GRAND RAPIDS, Mich. (AP) — Donald Trump accused President Joe Biden of unleashing a “bloodbath” at the U.S.-Mexico border Tuesday, escalating his inflammatory rhetoric as he campaigned in two midwestern swing states likely to be critical to the outcome of the 2024 election.

Trump, who has accused migrants of “poisoning the blood of the country” and vowed to launch the largest domestic deportation operation in the nation’s history if he wins a second term, accused Biden of allowing a “bloodbath” that was “destroying the country.” In Michigan, he referred to immigrants in the U.S. illegally suspected of committing crimes as “animals,” using dehumanizing language that those who study extremism have warned increases the risk of violence.

“Under Crooked Joe Biden, every state is now a border state. Every town is now a border town because Joe Biden has brought the carnage and chaos and killing from all over world and dumped it straight into our backyards,” Trump said in Grand Rapids, where he stood flanked by law enforcement officers in uniform before a line of flags.

While violent crime is down, Trump and other Republicans have seized on several high-profile crimes alleged to have been committed by immigrants in the U.S. illegally to attack Biden as border crossings have hit record highs. Polls suggest Trump has an advantage over Biden on issues as many prospective voters say they’re concerned about the impact of the crossings.

Trump continued to hammer the theme at a rally in Green Bay, Wisconsin, Tuesday evening as the state was holding its presidential primaries. Trump accused rogue nations of “pumping migrants across our wide open border,” and “sending prisoners, murders, drug dealers, mental patients, terrorists” — though there is no evidence any country is engaged in that kind of coordinated effort.

He also claimed that migrants would cost the country trillions of dollars in public benefits and cause Social Security and Medicare to “buckle and collapse.”

“If you want to help Joe Biden wheel granny off the cliff to fund government benefits for illegals, then vote for Crooked Joe Biden,” he said. “But when I am president, instead of throwing granny overboard, I will send Joe Biden’s illegal aliens back home.”

On Tuesday, the White House emphasized that immigration is a positive for the U.S. economy. They argued that recent gains in immigration have helped to boost employment and sustained growth as the Federal Reserve hiked interest rates to bring down inflation.

“We know immigrants strengthen our country and also strengthen our economy,” White House press secretary Karine Jean-Pierre said at Tuesday’s briefing, noting that immigrants were the ones doing the “critical work” on the Francis Scott Key Bridge in Baltimore when it collapsed after being struck by a ship.

Trump on Tuesday focused on the killing of Ruby Garcia, a Michigan woman who was found dead on the side of a Grand Rapids highway on March 22. Police say she was in a romantic relationship with the suspect, Brandon Ortiz-Vite. He told police he shot her multiple times during an argument before dropping her body on the side of the road and driving off in her red Mazda.

Trump incorrectly referred to the 25-year-old Garcia as a 17-year-old.

Authorities say Ortiz-Vite is a citizen of Mexico and had previously been deported following a drunken driving arrest. He does not have an attorney listed in court records.

Trump in his remarks said that he had spoken to some of her family. Garcia’s sister, Mavi, however, disputed his account, telling FOX 17 that they had not. “No, he did not speak with us,” the outlet said she told them in a text message, declining to comment further.

She also pleaded on Facebook last week for reporters to stop politicizing her sister’s story, and on Tuesday asked for privacy, saying she only wanted “justice to be served” and to “be left alone.”

Trump also again mentioned the killing of Laken Riley, a nursing student in Georgia. A Venezuelan man whom officials say entered the U.S. illegally has been charged. Riley’s family attended Trump’s rally in Georgia last month and met with him backstage.

Trump referred to the suspect in Riley’s death as an “illegal alien animal.”

“The Democrats say, ‘Please don’t call them animals. They’re humans.’ I said, ‘No, they’re not humans, they’re not humans, they’re animals,’” he said.

FBI statistics show overall violent crime dropped again in the U.S. last year, continuing a downward trend after a pandemic-era spike. In Michigan, violent crime hit a three-year low in 2022, according to the most recent available data. Crime in Michigan’s largest city, Detroit, is also down, with the fewest homicides last year since 1966.

Top Republicans from across Michigan had packed into a conference room in downtown Grand Rapids to hear Trump speak in a county he won in 2016 but lost to Biden in 2020. Outside the event center, over 100 supporters stood in the cold rain to line the street where Trump’s motorcade was expected to pass.

At a nearby park, a small group advocating for immigration reform gathered to hold a moment of silence for Garcia while holding signs that read “No human being is illegal” and “Michigan welcomes immigrants.”

In Green Bay, some supporters braved snowfall for three hours outside to enter the venue.

“Tomorrow, Donald Trump is coming to Grand Rapids where he is expected to once again try to politicize a tragedy and sow hate and division to hide from his own record of failing Michiganders,” said Alyssa Bradley, the Biden campaign’s Michigan communications director.

Michigan Gov. Gretchen Whitmer, a Democrat, said Monday that there is “a real problem on our southern border” and that it’s “really critical that Congress and the president solve the problem.”

“There was a solution on the table. It was actually the former president that encouraged Republicans to walk away from getting it done,” Whitmer said. “I don’t have a lot of tolerance for political points when it continues to endanger our economy and, to some extent, our people as we saw play out in Grand Rapids recently.”

Trump has been leaning into inflammatory rhetoric about the surge of migrants at the southern border. He has portrayed migrants as “poisoning the blood of the country,” questioned whether some should even be considered people, and claimed, without evidence, that countries have been emptying their prisons and mental asylums into the U.S.

He has also accused Biden and the Democrats of trying to “collapse the American system, nullify the will of the actual American voters and establish a new base of power that gives them control for generations.”

In Green Bay, Trump spoke beside an empty podium that read, “Anytime. Anywhere. Anyplace.” Trump said it was meant for Biden, whose campaign has not committed to participating in debates.

Gomez Licon reported from Green Bay, Wis. Colvin reported from New York. Associated Press writers Scott Bauer in Madison, Wisconsin and Josh Boak in Washington contributed to this report.

NADI, Fiji Islands — “That’s Tom Hanks’ island, in ‘Cast Away’ the movie,” said the passenger sitting nearby, on the rear deck.

We’d seen him standing in line, a college kid in a red shirt, packing and repacking a knapsack while we waited to board the early morning ferry out of Viti Levu, largest of Fiji’s 330 islands. Leaning over the railing, he pointed at the horizon and a faint grey-green shape.

“Its real name is Modriki, and it’s small, just 100 acres,” he said. “But the beach is awesome. Tourists can’t wait to go.”

No surprise there. For most South Pacific travelers, nothing rivals Fiji’s sandy beaches, palm-shaded gardens, starry nights and Melanesian hospitality. We’d island-hopped over the years, tried a dozen different beach resorts, and liked most of them. Until 2019, when we joined a hiking group for a long look at the island’s mountains.

Finally last fall, with COVID in decline and Fiji open for tourists, we hopped a plane and headed back, this time for another look at what makes the country tick. Finding hotels wasn’t easy; Fiji is to Australians what Hawaii is to Americans. But we crossed our fingers, found five with rooms and struck gold at three places begging for a repeat visit.

The Fiji Orchid, a stately manor house near Viti Levu’s northwest shore and the former home of Hollywood actor Raymond Burr, star of the detective series “Perry Mason,” felt nothing like a hotel and everything like a home away from home. With an inviting living room and framed memorabilia, it beckoned at the end of a very long day.

Hotel Manager Deepika Dimlesh arranged an authentic Fijian dinner, and co-owner Gordon Leewie told tales of Fiji life in the early days. Though Nadi (NAN-dee) International Airport was 20 minutes away, our bure (BOO-ray, room, house), one of six in the lush tropical garden, was as quiet as a cemetery.

“We’ve had guests who stayed for weeks,” said Dimlesh at dinner. “One was even writing a book. But most are international travelers, businessmen flying through. We tell them, if you have a layover don’t try to sleep in the lounge. We’ll pick you up, you can use the pool, eat dinner or go to bed, and we’ll drive you back.”

Curious about Lautoka, Viti Levu’s second-largest town on the northwest shore, we hired tour guide and driver Kesho Goundar, who (like many Fijians) speaks Fijian, English and Hindi. Stopping at the town’s huge covered market, he bought a couple of kava “sticks,” the gifts we would need – for the chief – if we visited a village.

Then it was on to the Sabeto Mountains and the Garden of the Sleeping Giant. A popular park, it was founded by Burr, a worldwide orchid collector. Hundreds of orchids, planted along the trail to the summit, a huge head-like rock, are the highlight of a visit. And the adjacent forest — a tower of vines, shadowy branches and strange flowers — was a set waiting for a movie.

The next day we headed upcountry to Navala Village, the country’s last thatched village, driving past barnyards, gardens, sugar cane fields, villages, the occasional manufacturing plant and Methodist, Muslim, Sikh, Hindu and Catholic-oriented primary schools.

At first glance Navala looked empty, until guide Mark Navaroka came out to collect our $25 entrance fee and a kava stick for the chief.

Turning onto the Nausori Highland Road – not another car in sight – we lurched uphill over a rocky, pot-holed track for more than an hour, each hill steeper than the one before, until we rounded the top, a photographer’s delight. Finally, around the corner, we passed two hunters on horseback with rifles and dogs.

Moving to Viti Levu’s southwest corner, we checked into the Intercontinental Fiji Golf Resort & Spa, a 35-acre landscaped property on Natadola Bay. And instead of salesmen in suits, the hotel was as busy as a country club on a holiday weekend. Dads and kids played volleyball; moms worked out at a fitness center. We spotted kids racing hermit crabs, and others learning Fijian words and Polynesian dances. Menus at the hotel’s several restaurants listed continental and some Fijian dishes, and our favorite, the lively Toba Bar & Grill, took our order in five minutes and served the food in 10.

Coaxed into trying the Jet Ski “experience,” we flew over the waves, riding tandem behind two watersports guides. But the skis were trumped by the hotel’s Coral Planting project, headed by marine scientists Lawaci Koroyawa and Luke Romatanababa. Joining them in the water, we learned how to plant healthy corals onto damaged reefs.

Most memorable was the river cruise with Singatoka River Safari. Wide and long, the river winds through an endless valley, weaving past rocky hills, farms and meadows. Children splashed in it and men scrubbed their horses, waving as we passed. Pastoral and peaceful, it was a nod to an older century.

The 35-mile-long trip ended at a village, with a tour, lunch at the community center and a kava ceremony — shared cups – with the chief and town fathers. Kava is calming, some say. Just more weak tea, say others.

How many villages are there, we wondered. “Hundreds, but that’s not all,” said the hotel’s desk clerk. Each indigenous Fijian family belongs to a village that owns the land its on. It’s like a clan, she explained. And only indigenous Fijians can own land. So add all the villages and their land and it’s nearly 90% of the country. “The government makes Fiji’s laws, but the villages rule themselves. That’s why they’re important.”

As our last week approached, we took the ferry to Lomani Island Resort – yes, an adults-only beach resort – on Malolo Lailai island, a single hour’s ferry ride to the mainland and Nadi International Airport. You can stay overnight and still make it to the airport on time.

But it wasn’t the beach that earned the gold star. It was the charming cottages, each with a private yard and plunge pool. The smiling waiters and creative, chef-designed meals, served at candle-lit tables. The “double-X” swimming pool and the water sports center.

“It’s peaceful here,” said Shelley White, the general manager, when we met at the cocktail hour. “And quiet. But with Nadi next door, we stay busy with weddings and anniversaries, and lately, even business retreats. We can order everything we need and get it delivered the next day,” she said.

“Still, we love to have visitors like you, people who know this place and like it,” she added, with a puckish smile. “Let me know the next time you travel. I might decide to come along.”

If you go

Fiji Airways flies from Los Angeles, with Fijian attendants and quality service, and includes dinner, breakfast and snacks. Departures leave just before midnight and arrive at 5:30 a.m. Fiji Airways also flies from San Francisco and Honolulu.

Air New Zealand flies from Los Angeles, San Francisco and Honolulu

American Airlines flies from Los Angeles and San Francisco

United Airlines flies from Houston

Delta Airlines flies from Los Angeles and Seattle

©2024 Tribune Content Agency, LLC.

Leading vacation rental company Airbnb is updating its Extenuating Circumstances Policy, including renaming it the Major Disruptive Events Policy “to better reflect its purpose.” This will provide greater flexibility for travelers who may need to cancel their reservations when unforeseen circumstances, such as natural disasters, extreme weather events and government-imposed travel restrictions, affect their ability to complete their stay.

Under this updated cancellation policy, guests can cancel reservations and receive refunds in cases of “foreseeable weather events,” such as hurricanes, that would result in another covered event occurring, such as large-scale utility outages. According to Travel + Leisure, the policy already applies to other “unexpected major events,” such as declared public health emergencies, including epidemics, but excluding COVID-19. This revised policy, which will go into effect on June 6, overrides individual hosts’ own cancellation policies.

This updated policy also applies to mid-trip cancellations, making it so that travelers can receive refunds for the unused portion of their stays in the event of a covered cancellation.

However, it’s important to note that Airbnb’s policy does not cover all unforeseen incidents, such as injuries, illnesses or government-imposed requirements, like jury duty or court appearances.

“The changes to this policy, including its new name, were made to create clarity for our guests and Hosts, and ensure it’s meeting the diverse needs of our global community,” Juniper Downs, Airbnb’s Head of Community Policy, said in a statement. “Our aim was to clearly explain when the policy applies to a reservation, and to deliver fair and consistent outcomes for our users. These updates also bring the policy in line with industry standards.”

The introduction of this revised policy aligns with Airbnb’s recent efforts to bolster travelers’ confidence in booking home-share stays. For example, earlier this month, it banned indoor security cameras in its rental homes worldwide due to privacy concerns, and, in 2022, instituted a permanent ban on parties, a move which was initially instituted temporarily during the COVID-19 crisis.

Last year, to crack down on fraudulent listings, the company introduced a “verified” status and badge for its rentals in an effort to reassure customers that the specified property does actually exists at the address indicated and that the host is reliable.

In 2022, Airbnb also updated its policies and platform to provide greater pricing transparency, displaying total costs, including fees, in user searches and altering its algorithm to rank listings with the best total prices higher in the results. At the same time, Airbnb provided “guidance” to hosts, encouraging them to set only “reasonable” checkout requests and requiring them to be displayed in the listing.

“Guests should not have to do unreasonable checkout tasks such as stripping the beds, doing the laundry, or vacuuming when leaving their Airbnb,” the company wrote in a statement at the time. “But we think it’s reasonable to ask guests to turn off the lights, throw food in the trash, and lock the doors — just like they would when leaving their own home.”

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©2024 Northstar Travel Media, LLC. Visit at travelpulse.com. Distributed by Tribune Content Agency, LLC.

Like many women of her generation, the unnamed Japanese American writer at the center of Marie Mutsuki Mockett’s bold, erotic “The Tree Doctor,” finds herself in midlife, squarely ensconced in the sandwich generation. She’s burdened with the double-whammy of childcare and tending to an elderly parent while holding down a job, in this case as an adjunct lecturer.

At novel’s start, Mockett’s protagonist has flown from her home in Hong Kong for what was supposed to be a brief trip to northern California to help her widowed mother, who has dementia and needs to be placed in long-term care.

Then, the pandemic hits. All nonessential travel is banned; Hong Kong has imposed a strict quarantine for travelers. The woman is stranded in her childhood home, remotely teaching a class on Japanese aesthetics and trying to console her two children and husband through video chats.

This could have been a novel solely about the unfair amount of work that disproportionately fell upon many women during the pandemic, the care-giving while also doing economic labor. But Mockett has something far more sly in mind. And it’s not about learning how to bake sourdough bread, like so many pandemic-era memes aimed at women.

As she cares for her mother’s long-neglected garden, the woman calls on a man at the local nursery — known as “The Tree Doctor” — and one thing leads to another, as the saying goes. A torrid, graphic, no-holds barred affair ensues.

The woman isn’t going to leave her husband or children. She’s not looking for a replacement mate. She’s intellectually fulfilled by discussing the intricacies of “The Tale of Genji” with her bright college students. No, she’s in it for the sex, for re-discovering what her body needs after decades of putting herself dead last on the checklist of things to do.

Mockett is the author of four books, including novel “Picking Bones from Ash” and two works of nonfiction. Her prose is as lush as the garden in the woman’s Carmel home, as Mockett weaves together discussions of flora, dissections of passages from “Genji” and the woman’s memories of childhood trips to Japan with her mother.

The title character remains an archetype, an antidote to the life of self-sacrifice that has been unhealthy for the woman. He may be a fantasy of sorts, but it’s also unrealistic to expect women, particularly mothers, to fulfill everyone else’s needs but their own. As the woman notes, “Someone once said that for every baby a woman has, that’s two books she doesn’t write.”

“Tree Doctor” is a book that says that kind of sacrifice takes its toll.

The Tree Doctor

By: Marie Mutsuki Mockett.

Publisher: Graywolf, 256 pages, $17.

©2024 StarTribune. Visit at startribune.com. Distributed by Tribune Content Agency, LLC.

Here’s an easy and delicious way to flavor pork tenderloin. It’s a sweet and sour sauce made with apricot jam and apple cider vinegar, that adds a tangy flavor and takes only 2 to 3 minutes to make.

I thought barley would be a nice side dish but didn’t want to spend a lot of time or another pot to cook it. So, using quick-cooking barley, I made the barley and green beans in the microwave oven. It’s easier, minimizes cleanup and turns out the same as if made on the stove.

HELPFUL HINTS:

Any type of green vegetable such as broccoli florets or snow peas can be used instead of green beans.

Look for quick-cooking barley in the supermarket.

Orange marmalade can be used instead of apricot jam.

COUNTDOWN:

Prepare all ingredients.

Microwave green beans and barley.

While they cook, make pork.

SHOPPING LIST:

To buy: 3/4 pound pork tenderloin, 1 jar apricot jam, 1 bottle apple cider vinegar, 1 can olive oil spray, 1 jar Dijon mustard, 1 container fat-free chicken broth, 1 box quick cooking barley and 1/2 pound green beans,

Staples: olive oil, salt and black peppercorns,

Sweet and Tangy Sauced Pork Tenderloin

Recipe by Linda Gassenheimer

• 1/4 cup apricot jam
• 2 tablespoons apple cider vinegar
• 1 tablespoon Dijon mustard
• 3/4 pound pork tenderloin
• Olive oil spay
• Salt and freshly ground black pepper

Mix apricot jam, apple cider vinegar and mustard together in a small bowl and set aside. Cut tenderloin into 1-inch slices and press with the back of a large spoon to about 1/2-inch thick. Heat a large nonstick skillet over medium-high heat and spray with olive oil spray. Add pork slices and saute 2 minutes turn over and saute 2 more minutes, A meat thermometer should read 145 degrees. Saute another minute or 2 if needed. Remove pork to two dinner plates and sprinkle with salt and pepper to taste. Add the sauce to skillet and stir until jam melts and sauce begins to thicken about 2 to 3 minutes. Spoon sauce over pork slices.

Yield 2 servings.

Per serving: 290 calories (12 percent from fat), 4.0 g fat (1.2 g saturated, 1.5 g monounsaturated), 108 mg cholesterol, 36.2 g protein, 26.3 g carbohydrates, 0.5 g fiber, 190 mg sodium.

Green Beans and Barley

Recipe by Linda Gassenheimer

• 1 cup fat-free, no-salt-added chicken broth
• 1/2 cup quick-cooking barley
• 1/2 pound green beans cut into 1 to 2-inch pieces
• 2 teaspoons olive oil
• Salt and freshly ground black pepper

Place chicken broth and quick cooking barley in a large microwave safe bowl. Cover the bowl with a plate or plastic wrap. Microwave on high for 5 minutes. Remove bowl from microwave and add the green beans. Cover with the plate and microwave 5 more minutes. Remove from the microwave and keep the cover on the bowl. While you make the pork. Add oil and salt and pepper to taste and serve with the pork.

Yield 2 servings,

Per serving: 256 calories (19 percent from fat), 5.3 g fat (0.8 g saturated, 2.3 g monounsaturated), no cholesterol, 8.0 g protein, 47.0 g carbohydrates, 10.9 g fiber, mg 29 sodium.

Stovetop method if preferred:

Bring broth to a boil in medium-size saucepan over high heat and add barley and green beans. Reduce heat to medium-high and simmer 10 minutes, uncovered. Drain and add oil, and salt and pepper to taste.

Yield 2 servings.

(Linda Gassenheimer is the author of over 30 cookbooks, including her newest, “The 12-Week Diabetes Cookbook.” Listen to Linda on www.WDNA.org and all major podcast sites. Email her at Linda@DinnerInMinutes.com.)

©2024 Tribune Content Agency, LLC

Anamaria Marinca has a knack for playing characters you’d want in your corner during a crisis. The Romanian actress, who starred in Cristian Mungiu’s harrowing abortion thriller “4 Months, 3 weeks and 2 Days,” is the eye of the storm in Goran Stolevski’s “Housekeeping for Beginners,” a riveting domestic drama that finds her similarly raging against the machine.

No one smokes a cigarette with such quietly harried intensity as Marinca, and there is no forgetting her glittering stare, both of which Stolevski utilizes to great effect. In his third feature in as many years —this one selected as the North Macedonian Oscar entry for best international film — the Macedonian Australian filmmaker plunges us into the swirling eddy of merry but harrowing chaos among an unusual family. The film is a showcase for the skill and screen presence of the criminally underrated Marinca, who stars as Dita, a lesbian social worker trying to hold together her tribe by sheer force of will, coaxing and cajoling the system in order to knit together her queer found family.

There’s a deeply humanist core to Stolevski’s work, which varies in genre and tone, but always captures the bittersweet beauty of life. He made his feature debut with “You Won’t Be Alone,” a life-affirming fairy tale in which Marinca co-starred as a grotesquely disfigured witch. His sophomore feature, “Of an Age” is a queer romance about two young men who connect in a Melbourne beach town.

We enter “Housekeeping for Beginners” with a burst of joyous song, as Ali (Samson Selim), Vanesa (Mia Mustafa) and Mia (Dzada Selim) dance and sing around a living room. Their carefree fun is quickly juxtaposed with a burst of rage, in a doctor’s office, as Suada (Alina Serban), with Dita by her side, explodes at a bored, negligent doctor. She’s furious at him for ignoring her and other patients who look like her — Roma. With these two scenes, Stolevski establishes the film’s message and tone, weaving together childlike play and mischief with the crushing reality of racial and sexual inequality.

Stolevski, who wrote, directed and edited the film, delivers the relevant story details in snippets of dialogue and visual asides snatched out of the river of familial hubbub that is captured with a roaming handheld cinematography by Naum Doksevski. Dita and Suada are partners, and Suada’s kids, Vanesa and Mia, live with them in Dita’s home. Their gay roommate, Toni (Vladimir Tintor) had Ali over for a hookup, but he’s so much fun he becomes one of the stray queer kids they collect, which also includes a trio of young lesbians (Sara Klimoska, Rozafa Celaj and Ajse Useini) who seek refuge in this “safe house.”

Suada has cancer, and knowing that her prognosis is terminal, she demands that Dita become the mother of her girls, in her final, fierce act to secure their future. She also requests that Dita give them Toni’s last name so that they might escape the discrimination she faced as a Roma woman. The girls need legal guardians, and that is how a stressed lesbian and grumpy gay man find themselves married. To each other.

Within its restless, naturalistic aesthetic, Stolevski crafts complex and poignant images, contrasting the play-acting the couple is forced to do with their searing gazes. At a parent-teacher conference, condolences are delivered to Toni, but the camera rests on the bereaved Dita’s face, unable to openly grieve the loss of her longtime partner. Their courthouse wedding is also a study in ironic double-meaning, as Ali sits next to his lover Toni, but only as a witness. At their raucous, booze-soaked celebration at home later, Ali thanks Dita for the opportunity to sit in front of the marriage registrar with the man he loves.

There’s no preciousness or over-explication about the sociopolitical and economic issues that shape their reality and make up the fabric of their lives: how they move in the world, the risks they take, the dreams they have. It is a quotidian kind of oppression, rendered here as a series of irritating clerical hoops, though the consequences of not jumping through them could be deadly.

While the subject matter is sobering, there is a dry humor at play, coupled with real warmth. Dzada Selim steals the movie as the precocious Mia, and if Dita is the spine of the family, Ali is the heart, his ability to connect proving valuable when Vanesa’s teenage rebellions spiral out of control.

Stolevski’s scripts always bear a line that pierces at the heart of life itself, and “Housekeeping for Beginners” is no exception. “It doesn’t go away, the needing,” Dita promises Vanesa, “even when you get old. It’s a nasty business.” It’s a beautifully, brutally apt way to describe a family, and the human condition, perfectly, concisely expressed in the way only Stolevski can.

———

‘HOUSEKEEPING FOR BEGINNERS’

(In Albanian, Macedonian and Romani with English subtitles)

4 stars (out of 4)

MPA rating: R (for sexual content, language throughout and some teen drinking)

Running time: 1:47

How to watch: In theaters Friday

———

©2024 Tribune Content Agency, LLC

KENOSHA, Wis. (AP) — Voters in four states weighed in Tuesday on their parties’ presidential nominees, a largely symbolic vote now that both President Joe Biden and former President Donald Trump have locked up the Democratic and Republican nominations.

Biden and Trump easily won primaries in Rhode Island, Connecticut, New York and Wisconsin, adding to their delegate hauls for their party conventions this summer.

Their victories, while hardly surprising, nevertheless offer clues about enthusiasm among base voters for the upcoming 2020 rematch that has left a majority of Americans underwhelmed. Biden has faced opposition from activists encouraging Democrats to vote against him to send a message of disapproval for his handling of the war between Israel and Hamas, and some Republican Trump critics are still voting for rivals who have dropped out.

“Uncommitted” in Rhode Island and Connecticut was getting a similar share of the Democratic vote as protest campaigns in Minnesota and Michigan, which got 19% and 13% respectively.

In particular, the tallies in Wisconsin, a pivotal November battleground, will give hints about the share of Republicans who still aren’t on board with Trump and how many Democrats are disillusioned with Biden. Trump campaigned Tuesday in Wisconsin and Michigan, two Midwest battlegrounds.

“Donald Trump is the first person I can remember who actually tried to keep all of the promises that he made during the campaign,” said Scott Lindemann, a 62-year-old contractor in Kenosha, Wisconsin, who voted for the former president in the GOP primary. “I was very impressed with that.”

In New York, 70-year-old Steve Wheatley, a registered Republican, said he wishes there were more candidates to choose from. He said he voted for Nikki Haley even though “she has no shot” because of the lack of options.

“We need younger candidates with fresh ideas to run for president,” said Wheatley, a resident of Athens, a small town in the Hudson Valley. “I prefer a Democrat but our choices are thin. Look at what Biden has done so far with the economy.”

Theresa Laabs, a 55-year-old cashier in Kenosha, said her family is feeling the squeeze from higher food and gasoline prices, but she voted for Biden in the Democratic primary because she feels like he’s working to alleviate inflation.

“I understand it’s the economy now, and I’m hoping that Joe will keep working even harder in the next four years to try and bring these things down and make it easier for the working family,” Laabs said.

Trump and Biden turned their attention to the general election weeks ago after Haley dropped out of the GOP contest. Biden visited all the top battlegrounds last month after his State of the Union speech.

Trump is looking to one-up his rival with a fundraiser in Palm Beach, Florida, this weekend that he hopes will bring in $33 million.

With the presidential candidates locking up their parties’ nominations, turnout was slow in Rhode Island, where only 4% of eligible voters had cast ballots by 5 p.m., a figure that included Tuesday’s in-person votes as well as mail-in and early votes.

It was slow across the border in Connecticut as well, where early voting was held for the first time in state history. Secretary of the State Stephanie Thomas said turnout was only 1% to 2% in some communities by 11 a.m., while it was 4% in Stamford, one of the state’s larger cities. “What we have been hearing on the ground from people over the last few weeks is that this isn’t a competitive primary,” she said about the low numbers.

Cooper reported from Phoenix. Associated Press writer Susan Haigh in Hartford, Connecticut, and Maysoon Khan in Athens, New York contributed.

On Friday, April 5, the documentary “Girls State” premieres on Apple TV+, the much-anticipated sequel to the lauded 2020 documentary “Boys State,” also on Apple TV+. Directed by accomplished documentarians Jesse Moss and Amanda McBaine, the film takes an anthropological approach to studying the inner workings of the weeklong political camps for American high schoolers sponsored by the American Legion. During each session the teenagers are required to create a fully working government through a series of elections, a microcosm of our own system.

While structured in the same way, with fly-on-the-wall cameras following a select few students during their experience, “Girls State” is naturally a very different film. Filmed at a Missouri university just weeks before the Supreme Court’s Dobbs decision overturned Roe v. Wade, women’s rights and reproductive issues are a hot-button issue for the girls, among the other teenage troubles such as social anxieties, future worries and other personal issues that are thrown into stark relief in such a setting. But once again, it’s a fascinating documentary that argues that while the kids might be alright, there are certain aspects of the system that need an overhaul.

It’s yet another fascinating film from the duo of Moss and McBaine, who have collaborated on many documentaries, which intersect at the juncture of the political and personal.

Their most recent film was last year’s “The Mission,” a complicated portrait of the young American missionary John Chau, who was killed in 2018 when he attempted to make contact with the isolated Sentinelese tribe on North Sentinel Island. Using interviews with loved ones and John’s diaries and letters, the filmmakers offered a look at why Chau set out on such a dangerous trip, diving in headfirst to examine his complex motivation. Released by NatGeo, “The Mission” is streaming on Disney+ and Hulu.

McBaine has been a longtime producer for Moss, and before they collaborated as co-directors on “Boys State” and “The Mission,” she produced several films he directed including 2021’s “Mayor Pete,” a campaign trail doc about the presidential run of current Secretary of Transportation Pete Buttigieg. Stream it on Prime Video.

Moss’ breakout documentary was the 2014 Sundance hit “The Overnighters” (also produced by McBaine), about a North Dakota pastor offering shelter in his church to nomadic workers arriving in his oil boomtown looking for work. Once again a complex portrait of a complicated person whose life reflected a specific political reality, “The Overnighters” is a moving, surprising film that captures this moment in time in such granular detail because Moss immersed himself in the culture of this town. Stream it on Kanopy or rent it elsewhere online.

Moss also directed all five episodes of the 2019 Netflix documentary miniseries “The Family,” following the work of journalist Jeff Sharlet, who has written about a secretive conservative Christian group known as “The Family” and their influence on American politics. It’s a chilling and sobering uncovering of one of the shadowy organizations that has an outsize influence on our country. He also directed an episode of the 2018 Netflix miniseries“Dirty Money,” which looks at scandal and corruption in business, with Moss’ episode (Season 1, Episode 2) examining payday lenders. Stream both on Netflix.

Moss has an upcoming film called “War Game” on the way, but check out “Girls State” and “Boys State” on Apple TV+, and the rest of he and McBaine’s political docs, covering a wide array of fascinating topics.

———

(Katie Walsh is the Tribune News Service film critic and co-host of the “Miami Nice” podcast.)

©2024 Tribune Content Agency, LLC

WASHINGTON — They’re weighed down by student debt. They’re shut out of the housing market. They’re hit by higher costs of living. And they want President Joe Biden to listen.

At a time when Donald Trump is cutting into Biden’s 2020 advantage with young adults, the growing list of grievances among those between the ages of 18 to 29 is a worrying sign for Biden as he seeks a second term.

People in that age cohort are more than twice as likely to cite the economy as their top concern compared with older adults in recent Gallup data. And while all voters are more worried about the economy now than they were heading into the 2020 presidential election, the pessimism has spiked the most among those under 30.

That concern is being reflected in polls. Trump is currently leading the president 47% to 40% with voters aged 18 to 34 in swing states, according to a March Bloomberg News/Morning Consult poll. By contrast, Biden won 61% of voters under 30 last cycle.

Though the November election is months off and attitudes can shift, there’s no doubt Biden will need support from Generation Z and Millennial voters to win.

Incumbents get the blame when voters are dissatisfied with the economy. The challenge for Biden is that even though economic growth has been solid in the past year, the job market is robust and the inflation rate is cooling, polls after polls show many people don’t feel like it.

Younger Americans have a long list of headwinds: stunted action on student-loan forgiveness, the highest interest rates since they’ve been in diapers and expensive rents.

Older Americans, who are more likely to live in houses they own with low mortgage rates and who have benefited from years of housing and stock market appreciation, are less pessimistic about the economy. The contrasting way generations emerged financially from the coronavirus pandemic may provide a playbook for Biden on how to hone his political message to young adults.

Christian Martin, a 22-year-old college senior from Atlanta, said he hasn’t yet felt the impact of Biden’s economic policies. He’s worried about making student-loan payments after he graduates while keeping up with the elevated costs of living.

“If Biden can address the issues that the youth are feeling, then the turnout can be stronger than what it’s projected to be,” he said in an interview. “This is Biden’s chance to hear what we have to say, because that’s essentially all it is, you know, unfulfilled promises.”

Biden’s plan to forgive billions of dollars in student debt was struck down last year by the Supreme Court, which rejected one of his signature initiatives as exceeding his power.

“The President is fighting to lower costs for young Americans — forgiving student debt, lowering health and eliminating junk fees,” Seth Schuster, a Biden campaign spokesperson, said by email. “Meanwhile, Donald Trump appointed the Supreme Court Justices who denied student-debt relief and ensured that young people now have less rights than the generations before them.”

In a statement, Trump campaign spokesperson Karoline Leavitt said that “President Trump will create a safe, prosperous, and free nation that helps all young people achieve their American Dream.”

The pandemic upended the economy when young voters were just entering adulthood, endangering their job prospects as businesses locked down and complicating their housing options as rents skyrocketed.

“They had a more severe impact of COVID itself in a direct economic way,” said Kei Kawashima-Ginsberg, Newhouse director of Tufts University’s Center for Information & Research on Civic Learning and Engagement. “Whether it’s gas, or housing, or rent or health care, they’re having a really hard time having affordability for that because of the lack of stored wealth.”

Inflation has eased significantly in the past year, including for necessities such as food, but prices remain considerably higher than they were before the 2020 election. And while wages have grown for all age groups in recent years, young adults have the lowest earnings in addition to having fewer assets.

Debt is also souring some younger Americans’ views about the economy, according to EY Chief Economist Gregory Daco. Adults in their twenties and thirties have higher rates of credit-card debt that have deepened into serious delinquency, meaning the debt is 90 days or more past due, according to data from the New York Fed.

Many young adults are making payments on federal student debt that they had hoped would be forgiven by Biden’s plan. The White House has used more narrow methods to approve nearly $144 billion in forgiveness, targeting specific groups, including those with disabilities, some former for-profit college students and public servants who have been paying their loans for years.

Student loans and rent prices weigh on Ariela Lara, an 18-year-old high school senior from San Leandro, California, as she debates which college to attend. Lara said her family cannot afford to take on debt, so she will attend the school that offers her the most in aid.

“As I’ve been getting into this world of adulthood, it’s hard to achieve financial stability in our country,” she said, adding that climate change and the economy are her top issues as she considers her first vote in a presidential election. “We’re telling Biden to wake up and to start saying that he needs the youth vote. He needs us immensely.”

(Christian Hall contributed to this story.)

©2024 Bloomberg L.P. Visit bloomberg.com. Distributed by Tribune Content Agency, LLC.

As the presidential campaign slowly progresses, artificial intelligence continues to accelerate at a breathless pace — capable of creating an infinite number of fraudulent images that are hard to detect and easy to believe.

Experts warn that by November voters will have witnessed counterfeit photos and videos of candidates enacting one scenario after another, with reality wrecked and the truth nearly unknowable.

“This is the first presidential campaign of the AI era,” said Matthew Stamm, a Drexel University electrical and computer engineering professor who leads a team that detects false or manipulated political images. “I believe things are only going to get worse.”

Last year, Stamm’s group debunked a political ad for then-presidential candidate Florida Republican Gov. Ron DeSantis ad that appeared on Twitter. It showed former President Donald Trump embracing and kissing Anthony Fauci, long a target of the right for his response to COVID-19.

That spot was a “watershed moment” in U.S. politics, said Stamm, director of his school’s Multimedia and Information Security Lab. “Using AI-created media in a misleading manner had never been seen before in an ad for a major presidential candidate,” he said.

“This showed us how there’s so much potential for AI to create voting misinformation. It could get crazy.”

Election experts speak with dread of AI’s potential to wreak havoc on the election: false “evidence” of candidate misconduct; sham videos of election workers destroying ballots or preventing people from voting; phony emails that direct voters to go to the wrong polling locations; ginned-up texts sending bogus instructions to election officials that create mass confusion.

Pennsylvania Secretary of State Al Schmidt is leading a newly formed Election Threats Task Force, intended in part to combat misinformation about voting. In a brief interview, Schmidt noted that in recent years we’ve seen “how easily misinformation has been spread using far more primitive methods than AI — tweets and Facebook posts with no video or audio.

“So AI presents a far greater challenge if it’s weaponized to deceive voters or harm candidates.”

Sham Biden call

Like the internet itself, AI can be a powerful tool to both advance and hinder society.

And while bad actors have long possessed the ability to generate fraudulent content in the digital age, the contouring of text and imagery to shame or denigrate a political opponent was once “slow and painful,” said computer science professor David Doermann from the University of Buffalo, State University of New York.

“It took work to use Photoshop and video tools,” Doermann said. “You needed experts. But now, your average high school student can generate deepfakes.”

Deepfakes are synthetic media in which a person in a photo or video is swapped with another person’s likeness, or a person appears to be doing or saying something they didn’t do or say.

A recent example occurred before the January New Hampshire primary. An AI-generated robocall simulated President Joe Biden’s voice, urging voters not to participate, and “save” their votes for the November election.

Average voters could have easily believed Biden recorded the message and become disenfranchised as a result, noted the Campaign Legal Center, a nonpartisan government watchdog group in Washington, D.C.

“This is the first year to feature AI’s widespread influence before, during and after voters cast ballots,” said CLC executive director Adav Noti. “AI provides easy access to new tools to harm our democracy more effectively.”

Malicious intent

AI allows people with malicious intent to work with great speed and sophistication at low cost, according to the Cybersecurity & Infrastructure Security Agency, part of the U.S. Department of Homeland Security.

That swiftness was on display in June 2018. Doermann’s University of Buffalo colleague, Siwei Lyu, presented a paper that demonstrated how AI-generated deepfake videos could be detected because no one was blinking their eyes; the faces had been transferred from still photos.

Within three weeks, AI-equipped fraudsters stopped creating deepfakes based on photos and began culling from videos in which people blinked naturally, Doermann said, adding, “Every time we publish a solution for detecting AI, somebody gets around it quickly.”

Six years later, with AI that much more developed, “it’s gained remarkable capacities that improve daily,” said political communications expert Kathleen Hall Jamieson, director of the University of Pennsylvania’s Annenberg Public Policy Center. “Anything we can say now about AI will change in two weeks. Increasingly, that means deepfakes won’t be easily detected.

“We should be suspicious of everything we see.”

‘Democracy can wither’

Misinformation has gushed like a “fire hose of falsehoods,” some of it from Russia, said Matt Jordan, director of the Pennsylvania State University News Literacy Initiative, which helps students and citizens distinguish “reliable journalism” from “the noise that often overwhelms and divides us,” according to its website.

Democracy, Jordan said, “depends on a capacity to share reality,” which misinformation shatters. In such an atmosphere, he warned, “democracy can wither.”

Politicians aren’t the only ones at risk in that atmosphere.

Security specialists recommend election workers keep personal social media accounts private so that pernicious individuals armed with AI have less access to their images and voices. To avoid online intimidation on Election Day, experts also suggest election workers use multistep log-ins, ever-changing pass phrases, and fingerprint scanning.

“In 2020, we encountered a lot of ugliness related to threats, and have had to scramble to make sure our people feel safe,” said Schmidt, Pennsylvania’s top election official.

AI-generated misinformation helps exacerbate already entrenched political polarization throughout America, said Cristina Bicchieri, Penn professor of philosophy and psychology.

“When we see something in social media that aligns with our point of view, even if it’s fake, we tend to want to believe it,” she said.

To battle fabrications, Stamm of Drexel said, the smart consumer could delay reposting emotionally charged material from social media until checking its veracity.

But that’s a lot to ask.

Human overreaction to a false report, he acknowledged, “is harder to resolve than any anti-AI stuff I develop in my lab.

“And that’s another reason why we’re in uncharted waters.”

_____

(c)2024 The Philadelphia Inquirer. Visit The Philadelphia Inquirer at www.inquirer.com. Distributed by Tribune Content Agency, LLC.

A team led by University of Pennsylvania scientists has discovered three genetic variants that offer the first strong clues as to why glaucoma disproportionately affects Black people.

The variants are common in people with African ancestry and are associated with a significantly higher risk of developing the sight-robbing disease, the researchers found in their study of more than 11,000 volunteers, including 6,300 from the Philadelphia area.

More research is needed to determine if these variants — each consisting of just a single “letter” among the 3 billion pairs of letters that spell out the human genome — play a direct role in causing glaucoma. But if they stand up to scrutiny, the findings someday could be used to develop better treatments and identify people who could benefit from them, said Shefali Setia Verma, one of the lead study authors and an assistant professor at Penn’s Perelman School of Medicine.

“The idea is that this can help identify individuals who are at higher risk before any symptoms occur,” she said.

Previous studies have found more than 170 other genetic variants that are involved in glaucoma, a condition in which the optic nerve becomes damaged, often as a result of increased pressure inside the eye. But most of those studies were conducted among white or Asian populations — despite the fact that glaucoma is more common in Black people and, when it occurs, is more likely to lead to blindness.

And most of the genetic variants discovered in those previous studies turned out to play little or no role in the disease for Black people, illustrating the need for diversity in study populations, said Penn physician-scientist Joan M. O’Brien.

“It was a hugely unmet need,” she said.

Gaining trust from Black patients

That’s what prompted O’Brien, Verma, and their colleagues to launch the new study, which is among the first — and by far the largest — conducted among Black people.

O’Brien blamed the shortage of studies partly on the justifiable misgivings that many Black people hold about medical research, citing examples of misconduct such as the Tuskegee experiment in which Black men were not treated for syphilis.

Ongoing bias in medicine continues to contribute to mistrust. For instance, Black patients are less likely than white patients to receive pain medication, and less likely to be admitted to the hospital from the emergency room. Until recently, they had to wait longer than white patients for a kidney transplant.

“Clearly there are reasons for individuals of African ancestry to distrust studies and distrust medicine and distrust many things related to science,” she said. “That doesn’t excuse us from trying to involve people of African ancestry.”

They ended up with 11,275 study participants, including the 6,300 that Penn physicians enrolled from the Philly area. The rest came from elsewhere in the United States, as well as Ghana and Nigeria, recruited by collaborators at other institutions.

The scientists started by comparing the genomes of study participants who had glaucoma with the genomes of participants who did not, identifying dozens of genetic variants that differed between the two groups.

Then winnowed down that list to the final three by conducting a series of laboratory studies in human cells. They also validated their findings by checking them against other genetic databases, including Penn Medicine’s own BioBank, a repository of blood and genetic samples of which 17% were contributed by Black people.

Glaucoma risk increase

All three variants were found in noncoding regions of the genome — what used to be erroneously referred to as “junk DNA,” or stretches of DNA that lie outside the genes. But as scientists have found in many other instances, these three variants, despite not being part of any gene, appear to play a role in the activity of nearby genes.

One of the variants was associated with a 75% increase in the risk of glaucoma. The other two each were linked to a 25% increase in risk of the disease.

The three variants appear to play some sort of causal role in the disease, but more work is needed to be sure what that is. O’Brien, director of the Penn Center for Genetics of Complex Disease, hopes that someday the findings could be incorporated into a rapid test, suitable for use in a primary-care office.

Such a test would allow physicians to identify and counsel at-risk patients before they are aware of any symptoms. People with the disease often are unaware they have it, as it typically starts with declining peripheral vision, which patients may not notice at first.

The genetic findings also could guide the development of better drugs, O’Brien said. Currently, physicians treat the disease by trying to lower the pressure inside patients’ eyes, first with medication and later, if needed, surgery.

But those tactics don’t work for everyone in whom the disease is caused by elevated eye pressure, O’Brien said. And in some cases, the disease can occur in people whose eye pressure is normal.

“We know it’s not just the pressure,” she said. “But that’s the only treatment we have to give.”

©2024 The Philadelphia Inquirer, LLC. Visit at inquirer.com. Distributed by Tribune Content Agency, LLC.

Jason George began noticing in September that Medicaid payments had stalled for some of his assisted living facility residents, people who need help with daily living.

Guardian Group Montana, which owns three small facilities in rural Montana, relies on the government health insurance to cover its care of low-income residents. George, who manages the facilities, said residents’ Medicaid delays have lasted from a few weeks to more than six months and that at one point the total amounted to roughly $150,000.

George said the company didn’t have enough money to pay its employees. When he called state health and public assistance officials for help, he said, they told him they were swamped processing a high load of Medicaid cases, and that his residents would have to wait their turn.

“I’ve mentioned to some of them, ‘Well what do we do if we’re not being paid for four or five months? Do we have to evict the resident?’” he asked.

Instead, the company took out bank loans at 8% interest, George said.

Montana officials finished their initial checks of who qualifies for Medicaid in January, less than a year after the federal government lifted a freeze on disenrollments during the height of the covid-19 pandemic. More than 127,200 people in Montana lost Medicaid with tens of thousands of cases still processing, according to the latest state data, from mid-February.

Providers who take Medicaid have said their state payments have been disrupted, leaving them financially struggling amid the unwinding. They’re providing care without pay, and sometimes going into debt. It’s affecting small long-term care facilities, substance use disorder clinics, and federally funded health centers that rely on Medicaid to offer treatment based on need, not what people can pay.

State health officials have defended their Medicaid redetermination process and said they have worked to address public assistance backlogs.

The problem is ongoing: George said two Guardian residents were booted from Medicaid in mid-March, with the state citing a lack of information as the cause.

“I have proof we submitted the needed information weeks ago,” he said.

Providers said they’ve also experienced cases of inconsistent Medicaid payments for people who haven’t lost coverage. It can be hard to disentangle why payments suddenly stop. Patients and providers are working within the same overstretched system.

Jon Forte is the head of the Yellowstone County health department in Billings, which runs health centers that provide care regardless of patients’ ability to pay. He said that at one point some of the clinics’ routine Medicaid claims went unpaid for up to six months. Their doctors are struggling to refer patients out for specialty care as some providers scale back on clientele, he said.

“Some have honestly had to stop seeing Medicaid patients so that they can meet their needs and keep the lights on,” Forte said. “It is just adding to the access crisis we have in the state.”

Payment shortfalls especially hurt clinics that base fees on patient income.

David Mark, a doctor and the CEO of One Health, which has rural clinics dotted across eastern Montana and Wyoming, said the company anticipated making about $500,000 in profit through its budget year so far. Instead, it’s $1.5 million in the red.

In Yellowstone County, Forte said, the health department, known as RiverStone Health, is down $2.2 million from its anticipated Medicaid revenue. Forte said that while state officials have nearly caught up on RiverStone Health’s direct Medicaid payments, smaller providers are still seeing delays, which contributes to problems referring patients for care.

Jon Ebelt, a spokesperson for the Montana Department of Public Health and Human Services, said Medicaid can retroactively pay for services for people who have lost coverage but are then found eligible within 90 days. He said the state’s average redetermination processing time is 34 days, the average processing time for applications is 48 days, and, when processing times are longer, it’s often due to ongoing communication with a client.

Ebelt didn’t acknowledge broader Medicaid payment delays, but instead said a provider may be submitting claims for Medicaid enrollees who aren’t eligible. He rejected the idea that individual examples of disruptions amount to a systemic problem.

“We would caution you against using broad brush strokes to paint a picture of our overall eligibility system and processes based on a handful of anecdotal stories,” Ebelt said in an emailed response to a KFF Health News query.

Ebelt didn’t directly answer questions about continued long waits for people seeking help but instead said continued coverage depends on individual beneficiaries submitting information on time.

Federal data shows Montana’s average call center wait time is 30 minutes — putting it among states with the highest average wait times. Mike White, co-owner of Caslen Living Centers, which has six small assisted living facilities across central and southwestern Montana, said some family members allowed the company to manage residents’ Medicaid accounts to help avoid missing deadlines or paperwork. Even so, he said, the company is waiting for about $30,000 in Medicaid payments, and it’s hard to reach the state when problems arise.

When they do get through to the state’s call center, the person on the other end can’t always resolve their issue or will answer questions for only one case at a time.

“You don’t know how long it’s going to take — it could be two months, it could be six months — and there’s nobody to talk to,” White said.

Ebelt said long-term care facilities were provided information on how to prepare for the unwinding process. He said new Medicaid cases for long-term care facilities are complicated and can take time.

Stan Klaumann lives in Ennis and has power of attorney for his 94-year-old mom, who resides in one of Guardian’s assisted living homes. Klaumann said that while she never lost coverage, the state didn’t make Medicaid payments toward her long-term care for more than four months and he still doesn’t know why.

He said that since last fall the state hasn’t consistently mailed him routine paperwork he needs to fill out and return in exchange for Medicaid payments to continue. He tried the state’s call center, he said, but each time he waited on hold for more than two hours. He made four two-hour round trips to his closest office of public assistance to try to get answers.

Sometimes the workers told him that there was a state error, he said, and other times that he was missing paperwork he’d already submitted, such as where money from selling his mom’s car went.

“Each time I went, they gave me a different answer as to why my mother’s bills weren’t being paid,” Klaumann said.

Across the nation, people have reported system errors and outdated contact information that led states to drop people who qualify. At least 28 states paused procedural disenrollments to boost outreach to people who qualify, according to federal data. Montana stuck to its original time frame and has a higher procedural disenrollment rate than most other states, according to KFF.

Stephen Ferguson, executive director of Crosswinds Recovery in Missoula, said the substance use disorder program doesn’t have a full-time person focused on billing and sometimes doesn’t realize clients lost Medicaid coverage until the state rejects thousands of dollars in services that Crosswinds submits for reimbursement. After that, it can take months for clients to either get reenrolled or learn they truly no longer qualify.

Ferguson said he’s writing grant proposals to continue to treat people despite their inability to pay.

“We’re riding by the seat of our pants right now,” he said. “We are unsure what next month or the next quarter looks like.”

(KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)

©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

JERUSALEM (AP) — World Central Kitchen, the food charity founded by celebrity chef José Andrés, called a halt to its work in the Gaza Strip after an Israeli strike killed seven of its workers, mostly foreigners.

The group, which said it will make decisions about longer-term plans in the region soon, has been bringing desperately needed food to Gazans facing widespread hunger and pioneered the recently launched effort to deliver aid by sea from Cyprus. Its absence, even if temporary, is likely to deepen the war-torn territory’s misery as the United Nations warns that famine is imminent.

Here’s a look at the charity’s work in Gaza and what its absence could mean:

WHAT IS WORLD CENTRAL KITCHEN?

Founded in 2010, World Central Kitchen delivers freshly prepared meals to people in need following natural disasters, like hurricanes or earthquakes, or to those enduring conflict. The group has also provided meals to migrants arriving at the southern U.S. border, as well as to hospital staff who worked relentlessly during the coronavirus pandemic.

The aid group sends in teams who can cook meals that appeal to the local palate on a large scale and fast.

“When you talk about food and water, people don’t want a solution one week from now, one month from now. The solution has to be now,” Andrés is quoted as saying on the group’s website.

World Central Kitchen has worked in dozens of affected areas and currently has teams in Haiti, addressing the needs of Ukrainians displaced by Russia’s invasion, as well as providing meals to people affected by the war in Gaza.

WHAT HAS IT DONE DURING THE WAR IN GAZA?

Teams from the charity have fanned out across the region since Hamas-led militants attacked southern Israel on Oct. 7 and throughout the war that it sparked. It has fed Israelis displaced by the attack as well as former hostages, according to its website, and people in Lebanon displaced by fighting with Israel. But its work in Gaza has been the most demanding.

In Gaza, the group says it has provided more than 43 million meals to Palestinians.

The group has set up two main kitchens, in the southern city of Rafah and the central town of Deir al-Balah. It lends support to 68 community kitchens throughout the territory, serving more than 170,000 hot meals a day. The group ramped up its work during Ramadan, the holy month when Muslims traditionally fast from sunrise to sundown and then eat a lavish meal, distributing 92,000 food boxes or about 4.7 million meals.

The group has also provided meals through airdrops and has led two shipments by sea carrying hundreds of tons of food for northern Gaza, where the food emergency is most acute.

In an interview with The Associated Press last month, Andrés credited the charity’s sea deliveries with prompting the U.S. to declare that it would build a floating pier for aid delivered to Gaza by sea.

“I think this has been our achievement,” he said.

WHAT WILL THE CHARITY’S ABSENCE MEAN FOR PEOPLE IN GAZA?

With World Central Kitchen immediately suspending its work, tens of thousands of meals a day won’t be handed out.

Following the deadly strike, Cyprus’ foreign ministry spokesperson said aid ships that arrived in Gaza this week will return to the Mediterranean island nation with some 240 tons of undelivered aid. Roughly 100 tons have already been offloaded, the spokesperson said.

Other aid organizations are still on the ground providing assistance to Palestinians, including the U.N. But aid groups say supplies are not coming in quickly enough and once they have entered Gaza, delivery is hobbled by logistical problems as well as the constant fighting. Israel denies there is a food shortage in Gaza and blames the U.N. and other aid groups for failing to scale up deliveries inside the territory.

World Central Kitchen was at the vanguard of the two sea shipments that have arrived in Gaza so far. It was not clear in what capacity the sea corridor would continue without the group, but the president of Cyprus said Tuesday that more aid could be shipped to Gaza from Cyprus “before the end of the month,” as the U.S. completes construction of a floating pier off the Palestinian territory’s coastline.

President Nikos Christodoulides said the Cyprus-Gaza aid shipments “will continue as humanitarian needs are there.”

Your insurance company may know more about you than you realize.

The technology that saturates today’s world — smart-home devices, drone images, fitness trackers, social media posts and telematics programs that monitor your driving habits — can help insurers piece together a detailed picture of your behavior.

Your permission isn’t always required. Many facts about your house, car and neighborhood are public records. Data brokers also gather and sell details about your activity, like which stores you visit, what you click online and the whereabouts of your mobile phone.

For a human, all that data is too much to process. But the ability of artificial intelligence to interpret data could upend the process of buying an insurance policy and filing a claim. As insurers face questions about fairness and privacy, some people may find it’s harder to get coverage. Others will benefit from cheaper rates, quicker applications and easier claims.

Faster insurance applications

Customers could see a shortened application process as insurance companies embrace AI.

Insurers may drastically cut the number of questions they ask in a home insurance application, says Peter Flynn, head of personal lines for the Americas at insurance consulting firm Xceedance.

“In the future, they might only ask five questions,” Flynn says. “But they might gather 5,000 additional data points, and they might interpret those 5,000 things in addition to the five answers they get from the applicant.”

A similar shift is happening in life insurance underwriting, which traditionally requires a medical exam plus a health and lifestyle questionnaire. As AI models improve, more carriers offer accelerated underwriting — quickly issuing policies to low-risk customers based on digital medical records and other data, while flagging higher-risk applicants for conventional underwriting.

“You can put a little bit of information and they can return a rate that’s not based on somebody coming to your house and taking blood,” says David Embry, CEO of online insurance broker Mylo.

To get the most accurate rate, make sure your records are correct and up to date before starting a life insurance application. You might also want to have supporting documents — like a summary from your doctor about any medical conditions — ready to go.

More personalized insurance rates

Low-risk customers stand to save money as insurers use data to create increasingly personalized profiles of their users.

The auto insurance industry is leading the charge with telematics programs that monitor things like your speed, braking patterns and mileage, enabling insurers to base pricing on driver behavior.

“In an AI-enabled or machine-learning-enabled environment, they can take that to an infinite degree and gather and collect as much data as available and interpret it in real time,” making predictions based on an individual’s habits, Flynn says.

While low-risk buyers reap the benefits of a constantly fine-tuned prediction model, a 2020 report by the Organization for Economic Cooperation and Development warns of the potential downside of this approach. Slicing and dicing customers into smaller risk pools could effectively price some applicants out of insurance, the OECD report says.

For drivers, the smart approach is to compare car insurance quotes from several companies. Insurers don’t all use the same sources of data, and they weigh each factor differently.

Simpler claims, and maybe fewer of them

Filing an insurance claim can be a stressful experience. Insurers’ use of AI could make the process smoother for customers and get them a decision — and their payout — much more quickly.

AI can help insurers identify the most urgent claims, reconstruct accident scenes, analyze medical records and flag cases for signs of fraud, according to a 2023 report by research firm Everest Group and professional services company Ernst & Young. Making claims more efficient is a priority for more than half of the property and casualty insurers surveyed, the report says.

New York-based insurer Lemonade says AI-based insurance fraud detection allows about 40% of its claims to be resolved within moments.

AI could even help prevent losses before the need for a claim arises — known as a “predict and prevent” model instead of the current “detect and repair” approach. For example, data relayed by smart-home devices could automatically trigger intervention if, say, a sensor catches early warning signs of a leak or a frozen pipe.

AI can also deliver feedback to drivers, helping them adjust their behavior. Programs like Allstate’s Drivewise reward those who avoid risky habits like speeding, hard braking or using a phone while driving.

But as the insurance industry integrates AI, there are concerns about cybersecurity, privacy and the potential for AI models to discriminate based on characteristics like race or gender.

The National Association of Insurance Commissioners issued guidelines in December 2023, encouraging insurers to correct errors in AI models and avoid bias. But each state creates its own rules, and regulation remains in its infancy stages.

Oversight will evolve, Flynn says. “But I’ll bet you the technology evolves faster than the regulation.”

The article 3 Ways AI Could Transform Your Insurance Policy originally appeared on NerdWallet.

Six construction workers are thought to have perished after the Dali, a Singapore-flagged container ship, smashed into a key support column and sent the bridge and the roadway workers on it into the Patapsco River.

The night shift crew began working in the evening March 25, filling potholes on Interstate 695. After a mayday from the ship early the next morning, police officers successfully halted car traffic onto the bridge moments before it fell, but warnings didn’t make it to most of the workers in time.

A seventh member of the Brawner Builders crew was rescued and treated at a hospital. A bridge inspector also survived.

Baltimore’s Latino community is grieving the six lives lost as it rallies around the families. For some, the men’s deaths symbolize the sacrifices many Latin American immigrants make when they work dangerous jobs in the United States to improve their families’ futures.

The men who died came from Mexico, Honduras, Guatemala and El Salvador. The youngest were in their 20s, while the eldest was a 49-year-old grandfather.

Miguel Luna, 49

Luna, who was from the town of California in El Salvador, immigrated to the United States about 19 years ago, according to CASA, a nonprofit supporting immigrants of which Luna was a member.

He became a welder and lived in Glen Burnie. When he wasn’t working construction, he often cooked alongside his wife, who operates a food truck called Pupuseria Y Antojitos Carmencita Luna, based in Glen Burnie. Friends described Luna as a hardworking “family man,” who had three children, and also was a grandfather. One friend reminisced about their time playing professional soccer together in El Salvador as young men, adding that Luna was a skilled defender.

Miguel Luna, victim of Key Bridge collapse, was a kindhearted family man from El Salvador

Alejandro “Alex” Hernandez Fuentes, 35

Hernandez was the foreman of the crew working on the bridge that night. Former coworkers described him as a “fireball” who took his job seriously, and climbed the ranks at Brawner Builders, going from a laborer to driving a company truck.

Hernandez was a devout Christian, who often encouraged his coworkers to turn on religious radio stations as they drove from job to job. Hernandez, who was born in Mexico and lived in Essex, left behind a wife and four children. His body was found last week submerged in the Patapsco, in a red pickup truck. Hernandez’s brother-in-law Julio was part of the crew working on the bridge March 26 but survived the collapse, a former coworker said.

Alejandro Hernandez Fuentes, foreman of crew killed in Key Bridge collapse, was devout father of four

Maynor Yassir Suazo Sandoval, 38

The youngest of eight siblings, Suazo Sandoval grew up in Azacualpa, Honduras. He immigrated to the United States more than 17 years ago, and often sent money back to his hometown, even sponsoring a soccer league. He had a wife and two children and lived in Owings Mills.

Skilled with machinery, he dreamed of starting his own business one day, according to CASA, of which Suazo Sandoval was a member. In his spare time, Suazo Sandoval loved visiting parks and beaches with his wife and young daughter, said his brother Carlos, who took to the Patapsco River Friday to observe the wreckage and sent videos to his family members.

Awaiting closure, Maynor Suazo Sandoval’s family remembers him as a happy provider

Dorlian Ronial Castillo Cabrera, 26

Born in Guatemala, Castillo Cabrera lived in the Baltimore area. Relatives living at a Dundalk address listed for him said they were not ready to speak to reporters. A friend named Melvin Ruiz, of Baltimore, told The Baltimore Sun that Castillo Cabrera was a kind person with a joyous sense of humor.

Castillo Cabrera routinely volunteered to drive fellow crew members to work and other members of Baltimore’s Latino community to the store or to various appointments as needed, Ruiz said.

“He was a genuinely selfless person,” Ruiz said.

Elba Yanez, who cut his hair at a Patapsco Avenue barber shop, described him as sweet. Castillo’s body was recovered last week in the submerged truck, alongside Alex Hernandez. He was originally from San Luis, Petén, according to the Consulate General of Guatemala in Maryland.

Jose Mynor Lopez, in his 30s

Lopez, described as a loving family man and an attentive father, emigrated to the United States 19 years ago from Guatemala in order to create better opportunities for his family.

He had four children, including a young daughter, his uncle Wilmer Raul Orellana said. His wife worked at Owls Corner Cafe in Dundalk, according to his friend and former coworker Melvin Ruiz. A co-owner of the cafe set up a GoFundMe to raise money for his family.

For much of his time in the U.S., Lopez worked in Virginia for Marksmen, a Baltimore bridge repair and marine construction company. Lopez had taken a job with Brawner and moved to the Baltimore about a year ago. He lived in Dundalk.

Carlos Hernandez

Other news outlets have identified Carlos Hernandez as one of the victims who died on the bridge. The Mexican embassy told The Sun that three Mexicans were working on the bridge when it collapsed, including the man who survived. The Mexican state of Michoacán told CNN that the three Mexican men — Carlos Hernandez, Alejandro Hernandez, and Julio — were related to one another.

Baltimore Sun reporter Jonathan M. Pitts contributed to this article.

The Congressional Budget Office warned in its latest projections that U.S. federal government debt is on a path from 97% of GDP last year to 116% by 2034 — higher even than in World War II. The actual outlook is likely worse.

From tax revenue to defense spending and interest rates, the CBO forecasts released earlier this year are underpinned by rosy assumptions. Plug in the market’s current view on interest rates, and the debt-to-GDP ratio rises to 123% in 2034. Then assume — as most in Washington do — that ex-President Donald Trump’s tax cuts mainly stay in place, and the burden gets even higher.

With uncertainty about so many of the variables, Bloomberg Economics has run a million simulations to assess the fragility of the debt outlook. In 88% of the simulations, the results show the debt-to-GDP ratio is on an unsustainable path — defined as an increase over the next decade.

The Biden administration says its budget, featuring a slew of tax hikes on corporations and wealthy Americans, will ensure fiscal sustainability and manageable debt-servicing costs.

“I do believe we need to reduce deficits and to stay on a fiscally sustainable path,” Treasury Secretary Janet Yellen told lawmakers in February. Biden administration proposals offer “substantial deficit reduction that would continue to hold the level of interest expense at comfortable levels. But we would need to work together to try to achieve those savings,” she said.

Trouble is, delivering on such a plan will require action from a Congress that’s bitterly divided on partisan lines.Republicans, who control the House, want deep spending cuts to bring down the ballooning deficit, without specifying exactly what they’d slash. Democrats, who oversee the Senate, argue that spending is less of a contributor to any deterioration in debt sustainability, with interest rates and tax revenues the key factors. Neither party favors squeezing the benefits provided by major entitlement programs.

In the end, it may take a crisis — perhaps a disorderly rout in the Treasuries market triggered by sovereign U.S. credit-rating downgrades, or a panic over the depletion of the Medicare or Social Security trust funds — to force action. That’s playing with fire.

Last summer provided a foretaste, in miniature, of how a crisis might begin. Over two days in August, a Fitch Ratings downgrade of the U.S. credit rating and an increase of long-term Treasury debt issuance focused investor attention on the risks. Benchmark 10-year yields climbed by a percentage point, hitting 5% in October — the highest level in more than one and a half decades.

As for how things might end, Britain’s experience in fall 2022 provides a glimpse into the abyss. Then-Prime Minister Liz Truss’s plan for unfunded tax cuts sent the gilt market into a tailspin. Yields soared so quickly that the central bank had to step in to snuff out the risk of an outright financial crisis. The bond vigilantes’ actions forced the government to call off the plan and Truss out of office.

For the U.S., the dollar’s central role in international finance and status as the dominant reserve currency lowers the odds of a similar meltdown. It would take a lot to shake investor confidence in U.S. Treasury debt as the ultimate safe asset. If it did evaporate, though, the erosion of the dollar’s standing would be a watershed moment, with the U.S. losing not just access to cheap financing but also global power and prestige.

Variable variables

How does the CBO, Washington’s official budget watchdog, arrive at its debt forecast? The CBO’s assumptions for crucial variables — GDP growth around 2%, inflation returning to 2%, interest rates drifting down from the current levels — are squarely in the ballpark of plausibility. They’re also not far from numbers in the Federal Reserve Bank of Philadelphia’s Survey of Professional Forecasters. Indeed, the CBO’s view on rates is a little higher than the most recent consensus.

Examine them closely, though, and key assumptions underpinning the CBO forecast appear optimistic:

• By law, the CBO is compelled to rely on existing legislation. That means it assumes the 2017 Trump tax cuts will expire as scheduled in 2025. But even President Joe Biden wants some of them extended. According to the Penn Wharton Budget Model, permanently extending the legislation’s revenue provisions would cost about 1.2% of GDP each year starting in the late 2020s.
• The CBO also must assume that discretionary spending, which is set by Congress each year, will increase with inflation, not keep pace with GDP. As a result, defense spending falls from around 3% of GDP now to about 2.5% in the mid-2030s — a tall order given the wars currently raging and the geopolitical threats that loom. Former Treasury Secretary Lawrence Summers says a more realistic forecast would add at least 1% of GDP to the CBO’s outlook.
• Market participants aren’t buying the benign rates outlook, with forward markets pointing to borrowing costs markedly higher than the CBO assumes.

Bloomberg Economics has built a forecast model using market pricing for future interest rates and data on the maturity profile of bonds. Keeping all the CBO’s other assumptions in place, that shows debt equaling 123% of GDP for 2034. Debt at that level would mean servicing costs reach close to 5.4% of GDP — more than 1.5 times as much as what the federal government spent on national defense in 2023, and comparable to the entire Social Security budget.

Heavyweights from across the political spectrum agree the long-term outlook is unsettling. Fed Chair Jerome Powell said earlier this year it was “probably time — or past time” for politicians to get going in addressing the “unsustainable” path for borrowing. Former Treasury Secretary Robert Rubin said in January the nation is in a “terrible place” with regard to deficits. From the realm of finance, Citadel founder Ken Griffin told investors in a letter to the hedge fund’s investors Monday that U.S. national debt is a “growing concern that cannot be overlooked.” Days earlier, BlackRock Inc. Chief Executive Officer Larry Fink said the U.S. public debt situation “is more urgent than I can ever remember.” Ex-IMF chief economist Kenneth Rogoff says while an exact “upper limit” for debt is unknowable, there will be challenges as the level keeps going up.

Rogoff’s broader point is well taken: forecasts are uncertain. To put some parameters around the uncertainty, Bloomberg Economics has run a million simulations on the CBO’s baseline view — an approach economists call stochastic debt sustainability analysis. Each simulation forecasts the debt-to-GDP ratio with a different combination of GDP growth, inflation, budget deficits, and interest rates, with variations based on patterns seen in the historical data.

In the worst 5% of outcomes, the debt-to-GDP ratio ends 2034 above 139%, which means that the U.S. would have a higher debt ratio in 2034 than crisis-prone Italy did last year.

Yellen has another way of thinking about debt sustainability: inflation-adjusted interest expense, which she’s indicated she’d prefer to see below 2% of GDP. On that basis, the results are more hopeful — finding that the metric averaged over the next 10 years violates the threshold in less than a third — 30% — of simulations. The Treasury chief herself acknowledged in a Feb. 8 hearing that “in an extreme case” there could be a possibility of borrowing reaching levels that buyers wouldn’t be willing to purchase everything the government sought to sell. She added that she saw no signs of that now.

Partisan politics

Getting to a sustainable path will require action from Congress. Precedent isn’t promising. Disagreements over government spending came to a head last summer, when a standoff over the debt ceiling brought the U.S. to the brink of a default. The deal to halt the havoc suspended the debt ceiling until Jan. 1, 2025, postponing yet another clash over borrowing until after the presidential election.

It’s hard to imagine a U.S. debt crisis. The dollar remains the global reserve currency. The annual and unseemly spectacle of government-shutdown brinksmanship typically leaves barely a ripple on the Treasury market.

Still, the world is changing. China and other emerging markets are eroding the dollar’s role in trade invoicing, cross-border financing and foreign exchange reserves. Foreign buyers make up a steadily shrinking share of the U.S. Treasuries market, testing domestic buyers’ appetite for ever-increasing volumes of federal debt. And while demand for those securities has lately been supported by expectations for the Fed to lower interest rates, that dynamic won’t always be in play.

Herbert Stein — head of the Council of Economic Advisers in the 1970s — observed that “if something cannot go on forever, it will stop.” If the U.S. doesn’t get its fiscal house in order, a future U.S. president will have the truth of that maxim confirmed. And if confidence in the world’s safe asset evaporates, everyone will suffer the consequences.

Methodology

As a starting point for the analysis, Bloomberg Economics uses the baseline fiscal and economic outlook — including the effective interest rate, primary budget balance as a percent of GDP, inflation as measured by the GDP deflator, and real GDP growth rate — from the latest long-term CBO projections.

For the calculation of the debt-to-GDP ratio using market forecasts for rates, we substitute in forward rates as of March 25, 2024, and project future effective rates on federal debt based on a detailed bond-by-bond analysis.

To forecast the distribution of probabilities around the CBO’s baseline debt-to-GDP view, we conduct a stochastic debt-sustainability analysis:

• We estimate a VAR model of short- and long-term interest rates, primary balance-to-GDP ratio, real GDP growth rate, and GDP deflator growth using annual data from 1990 to 2023. The covariance matrix of the estimated residuals is then used to draw one million sequences of shocks.
• We use data on the maturities of individual bonds to map short- and long-term interest-rate shocks to the effective rate of interest paid on U.S. federal debt.
• Using this model, Bloomberg Economics considers two definitions of sustainability. First, we check if the debt-to-GDP ratio increases from 2024 to 2034. Second, we examine if the average inflation-adjusted interest expense, scaled by nominal GDP, over the 10 years from 2025-2034 is less than 2%.

With assistance from Jamie Rush, Phil Kuntz and Viktoria Dendrinou.

©2024 Bloomberg L.P. Visit bloomberg.com. Distributed by Tribune Content Agency, LLC.

DEIR AL-BALAH, Gaza Strip (AP) — Some of Israel’s closest allies, including the United States, on Tuesday condemned the deaths of seven aid workers who were killed by airstrikes in Gaza — a loss that prompted multiple charities to suspend food deliveries to Palestinians on the brink of starvation.

The deaths of the World Central Kitchen workers threatened to set back efforts by the U.S. and other countries to open a maritime corridor for aid from Cyprus to help ease the desperate conditions in northern Gaza.

President Joe Biden issued an unusually blunt criticism of Israel by its closest ally, suggesting that the incident demonstrated that Israel was not doing enough to protect civilians.

“Israel has not done enough to protect aid workers trying to deliver desperately needed help to civilians,” he said, adding he was “outraged and heartbroken” by their killings.

“Incidents like yesterday’s simply should not happen,” he added. “The United States has repeatedly urged Israel to deconflict their military operations against Hamas with humanitarian operations, in order to avoid civilian casualties.”

Ships still laden with some 240 tons of aid from the charitable group turned back from Gaza just a day after arriving, according to Cyprus. Other humanitarian aid organizations also suspended operations in Gaza, saying it was too dangerous to offer help. Israel has allowed only a trickle of food and supplies into Gaza’s devastated north, where experts say famine is imminent.

The dead from Monday night’s strikes included three British citizens, Polish and Australia nationals, a Canadian-American dual national and a Palestinian. Those countries have been key backers of Israel’s nearly 6-month-old offensive in Gaza, and several of them denounced the killings.

Israel already faces growing isolation as international criticism of the Gaza assault has mounted. On the same day as the deadly airstrikes, Israel stirred more fears by apparently striking Iran’s consulate in Damascus and killing two Iranian generals. The government also moved to shut down a foreign media outlet — Qatari-owned Al Jazeera television.

Israel’s military chief, Lt. Gen. Herzi Halevi, announced the results of a preliminary investigation early Wednesday.

“It was a mistake that followed a misidentification – at night during a war in very complex conditions. It shouldn’t have happened,” he said. He gave no further details. He said an independent body would conduct a “thorough investigation” that would be completed in the coming days.

Israeli Prime Minister Benjamin Netanyahu had earlier acknowledged the “unintended strike … on innocent people” and said officials would work to ensure it does not happen again.

World Central Kitchen said it had coordinated with the Israeli military over the movement of its cars. Three vehicles moving at large distances apart were hit in succession. They were left incinerated and mangled, indicating multiple targeted strikes.

At least one of the vehicles had the charity’s logo printed across its roof to make it identifiable from the air, and the ordnance punched a large hole through the roof. Footage showed the bodies at a hospital in the central Gaza town of Deir al-Balah, several of them wearing protective gear with the charity’s logo.

Israeli TV said the initial military investigation found that the army identified the cars carrying World Central Kitchen’s workers arriving at its warehouse in Deir al-Balah and observed suspected militants nearby. Half an hour later, the vehicles were struck by the air force as they headed south. The reports said it was not clear who ordered the strikes or why.

Throughout the war, Israel has said it seeks to avoid civilian casualties and uses sophisticated intelligence to target Hamas and other militants. Israeli authorities blame them for civilian deaths because they operate in populated areas. Hamas has been designated as a terrorist organization by the United States, Canada and the European Union.

At the same time, Israel has also insisted that no target is off-limits. Israeli forces have repeatedly struck ambulances and vehicles carrying aid, as well as relief organization offices and U.N. shelters, claiming that armed fighters were in them.

Israeli forces have also shown a readiness to inflict widespread destruction on suspicion of a militant presence or out of tactical need. Homes with Palestinian families sheltering inside are leveled by strikes almost daily with no explanation of the intended target. Videos of strikes released by the military often show them hitting individuals without visible weapons, while identifying them as militants.

More than 32,900 Palestinians have been killed in the war, around two-thirds of them women and children, according to Gaza’s Health Ministry, which does not distinguish between civilians and combatants in its count.

Celebrity chef José Andrés, who founded the World Central Kitchen charity, said he was “heartbroken” by the deaths of the staffers.

“The Israeli government needs to stop this indiscriminate killing. It needs to stop restricting humanitarian aid, stop killing civilians and aid workers, and stop using food as a weapon,” he wrote on X, formerly Twitter.

The U.S., Britain, Poland, Australia and Canada all called on Israel to give answers on the deaths. Israeli Defense Minister Yoav Gallant launched an investigation and ordered the opening of a joint situation room enabling coordination between the military and aid groups.

But anger among its allies could put new pressure on Israel.

The British government summoned Israel’s ambassador for a rebuke and called for an immediate humanitarian pause to allow more aid in and the release of hostages.

British Prime Minister Rishi Sunak told Netanyahu that he was “appalled” by the workers’ deaths and described the situation in Gaza as “increasingly intolerable.”

A senior Canadian government official said there will be a joint formal diplomatic rebuke at the foreign ministry in Israel on Wednesday. The official also said a top official with Canada’s Global Affairs department made a formal representation to Israel ambassador’s to Canada on Tuesday. The official spoke on condition of anonymity as they were not authorized to speak publicly on the matter.

The deaths sent a further chill through U.N. agencies and other aid groups that have said for months that sending truck convoys around Gaza — particularly in the north — has been extremely difficult because of the military’s failure to either grant permission or ensure safe passage. Israel has barred UNRWA, the main U.N. agency in Gaza, from making deliveries to the north.

The U.S. and other countries have been working to set up the sea passage from Cyprus to get around the difficulties.

World Central Kitchen was key to the new route. It and the United Arab Emirates sent a pilot shipment last month. Their second delivery of around 400 tons of food and supplies arrived in three ships to Gaza hours before the strikes on the convoy.

Around 100 tons were unloaded before the charity suspended operations, and the rest was being taken back to Cyprus, Cypriot Foreign Ministry spokesman Theodoros Gotsis said.

Still, Cypriot President Nikos Christodoulides said Tuesday that ship deliveries would continue.

Anera, a Washington-based aid group that has been operating in the Palestinian territories for decades, said that in the wake of the strikes it was taking the “unprecedented” step of pausing its own operations in Gaza, where it had been helping to provide around 150,000 meals daily.

“The escalating risks associated with aid delivery leave us with no choice,” it said in a statement.

Jamie McGoldrick, the United Nations humanitarian coordinator for the Palestinian territories, said the strikes were “not an isolated incident.” The U.N. says more than 180 humanitarian workers have been killed in the war.

“This is nearly three times the death toll recorded in any single conflict in a year,” he said.

The war began when Hamas-led terrorists stormed into southern Israel in a surprise attack on Oct. 7, killing some 1,200 people and taking around 250 hostage. Israel responded with one of the deadliest and most destructive offensives in recent history.

Two other Israeli strikes late Monday killed at least 16 Palestinians, including eight children, in Rafah, where Israel has vowed to expand its ground operation. The city on the Egyptian border is now home to some 1.4 million Palestinians, most of whom have sought refuge from fighting elsewhere.

One strike hit a family home, killing 10 people, including five children, according to hospital records. Another hit a gathering near a mosque, killing at least six people, including three children.

Magdy reported from Cairo. Associated Press writers Monika Scislowska in Warsaw, Poland; Rod McGuirk in Melbourne, Australia; Rob Gillies in Toronto; and Menelaos Hadjicostis in Nicosia, Cyprus, contributed to this report.

Kao Kalia Yang has been called the foremost chronicler of Hmong life in the United States, and though this isn’t wrong, it’s the kind of tempered acclaim with which immigrant authors are especially familiar. Let’s retire the qualified praise. Her immensely powerful new book confirms Yang as one of America’s sharpest nonfiction writers.

“Where Rivers Part: A Story of My Mother” is about Tswb (pronounced “Chew”) Muas. Yang fans know her by another name. She was “Chue” in Yang’s “The Latehomecomer,” and excellent follow-up, “The Song Poet: A Memoir of My Father,” which Esquire named one of the 50 best biographies ever published.

Tswb gave birth to Yang in a Thai refugee camp, where her family lived for eight years before moving to Minnesota in 1987. Because her life has been a study in resilience, this book could’ve been too reverent for its own good. But, sticking to the approach that worked so well in “Poet,” Yang foregoes third-person narration in favor of her mother’s first-person voice. This gives the book immediacy, authenticity and humor (Yang also has an autobiographical picture book, “The Rock in My Throat,” out this month).

Born in Dej Tshuam, Laos — known locally as the Village Where the Rivers Meet — Tswb’s youth was distressing and brief. Her mother was widowed three times. Seeking stability amid chaos — North Vietnamese and Lao troops stalked members of the Hmong ethnic group, some of whom aided America during the Vietnam War — Tswb wed at 16.

Tswb consulted her mother about such decisions. “Young men who smell bad will only smell worse with age,” her mother said. Nineteen-year-old Npis — “Bee” in Yang’s previous books — must’ve smelled just fine.

Hiding in Laotian jungles, Tswb’s family survived by fishing, bartering and gathering vegetables. They made toothpaste from cooked banana peels.

In 1979, Tswb, Npis and their first child, Dawb, nearly died crossing the Mekong River, yet made it safely to a refugee camp in Thailand. There, the growing family lived near an open sewage canal and trembled as wind blew the roof off their communal house. “Pressures of this transient life” caused marital arguments.

In the Twin Cities, Tswb worked in factories and earned her high school diploma. More challenges awaited: Repetitive-stress injuries, depression. One of her toddlers ate lead paint.

The book is stronger for Yang’s decision to include fraught, not necessarily flattering, scenes. In one, Npis, having learned Tswb was pregnant, says he’s too old to raise another child. To Tswb, this is cowardice, the words suggesting she “kill the child inside me.”

For all its harrowing detail, “Where Rivers Part” lets the reader see the world afresh. As young Tswb washes bowls in a stream, “little minnows emerge out of the rocks to grab the bits of rice swimming down the current.” Years later, Minnesota snowdrifts assume “shapes like sheet-clad American ghosts in the orange glow of the streetlamps.”

After marrying, Tswb was known to relatives as “Npis’ wife.” In her daughter’s exceptional book, Tswb shines in the lead role.

Where Rivers Part: A Story of My Mother’s Life

By: Kao Kalia Yang.

Publisher: Atria, 310 pages, $28.99.

©2024 StarTribune. Visit at startribune.com. Distributed by Tribune Content Agency, LLC.

A captain flying on a commercial airline’s largest aircraft can bring home an average of $348,252 a year, based on recent pilot contracts that passed over the last year.

That’s just the best of the best when it comes to being a commercial airline pilot — a career that comes with years of high-earning salaries and benefits. But to get there, pilots need to invest into training and flying hours, which can often come with mounds of debt. ATP Flight School estimates it costs $108,995 to become a pilot when starting with no previous experience or $86,995 when starting with a private pilot certificate.

So what are the top commercial airlines for pilots to earn the big bucks? Here’s a list of a few.

American Airlines

At American, first-year pilots are at a flat rate, Tajer said. A first-year, first officer at American would be paid $116 an hour in 2024 under the new contract. Depending on how often that new commercial airline pilot would fly, that could mean an average $114,180 annual salary starting out, Darby said.

On average a major airline first officer in their first year flying the smallest aircraft may bring home $98,616, according to Darby.

Pay scales are based on a variety of factors, including each year of service, the type of aircraft the pilot flies and the rank of the pilot.

“It’s a good job,” Tajer said. “Each year you’ll get a pay raise because of the length of service and that goes out to 12 years. If you stay as a first officer, you’ll get an annual increase for your longevity up to 12 years and then you’ll cap out your pay per flight hour.”

Southwest Airlines

At Southwest, it is the only airline that pays per trip and a formula is used to calculate how much the pilot makes.

Southwest also only flies Boeing 737 airplanes — a difference in how other airlines get paid. First officers or captains at other major airlines, like American, can see pay bumps if they upgrade to larger airplanes.

A first-year, first officer would make approximately $133.76 an hour at Southwest, under the union’s calculations. Darby estimates that to be about $11,370 a month on average.

Top-of-scale captains at Southwest make $364.52 an hour, but Southwest believes this to be closer to $368.01. That would mean about $371,808 on average per year, Darby said.

Pilots are not paid during boarding or getting to their flight. Pilots sometimes work 10 to 12 hours a day but are only paid for when they are flying.

“What it boils down to is everybody’s competing for the best pilots, the most experienced pilots and that experience translates to safety,” Southwest Airlines Pilot Association president Casey Murray said. “When customers purchase tickets, that’s what they’re buying.”

Delta Air Lines

At Delta Air Lines, the Atlanta-based airline which nailed down its contract before all other airlines early last year, a first officer flying its smallest aircraft can make an average of $109,212 annually, according to Darby.

Pilots at Delta are represented by the Air Line Pilots Association. The deal raised their pay by more than 30% over four years. The union of about 15,000 pilots voted in the contract in March.

Flying their largest aircraft, a captain can make $420,876 a year on average.

United Airlines

United’s pilots who are first officers in their first year on the smallest aircraft can bring home a similar salary — $114,696, according to Darby’s estimate.

In July, United Airlines pilots reached an agreement for a new four-year contract, providing a cumulative increase in total compensation of as much as 40.2% over the life of the agreement.

On the other side of the scale, senior-most captains flying United’s largest aircraft can make a salary of $424,920.

Other commercial airlines

At JetBlue Airways, a first-year pilot can make $99,000. Top of the line, a captain at JetBlue flying its largest planes will make $303,840 on average.

At Allegiant Air, a first-year pilot might make around $55,356. A senior captain on average makes $222,696 flying its largest airplanes.

Spirit Airlines’ first officers starting out on the smallest aircraft make $92,868 a year. For captains flying the largest aircraft, that’s an average of $297,876 a year on average at Spirit.

Alaska Airlines pilots flying the smallest aircraft in their first year make $107,844 in the first year. As a senior captain, they can bring home $326,640 on average flying the largest airplanes at Alaska.

©2024 The Dallas Morning News. Distributed by Tribune Content Agency, LLC.

Deviled eggs — the darlings of church suppers and potlucks — may sound retro, but when served at a fancy cocktail soiree, those eggs disappear long before the canapés. You’ll be hard-pressed to see a leftover deviled egg.

If you’re left with too many Easter eggs, try experimenting with a range of fillings. The eggs are already cooked and easy to fill. I like to make a big batch of a relatively simple stuffing, then tweak small amounts with different flavors to fill different eggs.

Theories of the best way to hard boil eggs abound. Here’s my basic method: Place the eggs in a pot with enough water to cover them by at least four inches. Set the pot over high heat, bring to a low boil, cook the eggs for 10 minutes; then with a slotted spoon, remove the eggs to an ice bath to cool for at least 5 minutes. Instant Pot users swear by the “5-5-5″ method: 5 minutes on high pressure, 5 minutes of natural release, and 5 minutes in an ice bath.

Removing the shells can be tricky. It helps to gently crack the shell all over, then run cold water over the egg while peeling it. This seems to help the shell more easily loosen up. Once the eggs are peeled, use a sharp knife to slice them horizontally. Use a teaspoon to gently remove the yolks, and pile them into a bowl for the base.

The jury is out about what fat is best to enrich the filling and enhance the flavor. Mayonnaise is a must, and some cooks add a little cream cheese or yogurt, too. Some cooks prefer a smooth, velvety filling and opt for the food processor. But if you like a few lumps, use a fork to mash the yolks with the mayonnaise.

The fun is deciding what comes next. Here you’ll find a range of options — from smoked salmon to salsa, pickled beets to pickled okra — for different fillings that can be salty, tangy, salty or hot. Taste, adjust, taste again. You won’t go wrong. The only mistake is not making enough.

Classic Deviled Eggs

Makes 24 halves.

Here is my go-to classic deviled egg recipe. Be sure to use a good mayonnaise (i.e. Duke’s) for the filling. These are great on their own, but also can be the base for a range of different options. Just season to taste and use whatever you have on hand.

• 12 hard-cooked eggs
• 1/3 c. mayonnaise
• 2 tsp. Dijon mustard, to taste
• Salt and freshly ground black pepper, to taste
• Dusting of paprika for garnish

Directions

Cut the eggs in half horizontally; carefully remove the yolks and place in a bowl. Set the whites aside.

Using a fork, mash the egg yolks with the mayonnaise until the mixture is creamy but a few lumps remain. Stir in the mustard. Season to taste with salt and freshly ground black pepper. For the most classic deviled eggs, simply scoop the filling back into the egg whites and garnish with the paprika. Or, create your own variations. Here are a few ideas.

Deviled egg variations

Mexican: Season with a splash of fresh lime juice and a little Tajin seasoning, to taste. Garnish with a sprinkle of Tajin.

Moroccan: Season with Za’atar and ground cumin; garnish with chopped parsley and grated lemon zest.

Miso Sriracha: Season with miso to taste and garnish with a drizzle of Sriracha.

Pickled: Stir in chopped pickled okra or chopped dill pickles and garnish with sliced pickle or pickled okra.

Smoked Salmon: Stir in flaked smoked salmon and prepared horseradish and garnish with capers.

Prosciutto: Stir in chopped prosciutto and garnish with more prosciutto.

Pickled Beet: In a covered container, soak the hard boiled, peeled eggs in pickled beet juice in the refrigerator overnight. Remove and discard the beet juice and garnish with chopped pickled beets.

Spicy and Corny: Stir in corn salsa and garnish with chopped cherry tomato.

Tex-Mex: Stir in chopped avocado, chili powder, a little lime juice and garnish with chili powder.

Asian Peanut: Stir in spicy peanut sauce and garnish with chopped peanuts and chopped cilantro.

Roasted Pepper: Stir in chopped roasted red peppers, a shot of hot sauce and garnish with chopped mint.

Beth Dooley is the author of “The Perennial Kitchen.” Find her at bethdooleyskitchen.com.

©2024 StarTribune. Visit at startribune.com. Distributed by Tribune Content Agency, LLC.

Based on the title track of the group’s 2008 album of the same name, the book is “a call to arms to stand strong and persevere during trying times … (and) follows the path of a humble armadillo who discovers along the way how music can pull together a disparate cast of characters,” according to a press release.

“Stay Positive” was illustrated by Mexican cartoonist and comic book author David “El Dee” Espinosa.

Said lead singer Craig Finn: “‘Stay Positive’ has a line that says, ‘The kids at the shows will have kids of their own’ and it’s true. Each year more Hold Steady fans become parents or grandparents. So, I’m thrilled that we’re offering the children’s book version of ‘Stay Positive,’ which brings THS joy to the whole family.”

The book follows last year’s publication of “The Gospel of the Hold Steady: How a Resurrection Really Feels,” an oral history written by Michael Hann and the band.

Autographed copies of “Stay Positive,” and a package that includes a custom water bottle and stickers, are available for preorder at akashicbooks.com.

My parents were first-generation Italians. Even though they both spoke Italian, regretfully they never taught us the language.

They were proud to be Americans, and instead of going full Italian, we always had the traditional ham with all the trimmings for Easter dinner. The only exception was a homemade Italian bread with dyed hard-boiled eggs shaped into the dough and then baked.

This year Easter is early, and prepping for April showers I wanted to feature a ham and split pea soup, making use of the ham bone and leftover ham. You can substitute a ham hock if you don’t have a ham bone.

This makes enough soup to share or freeze. Any questions or comments, email me at cjvigos@yahoo.com.

Split Pea Soup with Ham

INGREDIENTS

1 pound of split peas soaking in water to clean

1 ham bone or ham hock

3 tablespoons butter

2 cups chopped onions

1 cup chopped celery

1 cup chopped carrots

4 teaspoons minced garlic

1 pound diced ham

1 teaspoon salt

1/2 teaspoon pepper

1/4 teaspoon crushed red pepper

12 cups water

2 bay leaves

1 teaspoon of dried thyme or 2 teaspoons of fresh thyme

DIRECTIONS

In a large pot and on medium high heat, melt the butter. Add the onions and saute for 2 minutes. Add the celery and carrots, stirring for 3 minutes. Add the garlic, stirring for 30 seconds.

Add the ham bone/ham hock and diced ham, stirring until starting to brown. Add drained peas, salt, pepper, crushed red pepper, the 12 cups of water, bay leaves and thyme.

Partially cover the lid and simmer until the split peas are done, about 11/2 to 2 hours. If the soup gets too thick while cooking, add water.

When done, remove the ham bone/ham hock and take off the meat.

If you like a smoother split pea soup, use a blender to get to your desired consistency.

Add the meat back to the soup. Adjust seasonings, top with oyster crackers if desired and serve.

One January morning in 2021, Carol Rosen took a standard treatment for metastatic breast cancer. Three gruesome weeks later, she died in excruciating pain from the very drug meant to prolong her life.

Rosen, a 70-year-old retired schoolteacher, passed her final days in anguish, enduring severe diarrhea and nausea and terrible sores in her mouth that kept her from eating, drinking, and, eventually, speaking. Skin peeled off her body. Her kidneys and liver failed. “Your body burns from the inside out,” said Rosen’s daughter, Lindsay Murray, of Andover, Massachusetts.

Rosen was one of more than 275,000 cancer patients in the United States who are infused each year with fluorouracil, known as 5-FU, or, as in Rosen’s case, take a nearly identical drug in pill form called capecitabine. These common types of chemotherapy are no picnic for anyone, but for patients who are deficient in an enzyme that metabolizes the drugs, they can be torturous or deadly.

Those patients essentially overdose because the drugs stay in the body for hours rather than being quickly metabolized and excreted. The drugs kill an estimated 1 in 1,000 patients who take them — hundreds each year — and severely sicken or hospitalize 1 in 50. Doctors can test for the deficiency and get results within a week — and then either switch drugs or lower the dosage if patients have a genetic variant that carries risk.

Yet a recent survey found that only 3% of U.S. oncologists routinely order the tests before dosing patients with 5-FU or capecitabine. That’s because the most widely followed U.S. cancer treatment guidelines — issued by the National Comprehensive Cancer Network — don’t recommend preemptive testing.

The FDA added new warnings about the lethal risks of 5-FU to the drug’s label on March 21 following queries from KFF Health News about its policy. However, it did not require doctors to administer the test before prescribing the chemotherapy.

The agency, whose plan to expand its oversight of laboratory testing was the subject of a House hearing, also March 21, has said it could not endorse the 5-FU toxicity tests because it’s never reviewed them.

But the FDA at present does not review most diagnostic tests, said Daniel Hertz, an associate professor at the University of Michigan College of Pharmacy. For years, with other doctors and pharmacists, he has petitioned the FDA to put a black box warning on the drug’s label urging prescribers to test for the deficiency.

“FDA has responsibility to assure that drugs are used safely and effectively,” he said. The failure to warn, he said, “is an abdication of their responsibility.”

The update is “a small step in the right direction, but not the sea change we need,” he said.

Europe Ahead on Safety

British and European Union drug authorities have recommended the testing since 2020. A small but growing number of U.S. hospital systems, professional groups, and health advocates, including the American Cancer Society, also endorse routine testing. Most U.S. insurers, private and public, will cover the tests, which Medicare reimburses for $175, although tests may cost more depending on how many variants they screen for.

In its latest guidelines on colon cancer, the Cancer Network panel noted that not everyone with a risky gene variant gets sick from the drug, and that lower dosing for patients carrying such a variant could rob them of a cure or remission. Many doctors on the panel, including the University of Colorado oncologist Wells Messersmith, have said they have never witnessed a 5-FU death.

In European hospitals, the practice is to start patients with a half- or quarter-dose of 5-FU if tests show a patient is a poor metabolizer, then raise the dose if the patient responds well to the drug. Advocates for the approach say American oncology leaders are dragging their feet unnecessarily, and harming people in the process.

“I think it’s the intransigence of people sitting on these panels, the mindset of ‘We are oncologists, drugs are our tools, we don’t want to go looking for reasons not to use our tools,’” said Gabriel Brooks, an oncologist and researcher at the Dartmouth Cancer Center.

Oncologists are accustomed to chemotherapy’s toxicity and tend to have a “no pain, no gain” attitude, he said. 5-FU has been in use since the 1950s.

Yet “anybody who’s had a patient die like this will want to test everyone,” said Robert Diasio of the Mayo Clinic, who helped carry out major studies of the genetic deficiency in 1988.

Oncologists often deploy genetic tests to match tumors in cancer patients with the expensive drugs used to shrink them. But the same can’t always be said for gene tests aimed at improving safety, said Mark Fleury, policy director at the American Cancer Society’s Cancer Action Network.

When a test can show whether a new drug is appropriate, “there are a lot more forces aligned to ensure that testing is done,” he said. “The same stakeholders and forces are not involved” with a generic like 5-FU, first approved in 1962, and costing roughly $17 for a month’s treatment.

The fluoropyrimidine enzyme deficiency numbers are smaller — and people with the deficiency aren’t at severe risk if they use topical cream forms of the drug for skin cancers. Yet even a single miserable, medically caused death was meaningful to the Dana-Farber Cancer Institute, where Carol Rosen was among more than 1,000 patients treated with fluoropyrimidine in 2021.

Her daughter was grief-stricken and furious after Rosen’s death. “I wanted to sue the hospital. I wanted to sue the oncologist,” Murray said. “But I realized that wasn’t what my mom would want.”

Instead, she wrote Dana-Farber’s chief quality officer, Joe Jacobson, urging routine testing. He responded the same day, and the hospital quickly adopted a testing system that now covers more than 90% of prospective fluoropyrimidine patients. About 50 patients with risky variants were detected in the first 10 months, Jacobson said.

Dana-Farber uses a Mayo Clinic test that searches for eight potentially dangerous variants of the relevant gene. Veterans Affairs hospitals use a 11-variant test, while most others check for only four variants.

Different Tests May Be Needed for Different Ancestries

The more variants a test screens for, the better the chance of finding rarer gene forms in ethnically diverse populations. For example, different variants are responsible for the worst deficiencies in people of African and European ancestry, respectively. There are tests that scan for hundreds of variants that might slow metabolism of the drug, but they take longer and cost more.

These are bitter facts for Scott Kapoor, a Toronto-area emergency room physician whose brother, Anil Kapoor, died in February 2023 of 5-FU poisoning.

Anil Kapoor was a well-known urologist and surgeon, an outgoing speaker, researcher, clinician, and irreverent friend whose funeral drew hundreds. His death at age 58, only weeks after he was diagnosed with stage 4 colon cancer, stunned and infuriated his family.

In Ontario, where Kapoor was treated, the health system had just begun testing for four gene variants discovered in studies of mostly European populations. Anil Kapoor and his siblings, the Canadian-born children of Indian immigrants, carry a gene form that’s apparently associated with South Asian ancestry.

Scott Kapoor supports broader testing for the defect — only about half of Toronto’s inhabitants are of European descent — and argues that an antidote to fluoropyrimidine poisoning, approved by the FDA in 2015, should be on hand. However, it works only for a few days after ingestion of the drug and definitive symptoms often take longer to emerge.

Most importantly, he said, patients must be aware of the risk. “You tell them, ‘I am going to give you a drug with a 1 in 1,000 chance of killing you. You can take this test. Most patients would be, ‘I want to get that test and I’ll pay for it,’ or they’d just say, ‘Cut the dose in half.’”

Alan Venook, the University of California-San Francisco oncologist who co-chairs the National Comprehensive Cancer Network, has led resistance to mandatory testing because the answers provided by the test, in his view, are often murky and could lead to undertreatment.

“If one patient is not cured, then you giveth and you taketh away,” he said. “Maybe you took it away by not giving adequate treatment.”

Instead of testing and potentially cutting a first dose of curative therapy, “I err on the latter, acknowledging they will get sick,” he said. About 25 years ago, one of his patients died of 5-FU toxicity and “I regret that dearly,” he said. “But unhelpful information may lead us in the wrong direction.”

In September, seven months after his brother’s death, Kapoor was boarding a cruise ship on the Tyrrhenian Sea near Rome when he happened to meet a woman whose husband, Atlanta municipal judge Gary Markwell, had died the year before after taking a single 5-FU dose at age 77.

“I was like … that’s exactly what happened to my brother.”

Murray senses momentum toward mandatory testing. In 2022, the Oregon Health & Science University paid $1 million to settle a suit after an overdose death.

“What’s going to break that barrier is the lawsuits, and the big institutions like Dana-Farber who are implementing programs and seeing them succeed,” she said. “I think providers are going to feel kind of bullied into a corner. They’re going to continue to hear from families and they are going to have to do something about it.”

(KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)

©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

Elizabeth Bauer was working out at the gym one morning last August when she got a phone call from her fertility nurse. It was a call that Bauer and her wife, Rebecca, had long been waiting for.

Elizabeth dialed in Rebecca so they could listen together: They were pregnant.

The Washington, D.C., couple decided before they got married three years ago that they wanted to have a child. Both wanted to play a biological part in the pregnancy. So, they used a process called reciprocal in vitro fertilization, through which eggs were retrieved from Rebecca and fertilized with donor sperm to create embryos. Then one of the embryos was implanted in Elizabeth’s uterus.

Elizabeth, a 35-year-old elementary school teacher, and Rebecca, a 31-year-old nonprofit consultant, had health insurance, but it wouldn’t cover the roughly $20,000 procedure, so they had to pay out of pocket.

But beginning next year, insurers providing coverage in D.C. will have to pay for IVF for beneficiaries, including same-sex couples, who can’t conceive on their own. Only seven states (Colorado, Delaware, Illinois, Maine, Maryland, New Jersey and New York) have similar mandates. However, a new definition of “infertility” could prompt other states to follow suit.

The American Society for Reproductive Medicine in October expanded the definition of infertility to include all patients who require medical intervention, such as use of donor gametes or embryos, to conceive as a single parent or with a partner. Previously, the organization defined infertility as a condition in which heterosexual couples couldn’t conceive after a year of unprotected intercourse.

The group emphasized the new definition should not “be used to deny or delay treatment to any individual, regardless of relationship status or sexual orientation.”

Dr. Mark Leondires, a reproductive endocrinologist and founder and medical director at Illume Fertility and Gay Parents To Be, said the new definition could make a huge difference.

“It gives us extra ammunition to say, ‘Listen, everybody who meets the definition of infertility, whether it’s an opposite-sex couple or same-sex couple or single person, who wants to have a child should have access to fertility services,’” he said.

At least four states (California, Connecticut, Massachusetts and Rhode Island) are currently weighing broader IVF coverage mandates that would explicitly include same-sex couples, according to RESOLVE: The National Infertility Association. Bills were introduced but failed to advance in Oregon, Washington and Wisconsin.

A recent policy shift at the federal level also might add to the momentum. Earlier this month, the departments of Defense and Veterans Affairs announced expanded IVF service benefits to patients regardless of marital status, sexual orientation or whether they are using donor eggs or sperm. The new policy follows a lawsuit filed in federal court last year.

“The federal government is the largest employer in the country, so if they’re providing these type of benefits, it definitely adds pressure on other employers and states to do the same,” said Betsy Campbell, RESOLVE’s chief engagement officer.

A total of 21 states have laws mandating that private insurers cover fertility treatments, but only 15 include at least one cycle of IVF in that mandate. Only New York and Illinois provide some fertility coverage for people who are insured through Medicaid, the state-federal program for people with low incomes and disabilities. Neither state covers IVF for Medicaid recipients.

100,000 babies

IVF involves collecting mature eggs from ovaries, using donated sperm to fertilize them in a lab, and then placing one or more of the fertilized eggs, or embryos, in a uterus. One full cycle of IVF can take up to six weeks and can cost between $20,000 and $30,000. Many patients need multiple cycles before getting pregnant.

Nearly 100,000 babies in the U.S. were born in 2021 through IVF and other forms of assisted reproductive technology, such as intrauterine insemination, according to federal data.

IVF continues to garner nationwide attention in the wake of the Alabama Supreme Court’s ruling last month that under state law, frozen IVF embryos are children, meaning patients or IVF facilities can be criminally charged for destroying them. The decision caused an uproar, and three weeks later Alabama Republican Gov. Kay Ivey signed a bill into law that provides criminal and civil immunity for IVF clinicians and patients.

Polly Crozier, director of family advocacy at GLBTQ Legal Advocates & Defenders, or GLAD, described the Alabama decision as “a shock to the system.” But Crozier said the reaction to it sparked a “bipartisan realization that family-building health care is important to so many people.”

Crozier praised the insurance mandates in Colorado, Illinois, Maine and Washington, D.C., for more explicitly including LGBTQ+ people. Maine’s law, for example, states that a fertility patient includes an “individual unable to conceive as an individual or with a partner because the individual or couple does not have the necessary gametes for conception,” and says that health insurers can’t “impose any limitations on coverage for any fertility services based on an enrollee’s use of donor gametes, donor embryos or surrogacy.”

Christine Guarda, financial services representative at the Center for Advanced Reproductive Services at the University of Connecticut School of Medicine, said more same-sex couples are seeking help starting families. One reason, she said, is that more large employers that provide insurance directly to their employees, such as Amazon, are including broad IVF coverage.

‘Elective procedure’?

But some lawmakers are skeptical of expanding the definition of infertility to include same-sex couples. That was evident at a hearing on the Connecticut bill earlier this month, where Republican state Rep. Cara Pavalock-D’Amato noted that “infertility isn’t necessarily elective, but having a baby is.”

“Now, we are changing definitions to cover elective procedures,” Pavalock-D’Amato said. “If we’re changing the definition for this elective procedure, then why not others as well?”

She added: “Infertility, whether you are straight or gay, up to this point has been a requirement. Now, is it through this bill that we are no longer requiring people to be sick? They no longer have to be infertile?”

But proponents of the change argue that extending IVF mandates to cover same-sex couples is a question of fairness.

“I don’t think anybody in the LGBTQ community is asking for more. They’re just asking for the same benefit, and it is discriminatory to say, ‘You don’t get the same benefit as your colleague simply because you have a same-sex partner,’” Leondires said in an interview.

“If you’re paying to the same health care system as the person sitting next to you, then you should have the same benefit,” he said.

Elizabeth and Rebecca Bauer, who are busy decorating a nursery and buying baby clothes, recognize that they were fortunate to have the money to pursue IVF even without insurance coverage, and that “there are plenty of people who don’t have the time or the ability.”

“There are so many ways that people who want to build a family might struggle,” Elizabeth said, adding that the previous infertility definition felt like a “pretty impossible barrier” for non-straight couples. “Insurance should make building a family possible for any person or persons who want to.”

Stateline is part of States Newsroom, a national nonprofit news organization focused on state policy.

©2024 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

In a real estate transaction, there’s always some level of negotiation. If you’re the seller, you face haggling not only with prospective buyers, but also with the person you’re working with to seal the deal: your real estate agent.

Thanks to a federal lawsuit that was recently settled, the way real estate commissions work will change in July 2024 (pending court approval). If you’re looking to save some money, here’s what you need to know about how commissions work, and how to agree on a rate that both you and your agent can feel good about.

How real estate commission works, and who pays for it

A generation ago, real estate commission rates were typically around 6% of a home’s sale price. But the average real estate commission rate has gone down in recent years to just under 5% of a home’s sale price, according to Real Trends, a real estate research and consulting firm, and to Anywhere Real Estate, the parent of Century 21, Coldwell Banker and other brokerage brands.

Under the current system, the fee is typically paid by the seller at closing, and it’s customarily split down the middle between the seller’s agent and the buyer’s agent. (So, for a 5% commission, each agent would earn 2.5%.) On a $400,000 transaction, which is around the median sale price nationwide, the 5% fee amounts to $20,000.

Agents and brokerages can offer a variety of commission structures, though, with some marketing flat fees or other incentives. So there may be opportunity to negotiate the rate if you’re looking to save on the cost of selling your home.

“There are agents and brokerages that reduce, discount or coupon their services,” says Kevin Van Eck, an executive with @properties, a brokerage in Chicago. “Each agent, along with their brokerage, can determine where they set commissions based on the value and success created.”

Can you negotiate Realtor fees?

Often, yes, there is room for bargaining. And as of July, there may be even more room. As a result of a lawsuit involving the National Association of Realtors (NAR) and several major brokerages, new commission rules will take effect that month that will mean sellers no longer have to cover the cost of the buyer’s agent’s fee, which may lead to more aggressive price competition among buyer’s-side agents. In addition, listing agents will no longer be permitted to state the buyer’s agent commission in the MLS (multiple listing service), as has been common practice.

Your success at negotiating often depends on an individual agent’s circumstances, says Dave Liniger, chairman and co-founder of RE/MAX Real Estate. “Some agents are dead-set,” he says. “Other agents need the business so bad they’ll readily negotiate.”

As you prepare to list your home for sale, you may want to meet with a few listing agents to find the right one for the job. Ask each agent about their commission rate and what exactly you’ll be getting for that price. Consider not only how the agent plans to market your home, but also their skill in pricing it, experience, resources and track record.

“It’s OK for a seller to ask about the commission, but the best time is after talking with the agent and understanding their experience, how they will create exposure for the home and the value they bring to the table,” says Van Eck.

Liniger suggests that sellers invite three to five listing agents to their homes to make their pitches. The competing proposals will let you see how much agents charge, and give you leverage to bargain for a better deal. “You don’t get if you don’t ask,” he says.

You might also consider weighing what you learn from full-service agents against the services of a discount broker. Just keep in mind that the discounter’s offerings may be limited compared to those of a traditional agent.

How to negotiate real estate commissions

Once you understand exactly what you’re paying for, you will be in a better position to ask for a discount. Here are some tips:

• If you’re able to offer the agent more than one listing opportunity, that might be a compelling argument for a reduced commission. “If [you’re] a real estate investor who is looking to offload several properties, I would definitely talk about the commission,” says Dana Bull, an agent with Compass in the Boston area. Most agents welcome repeat business, she says.
• If you don’t have another listing opportunity of your own to offer, try leveraging your ability recommend the agent to others in your neighborhood or network. This might be especially impactful if you know they are looking to build their business. “I can’t just slash my commission, but I might be willing to give a slight discount if the client offered some sort of other strategy to get more business after the sale,” Bull says.
• If you have a home in a sought-after area, or a buyer already interested, or an unusually high sale price, your agent may not need to do as much to earn their fee. If neither party can foresee the need for additional services — “if an agent is coming in to basically just do some hand-holding, keeping the transaction on schedule and assisting with paperwork,” Bull says — that might be another good reason to propose a slightly lower rate.
• If you plan to buy a new home while selling your current one, use that in your favor. Liniger says an agent who can represent you on both the sale and the subsequent purchase will likely be willing to cut their fee.

You may be considering skipping the commission conversation entirely and selling your home yourself. If so, be aware: While an experienced house flipper might be skilled enough to list a home without an agent, for most homeowners, the for-sale-by-owner route can be more challenging, more costly and more time-consuming in the long run.

Bottom line

In any negotiation, both parties must be willing to give and take. Negotiating your agent’s commission can work in your favor, but an agent can walk away if they don’t necessarily need your business. Keep in mind, too, that it can make sense for sellers to pay more for additional services instead of negotiating the commission down, Bull says. These might include higher-end marketing, home staging or additional mailers, for instance. And if you’re not in a rush, consider waiting until after the July rule change to see how things shake out. Ultimately, it’s important to find an agent you can speak with openly about cost, and who you trust to do the best job to sell your home.

(Visit Bankrate online at bankrate.com.)

©2024 Bankrate.com. Distributed by Tribune Content Agency, LLC.

Financial stress is so common that certified financial planner Katie Lindquist says almost every client she has tells her they are feeling it.

“They don’t know what they should be doing with their money, and they feel like they should know. They feel shame around their money habits, which is a huge driving force of stress,” Lindquist says.

To alleviate that tension, Lindquist helps them get organized and take inventory of their financial accounts and goals. “People who have financial plans are a lot less stressed because they know where they are and where they want to go,” says Lindquist, who is based in Madison, Wisconsin.

To combat overwhelming feelings of money stress, financial experts suggest taking these steps:

Normalize the feeling

Knowing how common financial stress is can help people realize there isn’t something wrong with them when they feel it, says Bari Tessler, author of “The Art of Money” and a financial therapist in Boulder, Colorado.

“Increased financial anxiety has everything to do with interest rates, inflation, job challenges, life curveballs and world events,” Tessler says. Those stressors impact almost everybody. It can lead people to freeze and ignore their finances or to check them too obsessively, she says, neither of which is helpful.

Check in with your body

Sometimes, your body can alert you to financial stress first. Sonya Lutter, director of financial health and wellness in the School of Financial Planning at Texas Tech University, says when people experience financial stress, their fingers often get cold because they are experiencing a fight-or-flight response that affects blood flow.

“You can easily train yourself to notice when you are physiologically stressed,” Lutter says. Then, you can avoid making big financial decisions until you are in a calmer state. Otherwise, she says, fight-or-flight “leaves us to make very myopic decisions. You just want to get through right now, and definitely don’t care about 10 years from now, which is horrible for financial decision-making.”

If you’re making money choices with a partner, Lutter adds, you can gauge if you’re both in the right mindset by first holding hands to check in on temperatures and stress levels. You might decide to tackle the topic later when you’re both more relaxed.

Learn your triggers

Sometimes, negative experiences around money from childhood can lead to a high-stress response whenever the topic comes up as an adult, says Jannese Torres, author of the forthcoming book “Financially Lit!” and host of the podcast “Yo Quiero Dinero.”

The idea of negotiating for a salary or bartering at the car dealership could send you into an emotional tailspin, Torres explains. She says exploring those early life experiences can help people learn to navigate financial conversations rather than avoid them.

“The more you know what triggers you, the easier it is to look objectively at your finances and realize you can handle it,” she adds.

Look for ways to reset

Tessler suggests slowing your mind down before a big decision, which could be done through activities like hiking, meditation, taking a shower or listening to music. Sometimes, getting a snack, going outside or lowering your shoulders can go a long way toward resetting, she says.

“I would literally take a deep breath. Nobody even has to know. Walk away and analyze the situation,” Lutter says.

“It’s OK to pause and come back” to the decision later, she adds.

Take the first step to regain control

Because stress can cause us to freeze in the face of financial decisions, Stacy Dervin, founder of Tailored Financial Planning in Eugene, Oregon, suggests tackling one thing at a time. “Trying to solve everything at once can be really overwhelming. Just focus on the next right thing to help build your confidence,” she says.

Sara Zuckerman, a CFP in Scottsdale, Arizona, and founder of Reset Financial Planning, says focusing on organizing your finances can bring you back to your own goals instead of comparing yourself to others, which can exacerbate stress.

“To really understand what you have and where it’s going is the biggest step toward putting that initial feeling of control in place,” Zuckerman says.

This article was written by NerdWallet and was originally published by The Associated Press.

The article 5 Ways to Calm Financial Stress originally appeared on NerdWallet.

WASHINGTON (AP) — Voters in the pivotal swing state of Wisconsin and three Northeastern states will have a chance to indicate their support or opposition to their parties’ presumptive nominees in presidential primaries Tuesday. Wisconsin voters will also decide the fate of two Republican-backed statewide ballot measures that will shape how elections in the state are run and funded.

Farther south, Arkansas and Mississippi voters will return to the polls to decide a handful of legislative seats that were forced to runoffs in primaries held in March.

Although multiple names remain on the presidential ballots in Wisconsin, Connecticut, New York and Rhode Island, President Joe Biden and former President Donald Trump face no major challengers and already have secured more delegates than they need to win their parties’ nominations at the conventions this summer. Voters in Connecticut and Rhode Island will have the additional option of voting “uncommitted” if they want to register a protest vote against Biden, a Democrat, or Trump, a Republican. Wisconsin voters have a similar option, although it’s called “Uninstructed Delegation” on their ballot.

Delaware was also scheduled to hold a Republican presidential primary on Tuesday, but the contest was canceled on March 19 after former candidate Nikki Haley had her name removed from the ballot, leaving Trump the only remaining candidate. A Democratic primary there would also have been held Tuesday, but Biden was the only candidate to file for the ballot, so the event was never scheduled. In both cases, the parties awarded all the state’s delegates to Biden and Trump, as they were the only candidates remaining in their contests.

DECISION NOTES

In the presidential race, Biden and Trump are the favorites in their primaries as neither candidate faces a strong challenge. In all four contests, the first indications that they are winning statewide on a level consistent with the overwhelming margins seen in most other contests held this year may be sufficient to determine the statewide winners.

For the Wisconsin constitutional amendments, the fault lines hew closely to traditional partisan lines, with Republican state lawmakers backing the two measures and Democrats in opposition. Thus, the state’s vote history and political demographics will inform the race-calling process.

As for the races in Arkansas and Mississippi, runoffs tend to be lower-turnout events than the initial elections that prompted them. For local races, in which turnout for regularly scheduled elections is already relatively low, this could slow the race-calling process in particularly close contests since determining the outcome could rest on a handful of votes. For example, in Arkansas state House District 63, only 108 votes separated the first- and second-place candidates, out of 1,700 total votes cast.

The Associated Press does not make projections and will declare a winner only when it’s determined there is no scenario that would allow the trailing candidates to close the gap. If a race has not been called, the AP will continue to cover any newsworthy developments, such as candidate concessions or declarations of victory. In doing so, the AP will make clear that it has not yet declared a winner and explain why.

Here are the April 2 contests at a glance:

DELEGATES AT STAKE ON TUESDAY

Democrats: 436

Republicans: 179

STATES WITH PRESIDENTIAL PRIMARIES (4)

Connecticut, New York, Rhode Island, Wisconsin

STATES WITH NON-PRESIDENTIAL PRIMARIES AND ELECTIONS (3)

Arkansas (runoff), Mississippi (runoff), Wisconsin

TUESDAY TIMELINE

8 p.m. EDT: All polls close in Connecticut, Mississippi, Rhode Island

8:30 p.m. EDT: All polls close in Arkansas

9 p.m. EDT: All polls close in New York, Wisconsin

ARKANSAS

STATE HOUSE PRIMARY RUNOFF, DISTRICT 35 (D): Jessie McGruder, Raymond Whiteside

STATE HOUSE PRIMARY RUNOFF, DISTRICT 63 (D): Fred Leonard, Lincoln Barnett

STATE HOUSE PRIMARY RUNOFF, DISTRICT 88 (R): Arnetta Bradford, Dolly Henley

WHO CAN VOTE: Voters who participated in the March 5 primary for a specific seat may only vote in the same party’s runoff for that seat. In other words, voters who cast ballots in the Republican primary on March 5 may not vote in a Democratic runoff for the same seat. Voters who did not participate in any party’s primary for a specific seat on March 5 may also participate in the runoff. All voters must be registered in the district holding the runoff.

FIRST VOTES REPORTED (March 5 primary): 8:36 p.m. ET

LAST ELECTION NIGHT UPDATE: 3:28 a.m. ET with about 99.7% of the total votes counted

CONNECTICUT

PRESIDENTIAL PRIMARY (D): Biden, Dean Phillips, Marianne Williamson, Cenk Uygur, “Uncommitted.” 60 delegates at stake

PRESIDENTIAL PRIMARY (R): Trump, Ryan Binkley, Ron DeSantis, Haley, “Uncommitted.” 28 delegates at stake

WHO CAN VOTE: Only voters registered with a party may participate in that party’s primary. Democrats can’t vote in the Republican primary or vice versa.

FIRST VOTES REPORTED (2022 primaries): 8:08 p.m. ET

LAST ELECTION NIGHT UPDATE: 12:52 a.m. ET with about 99.9% of the total votes counted

MISSISSIPPI

U.S. HOUSE PRIMARY RUNOFF, DISTRICT 2 (R): Ron Eller, Andrew Smith

WHO CAN VOTE: Voters who participated in the March 12 primary for District 2 may only vote in the same party’s runoff. In other words, voters who cast ballots in the Democratic primary on March 12 may not vote in Tuesday’s Republican runoff. Voters who did not participate in any party’s primary for this seat on March 12 also may participate in the runoff. All voters must be registered in the 2nd Congressional District.

FIRST VOTES REPORTED (March 12 primary): 8:07 p.m. ET

LAST ELECTION NIGHT UPDATE: 12:35 a.m. ET with about 97% of the total votes counted

NEW YORK

PRESIDENTIAL PRIMARY (D): Biden, Dean Phillips, Marianne Williamson. 268 delegates at stake

PRESIDENTIAL PRIMARY (R): Trump, Chris Christie, Haley, Vivek Ramaswamy. 91 delegates at stake

WHO CAN VOTE: New York has a closed primary system, which means only Democrats may vote in the Democratic primary and only Republicans may vote in the Republican primary.

FIRST VOTES REPORTED (2022 primaries): 9:01 p.m. ET

LAST ELECTION NIGHT UPDATE: 2:49 a.m. ET with about 94% of the total votes counted

RHODE ISLAND

PRESIDENTIAL PRIMARY (D): Biden, Dean Phillips, “Uncommitted,” Write-in. 26 delegates at stake

PRESIDENTIAL PRIMARY (R): Trump, Chris Christie, Ron DeSantis, Haley, Vivek Ramaswamy, “Uncommitted,” Write-in. 19 delegates at stake

WHO CAN VOTE: Rhode Island voters registered with a specific political party may cast ballots only in their own party’s primaries. Voters who are not affiliated with any party may participate in any party primary, but doing so will automatically affiliate them with that party in state records.

FIRST VOTES REPORTED (2022 primaries): 8:10 p.m. ET

LAST ELECTION NIGHT UPDATE: 11:03 p.m. ET with about 97% of total votes counted

WISCONSIN

PRESIDENTIAL PRIMARY (D): Biden, Dean Phillips, “Uninstructed Delegation,” Write-In. 82 delegates at stake

PRESIDENTIAL PRIMARY (R): Trump, Chris Christie, Ron DeSantis, Haley, Vivek Ramaswamy, “Uninstructed Delegation,” Write-In. 41 delegates at stake

STATEWIDE BALLOT MEASURE, QUESTION 1: “Use of private funds in election administration. Shall section 7 (1) of article III of the constitution be created to provide that private donations and grants may not be applied for, accepted, expended, or used in connection with the conduct of any primary, election, or referendum?”

STATEWIDE BALLOT MEASURE, QUESTION 2: “Election officials. Shall section 7 (2) of article III of the constitution be created to provide that only election officials designated by law may perform tasks in the conduct of primaries, elections, and referendums?”

WHO CAN VOTE: Any registered voter in Wisconsin may participate in either primary.

FIRST VOTES REPORTED (2022 primaries): 9:14 p.m. ET

LAST ELECTION NIGHT UPDATE: 3:01 a.m. ET with about 99.8% of the total votes counted

UNCOMMITTED ON THE BALLOT

Connecticut, Rhode Island, Wisconsin (as “Uninstructed Delegation”)

ARE WE THERE YET?

As of Tuesday, there will be 104 days until the Republican National Convention in Milwaukee, 139 days until the Democratic National Convention in Chicago, and 217 days until the November general election.

ROBERT YOON is an elections and democracy reporter for The Associated Press, with a focus on analyzing vote and demographic data and explaining the intricacies of the electoral process. He is now covering his seventh presidential campaign cycle.

ST. PAUL, Minn. (AP) — An appeals court ruling that weakened a key part of the Voting Rights Act is spurring lawmakers in several states to enact state-level protections to plug gaps that the ruling opened in the landmark federal law aimed at prohibiting racial discrimination in voting.

Democratic-led states have been taking matters into their own hands because national legislation to expand voting rights remains stalled in a divided Congress. Meanwhile, Republican lawmakers in many states have tried to erode safeguards in the name of protecting election integrity amid former President Donald Trump’s false claims that vote fraud cost him the 2020 election.

Legislators in Minnesota, Michigan, Maryland, New Jersey and Florida are pursuing state voting rights acts, building on ones enacted by New York in 2022 and Connecticut in 2023, as well as ones enacted earlier in Virginia, Oregon, Washington and California.

“And we know of interest from other states that are considering taking up state VRAs in the next year or so,” said Michael Pernick, an attorney for the NAACP Legal Defense Fund in New York.

In Minnesota, Democratic Rep. Emma Greenman, of Minneapolis, said she felt an urgent need to act after the 8th U.S. Circuit Court of Appeals ruled last year in an Arkansas case that voters and groups could no longer sue under Section 2 of the federal Voting Rights Act — only the U.S. attorney general.

Section 2 prohibits voting practices or procedures that discriminate on the basis of race, including maps that disadvantage voters of color. Lawsuits have long been brought under the section to try to ensure Black voters have adequate political representation in places with a long history of racism, including many Southern states.

The appeals court decision currently applies only to the seven states in the 8th Circuit, which stretches from Minnesota to Arkansas. Legal observers expect the case to end up before the U.S. Supreme Court.

“As with other areas of policy, what you’re seeing is, states really have to say, ‘We need to make sure that … we have a system that is free from discrimination, we need to protect the rights of voters,’” Greenman said.

The 1965 Voting Rights Act is seen as a crowning achievement of the civil rights movement. But federal courts have “chipped away” at it over the decades, said Lata Nott, an attorney with the Campaign Legal Center in Washington, D.C., who testified for the Minnesota bill.

The biggest blow to the federal law in the view of voting rights advocates was a 2013 Supreme Court ruling in an Alabama case that stripped the government of a potent tool to stop voting bias by eliminating the requirement that jurisdictions with a history of racial discrimination in voting get “preclearance” from the federal government for major changes in the way they hold elections.

Conservatives have argued the requirement did not account for racial progress and other changes in society and that existing voting rights protections are adequate.

“It looks like this an effort by the Left in the state to do at the state level what they can’t do at the federal level under the VRA,” said Zack Smith, a legal fellow at the conservative Heritage Foundation’s Edwin Meese III Center for Legal and Judicial Studies.

The 8th Circuit decision sounded new alarms because most lawsuits to enforce the act have come from private individuals and groups, not the Justice Department, Nott said. Administrations change, so allowing people to protect their own voting rights is a “valuable enforcement mechanism,” she said.

There are broad similarities among the various state voting rights acts under consideration and the New York and Connecticut laws. They all give voters and groups a “private right of action” to challenge laws that dilute or suppress the votes of people of color, Pernick said. That’s the right the 8th Circuit struck down on the federal level.

Some of the state proposals also include preclearance requirements for changes in voting to make sure they don’t harm voters of color.

Several state proposals include “safe harbor” provisions to try to head off the kind of lengthy, expensive litigation that often has been needed to enforce the federal law. The Minnesota bill, for example, would require potential plaintiffs to notify political subdivisions before they sue to create opportunities to negotiate remedies first.

Minnesota has an image as progressive on voting rights, and the current Legislature is the most diverse in state history. But witnesses who testified before the Legislature recently said there are still problems.

They point to data showing county boards across the state, which make important decisions affecting communities of color, are disproportionately white. Electing local bodies by districts that minority candidates could win, instead of at-large seats, is one potential remedy for preventing vote dilution.

Minnesota Secretary of State Steve Simon, a Democrat who is president-elect of the National Association of Secretaries of State, said he is trying to enlist as many of his fellow election officers across the country to file a friend-of-the-court brief urging the U.S. Supreme Court to overturn the 8th Circuit decision if the plaintiffs in the Arkansas case appeal. But for now, he said, that ruling is the law in seven states.

“If we can no longer count on the federal Voting Rights Act to allow private citizens to protect their own voting rights, then we need a Minnesota Voting Rights Act to fill the gap,” Simon testified. “And that’s what this bill does. It fills the gap by guaranteeing a day in court for Minnesota voters to defend their voting rights against laws or policies that they believe discriminate against them.”

Officials with groups representing Minnesota’s local governments testified they support the concept but were concerned about the potential extra costs it could impose on them, an issue that raised concerns among Republicans on the committees that have heard the bill. Republicans also argued it’s a heavier-handed tool than Minnesota needs.

Democratic Minnesota Gov. Tim Walz said he had not studied the proposal in detail, but he shares the ideals of making voting easy and accessible.

“If this is moving down those paths, that’s a good thing,” Walz said.

Minnesota Senate President Bobby Joe Champion, a Minneapolis Democrat, is the lead author of the Minnesota Voting Rights Act in the Senate.

“Our democracy is important. We want more people voting, not less. We want more people’s voice to be heard, not silenced. We want people’s rights to be protected, not squandered,” Champion said.

WASHINGTON (AP) — President Joe Biden’s reelection campaign is raising gobs of cash. And it has an election-year strategy that, in a nutshell, aims to spend more — and spend faster.

Not only has Biden aimed to show himself off as a fundraising juggernaut this month, but his campaign is also making significant early investments both on the ground and on the airwaves — hoping to create a massive organizational advantage that leaves Republican Donald Trump scrambling to catch up.

But while the money pouring in has given Biden and the Democrats a major cash advantage, it’s also becoming clear Biden will need it. Throughout his life in business and politics, Trump’s provocations have earned him near limitless free media attention. Biden, meanwhile, has often struggled to cut through the noise with his own message despite holding the presidency.

That means Biden is going to need oodles of cash to blanket battleground states where a few thousand votes could mean the difference between victory or defeat. Add to that the challenge of reaching millennials, as well as even younger voters, who formed an important part of his 2020 coalition, in a far more fractured media ecosystem that skews toward streaming services over conventional broadcast and cable.

Biden’s organizational and outreach effort began in earnest this month, with the campaign using his State of the Union address as a launching pad to open 100 new field offices nationwide and boosting the number of paid staff in battleground states to 350 people. It’s also currently in the middle of a $30 million television and digital advertising campaign targeting specific communities such as Black, Hispanic and Asian voters.

In one example of the incumbent president’s organizational advantage, his reelection campaign in February had 480 staffers on the ground, compared with 311 to that of Trump and the Republican National Committee, according to Biden campaign officials.

“We’re ramping up campaign headquarters and field offices, hiring staff all across the country before Trump and his MAGA Republicans have even opened one single office,” Biden boasted Friday in New York during a meeting of his national finance committee, which included 200 of his largest donors and fundraisers from in and around the city.

A massive ground game disadvantage didn’t prevent Trump from winning the presidency in 2016, a fact Democrats keenly remember.

“It’s one of the stubborn challenges of Trump,” said Robby Mook, campaign manager for Hillary Clinton’s 2016 presidential bid. “Trump is Trump’s best organizer, and Trump can motivate people from the podium.”

But, Mook added, the Biden campaign is doing what it needs to do, pointing to the State of the Union as a powerful example of how to effectively mobilize the base and harness the anti-Trump energy that will inevitably motivate many Democrats this year.

“The most magical and the scariest part of politics is, you never know until Election Day,” Mook said. “And so I wouldn’t want to leave anything on the table if I were them, and the great part about having a resource advantage is, you get to have all these different things.”

Even Biden’s bricks-and-mortar campaign is likely to be far more costly this year.

Unlike 2020, when many Americans were hunkered down due to the pandemic, Biden will need to travel more while also building a political infrastructure that will be far more expensive than the socially distanced, virtual campaign he waged from his basement the last time around.

His reelection campaign will also have expenses that Trump won’t have to confront, such as reimbursing the federal government for use of Air Force One. So far, it has reimbursed $4.5 million for use of the official presidential aircraft for political activity, according to the campaign.

Mook said decisions about how to strategically invest the campaign’s cash are never as nimble as the staff wants them to be, and there is not only a risk in spending too much, too fast — but also spending far too late in an election year.

Last fall and summer, Democrats fretted about Biden’s early lack of fundraising and campaign activity. Writers’ and actors’ guild strikes in Hollywood didn’t help, either — effectively sidelining the pro-labor union president from raising money in a region that has long bankrolled the party’s political ambitions.

Now, even donors lukewarm to the president are contributing, Democratic Party donors and fundraisers say.

“I think people really want to hear what they have to say,” said Michael Smith, a major Hollywood donor and fundraiser, who hosted a Los Angeles event earlier this year featuring rocker Lenny Kravitz and held another event last week in Palm Springs with the president’s wife, Jill Biden. “They realize this is an investment.”

Trump campaign officials concede that Biden and the Democrats will likely have more cash to spend, though they argue that Trump will still be able to run an effective campaign given his ability to attract media coverage.

“Our digital online fundraising continues to skyrocket, our major donor investments are climbing, and Democrats are running scared of the fundraising prowess of President Trump,” said Steven Cheung, communications director for the Trump campaign. “We are not only raising the necessary funds but we are deploying strategic assets that will help send President Trump back to the White House and carry Republicans over the finish line.”

But given Trump’s propensity for making explosive remarks, that can also cut both ways, which Democrats are sure to exploit by using their cash advantage to run ads. Trump’s legal fees from the myriad of court cases he is tied up with are also sure to be a drag on his cash situation. Records show his political operation has shelled out at least $80 million to cover court costs over the past two years.

“Trump promises to be a Dictator on Day 1, suspend our Constitution and bring back political violence even worse than January 6. His MAGA agenda is so toxic and extreme that hundreds of thousands of Republicans in swing states voted for Nikki Haley over him, even after she dropped out — how unique!” Biden campaign spokesperson Lauren Hitt said. “Donald Trump has no resources or even the will to bring those critical voters back.”

There’s also the open question of whether Trump will be able to break through in the same ways he did in 2016, when he was a political novelty. Or as he did during the 2020 election, when he held the presidency and was a ubiquitous presence at a time when locked-down Americans were glued to their TVs.

“The media landscape and where voters get their news has changed and so assumptions based on Trump’s ability to dominate mainstream media conversations should be questioned,” said Josh Schwerin, a Democratic strategist who formerly worked at Priorities USA, the Democrats’ primary super PAC during the 2020 presidential campaign.

“Fewer voters are getting their news from traditional outlets and finding ways to get information in front of them is getting harder and harder — and that takes money,” he said. “Both candidates are going to have to do this. And this is one place where having a financial advantage is going to be a big benefit to the Biden campaign.”

NEW DELHI (AP) — The world’s largest democratic election could also be one of its most consequential.

With a population of over 1.4 billion people and close to 970 million voters, India’s general election pits Prime Minister Narendra Modi, an avowed Hindu nationalist, against a broad alliance of opposition parties that are struggling to play catch up.

The 73-year-old Modi first swept to power in 2014 on promises of economic development, presenting himself as an outsider cracking down on corruption. Since then, he has fused religion with politics in a formula that has attracted wide support from the country’s majority Hindu population.

India under Modi is a rising global power, but his rule has also been marked by rising unemployment, attacks by Hindu nationalists against minorities, particularly Muslims, and a shrinking space for dissent and free media.

HOW DOES THE ELECTION WORK?

The 6-week-long general election starts on April 19 and results will be announced on June 4. The voters, who comprise over 10% of the world’s population, will elect 543 members for the lower house of Parliament for a five-year term.

The polls will be held in seven phases and ballots cast at more than a million polling stations. Each phase will last a single day with several constituencies across multiple states voting that day. The staggered polling allows the government to deploy tens of thousands of troops to prevent violence and transport election officials and voting machines.

India has a first-past-the-post multiparty electoral system in which the candidate who receives the most votes wins. To secure a majority, a party or coalition must breach the mark of 272 seats.

While voters in the United States and elsewhere use paper ballots, India uses electronic voting machines.

WHO IS RUNNING?

Modi’s Bharatiya Janata Party and his main challenger, Rahul Gandhi of the Indian National Congress, represent Parliament’s two largest factions. Several other important regional parties are part of an opposition bloc.

Opposition parties, which have been previously fractured, have united under a front called INDIA, or Indian National Developmental Inclusive Alliance, to deny Modi a a third straight election victory.

The alliance has fielded a single primary candidate in most constituencies. But it has been roiled by ideological differences and personality clashes, and has not yet decided on its candidate for prime minister.

Most surveys suggest Modi is likely to win comfortably, especially after he opened a Hindu temple in northern Ayodhya city in January, which fulfilled his party’s long-held Hindu nationalist pledge.

Another victory would cement Modi as one of the country’s most popular and important leaders. It would follow a thumping win in 2019, when the BJP clinched an absolute majority by sweeping 303 parliamentary seats. The Congress party managed only 52 seats.

WHAT ARE THE BIG ISSUES?

For decades, India has clung doggedly to its democratic convictions, largely due to free elections, an independent judiciary, a thriving media, strong opposition and peaceful transition of power. Some of these credentials have seen a slow erosion under Modi’s 10-year rule, with the polls seen as a test for the country’s democratic values.

The polls will also test the limits of Modi, a populist leader whose rise has seen increasing attacks against religious minorities, mostly Muslims. Critics accuse him of using a Hindu-first platform, endangers the country’s secular roots.

Under Modi, the media, once viewed as vibrant and largely independent, have become more pliant and critical voices muzzled.Courts have largely bent to Modi’s will and given favorable verdicts in crucial cases. Centralization of executive power has strained India’s federalism. And federal agencies have bogged down top opposition leaders in corruption cases, which they deny.

Another key issue is India’s large economy, which is among the fastest growing in the world. It has helped India emerge as a global power and a counterweight to China. But even as India’s growth soars by some measures, the Modi government has struggled to generate enough jobs for young Indians, and instead has relied on welfare programs like free food and housing to woo voters.

The U.N.’s latest Asia-Pacific Human Development Report lists India among the top countries with high income and wealth inequality.