Breaking Down on the ‘Last Mile’

In the wake of the Dobbs ruling and subsequent state-level actions on abortion, this is the season for the pro-life movement to make big asks on behalf of vulnerable families. Leading politicians from both parties have endorsed expanded support for families and children, even if they haven’t agreed on which approach to take. But to have a real win for moms and babies, the pro-life movement needs to make sure that any program it backs will be designed to actually reach the families that need it most. After all, an aid program matters little without funding to support the last mile of work to deliver aid to the most vulnerable families.

Sen. Marco Rubio and Rep. Nancy Mace have introduced the “Standing with Moms Act” which simply proposes creating a national website where mothers can look up local and federal relief programs. That’s marginally useful, but the more common problem is that even when parents know about programs, the promises are only good on paper, not in reality.

During the pandemic, I got my expanded child tax credit payments without a hiccup, but families that didn’t file tax returns couldn’t receive payments automatically. They had to initiate the ask, navigating the IRS’s clunky website—which initially didn’t work on mobile phones. 

It wasn’t just a problem with programs cobbled together on the fly. Temporary Aid to Needy Families (TANF), which was established in the 1990s, made headlines when Brett Favre allegedly diverted more than $5 million of the program’s funding to build a volleyball stadium at his daughter’s college, but TANF fails in small ways every day: Today it reaches only about 1 in 5 families with children in poverty. In New York City, tens of thousands of free preschool spots go unclaimed because the city hasn’t reached out to the poorest families to sign up.

For the poorest, benefits delayed are functionally benefits denied. Social Security Disability Insurance applications take, on average, seven months to be assessed at all. For a quarter of applicants who will ultimately be approved for benefits, getting benefits granted requires working through two layers of appeals. On average, the appeals process takes nearly two and a half years. 

But instead of treating this as a serious problem, politicians treat our failure to get aid to the families that need it most as budget savings. When the CBO scored President Biden’s proposed child care aid in the Build Back Better program, it anticipated that a third of children would not receive the aid for which they qualified. Democrats didn’t see that as a reason to go back to the drawing board, but as a strategy to keep the program under the desired $400 billion cost. The cost savings weren’t a matter of solving administrative inefficiencies, but the fruits of a profound anticipated inefficiency in paying it out. 

The government can learn from the example of nonprofits that work specifically on building out the neglected last mile of public policy. When COVID vaccines became available on paper, they were initially inaccessible to many of the most vulnerable in practice. It wasn’t just a matter of shortages or how prioritizing groups was set—it was often impossible to figure out where vaccines were being offered or how to prove eligibility. When I made appointments for family members, I relied on special tips like “Enter the CVS portal through Hawaii to avoid the website timing out” that I got through vaccination navigator Facebook groups.

VaccinateCA initially swung into action with a low-tech solution—they simply called California pharmacies to ask whether vaccines were in stock and logged what they learned on a map. The group attracted volunteers and funders, all committed to connecting people with what they’d been promised on paper, until eventually they were running paid call centers and providing the back-end data for the CDC’s official Vaccines.gov page.

It’s good when groups like VaccinateCA or Code for America step in to fill the gap. But when the government keeps creating programs that pass the buck on implementation to nonprofits, they aren’t serious about pro-life family policy. Making sure that laws are implemented requires a different approach, and much more money. 

A successful system to help the most vulnerable will be one that is more focused on serving the poor than on preventing fraud. A criminal trying to steal will often be better prepared to navigate a tricky bureaucratic system than a mother using the library computer with one hand while soothing her baby with the other. 

It requires putting fewer resources toward hurdles, automatic disqualifications, and all-caps warnings about criminal penalties, and more money on trained staff who offer help “curing” questionable applications. Just as we send census workers to the door when people don’t fill out their forms, the state should proactively reach out when applications get rejected on correctible technicalities. 

For a time, I worked for a mobile money remittance company, helping immigrants send money home to family without spending so much on corrupt middlemen or exploitative fees. We couldn’t afford to be bilked by fraudsters, but we also couldn’t afford to lose potential lifetime customers by making signing up too onerous. Automated tools caught good faith users and serial fraudsters. We could tune our machine learning algorithm to catch more bad guys and snag fewer good guys, but we would always need an extensive support staff to help identify our real users and help them get out of payment limbo. 

I was running HR, but, just like everyone at the company, I did some shifts with the support team. Our CEOs wanted everyone to know how our service felt to users. Many government programs would benefit if the administrative heads and congresspeople did occasional shifts in a local Social Security office, answered the IRS help line, or sat next to people who were recently laid off as they worked through their unemployment insurance application. 

We had to make things right for our users—a business can’t survive if it doesn’t provide real value to its customers. But too often, the government doesn’t treat the people it serves as though their needs are real and urgent. It offers aid without access, as though the point of the program was more to tout our own charity than to actually help.

A program for the poor should be designed for the poor. Our brusque, byzantine bureaucracies make it hard for poor families to welcome even a planned, wanted child. It is much harder when the new baby is a surprise and strains both the mother’s finances and her ability to keep up with the paperwork that helps her family afford groceries.  Vulnerable families don’t just need monetary aid, but to be treated with dignity and care at every step of the application and administrative process. Every parent knows that care isn’t a matter of just proving that you tried, but of sustained, sincere accompaniment with your child when they need you. Our aid to parents has to work the same way. It will cost more financially to do it right, but it costs us much more morally to make empty offers to the poor.