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JUDY WOODRUFF: But first: A key part of President Trump’s campaign was pledging to restore prosperity and to ease the anxiety for those left behind by globalization.

Income inequality was a problem during President Obama’s tenure, too. The trend began well before either took office. And the widening gap here is connected to growth in other parts of the world.

Our economics correspondent, Paul Solman, has been exploring those trends, and it’s the focus of his weekly segment, Making Sense.

BRANKO MILANOVIC, Author, “Global Inequality”: The good news is that people around this point A, like one third of the global population, have done really quite well.

PAUL SOLMAN: At the City University of New York Graduate Center, economist Branko Milanovic and the hottest curve in economics right now, charting the climb of a billion out of poverty, and explaining the rise of China, the rise of populism in Europe, the rise of Donald Trump.

And thanks to its pachydermal profile, and Twitter, it has an almost unforgettable name: the Elephant Chart.

BRANKO MILANOVIC: I remember in June 2012, the first time that I saw what later became the Elephant Chart, I was immediately struck, because I thought, well, that’s exactly what we all knew.

PAUL SOLMAN: And what is it that we knew?

BRANKO MILANOVIC: Well, we knew that China and large groups of people in Asia who were not very rich compared to Americans, who have done very well. We knew that lower- and middle-class Americans and Japanese and Germans have not done well, and then we also knew that the top 1 percent in the rich countries have done well.

PAUL SOLMAN: Now, at the risk of Dumbo-ing this down, let’s take the Elephant Chart from tail to tusk.

For that, we have to head into the wild blue yonder of my producer’s basement. On the bottom, the horizontal axis is the entire world population, arranged by their incomes back in 1988, poorest over here to the left, the richest to the right.

Just past the middle, at about the 55th percentile, a family of four with $3,000 a year after-tax income. Middle-class U.S. family taking home $30,000 a year would land about here, at the 80th percentile. And in 1988, $160,000 of after-tax income would’ve lifted you into the global 1 percent.

On the vertical axis, going from bottom to top, is how much income grew, in percentage terms, over 20 years, from 1988 to 2008. The two winning groups, the fabled 1 percent and those in the middle of the income distribution. As for the poorest, they had about a 10 percent rise.

BRANKO MILANOVIC: If they started with like $2 a day, now they have $2.3 a day.

PAUL SOLMAN: But now what this story is telling us is, here, at the middle of the income distribution globally, those people have almost doubled their income in real terms after taxes.

BRANKO MILANOVIC: Right. Right. After taxes, yes.

And as you can see, this is not a small group of people. So we are talking about people from the 40th percentile to the 70th. So this is almost like one-third of the global population who have done really quite well.

PAUL SOLMAN: And who are we talking about here? These are the Indians in Bangalore, the Brazilian middle class, the South Koreans, the Chinese, who’ve flocked from the countryside to the cities.

BRANKO MILANOVIC: There was a large chunk of people, two-and-a-half billion, who have done extremely well.

PAUL SOLMAN: And those are the people up at the top of the back of the elephant.

BRANKO MILANOVIC: Top of the back of the elephant, so basically what is called resurgent Asia.

PAUL SOLMAN: Resurgent Asia, indeed. Now, you may have seen one of the most popular Ted Talks of all time.

HANS ROSLING: Income per person on this axis, poor down here, rich up there.

PAUL SOLMAN: The late great Hans Rosling depicting this phenomenon in his own inimitably graphic way.

HANS ROSLING: You see China under foreign domination actually lowered their income and came down to the Indian level here, whereas U.K. and United States is getting richer and richer, and after Second World War, United States is richer than U.K. But independence is coming here. Growth is starting, economic reform. Growth is faster.

PAUL SOLMAN: So, the good news is that income inequality has, from a global perspective, gone down, as the incomes in the developing world rise, catching up with incomes in the developed world.

And that’s a point the Elephant Chart is often used to make. But perhaps the chart’s most memorable message of the moment is the crisis of inequality in the very well-developed world, the hollowing out of the middle class in France, the United Kingdom and especially the United States of America.

Here, at incomes of about $20,000 to $100,000 a year, inflation-adjusted, there’s been negligible income growth for decades. Once you get to the 70th percentile, so you’re the richest 30 percent of the world’s income distribution, it falls off a cliff.

BRANKO MILANOVIC: True. It was really people who are generally dissatisfied with their economic position and who feel threatened by migration and who feel threatened by lack of jobs or insecurity of jobs.

And you look at actually who are voting for Le Pen in France, who voted for Brexit, and then — and Trump, we saw that this sort of growth of right-wing populism is driven on one hand by this insecurity of jobs, which is a result of globalization, and by migration, which is also part and parcel of globalization.

PAUL SOLMAN: And globalization was supposed to be win-win for everyone, wasn’t it?

BRANKO MILANOVIC: One thing was promised to them essentially, with globalization, they would all get better off. And then gradually they see that their wages are stagnant, and they have been stagnant for 25 years.

PAUL SOLMAN: The rich getting richer, the trunk of the elephant tilted skyward.

And then, of course, you look backwards, and then you see that these people might be catching up to you.

BRANKO MILANOVIC: Yes, right, because they actually are coming on the big tide, like a wave, and then really your relative position is going to really slide down quite quickly.

PAUL SOLMAN: And so we end with the jumbo takeaway, that while a rising middle class in the developing world has been narrowing global inequality for decades, the story has been just the opposite closer to home, and fueling a reaction as radical as it is understandable.

For the PBS NewsHour, this is economics correspondent Paul Solman, reporting from the City University of New York and my producer’s basement.

JUDY WOODRUFF: And we’re just glad you’re safe, Paul.

And there’s more of Paul’s conversation with economist Branko Milanovic on our Web site. You can find it at pbs.org/newshour.

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JUDY WOODRUFF: Now a health care story about providing help to those who need it most.

Even as the debate over replacing the Affordable Care Act continues, one California city has come up with an innovative solution to an intractable problem.

Special correspondent Kathleen McCleery reports from Alameda County.

KATHLEEN MCCLEERY: On the south edge of the city of Hayward sits a neighborhood with especially high rates of poverty, unemployment and violent crime. People are sicker, too. Many suffer from diabetes, obesity, asthma and other ailments.

Options for care here are limited. There’s just one hospital, and few doctors welcome Medicaid patients. Some call it a health care desert.

ALEX BRISCOE, Former Director, Alameda County Health Care Services: South Hayward is the poster child for lack of access to primary care.

KATHLEEN MCCLEERY: When Alex Briscoe was with Alameda County Health Care Services — he was agency director for six years — he hunted for ways to improve access to care. In 2009, as he coped with the swine flu, or H1N1, epidemic, Briscoe had a light bulb moment.

ALEX BRISCOE: Firefighters joined our public health nurses and many other providers, and we very successfully vaccinated, immunized hundreds of thousands of people.

MAN: Airway aids and tracheal tubes.

KATHLEEN MCCLEERY: Briscoe wondered if firefighters skilled as trained paramedics could help solve another piece of the health care puzzle.

ALEX BRISCOE: This H1N1 experience, combined with our already robust relationship with fire on the EMS system, it’s kind of like peanut butter and chocolate. Do these two ideas go together, and is there a way for us to use this already existing resource and preexisting trust as well?

KATHLEEN MCCLEERY: Trust, because approval ratings for firefighters far exceed other public servants. That got officials here thinking about how to leverage manpower and location.

Kristel Acacio runs special projects for the county agency.

KRISTEL ACACIO, Alameda County Health Care Services Agency: Fire stations, firefighters are strategically located in every community. So we saw this as an existing, but perhaps untapped resource to serve our patient population.

Around the fire station, there is a concentration of low-income residents.

KATHLEEN MCCLEERY: When Acacio examined data about that population, she discovered that the neediest area was just where the county planned to build a new fire station.

KRISTEL ACACIO: And what we can see in this map is that in Hayward, and in particular in South Hayward, that the concentration of avoidable emergency department visits is 1.5 times or greater the county rate.

KATHLEEN MCCLEERY: County health officials seized the chance to collaborate with the city, a community health center and a nonprofit architectural firm to design and build two structures on the same campus. They opened in late 2015.

The clinic is right in front of us, and the fire station is right here.

GARRETT CONTRERAS, Fire Chief, City of Hayward: Yes, the same style. They look integrated, and basically taking advantage of that sort of known trust and location.

KATHLEEN MCCLEERY: Fire chief Garrett Contreras was a supporter from the start.

GARRETT CONTRERAS: Upwards of 70 percent of our 911 calls in the Hayward Fire Department are for medical emergencies. Some of these more routine-type medical problems can be treated at a much lower-cost setting and keep the emergency room beds available for our most critical patients.

KATHLEEN MCCLEERY: Reducing the number of transports to the E.R. is one way to measure success, says David B. Vliet, CEO of the Tiburcio Vasquez Health Center, which runs eight community clinics, including this one.

DAVID B. VLIET, CEO, Tiburcio Vasquez Health Center: Because we have delivered 6,000 urgent care, convenient care visits here, those are visits that didn’t go to the E.R., so right away we know we have kept that volume out of the emergency room.

KATHLEEN MCCLEERY: But not everything went according to plan.

KRISTEL ACACIO: Initially, what we wanted the firefighters to do was that we could possibly dedicate a couple paramedics to actually work in the clinic.

KATHLEEN MCCLEERY: That idea was quickly squelched by the California Nurses Association. Karen Rothblatt has been a nurse for 30 years.

KAREN ROTHBLATT, Registered Nurse: You wouldn’t want me to come and respond to you in that critical first moment. It’s not what my training is about. Same, turn that around, I think you could say that a paramedic hasn’t been trained to do what a nurse has been trained to do, so why would you have them do that? I think it would be putting people at risk.

ALEX BRISCOE: My first thought is the “Family Feud sound. Look, no nurse would say that while a paramedic is trache-ing them or starting an I.V. line Paramedics are extremely highly trained, and highly skilled, and I think that they can do far more than what they’re currently doing, if we remember that the point of our health care delivery system is to serve people, not to protect health care market share.

KAREN ROTHBLATT: Well, I find that insulting, actually. There are jobs out there for nurses. It’s not about that. It’s really, really about making sure that that clinic really functions in a way that is best for the patients that arrive there.

KATHLEEN MCCLEERY: At the clinic, patients are seen by a nurse practitioner or physician’s assistant. No doctor is on staff yet, but they say they are hiring one soon.

Firefighters are close by if the clinic needs lifesaving care for heart attacks, strokes or to get patients to a fully staffed emergency room. And proximity promotes communication, too. Those in the field, like Captain LaShon Earnest, encourage people to use the clinic.

CAPT. LASHON EARNEST, Captain, Hayward Fire Department: We go on a lot of calls where we can make a determination where somebody who doesn’t necessarily need to go to the emergency room, the tax the system. For something — say, for a stubbed toe, this is someone that could probably use the clinic.

Well, did you know the clinic was right next door to the firehouse? Oh, I didn’t know that. OK. Well, maybe I’m fine right now, I don’t need to go to the hospital. I will have my mother drive me tomorrow to the clinic.

KATHLEEN MCCLEERY: Tina Greives lost her insurance after an on-the- job injury as a long-distance trucker. For her, the location, next to the fire station, is convenient.

TINA GREIVES: I don’t have a vehicle, which is unusual for somebody in California. This one is just seriously within walking distance if I’m doing good, or a 15-minute bus ride. So, it’s in a perfect location.

KATHLEEN MCCLEERY: Greives, like most treated in this clinic, qualifies for Medicaid. More than 120,000 people in Alameda County were added to the rolls with the passage of the Affordable Care Act.

The uncertainty over health care in Washington is causing worry here in South Hayward. Cuts to Medicaid could reduce a key funding stream for this clinic, keeping it from being self-sustaining in the coming years. And that’s a concern for providers and patients alike.

TINA GREIVES: I wouldn’t be covered by the new bill. That’s all there is to it, and it’s just like, holy dirty word. So, it’s an uncertainty, and it’s scary.

DAVID B. VLIET: Ultimately, it means that more folks cannot be seen in a health center like this, and would not have a paying source in order to do that.

KATHLEEN MCCLEERY: The partnership of firefighters and health care workers is a first for California.

ALEX BRISCOE: The attempt to bridge the 911 system and the primary care system, I think that’s a unique experiment.

GARRETT CONTRERAS: I do believe it can be a model. I do believe it will be — can be repeated. It’s not easy. Not so easy to do to get multiple governmental agencies to work together, drop the boundaries, drop the egos, drop the who said what, who’s doing what, who’s getting credit for anything, and just do it because it’s the right thing to do and it’ll improve service to the community.

KATHLEEN MCCLEERY: I’m Kathleen McCleery for the PBS NewsHour in Hayward, California.

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JUDY WOODRUFF: The battle for the largest city held by ISIS appears close to being over. Iraqi government forces captured an ancient landmark in the old city of Mosul today, a significant symbolic victory. The militants now hold very little territory in the city, once home to one-and-a-half million Iraqis.

William Brangham reports.

WILLIAM BRANGHAM: For Iraqi forces, it’s clearly a major victory after months of block-by-block fighting. They have recaptured Western Mosul’s al-Nuri Mosque compound, and what remains of its 12th century minaret.

HASSAN SALEH JABER, Iraqi Counter Terrorism Service (through interpreter): We stormed the area in the early hours of the morning from different directions. We stormed the mosque and secured the area, and operations are going on to fully clear and search the area.

WILLIAM BRANGHAM: The compound was blown up by ISIS fighters last week as they retreated, but that did little to diminish the symbolism of today’s events.

In a statement, Iraqi Prime Minister Haider al-Abadi said: “It marks the end of the ISIS state of falsehood.”

In July 2014, the ISIS leader, Abu Bakr al-Baghdadi, stood in the al-Nuri Mosque just weeks after his forces seized the city and announced the formation of a so-called caliphate across much of Iraq and Syria.

ABU BAKR AL-BAGHDADI, Islamic State Leader (through interpreter): God has granted your brothers, the mujahideen, victory and a conquest after years of patience and holy struggle, and enabled them to achieve their objective.

WILLIAM BRANGHAM: There have been recent claims from the Russians and the Iranians that al-Baghdadi has been killed, but the U.S. hasn’t confirmed that.

Now his group now holds less than one square mile of territory in the western half of the city. Part of Mosul’s Old City remains under ISIS control, as does a key nearby hospital complex.

U.S. Army Colonel Ryan Dillon is a spokesman for the coalition that’s supporting Iraqi forces, the ISF.

COL. RYAN DILLON, Spokesman, Operation Inherent Resolve: The Old City still remains a difficult, dense, suffocating fight. Tight alleyways with booby-traps, civilians, and ISIS fighters around every corner make the ISF’s advance extremely challenging.

WILLIAM BRANGHAM: Last October, Iraqi units and their allies opened the campaign to retake Mosul, and captured the eastern half of the city by late January. The assault on Western Mosul began in February. Even now, it’s believed thousands of people are still trapped there.

MAN (through interpreter): Yes, there many families there still, hundreds of families all around. It’s miserable. There is no bread or water at all.

WILLIAM BRANGHAM: These months of battle have displaced more than 850,000 people. Hundreds arrived today at a processing center run by Iraqi forces as they attempted to flee for refugee camps.

Military trucks carried men, women and children out, as others tried to make their way back in to newly reclaimed areas.

MAN (through interpreter): Our neighborhood was liberated more than three months ago. We fled even before the liberation of our neighborhood and ISIS was chasing us from house to house.

WILLIAM BRANGHAM: Meanwhile, in Syria, U.S.-backed Kurdish fighters have seized the last road into Raqqa, the Islamic State’s self-proclaimed capital. The Syrian Democratic Forces are now in control of all major routes into the city.

For the PBS NewsHour, I’m William Brangham.

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JUDY WOODRUFF: President Trump’s use of Twitter has often brought praise from supporters for reaching out directly to the American people. But Mr. Trump has also managed to spark controversy in 140 characters, and, today, his tweets prompted some of the harshest criticism yet.

Our John Yang has more.

MIKA BRZEZINSKI, Co-Host, “Morning Joe”: President Donald Trump.

JOHN YANG: As Mika Brzezinski wrapped up her MSNBC show this morning, President Trump had a few choice words for her and co-host Joe Scarborough.

Mr. Trump said the hosts, whom he called “low I.Q. Crazy Mika and Psycho Joe,” were speaking badly of him, even though they insisted on joining him at Mar-a-Lago. Mr. Trump adding that, at the time, Brzezinski was “bleeding badly from a face-lift.”

Within minutes, Brzezinski responded, resurrecting the little hands insult that had been directed at him during the 2016 presidential primaries.

Mr. Trump’s words ignited a firestorm, even from his Republican allies.

SEN. LINDSEY GRAHAM, R-S.C.: I thought it was inappropriate, beneath the office, and not helpful.

SEN. ORRIN HATCH, R-Utah: I wish, I wish he hadn’t made the tweet.

REP. PAUL RYAN, R-Wis., Speaker of the House: I don’t see that as an appropriate comment. I think, look, what we’re trying to do around here is improve tone, the civility of debates. And this obviously doesn’t help do that.

QUESTION: Did you see the president’s tweets about Mika Brzezinski this morning? Do you have any reaction to that?

SEN. SHELLEY MOORE CAPITO, R-W.Va.: Distasteful.

JOHN YANG: And from Democrats.

REP. BRENDA LAWRENCE, D-Mich.: This is not acceptable, Mr. President.

JOHN YANG: Principal Deputy White House Press Sarah Huckabee Sanders insisted the president was just defending himself.

SARAH HUCKABEE SANDERS, Deputy White House Press Secretary: I don’t think that it’s a surprise to anybody that he fights fire with fire. But he’s not going to sit back and be attacked by the liberal media, Hollywood elites, and when they hit him, he’s going to hit back.

JOHN YANG: It recalled Mr. Trump’s past comments about women, in 2015, talking about journalist Megyn Kelly, then of FOX News, after she moderated the first Republican debate.

PRESIDENT DONALD TRUMP: She gets out and she starts asking me all sorts of ridiculous questions, and, you know, you could see there was blood coming out of her eyes, blood coming out of her whatever. But she was — in my opinion, she was off-base.

JOHN YANG: “Rolling Stone” quoted him saying of rival candidate Carly Fiorina: “Look at that face. Would anyone vote for that?”

And there was the 2005 “Access Hollywood” tape.

PRESIDENT DONALD TRUMP: I just start kissing them. It’s like a magnet, kiss, kiss. I don’t even wait. And when you’re a star, they let you do it. You can do anything.

Grab them by the (EXPLETIVE DELETED). You can do anything.

JOHN YANG: Name-calling was a staple of Mr. Trump’s campaign.

PRESIDENT DONALD TRUMP: Lyin’ Ted Cruz came today.

I watched little Marco.

I would say the co-founder would be crooked Hillary Clinton.

JOHN YANG: And it continued today, as the president of the United States taunted two cable television hosts.

For the PBS NewsHour, I’m John Yang.

JUDY WOODRUFF: For more now on the president’s comments today and earlier and the implications of what he says publicly, we turn to Matthew Dowd. He’s the former chief strategist for President George W. Bush in 2004 and author of “A New Way: Embracing the Paradox as We Lead and Serve.” And Beverly Gage, she’s professor of American history at Yale University.

And we welcome both of you back to the NewsHour.

Matt Dowd, I’m going to start with you.

We know we have seen politicians get into some tough language over the years. How does what we heard from President Trump today on Twitter fit into all of that?

MATTHEW DOWD, Former Chief Strategist, Bush-Cheney 2004: Well, we have come a long way from when I worked for George W. Bush in 2000, when he pledged to bring honor and dignity back to the Oval Office and won as that as being part of his platform.

Judy, I think this is a bigger problem. First, as you know, in this democracy, in order to have a healthy democracy, we have to get to the common good. But the only way to get to the common good is if we have a common set of facts, which we don’t seem to have today, and we have a common level of decency.

And my problem with the president and what happened today and why I think it affects the country as a whole is, first, we bring up our kids better than this. We teach them not to do this. We tell them not to do this, and it is not the right standard of behavior.

But for a president — secondly, but, for a president, he sets the pattern of behavior for the entire country and what we can expect for how we each other act and how we should be in politics.

And, third, just from a practical aspect of it, just totally looking at it pragmatically, his behavior in this, in the midst of what he is trying to do on health care and the votes he is trying to get, is incredibly counterproductive.

So, from all of those avenues, one from a history of our democracy that is dependent on a level of decency that doesn’t seem to be apparent here, but, two, just practically, if he wants to get something done, this makes it harder.

JUDY WOODRUFF: Well, I want to ask you about that latter part in a moment.

But, Beverly Gage, how does what this president is saying when these kinds of tweets go out, how does it compare from what we have heard from other presidents over time?

BEVERLY GAGE, Yale University: Unfortunately, I don’t think that American presidents have always lived up to the standard of decency that we have tended to expect of them, but I think presidents before Trump, when those moments happened, they tended to be the exception, rather than the rule.

So there was a famous moment in 1950 when Harry Truman was president, and a music critic wrote a very critical piece about Truman’s daughter, who had just given a singing recital. And Truman fired off this ferocious letter threatening to punch the guy out, and telling him that he was a gutter snipe and an idiot and he was going to kick him in the nuts.

Right? So, it was pretty aggressive language. And there was a big reaction to that at the time, a president kind of attacking a private citizen. Many people thought it wasn’t dignified. But nobody would have said that this is Harry Truman’s mode of being all the time. It was seen as a kind of authentic moment of outrage, and not a kind of permanent presidential style.

JUDY WOODRUFF: Matt Dowd, is there a level of dignity that Americans expect from a president? I mean, is there a defined or undefined line over which presidents shouldn’t go?

MATTHEW DOWD: Well, Americans expect our president to be human beings, and as imperfect as all of us are. They expect us to make mistakes and all that.

But one thing the American public likes is, if you make a mistake, you do that, you cross that line that they expect you to behave under, then you apologize or then you correct that behavior and said you have learned, you are going to do better, you are going to achieve better, and you are going to serve a higher purpose than that.

Let’s keep in mind that Donald Trump didn’t win because of himself. He won in spite of himself. A quarter of his voters voted for Donald Trump believing he wasn’t presidential and he didn’t have the temperament, but they had hope that he would grow into the office and become more presidential. That doesn’t seem to have happened, and I don’t think it will happen for a 71-year-old man.

JUDY WOODRUFF: And, Beverly, you know, apropos of what just Matt just said and what you said a moment ago, clearly, there are moments when presidents have grown angry, they have been upset because they have been criticized.

So is there some kind of standard, written or otherwise, for how a president is to speak to the American people?

BEVERLY GAGE: I don’t think there is a written standard, but I think up until this moment there have been some sort of accepted norms that the president in particular — on the campaign trail, it’s one thing, right?

That is a place where people attack each other when they have differences of opinion or maybe even personal attacks in that venue. It is sort of expected. There, Trump took it to a new level as well, I think.

But when you are the president, the idea that you cannot rise to the office, that you would attack private citizens, I think that that is something that a lot of people find troubling and sort of unworthy of the office.

JUDY WOODRUFF: Matt Dowd, clearly this was part and parcel of the president lashing out at the news media. He was reacting to, I guess, some of the conversation this morning on that program, on cable news.

But what is it that the president — in any way does this further the agenda of the president? You mentioned a minute ago his health care plan, the fact that he is trying to get this health care plan through the Senate, through the Congress, and this takes all the attention away from that.

MATTHEW DOWD: Well, I think attributing any every time somebody — Donald Trump does this, President Trump does this, people attribute some grand strategy.

I think what the president really has is a lack of impulse control. He has done this throughout, and it has actually hurt him in the process. He won the election, but, as I say, he won it in spite of himself.

Keep in mind, Judy, that there’s votes, three key votes that are needed in the health care plan, Shelley Moore Capito, Lisa Murkowski, and Susan Collins. And he attacks a woman basically in a sexist way. You can’t argue any otherwise in the midst of this, a woman who serves as an anchor on a television program.

None of that is going to be helpful in getting those votes. So, I think it is counterproductive. But anybody that goes to Donald Trump, first of all, nobody seems like they go to Trump to correct his behavior.

But anyone that goes to Donald Trump would have to make the argument, this doesn’t help you. I don’t think Donald Trump cares.

JUDY WOODRUFF: Beverly Gage, does history shows that Americans are forgiving of a president when they, I don’t know, go off the rails or however you want to describe this?

BEVERLY GAGE: Well, I think Americans have often warmed to a kind of pugilistic style. So Trump is not the first president to kind of marshal this hyper-masculinity, right?

You think of someone like Theodore Roosevelt bringing wrestlers into the White House, et cetera, or even a figure like Ronald Reagan, who we tend to have a much more benign view of now, but actually could be quite aggressive in his rhetoric.

I think what is different for Trump is that he is specifically demeaning women, and he’s demeaning particular women. It’s hard to see how that is going to be a benefit to him.

On the other hand I do think the record is that often this has worked as a kind of form of entertainment. Certainly, it is one of the things that people liked about Teddy Roosevelt, this kind of man who wasn’t going to take it from anyone.

JUDY WOODRUFF: Right.

BEVERLY GAGE: So, unfortunately, I don’t think it’s clear that this is going to be something that there is a lot of incentive to stop.

JUDY WOODRUFF: Matt, what does this mean for the president and his allies in the Republican Party?

MATTHEW DOWD: Well, I’m just going to — one response is, is, yes, the president — yes, the American public loves a fighter, but they want a fighter that is fighting on their behalf, not on their own behalf.

So, he has not connected the dots. And these tweets are no connection, as we talked about. It is going to actually make it worse for him to achieve any legislative platform, as opposed to better. There is no connection in fighting on Americans’ behalf.

I think you saw today, and as your piece laid out, is Republicans are upset about this, they have grown weary of this, they know it has made it more difficult on them. And I think, as his numbers, as his approval numbers continue to drop — they’re at the lowest level of any president in his first term or any — in any term at this point without a scandal involved — I think it makes it much harder and it sets up a problem for the midterm elections in 2018.

And I think all of that, Republicans are nervous about.

JUDY WOODRUFF: But quickly, Matt, they are still sticking with him for the most part, aren’t they?

MATTHEW DOWD: For the most part.

And I think that is one of the frustrations by many of us. I think you can say, oh, just discount his words and all that. At some point, they are going to have to hold Donald Trump’s feet to the fire. And they can do that.

Senators can do that and House members can do it. They can basically say, we are not going to pass an appointment, we are not going to pass legislation until you correct your behavior. There is no way right now we know, or there is no evidence that we have that they’re willing to do that. But that is in the end what they have control over.

JUDY WOODRUFF: But you’re right. We have not seen that yet.

Matthew Dowd, Beverly Gage, we thank you both.

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JUDY WOODRUFF: And in the day’s other news: Republicans in the U.S. House of Representatives pushed through two bills on illegal immigration. One toughens prison terms for deportees who reenter the U.S. illegally. The other blocks some federal funds to so-called sanctuary cities that refuse to assist immigration officials.

The secretary of homeland security and congressional Democrats traded arguments today over that second bill.

JOHN KELLY, U.S. Homeland Security Secretary: The word sanctuary calls to mind some place safe. But too often for families and victims affected by illegal immigrant crime, sanctuary cities are anything but safe. Instead, these cities are places that allow some criminal go free, undermine federal law enforcement and make our communities less safe.

REP. ADRIANO ESPAILLAT, D-N.Y.: A sanctuary city is a city that allows a mom to take her kid to school without being fearful that the principal will call Homeland Security on her. It allows a domestic violence victim the ability to go to the local precinct and report a batterer. It is a safety net for people that are part of our family.

JUDY WOODRUFF: The bills now move to the Senate, but it’s not clear that either can pass there.

Senate Republican leaders struggled again today to revise their health care bill, and win enough Republican votes to pass it. Majority Leader Mitch McConnell said there’s been — quote — “good progress.” But Senator Susan Collins of Maine warned that the bill needs a major overhaul.

Also today, further analysis by the Congressional Budget Office found the bill would cut federal Medicaid spending by 35 percent over 20 years.

A top Vatican official, Cardinal George Pell, was charged today with sexual assault in his native Australia. He’s the top financial adviser to Pope Francis, and the highest-ranking Vatican official implicated in the long-running scandal of clergymen abusing children.

Jonathan Miller of Independent Television News has our report.

SHANE PATTON, Commissioner, Victoria State Police: Cardinal Pell is facing multiple charges, in respect to historic sexual offenses. And there are multiple complaints relating to those charges.

JONATHAN MILLER: Last year, the former archbishop of Melbourne and Sydney, who is now one of the pope’s top advisers, testified to a royal commission investigating child sex abuse.

The commission found shocking levels of abuse by the clergy over decades. Pell supported, by bishops as a man of integrity, conceded institutional errors, but denied any sexual offenses himself.

News from Australia reached the Vatican overnight, and before dawn on the fifth day of Saints Peters and Paul, Cardinal Pell released his first statement, saying he would return home next month to clear his name. Then early this morning, he spoke to the press.

CARDINAL GEORGE PELL, Vatican Treasurer: I am looking forward finally to having my day in court. I am innocent of these charges. They are false. The whole idea of sexual abuse is abhorrent to me.

JONATHAN MILLER: Pope Francis, who Pell said he talked things over with, later presided over mass in St. Peter’s Square. Aussies in the square today wanted God’s truth to shine through.

WOMAN: Well, there’s been a lot of bad press about Pell in the Australian media. He is not very well-liked. And a lot of people are very angry that the church in Australia didn’t do enough to cover any of the sex abuse for many years.

JONATHAN MILLER: A song by musician Tim Minchin which pleaded with the ailing cardinal to return to Australia to testify to the royal commission went viral last year.

Now Cardinal George Pell, ordained 51 years ago, is coming home to face his accusers. He will appear before Melbourne Magistrates’ Court on the 18th of July.

JUDY WOODRUFF: That report from Jonathan Miller of Independent Television News.

In Russia, five men were found guilty today in the murder of opposition leader Boris Nemtsov in 2015. One was the man who pulled the trigger, a former security officer in the Chechnya region. But Nemtsov’s allies say that authorities have done nothing to find out who ordered the killing.

President Trump will come face to face with Russian President Vladimir Putin next week, for the first time since taking office. The White House and the Kremlin announced today that they will meet on the sidelines of the G20 summit in Germany.

Meanwhile, Syria and Russian accused the U.S. today of making baseless allegations that Damascus is preparing a new chemical attack. The White House issued the warning on Tuesday. Today, Syrian state TV today called the accusation — quote — “devoid of truth.” The Russian Foreign Ministry accused the U.S. of trying to destabilize the Syrian regime.

MARIA ZAKHAROVA, Russian Foreign Ministry Spokeswoman (through interpreter): The goal of it is obvious: to reanimate the theme of so-called crimes of the government and to return the situation in Syria to the same dead end where it has been led by the West, saying that Assad needs to leave. At the same time, it’s a provocation for the rebels to commit crimes linked to mass deaths of civilians.

JUDY WOODRUFF: The State Department dismissed the comments from both governments and said there’s no doubt the Syrian regime has used chemical weapons in the past.

Back in this country, the Federal Bureau of Justice statistics reports that most hate crimes over the past decade went unreported. That’s based on a survey of households. It found an average of 250,000 hate crimes each year between 2004 and 2015. More than half were not reported, most often because they were handled some other way. The report says that others decided the incidents were not important, or they doubted police would do anything.

More than 800 firefighters are now battling a Northern Arizona wildfire that’s scorched almost 39 square miles. Officials say that lighter winds today would help them make progress on the Goodwin Fire. Already, evacuations for one small town outside Prescott have been lifted. Major wildfires are also burning in Utah, Southern California and Washington state.

Dozens of employees at The New York Times staged a walkout today against a new round of job cuts. Reporters and editors tweeted pictures of staffers leaving, as well as signs in support of the staff. The newspaper is considering restructuring the newsroom, and possibly laying off half of its copy editors.

And on Wall Street, technology stocks took another hit, and pulled the broader market down. The Dow Jones industrial average lost 167 points to close at 21287. The Nasdaq fell 90, and the S&P 500 gave up 21.

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JUDY WOODRUFF: After months of legal and political wrangling, President Trump’s executive order banning entry into the U.S. from six Muslim-majority countries goes into effect tonight.

Earlier this week, the Supreme Court gave a partial green light to get started, ordering those with what it called bona fide family or business ties to the U.S. be granted entry. Last night, the Trump administration laid out which connections count.

And joining us to discuss these guidelines is Yeganeh Torbati. She covers the State Department for Reuters.

Yeganeh, welcome back to the program.

So what is the administration saying now about who is permitted in and who isn’t?

YEGANEH TORBATI, Reuters: Right.

From these six countries, and individuals who have certain family connections, so spouses, mothers, fathers, children, siblings, even step-siblings, they can be allowed in. The State Department is counting that as a bona fide connection.

But if you are the grandparents of a U.S. citizen, for instance, or the grandchild, and you are trying to get in and you’re a citizen from one of these six countries, that doesn’t count in the State Department, in the U.S. administration’s view.

JUDY WOODRUFF: And there was also a definition of business relationship.

YEGANEH TORBATI: Right.

So, if you are a student that has been accepted into a U.S. university, someone with an offer of employment from an American company, or even a lecturer coming in to lecture at a conference, for instance, or university, you can be allowed in. But if are you someone who has just booked a hotel room or a tour or something like that, that does not count.

JUDY WOODRUFF: And what about those people who were in the process of trying to get a visa to come here?

YEGANEH TORBATI: So, any individual who has been granted a visa, those visas are not going to be revoked. They are still valid and they will still be able to come into the United States.

But there’s thousands potentially of people who had applied for visas, they were waiting to hear back. Those individuals, we’re not exactly sure. But I think that is going to be something that now consulate officers will have to take into account these guidelines when they are assessing, are they actually going to give that visa to that person or not?

JUDY WOODRUFF: And, Yeganeh, did the administration explain how it made this dividing line when it comes to family relationships?

YEGANEH TORBATI: It seemed a little bit arbitrary from the outside.

What the administration said today to reporters is that they looked at guidelines that they have from the Immigration Nationality Act, which is the main U.S. law that governs U.S. immigration. And they said that that is how they are going to assess which family relationships count and which don’t.

Critics, of course, say that they’re still hewing this line very narrowly, they’re interpreting the Supreme Court ban narrowly, the Supreme Court ruling narrowly, so that they can let in as few people as possible.

JUDY WOODRUFF: So we know this has been subject to litigation. Is it expected there are going to be more lawsuits or does this settle it?

YEGANEH TORBATI: We haven’t seen people, and refugee groups or institutions like the ACLU running yet saying that they are going to be suing over this or filing new complaints. It is certainly a possibility.

One other thing to mention is that the administration seems to be very narrowly interpreting which refugees it’s going to let in. It is saying that just having a relationship to a resettlement agency is not enough, and therefore any additional refugees that will be coming in this year will have to have some family relationship in the United States.

The refugee groups are very upset about that. They think that that violates the spirit, if not the letter of the Supreme Court’s order. And that is something that we’re going to see if there is going to be litigation or not. It doesn’t seem like as of yet there’s been any complaints filed.

JUDY WOODRUFF: All right, Yeganeh Torbati with Reuters, thanks very much. This goes into effect tonight at 8:00 Eastern.

YEGANEH TORBATI: Yes.

JUDY WOODRUFF: We thank you.

YEGANEH TORBATI: Thank you.

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President Donald Trump’s commission investigating alleged voter fraud during the 2016 election is asking states for a list of the names, party affiliations, addresses and voting histories of all voters, if state law allows it to be public. Photo by REUTERS/Aaron Josefczyk/File Photo.

SACRAMENTO, Calif. — President Donald Trump’s commission investigating alleged voter fraud during the 2016 election is asking states for a list of the names, party affiliations, addresses and voting histories of all voters, if state law allows it to be public.

A letter sent Wednesday from the Presidential Advisory Commission on Election Integrity asks secretaries of state to provide about a dozen points of voter data and respond to questions about fraud and election integrity. Trump lost the popular vote to Democrat Hillary Clinton but has alleged, without evidence, that 3 to 5 million people voted illegally.

On Thursday, Democratic officials in California and Virginia said they will not comply because the letter is based on false notions of widespread voter fraud. Missouri’s Republican secretary of state says he is happy to assist.

READ MORE: Trump creates panel to investigate voter fraud

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The typical levels of neonicotinoids found in agricultural areas kill bees and hurt their ability to reproduce, according to the first, large-scale studies on the issue. Photo by viktor2013/via Adobe

Neonicotinoid pesticides commonly found in agricultural areas kill bees and hurt their ability to reproduce, two separate large-scale studies confirmed for the first time Thursday.

The two studies — one that examined honeybees in Canada and the other that looked at three bee species in the United Kingdom, Germany and Hungary — were the first large-scale investigations to test the popular agrochemicals influence on bees in real world settings.

The work also turns many preconceived notions about bees and pesticides on their heads.

While many studies had connected neonicotinoids — a common class of insecticides derived from nicotine — to bee deaths in the past, few studies had examined how much pesticide is needed to harm bees or how long the exposure must take. Critics argued previous scientific studies used unrealistic quantities of pesticides in their experiments.

The new studies say the environmental levels of neonicotinoids surrounding farms do not obliterate bee colonies outright, but instead kill them over extended periods of time. The pesticides also threaten bee queens in particular — which means colonies have lower reproductive rates.

“Neonicotinoids are not the only problem that bees face,” Dave Goulson, a biologist at the University of Sussex, who was not involved in either investigation, said. “But certainly both of these studies suggest very strongly that exposure to these pesticides is one of the factors causing bees to decline.”

Amro Zayed, a biologist at York University in Toronto, decided to measure agricultural chemical use near Canadian cornfields grown from neonicotinoid-treated seeds. While earlier studies had periodically tracked these chemicals at farms, Zayed’s team opted to study them over a full five-month growing season.

Neonicotinoids dissolve in water, and easily make their way into waterways via agricultural runoff, Zayed said. Flowers miles away from a farm can take up the chemicals, which seep into the stems, leaves, pollen and nectar. So Zayed’s team of researchers looked for the presence of the neonicotinoids on dead bees, forager bees, nurse bees, larvae, pollen and in nectar.

They found a combination of herbicides, fungicides and pesticides, including a handful of neonicotinoid chemicals. To their surprise, neonicotinoids were mostly detected on pollen from plants other than corn — willow trees, clovers and wildflowers — located near the crop fields.

Before, ecologists had thought bees were only exposed to the pesticides when near a treated, flowering crop, but Zayed’s study, published Thursday in Science, countered this mindset. The researchers also found the pesticides stuck around throughout the growing season. People had previously assumed the bees’ vulnerability to the pesticide lasted only as long as the crop was in bloom.

A slow decline

To peel apart what exactly happens to the bees, Zayed’s team carried its field measurements over to an outdoor lab — far away from the fields. Over a period of 12 weeks, researchers exposed bees to clothianidin — the most common neonicotinoid found at the Canadian farms — but at the same levels encountered near farms. Their experiment took a conservative approach: Each round of exposure had smaller and smaller amounts of pesticide — akin to what you might expect in nature as rain washes away the compound.

Eastern bumblebee, Bombus impatiens, pollinating lupine flowers in Canada. Photo by Jeremy T. Kerr

Though the bees in the lab were exposed to lower amounts of pesticide over time than bees near the farm, the insects still suffered. For example, worker bees in the lab lived three-quarters as long as those near the farms.

The pesticides not only reduced a bee’s chance of survival, but impaired its natural defense systems. While humans rely on vaccines or antibiotics, bees use social immunity, a tactic bees use to clean out dead or sick brood insects from the nest. Bees in colonies treated with clothianidin displayed less and less of this behavior over time, which means more sick bees were infecting, and staying in, the nests.

The researchers had noticed a similar trend in the cornfields the year before. By the end of the growing season, the bee hives near the fields performed this cleansing significantly less often than colonies far away from the fields.

Bad news for the queens

A lack of hygiene wasn’t the worst of it. The tainted hives tended to lose their queen and then struggled to find a new one. A queen sustains the colony, so without her, there are no eggs or future bees.

Remember those other chemicals — the herbicides and fungicides — the Canadian study found in the fields? Other labs had shown that fungicides make neonicotinoids more toxic, so Zayad’s team tested them, too. Neither the most common herbicide (linuron) nor the most common fungicide (boscalid) affected worker bee mortality on their own. But when the bees were exposed to the fungicide in combination with the neonicotinoid clothianidin, it took half as much of the chemicals to kill as many bees. The same applied if clothianidin was swapped with another neonicotinoid, thiamethoxam.

The second study, also published Thursday in Science, backed this idea. It evaluated how combinations of pesticides, fungicides and fertilizers in oilseed rape fields affected bee survival from one year to the next in the United Kingdom, Germany and Hungary.

Neonicotinoid exposure led to fewer bumblebee queens and lower reproductive success in all three countries. Neonicotinoids also reduced the next year’s honey bee colonies in Hungary and the U.K., but not Germany. This contrast suggests multiple factors — like regional climate and previous use of neonicotinoids — influence where the pesticides can harm bees.

Chris Krupke, an entomologist at Purdue University who was not involved in either study, highlighted the value of performing such work in Canada, which has strategies in place to mitigate bee exposure to neonicotinoids.

“But, there are important follow up questions. What is the next step? What can we do in terms of mitigation?” Krupke said. “That’s where the conversation should be. Frankly, it’s overdue.”

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An international passenger arrives at Washington Dulles International Airport in Virginia after the Supreme Court granted parts of the Trump administration’s emergency request to put its travel ban into effect later in the week pending further judicial review. Photo by James Lawler Duggan/Reuters

WASHINGTON — A scaled-back version of President Donald Trump’s travel ban is now in force, stripped of provisions that brought protests and chaos at airports worldwide in January yet still likely to generate a new round of court fights.

The new rules, the product of months of legal wrangling, aren’t so much an outright ban as a tightening of already-tough visa policies affecting citizens from six Muslim-majority countries. Refugees are covered, too.

Administration officials promised that implementation this time, which started at 8 p.m. EDT, would be orderly. Customs and Border Protection spokesman Dan Hetlage said his agency expected “business as usual at our ports of entry,” with all valid visa holders still being able to travel.

Still, immigration and refugee advocates are vowing to challenge the new requirements and the administration has struggled to explain how the rules will make the United States safer.

And in Iran, Foreign Minister Mohammad Javad Zarif denounced the partial reinstatement of the travel ban as a “truly shameful exhibition of blind hostility to all Iranians” — and argued that the measure will prevent Iranian grandmothers from seeing their grandchildren in America.

Zarif, who has persistently assailed the travel ban, wrote on his Twitter account that the “U.S. now bans Iranian grandmothers from seeing their grandchildren, in a truly shameful exhibition of blind hostility to all Iranians.”

Under the temporary rules, citizens of Syria, Sudan, Somalia, Libya, Iran and Yemen who already have visas will be allowed into the United States. But people from those countries who want new visas will now have to prove a close family relationship or an existing relationship with an entity like a school or business in the U.S.

[READ MORE: Supreme Court partly reinstates Trump’s travel ban]

It’s unclear how significantly the new rules will affect travel. In most of the countries singled out, few people have the means for leisure travel. Those that do already face intensive screenings before being issued visas.

Nevertheless, human rights groups girded for new legal battles. The American Civil Liberties Union, one of the groups challenging the ban, called the new criteria “extremely restrictive,” ”arbitrary” in their exclusions and designed to “disparage and condemn Muslims.”

The state of Hawaii filed an emergency motion Thursday asking a federal judge to clarify that the administration cannot enforce the ban against relatives — such as grandparents, aunts or uncles — not included in the State Department’s definition of “bona fide” personal relationships.

Los Angeles City Attorney Mike Feuer met with customs officials and said he felt things would go smoothly.

“For tonight, I’m anticipating few issues because, I think, there’s better preparation,” he told reporters at Los Angeles International Airport on Thursday night. “The federal government here, I think, has taken steps to avoid the havoc that occurred the last time.”

Much of the confusion in January, when Trump’s first ban took effect, resulted from travelers with previously approved visas being kept off flights or barred entry on arrival in the United States. Immigration officials were instructed Thursday not to block anyone with valid travel documents and otherwise eligible to visit the United States.

Karen Tumlin, legal director of the National Immigration Law Center, said the rules “would slam the door shut on so many who have waited for months or years to be reunited with their families.”

Trump, who made a tough approach to immigration a cornerstone of his election campaign, issued a ban on travelers from the six countries, plus Iraq, shortly after taking office in January. His order also blocked refugees from any country.

Trump said these were temporary measures needed to prevent terrorism until vetting procedures could be reviewed. Opponents noted that visa and refugee vetting were already strict and said there was no evidence that refugees or citizens of those six countries posed a threat. They saw the ban as part of Trump’s campaign promise to bar Muslims from entering the United States.

Lower courts blocked the initial ban and a second, revised Trump order intended to overcome legal hurdles. The Supreme Court on Monday partially reinstated the revised ban but exempted travelers who could prove a “bona fide relationship” with a U.S. person or entity. The court offered only broad guidelines.

[READ MORE: Who’s in and who’s left out as Trump’s travel ban takes effect]

In guidance issued late Wednesday, the State Department said the personal relationships would include a parent, spouse, son, daughter, son-in-law, daughter-in-law or sibling already in the United States. It does not include other relationships such as grandparents, grandchildren, aunts and uncles. On Thursday, the State and Homeland Security departments had both expanded the range of bona fide relationships to include fiancés.

Business or professional links must be “formal, documented and formed in the ordinary course rather than for the purpose of evading” the ban. Journalists, students, workers or lecturers who have valid invitations or employment contracts in the U.S. would be exempt from the ban. The exemption does not apply to those who seek a relationship with an American business or educational institution purely for the purpose of avoiding the rules.

Refugees from any country will face similar requirements. But the U.S. has almost filled its quota of 50,000 refugees for the budget year ending in September and the new rules won’t apply to the few remaining slots. With the Supreme Court set to consider the overall ban in October, the rules could change again.

The travel ban may have the biggest impact on Iranians. In 2015, the most recently available data, nearly 26,000 Iranians were allowed into the United States on visitor or tourist visas. Iranians made up the lion’s share of the roughly 65,000 foreigners from the six countries who visited with temporary, or non-immigrant visas that year.

American journalist Paul Gottinger said he and his Iranian fiancee applied for a visa nearly a year ago but are still waiting on a decision. Gottinger says they were to wed at a Japanese garden in his parents’ home state of Minnesota this month but postponed the ceremony until August because they had not yet received the visa.

Now, he expects they will have to delay again.

“Every twist and turn of the courts, we’re holding our hearts and our stomachs are falling to the floor,” he said by phone from Turkey.

The new regulations are also affecting the wedding plans of Rama Issa-Ibrahim, executive director of the Arab American Association of New York.

She is Syrian-American and had planned to get married this fall. While her father in Syria may be able to get a visa, her aunts and uncles may well be blocked.

“I would love for them to be at this wedding, and unfortunately, they aren’t going to be able to be here,” she said, adding that the ceremony would be postponed.

___

Associated Press writers Amy Taxin and Andrew Dalton in Los Angeles and Michael Noble in New York contributed to this report.

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Protesters demonstrate the Republican healthcare bill outside Republican Congressman Darrell Issa’s office in Vista, California, June 27, 2017. Top Senate Republicans may now try preserving a tax boost on the wealthy to save the unpopular bill. Credit: REUTERS/Mike Blake

WASHINGTON — Top Senate Republicans may try preserving a tax boost on high earners enacted by President Barack Obama in a bid to woo party moderates and rescue their sputtering push to repeal his health care overhaul.

The break from dogma by a party that has long reviled tax boosts — and most things achieved by Obama — underscores Senate Majority Leader Mitch McConnell’s feverish effort to yank one of his and President Donald Trump’s foremost priorities from the brink of defeat.

The money from the tax boost would instead be used to bolster proposed health care subsidies for lower-income people.

The change, proposed by Sen. Bob Corker, R-Tenn., would give a more populist flavor to the bill. The nonpartisan Congressional Budget Office says that as the legislation now is written, it would boost out-of-pocket costs for many poor consumers and produce 22 million uninsured people while cutting around $700 billion in taxes over a decade — largely for richer people and the health care industry.

“You’re increasing the burden on lower-income citizens and obviously alleviating the burden on the wealthy. That is not an equation that works,” Corker said. He said he was “very confident” that leaders would address the issue in the updated bill.

[READ MORE: Most Americans disapprove of GOP’s treatment of health care]

Top Republicans also considered an amendment pushed by conservatives to let insurers offer plans with low premiums and scant benefits. To do so, a company would also have to sell a policy that abides by the consumer-friendly coverage requirements in Obama’s 2010 statute, which the GOP is struggling to repeal.

Both proposals were encountering internal Republican opposition, and it was uncertain either would survive. But the effort underscored how McConnell, R-Ky., needed to mollify both wings of his divided party to rescue his health care legislation, which he wrote secretly but has floundered.

McConnell postponed a vote on an initial version Tuesday because of opposition from conservatives and moderates alike. By this week’s end, he wants to nail down changes that would assure the bill’s passage after Congress’ weeklong July 4 recess. No more than two of the 52 GOP senators can oppose the measure for him to prevail, and there were no indications he’d achieved that margin as senators left town Thursday.

“We’re kind of at a stalemate right now, I’d say,” said Sen. Shelley Moore Capito, R-W.Va., who with Ohio GOP Sen. Robert Portman and others wants to forestall reductions the measure would make in Medicaid. Discussions about easing those cuts were continuing, but progress so far was “not enough for me,” said Sen. Dean Heller, R-Nev. Trump weighed in on the stalemate Friday morning, tweeting: “If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!” That’s an approach advocated by Kentucky Republican Sen. Rand Paul.

The Medicaid program for low-income and disabled people has grown dramatically in their states and others, but the Republican bill would cut it, with reductions growing over time.

The CBO says Medicaid cuts in the Senate Republican health care bill would take a 35 percent bite off the program’s projected spending by 2036.

[READ MORE: Why McConnell plans to hide health care bill’s pain until after the midterms]

Under Corker’s proposal, the bill would retain Obama’s 3.8 percent tax increase on investment income for married couples making more than $250,000 a year and individuals making more than $125,000. Keeping that increase would save $172 billion over 10 years, and moderates want to use that money to make coverage more affordable for poorer consumers.

“If it takes something like that to get our members on board to move this process forward, I think we have to consider that,” said No. 3 Senate GOP leader John Thune of South Dakota.

Conservatives said they opposed the idea, along with the chairmen of Congress’ two tax-writing committees: Senate Finance chairman Orrin Hatch, R-Utah, and House Ways and Means chairman Kevin Brady, R-Texas.

Also in play was a proposal by Sen. Ted Cruz, R-Texas, to let insurers offer skimpier policies, which conservatives say would lower premiums.

Moderates oppose that, especially if it lets insurers raise premiums on people with pre-existing medical problems. No. 2 GOP leader John Cornyn of Texas suggested the proposal might not survive because Senate rules won’t allow it on the bill.

The leader of the conservative House Freedom Caucus suggested the Senate bill would be doomed if it excluded something like Cruz’s plan or House-approved provisions letting insurers charge higher prices to people with serious diseases. Many expect the House to try for quick passage of any health care bill the Senate approves, foregoing potential problems of negotiating a bicameral compromise.

“Is failure an option? Absolutely not,” said Rep. Mark Meadows, R-N.C. “Is failure on the doorstep knocking? Absolutely. So we’ve got to make sure we don’t answer that door.”

Republicans also said party leaders agreed to add $45 billion for battling opioids abuse to their bill. They were also considering a proposal by conservatives to let people use tax-advantaged health savings accounts to pay health care premiums.

___

Associated Press writers Erica Werner, Mary Clare Jalonick, Kevin Freking and Stephen Ohlemacher contributed to this report.

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The cost of two widely used radiology medicines for lung and kidney scans has jumped between 500 percent and 1,800 percent over the last four years. Photo by 06photo/via Adobe

Three years ago, pharmacist Dennis McClure was stunned by news from a key supplier.

The cost of two widely used radiology medicines that his pharmacy sells to hospitals for performing lung and kidney scans jumped between 500 percent and nearly 1,800 percent. Earlier this year, he received yet another jolt — prices not only rose again, but the supplier sent a long-term contract requiring him to purchase a minimum amount of another of its medicines, as well.

McClure believes the supplier, Jubilant DraxImage, acted unfairly, but felt he had to take the deal.

“They have a monopoly,” said McClure, who operates Nuclear Apothecary in St. George, Utah, one of about 110 independent nuclear pharmacies that prepare and dispense vials of medicines to hospitals. “If you don’t sign the contract, you don’t get the product. So we did. But prices have gone up exponentially … and this has had a deleterious effect.”

These pharmacies, which operate in a largely overlooked corner of the pharmaceutical world, may not be the only ones that will suffer consequences, though.

READ MORE: Meet the lawyer trying to pry drug pricing secrets out of Big Pharma

Some doctors and hospital administrators suggest there are negative implications for patient care. Why? Cash-strapped facilities may use other types of scans that do not require these increasingly costly medicines to diagnose patients. But some other scans could also pose health risks.

Meanwhile, legal experts say the Jubilant contracting may be problematic. “The bundling sounds like a potential antitrust violation, particularly if their product has the dominate share of the market,” said Herbert Hovenkamp, a University of Iowa law professor and antitrust scholar.

State and federal authorities have, in fact, been alerted to the concerns, according to sources familiar with the matter, although there is no indication that official probes are underway.

A spokeswoman for Jubilant — which is a unit of Jubilant Pharma in India — declined to comment.

This is only the latest incident in which rising drug prices are prompting heightened scrutiny of the pharmaceutical industry. In the last few years, numerous drug makers — big and small — have been investigated by Congressional committees, as well as state and federal investigators, in response to higher medicines costs and, in some cases, questionable competitive practices.

This particular episode began in January 2014, when Jubilant saw an opportunity to raise prices.

The Jubilant medicines are sold in powder form to nuclear pharmacies, which add a solution before filling orders from hospital radiology departments. A vial of MAA, which radiologists use for lung scans, rose from between $20 to $30 to between $350 and $450, depending upon quantities purchased. And DPTA, which is used for kidney scans, increased from between $20 to $30 a vial to between $130 and $160, depending upon quantities bought.

During a May 2014 conference call, however, Rajagopal Sankaraiah, the Jubilant chief financial officer, told investors these were “not just mere price hikes.” The company, he explained, was in a “very enviable position,” because Jubilant is a “single source” supplier, which means there are no other suppliers from which nuclear pharmacies could purchase the medicines (see page 8).

The pharmacies had little choice but to pass on a portion of the higher costs to hospitals, but those price hikes seem to have escaped wider notice. Now, though, some pharmacy owners said the combination of still more price hikes — MAA and DTPA each rose about 70 percent this year — and tightened contract requirements will have repercussions.

How so?

Many of these smaller nuclear pharmacies serve rural or less-populated markets where hospitals may not have much need to conduct a large number of lung or kidney scans on a regular basis. In the past, the pharmacies could order a certain amount of MAA or DTPA from Jubilant in advance of hospital orders and prepare numerous doses in each vial, which can only last up to about 12 hours.

READ MORE: Stung by surging prices, hospital pharmacies cut back on pricey drugs

Now, though, the Jubilant contracts that went into force earlier this year prevent the pharmacies from engaging in what is called anticipatory compounding. As a result, the pharmacies can only purchase enough of the Jubilant medicines to fill specific orders and, unless a hospital orders several doses, any leftover medicine is likely to be wasted.

The upshot: Pharmacies must spend more to keep customers.

“This has really hurt small pharmacies,” said Tom Wilkinson, who runs Austin Nuclear in Austin, Texas. “We don’t do the volume that a large operator does. From one vial of MAA, we may only get three doses, because we have fewer orders in a short period of time. The bigger guys can get up to seven doses from each vial. But if you can’t supply that product to a customer, that customer will go someplace else.”

Some hospitals are also feeling pinched.

The Cleveland Clinic Foundation is eating the higher costs, but spending less elsewhere, said Shashi Khandekar, the administrator for the imaging institute department. The 2014 price hikes added an extra $1 million to her $5 million budget. This may appear to be a small amount for a large hospital system, but it can mean delaying the purchase of new, state-of-the-art equipment.

READ MORE: Lawmakers chide Trump for seeking to ‘scale back’ hospital discount drug program

“One year, you’re paying the cost of a few lattes and the next year, you’re paying the cost of a whole cell phone bill,” explained Danielle Holtz, a CCF sourcing analyst. “You have to look for savings somewhere.”

Some hospitals may not be able to absorb the costs as easily, though, said Dr. Mark Tulchinksy, a radiologist at Penn State Health’s Hershey Medical Center. To cope, a hospital can use CT scans for examining lungs. These are less expensive than ventilation perfusion scans, which require the Jubilant medicines.

But this raises another issue, since a CT scan exposes patients to more radiation.

“A lot of hospitals still use [the VQ] as an absolute necessity,” he said. “And I still use it myself, but not for every patient. I try to do so very sparingly. … No amount of radiation is trivial. But this is how the health system responds. The type of test used for diagnosis can be switched purely on economic grounds. There’s no data to substantiate it, but I do think there’s been considerable fallout in patient care. And it started with the price hikes.”

This article is reproduced with permission from STAT. It was first published on June 29, 2017. Find the original story here.

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A Mazda car mechanic works at a garage affiliated with its dealership in Tokyo, Japan, February 16, 2017. Credit: REUTERS/Toru Hanai

DETROIT — Mazda is recalling nearly 228,000 cars in the U.S. because the parking brake may not fully release or could fail to hold the cars, increasing the risk of a crash.

The recall covers certain Mazda 6 cars from the 2014 and 2015 model years and the Mazda 3 from 2014 through 2016.

The company says water can get into the brake caliper, causing a shaft to corrode and bind. If that happens, the parking brake can get stuck in the on position or fail to fully engage. That can let the cars roll unexpectedly if parked on a slope.

The problem affects only cars with a hand-operated parking brake lever system, according to documents posted Friday by the U.S. National Highway Traffic Safety Administration.

The company got its first report of the problem in April of 2015 in Canada but decided to monitor it because it hadn’t received other reports. By February of 2017 Mazda had 13 reports in the U.S. of the problem happening on both models. It traced the cause to a sealing boot that wasn’t keeping water out. A collision was reported in Germany when a Mazda 6 rolled off unexpectedly, damaging the rear end. Another crash with bumper damage was reported in the United Kingdom. It wasn’t clear from the documents if there were any injuries.

Messages were left outside of normal business hours Friday for Mazda spokesmen to find out whether cars outside the U.S. are being recalled.

Dealers will check the rear brakes. If shafts are corroded, they’ll replace the calipers. If not, they’ll replace a boot that keeps water out.

Owners will be notified starting August 21.

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WASHINGTON — During a joint statement in the Rose Garden with South Korean President Moon Jae-in, President Donald Trump said “the era of strategic patience with the North Korean regime has failed.”

“Frankly, that patience is over,” he said.

Trump spent Friday discussing North Korea and trade with South Korea’s new leader, whose pro-engagement stance toward the North could clash with the U.S. administration’s intent to crank up sanctions. The two leaders had their first meeting over dinner Thursday, shortly after the Treasury Department blacklisted a Chinese bank accused of conducting millions in illicit business with North Korea.

Trump railed against the North Korean government as a “reckless and brutal regime” as he addressed the media with Moon.

He pointed to the death of American college student Otto Warmbier, who died shortly after being released from North Korean custody.

Trump says his goal is “peace, stability and prosperity” for the region, but warns the United States will “always” defend itself and its allies.

READ MORE: South Korean leader looks for common ground with Trump

Trump also praises the alliance between the U.S. and South Korea as “a cornerstone of peace and security in a very, very dangerous part of the world.”

Jae-in told reporters he invited Trump and his wife, Melania, to visit. Moon says Trump “graciously accepted” the offer.

Moon adds that the visit will “demonstrate not only our friendship but also the intimate bond our peoples have come to foster through thick and thin.”

The U.S. has been a longtime military ally of South Korea, which faces a nuclear weapons threat from North Korea. But Trump is also concerned about the trade deficit with South Korea, which has grown since a free trade pact began between the two countries in 2012.

The South Korean leader has sought to make clear to the U.S. that he is serious about dealing with his neighbor’s threat, despite his inclination to restart dialogue with the North to address its nuclear weapons development.

Moon appeared to try to break the ice early on during Thursday’s dinner, telling Trump that he also suffers from “fake news” coverage, prompting laughs. Trump has used the term to describe media reports he doesn’t like.

Trump wrote on Twitter that they had a “very good meeting” and that they discussed North Korea and trade. Those discussions are expected to continue Friday.

Just finished a very good meeting with the President of South Korea. Many subjects discussed including North Korea and new trade deal!

— Donald J. Trump (@realDonaldTrump) June 30, 2017

As well as the shared concerns over Pyongyang’s technological progress toward a nuclear-tipped missile that could strike the continental U.S, and the threat it already poses to Seoul, Trump will be pushing for a narrowing of the U.S. trade deficit with South Korea, which was $17 billion last year. He has been critical of a 2012 bilateral free trade agreement and barriers to U.S. auto exports.

South Korean companies on Thursday announced plans to import more American shale gas and build new factories in the U.S. that could help fend off the criticism.

Before Friday’s talks at the White House, Moon laid a wreath at the Korean War Memorial monument near the Washington Mall. He was accompanied by Vice President Mike Pence, whose father served in the U.S. Army during the 1950-53 Korean War. Under the pale blue morning sky, they observed a moment of silence as a lone trumpeter played “Taps.”

READ MORE: U.S. blacklists Chinese bank, revving up pressure over North Korea

It was the second occasion during Moon’s four-day visit that he has paid tribute to American veterans of that conflict. On Wednesday, he visited a memorial to Marines who fought in rearguard U.S. action in 1950 that enabled a mass evacuation of Korean civilians, including Moon’s parents.

Moon then pledged to stand firmly with Trump. “Together we will achieve the dismantlement of North Korea’s nuclear program, peace on the Korean Peninsula and eventually peace in Northeast Asia,” he said.

Moon’s conservative predecessor, who was impeached in a bribery scandal, took a hard line toward North Korea. Moon has sought to allay concerns that his softer stance could open fissures with Washington. In recent interviews he has said sanctions alone cannot solve the problem of North Korea’s nuclear and missile programs, but the “right conditions” are needed for dialogue.

Adding to those concerns he has delayed the full deployment of a U.S. missile defense system, which is intended to defend South Koreans and the 28,000 U.S. troops based in the country, pending an environmental review.

Associated Press writers Josh Boak, Jill Colvin and Ken Thomas contributed to this report.

The post WATCH: Trump says patience with North Korea ‘is over’ appeared first on PBS NewsHour.

South Korean President Moon Jae-in and U.S. President Donald Trump (R) deliver a joint statement from the Rose Garden of the White House in Washington, U.S., June 30, 2017. Credit: REUTERS/Carlos Barria

WASHINGTON — President Donald Trump said Friday the United States is renegotiating its trade deal with South Korea as he met the nation’s new leader for talks also addressing the nuclear weapons threat from North Korea.

Trump welcomed South Korean President Moon Jae-in for formal talks at the White House a day after they met over dinner. As well as concerns over North Korea’s technological progress toward a nuclear-tipped missile that could strike the continental U.S., Trump is pushing for a narrowing of the U.S. trade deficit with South Korea.

Since his 2016 election campaign, Trump has been critical of a 2012 bilateral free trade agreement and barriers to U.S. auto exports. South Korea had trade surplus of $17 billion with the U.S. last year when including both goods and services.

“We are renegotiating a trade deal right now as we speak with South Korea and hopefully it will be an equitable deal, it will be a fair deal for both parties,” Trump said alongside Moon in the Oval Office. “We want something that will be very good for the American worker.”

Ahead of Moon’s visit, the White House official said Trump would call for the lifting of barriers to U.S. auto sales in South Korea and voice concern over steel exports from China that reach the U.S. via South Korea. South Korean companies on Thursday announced plans to import more American shale gas and build new factories in the U.S. that Seoul hoped could help fend off the criticism.

Moon said he and Trump had “honest discussions” at dinner on the North Korean nuclear issue and other issues of mutual interest.

“It was a great opportunity for us to further the trust and friendship between me and President Trump,” Moon said. “It was also an opportunity for us to reconfirm the fact that the United States and Korea are walking together on the same path towards a great alliance.”

[READ MORE: Watch live: Trump and South Korean president speak at news conference]

After expanded talks involving other officials, the two leaders will make statements to reporters.

On North Korea, Trump said, “we have a very, very strong and solid plan.” On Thursday, the Treasury Department blacklisted a Chinese bank accused of conducting millions in illicit business with North Korea as Washington intensified pressure on Beijing to crackdown on its wayward ally.

The South Korean leader has sought to make clear to the U.S. that he is also serious about dealing with his neighbor’s threat, despite his inclination to restart dialogue with the North.

Moon’s conservative predecessor, who was impeached in a bribery scandal, took a hard line toward North Korea. In recent interviews, Moon has said sanctions alone cannot solve the problem of North Korea’s nuclear and missile programs, but the “right conditions” are needed for dialogue.

In another point of contention, Moon has delayed the full deployment of a U.S. missile defense system, which is intended to defend South Koreans and the 28,000 U.S. troops based in the country, pending an environmental review.

Before Friday’s talks at the White House, Moon laid a wreath at the Korean War Memorial monument near the Washington Mall. He was accompanied by Vice President Mike Pence, whose father served in the U.S. Army during the 1950-53 Korean War. Under the pale blue morning sky, they observed a moment of silence as a lone trumpeter played “Taps.”

It was the second occasion during Moon’s four-day visit that he has paid tribute to American veterans of that conflict. On Wednesday, he visited a memorial to Marines who fought in rearguard U.S. action in 1950 that enabled a mass evacuation of Korean civilians, including Moon’s parents.

__

Associated Press writers Josh Boak, Jill Colvin and Ken Thomas contributed to this report.

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The entrance to Francis Parkman School is boarded up in Chicago, Illinois, May 8, 2015. Forty-nine elementary schools were targeted by the country’s largest mass closing in 2013, as part of a drive to close a major state budget deficit. Credit: REUTERS/Jim Young

CHICAGO — Illinois is hours away from entering its third fiscal year without a state budget, territory that could mean some universities won’t be able to offer federal financial aid, road construction and Powerball ticket sales will halt, and the state’s credit rating will be downgraded to “junk.”

Lawmakers were meeting Friday to try to end an impasse between Republican Gov. Bruce Rauner and Democrats who control the Legislature that started when the first-term governor took office in 2015 promising change.

While a spending plan got early approval in the House on Friday, House Speaker Michael Madigan said there won’t be a deal before the Saturday start of the next fiscal year. Comptroller Susana Mendoza, who controls the state’s checkbook, warned that without a budget: “Derailment is imminent.”

Rauner has said he’ll keep legislators at work in Springfield until they can reach an agreement, continuing a special session that is costing taxpayers up to $48,000 per day.

[READ MORE: Illinois could be 1st state with ‘junk’ credit due to budget]

Here’s a look at the situation:

HOW BAD IS IT?

No other state has come close to the mess that Illinois is in.

Some states have gone months without a budget — Pennsylvania had a nine-month impasse that ended last year. But Illinois’ stalemate has been unprecedented since it reached a full year.

Illinois already has the lowest credit rating of any U.S. state, and it owes more than $15 billion in late payments to vendors — including doctors who provide health care to state employees and social service agencies that care for disabled people.

Some homeless and domestic violence shelters have been forced to close or reduce services, and some medical offices are no longer seeing patients on state insurance unless they pay cash up front. Universities have laid off thousands of employees.

Illinois also owes school districts millions of dollars for transportation, special education and other expenses.

WHAT ARE THE CONSEQUENCES?

If there’s no budget by Saturday, S&P Global Ratings has said it will likely downgrade Illinois’ credit rating to below investment grade. That would make Illinois the first U.S. state to be assigned “junk” status, and increase the cost to taxpayers when the state borrows money.

The Illinois Department of Transportation has said nearly 700 roadwork projects would stop, putting an estimated 25,000 people out of work, because the state can’t spend money collected through the gas tax without the Legislature approving an appropriation.

The Higher Learning Commission, which accredits schools in the Midwest, has warned the ongoing lack of funding could cause some universities to lose their accreditation. Southern Illinois University President Randy Dunn said that would mean the colleges wouldn’t be able to offer federal loans and grants to students, causing more to choose colleges in other states.

“We’re going into very dangerous territory,” Dunn said.

HOW DID IT HAPPEN?

Rauner, a former private equity investor, won election in 2014 on an anti-tax, pro-business agenda. He promised to shake things up, once even suggesting it might require a government shutdown.

As he was inaugurated, a temporary, four-year Democratic income tax increase that had provided up to $7 billion extra a year was allowed to expire, and the tax rate rolled back. Revenues fell far short of spending and red ink piled up.

Rauner has demanded cost-cutting changes to workers’ compensation laws, which he says are needed to lure businesses to Illinois. He also wants a freeze on local property taxes, which are among the highest in the nation.

Democrats, who have large majorities in the Legislature, argue that Rauner’s demands are an attack on the middle class. They say a property tax freeze would hurt school districts, which rely heavily on property tax.

HOW HAS ILLINOIS GOTTEN AWAY WITH IT?

In nearly two dozen states, failure to pass a budget leads to a government shutdown. Other states have consequences to deter late spending plans. In California, for example, lawmakers don’t get paychecks if they don’t send the governor a spending plan by June 15.

Illinois has no such laws. Instead, the state has been spending billions of dollars annually because of laws and court orders that require some items continue to be paid. Lawmakers also have passed various “stop-gap” appropriations bills to fund some areas, such as K-12 education.

People who rely on government for assistance have felt the pain. But for others, the impasse so far has barely been noticeable: Roughly 63,000 state workers are still getting paychecks, schools have remained open and some road construction projects have continued.

But the days of being able to get by are coming to an end.

WHERE DOES THE DEFICIT STAND NOW?

Because lawmakers never passed a budget accounting for the rollback of the income tax increase, Illinois is still spending more money than it has coming in.

And as more groups go to court to get paid, and judges order more spending, the deficit has grown. Illinois’ deficit for the current fiscal year is an estimated $5 billion.

Mendoza, the state comptroller, warned this week that without a budget, the state by August will have $185 million more in state-mandated and court-ordered payments than it will have revenue to pay them.

She said that would make “the unthinkable” — such as delaying pension payments or not paying state workers — very likely.

“Illinoisans must brace for maximum impact,” she said.

The post Illinois facing dire consequences as budget feud continues appeared first on PBS NewsHour.

This Independence Day, we asked historian Sean Wilentz to recommend five books he believes best shed light on America’s history. Photo by REUTERS/Carlo Allegri.

Historian Sean Wilentz has examined the history of America through the lens of our presidents, our party politics, the working class — and even our music. This Independence Day, we asked Wilentz, a professor of American history at Princeton University, where he has taught since 1979, to recommend five books he believes best shed light on America’s complex history.

His choices range from sprawling political and social histories to dystopian fiction. In his words:

Credit: Oxford University Press

1. “Washington’s Crossing” by David Hackett Fischer

One of the finest books ever written about the American Revolution, “Washington’s Crossing” focuses on a turning point in the war, when General Washington recovered from crushing defeat to lead his troops, over the winter of 1776-77, in the famous crossing of the Delaware River, the two battles of Trenton and the battle of Princeton. Brilliantly narrated, it is more than a fine military history: it plumbs the politics and social background on both sides of the conflict. A splendid blend of scholarship and literary craftsmanship, Fischer’s book fully deserved its Pulitzer Prize.

Credit: Harper Perennial

2. “Ecstatic Nation: Confidence, Crisis and Compromise, 1848-1877,” by Brenda Wineapple

Though James M. McPherson’s “Battle Cry of Freedom” is still widely and deservedly considered the best one-volume history of the Civil War, Wineapple’s more literary take on war and the Reconstruction adds a great deal of fresh insight. And like all of Wineapple’s writings, “Ecstatic Nation” is itself a literary gem.

Credit: Oxford University Press

3. “The Populist Vision,” by Charles Postel

Talk of “populism” dominates political conversation these days with the unpredicted rise of President Donald J. Trump but also with the emergence of unsettling, supposedly populist movements in Europe. Postel’s account of the original American populists makes clear, among other things, that what gets described as populism today is a far cry from the insurgency of the 1890s. This book is sympathetic but unsentimental. Postel’s interpretations of populist political ideas bring to life a crucial passage in the history of American democracy.

Credit: Vintage

4. “Voices of Protest: Huey Long, Father Coughlin and the Great Depression,” by Alan Brinkley

Carrying on with the populism theme, Brinkley’s book settles into the Great Depression, which gave rise to several extraordinary figures who embraced the darker side of American politics. Brinkley, who with this book established himself as one of our major historians, captures the fury behind the movement in what might be called an alternative history of the 1930s and 1940s.

Credit: Vintage

5. “The Plot Against America,” by Philip Roth

I know this is cheating, but after Brinkley’s book, I couldn’t resist another alternative history. Roth’s fictional reimagining of that same Great Depression era — in which Charles Lindbergh, not Franklin Delano Roosevelt, wins the election of 1940 — shows that great novelists can say important things about our history that historians just can’t. And Roth is a true student of the past, not just of events and persons but of textures, presumptions and places.

This list has been lightly edited for length and clarity.

The post This Independence Day, 5 books that explain America’s complex history appeared first on PBS NewsHour.

Churches should have the First Amendment right to endorse political candidates and still keep their tax-free status, say House Republicans. Photo by REUTERS/Jonathan Ernst.

WASHINGTON — Churches should have the First Amendment right to endorse political candidates and still keep their tax-free status, say House Republicans, who quietly tucked a provision into a sweeping spending bill that would deny the IRS money to enforce the 63-year-old law prohibiting such outright politicking from the pulpit.

Republicans repeatedly have failed to scrap the law preventing churches and other non-profits from backing candidates, so now they are trying to starve it. With little fanfare, a House Appropriations subcommittee added the IRS measure to a bill to fund the Treasury Department, Securities and Exchange Commission and other agencies.

The subcommittee passed the bill Thursday.

Republicans say the law is enforced unevenly, leaving religious leaders uncertain about what they are allowed to say and do.

“I believe that churches have a right of free speech and an opportunity to talk about positions and issues that are relevant to their faith,” said Rep. Jim Renacci, R-Ohio.

Some Democrats say the measure comes too close to mixing church and state. They say religious leaders already have First Amendment rights, just like anyone else. But if they want to get political, they don’t have a constitutional right not to pay taxes.

READ MORE: Trump vows to repeal political limits on churches

Some also worry that the measure could upend the system of campaign financing by allowing churches to use their tax-free status to funnel money to political candidates.

Rep. Richard Neal, D-Mass., recalled a speech that former President John F. Kennedy gave to religious leaders when he was running for president.

“He said the pope wouldn’t tell him what to do, and the people in that audience shouldn’t be telling people on Sunday morning who to vote for,” Neal said. “I don’t think churches should be endorsing.”

Many nonprofit groups want to avoid politics. In April, 4,500 nonprofit groups signed onto a letter to congressional leaders asking them to preserve the law.

The law prohibits tax-exempt charitable organizations such as churches from participating directly or indirectly in any political campaign to support or oppose a candidate. If the IRS determines that a group has violated the law, it can revoke its tax-exempt status.

The law doesn’t stop religious groups from weighing in on public policy or organizing in ways that may benefit one side in a campaign.

The bill specifically forbids the IRS from spending money to enforce the law against “a church, or a convention or association of churches,” unless the IRS commissioner signs off on it and notifies Congress.

READ MORE: Wisconsin-based atheist group sues Trump over church order

The bill doesn’t mention other types of non-profit groups, or even synagogues or mosques, said Nick Little of the Center for Inquiry, which promotes secularism.

“All they care about is the Christian groups, and in particular, it will end up as the extreme religious right Christian groups,” Little said. “If this goes through, this would add just another way in which unregulated dark money could be used.”

Religious leaders have been weighing in on political issues for generations, whether it’s the debate over abortion or advocating for the poor. But periodically, the IRS has stepped in when religious leaders explicitly endorse or oppose candidates.

The law is called the Johnson Amendment after former President Lyndon Johnson, who introduced it in 1954 when he was a Democratic senator from Texas. Johnson was upset because a few nonprofit groups attacked him as a communist in a Senate campaign.

The law was signed by a Republican president — Dwight Eisenhower — but Republicans have been attacking it in recent years.

House Republicans have pledged to repeal the law as part of a tax overhaul. President Donald Trump signed an executive order in May discouraging the IRS from enforcing the law.

Rep. Pat Tiberi, R-Ohio, says the law has been enforced unevenly.

“Some churches, including my own, have been very concerned about appearing political in any way shape or form,” Tiberi said. “Churches I went to that were primarily in Democrat areas, that I would go to because I had a Democrat district, the local candidates on the Sunday mornings before the election would be introduced, would speak from the pulpit about the campaign and why the congregation should vote for them.”

The full Appropriations Committee will consider the measure after the July 4th congressional recess.

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Given the task of enacting tax reform, congressional Republicans and the Trump administration would do well to look to history, writes David Smick, author of “The Great Equalizer.” Photo by Joe Marquette/Reuters

Editor’s Note: Tax reform. It’s item No. 2 on the Republicans’ legislative agenda, but as the health care bill straggles on, who would bet on a tax system overhaul any time soon?

But it doesn’t have to be that way. So says David Smick, a global macroeconomic strategist and the author of “The Great Equalizer: How Main Street Capitalism Can Create an Economy for Everyone.”

Below, Smick explains that though America’s last tax reform, 31 years ago under President Reagan, was a “fluke,” congressional Republicans and the Trump administration could learn something from it.

Smick analyzed the economic anxiety that led to the rise of Bernie Sanders and Donald Trump in “The Great Equalizer.” He predicted the global financial crisis in his 2008 book, “The World Is Curved: Hidden Dangers to the Global Economy.” So we figured he might be worth listening to this time around as well.

— Kristen Doerer, Making Sen$e Editor

Given the task of enacting tax reform, congressional Republicans and the Trump administration would do well to look to history.

The 1986 tax reform (the last reform of the federal tax code to become law) came about as an unexpected surprise. A fluke. In the two years leading up to its enactment, the conventional wisdom was that tax reform was impossible. As an adviser to that effort, between 1984 and 1986, I attended five “funerals” commemorating the death of any effort to change the tax code.

By 1986, the Reagan White House had produced a tax reform package that was literally declared “dead on arrival.” Congressional “supply siders” had their own version that essentially reflected the U.S. Chamber of Commerce’s preferred tax changes containing too many corporate giveaways and the elimination of too few business shelters. It too was going nowhere fast. Congressional Democrats offered the Bradley-Gephardt tax reform bill with not enough Democratic support, and almost no Republican support, for passage at a time when Republicans controlled Washington.

READ MORE: Column: Why we need to rewrite our tax code from scratch

But then something happened — a surprise shock to the political system — that would be an even rarer occurrence in today’s politically risk-averse Washington, D.C. At the time, former Merrill Lynch Chairman Donald Regan was Ronald Reagan’s sometimes politically tone-deaf treasury secretary. Unbeknownst to Regan, in the bowels of the U.S. Treasury Department, a nonpartisan group of tax nerds put together a bold tax reform package that managed the remarkable feat of skewering both party’s special interests. The corporate lobbying community was furious. But then something happened that changed the Washington dynamic. When the controversial plan was leaked to the press, the Democratic leadership on Capitol Hill came out in favor of “Ronald Reagan’s new tax initiative,” which was really a plan largely written by the Treasury’s civil servants who were not affiliated with either party.

The Reagan White House was furious at its own treasury secretary for allowing such a radical tax reform to be announced. Shortly thereafter, chief of staff James Baker and Regan switched jobs. But here’s the irony: Though never enacted, the surprise plan of the Treasury nerds broke the ideological and partisan logjam. Fairly quickly, a bipartisan group of congressional tax writers, including Sen. Bob Packwood, R-Ore., Sen. Bill Bradley, D-N.J., Rep. Jack Kemp, R-N.Y., and Rep. Dan Rostenkowski, D-Ill., and Treasury Secretary Baker relatively quickly hammered together a deal. Packwood, the Senate Finance chairman, was particularly adept at moving to find bipartisan common ground. In one of the great surprises of U.S. legislative history, tax reform became a reality.

Which brings us to the current debate over fiscal policy. If they really want tax reform, the Republican leadership should reach out to Democrats (particularly the 25 Senate Democrats up for reelection next year) with a plan that would be bipartisan in nature. That means there would be no overhauling of the individual tax code, which would only inflame partisan passions. No bipartisan consensus exists on the issue of individual tax cuts. But there does seem to be a joint consensus that today’s corporate tax rate, the highest in the world, has had the effect of encouraging American companies to move plants and jobs overseas. There also seems to be a bipartisan consensus to modernize the country’s infrastructure. There seems to be a consensus that the U.S. economy’s productivity has declined as a result of a slowdown in capital investment and business startups, now at a 15-year low. Most members of Congress can feel it in their bones that America’s innovative risk-takers are holding back.

To start the negotiations, the Republican leadership should throw on the table a bipartisan plan beginning with four elements. First, reduce the corporate tax rate from 35 percent to 20 percent (with “pass-throughs” for the small business sector included) and eliminate many loopholes. Second, allow immediate expensing of capital investment as a means of encouraging higher productivity growth, the key to raising today’s growth rates, now roughly half the historic average rates of economic growth. Third, create a generous repatriation incentive that allows American companies to bring home the $2 trillion to $5 trillion sitting offshore so long as they also agree to purchase a specified amount of low-interest infrastructure bonds. A separate pool of capital based on the issuance of these long-term bonds should be the source of the base of financial support for the fourth item — spending serious money to modernize the country’s major infrastructure.

Republicans should offer Democrats some sweeteners that would be tough to vote against. One might be a new program giving disadvantaged families vouchers to help them relocate to better job opportunities. Another might be a modest incremental increase in the minimum wage, carefully designed to avoid threatening small-business solvency and loss of entry-level jobs.

Both political parties need to fixate on encouraging startups, helping young firms survive and ending the regulatory, anti-trust and patent arbitrage games that large corporations use to gain competitive advantage over the small. They should make the process of going public easier and less expensive. And they should work together to help the workhorses of the grassroots economy, regional and community banks. Why this call for a bipartisan approach to startups? Unlike large corporations, startups take place and produce jobs in America.

Democrats and Republicans alike should remember that policy changes often show their effects after an uncertain lag. For example, President Jimmy Carter’s deregulation efforts in the late 1970s no doubt benefited Ronald Reagan’s economy in the early 1980s. The 1986 tax reform happened on Reagan’s watch, but arguably laid the foundation for the successful Clinton economy. Both parties gained politically, but the long-term winner from the bipartisan approach was the American people.

The key question: Is there a leader in Washington from either party with the nerve to make the first move?

Watch economics correspondent Paul Solman’s conversation with T.R. Reid about how the U.S. could improve its tax system.

The post Column: The secret tax deal Republicans should offer Democrats, and how it would pass appeared first on PBS NewsHour.

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JUDY WOODRUFF: Finally tonight: Often lost in the health care debate are the individual stories of fear and uncertainty that come with a medical diagnosis.

Elizabeth Silver is an author and attorney who was unexpectedly plunged into a world of statistics and probability. She offers her Humble Opinion on how to consider a prognosis.

ELIZABETH SILVER, Author, “The Tincture of Time”: When my daughter was six weeks old, she suffered a serious stroke and spent two weeks in the neonatal intensive care unit.

As new parents, my husband and I spent that time beside her, waiting for answers and, at the end, were given very few. At home, with a single click, we could watch videos, read articles, and, most importantly, stumble across numbers that would send us either rejoicing or panicking.

Like many parents, we had nothing to hold onto but statistics. According to one I read, her stroke carried a 20 percent chance of death and 90 percent chance of severe neurological damage. I focused on the 90 percent, and imagined very different versions of our lives.

Over the next year, as we weaved in and out of doctors’ offices, I recalled the aphorism that physicians are supposed to treat the patient, not the paper. Hippocrates, the ancient Greek philosopher and physician, said that it is more important to know what sort of person has a disease than to know what sort of disease a person has.

In other words, we must remember that patients are people with stories.

I took a step back and began looking at these statistics, these abstract medical studies and numbers, and started to view them just as I would a story, a novel or a film. After all, a statistic is only a particular version of a story. And, as with all stories, there are always multiple perspectives and multiple truths.

You can analyze them like literature: When was that statistic taken? Who was the source group? Was it self-selecting? What else do the subjects have in common?

When looking at a statistic in a medical study, you don’t have the full picture of your prognosis, unless you have every perspective, every detail in the story. And that is something you will never get from a number.

Three years later, my daughter escaped all her damning statistics and is living a full, happy life, as if it never happened. When I look closer at her story in its totality, those statistics didn’t differentiate based on age, my prenatal care, or even the actual size of the stroke.

We all know that statistics are useful, but if we rely on them with too much weight, this can only lead to a breakdown of trust with medicine. We end up focusing on the 90 percent chance of things going wrong, and, in the process, neglect the 10 percent chance of things going right.

Perhaps my daughter’s story might one day be counted in a future study, and her success will serve as a tick against those frightening, bigger numbers, because there is an alternate ending that includes the full picture, and it can be beautiful.

JUDY WOODRUFF: Elizabeth Silver.

The post My daughter escaped being a scary health statistic. Here’s what I learned. appeared first on PBS NewsHour.

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JUDY WOODRUFF: And to the analysis of Shields and Brooks. That’s syndicated columnist Mark Shields and New York Times columnist David Brooks.

Welcome, gentlemen.

David is joining us from the Rocky Mountains, Aspen, Colorado.

So, let’s start, both of you, by talking about health care.

Mark, we just heard a little while ago on the program Senator Roy Blunt of Missouri saying it’s going to be hard, he said, to get to 50 votes. What are you hearing?

MARK SHIELDS, Syndicated Columnist: It’s an understatement by Senator Blunt, a masterpiece of understatement.

Judy, never say never. I think it’s about time to say never. I mean, this is not being put together. Quite frankly, the motion to proceed, not to get inside baseball, but that’s when the majority leader — means bringing up a bill. And I have never seen a motion to proceed, which is just asking that the bill be brought up for debate, fail.

And Mitch McConnell’s reputation as an inside player has taken a big hit. But there is not — there is not majority on what to do. And it’s not there.

And I will just back to one Republican has spoken the absolute abject truth on this subject. And he said, “In the 25 years I have served in the Congress, Republicans have never, not one time ever agreed on a health care plan.”

That was Speaker John Boehner this year. And I think it remains true.

JUDY WOODRUFF: David, what are you picking up?

DAVID BROOKS, New York Times: Yes, I’m hearing negative vibes, but not quite as negative as Mark. I still think there’s a chance.

What you hear is frustration over, one, it’s hard to take away a benefit people have already been given by law. Two, the Republicans are more ideologically divided than they thought they were. Three, it’s very hard to pass a bill without a White House.

And the president basically ineffective here, and the vice president barely more so. And so they’re trying to do it without him. And I think what they’re beginning to hear, as the calls come in, is that this is a proposal that hits a lot of Republicans really hard.

If you’re a 60-year-old white male in Ohio, this can be devastating to you, both in the coverage loss and in the deductibles and the out-of-pocket expenses, so the calls are coming into the offices. And that’s making people skittish.

I think it’s an uphill fight. I don’t think it’s quite as impossible maybe.

JUDY WOODRUFF: I was struck, Mark, that Senator Blunt was saying the more the senators learn about what’s in here, the harder it gets.

MARK SHIELDS: That’s right. Yes. No, that’s absolutely — and I would just add to it, Judy, there is no public argument, a case to be made for this.

Senator Blunt answered your specific questions well, but there is no — there is not a rallying cry for, whether it’s preexisting condition or, you know, that everybody’s child can be on until the age of 26. The Obamacare, the Affordable Care Act, they could make a public case for it, that everybody is in, that rates will not be higher.

There’s none here. And I think that’s a real problem. David’s point about there is no political air cover from the White House. Quite the opposite. I mean, the White House has been a liability. The president has been unhelpful, uninformed, and this morning tweeting, let’s repeal, which, CBO, the Congressional Budget Office, has a score on, would put 26 million people uninsured immediately, so, you know, off of insurance.

So, this is not a recipe for success.

JUDY WOODRUFF: David, that’s right. I mean, the president did tweet this morning, well, if they can’t agree, they should repeal now and replace it later.

DAVID BROOKS: Yes, it’s the definition of bad leadership.

He had a more sensible position not too long ago, which is you do both things at the same time. If you repeal in the fantasy that you’re going to replace later, when you can’t replace now, that’s just not a realistic way to make policy.

I think Senator Blunt made a good point, that, we got a piece of legislation. If you can’t agree on this, there’s not some mythical future piece of legislation out there that’s going to pass.

The basic problem is that this is a bill that massively redistributes wealth from the poor to the rich. And there are a lot of senators, including Bob Corker of Tennessee and Portman of Ohio and Susan Collins of Maine, who are just uncomfortable with the level of upward redistribution that this bill entails.

And then there are other senators on the right, the Ted Cruzes, who just want to get rid of what they call job-killing taxes. And that’s just a diverse party. And McConnell is trying super hard to find some formula that will please both sides, but it just may be an unsolvable problem.

MARK SHIELDS: I will just add one thing, Judy.

You had an interview earlier this week with Senator John Thune of South Dakota, ranking Republican. And you asked him about one little mishap, which was that Dean Heller, the most vulnerable Republican incumbent in the country, up in Nevada next year, in the only state where Republicans running for reelection that Hillary Clinton carried in 2016, expressed his own reservations, misgivings, doubts, opposition to the bill as proposed last Friday.

And what happened? Joining the state’s governor, who pointed out that the rate of uninsured children in the state had been cut by one-half under Obamacare because of the Medicaid extension. And he back — he hollered backed at the governor, at which point the president’s own political action committee, staffed by the president’s own political aides and apparatchiks, organized a $1 million, expressed attack ad series on him, Heller, which Senator Thune objected to, that Senator McConnell opposed.

This is the political equivalent of coming down from the hills and shooting the wounded. And so they had to back off. And so you talk about White House-congressional relations. I mean, this is just — it’s more than counterproductive. It’s stupid.

JUDY WOODRUFF: You’re right. Senator Thune — David, Senator Thune’s comment, that wouldn’t be a good time to go after members of your own party.

DAVID BROOKS: Yes.

Yes. No, it’s — the relations are — it’s interesting to watch even the reactions to the tweets and everything else. They can’t get away from this guy. And what’s been interesting, talking to members of Congress, is, it would be one thing if he would just sort of disappear, but they have to spend so much of their time just reacting.

And it’s just very hard to make policy, aside from the problem of just making policy from Capitol Hill, which is difficult to start with.

JUDY WOODRUFF: Well, speaking of the tweets, David, we have seen some eyebrow-raisers. We have heard some gasps. But I guess the president’s tweet yesterday morning about the “Morning Joe” MSNBC cable hosts, Joe Scarborough and Mika Brzezinski, where the president tweeted very personal insults, low I.Q., face-lift, and so forth, it seemed to reach a new low.

Do we learn anything new about this president at this point?

DAVID BROOKS: Well, one of the nice things, if we can find a silver lining here, is, it’s possible for everybody to be freshly appalled, that we are not inured to savage, misogynistic behavior of this sort.

And I saw a lot of people around. And I certainly felt in myself a freshness, a freshness of outrage.

And I must say, when I hear Roy Blunt say it’s unhelpful to himself, well, that’s true, but it’s more than unhelpful to Donald Trump to tweet in this way. It’s morally objectionable. And I do wish more senators would say that. Lindsey Graham and Ben Sasse have said it, but a lot of others, oh, it’s just not helpful.

It’s more than that. And the issue here is the corruption of our public sphere. And that’s what Donald Trump does with these things. And it makes it harder for us, our country, to ever get back to normal, when these things are corrosive to just the way people talk to each other.

JUDY WOODRUFF: Corruption of the public sphere, Mark.

MARK SHIELDS: I think David is guilty of understatement.

No, I think he put it very well. This is hateful and it’s hurtful. Judy, I don’t know what a parent or a grandparent is supposed to say to a 10-year-old or a 12-year-old who said anything comparable to this and was sent — banished to their room or whatever else for it, I mean, that the president of the United States can talk this way, and there are no consequences.

The irony is that he’s more engaged on the back-and-forth with Joe Scarborough and Mika Brzezinski on this than he has been on health care or any other issue. He obviously — this is what matters to him. And it’s just that classic — not to be sectionally biased, but it’s sort of a New York bully approach to life, I mean, that you say anything, you do anything, because the important thing is winning.

And I just — you know, I don’t know what else there is to say, other than you want to put yourself through a car wash after you listen to the president talk this way.

JUDY WOODRUFF: Are there consequences, David? I mean, I heard what you said about some senators are just saying, well, it’s not helpful, but other senators are going further and saying, this is really wrong.

But are there ever consequences? Do we just go on like this?

DAVID BROOKS: Yes. Well, we will see if people eventually get disappointed and get tired.

I do think if it — one of the things that may begin to offend people is potential mafioso behavior. One of the things we heard this morning in the op-ed piece in The Washington Post by the two hosts was that the White House sort of threatened sort of extortion, that, if the show becomes more Trump-friendly, then a National Enquirer investigation into their relationship will be spiked.

And that’s sort of mafioso, extortion behavior. That’s beyond normal White House behavior. It’s beyond political hardball. It’s sort of using your media allies, The National Enquirer and the Trump administration, to take down enemies. And that’s not something we have seen in America since maybe Nixon, or maybe never.

JUDY WOODRUFF: It’s true, Mark, we haven’t seen anything like this in a while.

MARK SHIELDS: We haven’t.

But I think David’s point about extortion certainly strengthens the position of James Comey, that threats and extortion or a hint of extortion is part of the modus operandi.

To Republicans …

JUDY WOODRUFF: I mean, we should say the White House is denying it.

MARK SHIELDS: The White House is denying it. Jared Kushner, I guess, is denying it, or perhaps somebody else through him is denying it.

But the fact that there’s negotiations going back and forth or communications on this subject, you do this and we won’t print an injurious and harmful article in The National Enquirer, one of the great publications of our time.

But, Judy, I remember when Republicans used to get upset and angry at Bill Clinton because he didn’t wear a suit and tie in the Oval Office. And Donald Trump, who is supposed to be this great deal-maker, I mean, Joe and Mika Brzezinski have a morning show which is a show that watched very much in this area, but it doesn’t have a great national audience, and probably 1 percent of the people.

And he just made them a national — everybody now knows about this show. It’s probably increased their ratings, juiced them up. So I don’t understand where — if anything, it’s but counterproductive in every sense.

JUDY WOODRUFF: Well, it is true, David, that this is — it’s hard to find you said there may be a silver lining in fresh outrage, but beyond that, I’m not sure where it is.

DAVID BROOKS: No.

And, you know, the big question for me is, do we snapback? Do the norms that used to govern politics reestablish themselves after the Trump administration, or are we here forever?

And I hope, from the level of outrage, that we have a snap back. But the politics is broken up and down. And Trump may emerge from a reality TV world that is much more powerful than we think. And there is the prospect that this is where we are, which is an horrific thought.

JUDY WOODRUFF: Horrific thought.

MARK SHIELDS: Yes, it is that.

JUDY WOODRUFF: Mark Shields, David Brooks, we thank you both.

MARK SHIELDS: Thank you, Judy.

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