What the Biden Mask & Test Kit Plan Gets Right

Glimmers of hope for those involved in government service delivery

President Joe Biden, joined by Johnson & Johnson CEO Alex Gorsky and Merck CEO Ken Frazier, delivers remarks on COVID-19 vaccine production Wednesday, March 10, 2021, in the South Court Auditorium in the Eisenhower Executive Office Building at the White House. (Official White House Photo by Adam Schultz)
Official White House Photo by Adam Schultz

This morning James posted a critique of the recent announcement that the Biden Administration is giving away 400 million (oops… sorry James) Miiiillllion N95 masks. This effort to combat ongoing spread joins a previously announced program for free at-home COVID test kits (that starts today)1. James’s post is a short one and I recommend reading it (and the related comments) before proceeding with my take, as the post provides a bit more context about the program via Politico

Let me start by saying I agree with many of James’ critique points. I think our own Steven Taylor sums things up well with his comment:

There is a bit of “fixed the barn door after the horse has come home” to all of this (not that we are out of it, but the measures would have made a lot more difference some time ago).

https://www.outsidethebeltway.com/biden-to-distribute-400-miiiillllion-masks/#comment-2673680

It appears pretty clear, in a “Monday Morning Quarterback” way, that the Biden administration put most of its COVID eggs in the vaccine basket, underestimating the politicization of the vaccine and, perhaps, overestimating the vaccine’s ability to stop the spread of the rapidly mutating disease. As a result, they were late to the game in creating and implementing other direct-to-resident programs to help stem transmission.

Since James has already covered critique, I’m providing a different perspective based on my experience in government service delivery. As long-time readers of the comment section (or anyone who has scanned my bio below) may know, I’ve been working in the Civic Tech space for approximately half a decade. The last two of those years have been with Code for America, a national non-profit working to improve the delivery of government services at the municipal, state, and federal levels. This work gives me a slightly different perspective on what it takes to create these programs.

There are two things about these programs that stand out as moves in the right direction:

1. We are starting to think beyond mail for direct service delivery

For years a key concept for the distribution of government services is a “household.” There are two things that make up a household: people and a static mailing address. The latter of these things creates a problem for folks who are living at the margins. Without a stable mailing address, they are often unable to access needed services or engage in civic activities (like voting). While the test kit distribution is initially tied to the concept of a household and the mail, the plan from the White House includes expanding it to local pick-up, a phone line, free tests through insurers, and will also work with local and national Community-Based Organizations to distribute as well (I am not sure if those alternative distribution methods will still require a household or not). The masks are not based on households at all; instead, they rely on in-person pick-up. These are both good things.

Ultimately a robust program should have multiple delivery channels. Developing those channels takes time. For example, I suspect that the in-person mask distribution option was most likely made possible by existing relationships and networks created via the vaccine distribution system (an example of how programs can build on programs). If this is successful, my hope is that it moves governments towards more hybrid service delivery

2. There is no means-testing involved with these programs

Generally speaking, everyone who requests masks or test kits2 will get them. There are no questions about or need to verify income. Means testing is a huge issue in government service delivery. We as Americans have a, somewhat understandable, concern about free riders–people who take more than they give or access government benefits that they could otherwise pay for. For my purposes today, I’m not particularly interested in the moral arguments for/against this. There are, however, systematic costs to means testing. 

First, means-testing necessarily adds friction to the design and delivery of social services. The process needs to be interrupted to go through validation. Beyond the cost of designing and implementing the validation process, there is also the cost of the time that is lost to each validation process. A second issue is that means testing typically moves the administrative burden from the government to the individual. This is especially problematic for people living closer to the margins who need to collect the necessary documentation3 and often navigate complex systems (that hard to understand in English and are rarely well translated) to prove they qualify for services. As a result, it’s an accepted fact that means testing excludes many folks from the programs that they would otherwise qualify for. So from a public service delivery perspective, it’s a great sign that these programs (like the vaccination program) remove any explicit means-testing requirements.

Are these programs a civic technologist’s dream? Of course not. But both contain small steps towards a better, more equitable, not to mention faster, form of service delivery. And that’s a step towards making government work better for all the people within this country. Of course, the devil will be in the details (or in this case the rollout and usage) and time will tell as to how well the programs are implemented and utilized. I, for one, will be watching and, in the meantime, remaining cautiously optimistic.


Hat time to my Civic Tech colleague and former CfA’er Christa Hartsock for inspiring this post. She’s also part of the Logic Magazine editorial and production team. If you enjoy thoughtful explorations of a wide range of tech-related topics, I highly HIGHLY recommend subscribing to and supporting Logic.


1. In the process of doing research to draft this post, I order kits for our home via the simple form at covidtests.gov. I encourage everyone to do the same. Heck, it’s even getting meme’d.

2. Provided they have a valid household mailing address. Unfortunately, the USPS doesn’t have accurate data on multi-unit housing (a colleague guesstimates this somewhere in the area of 20 to 30% of all units). This will create problems for folks living in subdivided households and some apartments.

3. In addition to the challenges this creates for the unhoused and undocumented residents, it can also create a lot of burdens for low-income individuals. For example, often eligibility for programs, like pandemic relief, is tied to tax returns. One of the things that Code for America’s research has highlighted is that because of the various income streams they are drawing from, including state and federal support as well as sometimes multiple on- and off-the-book income sources, low-income individuals taxes tend to be more complex than the average citizen and more likely to contain errors. This creates problems for them down the road (either because of the errors or because they get frustrated and don’t end up filing).

FILED UNDER: COVID-19, Joe Biden, US Politics
Matt Bernius
About Matt Bernius
Matt Bernius is a design researcher working to create more equitable government systems and experiences. He's currently a Principal User Researcher on Code for America's "GetCalFresh" program, helping people apply for SNAP food benefits in California. Prior to joining CfA, he worked at Measures for Justice and at Effective, a UX agency. Matt has an MA from the University of Chicago.

Comments

  1. Mikey says:

    This effort to combat ongoing spread joins a previously announced program for free at-home COVID test kits (that starts today).

    It actually opened a day early, believe it or not. A friend alerted me to the availability of the site yesterday afternoon and I put in my order then.

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  2. Matt Bernius says:

    @Mikey:
    A soft launch like that is somewhat common (it gives them one more chance to test the system). As I mention in the footnote I ordered today and was pleasantly surprised by how well designed it was! Hats off to whichever office designed the experience (most likely USDS or 18f). Civil servants for the win!

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  3. matt bernius says:

    Also, to get a sense of the demand for these kits and the website, you can check out:
    https://analytics.usa.gov/

    In less than 24 hours covidtestkits.gov has become the second most visited Federal Government website with over 47,935,074 unique visits (as of this comment)!

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  4. gVOR08 says:

    Matt, thank you for this post. Criticism is fine, if fair, but credit where due. Even though I had just received four test kits from CVS, I ordered four from the .gov site yesterday. Fill in the address, hit submit, and get a message to expect them in my mailbox by the end of the month. Zip, pop. One click. Amazon doesn’t do any better.

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  5. Bob@Youngstown says:

    Got my emailed confirmation of order. The email thanks me for ordering through usps.com

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  6. inhumans99 says:

    I placed an order for the test kits just now through the USPS order page. I put in my info and my apartment # did not trigger a standard address format error (some folks reported that a small number of multi-dweller units like apartment buildings were at first limited to 4 kits for the entire complex, but my order went through just fine and my cost and S&H was $0.00).

    I also will be taking advantage of getting the free masks and appreciate that the masks will also be available for in-person pick-up.

    Matt, this was a great post. Logistics can indeed be a difficult thing to figure out how to get what where in the most efficient manner possible, heck, UPS has a well known Logistics division devoted to this subject.

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  7. matt bernius says:

    @Bob@Youngstown:

    The email thanks me for ordering through usps.com.

    Yup, ultimately it’s the post-office that is handling the backend work (in part because they have the master list of residences–or rather addresses that are known to be residences). covidtests.gov is what’s known as a redirect page. It’s used to keep the URL as simple as possible.

    That said, it can also create confusion. It’s one of those many things you have to track and think about when designing and implementing these services.

    @inhumans99:

    I put in my info and my apartment # did not trigger a standard address format error (some folks reported that a small number of multi-dweller units like apartment buildings were at first limited to 4 kits for the entire complex, but my order went through just fine and my cost and S&H was $0.00).

    That’s great to hear you were able to register. We’ve definitely heard reports of problems with that aspect of the site (including some co-workers who had issues).

    Apartments and subdivided houses are a bit of a nightmare. One of my colleagues who has been working on this issue “guesstimates” that the Post Office doesn’t have accurate data on 20-30% of subdivisions or apartments. And this is a case where that creates real issues (and again demonstrates the problem of relying solely on “households”).

    FYI, if folks are having problems, you can try testing addresses here: https://www.smarty.com/products/us-address-verification

  8. wr says:

    Thanks for this, Matt. I have to say I’m so tired of all the complaining about how inadequate Biden is — especially since so much of it is coming from people who have been working tirelessly to stop him from accomplishing anything. I get that he and his administration are not perfect, but I haven’t seen anyone coming up with better ideas out there, so it’s really wearing me down to see so much of the country line up to kick the only one who is doing anything for not doing more, doing better, or doing it in some perfect way they can’t identify but know is out there.

    Anyway, enough ranting. I really just wanted to thank you — with no disrespect intended for the other posters, whose messages are also filled with valuable information — for looking at this and explaining what’s good about it instead of just telling us what isn’t.

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  9. Sleeping Dog says:

    @Mikey:

    Yeah and the website worked.

    First, means-testing necessarily adds friction to the design and delivery of social services.

    It should be pointed out that for proponents of means-testing the friction is a feature, not a bug.

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  10. Matt Bernius says:

    @Sleeping Dog:

    It should be pointed out that for proponents of means-testing the friction is a feature, not a bug.

    100% correct. And to some degree friction in user experience isn’t inherently a bad thing.

    However, for all too many people in government, it isn’t so much the friction that’s the feature, it’s the discouragement that friction leads to that’s the real feature (see for example accessing unemployment benefits).

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  11. Michael Reynolds says:

    @wr:
    Hear, hear.

    So sorry that the only president ever to get no help at all from the previous administration, after a violent coup attempt, and in the midst of a pandemic actively spread by Republicans, did not snap his fingers and give everyone a pony.

    These are the whines of spoiled children, active saboteurs, and useful idiots.

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  12. Gustopher says:

    It would have been better to do this a few months ago, but it’s still important. The numbers aren’t sufficient to cover the entire population for the entire pandemic, but it does put a very clear signal out to those who are willing to listen that the minimum standards are changing — now you need a pretty good mask, and you should test yourself at some ill-defined points (perhaps the kits will come with some good materials that will make when to test clearer).

    It won’t get Camp Ivermectin to fall in line, but all the people who are trying but confused by changing guidance will get a clear message. Helps the people who are willing to be helped.

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  13. Monala says:

    So many complaints on Twitter today! Often from the left. I’ll try to address them, some with my own thoughts and others with ideas I’ve seen on Twitter.

    1. What about households larger than 4? Often such households are the most vulnerable.

    Agreed. It would have been great to have a way for people to request a bigger number, although still with a limit to prevent hoarding (say, 2 to 10). That might also slow down shipment somewhat, since it takes more time to organize, correctly label and weigh different size packages.

    2. Multi-unit housing.

    I’ve heard that adding your apartment or unit number to the main address field gets around this problem because it creates a unique address.

    3. Winter weather.

    Apparently the tests are fine if they freeze, you just have to wait for them to thaw before use.

    4. What about those without Internet or without an address?

    They’re supposed to be setting up a phone line and distributing tests to community organizations.

    5. Should have sent them to everyone.

    Hard no, in my opinion. Too many anti-test people in this country who would waste them. Plus creates a big burden for both mail carriers and garbage collectors.

    6. They should be giving the tests on an ongoing basis, like weekly.

    I think monthly makes more sense, to prevent test expiration and the postal burden.

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  14. Matt Bernius says:

    @Monala:

    1. What about households larger than 4? Often such households are the most vulnerable.

    This is definitely an issue, and my understanding is this may be more limited in the first round.

    It also is an example of the difference between equality (everyone household gets the same number of kits regardless of their need) and equity (each household gets a number of kits proportional to its needs).

    The reality is that equality is typically far easier to do than equity, and so our systems are optimized for the first regardless of whether or not that necessarily leads to the best policy outcomes.

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