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EDITORIAL BOARD QUESTIONNAIRES

Lauren Underwood

Democratic candidate for U.S. House (14th district)

Lauren Underwood

Lauren Underwood

Democratic candidate for U.S. House (14th district)

Education
Neuqua Valley High School Naperville, IL 2004 University of Michigan Ann Arbor, MI 2008 - BSN Johns Hopkins University Baltimore, MD 2009 - MSN/MPH
Occupation
Registered Nurse. NextLevel Health
Home
Naperville
Past Political/Civic Experience
Appointee in the Administration of President Barack Obama. Senior Advisor, October 2016 - January 2017 Special Assistant, November 2014 - October 2016 Office of the Assistant Secretary for Preparedness and Response U.S. Department of Health and Human Services City of Naperville Fair Housing Advisory Commission, 2003 - 2004

Responses to our questions

The U.S. government is now $20 trillion in debt. To address that historic level of public indebtedness, the country would need to raise revenue and/or decrease spending. What is your position on the budget and debt?

I believe that it is our duty to continue to build a more perfect union for our children to inherit. If we do not make tough choices about spending, the American Dream will not be attainable for future generations.

The recently enacted GOP Tax Plan is a disaster for northern Illinois families and for our federal deficit. In the coming 10 years, this plan raises taxes for many middle- and upper-middle-class families in order to provide a tax cut to the wealthiest 1% and large corporations, all while adding over $1 trillion to the federal deficit. In passing this bill, congressional Republicans have vacated their commitment to fiscal responsibility and to our children -- leaving them to foot the bill. This is unacceptable.

I support responsible governance -- properly funding the programs that American families count on to protect our borders, serve our veterans, elderly, and disabled, and support our schools. It shouldn't take billions of dollars of additional borrowing to fund these efforts. If families across our country can be disciplined enough to develop and stick to a budget, so can Washington leaders. Additionally, it has been years since Congress passed a budget according to standard appropriation cycles. At the time of writing, we are facing our third potential government shutdown of the Trump era. "Washington dysfunction" as the explanatory refrain has somehow become routine, but the current cycle of short-term continuing resolutions is unsustainable.

Congress needs to re-prioritize responsibility of one of its primary legislative functions: timely appropriation of funds to operate the federal government. This work can, and should, be done on a bipartisan basis in 2018 and beyond.

Can you identify any major federal expenditures or programs that you would eliminate?

The federal government should be a model of American efficiency and excellence. Throughout my career as a federal employee and Obama appointee, I worked with some of the smartest, most dedicated policy experts in the country.

My former colleagues are deeply committed to serving the American people and being thoughtful stewards of taxpayer dollars. This ethos of fiscal constraint was deeply rooted, particularly as resources became increasingly limited as a result of funding cuts, sequestration, and other cost containment strategies. It is with this perspective that I suggest two areas of contemporary spending and proposals that run counter to the values of frugality, stewardship, and efficiency that were emphasized during my time in government.

The Trump Administration brought in an era of unprecedented spending to protect the president and his family. The frequent trips to their preferred leisure locations, namely the Trump owned resorts, have cost taxpayers millions to date in agent overtime and related security expenses. If our country cannot find $9 billion to reauthorize and properly fund coverage for children under the Children's Health Insurance Program (CHIP), how can we continue to rationalize and normalize the extravagance of the Trump family travels?

Additionally, the relentless efforts by Washington Republicans to leverage and rationalize the President's enthusiasm for a border wall is a failing proposition -- there is no public mandate, no dedicated funding, and no bilateral agreement with Mexico to support the construction. The first phase of the wall will require $18 billion in federal resources, per a January 5 budget request from U.S. Customs and Border Protection.

I continue to believe the United States should invest in strong border security, however an expensive and ineffective physical barrier along our southern border is inappropriate. Our President has made it clear that he has a deep disdain for communities of color, immigrant or otherwise. In making policy decisions about immigration and border security, we should honor the legacy of immigrant families who have come to this country for centuries in search of the American dream.

America has always been a shining example of possibility in world filled with uncertainty, suppression, war and turmoil. The proposed wall is an expensive barrier that tarnishes the important legacy new Americans have had on this country. Lady Liberty called for tired, poor, huddled masses seeking freedom. This wall is a mockery of those words that welcomed millions for decades. We are better than this.

Medicare and Medicaid costs continue to spiral. How can these programs be restructured to control costs and avoid collapse? Be specific about your willingness to change or reduce future benefits.

Medicare and Medicaid are critical programs that are run relatively efficiently, however, there is always room for improvement. According to the Kaiser Family Foundation, from 2010 to 2016, average per capita spending growth was 1.3 percent within the Medicare program, down from 7.4 percent between 2000 and 2010.

  1. Significant reforms to the Medicare program have been enacted in recent years, leading to this drop in per capita spending growth, and should be continued. These delivery system reforms, including bundled payments and value-based purchasing, were first implemented through the Affordable Care Act, and like bundled payments and value-based purchasing, improve efficiency and quality of care while also reducing costs.
  2. We need to boost program integrity efforts, like aggressively collecting on overpaid claims, and recovering payments due to fraud, waste and abuse. The dollars spent in program integrity consistently demonstrate a strong return on investment - the FY2018 HHS Budget in Brief touts an ROI at $12 returned for every $1 invested.
  3. We must reign in the cost of prescription drugs. It's time we authorize Medicare to directly negotiate drug prices with pharmaceutical companies. This negotiation should occur in tandem with a formulary and clear pricing structure, a standard practice in the private insurance market. At the same time, we must maintain a pathway for beneficiaries to have fair, open access to preventive and treatment drugs as needed, while assuring a lower price to taxpayers.

The Medicaid expansion has been an incredible success in Illinois and across the country. I see two opportunities for cost reduction and quality of care improvement, which would strengthen the program.

  1. Maternal health care. Medicaid is the leading payer for maternity services domestically - CMS estimates that Medicaid finances 45% of all births domestically. Our country has unacceptably high maternal and infant mortality rates, particularly for communities of color, and CMS has an opportunity to examine and invest in interventions to reduce these outcomes. I support a larger role for nurse midwives and birth centers in maternity care for low-risk Medicaid pregnant women. I also support standards to provide greater consistency across the country in medicaid maternity benefits, including evidence based home visit programs.
  2. Mental health services. Medicaid is also the largest payer for mental health services in the nation, and significantly finances substance use disorder services. Access to care is critical to proper treatment of behavioral health disorders and I strongly oppose proposals to restructure Medicaid as a block grant or per capita cap program. We must equip all states with resources to cover behavioral health services.

More broadly, there should also be a stronger emphasis on preventive care in Medicare and Medicaid. Finally, we have a responsibility to fund the Children's Health Insurance program (CHIP).

What if anything should be the federal government's role in helping Americans obtain health insurance coverage?

Every American has the right to high quality, affordable health care. This fundamental belief in healthcare as a human right is at the core of my nursing practice. As I approach a decade of experience as a nurse, I remain focused on ensuring all families across Illinois can lead healthy lives.

Thanks to the Affordable Care Act, we saw a historic drop in the uninsured rate, which means millions of families no longer have to worry about being one bad diagnosis away from bankruptcy. In the 14th district, 37,000 hard working folks have coverage through Obamacare.

It was an incredible honor to work at the federal level to implement this program for these families across my district and the millions of other Americans who have benefited from the coverage and reforms codified under the law. I am committed to ensuring that these Illinoisans and all Americans maintain the coverage they need.

Obviously, the Affordable Care Act is not perfect and I support policies that will improve the law, including:

    Stabilizing the health insurance marketplaces by providing long-term commitment to cost-sharing reductions, and an incentive for all Americans to maintain insurance coverage;
  • Properly funding risk pools so that more insurers will offer plans on the marketplace;
  • Helping more middle class families afford coverage by expanding eligibility for tax credits and cost-sharing reductions;
  • Reigning in the soaring cost of prescription drugs; and
  • Investing in comprehensive mental health coverage.

Finally, like many communities across the country, the 14th has been impacted by the opioid epidemic. This problem will not be solved by law enforcement solutions alone - addressing the underlying behavioral health components of addiction is critical. To tackle this crisis, we need everyone to come to the table to implement a fully funded, comprehensive solution that will address prevention, treatment, and recovery. We must curb future addictions, but we also cannot forget those who are currently struggling without access to much needed treatment. We need to pass legislation that will reduce cost barriers to treatment, and that will ensure Medicaid and health insurance cover both detox and rehab. Inaction on this issue is not an option.

Economic growth has been steady but wage growth is slow. Are you content with the state of the economy? What is your recipe for enhancing American prosperity?

Families across the IL-14 deserve good, high-paying jobs and a strong local economy. Now. We first need a broad approach to local job creation. We need to:

  1. Invest in small businesses by developing and sustaining an effective entrepreneurial ecosystem in IL14. Its critical that we are serious about ensuring access to capital for aspiring entrepreneurs to launch new ventures and grow to scale. The Small Business Administration should be a partner with local municipalities to incentivize place-based accelerator and incubator development, supported by tax credits and perhaps even in collaboration with the federal procurement process.
  2. Incentivize employers to hire out-of-work or underemployed individuals. Offering tax credits to Social Enterprise Businesses that prioritize hiring disabled and chronically under- or unemployed individuals would be a strong start. Local apprenticeship programs provide excellent training and connections to job opportunities across the 14th district. Federal support for these programs, including those sponsored by labor unions, could allow for local expansion. Everyone should have the opportunity to have a job that offers meaningful work and high wages.
  3. Prioritize investment in new and emerging sectors that can generate jobs for the 21st century. Illinois has become a leader in the clean energy economy, and the 14th district should be the local home for clean energy innovation, given our proximity to both the Fermi National Accelerator Laboratory and the Illinois Research and Development Corridor. The jobs created in the emerging energy sector also support the economy by helping consumers save money and protecting against climate change.

Additionally, our community needs significant investment in modernizing our local infrastructure. From rehabbing highways and bridges, to supporting Metra commuter rail stops for DeKalb and Kendall counties, infrastructure investment can improve our quality of life and public safety throughout the 14th district, and stimulate significant job growth. America has never succeeded by looking backwards; we succeed when we look forward, when we innovate, when we lead, and when we build.

Finally, we must create an economy that works for all Americans. The cornerstone of economic security is equal pay. Closing the gender wage gap is a priority, and I support interventions such as raising the federal minimum wage to $15 an hour. To complement this we must pass legislation to establish paid family and sick leave, ensure families can access affordable child care, and protect women's unrestricted access to reproductive health services.

If you could fix longstanding problems with this country's immigration system tomorrow, what would you do? What is your position on the future of DACA and the Dreamers?

Immigrants have been vital to the cultural fabric and economic success of America since our nation's founding. Our policies must honor and recognize the value and dignity of all of our immigrant communities and I strongly condemn the hurtful and divisive rhetoric that has become commonplace under the new administration.

Approximately 800,000 immigrants in this country were protected under the Deferred Action for Childhood Arrivals ("DACA") program, which President Trump recently rescinded, thereby threatening these young people with deportation from the only country they have known. This is not only cruel, it is bad for our economy. The DACA-eligible population earns almost $19.9 Billion and contributes more than $1.4 Billion in Federal and $1.6 Billion in State and Local Taxes annually. In the IL-14 the estimated 3,700 DACA-eligible population contributes an estimated $116,400,000 to our local economy, according to national analysis completed by the University of Southern California. These are bright, hard-working people who contribute to our northern Illinois economy and enrich our communities. We must take immediate action to provide all DACA recipients a pathway to citizenship through a clean Dream Act.

Finally, our current immigration system is broken. Simple, structural barriers such as Trump's proposed border wall, will not solve this complex, multi-faceted problem. We must take immediate action to pass comprehensive immigration reform, including re-evaluating which countries receive preferential immigration authority. I am eager to support policies that provide clear guidance around legal immigration, recognize existing economic and civic contributions of our immigrant communities, offer a pathway to citizenship, and decriminalize immigration enforcement action.

North Korea's nuclear weapons program represents a direct threat to the security of the United States and its Pacific allies. How should the U.S. confront or contain Kim Jong Un's regime?

Fundamentally, the United States needs to adopt a foreign policy position with North Korea that does not escalate tensions. President Trump's reckless taunting of Kim Jong Un presents a clear and present danger to our national security and to the stability of our relationships on the peninsula. Diplomacy and leadership, backed by a strong military, are critical to deterring further aggression by the North Korean regime. This means investing in our State Department and diplomatic programs in order to strengthen our relationships with our Pacific allies and work to combat the threat of the North Korean nuclear activity. It also means treating this situation with the gravity it deserves -- and not picking fights with a dangerous, nuclear armed dictator on Twitter.

Congress needs to step up oversight in foreign affairs. At a time when Kim Jong Un has reportedly developed missiles that can reach all of the United States, the Congress must be willing to assert its War Powers responsibilities to ensure we only enter a conflict with North Korea when the data and intelligence unimpeachably suggest an a valid and credible threat. We must also be ready to defend ourselves, and this means that the United States must continue to invest in radiological and nuclear countermeasure development under Project Bioshield. We must be prepared in the event of an attack.

ISIS is contained in Syria and Iraq but terrorism remains a threat. What are your priorities in keeping the country safe?

Despite progress to contain ISIS, we must remain vigilant in our efforts to protect Americans domestically and abroad. Central to this effort is continuing to uplift and support our intelligence and law enforcement agencies who serve to keep us secure, often at great risk to their own personal safety. These intelligence and law enforcement officers have halted countless domestic attacks and this work must continue. The radicalization of individuals at home and abroad is often influenced by socio-economic conditions, whether poverty, inequality, repression, war, bigotry, or islamophobia. We must continue intervene to address these factors, and I strongly support the United Nations recent initiative focused on addressing root causes of violent extremism.

Finally, the United States must maintain our preparedness against bioterror agents. Our continued investment in countermeasure development and maintaining an adequate pipeline of products will allow our country to be nimble as we respond to future terror threats.

Should the U.S. continue to abide by the terms of the nuclear agreement with Iran?

Yes. The United States pursued an agreement with Iran as part of our work as a permanent member of the United Nations Security Council. In partnership with other nations, we entered into a commitment that pooled our collective leverage of economic penalties, sanctions and embargoes to halt Iran's progress towards nuclear weapons capability. Congress recently leta key December 2017 deadline to reimpose sanctions pass, allowing the Iran agreement to remain intact. I support this decision by Congress.

It is widely held that this agreement is producing desired outcomes and I believe it continues to be in the United States' national security interest to abide by the agreement. However, it is disappointing that this ideological disagreement between President Trump and Congressional leadership is playing out on the world stage. Displaying these fissures could weaken our credibility as a negotiator, which has significant long-term consequences.

What is your position on the continued presence of U.S. soldiers in Afghanistan?

The United States continues to play a valuable role in supporting the Afghan government against the threat of the Taliban and other terrorist groups. Given the perilous state of stability both within Afghanistan, and across the region, it is appropriate to maintain our current presence. That said, I remain concerned about the limited information that the Trump Administration is willing to disclose regarding the number of troops deployed or the objectives of their engagement. In their oversight capacity, Congress should continue to closely monitor the comprehensive strategy behind the war in Afghanistan, and should insist the Trump Administration improve transparency in this important policy area.

Do you support a unified, federal background check system for gun sales? Do you support magazine limits or a ban on certain rifles? Describe, briefly, your position on how to balance safety with the Second Amendment.

We have a moral obligation to address the gun violence epidemic that is threatening communities across our country. First, we absolutely need universal background checks for all gun sales, whether through federal licences, over the internet, or through private exchanges. The current system includes loopholes that make it easy for criminals and dangerously mentally ill to buy guns; it's just common sense to fix this vulnerability. Additionally, individuals who have existing legal actions regarding threats of violence (ie. restraining orders) should not be permitted to purchase new firearms. This is a public safety issue of critical importance, and I have been so disappointed in the lack of courage or congressional action on this issue. We deserve better.

Additionally, we need to treat gun violence like the epidemic that it truly is. For example, the Centers for Disease Control and Prevention should be able to complete epidemiologic studies on the impact of gun violence on populations, and study the psychological triggers or signs that lead to gun violence. For example, we know that gun violence is the third leading cause of death for children in our country, and we have an obligation to keep them safe and reduce these deaths. These important, science-based research initiatives can take place without infringing upon any citizen's second amendment rights.

I respect the second amendment and believe in protecting all of our rights as Americans. Our country should not be numb to the horrific frequency of mass shootings and related acts of gun violence. I am personally tired of reacting with perfunctory "thoughts and prayers" after horrific acts of gun violence. I believe we must honor the victims and survivors with action. When automobile accidents took too many American lives each year, we intervened with research and then fact-based policy regulations for seat belts and airbags. There is no reason we should be unable to do the same with respect to gun violence. It's a safety issue.

Should the U.S. government take steps to curb emissions of greenhouse gas? If so, what steps? If not, why not?

Climate scientists nearly unanimously agree that the Earth's temperature increases have been driven by excess greenhouse gas emissions caused by humans. Given the current trajectory, climate change presents both an existential threat to life on earth and also one of our most pressing national security issues.

The impact of climate refugees, fights for basic resources like food and water caused by these events, and increased numbers of public health emergencies and disasters, will pose real, destabilizing challenges -- and we have a responsibility to act in an effort to curb these threats. Throughout 2017, we saw the danger of severe weather events -- from the hurricanes in Texas, Puerto Rico & Florida, to the wildfires across California, to the heavy rainfalls and flooding across much of McHenry and Lake Counties -- and we know that these types of events will only continue to intensify and multiply.

By 2020, Illinois could see declined corn yields of up to 20% annually due to climate change according to the Risky Business Project. Of course, we can continue to invest in mitigation strategies, like federally funded crop and flood insurance programs, but ignoring the scientific evidence of climate change will disadvantage our economic standing in the future.

I support expanded investment and deployment of renewable energy projects, investment in public transportation projects, and a fully funded and appropriately staffed Environmental Protection Agency with authority to regulate, monitor and enforce standards associated with the Clean Air Act, Clean Water Act and other safeguards to promote health, safety and our environment. Finally, it was a mistake for the United States to pull out of the Paris Climate Agreement. In doing so, we ceded our international leadership role and we are now unable to achieve an important multilateral goal of reducing emissions. We must recommit ourselves to innovating and leading on the world stage in the fight against the dangerous impacts of climate change -- because the future of our planet depends on it.

Tell us something about you that might surprise us.

My family first moved to Naperville in 1990. I proudly completed my elementary and high school education in this community, graduating from Neuqua Valley High School in 2004. I also attended the University of Michigan on a full scholarship, and like many students, financial assistance was essential in my ability to complete my higher education. These experiences have shaped my commitment to public education. Public K-12 education requires continued investment, and I firmly believe that every child in our community should have access to an excellent public education.

Additionally, we should be making it easier for students to afford college by increasing our investment in higher education institutions. I support increased funding for pell grants, increased availability of affordable subsidized student loans, and the continuance of the public service loan forgiveness program. Higher education should not be a privilege of a certain class of people and we must address the student loan crisis now before it prevents many of my fellow millennials or Generation Z students from reaching financial goals and milestones like homeownership or retirement later in life.

Also, I love gardening, am obsessed with farmers markets, and am a big fan of Beyonce.

If you are an incumbent, tell us the most significant accomplishment of your current term.

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Candidates for U.S. House (14th district)

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