arrangements that provide health coverage to a collective body of employers or individuals (e.g., self-employed persons). AHP coverage may be provided through different types of organizations, including but not limited to trade associations, professional societies, and chambers of commerce. Given the absence of a federal definition for either association health plan or association coverage, applicable federal agencies have indicated that a given AHP should be regulated according to the characteristics of the organization offering the AHP coverage and plan enrollees. Generally, association coverage is addressed through sub-regulatory guidance. The vast majority of AHPs provide either individual or small-group coverage, as determined by federal regulatory agencies. On January 5, 2018, the Department of Labor issued a proposed regulation that would amend the federal definition of employer. The proposed amendment potentially could allow certain AHPs that currently are regulated as individual or small-group coverage to be regulated as large-group coverage instead, and it could encourage the formation of new AHPs. Such a change would reduce the overall scope of federal requirements applicable to those AHPs. AHP proponents argue that the proposed changes would expand coverage options and reduce premiums for certain consumers. AHP opponents argue that those changes would raise premiums for consumers with greater health care needs, particularly in the individual market. Short-term, limited-duration insurance is a type of health insurance that generally is designed to fill gaps in health insurance coverage, particularly for individuals transitioning from one type of coverage to another. STLDI is defined in regulations as health insurance coverage with a maximum duration of three months (including any extensions a consumer may request) that is marketed and issued with disclaimer language about the coverage not being considered minimum essential coverage for purposes of avoiding the individual mandate penalty. Beyond this definition, STLDI is not subject to federal requirements applicable to health coverage. On February 21, 2018, the Departments of Health and Human Services (HHS), Labor, and the Treasury jointly issued proposed regulations that would increase the maximum duration of STLDI from 3 months to 12 months, make policy extensions easier, and modify the required disclaimer language. Proponents of expanding access to STLDI argue that these changes would provide more insurance options for consumers; opponents of the proposed changes have emphasized the potential negative impacts on the risk pool for the individual market for comprehensive coverage. Health reimbursement arrangements are employer-established arrangements that pay or reimburse employees for substantiated medical care expenses up to a maximum dollar amount. HRAs are funded solely by employers; employees cannot contribute to HRAs. Payments and reimbursements from an HRA for an employee’s substantiated medical care expenses (and those of the employee’s spouse and dependents) are excluded from the employee’s income and employment taxes. In general, employers may offer to employees only HRAs that are integrated with another group health plan (that is not an HRA). Although HRAs are governed under the federal tax code, they are not explicitly authorized by legislation. Generally, HRAs are addressed through sub-regulatory guidance. As of the publication date of this report, the agencies identified in E.O. 13813 (Treasury, Labor, and HHS) have not published guidance or proposed regulation on HRAs in response to the order.

Jun 6, 2018

Increase in Illicit Fentanyl Overdose Deaths

Fentanyl, heroin, and some prescription painkillers (such as morphine and oxycodone) belong to the class of drugs known as opioids, which act on receptors in the brain important in regulating pain and emotion. Opioids have susceptibility for abuse and potential for overdose. In 2016, more than 42,000 of the nearly 64,000 drug overdose deaths in the United States involved opioids. Led by fentanyl, a synthetic opioid 50-100 times more potent than morphine, synthetic opioids emerged as the leading cause of opioid-related overdose deaths in 2016. The steep increase in deaths involving fentanyl is seen as a “new chapter” in the opioid epidemic. What Is Fentanyl? Currently, two types of fentanyl exist: (1) pharmaceutical fentanyl used to treat pain and (2) illicit, nonpharmaceutical fentanyl used illegally as a recreational drug. Pharmaceutical fentanyl is a Schedule II narcotic approved by the Food and Drug Administration (FDA) as an analgesic for severe pain. While some pharmaceutical fentanyl is diverted from legitimate use, most fentanyl-related overdoses are associated with illicit, nonpharmaceutical fentanyl. Illicit fentanyl is abused by itself or mixed with heroin or other drugs, sometimes without the consumer’s knowledge. Illicit fentanyl comes in many chemical formulations, known as analogues. The availability of illicit fentanyl over the past several years has increased substantially. There has also been a rise in the amount of illicit fentanyl mixed with other drugs such as heroin and cocaine or pressed into counterfeit painkillers. Rise of Fentanyl Overdoses Until 2001, overdose deaths attributed to fentanyl were relatively uncommon compared to heroin and prescription drugs. The Centers for Disease Control and Prevention (CDC) distinguishes between opioid-involved deaths by the following categories: (1) heroin, (2) natural and semisynthetic opioids (including most prescription painkillers), (3) methadone, and (4) synthetic opioids other than methadone. Deaths involving synthetic opioids other than methadone, like fentanyl, rose gradually from 2001 through 2013. Beginning in 2013, the number of deaths involving synthetic opioids rose precipitously. Dominated by fentanyl, deaths involving synthetic opioids increased 625% between 2013 and 2016, according to the CDC (see Figure 1). By 2016, synthetic opioids accounted for 19,413 deaths, surpassing heroin and prescription drugs as the number one cause of opioid-related deaths. According to a National Center for Health Statistics (NCHS) Data Brief, the rate of overdose deaths involving synthetic opioids increased from 1.0 per 100,000 in 2013 to 6.2 per 100,000 in 2016. Figure 1. Opioid-Related Deaths Number of Deaths by Type of Opioid 1999-2016 / Source: CRS presentation of data from the CDC NCHS Data Brief. Notes: Deaths involving more than one opioid category are counted in both categories. According to the CDC, the opioid epidemic is “spreading geographically and increasing across demographic groups.” In 2016, overdose deaths increased in all demographic categories, including all age groups over 15 years old, both sexes, all racial or ethnic groups, and across all levels of urbanization. In the last half of 2016, fentanyl was detected in 56.3% of opioid overdose deaths in 10 states included in the CDC’s Enhanced State Opioid Overdose Surveillance program. Fentanyl is exponentially more potent, and the maximum physical effects of the drug, including respiratory depression, may occur faster than intravenous heroin. The CDC and FDA report that in many cases multiple doses of naloxone—an emergency overdose reversal medication—may be needed to revive a patient during a fentanyl overdose. Figure 2 depicts the physical size of a lethal dose of fentanyl. Figure 2. Size of a Lethal Dose of Fentanyl / Source: Drug Enforcement Administration Multi-Media Library: Fentanyl. Notes: Two milligrams of fentanyl—here compared to a U.S. penny—is a lethal dose for most people. Fentanyl causes respiratory depression, which can cause breathing to stop completely, resulting in death. Availability of Fentanyl According to the CDC, a “substantial portion” of the increase in deaths due to synthetic opioids appears to be related to the availability of illicit fentanyl. Areas reporting large increases in illicit fentanyl seizures have also reported sharp increases in fentanyl-related deaths. Fentanyl is less expensive and easier to manufacture than heroin. It is shipped in small amounts, which reduces risks of detection. Nonpharmaceutical fentanyl is widely available in the United States. It is manufactured in China and likely Mexico, and commonly transported in the mail directly from China (or from China through Canada) and smuggled across the southwest border from Mexico. It is often mixed with or sold as heroin, and is increasingly available in counterfeit pills that resemble prescription opioids. The increased potency of synthetic fentanyl compounds, which when combined with heroin and other synthetic opioids are especially deadly, is extremely dangerous. Law enforcement expects that the fentanyl market will continue to expand in the future as new fentanyl analogues are created. Policy Considerations The rise in deaths due to fentanyl is an area of interest for Congress. Members have introduced over 150 bills related to opioids during the 115th Congress. Since nonmedical use of prescription opioids remains the most common pathway to heroin use, policies curbing inappropriate prescribing may reduce further addictions and illicit opioid use; however, restricting access to prescription opioids may result in those already dependent on opioids pursuing illicit forms, including fentanyl. Preventing further addiction by regulating prescribing practices, while also ensuring that individuals with dependency issues do not seek illicit and more fatal sources elsewhere, has been referred to as “two major and urgent – yet partly conflicting – tasks.” Emphasizing one, without balancing the other, may exacerbate the problem. Some patient advocates also warn that restricting opioid prescribing practices may deny patients helpful medications for pain management. Additional options include improving reporting of drug overdose mortality data, increasing access to naloxone, and improving the ability to test for the presence of fentanyl in other substances. Another possible strategy is to reduce the availability of illicit fentanyl and other opioids by bolstering law enforcement efforts. Among several recommendations it made in a report to Congress, the Government Accountability Office (GAO) proposed that U.S. Customs and Border Protection (CBP) assess the volume of illicit fentanyl at each port of entry to efficiently target resources for interdiction efforts. It further recommended that law enforcement agencies, such as the Drug Enforcement Administration, establish performance measures to assess their strategies for dealing with the illicit opioid supply. Such measures, however, may be difficult to develop, partly because the opioid threat continues to evolve and the nature of the threat varies by region.

Jun 6, 2018

Congressionally Directed Medical Research Programs Funding for FY2018

Jun 5, 2018

The Opioid Epidemic and the Food and Drug Administration: Legal Authorities and Recent Agency Action

According to the Centers for Disease Control and Prevention (CDC), the annual number of drug overdose deaths in the United States involving opioids has more than quadrupled since 1999. CDC estimates that in 2016, more than 63,000 people died from a drug overdose, and more than 42,000 of these deaths involved prescription or illicit opioids. A report issued in November 2017 by the President's Commission on Combating Drug Addiction and the Opioid Crisis also observed that “[t]he crisis in opioid overdose deaths has reached epidemic proportions in the United States ... and currently exceeds all other drug-related deaths or traffic fatalities.” In combating the opioid epidemic, one central challenge for state and federal regulators is striking a balance between taking aggressive action to fight opioid misuse and addiction, while simultaneously protecting patients who experience severe pain. The Food and Drug Administration (FDA)—the executive agency tasked with protecting the public health by ensuring the nation’s drug supply is safe and effective—has a pivotal role in addressing these issues. This report focuses on FDA as a key player in federal efforts to curb the opioid epidemic. The report provides an overview of FDA’s role in approving new prescription drugs, including certain challenges presented by the approval and regulation of opioid products. Next, the report addresses FDA’s multifaceted approach in its response to the opioid epidemic, the agency’s use of its existing legal authorities under the Federal Food, Drug, and Cosmetic Act (FD&C Act or Act), and recent agency action taken to target the misuse of opioid medications. The report concludes with a discussion of selected opioid-related legislation in the 115th Congress that would amend the FD&C Act.

Jun 5, 2018

Legislative Branch: FY2019 Appropriations

The legislative branch appropriations bill provides funding for the Senate; House of Representatives; Joint Items; Capitol Police; Office of Compliance; Congressional Budget Office (CBO); Architect of the Capitol (AOC); Library of Congress (LOC), including the Congressional Research Service (CRS); Government Publishing Office (GPO); Government Accountability Office (GAO); Open World Leadership Center; and the John C. Stennis Center. The FY2019 legislative branch budget request of $4.960 billion was submitted on February 12, 2018. The budget request levels were developed prior to the enactment of full-year appropriations for FY2018. Agency assessments for FY2019 may subsequently have been revised—for example, to account for items funded or not funded in the FY2018 Consolidated Appropriations Act. Subsequent discussions may vary from the levels or language included in the budget request due to this timing. For purposes of this report, however, FY2019 requested levels refer to the requested levels originally submitted unless otherwise noted. By law, the President includes the legislative branch request in the annual budget submission without change. The House Appropriations Committee’s Legislative Branch Subcommittee held hearings in April to consider the FY2019 legislative branch requests. On May 8, 2018, the House Appropriations Committee held a markup of the bill. Three amendments were considered: one, a manager’s amendment, was adopted; one amendment was not adopted; and one amendment was withdrawn. The bill was ordered reported. The House-proposed total for legislative branch activities, excluding Senate items, is $3.811 billion (H.R. 5894, H.Rept. 115-696). The Senate Appropriations Committee’s Legislative Branch Subcommittee held hearings in April and May to consider FY2019 legislative branch requests. The FY2018 Consolidated Appropriations Act (P.L. 115-141) provided $4.700 billion, an increase of $260.0 million (+5.9%) from FY2017. The FY2017 level of $4.440 billion was an increase of $77.0 million (+1.7%) from FY2016. The FY2016 level of $4.363 billion represented an increase of $63 million (+1.5%) from the FY2015 level of $4.300 billion, and the FY2015 level represented an increase of $41.7 million (+1.0%) from the FY2014 funding level of $4.259 billion. The FY2013 act funded legislative branch accounts at the FY2012 enacted level, with some exceptions (also known as “anomalies”), less across-the-board rescissions that applied to all appropriations in the act, and not including sequestration reductions implemented on March 1. The FY2012 level of $4.307 billion represented a decrease of $236.9 million (-5.2%) from the FY2011 level, which itself represented a decrease of $125.1 million (-2.7%) from FY2010. The smallest of the appropriations bills, the legislative branch comprises approximately 0.4% of total discretionary budget authority.

Jun 4, 2018

National Park Service: FY2019 Appropriations

Jun 4, 2018

What Happens When Five Supreme Court Justices Can’t Agree?

Jun 4, 2018

Prioritizing Waterway Lock Projects: Barge Traffic Changes

Congress faces decisions about prioritizing new lock construction projects on the inland waterway system. As both houses debate differing versions of water resources and development bills (S. 2800, H.R. 8) and the FY2019 Energy and Water Development Appropriations bill (S. 2975, H.R. 5895), the decision about which of these projects could be undertaken first will likely be among the most controversial issues. The inland waterway system supports barge transportation of heavy raw materials such as grain, coal, petroleum, and construction aggregates. The new locks are needed, according to the Army Corps of Engineers (USACE) and barge shippers, where existing locks are in poor condition, requiring frequent closures for repairs, and/or because a lock’s size causes delays for barge tows. The total estimated cost for the 21 planned lock projects is several billion dollars (many of the individual projects have a cost estimate of between $300 million and $800 million). However, available funding for these projects is about $200 million per year. This is because of limited appropriations and cost-sharing capabilities. Under current cost-share arrangements, the barge industry pays half the cost of construction projects. It does this by paying a $0.29 per gallon fuel tax, which annually generates around $100 million. Significant changes in traffic levels through particular locks may affect the benefits that were estimated as expansion projects were advanced. The calculation of benefits is critical to advancing a project: the Office of Management and Budget (OMB) will not request funding for a project unless the estimated economic benefit is at least 2.5 times the expected cost. The lock projects are clustered in three regions, each facing different economic conditions that are affecting barge traffic in the agricultural heartland, record corn and soybean harvests have reversed the long-term downward trend of cargo volumes on the Upper Mississippi River; in the Ohio and Tennessee River Valleys, the domestic natural gas boom has reduced the demand for coal by barge to power plants by nearly half; along the Texas and Louisiana intracoastal waterway, tank barge traffic is still in a state of flux as the petrochemical industry makes longer-term investments related to the Texas shale oil boom. The U.S. Department of Agriculture (USDA) is expecting corn and soybean exports to increase slightly over the next decade, but this projection could be affected by possible Chinese tariff increases on U.S. agricultural goods, including soybeans. The closing of additional coal-fired electric power plants along the Ohio, Monongahela, and Tennessee Rivers would reduce waterway use, as the power plants generate 75% or more of the barge traffic through many of the locks on these rivers. The loss of coal traffic is significant for other commodities as well, as it could lead to more empty repositioning of barges, reducing economies of density for barge transport on the rivers. New pipeline construction and the lifting of the crude oil export ban at the end of 2015 are two factors that could influence barge demand over the long-term on the Gulf Intracoastal Waterway.

Jun 1, 2018

Water Authorization Legislation in Brief: H.R. 8 and S. 2800

The 115th Congress is deliberating two water authorization bills: H.R. 8, the Water Resources Development Act of 2018 (WRDA 2018), and S. 2800, America’s Water Infrastructure Act of 2018 (AIWA 2018). Both bills were introduced and marked up by their respective authorizing committees in May 2018. H.R. 8 is focused on authorizing water resource projects and activities of the U.S. Army Corps of Engineers (USACE). S. 2800 includes provisions related to USACE water resource projects and activities, provisions related to water-related programs of the U.S. Environmental Protection Agency (EPA), and a few provisions on water-related activities and authorities of the Department of the Interior (DOI). For the 115th Congress, some of the issues related to these deliberations on the two bills include the scope of water issues to be addressed, how the legislation would affect federal spending, and how the legislation would affect federal and nonfederal investments in water infrastructure. In addition, there is some interest in altering how the USACE is structured and in modifying its operations and delivery of water resource projects. Both H.R. 8 and S. 2800 include numerous provisions that address USACE-related activities. For example, both bills would authorize USACE to conduct new studies and construct new projects, and both would modify and extend existing project and program authorizations. However, despite these similarities, numerous provisions in one bill have no counterpart in the other. In particular, many provisions in S. 2800 have no related provision in H.R. 8. For example, S. 2800 includes numerous provisions related to EPA-administered water quality and infrastructure programs. Most of these provisions occur in Title V, but other titles also include EPA-related provisions. Title V of S. 2800 would amend the Clean Water Act for various purposes (e.g., to reauthorize the appropriation of grants for sewer overflow projects and make stormwater management projects eligible, to authorize integrated planning to help municipalities comply with wastewater discharge mandates, and to require EPA to promote and integrate the use of green infrastructure into various agency activities). It also would amend the Safe Drinking Water Act (SWDA); among other amendments to the SWDA, the Senate bill would (1) make permanent the requirement to use U.S.-produced iron and steel in all projects receiving Drinking Water State Revolving Fund (SRF) assistance and (2) formally authorize EPA’s WaterSense program. S. 2800 would amend the Water Infrastructure Finance and Innovation Act (WIFIA; P.L. 113-121, Title V, Subtitle C) to authorize special terms for loan assistance provided to state Clean Water and Drinking Water SRF finance authorities. Further, it would require a study on WIFIA accessibility for certain communities. H.R. 8, in contrast, contains none of these provisions and generally remains focused on USACE activities. This report provides an overview of H.R. 8 and S. 2800, including context related to the bills and the topics shaping deliberation associated with the USACE- and EPA-related provisions. Among the issues shaping deliberations are the extent to which the legislation improves delivery of water infrastructure, including USACE water resource projects, and the effect of the legislation on federal spending and nonfederal investments. As of May 31, 2018, no Congressional Budget Office cost estimates were available for H.R. 8 or S. 2800.

Jun 1, 2018

The Role of the Office of National Drug Control Policy (ONDCP)

ONDCP Mission and Responsibilities The Office of National Drug Control Policy (ONDCP) is responsible for creating, implementing, and evaluating U.S. drug control policies to reduce the use, manufacturing, and trafficking of illicit drugs as well as drug-related health consequences, crime, and violence. ONDCP is located in the Executive Office of the President. It was created by the Anti-Drug Abuse Act of 1988 and most recently reauthorized by the Office of National Drug Control Policy Reauthorization Act of 2006. Authorization of appropriations for ONDCP expired at the end of FY2010, but it continues to receive funding. The ONDCP director must develop a National Drug Control Strategy (Strategy) to direct the nation’s anti-drug efforts—and a companion National Drug Control Budget (Budget)—and evaluate the implementation of the Strategy by agencies contributing to the Federal Drug Control Program and the outcomes (reducing illicit drug use and its consequences). In addition, ONDCP manages the High Intensity Drug Trafficking Areas (HIDTA) program and other programs, including Drug Free Communities (DFC). Shifting Priorities ONDCP was created during the “war on drugs”—a term popularized by former President Nixon and commonly used for nearly 40 years to describe U.S. drug policy. In 2009, however, ONDCP distanced itself from the term. While drug use had been considered primarily a criminal justice problem, it has transitioned to being viewed as a combination of criminal justice and public health problems. Mirroring this shift, federal drug control spending has increased the proportion of money allocated for prevention and treatment and decreased that for enforcement and interdiction. Nonetheless, the Budget continues to show a majority of funding is dedicated for supply reduction, as outlined in Table 1. Table 1. Federal Drug Control Budget by Function, FY2013-FY2017 Amounts in billions of dollars Function FY2013 FY2014 FY2015 FY2016 FY2017 Treatment $7.889 $9.482 $9.553 $9.845 $10.580 Prevention 1.275 1.317 1.342 1.486 1.507 Domestic Law Enforcement 8.857 9.349 9.395 9.283 9.299 Interdiction 3.941 3.949 3.961 4.735 4.569 International 1.849 1.637 1.643 1.525 1.521 Total $23.811 $25.734 $25.894 $26.874 $27.476 Demand Reductiona 9.164 10.799 10.895 11.332 12.088 Percentage of Total Drug Control Budget 38.5% 42.0% 42.1% 42.2% 44.0% Supply Reductionb 14.646 14.934 14.998 15.543 15.389 Percentage of Total Drug Control Budget 61.5% 58.0% 57.9% 57.8% 56.0% Source: Amounts taken from ONDCP, National Drug Control Budget: FY2018 Funding Highlights, p. 19. Percentages calculated by CRS. Notes: Amounts may not add to totals due to rounding. ONDCP defines demand reduction as treatment and prevention. ONDCP defines supply reduction as domestic law enforcement, interdiction, and international initiatives. Potential Reauthorization Issues Oversight of ONDCP Over the last several years, ONDCP has not released its Strategy during the relevant fiscal year, and it has not released a 2017 or 2018 Strategy to accompany the FY2018 Budget highlights released in May 2017. It has, however, been directly involved in the President’s Commission on Combating Drug Addiction and the Opioid Crisis. Congress might consider whether ONDCP’s modern role involves more coordinating and advising than implementing and evaluating strategy and policy. Should Congress consider reauthorizing ONDCP, it may question its role. Specifically, if ONDCP continues to delay the release of the Strategy and Budget, and the director’s position remains outside of the President’s Cabinet, Congress may question the role ONDCP plays in U.S. drug policy. Policymakers may also consider the nature of ONDCP altogether. In the FY2019 budget request, the Trump Administration proposes transferring the HIDTA program to the Drug Enforcement Administration (DEA) and DFC program to the Substance Abuse and Mental Health Services Administration (SAMHSA). While SAMHSA currently co-administers DFC and other grant programs, DEA does not manage grant programs. Congress may question whether DEA has sufficient resources to properly administer a grant program or whether another Department of Justice (DOJ) entity—such as the Office of Justice Programs—would be better suited to administer the HIDTA program if it were moved out of ONDCP. Policymakers may also question whether the HIDTA program, if administered by DEA, would continue to be seen as a collaborative law enforcement program rather than one directed by a single federal law enforcement agency. Further, if ONDCP no longer administers these grant programs, Congress may consider how this might affect its overall role in federal drug control. Since ONDCP first received funding in FY1989, its operating budget and number of full-time equivalents (FTEs) have fluctuated. However, both the operating budget (not including funding designated for grant programs) and number of FTEs have decreased each fiscal year since FY2010—the longest continual decline in its history. ONDCP’s FY2018 operating budget is $18.4 million, and the number of FTEs is 65—the lowest levels for both over the last two decades. Figure 1. ONDCP FTEs and Operational Budget FY1989-FY2018 / Source: For budget data, see GAO/GGD-93-144, the National Drug Control Budget Summary for FY1994-FY2017, P.L. 115-31, and P.L. 115-141. FTE data provided by ONDCP. Notes: For certain years, the number of FTEs does not appear to match the ONDCP operating budget; the reasons for this are unclear. Funding data are provided in nominal dollars and not adjusted for inflation. Opposition to Legalization of Schedule I Substances In 1970, the Controlled Substances Act (CSA) designated marijuana and other drugs as Schedule I controlled substances. This officially prohibited the unauthorized manufacture, distribution, dispensing, and possession of these substances. Current law requires the director of ONDCP to ensure that ONDCP’s funding is not used for any study or contract relating to the legalization of a substance listed in Schedule I of the CSA and oppose any attempt to legalize any substance that the Food and Drug Administration has not approved for medical use. Despite federal restrictions on marijuana, states have deviated by establishing a range of laws and policies allowing its medical and recreational use. As such, Congress may choose to address ONDCP’s ability to support or oppose legalization or remain neutral.

Jun 1, 2018

The Coastal Barrier Resources Act (CBRA)

May 31, 2018

Forest Service: FY2018 Appropriations and FY2019 Request

May 31, 2018

Farm Bills: Major Legislative Actions, 1965-2018

The farm bill provides an opportunity for Congress to address agricultural and food issues comprehensively about every five years. Over time, farm bills have tended to become more complicated and politically sensitive. As a result, the timeline for reauthorization has become less certain, and in general recent farm bills have taken longer to enact than in previous decades. Recent farm bills, beginning with the 2008 farm bill (P.L. 110-246), have been subject to various developments that have delayed enactment, such as insufficient votes to pass the House floor, presidential vetoes, and short-term extensions. The 2014 farm bill took more than 21 months from introduction to enactment and spanned the 112th and 113th Congresses. The House rejected a bill in 2013 and then passed separate farm and nutrition assistance components before procedurally recombining them for conference with the Senate. Somewhat similarly, the 2008 farm bill took more than a year to enact and was complicated by revenue provisions from another committee of jurisdiction, temporary extensions, and vetoes. Whether the House or Senate proceeds first in committee or on the floor is also not always predictable. Both the 2008 farm bill and the 2002 farm bill were extended before their successors were enacted. In 2018, a farm bill reauthorization was reported from the House Agriculture Committee on April 18 (H.R. 2). An initial floor vote on passage on May 18 failed in the House 198-213, but floor procedures allow that vote to be reconsidered through the legislative day of June 22, 2018 (H.Res. 905). The Senate has not yet marked up its bill. This report examines the major legislative milestones for the last 11 farm bills covering 53 years and illustrates trends that may provide useful background and context as the current farm bill debate proceeds.

May 31, 2018

The House Journal: Origin, Purpose, and Approval

The Journal of the House of Representatives is the official record of the chamber’s legislative actions. The Journal’s contents include the titles of introduced legislation, the results of votes, presidential veto messages, and any other matters the House deems to be official proceedings. Unlike the Congressional Record, it is not a transcript of debate. Rather, the Journal is a listing of House actions without the debate accompanying those actions. The Constitution mandates that each House keep a journal of its proceedings (Art. 1, §5). The Constitution, House rules and practices, and, to a lesser extent, statutes direct which proceedings must be recorded. The Journal is public, enabling citizens to follow House actions, excepting those that require secrecy, such as matters of national security. Under House rules, the Speaker announces his or her approval of the Journal at the start of each legislative day. In current practice, approval is automatic unless a Member demands a vote. If that occurs, the Speaker then holds or postpones a voice or record vote to agree to the approval of the Journal. Members may call for a vote, or vote against the Journal’s approval, in order to pursue changes to the Journal or for strategic reasons unrelated to the Journal’s contents. For instance, Members may use votes to ascertain the presence of Members, delay proceedings, protest an action, assemble Members prior to a vote or announcement, or establish independence from leadership. If the vote to approve the Journal fails, the Journal may be subject to amendment. In the period examined (1990-2016), no record vote on approval of the Journal has failed. However, in 1990, a voice vote failed, allowing a Member to offer an amendment, which was approved. This report considers the origin and purpose of the Journal as well as the procedures related to its approval. It discusses why a Member might call for a vote and why a Member might vote against the Journal’s approval. The report also examines record approval votes from 1991 to 2016 (102nd-114th Congresses), addressing trends in the frequency of these votes, the percentage of votes initiated by majority party Members, and the procedures used to call for or postpone record votes.

May 31, 2018

Global Oil Markets and U.S. Gasoline Prices 2018

May 30, 2018