Copyright 2019

Voter Vitals

Voter Vitals are non-partisan, fact-based explainers written by Brookings experts on the issues shaping the 2020 election.

Production of Brookings’s Voter Vitals is possible thanks to editorial guidance from Senior Fellows David Wessel, who also serves as Director of the Hutchins Center on Fiscal and Monetary Policy, and Elaine Kamarck, who also serves as Founding Director of the Center for Effective Public Management.

View Spanish versions of our Voter Vitals here »

Chinese and U.S. flags are set up for a signing ceremony during a visit by U.S. Secretary of Transportation Elaine Chao at China's Ministry of Transport in Beijing, China April 27, 2018. Picture taken April 27, 2018. REUTERS/Jason Lee - RC13D78E0020 Why has China become such a big political issue?

Ryan Hass unpacks what led China to become a more prominent political issue in the U.S. and the likelihood it drives the national conversation in 2020.

Immigrants are sworn in as new U.S. citizens at a naturalization ceremony in Los Angeles, California, U.S., August 22, 2019. REUTERS/Lucy Nicholson - RC1AFC189020 How many undocumented immigrants are in the United States and who are they?

Elaine Kamarck and Christine Stenglein outline recent trends in illegal immigration to the U.S. and explain why accurately determining the size of the America’s undocumented population is so difficult.

Row houses are seen in the historic Pullman neighborhood in Chicago November 20, 2014. U.S. President Barack Obama is expected to announce the designation of the Pullman neighborhood as a national park on February 19, according to park advocates. The neighborhood's brick homes and ornate public buildings were built in the 1800s by industrialist George Pullman as a blue-collar utopia to house workers from his sleeper car factory. Picture taken November 20, 2014.    REUTERS/Andrew Nelles (UNITED STATES - Tags: SOCIETY ENVIRONMENT POLITICS) - TM3EABN1EN001 How are communities making housing more affordable for middle-income families?

Jenny Schuetz and Tiffany Ford discuss the rationale for housing subsidies targeted to middle-income families and discuss the political and economic implications of those policies.

Used Narcan (naloxone hydrochloride) containers and syringes sit in a case, after paramedics revived a man in his 40's, who was found unresponsive, after overdosing on opioids in Salem, Massachusetts, U.S., August 9, 2017. Picture taken August 9, 2017. REUTERS/Brian Snyder - RC19B9CD7CC0 How do we tackle the opioid crisis?

Christen Linke Young and Abigail Durak assess the severity of the opioid crisis and present policies for preventing opioid abuse and treating the currently addicted.

Students board their school bus in a sub-zero temperature in Minneapolis, January 8, 2014. A deadly blast of arctic air shattered decades-old temperature records as it enveloped the eastern United States on Tuesday, snarling air, road and rail travel, driving energy prices higher and overwhelming shelters for homeless people. According to, the extreme cold won't last much longer. The frigid air and "polar vortex" that affected about 240 million people in the United States and southern Canada will depart during the second half of this week, and a far-reaching January thaw will begin, according to  REUTERS/Eric Miller (UNITED STATES - Tags: ENVIRONMENT EDUCATION) - GM1EA190G4I01 What are charter schools and do they deliver?

Jon Valant explains the controversies around charter schools and why it’s difficult to reach consensus on their efficiency.

Cataldo Ambulance medics John Gardner (L) and David Farmer care for a man in his 40's who was found unresponsive after overdosing on an opioid in the Boston suburb of Salem, Massachusetts, U.S., August 9, 2017.  The victim received a total of 12mg of naloxone. Nurses at the hospital recognised the man, saying he was brought in the day before after overdosing. REUTERS/Brian Snyder  SEARCH "SNYDER OPIOIDS" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. - RC18CB977100 What is surprise billing for medical care?

Experts from the USC-Brookings Schaeffer Initiative for Health Policy explain the reasons for surprise medical billing, the consequences such billings have on healthcare premiums, and solutions for policymakers interested in ending the practice.

Supplies are seen in an operating room at Johns Hopkins hospital in Baltimore, Maryland, U.S., May 13, 2019. Picture taken May 13, 2019. REUTERS/Rosem Morton - RC1222F01D90 What would the 2020 candidates’ proposals mean for health care coverage?

Christen Linke Young and Matthew Fiedler provide an overview on the state of healthcare coverage and explain how popular proposals would change current arrangements.

A bird flies over an apartment building along North Avenue in Baltimore, Maryland May 2, 2015. Thousands of people took to the streets of Baltimore on Saturday as anger over the death of young black man Freddie Gray turned to hopes for change following swift criminal charges against six police officers. REUTERS/Carlos Barria - GF10000082067 How can government make housing more affordable?

Jenny Schuetz explains the current housing affordability crisis and how the 2020 Democratic presidential candidates are proposing to fix it.

Heather Padgett, with her mother Debi Padgett (R), takes her daughters Kinsley and Kiley for a walk outside their home in Cincinnati, Ohio July 16, 2015. Until she got clean last August, Heather was part of what the Centers for Disease Control has called a heroin epidemic - a 100 percent rise in heroin addiction among Americans between 2002 and 2013. The sharp rise in heroin addiction, coupled with the risks of newborns developing withdrawal symptoms after they are sent home, has led a group of Cincinnati hospitals to try what they say is the first program of its kind in the United States: testing all mothers, or their infants, for opiates regardless of background, not just those who seem high-risk. To match Feature USA-HEROIN/MATERNALTESTING  Picture taken July 16, 2015.  REUTERS/Aaron P. Bernstein - GF20000015645 What are the challenges to adopting a federal paid family leave program?

Isabel Sawhill and Sarah Nzau explain the current state of paid family leave legislation in the United States.

U.S. Navy guided-missile destroyer USS Porter (DDG 78) sails in the Bosphorus, on its way to the Mediterranean Sea, in Istanbul, Turkey, August 16, 2019. REUTERS/Murad Sezer - RC1592967510 Is US defense spending too high, too low, or just right?

Michael O’Hanlon explains why context rather than size helps us make sense of the defense budget.

A general view of the U.S. Internal Revenue Service (IRS) building in Washington May 27, 2015. Tax return information for about 100,000 U.S. taxpayers was illegally accessed by cyber criminals over the past four months, U.S. IRS Commissioner John Koskinen said on Tuesday, the latest in a series of data thefts that have alarmed American consumers. REUTERS/Jonathan Ernst - GF10000109446 Who are the rich and how might we tax them more?

David Wessel presents the pros and cons of raising taxes on the wealthiest Americans.

Yaneidi Guzman, 38, walks home with her mother-in-law in Caracas, Venezuela, February 17, 2019. Guzman has lost a third of her weight over the past three years as Venezuela's economic collapse made food unaffordable and she now hopes the opposition will succeed in bringing urgently needed foreign aid. She is one of many Venezuelans suffering from malnutrition. "It's not that I want to be rich, or a millionaire", Guzman said. "But I do want to give my children a good future, to make sure I can take them to the doctors when they get ill... and that they eat well." REUTERS/Carlos Garcia Rawlins  SEARCH "RAWLINS GUZMAN" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. - RC1F8A0356E0 What every American should know about US foreign aid

George Ingram discusses foreign aid—what it is, what percentage of the federal budget it makes up, its efficiency, and who supports it.

Doctors confer in the neonatal intensive care unit of the Holtz Children's Hospital at Jackson Memorial Hospital in Miami September 30, 2013. The Obama administration accelerated its push to persuade individual Americans to sign up for the most extensive overhaul of the U.S. healthcare system in 50 years, the Affordable Care Act (commonly referred to as "Obamacare"), even as the program's foes in Congress fought to delay its launch with the threat of a federal government shutdown. The Jackson Health System is the largest in Florida and one of the largest in the U.S.  REUTERS/Joe Skipper (UNITED STATES - Tags: HEALTH) - GM1E9A10J3G01 Current debates in health care policy: A brief overview

Matthew Fiedler and Christen Linke Young provide an overview of what are among the most prominent issues in 2020 the election: health care coverage and health care costs.

A man walks away from the U.S Treasury Department in Washington, U.S., August 6, 2018.     REUTERS/Brian Snyder - RC1FD03EA500 How worried should you be about the federal deficit and debt?

David Wessel explains why the federal debt is on an unsustainable course and the potential consequences on the way.

U.S. Senate Minority Whip John Cornyn (L), Senate Minority Leader Mitch McConnell (2nd L) and Senate Majority Leader Harry Reid (R) head to the front of the chamber together before President Barack Obama delivers his State of the Union speech on Capitol Hill in Washington, January 28, 2014. REUTERS/Larry Downing (UNITED STATES  - Tags: POLITICS)   - TB3EA1T07R4IC What is the Senate filibuster, and what would it take to eliminate it?

Molly Reynolds explains the history of the Senate filibuster and the possible, but politically unlikely, ways to reform or eliminate it.

A Cataldo Ambulance medic holds used doses of naloxone after medics revived a man in his 40's who was found unresponsive from an opioid overdose in the Boston suburb of Salem, Massachusetts, U.S., August 9, 2017. The victim received a total of 12mg of naloxone. Nurses at the hospital recognised the man, saying he was brought in the day before after overdosing. REUTERS/Brian Snyder  SEARCH "SNYDER OPIOIDS" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. - RC18689E2910 Understanding the role of despair in America’s opioid crisis

Carol Graham discusses the causes and consequences of the opioid crisis and what policymakers can do to address it.

Graduate students and others rally against the proposed GOP tax reform bill at Union Square in the Manhattan borough of New York City, New York, U.S., November 29, 2017. REUTERS/Shannon Stapleton - RC1BAA1EABA0 What are tax expenditures and loopholes?

William Gale explains how tax reforms could simplify taxes, address income inequality, and raise government revenue.

Demonstrators march down Pennsylvania Avenue during a People's Climate March, to protest U.S. President Donald Trump's stance on the environment, in Washington, U.S., April 29, 2017.     REUTERS/Mike Theiler       TPX IMAGES OF THE DAY - RC1C93696C90 What to do about climate change and why?

Samantha Gross discusses effective policies to combat climate change given the widespread dependence on fossil fuels in the American and global economies.