FORT WORTH, Texas — The Texas Republican Party now endorses so-called “reparative therapy” for gays, under a new platform given final approval at its annual convention Saturday.

The new anti-gay language never came up for debate before roughly 7,000 delegates ratified a Texas GOP platform that tea party groups succeeded in pushing further to the right, including winning a harder line on immigration.

One influential tea party group called Texas Eagle Forum had urged the party to support psychological treatments that seek to turn gay people straight. It comes after Republican New Jersey Gov. Chris Christie last fall signed a law banning such therapies on minors, and California has a similar law.

The Fort Worth Convention Hall cheered when party leaders announced that Christie finished a distant 11th in a 2016 presidential straw poll.

“There’s a very, very small group of people who want to keep the party in the past. We were here today to try to pull the party into the future,” said Rudy Oeftering, vice president of the gay conservative group Metroplex Republicans. “The only way the party can go into the future is to start listening to young people, to start listening to people who have gay family members.”

Oeftering and allies had lined up to speak against the therapy language that had been added earlier this week. But they never got a chance to address delegates, because a parliamentary motion to approve the full platform was called first.

Under the new plank, the Texas GOP recognizes “the legitimacy and efficacy of counseling, which offers reparative therapy and treatment for those patients seeking healing and wholeness from their homosexual lifestyle.”

The American Psychological Association and other major health organizations have condemned such counseling, which generally try to change a person’s sexual orientation or to lessen their interest in engaging in same-sex sexual activity. The groups say the practice should not be used on minors because of the danger of serious psychological harm.

“The platform reflects what the people in the Republican Party have asked for, and that should be no surprise: family values, protection of marriage between one man and one woman and everything that goes along with that,” said Jonathan Saenz, president of the conservative group Texas Values and a convention delegate.

Gay conservatives did come away with a rare victory at the convention: Winning the removal of decades-old language in the state party platform that states, “homosexuality tears at the fabric of society.”

Follow Paul J. Weber on Twitter @PaulJWeber

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Los Angeles Superior Court Judge Rolf Treu struck down multiple California laws providing job protections for the state’s public school teachers, calling them unconstitutional, reports KPCC in Los Angeles.

The lawsuit was filed in 2012 by Student Matters, a group representing nine California students. They argued the state’s laws — granting teachers tenure after two years on the job, governing teacher dismissals and requiring teacher layoffs be based on seniority — codify inequality in the state’s public schools. The plaintiffs called witnesses who testified these laws mean predominantly low-income, black and Latino students are most roiled by budget cuts and most likely to be staffed with ineffective teachers.

California and the state’s two teachers unions argued that factors outside of a classroom teacher’s control, including years of dramatic state funding cuts, concentrated poverty, racial segregation, inadequate housing and limited access to healthcare, are to blame for most of the so-called achievement gap between high- and low-performing schools. Witnesses also argued that administrators have sufficient leeway to dismiss ineffective teachers.

NewsHour Weekend examined the issues at play in the two month-long trial in March. Each side called students, teachers, school district administrators and education researchers to testify.

California and the teachers unions are expected to appeal the ruling. National education advocacy groups like the National Center for Teacher Quality, StudentsFirst and the Education Trust backed the Students Matter case.

Laws to modify or end teacher tenure have passed in at least 18 states in recent years. Students Matter is considering similar lawsuits in more than half a dozen other states, according to Politico .

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Although the school nurse is a familiar figure, school-based health care is unfamiliar territory to many medical professionals, operating in a largely separate health care universe from other community-based medical services.

Now, as both schools and health care systems seek to ensure that children coping with chronic conditions such as diabetes and asthma get the comprehensive, coordinated care the students need, the schools and health systems are forming partnerships to better integrate their services. In these projects, some funded by the health law, school health professionals gain access to students’ electronic health records and/or specialists and other health system resources. Such initiatives currently exist or are on the drawing board in Delaware, Miami and Beaverton, Ore., among other locations.

School nurses today do a lot more than bandage skinned knees. They administer vaccines and medications, help diabetic students monitor their blood sugar, and prepare teachers to handle a student’s seizure or asthma attack, among many other things.

A 2007 study found that 45 percent of public schools have a full-time nurse on site, while 30 percent have one who works part time. In addition to school nurses, 12.5 percent of school districts have at least one school-based health center that offers both health services and mental health or social services, according to the federal Centers for Disease Control and Prevention’s 2012 Schools Health Policies and Practices Study. School nurses often work closely with school-based health centers, referring students there as needed.

“Chronic disease management is what school nurses spend most of their time doing,” says Carolyn Duff, president of the National Association of School Nurses. “We do care for students in emergencies, but we spend more time planning to avoid emergencies.”

School-based health care providers may bill Medicaid for some services, but rarely bill private insurers.

“The juice isn’t worth the squeeze,” says John Schlitt, interim president for the School-Based Health Alliance, an advocacy organization for school-based health centers. “It takes so much energy to track these bills from the commercial insurers, many just stop trying.”

Although school nurses see many students regularly, they don’t always have the most up-to-date information about the students’ health. School nurses must get permission from parents to communicate with a child’s doctor. Once the doctor gives them a care plan for the child, they generally rely on the doctor and/or parents for updates and changes.

“When things change, we don’t always get told in a timely manner,” says Nina Fekaris, a school nurse in the Beaverton, Ore., school district. “It works, but it takes a lot of coordination.”

School nurses in Delaware voiced similar concerns a few years ago to administrators at Nemours Children’s Health System that serves residents around the state.

“Lots of nurses expressed that they had difficulty communicating with providers” at Nemours, says Claudia Kane, program manager of the Student Health Collaboration at Nemours. In 2011, the health system got together with the Delaware School Nurses Association and the state Department of Education to develop a program that, with parental approval, now gives school nurses read-only access to the electronic health records of more than 1,500 students who have complex medical conditions or special needs such as diabetes, asthma, attention deficit hyperactivity disorder, seizure disorders or gastrointestinal problems.

Now that she has access to the Nemours system, Beth Mattey can check the recent lab test results of a student who has diabetes.

“It’s helpful for me to monitor his [blood sugar levels] and work with him to make sure he’s in better control,” says the Wilmington school nurse who is president-elect of the National Association of School Nurses.

When a student put a staple through his finger, she was able to check to make sure he went to the doctor and got treatment.

“Checking with him directly involves calling him out of class,” she says.

Eventually school nurses will be able to put information into the Nemours electronic records system as well, says Kane. In the meantime, Nemours doctors, some of whom were initially skeptical about allowing school nurses access to health system medical records, are warming up to the arrangement. It encourages communication between Nemours physicians and school nurses, and eases the burden of routine tasks because Nemours doctors no longer have to fax over care plans or instructions to the school nurse every couple of months for students who are part of the program, says Kane.

The Nemours Student Health Collaboration project is operating in all Delaware public school districts as well as half of charter schools and about a third of private schools. Nemours plans to extend the program to school-based health centers next, says Kane.

“Our primary care practices are going through the process to become certified as medical homes,” says Kane. “School nurses have a big role in care coordination, and this program is integrated as a piece of that.”

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Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

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WASHINGTON — Fifteen CIA employees were found to have committed sexual, racial or other types of harassment last year, including a supervisor who was removed from the job after engaging in “bullying, hostile behavior,” and an operative who was sent home from an overseas post for inappropriately touching female colleagues, according to an internal CIA document obtained by The Associated Press.

The examples, sent several weeks ago in an email to the CIA’s workforce by the director of the agency’s Office of Equal Employment Opportunity, were meant to show how the agency is enforcing a zero-tolerance policy toward harassment. But the announcement sparked heated commentary in postings on the CIA’s internal networks, officials acknowledged, with some employees arguing the agency does not sufficiently ferret out and punish misconduct.

The CIA’s personnel systems seem to be fundamentally broken, and harassment frequently goes unreported, one officer said in an excerpt of an employee posting obtained by the AP. The authenticity of the posting was not disputed by the agency.

CIA officials took issue with that assertion after agreeing to discuss the workforce message on the condition that they not be quoted by name.

The agency officials made available CIA Director John Brennan’s March workforce message reaffirming the zero-tolerance policy, saying, “Words or actions that harm a colleague and undermine his or her career are more than just unprofessional, painful and wrong — they are illegal and hurt us all.” Brennan assured employees that he would not tolerate acts of reprisal against those who complained of harassment.

The agency won’t release its employee workplace surveys or details about complaints, on the grounds that such numbers are classified. The CIA takes that position even though the size of its workforce — 21,459 employees in 2013, not counting thousands of contractors — was disclosed in the “black budget” leaked last year by former National Security Agency contractor Edward Snowden.

The message to employees on harassment, which CIA officials said was the first of its kind, said 15 out of 69 complaints in the 12 months ending Sept. 30, 2013, were found to be true.

In the interest of “transparency,” the message said, officials shared summaries of four examples involving three unidentified CIA employees and a contractor:

• A supervisor who engaged in bullying, hostile behavior and retaliatory management techniques was removed from the job, given a letter of reprimand, and ordered to undergo leadership and harassment training.
• A male officer who sexually harassed female colleagues at an overseas post was sent back to the U.S. and given a letter of counseling and mandatory harassment training.
• An employee who used a racial slur and threatened a contractor was given a letter of reprimand.
• A contractor who groped a woman was removed from his tour and “reviewed for possible termination.”

In response to the memo, CIA officials acknowledged, many employees complained that none of the government employees involved were fired or demoted.

The CIA officials said the idea was to deter the behavior, not punish the offenders.

The officials declined to name the disciplined employees or describe their jobs. One recent disciplinary action was not included in the examples, officials said: Jonathan Bank, the CIA’s director of Iran operations, who was removed from his post at headquarters in March after it was found he created a hostile work environment that caused morale to plummet. He is now assigned to the Pentagon.

Many large organizations grapple with workplace harassment, but the CIA faces some unique challenges. For example, the agency, which trains its case officers to manipulate people and lead secret lives, had for years been a place where trysts between managers and subordinates were common, former CIA officials say. And since most of the agency’s business is conducted in secret, there has been almost no public accountability for misconduct by senior officials, as there has been in the military.

In 2010, a senior clandestine service manager was forced to quietly retire after he had an affair with a female subordinate. But that was because her husband complained to Leon E. Panetta, then the CIA director, said two former officials who refused to be named because they could lose their security clearances for discussing internal CIA matters. Other similar workplace relationships resulted in no action, they said.

In 2012, then-CIA director David Petraeus sent a message to agency staff members outlining a new effort to curb sexual harassment in war zones, where CIA men and women often live in close quarters under stressful conditions. Petraeus himself later admitted he was having an affair with his biographer and resigned his post.

The agency has faced complaints of gender bias in the past. In 2007, a group of female officers filed a class-action complaint with the federal Equal Employment Opportunity Commission, alleging that women who had affairs with foreigners were treated more harshly than their male counterparts. An EEOC judge dismissed the case, however, on the grounds that there were not enough women in the class. The women pursued their cases separately, and some were paid settlements, said former CIA officer Janine Brookner, the lawyer who brought the case.

In 1995, the agency paid $990,000 to settle a class-action lawsuit by 450 women. The settlement included promotions, raises and better assignments for about 100 female officers.

Neither the CIA nor its National Clandestine Service has ever been headed by a woman. CIA officials point out that the agency now has a female No. 2, deputy director Avril D. Haines. Another woman, Fran P. Moore, is director of intelligence, the agency’s analytical arm. Female analysts also played a key role in the effort to find Osama bin Laden.

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When the 2014 World Cup kicks off June 12, it may be scoring a new goal for Twitter.

Guilherme Ribenboim, Brazil’s general director for Twitter, said Tuesday that the microblogging company expects that the month-long international soccer competition will easily be the most tweeted event in the website’s history, eclipsing the 150 million tweets sent during the 2012 London Olympic Games.

“The World Cup will take all that to a whole different level,” Ribenboim said, in an interview with Reuters.

In addition to viewer tweets, the athletes themselves will also be dribbling into the social media field. Twitter claims to be working with soccer players and organizations, telling them how to use the website and engage with the fans.

According to FIFA, the governing body that organizes and oversees international soccer, 3.2 billion people watched at least part of the 2010 World Cup. Twitter’s user base currently sits at 255 users worldwide.

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Pedestrians walk past the U.S. Department of Veterans Affairs (VA) headquarters in Washington, D.C. Photo by Andrew Harrer/Bloomberg via Getty Images

The 426-0 final vote was Congress’ strongest response yet to the outcry over backlogs and falsified data at the beleaguered agency. Senate leaders plan debate soon on a similar, broader package that has also drawn bipartisan support, underscoring how politically toxic it could be to be seen as ignoring the problem.

House members didn’t want to be left out of their roll call. An unusual second vote, superseding the chamber’s 421-0 passage of the bill barely an hour earlier, was taken after a handful of lawmakers missed the first one. They included Veterans Affairs Committee Chairman Jeff Miller, R-Fla., the bill’s author, who said he had been in his office.

The VA, which serves almost 9 million veterans, has been reeling from mounting evidence that workers fabricated statistics on patients’ waits for medical appointments in an effort to mask frequent, long delays. A VA audit this week showed that more than 57,000 new applicants for care have had to wait at least three months for initial appointments.

“I cannot state it strongly enough – this is a national disgrace,” Miller said during the debate.

“We often hear that the care that veterans receive at the VA facilities is second to none – that is, if you can get in,” said Rep. Mike Michaud of Maine, top Democrat on the committee. “As we have recently learned, tens of thousands of veterans are not getting in.”

The controversy led Eric Shinseki to resign as head of the VA on May 30, but the situation remains a continuing embarrassment for President Barack Obama and a potential political liability for congressional Democrats seeking re-election in November.

Monday night, a top VA official told the veterans committee that there is “an integrity issue here among some of our leaders.”

Philip Matkovsky, who helps oversee the VA’s administrative operations, said of patients’ long waits and efforts to hide them, “It is irresponsible, it is indefensible, and it is unacceptable. I apologize to our veterans, their families and their loved ones.”

Matkovsky did not specify which VA officials had questionable integrity. The agency has started removing top officials at its medical facility in Phoenix, a focal point of the department’s problems, and investigators have found indications of long waits and falsified records of patients’ appointments at many other facilities.

Richard Griffin, acting VA inspector general, told lawmakers his investigators were probing for wrongdoing at 69 agency medical facilities, up from 42 two weeks ago. He said he has discussed evidence of manipulated data with the Justice Department, which he said was still considering whether crimes occurred.

“Once somebody loses his job or gets criminally charged, it will no longer be a game and that will be the shot heard around the system,” Griffin said.

The VA drew intensified public attention two months ago with reports of patients dying while awaiting agency care and of cover-ups at the Phoenix center. The VA, the country’s largest health care provider, serves almost 9 million veterans.

The House bill would let veterans facing long delays for appointments or living more than 40 miles from a VA facility choose to get care from non-agency providers for the next two years. Some veterans already receive outside care, but the bill would require the VA to provide it for veterans enduring delays or who live far away.

In Chicago, the American Medical Association added its voice, urging President Barack Obama to take immediate action to enable veterans to get timely access to care from outside the VA system. The nation’s largest doctors group also recommended that state medical societies create and make available registries of outside physicians willing to treat vets.

VA performance bonuses have also been an issue in recent disclosures. And the House bill would ban bonuses for all VA employees through 2016 and require an independent audit of agency health care. An earlier House-passed bill would make it easier to fire top VA officials.

Miller said VA would save $400 million annually by eliminating bonuses, money the agency could use for expanded care.

Senators have written a similar bill, which Senate Majority Leader Harry Reid, D-Nev., said his chamber would consider “as soon as it is ready.”

Senate Minority Leader Mitch McConnell, R-Ky., said the chamber should debate the bill immediately, instead of first considering a Democratic measure letting borrowers refinance student loans at lower rates.

“Veterans have been made to wait long enough at these hospitals,” McConnell said.

On Monday, the VA released an internal audit showing more than 57,000 new patients had to wait at least three months for initial appointments. It also found that over the past decade, nearly 64,000 newly enrolled veterans requesting appointments never got them, though it was unclear how many still wanted VA care.

The audit covered 731 VA medical facilities. It said 13 percent of scheduling employees said they’d been instructed to enter falsified appointment dates, and 8 percent used unofficial appointment lists, both practices aimed at improving agency statistics on patient wait times.

As a result, the agency said it was ordering further investigations at 112 locations where interviews revealed indications of fabricated scheduling data or of supervisors ordering falsified lists.

Sloan Gibson, the acting VA secretary, directed several steps to address Monday’s audit, including a short-term boost in medical services at overburdened facilities, including using mobile units.

The agency has contacted 50,000 veterans awaiting appointments and plans to reach 40,000 others to accelerate care, letting them choose VA treatment or local non-VA health care providers.

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Obama is reflecting on frequent mass shootings during a question-and-answer session on social media site Tumblr. He says the U.S. should be ashamed.

Obama says there’s no place else in the world where mass shootings are a once-a-week occurrence. He says the country must do some soul-searching.

Obama says he respects gun rights. But he says he was stunned after the Newtown school shooting that Washington couldn’t even pass universal background checks. He’s citing the political strength of the National Rifle Association and gun manufacturers.

Obama says until there’s public opinion a fundamental shifts, the problem won’t change. He says as a parent, that’s terrifying.

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The U.S.-Mexico border fence in Nogales, Ariz. on June 27, 2009. Photo by Flickr user Ryan Bavetta

Obama administration officials said Monday federal agencies are requesting more than $2 billion from Congress to pay for more shelters.

Unaccompanied migrants under the age of 18 are only supposed to be held in Department of Homeland Security facilities for fewer than 72 hours before they’re transferred to the custody of the Department of Health and Human Services. They are supposed to be housed in shelters run by that agency’s Office of Refugee Resettlement.

But a shortage of space in those shelters means the children have been languishing in facilities that are not equipped for them.

In the last eight months, border agents made more than 47,000 child apprehensions. That is more than a 90 percent increase from the same time period last year.

Many of these young migrants are fleeing violence and gangs in Central America. Some have heard rumors that U.S. immigration policy is lenient for children who cross alone.

The Obama administration has called this an “urgent humanitarian situation requiring a unified and coordinated federal response.”

Back in late May, before this issue became known publicly as a presidential priority, a 24-year-old Honduran migrant named Marleny Bueso Ponce was detained in a Border Patrol station in Arizona. There she met a boy who had been caught at the border without his parents.

“He was crying that he wanted to phone his mother, to tell her that he loved her, that he missed her,” Bueso Ponce said.

Bueso Ponce and her own child were paroled after a couple days, as has been typical for families apprehended at the border. But she says the boy stayed behind at the holding cell when she left.

She says the boy told her he’d already been held there for 11 days.

That would be a violation of a federal statute that says unaccompanied children must be transferred out of such DHS facilities within 72 hours.

Bueso Ponce’s account of the boy’s story can’t be verified. But Obama administration officials say cases like this one are happening. On Monday they acknowledged on a press call that migrant children have been held in short-term DHS facilities for longer than three days.

The officials spoke to reporters on the condition of anonymity.

“Border Patrol stations were not designed for any kind of long-term custody,” said Michelle Brané of the Women’s Refugee Commission in Washington, D.C. “They are completely ill-equipped to deal with anybody long-term, and they are particularly inappropriate for children to be in for any length of time.”

Brané said such facilities have no showers, beds or recreation areas.

“And not having a shower, for example, we have been hearing kids have been in facilities for up to two weeks,” Brané said. “That is a very long time to be in the same clothes you have traveled in and crossed rivers in.”

As the number of unaccompanied children crossing the border has surged, there hasn’t been enough space for them in HHS shelters. The federal government has been trying to set up more, but Brané says that doesn’t happen overnight.

“You need to find beds quickly but you also want them to safe,” Brané said. “So that is where I think this bottleneck is coming. Places need to be licensed. They need to have the appropriate staff caring for them. They need to have protection mechanisms for the children.”

Obama administration officials said, HHS is requesting an additional $2 million from Congress for this effort. DHS is also requesting an additional $160 million.

In the meantime, the federal government has been setting up emergency housing for child migrants on military bases in California, Texas and Oklahoma.

Over the weekend, federal officials started adding showers and other amenities at a processing center in Nogales, Arizona. It will serve as a way-station for up to 1,500 children at a time, before they’re transferred to more permanent sites.

Tony Banegas, the honorary Honduran consul in Arizona, visited the Nogales site over the weekend. Many of the children there had been flown in from South Texas, where they were apprehended.

Banegas said the conditions there were still a work in progress.

“They need mattresses, they need toothpaste,” Banegas said. “Better food, warm food.”

Banegas said he is grateful for the effort federal agents are making. But he says it is still very difficult for the children who are housed there.

“Some are young and they miss their family, they don’t know what is going to happen,” he said. “It’s scary.”

Eventually these children will be transferred to a shelter, and then may be reunited with family members or placed in foster care.

They’re still in deportation proceedings, though. So they’ll either be ordered to return to their home countries, or win the right to stay in the U.S.

Obama administration officials said they had planned for an increase in unaccompanied migrant children this year, but were caught by surprise by the size of the increase.

Central American women caught crossing the border with children are also overwhelming federal facilities in South Texas. Community shelters and churches in El Paso are helping to house these families after they are released from border facilities.


This story was reported by the Fronteras: Changing Americas Desk, a multimedia collaboration among seven public radio stations. It is led by KJZZ in Phoenix and KPBS in San Diego and funded by the Corporation for Public Broadcasting as part of its Local Journalism Center initiative.

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JUDY WOODRUFF: The international coalition in Afghanistan launched an investigation today after five U.S. special operations soldiers were killed, apparently by friendly-fire.

It happened in Zabul province in the south, and may be one of the worst such incidents in almost 14 years of the Afghan war.

For more, I spoke earlier with NPR reporter Sean Carberry, who’s in Kabul.

Sean Carberry, thank you very much for talking with us.

What is known exactly about what happened?

SEAN CARBERRY, NPR: Well, U.S. special operations forces and Afghan forces were carrying out a clearing operation in Zabul province, which is one of the more unsecured provinces in the country.

And according to Afghan officials, when the troops were on their way back to the base from this operation, it came under attack by Taliban militants. At that point, they called in for air support, and the airstrike apparently hit the friendly forces, killing five U.S. troops and one Afghan force.

NATO and U.S. officials have not officially confirmed that it was a friendly-fire incident. They have indicated they’re investigating that. However, Afghan officials said the airstrike hit the friendly forces, again, killing five U.S. and one Afghan troops.

JUDY WOODRUFF: So it’s not confirmed, but it sounds like the evidence points to friendly-fire. Is it known what type aircraft?

SEAN CARBERRY: Reports are that it was a B-1 bomber, so this is not an Apache helicopter or a gunship or something like that. So, this was most likely heavy munitions, a heavy bomb that would have been dropped in this instance.

JUDY WOODRUFF: Sean, we’re just a few days away from the presidential election runoff there in Afghanistan. What is the security situation there overall? You’re in Kabul.

SEAN CARBERRY: Well, security has tightened.

In the last few days, we have seen an increase in the number of checkpoints around the city. Security officials have said that they’re now on essentially high alert going into the elections. In terms of the security incidents, there haven’t been as many as people have been expecting. There have been fewer attacks than there were in the run-up to the first round of voting in April.

However, last weekend, militants did carry out a suicide attack against presidential candidate Abdullah Abdullah. He and his entourage survived. But that’s the most high-profile attack we have seen, but officials are expecting more violence for election day this year because it’s coming in peak fighting season, whereas the first round was at the tail end of spring and, at that point, the thaw hadn’t happened. Fighters weren’t as active at that point.

JUDY WOODRUFF: Sean Carberry, we thank you very much, talking to us from Kabul.

SEAN CARBERRY: You’re welcome, Judy.

JUDY WOODRUFF: U.S. officials in Washington declined comment on the incident, saying they are waiting for the investigation.

GWEN IFILL: Gunmen in Pakistan attacked a police training facility today near the Karachi Airport. It followed Sunday night’s Taliban assault that killed 26 people at the airport itself.

Today’s incident forced a temporary suspension of flights and triggered a brief shoot-out with security forces. But airport officials downplayed its severity.

AZAM KHAN, Director General, Airport Security Force (through interpreter): The wrong word was used, that there was an attack. There was no such situation. There was a firing incident, which was within our capability to manage. However, the word attack was used by the media, which created panic. You saw the response, police, rangers, army. Everyone was immediately here.

GWEN IFILL: The Taliban said it was also behind today’s attack and warned of more violence to come.

JUDY WOODRUFF: In Syria, infighting between an al-Qaida-linked group and other rebel factions has taken a heavy toll in recent weeks. The Syrian Observatory for Human Rights reported today more than 630 people have been killed in the east, near the Iraqi border, since the end of April. At least 130,000 others have fled the region.

GWEN IFILL: There was more fallout in Congress today over that prisoner swap that freed Army Sergeant Bowe Bergdahl in Afghanistan. The Senate’s number two Democrat, Dick Durbin of Illinois, said there was no time to notify lawmakers in advance because the deal to free five Guantanamo detainees in exchange for Bergdahl was finalized just one day before it happened.

But Republican Jeff Sessions rejected that reasoning after a closed briefing by defense officials.

SEN. JEFF SESSIONS, R, Ala.: I’m not satisfied in any way that Congress shouldn’t have been consulted in this matter. Just as a matter of courtesy, whether it was in law or not, a matter of this importance should have been discussed with at least key leaders in the Congress.

GWEN IFILL: Democratic Senator Carl Levin of Michigan came out of that same briefing, saying military leaders supported the prisoner swap.

SEN. CARL LEVIN, D, Mich.: Armed Services Committee Chairman: What the media has not carried, I think, is the critical question: Do our top military uniformed leaders support this agreement? Did they — were they involved in it? They assured me they were. And did they support it? They assure me they strongly support it because of the ethos of getting our people back.

GWEN IFILL: The House begins hearings on the Bergdahl release tomorrow. Defense Secretary Chuck Hagel will testify before the Armed Services Committee.

JUDY WOODRUFF: The House has voted unanimously to make it easier for veterans to get in to see doctors. The bill that passed today would pay for vets to get care outside the Veterans Affairs system, if they have had long waits or if they live more than 40 miles from a VA hospital. A similar bill is pending in the Senate.

GWEN IFILL: Crew members of the South Korea ferry that sank in April appeared in court today at an emotional hearing. Relatives of the more than 300 who died in the sinking wrestled with officials and packed the courtroom. Some shouted “murderer” when the captain entered. The 15 crew members face charges ranging from negligence to homicide for abandoning the ship.

JUDY WOODRUFF: And this is primary election day for six more states. Republican Senator Lindsey Graham of South Carolina and House Majority Leader Eric Cantor of Virginia are both expected to hold off Tea Party challengers. Primaries are also scheduled in Maine, Nevada, and North Dakota; and Arkansas is holding a series of runoffs.

GWEN IFILL: Wall Street had a relatively quiet day. The Dow Jones industrial average gained not quite three points to close near 16,946. The Nasdaq rose more than one point to close at 4,338. And the S&P 500 slipped half-a-point to end at 1,950.

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JUDY WOODRUFF: In a major blow to the government of Iraqi Prime Minister Nouri al-Maliki, and to that country’s stability, Sunni militants have taken over Iraq’s second largest city.

The militants, also known as ISIS, or ISIL, captured military depots, equipment and weapons in Mosul. They also seized provincial government headquarters and freed more than 1,000 prisoners. Thousands of residents fled north toward the Kurdish autonomous region, jamming roads. Some were Iraqi soldiers, who left their uniforms in the streets.

In Baghdad, newly-reelected Prime Minister Nouri al-Maliki addressed the most serious challenge yet in his eight-year tenure.

NOURI AL-MALIKI, Prime Minister, Iraq (through interpreter): I call upon the parliament to live up to its responsibility to declare a state of emergency and general mobilization. We have to declare a comprehensive mobilization and the highest alert in political, financial and popular capabilities to defeat terrorism and bring life to normal in all areas occupied by terrorists, either in Mosul or any other city.

JUDY WOODRUFF: But Maliki’s Shiite-led government has largely failed in reconciling with Iraq’s Sunni population. The Islamic State has taken advantage of the breach. The Sunni extremist group previously took over Fallujah and parts of Ramadi in western and central Iraq.

It’s also a principal combatant in Syria’s civil war, but has fought against other rebel groups as fiercely as many of its units have fought against the army of President Assad. The group’s ambitions there have led to a rupture with al-Qaida’s core organization, which sides with the Syrian rebellion.

The attack on Mosul now threatens to draw nearby Kurdish forces into the fighting as well.

That drew this reaction from the U.S. State Department today.

JEN PSAKI, State Department Press Secretary: The threat ISIL is presenting is not just threat to Iraq or the stability of Iraq, but it is a threat to the region. And this growing menace exemplifies the importance of Iraqis from all communities working together to confront this common enemy.

JUDY WOODRUFF: Iraq’s parliament has announced it will meet Thursday to decide on a state of emergency.

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JUDY WOODRUFF: For more on what this takeover means for Iraq, for the region and beyond, I’m joined by Laith Kubba. He’s senior director for the Middle East and North Africa at the National Endowment for Democracy. And Kimberly Kagan, she’s president of the Institute for the Study of War.

So, Kimberly Kagan, let me start with you.

We know these insurgents have been creating havoc for some time, launching attacks. How important is this particular attack, taking over the city of Mosul?

KIMBERLY KAGAN, Institute for the Study of War: This attack that the Islamic State of Iraq and Sham, or the Levant, has launched on Muslims is incredibly important, because it is the beginning of a campaign and a push beyond Mosul into the areas toward Baghdad that the Islamic State of Iraq wants to govern.

It seeks to establish an emirate or a state and govern terrain inside Iraq, as well as governing the terrain inside of Syria, in Raqqa, where it has announced the beginning of its emirate. I believe Mosul will be its new capital.

JUDY WOODRUFF: Laith Kubba, how do you see it? And why is this happening now? How is it that this insurgent group has gotten to this level of where they can wreak this kind of chaos in the country?

LAITH KUBBA, National Endowment for Democracy: Well, over the last two years, I think they have been growing steadily.

All the signs were there. Nobody wanted to read them. They moved from being an offshoot, a terrorist group — and there, people might think we can live with terrorist groups and the skirmishes they create, but this has become an army of 10,000 to 15,000, very well-equipped with rocket launchers, some air missile — missiles, and they are so coordinated

I think they have become a magnet for more soldiers to join them. This latest attack, not only one attack — it’s coordinated attacks on five cities in Iraq — has given them immense momentum and credibility, and they’re going to become a serious threat to the region.

I’m not really sure if they can hold territory for long, but certainly they have achieved their objective in saying, we’re a force, and I think hundreds will join them, and this is going to become a regional problem.

JUDY WOODRUFF: Kimberly Kagan, how did they get to this to have this capability? Because it wasn’t the case when the U.S. pulled out of Iraq.

KIMBERLY KAGAN: The Islamic State of Iraq is no longer a terrorist group. It is an army.

It is an insurgency, and it has grown in its capabilities inside of Iraq by really fielding an army, by freeing prisoners that were held in Iraqi prisons, by testing the Iraqi security forces, by taking control piecemeal.

And if we try to confront it as a terrorist organization, we will misunderstand its nature. It is an insurgency. It is fighting for terrain, and it has really come of importance as Prime Minister Maliki started to exclude Sunnis from his government and create resentment among the Sunni population in Iraq.

JUDY WOODRUFF: And that’s what I want to ask you about, Laith Kubba. What is the role of the Maliki government, in that this is happening under their noses?

LAITH KUBBA: I think there are two elements here.

There is one element — the emergence of ISIS is very much a product of what is going on in Syria. But I think…

LAITH KUBBA: But I think the failure of politics in Baghdad and the failure certainly of the Iraqi army is a direct result of what’s going on in Baghdad.

Bear in mind, the prime minister is the commander in chief. He’s been prime minister for eight years. Iraq is an oil-producing country. And its army could not stand their ground in front of hundreds of attackers? Just think of a country that managed to keep Iran at check for eight years, where the same country now is not capable of keeping an insurgency at check?

I think, for Iraqis, this is an evidence that something is fundamentally wrong in the way their country is governed. Even the electoral process that is repeated over and over again is not producing a good government.

JUDY WOODRUFF: Kimberly Kagan, what’s to stop them, ISIS, or ISIL, depending on what you call them, from just going — doing what they want and taking over any territory they want?

KIMBERLY KAGAN: I think that the organization has momentum.

The organization has aimed for a year to dissolve the Iraqi security forces and has named a campaign, the soldiers’ hardest campaign, that it’s been conducting for a year with that goal. I think that the Iraqi security forces are breaking and will continue to break, even though Prime Minister Maliki has declared a state of emergency.

And the only question now is, are they able really to defend Baghdad and its environs? And will they be able to mobilize, as they already have, Shia militants grouped backed by Iran and trained by Hezbollah that have fought in Syria in order to defend the Shia areas of Baghdad and south of Baghdad that Maliki relies on?

JUDY WOODRUFF: Is that what we are looking for, some kind of showdown around Baghdad?

LAITH KUBBA: Well, just to emphasize the point, Iraq, Iraqis expect a state with an army, not militias that are sponsored or sent to Syria to fight or called upon to defend a city.

Iraq should have an army, and I think it’s a sign of how far things have gone to see militias roaming trying to defend cities.

JUDY WOODRUFF: Less than a minute, but both of you — Laith Kubba, to you first.

Effect on the region? Why does this matter in the broader region? You have got the civil war going on right next door in Syria. The effect on countries in the area?

LAITH KUBBA: The fact that this army now controls territory, so well-equipped and so capable and with momentum, I would worry about Jordan, because that’s a very soft front. They can push there any time. And this group now is increasing in numbers and sophistication.

They’re going to be there for a long time.

JUDY WOODRUFF: And, again, the same question I asked a minute ago, what’s to stop them from just marching and going where they want?

KIMBERLY KAGAN: Well, I certainly hope that the Iraqi security forces can stop them, but, realistically, what we see now is a safe haven that has developed in Iraq and Syria from which Islamist militants can both launch attacks and train foreign fighters and send them out, and also govern terrain and oppress people.

That is precisely the kind of safe haven that this administration and its predecessor have stated that the United States will not tolerate in the region.

JUDY WOODRUFF: And that of course raises questions that we will be continuing to look at and want to ask about in the days to come.

Kimberly Kagan, Laith Kubba, we thank you both.

LAITH KUBBA: Thank you.

KIMBERLY KAGAN: Thank you.

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GWEN IFILL: Former Secretary of State Hillary Clinton headed back out on the trail today, not for a political campaign, but to support her new memoir.

The book tour formally began this morning, with the author arriving at a Barnes & Noble in New York to applause and an army of cameras. But the buildup started weeks ago.

HILLARY RODHAM CLINTON, Former Secretary of State: It’s really about the hard choices everybody has to make in life.

GWEN IFILL: After days of leaks and secretly purchased advance copies, Hillary Clinton’s second memoir, “Hard Choices,” is now officially on the bookshelves.

In New York today, book buyers lined up to meet the former first lady, senator and secretary of state. The carefully-orchestrated rollout only stokes speculation that she is launching a 2016 presidential practice run. She’s on the cover of “People” magazine. She’s made high-profile appearances at a number of recent forums.

And she’s sitting down for a slew of television interviews, starting last night with ABC News’ Diane Sawyer.

DIANE SAWYER: When are you going to decide whether you are running for president?

(LAUGHTER)

HILLARY CLINTON: You know, I’m going to decide when it feels right for me to decide, because…

DIANE SAWYER: Still by the end of this year?

HILLARY CLINTON: Well, certainly not before then.

I just kind of want to get through this year, travel around the country, sign books, help in the midterm elections in the fall, and then take a deep breath, and kind of go through my pluses and minuses about what I will and will not be thinking about as I make the decision.

GWEN IFILL: In that same interview, Clinton said she made millions in paid speeches because she and former President Bill Clinton were dead broke when they left the White House in 2001.

After Republicans said this proves Clinton is now out of touch with average Americans, she returned to ABC this morning to defend herself.

HILLARY CLINTON: I fully appreciate how hard life is for so many Americans today. It’s an issue that I have worked on and cared about my entire adult life.

Bill and I were obviously blessed. We worked hard for everything we got in our lives, and we have continued to work hard and we have been blessed in the last 14 years. But I want to use the talents and resources I have to make sure other people get the same chances.

GWEN IFILL: Early reviews have been decidedly mixed.

The New York Times called it a “subtle, finely calibrated work.” The Washington Post described it as “a careful book,” and Slate said Clinton goes on at great length, but not great depth. Part travelogue and party policy treatise, “Hard Choices” clocks in at 600 pages, focusing largely on Clinton’s time as secretary of state.

It includes photos from Clinton’s time campaigning for President Obama, working with Vice President Biden, who is also considering a 2016 run himself, as well as her meetings with world leaders from Africa to Asia.

For more on the rollout of Mrs. Clinton’s memoir and what it might tell us about her future in politics, we are joined by Ann Lewis, a longtime adviser to both Hillary and President Bill Clinton, Chris Lehane, a Democratic strategist who worked in the Clinton administration, and Amy Chozick, national political reporter for The New York Times who is covering Mrs. Clinton.

Amy Chozick, words that come to mind are orchestrated, calibrated, structured, this rollout. How organized is it?

AMY CHOZICK, The New York Times: Absolutely.

I think it was incredibly well-thought-out, right up until the Mother’s Day excerpt about Hillary Clinton’s mother, Dorothy Rodham, that was kind of our introduction to the book, and also showed a very softer side of her, I would say, and it just continued from then, the “People” magazine cover, right up to today, the event at Barnes & Noble in New York.

GWEN IFILL: What was that like? Was it crazy?

AMY CHOZICK: It was insane. There were 1,000 people outside. A lot of people had slept out front ready for Hillary. The outside group had a giant bus that looked like a campaign bus signing people up.

I talked to a woman who pulled her 11-year-old daughter out of school to attend. So it definitely had the sort of feel and enthusiasm of a campaign. That said, of course, this was the middle of downtown Manhattan, so not exactly a proxy for a nationwide presidential campaign.

GWEN IFILL: Ann Lewis, you have been involved in Ready for Hillary since it kicked off. Ready for what, exactly?

ANN LEWIS, Former Clinton Adviser: Whatever Hillary Clinton decides to do.

I think Ready for Hillary, which now has about two million members or more, growing every day, said, here’s this wonderful public servant. And anybody who reads the book is going to see how much Hillary Clinton cares and policy, about doing the right thing, how proud she is of our country.

We want her to go as far as she would like to go. And we want her to know that, if she wants to go further, we will be there.

GWEN IFILL: Is it just me, or does this seem to be much more carefully rolled out, structured, not — if not in collaboration with Ready for Hillary, but certainly much more — done with more of an eye of the political future than the last book rollout in 2008?

ANN LEWIS: Well, the last book, after all, was in a very different climate.

And if you go back and look — and, by the way, a different media landscape. Look at all the ways we’re talking now about the book that didn’t exist for the last time. There was no Twitter at the time, right, that says Hillary’s book.

So you got — there’s a very high-tech, very sophisticated kind of conversations that are going on throughout I guess the blogosphere, and then you have also got the low-tech like the bus. Doesn’t get much more low-tech than that.

GWEN IFILL: Chris Lehane, you have a candidate here, presumably, or potentially a candidate, with 100 percent name recognition.

How do you handle — if this is indeed a political rollout as well as a literary one, how do you handle that differently from any other candidate?

CHRIS LEHANE, Democratic Strategist: Yes, great question. I’m not sure whether the book will or will not be the political equivalent of “War and Peace,” but it’s certainly been handled about as well as you could, at a “War and Peace” level.

And by that, I mean, what I think is really smart, and I think probably informed a little bit by Hillary Clinton’s experience in the 2008 presidential campaign, if this is really an effort to control the narrative, define herself on her own terms.

And even the timing of this, right — typically, presidential aspirant books, if that is indeed what this may or may not be, typically those happen a year out. This is happening several years out, goes to the fact — I think Ann was alluding to this — that we live in a perpetual campaign world.

And it’s really imperative to control, own, drive your narrative, your profile, your character definition. And even down to the title of this book and the content, she’s doing that, and I think it’s a smart strategy and the execution has been extremely effective.

GWEN IFILL: Amy Chozick, but the execution also includes getting in front of interviewers and answering questions in ways that might kind of take you off topic.

Like, she was asked last night about Monica Lewinsky. She’s been asked Benghazi and she made the comment to Diane Sawyer that she and Bill Clinton needed to earn that money in order to pay for their houses and their mortgages, which Republicans jumped on. So there’s also a potential for some slip-ups here.

AMY CHOZICK: Yes, absolutely.

And I was actually — I actually welcomed the slip-ups, because I thought that signaled that if she’s a candidate in 2016, maybe she won’t be so scripted and everything that she says is polled, to figure out how Americans feel about it before she utters every line.

I kind of found the gaffe sort of refreshing in a way, at least as a political reporter.

GWEN IFILL: So, Ann Lewis, you have been through a lot of this with the Clintons. And I wonder if part of this isn’t also trying to define yourself before everybody races in and defines you on just the kinds of issues that we were just talking — that have now been described as her gaffes.

ANN LEWIS: Yes, good point.

Let me say, I think the first part of it is Hillary Clinton talking about the last four years. As secretary of state, she was really America’s ambassador to the war. She wants people to know why that is so important. We need to be leaders. Here’s what’s at stake. Here are all these countries and comments.

And she wants to do it in her own voice. This is something she cares about very deeply. And people who read the book are going to get that sense from her, both the policy, the substance, but also the personality she brings to it. She can do that better for herself than anybody else can talking about her.

GWEN IFILL: Chris Lehane, you talked about the title of the book, “Hard Choices.”

One of the things she said today, yesterday — there have been so many interviews, it’s hard to keep track, but she said hard choices are what presidents do. That’s the closest she’s come, it seems to me, in saying that “Hard Choices” is about considering the presidency.

CHRIS LEHANE: Yes, well, as we were talking about, right, that sometimes you’re not supposed to judge a book by its title, but I think in these types of books, there’s an awful lot to the title, because ultimately what you’re trying to do is to give folks a sense of who you are as a person.

And particularly if you end up being a presidential candidate — and she obviously has been one before and has a lot of experience — that sort of breaks into two categories. One is your character, your personality, and the other is your vision for the country, and I think the title “Hard Choices” sort of does a good job of encapsulating both.

By the way, it would fit very nicely on a bumper sticker. And I think, again, it is a smart way to package all of this, and at the end of the day, she is talking about the fact that when you are a president or you are secretary of state or you are in the U.S. Senate, that you do have to make hard choices.

That is part of being a leader. And again I think this goes to both elements, the character, personality, who she is, but also that vision for the country. And, you know, based on what I have seen from the book, she is talking retrospectively about her four years, but extrapolating from that in terms of what she cares about and how potentially she would look at issues prospectively. So I think it does a very good job of both.

GWEN IFILL: Chris, I want to ask you this, and Amy as well.

You have both talked to enough people inside Hillary-land to know, to answer this. Is there anybody who doesn’t think that she’s running?

First, Chris, then Amy.

(LAUGHTER)

CHRIS LEHANE: Well, I think that, every single signal and sign out there would certainly suggest that she’s doing everything possible to make sure that she’s in a position to run.

Obviously, I defer to her. It’s her choice, and I think we all recognize it and respect that. But this book — I mean, this book, to me, is a prism by which you can evaluate the process and the approaches that she’s taking. And it’s certainly indicative of someone who’s doing everything possible to put themselves in the strongest position to be able to say, yes, indeed, I am a candidate for president in 2016.

GWEN IFILL: Amy, as you do your interviews and you talk to people, and you devote so much time to tracking her footprints, anybody say, no, she’s not going to do it?

AMY CHOZICK: A source yesterday told me that it now looks like 99 percent sure — that this person was sure that she was running.

Another source told me that, the duller the book, the more chance that she’s running. So read into that what you will. But I do think that there is thinking that the book was cautious, so that she could leave her options open.

Of course, there are friends of hers, Cheryl Mills being a key one, who have said that they don’t want her to run, that they worry about the scrutiny of the campaign, and they just want her to kind of enjoy her life.

GWEN IFILL: Does it freeze the field for other Democrats who might be considering it, Amy?

AMY CHOZICK: She — it was interesting, because Clinton addressed this in one of the interviews, and she said that she wasn’t worried that it was freezing out the field.

But I definitely do think that the party is anxious for her to make up her mind, and so that they can get behind someone else if for any reason it is not her.

GWEN IFILL: Ann Lewis, what’s the hardest choice Hillary Clinton has to make between now and, say, the end of the year?

ANN LEWIS: Well, I think by the end of the year — and she has referred to this — she will probably have to decide whether, in fact, she’s going forward.

Can I stop for a moment and disagree? I almost never disagree with Amy. And she’s been a great observer on this. But I think people who read this — and a lot of people are going to read this book — will not think it’s dull. You know, it is — could more interesting…

AMY CHOZICK: I don’t think it’s dull. I’m just saying this person said that.

ANN LEWIS: Oh, good. All right.

(LAUGHTER)

ANN LEWIS: I just want to get that on the record.

GWEN IFILL: She’s leaving open the possibility it may not be exciting.

ANN LEWIS: Oh, I think it is going to be thrilling.

But going beyond that, the hardest choice — and Hillary Clinton has said this — she is right now in, for her, a very unusual place. That is, she can take her time when she gets up in the morning. She can go out and walk. She can spend that time with her husband.

She really, at the same time, has this opportunity to step forward, to be a leader again for the United States. She has to decide that. And, again, nobody should underestimate. That is a very tough choice.

GWEN IFILL: Well, and a lot of people are weighing pro and con to see what she does with that choice.

Ann Lewis, Amy Chozick, Chris Lehane, thank you all very much.

CHRIS LEHANE: Thank you.

AMY CHOZICK: Thanks for having me.

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JUDY WOODRUFF: The battles over whether to expand Medicaid coverage under the federal health care law are still playing out in a number of states this summer, the latest, Virginia, where Republicans in the state Senate grabbed control of that chamber yesterday, and prevented Governor Terry McAuliffe, a Democrat, from opting into the expansion.

Meanwhile, there are a handful of states, including Indiana, Pennsylvania and Utah, where Republican governors are considering participating in Medicaid expansion, but only with more requirements and restrictions from those who would be covered.

So far, 26 states, plus the District of Columbia, have agreed to expand. The Obama administration says six million people have gained Medicaid coverage. But there may be nearly two million waiting for their applications to be processed.

Julie Rovner, who is now with Kaiser Health News, joins us now.

And welcome back to the program, Julie.

JULIE ROVNER, Kaiser Health News: Nice to be here.

JUDY WOODRUFF: So, why have some states still not made a decision about whether to expand Medicaid?

JULIE ROVNER: Well, of course, they don’t have to. In 2012, the Supreme Court said that this was optional. This, of course, was not going to be optional as the health law was passed.

The health law expected and anticipated that every state would expand Medicaid. Congress of course knew when it passed the law in 2010 that states didn’t have a lot of extra money lying around to help pay for Medicaid, which is of course a shared program between federal and state governments. Basically, the federal government pays a little more than half of the cost for it.

But the federal government said that for this expansion population, they would pay 100 percent of the cost for the first three years and it would phase down to 90 percent, so it would still be most of the cost going into perpetuity, but when the Supreme Court made it optional, half the states, as you pointed out, jumped in, and the other half, most of them Republican states, have said, we don’t even know if we can afford that 10 percent that we would have to kick in after the three years, when it’s going to be, you know, fully federally funded.

So, they’re still arguing about in the states.

JUDY WOODRUFF: And as we were just pointing out, in one of these states where it’s on the cusp, they’re trying to figure out what to do, Virginia, with a new Republican governor, having had…

JULIE ROVNER: A new Democratic governor.

JUDY WOODRUFF: I’m sorry, a new Democratic governor, having had a Republican governor — the state legislature, state Senate, now has this switch, a very unusual situation there.

JULIE ROVNER: Yes.

Well, of course, the new Democratic governor ran with this as his number one priority to expand Medicaid, and, of course, it’s a Republican House, and it was a split. The Senate, it was 50/50, with, of course, the lieutenant governor being the deciding vote. So this one resignation by this state senator has slipped the state Senate to the Republicans.

And basically there’s this budget standoff. And it could have — it was thinking that it was going to close — shut down the state over the budget. Now, of course, it looks like the budget will not have the Medicaid expansion it in, much to the dismay of the Democratic governor.

JUDY WOODRUFF: Terry McAuliffe.

JULIE ROVNER: There is still a possibility — that’s right. There is still a possibility that there could be a special session, that Medicaid could come back.

There are a couple of moderate Republicans in the Senate who do support the Medicaid expansion, but certainly it puts it in much more doubt, just with this one expected and unknown-why resignation.

JUDY WOODRUFF: But when — but then you have, Julie, these other states that are trying to figure out, Republican governors, Utah, Pennsylvania, Indiana, just to name a few of them, politics peculiar to each state in play in every one.

JULIE ROVNER: Yes, and we’re starting to see kind of a theme with these Republican governors who would like the federal money.

It’s a lot of money for a large uninsured population in many of the states. Pennsylvania has perhaps 400,000 people who could be covered. And what many of these Republican governors are doing — we have seen this in Iowa already — is they’re saying, OK, we want to expand Medicaid, but we want to do it our way. So we want to have perhaps these people go into private plans. We have already seen that in Arkansas.

We want to have these people perhaps pay a little bit more in cost sharing, so have this low-income population pay something for their coverage. That’s not traditionally been allowed in Medicaid. And we want to have perhaps incentives for them to have — do healthy behaviors, maybe stop smoking or lose weight.

So those tend to be the kinds of things they’re asking for, and they haven’t necessarily got that yet from the federal government.

JUDY WOODRUFF: And what is the pushback that you’re hearing from advocates for the poor, who say even a small amount that some of these folks are required to pay can prevent them from having access?

JULIE ROVNER: Well, there’s a large body of research that suggests that cost sharing does deter people from getting care and it particularly deters poor people from getting care. And there’s a concern that if — that even if you put small amounts of cost sharing on, that people who need care, particularly people with chronic ailments, won’t get that care, so it can be counterproductive

And they’re very concerned about the idea of having — quote, unquote — “skin in the game” for the Medicaid population in particular.

JUDY WOODRUFF: So while those dramas play out and with very real consequences, just quickly, Julie, this notion that there are several million people who have applied for Medicaid don’t have their applications responded to yet.

JULIE ROVNER: That’s right. And this is partly because in putting in the Affordable Care Act, every state had to change the way it calculated eligibility for the Medicaid population.

This was to basically make it standardized across all of the states. And so basically, as of January 1, every state had to change the way it calculated eligibility. Also, there was some difficulty in healthcare.gov, the Web site, reporting — basically sending the information to the states and getting it back and forth.

So there is this backlog. Most of it turns out to be in California and Illinois, two big states. This was some work done by my Kaiser Health News colleague Phil Galewitz. But there’s also a backlog, it turns out, in some states that didn’t expand Medicaid, states like North Carolina, and Georgia. Hopefully, just over the next few weeks, as these states get their I.T. problems straightened out, the backlog will dissipate, if not go away.

JUDY WOODRUFF: Julie Rovner, always on top of it, thank you very much.

JULIE ROVNER: Thank you.

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GWEN IFILL: Teachers unions lost a major court case in California today, which could make it easier to fire ineffective teachers. A California judge ruled that the state’s tenure protections for public school teachers are unconstitutional.

We begin with some background.

Los Angeles Superior Court Judge Rolf Treu struck down three laws, saying they offered teachers job security at the expense of many students.

Elizabeth Vergara and her sister Beatriz are two of the students who brought the complaint. A year apart in age, they attend the same Los Angeles area high school. The sisters told the NewsHour this spring that when they were in middle school, they both sat through a history class taught by the same ineffective teacher:

ELIZABETH VERGARA, Plaintiff: He would just be at his desk, like, just using his computer or sleeping. I didn’t even learn anything. Like, I was getting behind.

GWEN IFILL: In 2012, they joined with seven other California students to file suit against the state, saying their education suffered because teacher and tenure laws prevented schools from acting in their best interest.

Teachers are eligible for tenure in California after 18 months. The students sought to get rid of that and other laws, including seniority protections and dismissal procedures they say allow poorly performing teachers to stay in the classroom.

But attorneys for the state and teachers unions told the judge the laws are key to recruiting and retaining a skilled teaching force, and were meant to ensure educators aren’t dismissed unfairly.

Fourth grade teacher Kelly Iwamoto considers that due process protection crucial:

KELLY IWAMOTO, Teacher: Because I speak out very frequently about resources being brought to our district, for lowering class sizes. And if I’m vocal, and then someone doesn’t like what I’m saying, then I can be let go for that. And I don’t think that’s fair.

GWEN IFILL: Several other states have either eliminated or limited tenure protection through law or union contracts. Lawyers for the state said they plan to appeal today’s ruling.

Now to the decision’s potential impact.

Russlynn Ali serves as an advisory board member of Students Matter, which represented the plaintiffs. She is a former assistant secretary for civil rights at the Department of Education. And Joshua Pechthalt is the president of the California Federation of Teachers, one of the key parties who lost in today’s ruling.

Joshua Pechthalt, there are six million students in California, 325,000 students. Is this the beginning of the end of teacher tenure?

JOSHUA PECHTHALT, President, California Federation of Teachers: No, I don’t think so.

We’re going to appeal this. And I think even more importantly, we’re going to continue to work with parents and community around a vision for a quality public education that both raises up kids and also values the men and women who work with them, which is the complete opposite of what this ruling attempts to do.

GWEN IFILL: Russlynn Ali, how do we know that it’s the teachers who are failing the students and not something else?

RUSSLYNN ALI, Former Assistant Secretary, U.S. Department of Education: Well, what the judge decided today, made it quite clear that, taken together, the statutes that guarantee lifetime employment after 18 months that don’t look at factors like whether teachers are actually teaching kids and whether they’re learning, statutes that make termination nearly impossible, costing hundreds of thousands of dollars, and statutes that ensure that those most new to the profession are first fired, and any time there needs to be a reduction of force for budget reasons, that, taken together, those statutes violate the quality right to an education guaranteed by California’s Constitution.

GWEN IFILL: Joshua Pechthalt, there are those who say that this is about funding. Is that part of the problem?

JOSHUA PECHTHALT: Well, I think funding is — yes, I think funding is a big part of this.

It’s funny that we’re going to — at least if the Vergara plaintiffs have their way, we are going to shape education policy based on layoffs. The California Federation of Teachers and the California Teachers Association worked very hard to pass a progressive tax measure which stopped massive years of budget cuts.

And more obviously has to be done. But we know the solutions for public education. We know what works. We have districts that are successful. We have schools that are successful. And in those districts and in those schools, it’s where the community works collaboratively.

Education is a collaborative endeavor. The slogan it takes a village to educate a child, that happens in a cooperative way, not by attacking teachers and teacher rights.

GWEN IFILL: Can I ask you something from something from the judge’s ruling today, in which he talked about the last hired, first fired part of the statute? And he said it was clear to him that keeping a senior and incompetent teacher was preferable to keeping a junior — or to letting go a junior effective teacher. What do you say to that argument?

JOSHUA PECHTHALT: Well, so, number one, we don’t want to see any teachers let go during layoffs.

So, that’s the most important point. But the reason to have seniority is because seniority creates an objective criteria for determining who’s in the classroom. If it’s about teacher effectiveness, that’s very subjective. And, really, what these folks ultimately want to get at is evaluating teachers based on test scores.

That’s the only measure that they are going to be able to come up with when you’re assessing thousands and thousands of teachers in a particular district. And we have seen years now of having test scores drive an educational curriculum. It distorts what happens in the classroom. It narrows the curriculum, and it’s not good education policy. And these folks are — have the money and resources to follow that agenda.

GWEN IFILL: Let me allow — pardon me, but let me allow Russlynn Ali to respond to that.

Is there another agenda at work here?

RUSSLYNN ALI: The only agenda that the plaintiffs in this case, that the lawyers, that all of us, it’s about what is right for students. This is not about pitting students against teachers.

That — Josh, that it would be framed that way, it does a disservice to what we all need to, as California citizens, want to accomplish. And that is to ensure that our students have access to the best and most motivated teachers, that they are inspired to learn, that we transform the way our schools work, so that everyone learns better.

GWEN IFILL: And do you judge that by test scores?

RUSSLYNN ALI: Well, we ought not use quality-blind determinations, right?

This notion that seniority and how long you have been in the profession is all that guarantees whether you stay in the profession or get promoted in the profession is quality-blind. We are not talking about widgets. We are talking about children and their lives. We need to know whether they are learning. That is not to suggest that we ought to use test scores alone, but as part of an evaluation system that gauges true learning in the classroom, we ought to look at the assessments that we give kids.

GWEN IFILL: Joshua Pechthalt…

RUSSLYNN ALI: Joshua also intimated that…

GWEN IFILL: I’m sorry.

RUSSLYNN ALI: Joshua also intimated that we were deciding policy based on layoffs, right?

What happens today is policy decided based on layoffs. The churn factor, that is, that in schools that serve mostly students of color, are some of our lowest-performing students and our highest-poverty schools. They suffer vacancies at a rate that is extraordinary. Those students in Los Angeles, for example, are at 68 percent more likely to have a grossly ineffective teacher if they are English-language learners.

They’re almost as likely to have an ineffective teacher if they are African-American students. We are talking about equity. We are talking about justice. Those principles ought not to fly in the face of what is in the best interest of teachers. What is in the best interest of students is in the best interest of teachers. These laws are not.

GWEN IFILL: We have less than 30 seconds, Joshua Pechthalt. What are the prospects for appeal?

JOSHUA PECHTHALT: Well, we are hopeful.

And we think the evidence is compelling that blowing up the education code in California doesn’t help with equity. If it — if doing away with seniority and due process rights was so effective, then why is it that in the states where these rights don’t exist for teachers, education is also suffering, and it’s suffering for poor and working-class kids?

There are obviously other, more compelling reasons that shape public education, not simply the teacher in front of the classroom. We want the best teachers in front of the classroom, and we want to put the resources in to raise everybody up, not create mechanisms for getting rid of people.

GWEN IFILL: We will see what happens with this in the next — now the judge has put a stay on its enforcement.

Joshua Pechthalt and Russlynn Ali, thank you both very much.

JOSHUA PECHTHALT: Thank you very much.

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JUDY WOODRUFF: Finally tonight: Across the country, there’s a new effort under way to preserve America’s historical sites, while at the same time teach a new generation the art and the importance of that work.

Jeffrey Brown has that story, part of his ongoing series Culture at Risk.

They have been renovating the Skyland Stables, which for generations have provided national park visitors with horses to ride along 200 miles of equestrian trails. This is the pilot project of the Hands-On Preservation Experience, or HOPE Crew, a new nationwide initiative from the National Trust for Historic Preservation.

Monica Rhodes is its volunteer coordinator.

MONICA RHODES, National Trust for Historic Preservation: What the National Trust hopes to bring to this — through this new initiative is an opportunity for a younger, more diverse audience to get involved with these buildings, to really interact with their environment and contribute to their country.

JEFFREY BROWN: The Trust is partnering with the National Park Service, the Corps Network and other groups to bring a new generation into the preservation fold across the country.

In this case, water damage and wear from the horses had damaged some of the wood on this rustic U-shaped stable. It also needed a new fence.

MONICA RHODES: There are number of historic buildings in the nation. The Park Service alone has about a $4.5 billion backlog of deferred maintenance, so these are historic buildings that are in need of repair and rehabilitation right now.

JEFFREY BROWN: Working with an expert craftsman, a team of students carried out the restoration work. Many are from cities far from the mountains, now studying at the Harpers Ferry Job Corps Center in West Virginia.

JARMAINE BUDD: I’m not used to being around horses. So, yes, their loud noises are pretty startling.

JEFFREY BROWN: While staying nearby, students like Jarmaine Budd earn $10 an hour, far less than the $40 to $60 an hour a contractor might charge. In exchange, they get hands-on experience in a new kind of work, which Budd says requires greater attention to detail.

JARMAINE BUDD: The challenging part about it is the matching of the wood. And the cuts are a little rougher. And some of the cuts have to be a little more cleaner and more precise than inside a house, where a little half-inch, you won’t really tell that difference, but, out here, it’s a big margin.

JEFFREY BROWN: Elijah Smith is from Washington, D.C.

ELIJAH SMITH: I think it’s important to save old buildings, because when you go back, you can see what you did right, what you did wrong, how you want to add ideas to it. And the older something is, the more value it is to it. It brings more people to it.

JEFFREY BROWN: In the 1930s it was the Civilian Conservation Corps, under President Franklin Roosevelt, that originally built the national park.

During that time, the stables and the nearby Skyland resort were also purchased by the National Park Service. To preserve them for new generations to come, craft expert David Logan, who owns a vintage restoration company in Virginia, says the HOPE Crew has done the heavy lifting.

DAVID LOGAN, Vintage, Inc.: What I have done is guided the team just on some approaches for replacing siding, ways of cutting out the old, and then how to handle the oak to let it move, and just little tips and advice.

JEFFREY BROWN: But he sees a real dearth of young people learning his trade.

DAVID LOGAN: In our area, the people that are really skilled are from 40 to 65. We rarely get young people coming into this field, and I think that’s very unfortunate.

JEFFREY BROWN: From a conservation standpoint, Logan argues that older structures like these deserve to be saved.

And student Nicholas Edwards agrees.

NICHOLAS EDWARDS: You are using more lumber to make a new building. And then, if you can use something’s that been standing up there for a while, it could be there for a little bit longer.

JEFFREY BROWN: Monica Rhodes says, in addition to conservation, this work is about preserving history and the memories people have for a place.

MONICA RHODES: It’s continuity. You know, it continues a historical conversation that started in the late ’30s into 2014. So it really contributes to a sense of what Shenandoah National Park is.

JEFFREY BROWN: She hopes upcoming projects like this one, in Missouri, Texas, New Mexico, and Montana, will help instill those values and inspire more people to go into this field.

For his part, Jarmaine Budd says he wants to do more preservation work. And after this project is complete, he hopes to return to the stables to see how his own work has held up over time.

JARMAINE BUDD: Come back to a place that we helped do, that we built, to show everybody else, this is what we did.

JEFFREY BROWN: Creating another connection to the park and to history.

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Photo by Andrew Harrer/Bloomberg via Getty Images

Cantor is the second-most powerful member of the U.S. House and was seen by some as a possible successor to the House speaker.

His loss to Dave Brat, a political novice with little money marks a huge victory for the tea party movement, which supported Cantor just a few years ago.

Brat had been a thorn in Cantor’s side on the campaign, casting the congressman as a Washington insider who isn’t conservative enough. Last month, a feisty crowd of Brat supporters booed Cantor in front of his family at a local party convention.

His message apparently scored well with voters in the 7th District.

“There needs to be a change,” said Joe Mullins, who voted in Chesterfield County Tuesday. The engineering company employee said he has friends who tried to arrange town hall meetings with Cantor, who declined their invitations.

Tiffs between the GOP’s establishment and tea party factions have flared in Virginia since tea party favorite Ken Cuccinelli lost last year’s gubernatorial race. Cantor supporters have met with stiff resistance in trying to wrest control of the state party away from tea party enthusiasts, including in the Cantor’s home district.

Brat teaches at Randolph-Macon College, a small liberal arts school north of Richmond. He raised just more than $200,000 for his campaign, according to the most recent campaign finance reports.

Beltway-based groups also spent heavily in the race. The American Chemistry Council, whose members include many blue chip companies, spent more than $300,000 on TV ads promoting Cantor. It’s the group’s only independent expenditure so far this election year. Political arms of the American College of Radiology, the National Rifle Association and the National Association of Realtors also spent money on ads to promote Cantor.

Brat offset the cash disadvantage with endorsements from conservative activists like radio host Laura Ingraham, and with help from local tea party activists angry at Cantor.

Much of the campaign centered on immigration, where critics on both sides have recently taken aim at Cantor.

Brat has accused the House majority leader of being a top cheerleader for “amnesty” for immigrants in the U.S. illegally. Cantor has responded forcefully by boasting in mailers of blocking Senate plans “to give illegal aliens amnesty.”

It was a change in tone for Cantor, who has repeatedly voiced support for giving citizenship to certain immigrants brought illegally to the country as children. Cantor and House GOP leaders have advocated a step-by-step approach rather than the comprehensive bill backed by the Senate. They’ve made no move to bring legislation to a vote and appear increasingly unlikely to act this year.

Cantor, a former state legislator, was elected to Congress in 2000. He became majority leader in 2011.

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Brazilian street artist Paulo Ito drew a picture of a crying child, who is served a soccer ball to appease his hunger, on the wall of a public school in Sao Paulo, as Brazil readies for the 2014 World Cup. Photo by Miguel Tovar/LatinContent/Getty Images

Much has changed in Brazil since the last time it hosted the FIFA World Cup in 1950, including a more skeptical, informed and middle class audience.

Roberto DaMatta, a professor at Catholic University of Rio de Janeiro, recently recalled the day in July 1950 when he went with his father to watch the Brazil-Yugoslavia match in the cavernous Maracana stadium — a game the Brazilians won 2-0.

“I was 15 years old and I realized we had built the greatest stadium in the world,” said DeMatta at a Wilson Center event. He said he and his father marveled at the team, the stadium and how they had gotten there by public transportation.

Now, public transportation workers are striking for higher wages, threatening to further tangle to Sao Paulo’s infamous traffic. It’s one of the areas people point to when they gauge whether or not Brazil is ready for World Cup, which starts Thursday.

In addition to the striking workers, Brazilians have staged protests over the $11 billion cost of hosting the tournament, saying the money would be better spent on hospitals, schools and airports.

Compared to 1950, the Brazilian population — equipped with computers and mobile phones — is not just more aware of the country’s problems but in general feels entitled to get better services, said DaMatta. “Football is no longer the opiate of the people.”

In 1950, Brazil was still in its early stages of industrial and urban development and had a relatively new democratic regime, said Joao Augusto de Castro Neves, Latin America director of Eurasia Group. At the time, Brazilians felt optimistic about hosting the World Cup, not least of which because the tournament had been on hiatus during the 1940s due to World War II, he said.

“There was a great sense of a new moment. Brazil was emerging from a dictatorship; it was this young country hosting this game and building the stadiums. It was a sign of a country coming of age.”

There still were problems related to stadium construction in 1950, but the bar was much lower then, in terms of the infrastructure needed to host such a huge commercial event, said Neves. In some ways, “Brazil in 1950 hosting the World Cup was similar to South Africa hosting it four years ago, as the first World Cup on the African continent,” he said.

But attitudes and demographics have changed. With industrialization and urbanization just getting started in 1950, there was a smaller middle class and more people living in rural areas. Now, about 85 percent of Brazil is considered urban. That shift increased infrastructure needs, traffic and air pollution, and launched a much larger middle class with its own demands, said Neves.

“They’re not satisfied only by having these huge state-of-the-art stadiums, they want everything that’s supposed to surround these stadiums like subway systems, airports and good roads, not to mention hospitals and schools,” he said.

The World Cup itself also has changed. “It’s an industry now — it wasn’t like that 60 years ago — demanding more investments across the board from the hosting countries,” said Neves. “It’s a profitable venture, but necessarily for the country itself.”

In Brazil, 12 cities are hosting the games, but half don’t have meaningful soccer teams, so the grand stadiums might not get much use later, Neves explained. “The stadiums will become while elephants in some cities.”

Large-scale sporting events, such as the World Cup and the Olympics, are supposed to benefit the host country but they can end up losing money, he said. “More and more, that vision is becoming clear” to the general public, prompting a backlash including the demonstrations in Brazil.

Mauricio Moura, a researcher for Harvard University, said by telephone from Sao Paulo that a survey of 5,000 Brazilians recently conducted for the university showed only 51 percent are in favor of the World Cup — the lowest rating for any previous World Cup where data is available.

“For Brazilians, having soccer as the main sport, it’s very strange to have about 45 percent of people against the World Cup,” said Moura. On the other hand, when Brazilians were asked if they would support the national team, 88 percent of respondents said “yes.”

There’s a separation between what people are feeling for the team and the soccer games, and frustration toward the Brazilian government and World Cup organization itself, he said.

So the sour taste in Brazil over the World Cup and the fewer flying flags might all change once the golden shirts take the field. “This is the first time we are seeing this dissonance” in the streets, but when World Cup begins, there will be at least some temporary peace, said DaMatta.

Why isn’t the U.S. more competitive on the world men’s soccer stage? Weigh in during our live Twitter chat at 1 p.m. EDT on Thursday using hashtag #NewsHourChats. We’ll also explore Brazil’s challenges in hosting the tournament on Wednesday’s broadcast. View all of our World Cup coverage.

Follow @NewsHourWorld

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Photo by Nicholas Kamm/AFP/Getty Images.

Updated June 11, 3:23 p.m. EDT | WASHINGTON — Repudiated at the polls, House Majority Leader Eric Cantor intends to resign his leadership post at the end of next month, officials said Wednesday, clearing the way for a potentially disruptive Republican shake-up just before midterm elections with control of Congress at stake.

Cantor was expected to announce his plans at a late-afternoon meeting of the party’s rank and file, less than 24 hours after the Virginia Republican lost a primary election to David Brat, a little-known and underfunded rival backed by tea party groups.

Before the announcement, jockeying already had broken out among fellow Republicans eager to move up the House leadership ladder — or establish a foothold on it.

Rep. Kevin McCarthy of California, the party whip and third-ranking leader, informed fellow Republicans he intended to run to succeed Cantor, and Rep. Pete Sessions of Texas also made clear his interest.

Rep. Peter Roskam of Illinois, the chief deputy whip, and Rep. Steve Scalise of Louisiana quickly jumped into the expected race to succeed McCarthy.

Cantor’s office declined to confirm his decision, which was reported by numerous Republican aides as well as lobbyists who said they had been informed of the plans. His intention was to declare his decision to step down from the leadership on July 31.

One Republican said he feared the effects of Cantor’s defeat could be debilitating for the party and the government.

Interviewed on MSNBC, Rep. Peter King, R-N.Y., said he was worried that Cantor’s stunning loss may lead to even more congressional gridlock. Asked if he thought immigration legislation was dead, he replied, “I’m concerned that Ted Cruz supporters, Rand Paul supporters, are going to use this as an excuse” to shut down the government.

“This is not conservatism to me,” King said. “Shutting down the government is not being conservative.”

The resignation would mark a swift end to a quick rise to power for Cantor, 51, who was elected to Congress in 2000, was appointed to the leadership two years later, and then rose steadily to become the second-most powerful Republican in the House. In that post, he was the most powerful Jewish Republican in Congress, and occasionally was seen as a potential rival to Speaker John Boehner but more often as a likely successor.

He was defeated Tuesday by primary rival David Brat, an economics professor making his first run for office in an underfunded campaign that benefited from the support of tea party groups.

Brat campaigned as a foe of immigration legislation, and said Cantor was likely to help immigrants living in the United States illegally gain amnesty if given a new term in the House.

Interviewed on MSNBC, Brat declined to spell out any policy specifics.

“I’m a Ph.D. in economics, and so you analyze every situation uniquely,” he said.

Brat begins the fall campaign as a decided favorite in the race against Democratic rival Jack Trammell in a solidly Republican Richmond-area district.

His primary triumph was by far the biggest of the 2014 campaign season for tea party forces, although last week they forced veteran Mississippi Sen. Thad Cochran into a June 24 runoff and they hope state Sen. Chris McDaniel will achieve victory then.

Tuesday’s outcome may well mark the end of Cantor’s political career, although at his age he has plenty of time to attempt a comeback.

The impact of Cantor’s surprise loss on the fate of immigration legislation in the current Congress seemed clear. Conservatives will now be emboldened in their opposition to legislation to create a path to citizenship for immigrants living in the country illegally, and party leaders who are sympathetic to such legislation will likely be less willing to try.

Cantor has compiled a solidly conservative voting record in his tenure, but he was sometimes viewed with suspicion by tea party activists who said he had been in Congress too long and was insufficiently committed to blocking immigration legislation. Many party officials argue that Republicans must temper their hard line on immigration if they are to compete effectively in future presidential elections.

Already on Wednesday, Hillary Rodham Clinton, a potential Democratic contender, said Cantor “was defeated by a candidate who basically ran against immigrants.”

Democrats, underdogs in the struggle for control of the House this fall, sought to cast Cantor’s defeat as evidence that the Republican Party and tea party groups were one.

“The Republican Party has been completely swallowed by the tea party. I mean, any debate over whether the tea party controls the Republican Party has ended,” Rep. Debbie Wasserman Schultz of Florida, the Democratic national chair, said on MSNBC.

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One of the most ardent supporters of the Common Core education guidelines, the Bill and Melinda Gates Foundation, is urging participating states to delay major accountability decisions based on assessment tests aligned to the standards.

The foundation’s director of education, Vicki Phillips, suggested in an open letter released Tuesday that significant actions tied to the testing, such as teacher evaluation and student promotion, be pushed back by two years.

“…no evaluation system will work unless teachers believe it is fair and reliable, and it’s very hard to be fair in a time of transition,” Philips wrote. “The standards need time to work. Teachers need time to develop lessons, receive more training, get used to the new tests and offer their feedback.”

Since 2010, 46 states and the District of Columbia adopted the Common Core State Standards, which are benchmarks in mathematics and English language arts, outlining what skills a student should have at the end of each grade.

But some teachers’ unions and parent groups have complained that the standards have been rolled out too quickly. In fact, implementation issues and other concerns have prompted three states — Indiana, Oklahoma, and South Carolina — to drop Common Core this year. Lawmakers in several other states, including Florida, Illinois and South Dakota, have introduced legislation reassessing their involvement with the both the standards and related tests.

According to a recent article published in the Washington Post, The Bill and Melinda Gates Foundation was not only the primary funder behind the development of the Common Core, but also “built political support across the country, persuading state governments to make systemic and costly changes.”

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Moh El-Naggar, an assistant professor of physics at the University of Southern California, holds a chip containing bacteria cells that are the basis for much of his team’s research on how microbes move electrons. Photos by Kent Treptow.

If you think that all living things need oxygen to breathe, you’re not only wrong, but hopelessly human-centric. But don’t be too hard on yourself. Most mammals are biased toward multicellular organisms.

It’s true that humans, along with mammals, birds, even insects and fish, require oxygen for survival. But not bacteria. What bacteria lack in intellect, they make up for in the extraordinary adaptability of their metabolism.

On Earth some 3 to 4 billion years ago, primitive microbes thrived in the absence of oxygen — anaerobically — by “breathing” iron-based minerals. Many species of bacteria still have the ability to do this.

That’s right. Cells can breathe rock. And to do so, they must send their electrons outside of their cell bodies, sometimes moving them great distances.

Chemists understand respiration differently than the rest of us. At the cellular level, it is simply this: taking electrons from food and giving them to the thing they’re breathing, whether that’s oxygen or rock. When oxygen is involved, this is a fairly simple process. Since oxygen is a soluble molecule, it gets easily diffused from the outside to the inside of the cell through the cell membrane.

“But what do you do if the thing you’re trying to pass your electrons to, a.k.a. the thing you’re breathing, is outside the cell?” asked Moh El-Naggar, an assistant professor at University of Southern California, who runs a lab dedicated to basic research. “Somehow you have to build a bridge to get your electrons to the outside.”

At his lab, El-Naggar and his team obsess about this process: how the electron gets from Point A to Point B.

“It is a beautiful problem at the interface of physics and biology,” he said.

Unlocking the secrets of how these processes work could lead to breakthroughs in semiconductors, fuel cells, solar power and understanding how life can thrive in the harshest environments.

Moh El-Naggar, an assistant professor of physics at the University of Southern California, sits at the probe station where he studies how bacteria shuttle electrons great distances. Photo by Kent Treptow

In May 2009, El-Naggar made a discovery, from which all of the experiments in his lab have since sprung: A few years earlier, a pair of scientists discovered that microbes grow long, hairy filaments or fibers that are electrically conductive. El-Naggar had a hypothesis. These fibers, he suspected, serve as a conductive bridge between the cell and the rock that they’re breathing. In other words, the path the electrons take to move from the cell body to material outside the cell.

Testing this theory was a two-year process, which required growing cells and building fantastically tiny rods to study the conductive properties of the fibers, or as they’re now called, “bacterial nanowires.”

It was late one night at Lawrence Berkeley National Laboratory that El-Naggar connected all the pieces, quite literally. He had flown out that morning with a silicon chip in a carry-on Canon camera case. The chip contained thousands of dead, but well-preserved cells, and their newly sprouted nanowires.

Moh El-Naggar holds a chip containing bacteria cells that are the basis for his research on how microbes move electrons. Photo by Kent Treptow

In a clean-room facility there, he used a powerful electron microscope to build dozens of tiny platinum electrodes – leads, he calls them — each measuring a micron long. That’s about 100th the width of a human hair. Then, with an electron beam, he deposited electrodes onto his chip, placing them at each end of several nanowires.

Once the nanowires and electrodes were connected, he moved the chip to a probe station containing an optical microscope and a voltmeter, fastened the chip to a plate and turned a knob to pump in electricity. He wanted to know if electrical current could move through the nanowires. And over the course of several minutes, he studied a figure on the screen.

“What you’d expect to see is that you get more current flowing through the nanowires, the more voltage you apply to them,” he said. “And that’s exactly what we saw.”

El-Naggar believed that current was generated by electrons surging through the nanowires to the platinum leads. But to be sure, he had to cut the nanowires and repeat the experiment. If he was right, breaking the fibers would kill the current. Using an ion beam — a tiny scalpel made out of pure energy — he sliced the wires. And then he performed the experiment again, hoping that he would see… nothing.

“It’s kind of weird, right?” he said. “People think we get more excited about seeing stuff. But every good experiment needs a good control. And sometimes nothing is as exciting as something.”

As he’d hoped, the numbers stayed frozen at zero. Alone in the lab, he pumped his fist in the air and then sent an email to his collaborators. One of his postdocs had vowed to grow his beard until the experiment was complete. In his email, El-Naggar recommended a shave. He had a bushy beard, he recalls now. “And it was beginning to look pretty bad.”

The finding was published in the journal PNAS in 2010.

El-Naggar now oversees a lab of five graduate students, two postdoctoral researchers and a small army of undergraduates. Earlier this year, he was awarded the Presidential Early Career Award for Scientists and Engineers. And his Twitter posts look like this:

Spread the word: I have an opening for a bioelectrochemistry postdoc to work on single microbe and single mitochondrion electron transport.

— Moh El-Naggar (@BioPhysicalMoh) March 31, 2014

Intimidating, right? But he is anything but.

“He’s the best advisor the physics department has had,” said Benjamin Gross, a postdoctoral candidate in his lab, who studies the basic biophysics of how electrons move. “Some advisors ignore you; some are anxious for you to publish good work,” but El-Naggar, he said, gets in the trenches with the young scientists. “People love working here.”

One big discovery, many applications

The whole story of El-Naggar’s lab since that night in Berkeley is about trying to move the ball forward on the electron transport discovery. And his team has taken that basic concept and launched it into wildly different directions of research.

One member of his team, Yamini Jangir, traveled to Death Valley, where, among the sand dunes and jagged salt flats and hellish 115-degree temperatures, she collected water samples from a giant pressurized well. In that water, bacteria thrives deep underground in low oxygen conditions.

Graduate student Jamini Jangir, 27, points out Shewanella bacteria cells on a computer screen at the University of Southern California. Photo by Kent Treptow

Back in the lab, Jangir built her own reactor out of a polypropylene jar, plastic piping, titanium wires and aluminum foil. Her hope is to recreate in the lab the anaerobic conditions from the Death Valley subsurface that allow this bacteria to thrive. Statistics for these bacteria are grim now — a mere 1 percent survive in the lab setting. The ultimate goal: to develop a technique that would allow scientists to cultivate underground bacteria in a lab setting, and thus study them better.

Yamini Jangir has built her own reactor using a polyproylene jar, plastic piping, titanium wires, a nitrogen bubbling system and aluminum foil. Photo by Kent Treptow

Another graduate student, Ian McFarlane is trying to make semiconductors in the greenest possible way – using only cells. And Benjamin Gross, a postdoctoral candidate, is studying the basic mechanism of how cells shuttle their electrons. (McFarlane and Gross both rely on a bacteria called Shewanella that was discovered in Lake Oneida in upstate New York.)

Against the wall in the wet lab is a fridge with glass bottles filled with arsenic and sulfur — nutrients for the bacteria — and a sign that says “No Food or Drink.” A “Poison” label is taped onto many of the bottles, which are sealed with black rubber caps to keep the oxygen out. A handful have a skull and crossbones scrawled across their midsection in black Sharpie.

Hand-drawn skull-and-crossbones mark a hazardous waste container used by scientists at a lab at the University of Southern California. Scientists at USC are doing basic research to determine how certain bacteria are able to transfer electrons great distances from themselves to other cells or inorganic minerals. Photograph by Kent Treptow for PBSNewsHour

On McFarlane’s computer screen are dozens of nanofibers, each about 15 microns long and ranging from 10 to 300 nanometers wide — roughly 1,000 times thinner than a sheet of paper. He hopes these will someday have a practical use as semiconductor devices, possibly as cheap solar panel material. The key, he explains, is having the bacteria do the work.

“They’re my little factories,” he said. “Rather than having a person make insulin, you have a bacteria make insulin. Rather than having a person make nanoscale fibers, you have bacteria do it.”

McFarlane moves to the far end of the room, where he’s done just that. He pulls a glass jar from a refrigerator. The jar contains a thick yellow substance resembling foam insulation. But when he shakes it, the consistency changes, becoming more liquid, like orange juice. The resemblance is so strong that he can no longer drink orange juice from a clear glass, he says.

Graduate student Ian McFarlane holds a bottle containing billions of semiconductor nanofibers. Photo by Kent Treptow

Inside the jar are billions of nanofibers created by combining arsenic and sulfur, adding bacteria and removing oxygen.

“I love the smell of rotten eggs,” McFarlane said. “It means it’s working.”

Removing the oxygen forces the bacteria to use a backup power source. In other words, to breathe the arsenic and sulfur. And the nanofibers that grow during that process act as primitive semiconductors.

Magnified on his computer, MacFarlane studies the fibers. Some look like smooth rods – others sport a crystalline pattern, like a spinal cord.

Ian McFarlane points to a set of bacterial nanofibers on his computer. Photo by Kent Treptow

He’s creating fully-functioning transistors out of these semiconductors, El-Naggar explains. Understanding their shape and structure could help engineers put the incredible metabolism of these microbes to practical use. Engineers, they hope, could one day harness the bacteria’s breathing system to power fuel cells, for example.

So many dead cells

A few feet from McFarlane, undergraduate James Lu painstakingly prepares slides for Gross, who studies Shewanella bacteria cells one at a time as they pass their electrons onto electrodes. They are clumsy-looking slides with black and white wires sticking out, cover glass embedded with electrodes, and a plastic chamber, mounted onto a plate with double sticky tape.

Postdoctoral candidate Benjamin Gross injects millions of bacteria cells into a chamber. Photo by Kent Treptow

On his computer, Gross pulls up a graphic of a cell. The cell takes in food, he explains — acetate or lactate, for example. It converts the food into something called ATP – Adenosine triphosphate. And then it spits out the electron.

“It needs to get rid of the electron, or it will gum up the works,” he says.

Gross moves to the lab counter, and using a syringe, draws half a milliliter of solution from a glass bottle and injects it into the chamber on the plate. Then he caps the two ends so they’re airtight. He has just injected millions of cells into the chamber.

You can’t see them now, but the glass on the plate is patterned with electrodes made of indium tin oxide, a material that’s widely used in smartphone touch screens, solar cells and as a defroster for Boeing 747 aircraft windshields.

Earlier, he had bubbled nitrogen into the solution and added the amino acid, cysteine. Both work jointly to starve out the oxygen, so the cells will be forced to breathe the ITO, just like MacFarlane’s cells were forced to breathe sulfur and arsenic.

“We’re suffocating the children,” Gross says, and impersonates the bacteria. “Fine. I’ll breathe your electrode.”

Benjamin Gross manipulates a laser as he tries to trap and isolate a cell on a computer screen. Photo by Kent Treptow

In a dry lab across the hall is a device called an optical trap that Gross spent six months building. It relies on an infrared laser to trap and isolate cells, a laser that could blind you, he warns, causing excruciating pain if your eyes were to wander directly into the light without safety glasses.

“There. I found an electrode,” he says. “Now we kind of go fishing.”

He is fishing for cells, which ideally will search out the ITO electrodes and stick to them. Then, he will use highly sensitive electronics to detect the amount of electrical current. Lines spiking on the computer indicate that the cell is squirting electrons into the electrode. And his research has shown that about a million electrons a second cross from the bacteria and land on the electrode.

El-Naggar explains that Gross has taken his initial experiment a step further.

“The kinds of measurements I did myself in Berkeley in 2009 were non-biological measurements,” El-Naggar said. “Crude tools to assess the conductivity of the wires. Now we’re at a stage where we’re grabbing individual cells live and measuring respiration.”

Benjamin Gross spent six months building this optical trap used to isolate cells and measure their conductivity. Photo by Kent Treptow

Suddenly, one of those live cells appears – a tiny blob darting through across the screen.

“Oh, there’s a little guy,” Gross says. “Where’d you go, buddy?”

And just as suddenly, the image turns black.

“Uh oh.” His face becomes serious. “It looks like a little atomic bomb went off on my electrode.”

The electrode, he explained, had gotten fried by the machine’s laser. It’s two full days of work — gone.

“So many dead cells,” he said. “It happened so fast.”

Put simply, he explained, the laser was too strong and the electrodes too thick. It’s the kind of troubleshooting that happens all the time.

“A large number of questions we’re answering every day are like, ‘What’s the best way to glue these things together?’ or whatever mundane thing we’re doing, he says. “Once you have that figured out, you use it to answer a deeper question.

Among those deeper questions: What kind of electrode material is best? Should the electrode be rough or smooth? What are the best ways to grow the bacteria, so they’re most likely to stick to the electrode? How strong should the laser be to avoid these tiny massacres?

Failure, El-Naggar said, comes with the territory: “I have never myself designed and built an experiment that worked the second or third time. The key thing is to have the right temperament and attitude about science. A lot of people would be incredibly frustrated to waste two days of work.”

A proud physics tradition

El-Naggar’s goal is to be a cheerleader and protector of his students. He seeks funding, speaks at conferences and plans projects so that they have more time in the lab.

“I try to protect my students by keeping these things away from them, so they can focus on the exciting science, the research,” he said.

Moh El-Naggar, an assistant professor of physics at the University of Southern California, stands at the white board where he and his team brainstorm ideas about their work. Photo by Kent Treptow

This is especially true considering the do-it-yourself philosophy of his lab, where students build most components of the experiments themselves.

“Every Ph.D. student is essentially trying to do something original, so you can’t just buy a kit at the store,” Gross said. “You engineer from spare parts whatever you need to get it done. We end up being our own artisans to a degree.”

That homegrown quality is a proud physics tradition, El-Naggar added.

“Chemists study chemicals. Biologists study what’s alive. Physics is more mercurial than that,” he says. “It’s about the way we do things. Physics is one field that isn’t defined by the subject of the study as much as by the approach of the study. And the way we do things doesn’t matter, as long as we have a very quantitative approach.”

In this case, each experiment, each question answered, brings the scientists closer to the basic physics of how organisms move electrons very long distances. But it goes beyond that.

On one hand, El-Naggar says he hopes the research will ultimately lend itself to new technologies: using microorganisms to clean wastewater, power fuel cells, or build better solar power materials, for example. But more importantly, he says, it’s about curiosity.

“We do this because we’re curious about the world,” El-Naggar says. “Here is one particular example of something microorganisms have been doing for billions of years, and we’re only learning how they do it now.”

And there’s a lot of power in that.

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