Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, 2026

— 311 — Department of Agriculture ENDNOTES 1. U.S. Department of Agriculture, Fiscal Year 2023 Budget Summary, p.1, https://www.usda.gov/sites/default/ files/documents/2023-usda-budget-summary.pdf (accessed December 14, 2022). 2. See, for example, U.S. Department of Agriculture, “Transforming the U.S. Food System,” https://www.usda. gov/fst (accessed December 14, 2022). 3. U.S. Department of Agriculture, Fiscal Year 2023 Budget Summary, p.1. 4. U.S. Department of Agriculture, “USDA Celebrates 150 Years,” https://www.usda.gov/our-agency/about-usda/ history (accessed December 16, 2022). 5. The law stated, “[T]here is hereby established at the seat of government of the United States a Department of Agriculture, the general designs and duties of which shall be to acquire and to diffuse among the people of the United States useful information on subjects connected with agriculture in the most general and comprehensive sense of that word, and to procure, propagate, and distribute among the people new and valuable seeds and plants.” Gladys L. Baker et al., Century of Service: The First 100 Years of the United States Department of Agriculture, (Washington, DC: U.S. Government Printing Office, 1963) p. 13, https://babel. hathitrust.org/cgi/pt?id=uc1.b4254098&view=1up&seq=33 (accessed December 16, 2022). 6. U.S. Department of Agriculture, Fiscal Year 2023 Budget Summary, p. 2. 7. Ibid., p. 2. 8. U.S. Department of Agriculture, Strategic Plan: Fiscal Years 2022–2026, p. 3, https://www.usda.gov/sites/ default/files/documents/usda-fy-2022-2026-strategic-plan.pdf (accessed December 14, 2022). 9. News release, “USDA Announces Framework for Shoring Up the Food Supply Chain and Transforming the Food System to Be Fairer, More Competitive, More Resilient,” U.S. Department of Agriculture, June 1, 2022, https://www.usda.gov/media/press-releases/2022/06/01/usda-announces-framework-shoring-food-supply- chain-and-transforming (accessed December 14, 2022). 10. U.S. Department of Agriculture, “Transforming the U.S. Food System.” 11. U.S. Department of Agriculture, Strategic Plan: Fiscal Years 2022–2026, pp. 1–2. 12. U.S. Department of Agriculture, “Background on the U.S. Approach to the 2021 UN Food Systems Summit,” August 4, 2021, https://www.usda.gov/sites/default/files/documents/Background-on-US-approach-2021-UN- Food-Systems-Summit.pdf (accessed December 14, 2022). 13. U.S. Department of Agriculture, “UN Food Systems Summit,” https://www.usda.gov/oce/sustainability/un- summit (accessed December 14, 2022). 14. Mark Bittman et al., “How a National Food Policy Could Save Millions of American Lives,” The Washington Post, November 7, 2014, https://www.washingtonpost.com/opinions/how-a-national-food-policy-could- save-millions-of-american-lives/2014/11/07/89c55e16-637f-11e4-836c-83bc4f26eb67_story.html (accessed December 14, 2022); Daren Bakst and Gabriella Beaumont-Smith, “No, We Don’t Need to Transform the American Food System,” The Daily Signal, February 26, 2021, https://www.dailysignal.com/2021/02/26/ no-we-dont-need-to-transform-the-american-food-system/ (accessed December 14, 2022); and Daren Bakst, “Biden’s Food Conference Should Put People First, Not Environmental Extremism,” The Daily Signal, September 22, 2022, https://www.dailysignal.com/2022/09/22/bidens-food-conference-should-put-people- first-not-environmental-extremism/ (accessed December 14, 2022). 15. News release, “USDA to Invest Up to $300 Million in New Organic Transition Initiative,” U.S. Department of Agriculture, August 22, 2022, https://www.usda.gov/media/press-releases/2022/08/22/usda-invest-300- million-new-organic-transition-initiative (accessed December 14, 2022). 16. Gary Baise, “Sri Lanka’s Green New Deal Was a Disaster,” Farm Futures, November 14, 2022, https://www. farmprogress.com/commentary/sri-lankas-green-new-deal-was-disaster (accessed December 16, 2022). 17. See, for example, Catherine Greene et al., “Growing Organic Demand Provides High-Value Opportunities for Many Types of Producers,” Economic Research Service, U.S. Department of Agriculture, February 6, 2017, https://www. ers.usda.gov/amber-waves/2017/januaryfebruary/growing-organic-demand-provides-high-value-opportunities- for-many-types-of-producers/#:~:text=ERS%20research%20shows%20that%20many,flavor%20desired%20 by%20the%20consumer (accessed December 14, 2022), and Andrea Carlson, “Investigating Retail Price Premiums for Organic Foods,” Economic Research Service, U.S. Department of Agriculture, May 24, 2016, https://www.ers. usda.gov/amber-waves/2016/may/investigating-retail-price-premiums-for-organic-foods/ (accessed December 16, 2022). Further, there are many myths, such as those regarding the alleged health benefit of organic food. One — 312 — Mandate for Leadership: The Conservative Promise meta study found that “[t]he published literature lacks strong evidence that organic foods are significantly more nutritious than conventional foods.” Crystal Smith-Spangler et al., “Are Organic Foods Safer or Healthier Than Conventional Alternatives,” Annals of Internal Medicine, Vol. 157, No. 5 (September 4, 2012), pp. 348–366, https:// www.acpjournals.org/doi/epdf/10.7326/0003-4819-157-5-201209040-00007 (accessed December 16, 2022). 18. Steve Savage, “USDA Data Confirm Organic Yields Significantly Lower Than With Conventional Farming,” Genetic Literacy Project, February 16, 2018, https://geneticliteracyproject.org/2018/02/16/usda-data-confirm- organic-yields-dramatically-lower-conventional-farming/ (accessed December 16, 2022). 19. See, for example, U.S. Department of Agriculture, “Notice: Climate-Smart Agriculture and Forestry Partnership Program, Request for Comments,” USDA–2021–0010, October 21, 2021, https://www.regulations. gov/document/USDA-2021-0010-0001 (accessed December 16, 2022). 20. Inflation Reduction Act of 2022, Public Law 117–169. 21. U.S. Department of Agriculture, Economic Research Service, “Productivity Growth in U.S. Agriculture (1948–2019),” https://www.ers.usda.gov/data-products/agricultural-productivity-in-the-u-s/productivity- growth-in-u-s-agriculture-1948-2019/ (accessed December 14, 2022). 22. U.S. Department of Agriculture, Economic Research Service, “Total Food Budget Share Increased from 9.4 Percent of Disposable Income to 10.3 Percent in 2021,” July 15, 2022, https://www.ers.usda.gov/data-products/ chart-gallery/gallery/chart-detail/?chartId=76967 (accessed December 14, 2022). 23. U.S. Department of Labor, Bureau of Labor Statistics, “Quintiles of Income Before Taxes: Annual Expenditure Means, Shares, and Standard Errors, and Coefficients of Variation, Consumer Expenditure Surveys,” 2021, Table 1101, https://www.bls.gov/cex/tables/calendar-year/mean-item-share-average-standard-error/cu- income-quintiles-before-taxes-2021.pdf (accessed December 16, 2022), and Daren Bakst and Patrick Tyrrell, “Big Government Policies That Hurt the Poor and How to Address Them,” Heritage Foundation Special Report No.176, April 5, 2017, p. 7, https://www.heritage.org/sites/default/files/2017-04/SR176.pdf. 24. Daren Bakst and Joshua Sewell, “Congress Should Stop Abrogating Its Spending Power and Rein in the USDA Slush Fund,” Heritage Foundation Issue Brief No. 6052, February 19, 2021, p. 2, https://www.heritage.org/ budget-and-spending/report/congress-should-stop-abrogating-its-spending-power-and-rein-the-usda. 25. Commodity Credit Corporation Charter Act of 1948, Public Law 80–806. 26. Bakst and Sewall, “Congress Should Stop Abrogating Its Spending Power.” 27. Ibid., p. 3. 28. Daren Bakst, “Comment from Bakst, Darren” on “Notice: Climate-Smart Agriculture and Forestry Partnership Program, Request for Comments,” USDA–2021–0010, October 21, 2021,” November 1, 2021, https://www. regulations.gov/document/USDA-2021-0010-0001/comment?filter=bakst (accessed December 16, 2022). 29. U.S. Department of Agriculture, “Notice: Climate-Smart Agriculture and Forestry Partnership Program.” 30. Megan Stubbs, “The Commodity Credit Corporation (CCC),” Congressional Research Service Report for Congress, updated January 14, 2021, https://crsreports.congress.gov/product/pdf/R/R44606 (accessed December 16, 2022). 31. “Overall, 34 percent of all farms reported receiving some type of Government payment in 2021,” and “[o]verall, 14 percent of U.S. farms participated in Federal crop insurance programs.” Christine Whitt, Noah Miller, and Ryan Olver, “America’s Farms and Ranches at a Glance: 2022 Edition,” U.S. Department of Agriculture, Economic Research Service, pp. 24 and 26, https://www.ers.usda.gov/webdocs/publications/105388/eib-247. pdf?v=527.4 (accessed March 18, 2023). This data, which apparently does not cover crop insurance, included payments beyond just commodity payments, such as conservation payments. 32. Randy Schnepf, “Farm Safety-Net Payments Under the 2014 Farm Bill: Comparison by Program Crop,” Congressional Research Service Report for Congress, August 11, 2017, https://fas.org/sgp/crs/misc/R44914.pdf (accessed December 14, 2022). 33. Although livestock and specialty crop producers do receive some subsidies, former American Farm Bureau Federation President Bob Stallman captured the subsidy issue well. He “dismisse[d] outright the claim that farmers couldn’t survive without subsidy money. ‘Why does the livestock industry survive without subsidies?’ he ask[ed]. ‘Why does the specialty crop [fruit and vegetable] industry survive?’” Tamar Haspel, “Why Do Taxpayers Subsidize Rich Farmers?” The Washington Post, March 15, 2018, https://www.washingtonpost. com/lifestyle/food/why-do-taxpayers-subsidize-rich-farmers/2018/03/15/50e89906-27b6-11e8-b79d- f3d931db7f68_story.html (accessed March 18, 2023).

— 646 — Mandate for Leadership: The Conservative Promise 3. Section 121 (developing and administering an education program that teaches veterans about their health care options available from the Department of Veterans Affairs). 4. Section 152 (returning the Office for Innovation of Care and Payment to the Office of Enterprise Integration with a joint governance process set up with the VHA). 5. Section 161 (overhauling Family Caregiver Program expansion, which has gone poorly, so that it focuses on consistency of eligibility and awareness that the most severely wounded or injured may require the program indefinitely). l Require the VHA to report publicly on all aspects of its operation, including quality, safety, patient experience, timeliness, and cost-effectiveness, using standards similar to those in the Medicare Accountable Care Organization program so that the government may monitor and achieve continuous improvement in the VA system more effectively. l Encourage VA Medical Centers to seek out relevant academic and private- sector input in their communities to improve the overall patient experience. Budget l Conduct an independent audit of the VA similar to the 2018 Department of Defense (DOD) audit to identify IT, management, financial, contracting, and other deficiencies. l Assess the misalignment of VHA facilities and rising infrastructure costs. The VHA operates 172 inpatient medical facilities nationally that are an average of 60 years old. Some of these facilities are underutilized and inadequately staffed. Facilities in certain urban and rural areas are seeing significant declines in the veteran population and strong competition for fresh medical staff. In 2018, Congress authorized an Asset Infrastructure Review (AIR) of national VHA medical markets to provide insight into where the VA health care budget should be responsibly allocated to serve veterans most effectively. However, the Senate Veterans Affairs Committee lacked the political will to act on the White House’s nominations of commission members, and this ultimately led to termination of the AIR process. The next Administration should seek out agile, creative, and politically acceptable operational solutions to this aging infrastructure status quo, — 647 — Department of Veterans Affairs reimagine the health care footprint in some locales, and spur a realignment of capacity through budgetary allocations. Specifically: 1. Embrace the expansion of Community Based Outpatient Clinics (CBOCs) as an avenue to maintain a VA footprint in challenging medical markets without investing further in obsolete and unaffordable VA health care campuses. 2. Explore the potential to pilot facility-sharing partnerships between the VA and strained local health care systems to reduce costs by leveraging limited talent and resources. Personnel l Extend the term of the Under Secretary for Health (USH) to five years. Additionally, authority should be given to reappoint this individual for a second five-year term both to allow for continuity and to protect the USH from political transition. l Establish a Senior Executive Service (SES) position of VHA Care System Chief Information Officer (CIO), selected by and reporting to the chief of the VHA Care System with a dotted line to the VA CIO. l Identify a workflow process to bring wait times in compliance with VA MISSION Act–required time frames wherever possible. 1. Assess the daily clinical appointment load for physicians and clinical staff in medical facilities where wait times for care are well outside of the time frames required by the VA MISSION Act. 2. Require VHA facilities to increase the number of patients seen each day to equal the number seen by DOD medical facilities: approximately 19 patients per provider per day. Currently, VA facilities may be seeing as few as six patients per provider per day. 3. Consider a pilot program to extend weekday appointment hours and offer Saturday appointment options to veterans if a facility continues to demonstrate that it has excess capacity and is experiencing delays in the delivery of care for veterans. 4. Identify clinical services that are consistently in high demand but require cost-prohibitive compensation to recruit and retain talent, and examine exceptions for higher competitive pay.

— 296 — Mandate for Leadership: The Conservative Promise support went to just six commodities—corn, cotton, peanuts, rice, soybeans, and wheat—that together account for only 28 percent of farm receipts.32 Although many farmers do not receive much in the way of subsidies, especially those in the areas of livestock and specialty crops (fruit, vegetable, and nuts),33 there are still a sig- nificant number of farmers growing row crops like corn and cotton that do receive significant farm subsidies. The primary subsidy programs include the Agriculture Risk Coverage (ARC) program,34 the Price Loss Coverage (PLC) program,35 and the federal crop insur- ance program.36 Farmers can participate on a crop-by-crop basis in the ARC program or the PLC program. These programs cover about 20 different crops.37 The ARC program protects farmers from what are referred to as “shallow” losses, pro- viding payments when their actual revenues fall below 86 percent of the expected revenues for their crops.38 The PLC program provides payments to farmers when commodity prices fall below a fixed, statutorily established reference price.39 The federal crop insurance program is broader in scope than ARC and PLC, and in crop year 2019 covered 124 commodities.40 Farmers pay a portion of a premium to participate in the program. Taxpayers on average pay about 60 per- cent41 of the premium. As explained by CRS, “Revenue Protection was the most frequently purchased policy type in 2019, accounting for almost 70 [percent] of policies purchased.”42 While there are certainly other subsidy programs besides ARC, PLC, and federal crop insurance, one program that deserves special mention is the federal sugar program. This program, unlike most other subsidy programs, intentionally tries to restrict supply43 and thereby drives up prices. The program costs consumers as much as $3.7 billion a year.44 When it comes to reforming subsidy programs, the next Administration will primarily have to look to legislative solutions. The next Administration should champion legislation that would: l Repeal the federal sugar program. The federal government should not be in the central planning business, and the sugar program is a prime example of harmful central planning. Its very purpose is to limit the sugar supply in order to increase prices. The program has a regressive effect, since lower-income households spend more of their money to meet food needs compared to higher income households.45 l Ideally, repeal the ARC and PLC programs. Farmers eligible to participate in ARC or PLC are generally already able to purchase federal crop insurance, policies that protect against shortfalls in expected revenue whether caused by lower prices or smaller harvests. The ARC program is especially egregious because farmers are being protected from shallow — 297 — Department of Agriculture losses, which is another way of saying minor dips in expected revenue. This is hardly consistent with the concept of providing a safety net to help farmers when they fall on hard times. The Congressional Budget Office (CBO), in one of its options to reduce the federal deficit, has once again identified repealing all Title I farm programs, including ARC, PLC, and the federal sugar program.46 l Stop paying farmers twice for price and revenue losses during the same year. Farmers can receive support from the ARC or PLC programs and the federal crop insurance program to cover price declines and revenue shortfalls during the same year. Congress should prohibit this duplication by prohibiting farmers from receiving an ARC or PLC payment the same year they receive a crop insurance indemnity. l Reduce the premium subsidy rate for crop insurance. On average, taxpayers cover about 60 percent47 of the premium cost for policies purchased in the federal crop insurance program. One of the most widely supported and bipartisan policy reforms is to reduce the premium subsidy that taxpayers are forced to pay.48 At a minimum, taxpayers should not pay more than 50 percent of the premium. After all, taxpayers should not have to pay more than the farmers who benefit from the crop insurance policies. CBO has found that reducing the premium subsidy to 47 percent would save $8.1 billion over 10 years and have little impact on crop insurance participation or on the number of covered acres.49 In that analysis, there would be a reduction in insured acres of just one-half of 1 percent, and only 1.5 percent of acres would have lower coverage levels. 50 This reform is basically all benefit with little to no cost. In its recently released report identifying options to reduce the federal deficit, CBO found that reducing the premium subsidy to 40 percent would save $20.9 billion over 10 years.51 Beyond these legislative reforms, the next Administration should: l Communicate to Congress the necessity of transparency and a genuine reform process. The White House and the USDA should make it very clear that the farm bill process, including reform of farm subsidies, must be con- ducted through an open process with time for mark-up and the opportunity for changes to be made outside the Agriculture Committee process. The farm bill too often is developed behind closed doors and without any chance for real reform. The White House, given the power of the bully pulpit,