Whoever wins the November 3 presidential election has an opportunity – and a responsibility – to help the United States move forward by making human rights a priority in the next administration. This includes ending policies that undermine the rights of people in the United States to live in dignity, speak their opinions, have families as they please, put sufficient food on the table, see a doctor without fear of financial ruin, and feel safe in their own skin. For far too long, many people in the country have faced systemic racism and discrimination, often at the hands of their own federal government.
An urgent human rights agenda awaits the next administration. Regardless of who wins the election, Human Rights Watch urges the next administration to take the following priority steps toward advancing a future of dignity and respect for the rights of all.
POVERTY AND INEQUALITY
Provisions in the CARES Act, enacted in March, protected millions of families from falling into poverty by providing direct payments, unemployment insurance, and protection from eviction and student debt. But informal workers and undocumented people, who often make low incomes and lack access to social protection, were excluded from federal relief, making them even more prone to falling into poverty. For those who received support, much of it expired in July. Since then a Census Bureau survey indicates a growing number of people are having difficulty paying for food, housing, health care, and other expenses, and many have said their savings are exhausted. Without quick action to address these economic needs, rates of poverty and inequality are likely to increase.
Allocate resources for social protection programs: Funding sustained and adequate social protection can protect people from poverty and reduce economic inequality. Before the pandemic, social protection programs kept tens of millions of people out of poverty. The importance of using them to avert poverty has become even more evident since then. For example, in March, as job losses began to accelerate, the unemployment insurance (UI) system was temporarily strengthened as part of the CARES Act, extending eligibility to low-wage, part-time, and self-employed workers, and adding an extra weekly UI benefit of $600. Estimates suggest that the extended UI protected 7.3 million workers from falling into poverty. Without this, benefits for low-wage workers in some states are below the federal poverty line. The next administration should work with Congress to permanently provide UI to groups previously excluded, extend benefits to informal and undocumented workers, and ensure that benefits are adequate to protect people from experiencing poverty. It should also work with Congress and local authorities to allocate sufficient resources to other social protection programs that should be made universal, such as paid sick and family leave and targeted assistance to economically vulnerable groups that have been disproportionately impacted by the pandemic. All funding should aim to ensure people’s right to an adequate standard of living.
Ensure universal health care: The number of people with health insurance dropped in 2019, and this trend was exacerbated by Covid-19-related job losses, particularly for people who relied on employer-provided insurance. The next administration needs to assist Congress to develop and enact a policy that provides affordable, accessible health coverage to everyone in the United States during the pandemic and beyond.
Protect consumers from predatory lenders: As unemployment, food scarcity, and economic precarity rise, people may turn to lenders to pay mounting debts and fill budget gaps. The next administration should act quickly to protect borrowers from predatory lenders by reversing deregulation of payday lenders and introducing more robust protections, such as a cap on interest rates, restrictions on abusive debt collectors, protections against financial scams, and expanded debt relief.
Close the digital divide: As the pandemic laid bare, affordable, reliable, and quality access to the internet is necessary for the exercise of a range of rights. People depend on it to obtain essential information, to express themselves, for their livelihoods and for children’s education. The next administration should encourage Congress to support communications services for low-income households, schools, and libraries, building out affordable broadband to underserved areas, and promoting digital literacy. It should appoint Federal Communications Commission (FCC) commissioners who recognize the importance of affordable broadband access.
Economic Justice: Black, Latinx, Asian American and Pacific Islander workers are overrepresented in the lowest-paid agricultural, domestic, and service jobs that offer few benefits and little long-term opportunities. For Black workers this is largely a legacy of slavery and subsequent laws and policies continuing to the present that have hindered Black people’s efforts to advance and accumulate wealth. Black people face systemic obstacles to accessing capital and are disproportionately targeted by abusive lending practices that can lead to eviction or loss of employment. The next administration should support laws and policies designed to address these racial inequities and help ensure people’s right to an adequate standard of living, free of discrimination, including a living wage. This should include ending predatory lending practices that disproportionately target Black, Latinx, and low-income communities; improving access to affordable housing, fair credit, and savings tools; supporting a cap on interest rates similar to that proposed in the Veterans and Consumers Fair Credit Act; and developing other initiatives that would begin to address the wealth gap.
Oppressive, Excessive Law Enforcement: Law enforcement in the United States disproportionately targets Black, Indigenous, and Latinx communities, resulting in high levels of arrest and conviction in those communities and frequent interactions that can result in violence, including high rates of killings by police. Other laws, policies and practices keep those with criminal records from accessing jobs, housing, education, public assistance, and the right to vote. The next administration should work with Congress to review federal funding to state and local law enforcement and create strong incentives for state and local authorities to reduce law enforcement’s footprint, reinvesting saved resources in communities, and working to remove barriers to re-entering society for those with criminal records. For example, it should support initiatives and legislation such as those proposed in the Fair Chance at Housing Act, which would reform screening and eviction polices for federal housing, and “Ban the Box” initiatives, barring employers from asking certain questions about criminal histories during the hiring process.
Equitable Access to Health Care: Communities of color have poorer outcomes than white people. Black people in the US are significantly more likely to die of Covid-19, HIV, cancer, asthma, stroke, heart disease, diabetes, obesity and maternal mortality than white people. Black people and brown people live in poorer neighborhoods, attend lower-quality schools, receive health care at lower-quality hospitals, and are less likely to have health insurance. These outcomes are driven in part by government policies, including a historic underinvestment in health in communities of color, as well as limited access to healthy foods and quality health care, including maternal health care. The next administration and Congress should act to dismantle longstanding racial bias and discriminatory practices in health care and advance policies that will help to improve health outcomes in low-income and communities of color. This should include supporting Medicaid expansion in all states and upholding the rights protections in the Affordable Care Act.
Combatting White Supremacist Extremist Groups: The Federal Bureau of Investigation and the Department of Homeland Security have warned that white supremacist groups constitute the most serious threat posed by any violent group in the United States today. The next administration should take all necessary measures to counter the threat from such groups.
Reparations: Victims of serious human rights violations, including acts of racial discrimination, have a right to an effective remedy, which includes reparations for past harms. These victims include Black communities that still endure systemic discrimination rooted in the US history of slavery. The next administration should call on Congress to pass House Resolution (HR) 40, which would establish a commission to investigate the impacts of slavery and subsequent racist laws and policies that contribute to present-day discrimination, and direct proposals for reparations to Congress, including financial and other redress. If Congress does not pass HR 40 within the first 100 days, the administration should establish a similar commission by executive order.
CRIMINAL LEGAL SYSTEM
Criminal Legal System Reform Priorities: State and federal jails and prisons in the US hold over 2 million people, the highest figure of any country in the world, with another 4.4 million on probation or parole. Black people make up 13 percent of the US population but roughly 33 percent of those incarcerated. We urge the next administration to establish a criminal reform agenda that includes both federal reforms and effective incentives for state and local authorities to end abusive policing; excessive, disproportionate penalties; and systemic racial discrimination.
Reduce police footprint, invest in communities, ensure accountability: Support initiatives that dramatically reduce the use of police to solve societal problems in line with the recommendations in our Roadmap for Re-imagining Public Safety in the United States. End unnecessary arrests, especially for conduct related to homelessness and poverty, like loitering and trespassing; for conduct that should not be criminalized at all, like the possession of drugs for personal use, or sex work; and for violations that should result in citations rather than custodial arrest. Instead, support initiatives and legislation like the MORE Act, that would end federal marijuana prohibition, enable those with federal marijuana-related convictions to get their records expunged, and fund health, education, job training, and literacy programs in communities most impacted by the war on drugs; and other investments in services that directly address mental health needs, substance use disorder, and poverty, without criminalizing them. Making this shift, along with establishing effective and independent oversight bodies and the necessary legal tools to ensure accountability, is essential to limiting the police violence that has caused considerable harm.
Abusive pretrial detention systems: When arrests do occur, support limiting pretrial incarceration to exceptional cases. The broad use of pretrial incarceration punishes people who have not been convicted, pressures people to plead guilty regardless of actual guilt, and is often applied in a highly discriminatory way. The administration should seek to abolish money bail, but also prevent the use of discriminatory algorithmic risk assessments in its place.
Harsh Sentencing: Criminal laws and policies in the US have resulted in large numbers of people locked up for excessively long sentences, without evidence that such practices rehabilitate individuals or make communities safer. The next administration should work to end mandatory minimum sentences that prevent consideration of mitigating factors and other disproportionate or overly harsh sentences, including the death penalty. It should also seek to end the use of prolonged solitary confinement. In a system with an aging prison population, the administration should expand its use of compassionate release, support mechanisms to systematically review lengthy sentences, such as those proposed in the Second Look Act, and expand its use of clemency authority. It should also support ending the use of excessive fines and fees associated with criminal convictions that can lead to high debt, warrants being issued for failure to pay, and incarceration for those who cannot afford to pay, as well as bars to accessing public assistance, public housing, and the right to vote that make it more difficult to reintegrate into society.
Parole and Probation: Promoted as alternatives to incarceration that help rehabilitate people, parole and probation instead drive high numbers of people, disproportionately Black and brown, into jail or prison, while in large part failing to get people the help they need. The next administration should support initiatives that would dramatically shrink the use of probation and parole, curb incarceration for violating conditions of supervision, shorten terms, and allow earned time credits.
Eliminate barriers to federal assistance for comprehensive reproductive health care: The next administration needs to take steps to ensure women get the health care they need and oppose measures to limit treatment and access to contraception and abortion care. It should issue an executive order on day one revoking the January 23, 2017 Presidential Memorandum Regarding the Mexico City Policy and clarifying what federal assistance domestically and globally is permitted under current law to ensure access to comprehensive reproductive health care, including for abortion, to the maximum extent allowed. It should also:
Support ending harmful limits to reproductive freedom: Work with Congress to eliminate all harmful laws and appropriations riders that limit reproductive freedom, including the Hyde amendment and similar amendments related to foreign assistance.
Halt or rescind regulations that reduce access to reproductive health care: While the rates of people without health insurance in the US were rising before the pandemic, including nearly 10 million women without coverage, Covid-19 pandemic-related job loss likely increased this number dramatically. Lack of access to health care in the US contributes to mortality rates from maternal deaths and cervical cancer that are higher than in comparable countries. The next administration should halt all non-final regulations that would further limit access to reproductive health care, including abortion, and initiate the process of rescinding regulations that limit access to reproductive health care, including:
- Compliance with Statutory Program Integrity Requirements (also known as the Domestic Gag Rule).
- Religious Exemptions and Accommodations for Coverage of Certain Preventive Services Under the Affordable Care Act and Moral Exemptions and Accommodations for Coverage of Certain Preventive Services under the Affordable Care Act.
- Nondiscrimination in Health and Health Education Programs and Activities, Delegation of Authority, revising the regulations for the Section 1557 Health Care Rights Law.
- Protecting Statutory Conscience Rights in Health Care, Delegation of Authority, otherwise known as the “Refusal of Care Rule.”
- Inadmissibility Based on Public Charge Grounds.
Address the Prevention and Elimination of Gender-Based Violence in Connection with Communities: While reports of violence against women globally have increased during the Covid-19 pandemic, the US Congress has failed to reauthorize the Violence Against Women Act, a law with a track record of success: between 1993 and 2007, the annual number of deaths by intimate partner homicide dropped by 34 percent for women and 57 percent for men. This law supports the successful U-visa program, which helps immigrant women leave violent situations without fear of deportation and makes communities safer. The next administration should work to preserve progress to end violence against women, including by pressing Congress to pass a Violence Against Women Act reauthorization that reflects broader calls for community support that is intersectional and comprehensive and best serves communities at risk.
Push for Supportive Workforce Policies for All Workers: The Covid-19 crisis has increased inequalities between men and women in the workplace. The policies to address the pandemic and lack of employer supportive care policies have had disproportionate impact on women workers who ended up unemployed in much larger numbers compared to men. The next administration should push for modern workforce policies including paid family leave and care for aging loved ones.
Protect the Reproductive Freedom of Youth: Young people need information on sexual and reproductive health. They also need the government to address barriers to accessing the human papillomavirus (HPV) vaccine to prevent several types of cancer, including cervical cancer. The next administration should take steps to ensure that all federal programs related to sexual health education are science-based and non-discriminatory. Further, it should use its leverage with states to urge the removal of harmful parental involvement requirements that delay abortion care for young people under age 18, and other barriers states impose to limit access to care.
IMMIGRATION AND BORDER POLICY
The US approach to border enforcement in recent years has unlawfully sought to deter people from pursuing a basic right – the right to seek asylum – through policies that have resulted in serious abuses and harm to adults and children. US immigration policies place long-term immigrants in the US at risk of detention, deportation, and family separation without fair processes. Unauthorized immigrants are highly vulnerable to severe labor abuses and serious crimes, often without meaningful access to justice. The next administration should swiftly reverse recent abusive executive actions and policies, and work with Congress to advance extensive reform of laws that allowed such abuses to occur.
Ensure border policies protect the right to seek asylum and respond appropriately to humanitarian needs: The next administration should undo the slew of programs and policies that have dismantled the US asylum system, including the Migrant Protection Protocols, under which US immigration officials have sent more than 66,000 non-Mexican asylum seekers, including families with children, to Mexico, where they faced serious risks, significant challenges in preparing their asylum claims, and repeated delays in having their cases heard. It should retract the asylum bans, the Asylum Cooperative Agreements, and new regulations severely undermining long-established asylum law. It should withdraw the public health order used to close land borders to asylum seekers, which was issued without a public health rationale. It should also parole asylum seekers into the US to shelter with family and other networks of support or community-based alternatives to detention; decriminalize entering and re-entering the US without authorization; and order Customs and Border Protection to stop separating children from parents and extended family members. Relevant US agencies should dramatically speed up family reunifications. The US should prioritize resources to ensure asylum claims are processed in a fair and timely manner, with appropriate resources and staff to meet the humanitarian needs of families and children.
End detention abuses and protect family unity: The Covid-19 pandemic has underscored the US failure to protect the health and safety of people in immigration detention, with thousands infected and at least eight Covid-19-related fatalities. During the pandemic, the next administration should suspend enforcement, halt transfers into detention centers, and release people in detention unless lawfully held as a “last resort.” In the long-term, the next administration should end unnecessary and arbitrary detention and instead invest in community-based case management programs for those with pending proceedings. It should create enforcement policies and support legislative reform that would protect long-term residents from deportation and family separation without meaningful consideration of their ties to the US, including through a fair and inclusive legalization program.
Implement structures and cultures of accountability, including redress for those previously harmed: US immigration enforcement agencies have long records of abuse, including violations of US and international law. The next administration should create processes that increase transparency and accountability for abusive policies like family separation and prolonged detention, including of asylum seekers, families, and unaccompanied children, and redress for those previously harmed, such as policies allowing people wrongfully deported to return and pursue claims to remain in the US.
LESBIAN, GAY, BISEXUAL AND TRANSGENDER (LGBT) RIGHTS
In June 2020, the US Supreme Court in Bostock v. Clayton County recognized that federal laws prohibiting sex discrimination in employment also prohibit discrimination based on sexual orientation and gender identity. Nonetheless, many federal laws do not contain express protections for LGBT people, leaving them vulnerable to discrimination in housing, health care, and other domains. The next administration should encourage Congress to pass, and robustly enforce, clear and comprehensive nondiscrimination protections for LGBT people across the United States.
Equality Act: Support passage of the Equality Act, a bill that would expressly prohibit discrimination based on sexual orientation and gender identity in education, housing, public spaces, federally funded programs, credit, and jury service.
Transgender Military Ban: Swiftly reverse the discriminatory ban on transgender service in the military, which has jeopardized the careers of thousands of transgender service members in the US armed forces.
Regulatory Protections: Recognize that federal sex discrimination protections also prohibit discrimination based on sexual orientation and gender identity, consistent with the US Supreme Court’s decision in Bostock. Withdraw pending rules that would roll back protections for transgender people in health care, housing, and other domains. Enforce existing regulations that prohibit sex discrimination to address anti-LGBT discrimination. Ensure that transgender people in federal custody are housed in a manner that recognizes and respects their gender identity.
Sweeping Religious Exemptions: Work with Congress to ensure that religious exemptions are carefully crafted and do not infringe on the rights of others, including the rights of LGBT people. Ensure that federally funded programs serve all people without discrimination based on sexual orientation or gender identity, including in child welfare services.
Violence Against Women Act: Reauthorize an LGBT-inclusive Violence Against Women Act that is intersectional and comprehensive and best serves communities at risk. The Act should recognize LGBT people as an underserved population and ensure that LGBT victims of domestic violence and sexual assault are able to access services without discrimination. Take steps to address violence against transgender people, including stronger efforts to address poverty, homelessness, and barriers to obtaining gender-affirming care.
Access to Asylum: Ensure that LGBT people fleeing persecution in their countries of origin can claim asylum in the United States. Reverse policies and regulations that have left LGBT asylum seekers stranded in Mexican border towns or that have resulted in expedited removals or transfer to countries that do not provide adequate protection. These including metering, which limits the number of people who are allowed into the United States each day to make asylum claims, the Migrant Protection Protocols, the Prompt Asylum Claim Review and Humanitarian Asylum Review Process, the Asylum Cooperative Agreements with Guatemala, El Salvador and Honduras, and the Centers for Disease Control and Prevention’s “Order Suspending Introduction of Certain Persons from Countries Where a Communicable Disease Exists.” Withdraw proposed regulations issued in June and September 2020 that would further restrict access to asylum, including by eliminating seeking asylum on the grounds of “gender” and allowing immigration judges to introduce their own, potentially biased evidence into the record in asylum cases.
TECHNOLOGY AND HUMAN RIGHTS
Protect people’s data: The next administration should encourage Congress to adopt a strong federal data protection law that meaningfully regulates the collection, analysis, and sharing of personal data by companies with security and intelligence agencies; advertisers and data brokers who may engage in discriminatory profiling; and others whose actions may result in rights abuses. The law should also require human rights impact assessments that address all aspects of companies’ operations, including their underlying business model, and require human rights due diligence for their operations globally.
Rights-based regulation of big tech: It is nearly impossible to use the internet without relying on services or devices from one of the four major technology companies (Amazon, Apple, Facebook, and Google) and consenting to their terms of service. Facebook and Google in particular have become gateways for accessing and disseminating information. Their concentration of power exacerbates the harm that’s done when these companies fail to protect privacy or regulate content responsibly and in line with human rights. The source of many human rights concerns associated with Facebook and Google’s services is their surveillance-based business model. Addressing the monopolistic aspects of platforms isn’t a panacea for human rights problems, but it may make it easier to hold platforms accountable or create conditions for alternative models to emerge. Efforts to address the monopolistic aspects of technology companies should be rooted in human rights considerations. A key step would be to enable users to easily transfer data between social media platforms, giving them more control over their data and allowing them to communicate between social media platforms. This could enable competition and empower users to have real choices in where they find information and how they connect with people online.
Suspend use of facial recognition technology: Law enforcement agencies across the nation are using facial recognition to monitor public spaces and flag suspects in criminal investigations without sufficient transparency, accountability or oversight. This practice poses significant and ongoing risks to privacy, due process, non-discrimination and other human rights. The federal government should suspend its use of facial recognition technology nationwide and urge state and local governments to follow suit. During this period, the government should initiate a comprehensive inquiry into whether it should ban its agencies permanently from using the technology, examining whether the human rights risks associated with the technology outweigh any legitimate aim it seeks to achieve.
ENVIRONMENT AND HUMAN RIGHTS
Increase climate ambition: As the world’s second largest emitter of greenhouse gases, the United States should play a leading role in advancing global efforts to mitigate climate change. The next administration should re-enter the United States in the Paris Agreement and enact ambitious measures to advance the agreement’s goals of limiting global warming, including through dramatic reductions in greenhouse gas emissions within the United States.
Promote green recovery: The next administration should work with Congress to ensure that economic recovery efforts include measures aimed at shifting the US economy away from reliance on fossil fuels and toward cleaner sources of energy. Such measures could include steering recovery funds towards the renewable energy sector rather than fossil fuel industries, rejecting proposed fossil fuel infrastructure projects (such as the Keystone XL pipeline), and ensuring that the Arctic National Wildlife Refuge remains closed to oil and gas production. It should also work with Congress to target support to states and communities working to advance climate adaptation and resilience initiatives, while reducing administrative red tape associated with federal assistance requests.
Strengthen regulations to protect rights: The next administration should reverse regulatory rollbacks and adopt robust protections against environmental harms. It should ensure that environmental regulatory decision-making is based on an unbiased evaluation of scientific evidence. It should ensure that the lack of certainty around potential harms is not used as a pretext to prevent regulatory action when existing scientific evidence establishes a significant risk of harm from a practice or substance. Specifically, it should restrict or ban pesticides scientifically known to pose a significant risk of harm to people and the environment, including “highly hazardous pesticides.”
Support populations most vulnerable to climate impacts: The next administration should acknowledge the role climate change plays in exacerbating the frequency and intensity of extreme weather events, and its disproportionate impacts on people of color and other marginalized populations. It should prioritize effective and rights-respecting federal adaptation planning, including assessment of climate-related risks and preparation for responding to climate-related events, such as fires, floods, hurricanes, and extreme heat, and create incentives for state and local governments to do the same. It should ensure that responses are free from discrimination due to gender, race, age, ethnicity, disability or socio-economic status. It should prioritize the protection of natural buffers against climate-related events, such as wetlands and floodplains. And it should ensure that federal infrastructure projects take into account future climate scenarios based on the best available science.
Value chains: The next administration should require all companies doing business in the United States to conduct human rights and environment due diligence, including on climate change, in all of their global and domestic value chains, and develop measures to prevent or mitigate environmental and human rights harms. Such due diligence should be commensurate with the characteristics of the company, including its size and operational context, and the level of risk in its value chain. Businesses should be required to measure their direct and indirect greenhouse gas emissions, setting targets to reduce emissions in line with the Paris Agreement, and regularly monitor and report on their progress.
Access to safe drinking water: The next administration should recognize the human rights to water and sanitation, prioritize improvements in water and wastewater infrastructure and management, and work with Congress and local authorities to prohibit utilities from shutting off water access for failure to pay, particularly during the Covid-19 pandemic. Many people in the United States, particularly communities of color and Native Americans living on reservations, currently live with unsafe drinking water or face shutoffs for non-payment of bills. The administration should sign an executive order declaring it is the policy of the US government to recognize the human rights to water and sanitation, establishing an inter-agency working group to address the water crisis with a coordinating position on the Domestic Policy Council, and require any agencies that have jurisdiction over or engage on water issues to consider how to respect and protect them as part of regulatory programs and actions.
Child labor: Every day, 33 children on average are injured while working on US farms, and more US child workers die in agriculture than in any other industry. In contrast to other industries, which typically set a minimum employment age of 16, children as young as 12 can work unlimited hours on farms of any size with parental permission, as long as they don’t miss school. The next administration should encourage Congress to enact amendments to the Fair Labor Standards Act to eliminate exemptions that allow children to work in agriculture at much younger ages, for longer hours, and under more hazardous conditions than any other industry. Important bills include the Children’s Act for Responsible Employment and Farm Safety (CARE Act) and Children Don’t Belong on Tobacco Farms Act. The next administration should also update its list of hazardous occupations prohibited for children under 16, in line with recommendations from the National Institute for Occupational Safety and Health (NIOSH).
Education: The next administration should address inequalities in the educational system that have been exacerbated by Covid-19-related school closures, and tackle the acute learning and achievement gaps, and learning loss, overwhelmingly faced by Black, Indigenous and Latinx children, and children from low-income households. An estimated 16 million children – 30 percent of US schoolchildren – lack internet access or computers for online learning. As families face economic stress, children have entered the workforce or taken on household responsibilities, putting them at risk of dropping out of school for good. The embrace of online learning has also allowed education technology, or “EdTech” companies, to collect massive amounts of children’s educational data, exposing names, home addresses, behaviors, and other highly personal details to the risk of misuse.
The next administration should recognize digital literacy and access to the internet as indispensable to children’s education, and work to ensure affordable, reliable, and accessible internet service and capable devices for all students. It should also work with Congress to strengthen data protection laws for children and require school districts to include data privacy clauses in contracts with Ed Tech providers to protect data collected on children from misuse.
Juvenile Justice: The United States is the only country in the world to sentence people to life without the possibility of parole for crimes committed before age 18. In the US, children are routinely tried as adults, given excessive sentences, and needlessly incarcerated. The next administration should work with states and other authorities to prohibit life without parole sentences for juvenile offenders, end the transfer of children to adult courts, and accelerate initiatives to establish community-based alternatives to detention.
Workers’ rights priorities: US workers across industries have suffered from the government’s elimination or weakening of standards necessary to ensure safe workplaces. Declining union membership, down by about half since the 1950s, and the rise of the gig economy, which classifies workers as independent contractors who cannot join employees’ unions, have helped to drive the erosion of workers’ rights protections. Public health measures in response to the Covid-19 pandemic resulted in record high unemployment rates, with nearly 4 million job losses becoming permanent as businesses close for good. The government should urgently act to ensure that these people do not also lose access to health care and other basic needs along with their jobs.
Protect food production workers: Workers in food production, particularly meatpacking plants and agricultural workers, were required to work during the early stages of the pandemic in the absence of adequate labor rights protections, resulting in greater exposure and large numbers of infections, falling disproportionately on people of color, migrants, and those living in poverty who make up the majority of those working in these sectors. The federal government continued to roll back protections governing line speeds at meatpacking plants even after the onset of the pandemic. The new administration should reinstate line speed limits and inspectors to all factories and strengthen workplace health and safety rules.
Classify gig workers as employees: Companies generally classify app-based workers in the gig economy as independent contractors. As a result, these workers lack basic labor protections guaranteed to employees, including minimum wage, overtime, unemployment, paid sick leave, and the right to unionize. The absence of minimum wage protections has enabled gig companies to implement opaque algorithms for calculating workers’ earnings, driving them below the applicable state or local minimum wage. This practice, combined with the lack of adequate labor rights protections for them, are causing many workers to experience financial hardship and to assume significant health and safety risks while on the job. Several states have passed laws that extend state employment standards to the gig economy but they have faced resistance from gig companies. The new administration should address the misclassification of workers at the federal level and ensure that labor protections are extended to all workers in the gig economy.
Develop heat standards: A 2020 study found that there may have been around 12,000 heat-related deaths annually during the 2010s in the contiguous United States and warned this number may increase to 110,000 under high-emission “business-as-usual” climate change scenarios. Outdoor workers such as farmworkers and low-pay workers in hot warehouses, laundries, and the like may be especially vulnerable. The new administration should encourage Congress to pass laws that provide federal heat protections for all workers, such as the Asuncion Valdivia Heat Illness and Fatality Prevention Act and the Pregnant Workers Fairness Act to explicitly recognize pregnant workers’ right to reasonable accommodations so they can work safely while pregnant, including accommodations to prevent heat-related illnesses.
Regulate global value chains: To ensure that goods and services in the US are not made with abusive practices, the new administration should require all companies doing business in the US to conduct human rights and environmental due diligence, including on climate change, in all of their global and domestic value chains. Such due diligence should be commensurate with a company’s size, sector, operational context, ownership, structure, and the severity of their adverse human rights risks and impacts. It should include an assessment of human rights risks across value chains, development of measures to prevent or mitigate harm and to remedy harm when it does occur, and administrative penalties, and civil and criminal remedies for non-compliance. The results of due diligence should be transparent and made publicly available.
*Update: On 11/18/2020, the below was added.*
OLDER PEOPLE AND PEOPLE WITH DISABILITIES
End inappropriate use of antipsychotic drugs in nursing homes: In a 2018 report, Human Rights Watch documented widespread inappropriate use of antipsychotic drugs given to older people with dementia in nursing facilities in the US. We found that every week, more than 179,000 people in nursing homes were given antipsychotic drugs even though they had not been diagnosed with any condition for which the drugs’ use is approved. Often, facilities administer the drugs without making any effort to seek informed consent.
Many nursing homes use these drugs not to treat a specific medical condition—such as psychosis or a neurological disorder—but because of their sedative effect. Antipsychotic drugs make nursing home residents easier to control by pacifying and sedating them. Studies find that on average, antipsychotic drugs increase the risk of stroke, falls, pneumonia and death in older people with dementia.
Our research found several significant shortcomings in enforcement of federal regulations to protect nursing home residents, including insufficient penalties for noncompliance that failed to deter malfeasance. The administration should have the Centers for Medicaid and Medicare Services (CMS) strengthen its enforcement of federal regulations regarding antipsychotic drugs. Residents should be told they have the right to be informed of treatment alternatives and their right to refuse. The government should also ensure nursing homes employ enough staff to provide adequate care.
Ensure access to justice for nursing home residents: Human Rights Watch has expressed serious concerns about US government removal of prohibitions meant to protect access to courts for nursing home residents. In July 2019, CMS finalized a rule that allows nursing homes and other facilities to add clauses to their contracts requiring new residents to agree to an arbitration process in the event of a dispute with the facility and forgo the option of filing a case in court. This replaced a 2016 CMS rule that had banned arbitration requirements, CMS having found “significant evidence that pre-dispute arbitration agreements have a deleterious impact on the quality of care for Medicare and Medicaid patients” in nursing facilities. This limitation on the right of nursing home residents to bring lawsuits for alleged abuses can also mean that systemic problems or repeated offenses will go undetected. The administration should reinstitute the rule prohibiting mandatory arbitration clauses so that older people in nursing homes can have access to courts in the event of a dispute.
Ensure Policies for Sustained, Community-Based Services: The new administration should enact new policies and strengthen current ones to ensure community-based services and supports so that people with disabilities and older people can have a choice of where they live and receive services. For example, Medicaid’s Money Follows the Person (MFP) program has helped older people and people with disabilities move from nursing homes and other institutions to the community by providing federal matching funds to states. From the start of the program in 2008 through the end of 2019, 101,540 people have moved from institutions to community living. The December 2019 national MFP evaluation found that enrollees experienced significant increases in quality of life measures after leaving an institution. MFP also has helped states control per-enrollee spending, as providing enrollees with home and community-based services typically costs less than institutional care.
As part of a commitment to ensuring access to community-based services and equality in access, the administration should also urge Congress to pass HR 555, the Disability Integration Act, which would ensure state and local governments as well as insurance providers guarantee long-term services and support in the community, so that people with disabilities can lead an independent life.