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Analysis, background reports and updates from the PBS NewsHour putting today's news in context.

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    Politics Monday screenshot

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    GWEN IFILL: For both Democrats and Republicans, 2016 has turned into a season of disruption, as candidates have attempted to woo voters from the left and the right and encountered attacks from within.

    Here to sort it out this Politics Monday is Susan Page, Washington bureau chief for USA Today, and Stu Rothenberg of the Rothenberg & Gonzales Political Report and the Roll Call newspaper.

    Part of the disruption for the last several weeks has been Donald Trump. This week, he was at a Faith and Values Summit in Iowa and he was asked about John McCain, who had said that Donald Trump was stirring up the crazies, so Donald Trump responded.

    DONALD TRUMP (R), Presidential Candidate: I supported him. I supported him for president. I raised a million dollars for him. It’s a lot of money. I supported him.

    He lost. He let us down. But, you know, he lost. So I never liked him as much after that, because I don’t like losers.




    DONALD TRUMP: Frank, let me get to it.

    FRANK LUNTZ: He’s a war hero.

    DONALD TRUMP: He’s not a war hero.

    FRANK LUNTZ: He’s a war hero, five-and-a-half years as a prisoner…


    DONALD TRUMP: He is a war hero — he is a war hero because he was captured. I like people that weren’t captured.

    GWEN IFILL: He’s talking to Frank Luntz there, who is conducting the conversation and says he’s a war hero.

    So what effect do we think that Donald Trump’s statements this weekend, not only on that, but also religion, Susan, have to do with this race?

    SUSAN PAGE, USA Today: It’s interesting, because when Donald Trump made outrageous statements about Mexican immigrants, saying they were rapists and drug dealers, there was a pushback from his rivals, but not that strong a one.

    On this, almost all of the other Republican candidates came out and criticized him, called for him to apologize, something he has refused to do. And the question is, will this reinforce Donald Trump supporters, who tend to like the fact that he’s a no surrender sort of guy, or will this really peel off — will this mean that his support, his rapid rise, his phenomenal rise, we have seen in the Republican field, does it mean that is about to be reversed?

    GWEN IFILL: What do you think, Stu?

    STUART ROTHENBERG, The Rothenberg & Gonzales Political Report: Well, it’s too early to know.

    The indication over the past few weeks is that he’s been in first or second place either in national polls or in Iowa. He’s clearly touched a nerve. I’m skeptical that it’s going to last much longer, but the Republican electorate, the core Republican voter is angry, frustrated, disappointed not only at the president, but at leadership within their own party.

    And Donald Trump goes out there and he’s bombastic, and explosive, and causes trouble. He likes doing it, clearly, and it has resonated. Look, over the long haul, it’s hard to believe Donald Trump is going to be the Republican nominee for president, but in the short-term, he’s obviously having a factor in the debate and the discussions.

    GWEN IFILL: One of the things that struck me is not only did he insult the guy who most Republicans voted for in the last term, the party’s nominee in 2012, but he also — or 2008 — but he also did another interesting thing, in that he kind of insulted evangelicals a little bit, even though he was at an evangelical conference, saying — he himself is a Presbyterian, he goes for the little cracker, he goes for the little wafer, but he’s never asked God for forgiveness, which it seems to me would kind of — would hurt.

    SUSAN PAGE: I think that it does.

    I think that really caused more of a stir for that particular audience than his comments about John McCain, speaking of communion in a way that seemed very dismissive, and also saying he’s never asked God for forgiveness. Believe me, don’t put me in that category. I’m constantly asking for forgiveness for various shortcomings.

    But we know that isn’t his part of the Republican Party; his part of the Republican Party is more likely to be a Tea Party sort of Republican that thinks Washington doesn’t work, politicians can’t be trusted, here’s a guy who tells hard truths, although we do see — we don’t put too much story on a single poll, but we do have a new Washington Post/ABC poll out just tonight that shows Donald Trump in first place, 24 percent.

    But the pollster says that his support on the last night, on Sunday night of polling, when people possibly had heard about the McCain exchange, his support fell to single digits. That may be one early sign that this is going to hurt him a lot.

    STUART ROTHENBERG: I would simply add let’s remember that right now, when people answer poll questions, they’re not really answering the question of, who do you want to be president of the United States?

    They’re answering a different question. Who is reflecting your anger and frustrations and disappointments? Who is giving voice to your feelings?

    GWEN IFILL: OK, let’s assume that’s the answer — they’re answering your question for now.

    But what effect then does it have on the other people in the race? There are 20 other people in the race, and they all have to respond every single day to the Donald Trump whirlwind. So what does it tell us about them?

    STUART ROTHENBERG: It’s had a number of impacts.

    I think the greatest one is it’s kind of frozen the race. Nobody else can get much traction. How do you get through when Donald Trump is saying Donald Trumpisms, whatever they are? Individual candidates I think are hurt because his appeal to the Tea Party and to the angry older voters is eating into Ted Cruz’s.

    His emphasis on a straight-talking Republican, I will tell you what’s really going on eats into Chris Christie’s. So I think, more than anything else, he has been, as you said, a disrupter.

    SUSAN PAGE: And an opportunity cost, right? Other candidates not only can’t get any attention. They can’t talk about issues, including issues that are likely to be much more important in the presidential campaign than these.

    GWEN IFILL: Even though Jeb Bush and Hillary Clinton seemed to have thrown in the towel and decided, there is just something about him, where I can then use Donald Trump as an advantage?

    But what does it do for candidates like Scott Walker, the governor of Wisconsin, who got into the race last week, John Kasich, the governor of Ohio, who is getting into the race this week and who we assume both would be strong Midwestern governors? Do they get blown out of the water with all of this going on?

    SUSAN PAGE: I think it cost Scott Walker some of the bump he expected to get from his announcement.

    And one danger for Governor Kasich — tomorrow, he announces — does the attention to Trump cost him a little bit of the bounce that he’s hoping to get? And for John Kasich, that could be really important because you’re looking coming up on the first debate early next month. You need to be in the top 10 to participate. I think Kasich is counting on getting some kind of bump from tomorrow’s announcement to get him in at number 10 or number nine so that he can participate in the debate.

    GWEN IFILL: On the Democratic side of this, there was also disruption on the far left. And that is at the Netroots Nation conference, which is a very — a liberal conference where the candidates show up and they usually tell them what they want to hear, except both Bernard — Bernie Sanders and Martin O’Malley, the former governor of Maryland, and Bernie Sanders, senator from Vermont, got shouted down by people who were there on behalf of the black lives matter movement and neither of them came of out of it smelling like a rose.

    STUART ROTHENBERG: I think, in that case, the news told you less about the candidates and more about the constituents there.

    And this is the Tea Party version on the Democratic, on the progressive side, people who are distrustful of the Democratic Party’s leadership, want more ideology, more confrontation. Right now, the Democrats don’t quite have the problem that the Republicans have with the Tea Party and the division, but this conference was, I think, a warning that the Democrats have to worry about that kind of disruption.

    GWEN IFILL: Is it the kind of thing that Hillary Clinton has to worry about?

    Yes, I think it’s a warning to Hillary Clinton.

    We don’t think Martin O’Malley or Bernie Sanders is going to be the nominee. We think Hillary Clinton is likely to be the Democratic nominee. And she is going to have to deal with a party that has moved significantly to the left since her husband ran for president and that is distrustful of her in some ways, even though her support remains pretty strong even among liberals.

    She is going to have to deal with a liberal wing of the party that really feels energized.

    GWEN IFILL: And they’re all going to be dealing with energies on the far left or the far right. What a fun summer.

    Susan Page of USA Today, Stu Rothenberg of The Rothenberg Political Report and Roll Call, thank you both.

    The post Is Trump’s rapid rise headed for a reverse? appeared first on PBS NewsHour.

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    Cuban and American flags are straightened during the re-opening ceremony for the Cuban embassy in Washington July 20, 2015. The Cuban flag was raised over Havana's embassy in Washington on Monday for the first time in 54 years as the United States and Cuba formally restored relations, opening a new chapter of engagement between the former Cold War foes.  REUTERS/Chip Somodevilla/Pool - RTX1L46F

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    JUDY WOODRUFF: For more on the resumption of relations between the U.S. and Cuba, we turn to Maria de Los Angeles Torres. She’s a Cuban-born American and a professor at the University of Illinois, Chicago, where she is also executive director of the school’s program on Latino research.

    Ms. Torres, thank you very much for joining us.

    First of all, how would you describe this new relationship? How is it going to be different from diplomatic relations the U.S. has with other countries?

    MARIA DE LOS ANGELES TORRES, University of Illinois at Chicago: Well, I think it’s going to — first of all, there’s 50 years of hostility, and I think that it’s almost like the day after the storm.

    Right now, we have to see how many trees have fallen down and what we’re going to do with that. I think, also, because of the intimate relationship that the United States has had with Cuba, the fact that there are many Cubans living in the United States, the fact there are many other Cubans who would like to come to the United States, I think that there will be a unique set of challenges.

    The regime has not changed. I don’t think this policy is going to change the regime. It will, however, I think, help in what could be a peaceful transition.

    JUDY WOODRUFF: What sort of restrictions are still going to be there for Americans who want to travel to Cuba? Where do you see that headed?

    MARIA DE LOS ANGELES TORRES: Well, part of this is codified in law through Congress. I do not see that Congress is willing at this moment or any time at least in the immediate future to change the policy of the embargo.

    However, I think that this is going to allow a more porous, if you will, embargo. And we have already seen that happen. I think, in the last six months, we have seen there’s been an uptick in travel to Cuba, that restrictions on how much money could be sent to relatives has actually been expanded, so there’s more money going into Cuba.

    A lot of the small businesses that we see are actually being fueled by family members here in the United States, and I think, that we will see increased in the next few months.

    JUDY WOODRUFF: So, you see commerce increasing between the two countries?

    MARIA DE LOS ANGELES TORRES: Well, we already have.

    Cuba — the United States is the largest importer of goods to Cuba today, their agriculture and their pharmaceutical. This actually happened under the Bush administration. And as far as other kinds of activity, they are still going to be under the restriction of the embargo, which is congressional, but there will be other kinds of, I think, smaller kinds of businesses that are being allowed under executive order and under the power of the president.

    Most of these are coming from family members. That is why we are seeing all sorts of little businesses pop up and people supporting their family.

    JUDY WOODRUFF: What is going to happen to the homes, to the property left behind many years ago by Cuban Americans who fled that country, who came here, who have been living in the United States, but who left a lot behind there?

    MARIA DE LOS ANGELES TORRES: Well, I think that all these issues are negotiable, right?

    And what we have not had in the past is a means through which to negotiate. I think the reestablishment of diplomatic relations opens up those channels. Whether or not these are things that are going to be put on the table I think is a little too early to tell.

    I would like to say I have been back to the home that I was raised in until 6 years of age, and the lady who’s living in the home has tried to sell me that home several times over, actually, rather cheaply.


    MARIA DE LOS ANGELES TORRES: I wouldn’t want to buy that home.

    So I think that there’s — it’s going to be interesting, but what we do have now is that channel through which we can put these issues on the table and negotiate them, and hopefully move forward in what we do with our enemies and our friends.

    JUDY WOODRUFF: Maria de Los Angeles Torres at the University of Illinois at Chicago, we thank you.


    The post After five decades of hostility, what’s next for U.S. and Cuba appeared first on PBS NewsHour.

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    The Cuban national flag is seen raised over their newly reopened embassy in Washington, July 20, 2015. The Cuban flag was raised over Havana's embassy in Washington on Monday for the first time in 54 years as the United States and Cuba formally restored relations, opening a new chapter of engagement between the former Cold War foes.  REUTERS/Carlos Barria  - RTX1L3XR

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    JUDY WOODRUFF: The United States and Cuba officially normalized diplomatic relations today and the Cuban Embassy in Washington, closed since 1961, reopened this morning.

    The NewsHour’s P.J. Tobia has this report.

    P.J. TOBIA: With a ceremonial flourish, the Cuban flag was raised above the embassy in Washington this morning, a sight not seen in over five decades.

    As the mission officially opened, so did a new post-Cold War chapter in U.S.-Cuba relations. But deep differences between the two countries remain, as was evident when Foreign Minister Bruno Rodriguez spoke inside the embassy.

    BRUNO RODRIGUEZ, Foreign Minister, Cuba (through interpreter): The historic events we are living today will only make sense with the removal of the blockade, and the return of occupied territory in Guantanamo.

    P.J. TOBIA: The U.S. and Cuba severed diplomatic ties in 1961, when Cuban President Fidel Castro referred to the American Embassy as a nest of spies.

    Now, after more than two years of negotiations, relations are slowly thawing. But sticking points remain, chief among them, Havana’s demand for an end to a crippling trade embargo and U.S. calls for democracy and human rights in Cuba.

    Reaction was mixed on the streets outside the Cuban Embassy, as protesters from Cuba and around Latin America gathered.

    ROSA MARIA PAYA: I support the Cuban people, definitely.

    P.J. TOBIA: Rosa Maria Paya’s father was a Cuban opposition leader who died in Cuba under mysterious circumstances in 2012. She urged the U.S. to seize this opportunity to help improve Cuba’s human rights record.

    ROSA MARIA PAYA: So far, we have seen very concrete and specific steps from the part of the American administration, but not support and specific and concrete support to the demands of the Cuban citizens, to the demands of change for human rights.

    P.J. TOBIA: Secretary of State John Kerry met with his Cuban counterpart this afternoon at the State Department. Cuba’s flag now hangs in the building’s lobby, where it was installed in the pre-dawn hours without fanfare.

    JOHN KERRY, Secretary of State: We are taking a historic and long overdue step in the right direction. To keep moving forward, both governments must proceed in a spirit of openness and mutual respect.

    P.J. TOBIA: But on Capitol Hill, there remains significant opposition to the move.

    REP. ILEANA ROS-LEHTINEN (R), Florida: I look forward to working with my colleagues in Congress to try to block the expansion of a U.S. Embassy in Cuba, to try to stop the confirmation of a U.S. ambassador to the island.

    P.J. TOBIA: Meanwhile, in Cuba, the U.S. Embassy reopened for business in Havana. Cubans lined up to apply for visas to travel to the U.S. welcomed the historic occasion.

    The pomp and circumstance will wait until mid-August, when Kerry makes his historic visit to formally raise the American flag.

    The post U.S. and Cuba restore relations with reopened embassies appeared first on PBS NewsHour.

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    JUDY WOODRUFF: Good evening, and welcome to our new home for the PBS NewsHour.

    GWEN IFILL: Judy and I are settling into our new set, with fresh graphics and updated music, yet with the classic sound you have come to recognize as the signal that the NewsHour is on the air.

    JUDY WOODRUFF: We think this new look will give us greater flexibility and a new tool, so that we can better present the same quality journalism and analysis that the “NewsHour” has been doing for almost 40 years

    GWEN IFILL: And now let’s get to the news.

    JUDY WOODRUFF: The United Nations Security Council voted unanimously today to approve the nuclear deal negotiated in Vienna last week. The vote was 15-0, and it sets the stage for the lifting of economic sanctions, in exchange for limits on Tehran’s nuclear capabilities.

    In Washington, President Obama hailed the endorsement and called on Congress, which now has 60 days to review the deal, to approve it.

    PRESIDENT BARACK OBAMA: There’s broad international consensus around this issue, not just among the international community, but also among experts in nuclear proliferation. And my working assumption is, is that Congress will pay attention to that broad-based consensus.

    JUDY WOODRUFF: The president made the remarks as he met with Nigeria’s president, Muhammadu Buhari. It’s his first White House visit since he was elected in March in Nigeria’s first democratic transition of power in decades.

    GWEN IFILL: In Turkey, an explosion rocked Suruc near the border with Syria, killing 31 people. Turkish officials said the attack appeared to be a suicide bombing inspired by the Islamic State group. The midday explosion took place at a cultural center, as a group of young political activists was wrapping up a news conference. Nearly 100 people were wounded.

    JUDY WOODRUFF: The death toll from fierce fighting in Yemen yesterday has now risen to nearly 100. Shiite rebels bombarded a town close to the port city of Aden. The head of an international aid group says Sunday’s fighting was the worst day in three months. Meanwhile, Saudi-led fighter jets kept up their bombing campaign and hit a popular market in the Yemeni capital of Sanaa.

    GWEN IFILL: A NATO airstrike on two Afghan military checkpoints killed seven Afghan troops today. Afghan officials described it as an accident. Taliban fighters were clashing with troops near their remote checkpoints in Logar province at the same time coalition helicopters flew overhead. Afghan President Ashraf Ghani expressed his profound sorrow over the incident and ordered an investigation.

    JUDY WOODRUFF: There were more questions than answers today in the death of a young black woman in a Texas jail last week.

    Correspondent William Brangham has our story.

    REV. JAMAL BRYANT, Empowerment Temple Church: We strategically picked this place because we know we’re standing on a crime scene.

    WILLIAM BRANGHAM: Religious leaders and community activists spoke today outside the Waller County Jail, the same Texas jail where 28-year-old Sandra Bland died under mysterious circumstances a week ago.

    The incident began on July 10. In this video filmed on a bystander’s cell phone, Bland is seen being pinned to the ground by two state troopers. The troopers say Bland had just assaulted an officer after they’d pulled her over for a traffic violation. Bland was arrested, and taken to the county jail. Three days later, she was found dead in her cell.

    The sheriff’s office says Bland committed suicide by hanging herself with a plastic bag. Officials also pointed to a Facebook video Ms. Bland posted several months ago saying she was depressed.

    SANDRA BLAND, Died in Police Custody: I am suffering from something that some of you all may be dealing with right now. It’s a little bit of depression, as well as PTSD.

    WILLIAM BRANGHAM: But Bland’s family and others don’t believe it. They say that video was made when Bland was unemployed, and that she’d just started a new job at her alma mater, Prairie View A&M University, and was very excited about her prospects.

    REV. JAMAL BRYANT: This wasn’t a lazy woman. This wasn’t an unmotivated woman. This is a woman who had dreams and had desires and had drive.

    WILLIAM BRANGHAM: Today’s press conference followed several days of vigils and protest marches for Bland in her native Illinois and in Texas.

    For the PBS NewsHour, I’m William Brangham.

    JUDY WOODRUFF: Local prosecutors have promised a full investigation into Bland’s death. Today, they pointed to surveillance video from inside the jail that shows no one entered or exited her cell around the time she is believed to have died.

    GWEN IFILL: Greeks lined up outside banks today to withdraw money for the first time in more than three weeks. A steady stream of customers made their way to ATMs and banks, but there were strict limits on how much cash they could take out. And shopkeepers changed the prices on their goods to reflect the higher taxes they’re charging under the terms of an E.U. rescue deal.

    JUDY WOODRUFF: The price of gold continued its slide today, hitting a five-year low. The drop was helped along by the dollar’s gain and a looming interest rate hike. On Wall Street today, stocks were relatively stagnant. The Dow Jones industrial average gained 13 points to close at 18100. The Nasdaq added eight points and the S&P 500 gained more than a point.

    The post News Wrap: UN Security Council approves Iran nuclear deal appeared first on PBS NewsHour.

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    One out of five children live in poverty in the United States, more than before the start of the Great Recession, according to a new report from the Annie E. Casey Foundation. Photo by Getty Images

    One out of five children live in poverty in the United States, more than before the start of the Great Recession, according to a new report from the Annie E. Casey Foundation. Photo by Getty Images

    One out of five American children live in poverty, and we have the Great Recession to blame.

    That’s according to a new report out today from the Annie E. Casey Foundation that tracks the overall well-being of children in the United States.

    Today, 22 percent of children live in poverty, up from 18 percent in 2008.

    Despite policies and programs designed to help families recover, the economic slowdown left many families behind, said Laura Speer. She is the foundation’s associate director for policy reform and advocacy and oversees the national KIDS COUNT project.

    “It’s pretty clear from the data that the rising tide of economic recovery has not lifted all boats,” Speer said. “We still haven’t made up ground of where we were pre-recession” for many low-income families.

    Minnesota led the United States in children’s overall well-being, followed by New Hampshire and Massachusetts. It’s the first time in nearly a decade that a state outside of New England has ranked first nationwide.

    Minnesota has one of the lowest rates of uninsured children in the country.

    The state also maintains ongoing early childhood education programs that focus on school readiness and provides childcare assistance, says Stephanie Hogenson, research and policy director at the Children’s Defense Fund-Minnesota.

    At a time when economic crisis gripped the nation, and when many states cut social welfare programs in a desperate attempt to manage budget deficits, Minnesota preserved many of these programs that designed to help low-income individuals and families, such as providing tax-credits, raising the minimum wage and increasing childcare assistance, Hogenson said.

    Also, the economic slowdown did not hit the Upper Midwest as hard overall as it did rest of the country, Speer said.

    In Minnesota, roughly one out of seven children live in poverty.

    “It points to a long-term history of investment in kids,” Speer said. “It takes a while, but you can see those investments in our rankings eventually.”

    At the bottom is Mississippi, where the child-poverty rate is a staggering one in three. It fell behind Louisiana and New Mexico.

    “The states at the very top and very bottom are very far apart, and they always have been,” Speer said. “There’s been improvement in Mississippi, but the problem is that the improvement hasn’t kept up with other states.”

    “The states at the very top and very bottom are very far apart, and they always have been.” — Laura Speer, KIDS COUNT

    For this report, researchers collected nationally representative and state-based data from 2008 to 2013, the last year when data was available.

    Then, they created a composite score of children’s overall quality of life measured across four domains: economic well-being, education, health and stability of family and community. Within each domain are four indicators, such as absence of pre-school attendance or teen births per capita. Of the 16 total indicators combined, Speer said one carries more influence than any other: child poverty.

    That is because child poverty is so closely linked with indicators such as low birthweight, single-parent families, low-income housing and neighborhoods, Speer explained. These indicators signal the likelihood for success or failure throughout a child’s development.

    Since 1990 when the Casey Foundation first released its report, Mississippi has remained at the bottom every year except one, says Linda Southward. She studies families and children at Mississippi State University’s Social Science Research Center and directs Mississippi KIDS COUNT.

    “The fact that Mississippi is so much lower than the rest of the country on these measures, Mississippi would have to make tremendous gains on these measures to rise in the rankings,” she said.

    For Mississippi to improve the overall well-being for all of its children, Southward said, the state must make long-term investments. She suggested continued efforts to ramp up early childhood education and uniform screening methods that would alert teachers to a child’s unique learning needs.

    “We need to be strategic about it, and we need to be consistent,” Southward said.

    As a public elementary school teacher in the Mississippi Delta, Ashley Mostaghimi saw firsthand what happens when children grow up without access to basic needs. She arrived in Mississippi in 2005 as a Teach for America instructor from North Carolina. The Mississippi Delta was her first choice.

    “This is the only place I wanted to go. I don’t know if I quite grasped the level of challenge for children and teachers,” she said.

    “This is the only place I wanted to go. I don’t know if I quite grasped the level of challenge for children and teachers.” — Ashley Mostaghimi, teacher in Mississippi

    Rural isolation and abject poverty were no longer abstract concepts when she began teaching in Mississippi. Her students hadn’t seen skyscrapers or museums, and the only airplanes they’d ever seen were cropdusters.

    She taught a student whose only guaranteed meal each day was a school-provided lunch. She learned to keep a stash of granola bars at her desk for him.

    The state and its children are not without hope, said Mostaghimi, who later in 2009 earned a master’s degree in education policy and management from Harvard and continued to teach and recommend best practices to schools in the Mississippi Delta.

    “We have a great amount of opportunity in Mississippi, because we are small,” Mostaghimi said. “The level of impact we can have with one charter school, with one principal, with one superintendent is incredible compared to a big city.”

    But she acknowledges that the state has a long way to go.

    “You have children who come to school in kindergarten who have never held a book before,” she said, “because their parents can’t afford it, and there is no library where they live.”

    The post More children are in poverty today than before the Great Recession appeared first on PBS NewsHour.

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    Photo by Andrew Harrer/Bloomberg via Getty Images

    Photo by Andrew Harrer/Bloomberg via Getty Images

    About 7.5 million Americans paid an average penalty of $200 for not having health insurance in 2014 — the first year most Americans were required to have coverage under the Affordable Care Act, the Internal Revenue Service said Tuesday.

    By contrast, 76 percent of taxpayers checked a box indicating they had qualifying insurance coverage all year. Counting another 7 million dependents who were not required to report their coverage but also filed returns, the proportion rises to 81 percent, the IRS said.

    The government had estimated in January that from 3 million to 6 million households would have to pay a penalty: 1 percent of their annual income or $95 per adult in 2014, whichever is greater.

    Final figures for the tax year aren’t available. The IRS has so far processed about 135 million of the estimated 150 million returns expected. IRS Commissioner John Koskinen said the agency was reporting preliminary figures because it has received “numerous requests” from members of Congress.

    In addition to penalty totals, the IRS reported Tuesday on tax subsidies the health law provided for people who were buying coverage through the state or federal online exchanges and who qualified based on income. People had a choice of filing for credits in advance — money the government paid to their insurers — or when filing tax returns.

    About 2.7 million taxpayers claimed approximately $9 billion in subsidies, reporting an average subsidy of $3,400. About 40 percent claimed less than $2,000, 40 percent claimed $2,000 to $5,000, and 20 percent claimed $5,000 or more.

    Among taxpayers who claimed a subsidy, about 1.6 million, or half of taxpayers who claimed or received a subsidy, had to pay money back to the government because their actual income was higher than projected when they applied for the subsidy. The average amount repaid was about $800.

    When looking at the individual mandate, the report said the vast majority of people automatically satisfied the individual mandate because they were insured last year. Another 12 million had exemptions, including people whose incomes were too low and Native Americans.

    In all, the IRS said it has collected $1.5 billion from the individual mandate penalty included in the health law. About 40 percent of taxpayers who paid a penalty paid less than $100.

    About 300,000 taxpayers who made an individual mandate penalty payment should have claimed an exemption but did not, the government said. The agency is sending letters to these taxpayers telling them they generally have three years to file an amended tax return.

    More than 5 million taxpayers did not check the box on their tax form saying they had coverage, claim a health care coverage exemption, or pay a penalty. “We are analyzing these cases to determine their status,” the government said.

    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. You can view the original report on its website. KHN’s coverage of aging and long term care issues is supported in part by a grant from The SCAN Foundation.

    The post 7.5 million Americans paid fine for having no health insurance in 2014 appeared first on PBS NewsHour.

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    Photo by Getty Images

    Photo by Getty Images

    WASHINGTON — Older women with mild memory impairment worsened about twice as fast as men, researchers reported Tuesday, part of an effort to unravel why women are especially hard-hit by Alzheimer’s.

    Nearly two-thirds of Americans with Alzheimer’s are women.

    At age 65, seemingly healthy women have about a 1 in 6 chance of developing Alzheimer’s during the rest of their lives, compared with a 1 in 11 chance for men. Scientists once thought the disparity was just because women tend to live longer — but there’s increasing agreement that something else makes women more vulnerable.

    “Women are really at the epicenter of the Alzheimer’s disease crisis,” said Dr. Kristine Yaffe of the University of California, San Francisco. “We don’t really understand what this is all about.”

    A series of studies presented Tuesday at the Alzheimer’s Association International Conference uncovered signs of that vulnerability well before Alzheimer’s symptoms hit.

    First, Duke University researchers compared nearly 400 men and women with mild cognitive impairment, early memory changes that don’t interfere with everyday activities but that mark an increased risk for developing Alzheimer’s. They measured these people’s cognitive abilities over an average of four years and as long as eight years for some participants.

    The men’s scores on an in-depth test of memory and thinking skills declined a point a year while the women’s scores dropped by two points a year.

    Age, education levels and even whether people carried the ApoE-4 gene that increases the risk of late-in-life Alzheimer’s couldn’t account for the difference, said Duke medical student Katherine Lin, who coauthored the study with Duke psychiatry professor Dr. P. Murali Doraiswamy. The study wasn’t large or long enough to tell if women were more at risk for progressing to full dementia.

    Nor could it explain why the women declined faster, but the researchers said larger Alzheimer’s prevention studies should start analyzing gender differences for more clues. And two other studies presented Tuesday offered additional hints of differences in women’s brains:

    —A sample of 1,000 participants in the large Alzheimer’s Disease Neuroimaging Initiative compared PET scans to see how much of a sticky protein called beta-amyloid was building up in the brains of a variety of men and women, some healthy, some at risk and others with full-blown Alzheimer’s. Amyloid plaques are a hallmark of Alzheimer’s, and growing levels can help indicate who’s at risk before symptoms ever appear.

    “Overall, women have more amyloid than men,” even among the cognitively normal group, said Dr. Michael Weiner of the University of California, San Francisco. The study couldn’t explain why, although it didn’t appear due to the risky ApoE-4 gene, which seemed to make a difference for men with Alzheimer’s but not women.

    —Some seniors who undergo surgery while knocked out by general anesthesia suffer lasting cognitive problems afterward, often expressed to doctors as, “Grandma was never the same after that operation.” Tuesday, researchers reported that here again, women are at higher risk of getting worse.

    Dr. Katie Schenning of the Oregon Health & Science University tracked records of more than 500 participants in two long-term studies of cognitive aging, which included a battery of brain tests. About 180 participants underwent 331 procedures involving general anesthesia.

    Over seven years, people who had undergone surgery with general anesthesia declined faster on measures of cognition, their ability to function and even brain shrinkage than people who hadn’t had surgery. But women declined at a significantly faster rate than men, Schenning said.

    “It is worth letting our older patients know that they should perhaps talk about this with their practitioner, that this is a possibility and consider whether or not they need to undergo procedures that are considered to be elective,” she said.

    Schenning didn’t have amyloid measurements for these people; other studies have suggested that the people most at risk may have brewing cognitive problems already.

    The anesthesia alone isn’t the culprit, she cautioned. Indeed, animal research presented Tuesday showed that surgery in general can spur inflammation-causing molecules to cross into the brain and impair how nerve cells communicate.

    Together, the studies show how much more research is needed into the Alzheimer’s gender question, said UCSF’s Yaffe, who wasn’t involved in Tuesday’s studies but was part of a recent Alzheimer’s Association meeting to start determining those next steps.

    “It’s not just that women are living to be older. There’s something else going on in terms of the biology, the environment, for women compared to men that may make them at greater risk, or if they have some symptoms, change the progression,” Yaffe said.

    The post Study suggests that women with mild memory problems worsen faster than men appeared first on PBS NewsHour.

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    Public photo from Facebook.

    Sandra Bland was arrested in Texas on July 10, shortly after moving to the state to start a new job. Three days later, she was found dead in her jail cell. Photo from Facebook.

    The death of Sandra Bland — a 28-year-old African-American woman from Naperville, Illinois — is being treated as a murder investigation, a district attorney in Texas announced Monday night.

    The widely disputed details of Bland’s death in Waller County, Texas, are at the center of the investigation.

    On July 10, Bland was pulled over for failing to use a turn signal. The interaction between Bland and the police grew confrontational when Bland refused to put out her cigarette. The situation escalated, and Bland was ultimately arrested on a charge of assaulting a public servant.

    The altercation revealed on this dashcam starts at the eight-minute mark.

    Texas Dept. of Public Safety released the full dashcam video today. The officer asks Bland to put out her cigarette. After Bland refuses, he orders her to get out of her car. He tells her to “step out, or I will remove you.” He then gets out a taser and proceeds to pull her out of the car and tells her she is under arrest. The officer does not tell Bland why she is being arrested.

    A bystander’s video of the arrest shows Bland on the ground, with two officers standing over her. She can be heard saying, “You just slammed my head into the ground. Do you not even care about that?”

    Three days after her arrest, on the morning of July 13, a female guard found Bland hanging in her jail cell. Bland’s sister, Shante Needham, said she was held on a $500 bond.

    According to video released by the sheriff’s office, and a statement from Waller County Sheriff’s Captain Brian Cantrell, this is the July 13 timeline of events leading up to Bland’s death:

    • At 6:30 a.m., Bland refused a breakfast tray.
    • Shortly after 7 a.m., she tells an officer making a routine check, “I’m fine.”
    • From about 7:30 to 9:00 a.m., the video shows no movement. Mathis’s office does not believe this footage has been doctored.
    • At 7:55 a.m. Bland asked how to make a phone call, and was instructed to use the phone in her cell. The sheriff’s office found no record of Bland making a call.
    • At 9:07 a.m., Bland is found hanging.
    • By 9:16 a.m., paramedics have pronounced her dead.

    Authorities said Bland used a trash bag to hang herself, and an autopsy classified her death as suicide. But Bland’s friends and family are disputing the finding, and have sought an independent autopsy. Though she had posted a video to Facebook weeks before the arrest revealing that she was combating “a little bit of depression as well as PTSD,” her family says suicide wouldn’t make sense since she recently got a job at Prairie View A&M University.

    Soon after Bland’s death, questions arose. #SandraBland, #JusticeForSandy and #WhatHappenedToSandyBland trended on Twitter, with comparisons to the deaths of Freddie Gray, Walter Scott, Eric Garner and Michael Brown. And at the root of public skepticism is the ongoing debate over police brutality, and race relations in America. According to the Washington Post, 531 people have been shot and killed by police officers this year.

    “It is very much too early to make any kind of determination that this was a suicide or a murder because the investigations are not complete,” Mathis said.

    Bland’s case will go to a grand jury, which is expected to meet in August.

    Below is the affidavit of Bland’s arrest.

    Sandra Bland Affidavit by Colin Daileda

    The post Here’s what we know so far about Sandra Bland’s death appeared first on PBS NewsHour.

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    Nick Corcodilos started headhunting in Silicon Valley in 1979 and has answered over 30,000 questions from the Ask The Headhunter community over the past decade.

    In this special Making Sense edition of Ask The Headhunter, Nick shares insider advice and contrarian methods about winning and keeping the right job, on one condition: that you, dear Making Sense reader, send Nick your questions about your personal challenges with job hunting, interviewing, networking, resumes, job boards, or salary negotiations. No guarantees—just a promise to do his best to offer useful advice.

    Question: I had a phone interview with a hiring manager, then did some sample work. The manager said it was all great, and in a follow-up phone call we discussed my salary expectations and timeline. They invited me to meet them and I flew coast-to-coast for interviews with several people. Two days later, I got a phone call and I was offered the position.

    It is now a week later. The job has been reposted, and instead of a written offer I received an e-mail explaining that they are interviewing one more person, and they asked for another week to get back to me.

    It sounds to me that they are stringing me along, while waiting for another candidate to accept their offer, or maybe having somebody already starting and covering their tracks. What do you think?

    Nick Corcodilos: I think you’re probably right. They may really like you, but as their #2 or #3 candidate. They may be keeping you warm.

    In today’s market, many employers feel they can just keep interviewing candidates because the job boards tell them there are millions to choose from. “Just keep looking!” In the meantime, savvy people like you realize what’s going on — and disappear to take another opportunity while the employer wallows in indecision.

    Putting good candidates on hold is actually a common practice and by itself doesn’t indicate a problem. (See “Pop Quiz: Can an employer take back a job offer?”) It’s just business. What is a problem is that they offered you a job, at least orally, and then welshed. Of course, a company is free to do that, but this should enter into your calculus about them. If it really bothers you that they are behaving this way, take it into account if they come back with a written offer.

    Consider these three job offer gotchas:

    Do you really have an offer?

    Until a company gives you a written, bona fide offer, you really have no offer. (See “Get it in writing.”) While I believe an oral offer should be as good as a written one, and that a person’s word is their bond, this is business, and business is ultimately done in writing. When pressed, people and companies act in their self-interest. It seems this employer encountered a (possibly) better candidate, and is exercising its right to stretch out this process. I don’t like it any more than you do. The takeaway is simple: Don’t treat a job offer as real until you have it in writing.

    Job seekers do it, too

    Job seekers do what this employer has done. It cuts both ways. They change their minds when a better job offer comes along and they suddenly rescind their acceptance of a job. There’s a price to be paid for this, in a person’s reputation and credibility. The alternative is to stick to your promise and forego a better job or compensation. There is no easy way out. In this case, the employer is putting its reputation at risk but seems willing to do so.

    Everyone wants to keep their options open

    Most employers select first, second and third candidates and make offers down the line until one accepts. The employer doesn’t want to be left in the lurch if #1 or #2 declines. So, prudent employers keep other candidates “warm” until the new hire shows up for work. Otherwise, they have to start the process all over again. It’s why I tell job seekers to keep their own options open until they actually start a job. (See “There is no sure thing.”) An employer might terminate you — even on your first day. It’s not likely, but do you want to be left in the lurch? (See “Don’t get fired Day #1.”)

    I know this all smacks of low-down, sneaky business. To the party on the receiving end, it stinks. And that’s why I said you should take this company’s behavior into account. (This experience might even affect how you negotiate any offer they might ultimately give you. See “How to decide how much you want.”) I’m not saying you should walk away — just that you should proceed with open eyes. I’ve placed second-ranked candidates before and it’s worked out fine. But as I said, I don’t like that this employer issued an oral offer and is now putting you off.

    If something I’ve pointed out is helpful to you, I’m glad. Use your best judgment and do the best you can in this situation! In any case, congrats on at least getting an oral offer. My best advice is to keep pursuing other jobs while you wait on this one, because two can play this game.

    Dear Readers: What would you do in this situation? Is the employer at all justified about what it has done? What should the job seeker do next?

    Nick Corcodilos invites Making Sense readers to subscribe to his free weekly Ask The Headhunter© Newsletter. His in-depth “how to” PDF books are available on his website: “How to Work With Headhunters…and how to make headhunters work for you,” “How Can I Change Careers?”, “Keep Your Salary Under Wraps” and “Fearless Job Hunting.”

    Send your questions to Nick, and join him for discussion every week here on Making Sense. Thanks for participating!

    Copyright © 2013 Nick Corcodilos. All rights reserved in all media. Ask the Headhunter® is a registered trademark.

    The post Ask the Headhunter: Is this job offer for real? appeared first on PBS NewsHour.

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    Congress returns today after the long July 4 weekend. Photo by Gary Cameron

    Congress returns today after the long July 4 weekend. Photo by Gary Cameron

    WASHINGTON — Businesses big and small would get to keep claiming dozens of tax breaks that expired at the start of the year under a bill that overwhelmingly passed the Senate Finance Committee Tuesday.

    Struggling homeowners and people who live in states without a state income tax would get to keep their tax breaks, too.

    The bill would extend more than 50 tax credits, exemptions and deductions through 2016, beyond the upcoming presidential election. It would add $95 billion to the budget deficit over the next decade, according to the nonpartisan Joint Committee on Taxation, which provides official estimates for Congress.

    “While some tend to write off tax extenders as special-interest giveaways, in terms of dollars, the bulk of the extenders in this package go toward very popular, widely applicable provisions,” said Sen. Orrin Hatch, R-Utah, chairman of the Finance Committee.

    The committee passed the bill by a vote of 23 to 3. It now goes to the full Senate.

    Among the biggest breaks for businesses are a tax credit for research and development; an exemption that allows financial companies such as banks and investment firms to shield foreign profits from being taxed by the U.S.; and several provisions that allow businesses to write off capital investments more quickly.

    There is also a generous tax credit for using wind farms and other renewable energy sources to produce electricity.

    More narrow provisions include tax breaks for filmmakers, theatrical productions, racehorse owners and NASCAR track owners. There are also provisions to help rum producers in Puerto Rico and the Virgin Islands.

    The biggest tax break for individuals allows people who live in states without an income tax to deduct state and local sales taxes on their federal returns. Another protects struggling homeowners who get their mortgages reduced from paying income taxes on the amount of debt that was forgiven.

    Other provisions benefit commuters who use public transportation and teachers who spend their own money on classroom supplies.

    “With the understanding that our long-term goal is a tax code overhaul that works for all Americans, Congress needs to get these provisions back in place,” said Sen. Ron Wyden of Oregon, the top Democrat on the Finance Committee.

    Congress routinely lets the tax breaks expire, only to retroactively renew them for a year or two.

    Last year, the tax breaks expired in January, and Congress didn’t renew them until December. Lawmakers, however, only extended them for a few more weeks, through the end of 2015.

    The Senate bill would restore a tax credit for buying electric motorcycles. The $4 million provision, which expired at the end of 2014, was left out of last year’s bill by former Rep. Dave Camp, R-Mich., who used to chair the House Ways and Means Committee.

    The credit is championed by Wyden because it helps Oregon-based Brammo, a maker of electric motorcycles. House Republicans blamed Wyden for helping to derail negotiations last year that would have made some of the tax breaks permanent.

    Business groups have complained for years that the patchwork of temporary tax breaks makes it difficult for them to plan. The breaks were designed to provide incentives for businesses to invest and grow, yet those incentives are diminished when companies don’t know whether the tax breaks will be renewed from year to year.

    The House has voted to make a handful of the tax breaks permanent, leaving the fate of others unclear. The White House has threatened to veto the House bills because they would add billions to the budget deficit.

    Making all the tax breaks permanent would add more than $1 trillion to the budget deficit over the next decade, according to the Joint Committee on Taxation.

    The post Businesses one step closer to keeping tax breaks, thanks to Senate committee vote appeared first on PBS NewsHour.

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    A crowd gathers around an announcer at a sideshow on the boardwalk at Coney Island in the 1930s Photo by A. E. French/Archive Photos/Getty Images

    A crowd gathers around an announcer at a sideshow on the boardwalk at Coney Island in the 1930s. Photo by A. E. French/Archive Photos/Getty Images

    It was Coney Island in the early 1900’s. Beyond the Four-Legged Woman, the sword swallowers, and “Lionel the Lion-Faced Man,” was an entirely different exhibit: rows of tiny, premature human babies living in glass incubators.

    Barkers, including a young Cary Grant, called out to passersby, enticing visitors to come see the preemies.

    The brainchild of this exhibit was Dr. Martin Couney, an enigmatic figure in the history of medicine. Couney created and ran incubator-baby exhibits on the island from 1903 to the early 1940s, and though he died in relative obscurity, he was one of the great champions of this lifesaving technology and is credited with saving the lives of thousands of the country’s premature babies.

    The first doctor to use incubators for preemies was French obstetrician Dr. Stéphane Tarnier, who witnessed an incubator warming baby chickens at a Parisian zoo in the late 1870s, according to medical historian Dr. Jeffrey Baker. Tarnier thought he could use a similar device to save the premature babies dying of hypothermia in Parisian hospitals. While other European obstetricians pointed out that Tarnier’s first devices were hardly different from the hot water bottles and blankets used in many maternity wards, Baker writes, “such criticisms missed Tarnier’s most important contribution, which was to convince his colleagues that incubators (of whatever design) really made a difference.”


    A picture of the Coney Island Incubator sideshow facade at Luna Park ca. 1941. Photograph is courtesy of Beth Allen.

    A second generation of European obstetricians refined the incubators, adding individual thermostats and better ventilation systems, and spread the word about these new technologies through demonstrations at various expositions and Worlds Fairs. It was in 1896, at the Berlin Exposition that the French-born Dr. Couney first saw these new glass and metal incubators keeping premature babies alive and decided to import them to the United States, where they were extremely rare.

    Couney’s first incubator baby exhibit on Coney Island was at Luna Park, one of several amusement parks along the boardwalk. He opened a second at the neighboring Dreamland soon after. Visitors paid a few coins to enter and would approach rows of incubators along the wall, peering through the glass windows at the tiny, shriveled preemie babies living inside.

    Many of the infants in the exhibits came to Couney from local maternity wards that couldn’t care for them. (In the early 1900s, preemies had very high mortality rates, and often weren’t expected to live.) Couney’s own daughter was born prematurely, and she too spent time in one of her father’s Coney Island exhibits.

    A picture of Beth Allen and Martin Couney taken in 1941 at Luna Park, from the Coney Island History Project web site. Photograph is courtesy of Beth Allen.

    A picture of Beth Allen and Martin Couney taken in 1941 at Luna Park, from the Coney Island History Project web site. Photograph is courtesy of Beth Allen.

    Couney never charged parents for the care he provided, which also included rotating shifts of doctors and nurses looking after the babies. According to historian Jeffrey Baker, Couney’s exhibits “offered a standard of technological care not matched in any hospital of the time.”

    In a wonderful interview recorded by Storycorps and aired on NPR, a former incubator baby from one of Couney’s exhibits described how fragile she was at birth: “My father said I was so tiny, he could hold me in his hand,” said 95 year-old Lucille Horn, who was born prematurely in 1920 at the shockingly low birth weight of under two pounds. Baby Lucille was given no chance to live by her doctor.

    “I couldn’t live on my own, I was too weak to survive … You just died because you didn’t belong in the world.” Horn said. But Horn’s father, who had seen one of Couney’s exhibits on his honeymoon, bundled tiny Lucille up and took her out of the hospital. “I’m taking her to the incubator in Coney Island. The doctor said there’s not a chance in hell that she’ll live, but he said, ‘But she’s alive now,’ and he hailed a cab and took me to Dr. Couney’s exhibit, and that’s where I stayed for about six months.” (Listen to the entire interview here, including Horn’s recollection of going back to Coney Island years later and meeting Dr. Couney in person.)

    Other parents took more convincing. Beth Allen, who was born in a hospital in Brooklyn at 1 pound 10 ounces, recalls her own story via email.

    “My parents knew about the incubator baby “sideshow ” in Coney Island and were reluctant to send me there,” she wrote. “Dr. Couney came to the hospital and spoke to my mother and she agreed to put me under his care.”

    Allen spent three months on exhibit at Luna Park. She weighed five pounds when she left.

    Couney always claimed a higher purpose for his summertime exhibits — to show how a marvelous new technology could save fragile children, and, in so doing, to prod a reluctant medical establishment to embrace that technology. But given that he was often sharing a crowded boardwalk with the exploitative “freak shows” of the day, it’s hard to know exactly what drew visitors through his doors.

    Beth Allen's incubator. Photograph is courtesy of Beth Allen.

    Beth Allen’s incubator. Photograph is courtesy of Beth Allen.

    Was Couney an evangelist or a showman? Medical historian Jeffrey Baker calls this “the essential question about Couney. I suspect he had a bit of both in him.” (For example, Couney was known to occasionally dress his preemies in overly-large baby clothes to emphasize how tiny they were.)

    For his part, Couney bristled at the idea that just because his work was on Coney Island, it wasn’t in the interest of childrens’ health. “All my life I have been making propaganda for the proper care of preemies, who in other times were allowed to die,” he told The New Yorker’s A.J. Liebling in 1939.

    Charles Denson, director of the Coney Island History Project, which features photos from Couney’s exhibits, told the New York Times that Couney and Coney Island were a perfect match: “Couney was ahead of his time, and he found a place that was receptive to his dreams.”

    It wasn’t until after his death that incubators became common in hospital maternity wards — Couney died in 1950 in relative obscurity — but the families acknowledged the powerful impact he had on their lives. From former incubator baby Beth Allen:

    “Although I have just a vague memory of his house, my parents and I visited Dr. Couney every Father’s Day for several years.”

    On tonight’s NewsHour, William Brangham talks with Deanna Fei, who’s memoir “Girl in Glass” tells of the traumatic premature birth of Fei’s daughter, and the controversy that broke out over the cost of her medical care.

    The post How a Coney Island sideshow advanced medicine for premature babies appeared first on PBS NewsHour.

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    Muhsin al-Fadhli is seen in an undated photo.  Photo by State Department/Reuters

    Muhsin al-Fadhli is seen in an undated photo. Photo by State Department/Reuters

    WASHINGTON — A U.S. airstrike in Syria has killed a key figure in a dangerous al-Qaida offshoot, the Pentagon said Tuesday.

    Muhsin al-Fadhli was killed in a July 8 air attack while traveling in a vehicle near Sarmada, Syria, Pentagon spokesman Capt. Jeff Davis said in a statement. Davis did not further elaborate on the nature of the air strike, such as whether al-Fadhli was killed by a drone or a piloted aircraft.

    Al-Fadhli was a leader of the Khorasan Group, a cadre of al-Qaida operatives who were sent from Pakistan to Syria to plot attacks on the West. Officials say the Khorasan Group is embedded in the al Nusra front, Syria’s al-Qaida affiliate.

    Previously based in Iran, al-Fadhli was the subject of a $7 million reward by the State Department for information leading to his capture or death. He had been falsely reported as having been killed last fall.

    Davis noted that he was “among the few trusted al-Qaida leaders that received advanced notification of the Sept. 11, 2001, attacks.”

    Al-Fadhli was also involved in October 2002 attacks against U.S. Marines on Faylaka Island in Kuwait and on the French ship MV Limburg, Davis said.

    “His death will degrade and disrupt ongoing external operations of al-Qaida against the United States and our allies and partners.”

    Officials have said that the Khorasan militants were sent to Syria by al-Qaida leader Ayman al-Zawahiri to recruit Europeans and Americans whose passports allow them to board a U.S.-bound airliner with less scrutiny from security officials.

    According to classified U.S. intelligence assessments, the Khorasan militants have been working with bomb-makers from al-Qaida’s Yemen affiliate to test new ways to slip explosives past airport security. Officials feared the Khorasan militants would provide these sophisticated explosives to their Western recruits who could sneak them onto U.S.-bound flights.

    Because of intelligence about the collaboration among the Khorasan group, al-Qaida’s Yemeni bomb-makers and Western extremists, the Transportation Security Administration decided last July to ban uncharged mobile phones and laptops from flights to the U.S. that originated in Europe and the Middle East.

    The Khorasan group remains a threat, American officials said. Its existence demonstrates that core al-Qaida in Pakistan can still threaten the West, despite the damage done to that organization by years of drone missile strikes.

    The U.S. military has periodically targeted the group as part of its air campaign in Syria, beginning with eight strikes against Khorasan targets last September.

    Among those who have so far survived the bombs is a French-born jihadist who fought in Afghanistan with a military prowess that is of great concern to U.S. intelligence officials.

    David Drugeon, who was born in the Brittany region and converted to Islam as a youth, spent time with al-Qaida in the tribal areas of Pakistan before traveling to Syria, French officials say.

    The post U.S. airstrike kills senior Khorasan Group leader in Syria appeared first on PBS NewsHour.

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    girl in glass

    Watch Video | Listen to the Audio

    JUDY WOODRUFF: Now: when one family’s personal drama sparked national headlines.

    Deanna Fei’s premature baby girl had survived a long, arduous stay in the hospital, when she and her family were thrust into controversy. It happened when the CEO of AOL, where her husband worked, said he would cut benefits for all workers because of high medical costs for cases like hers.

    She describes the experience in a new memoir called “Girl in Glass: How My ‘Distressed Baby’ Defied the Odds, Shamed a CEO, and Taught Me the Essence of Love, Heartbreak, and Miracles.”

    William Brangham talked with her recently in Brooklyn, New York.

    WILLIAM BRANGHAM: Deanna Fei was just 25 weeks pregnant, hard at work on her second novel and months away from her delivery date. She’d been researching translations for a plot twist where one of her main characters would have a miscarriage.

    That night, her own contractions came out of nowhere. Rushing to the hospital with shooting pains in her womb, the translation of the word, “calamity” was still on her computer screen.

    DEANNA FEI, Author, “Girl in Glass”: The pain just got worse and worse and worse. And I found myself desperately thinking, like, could this be Braxton Hicks contractions, you know, the false labor?

    But it felt nothing like that. And by the time I got to the hospital, I was fully dilated. And the doctors had to perform an emergency C-section.

    WILLIAM BRANGHAM: Nothing in Fei’s own history predicted a calamity like this. She and her husband, Peter Goodman, had always been the lucky types, traveling the world together, pursuing careers in writing and journalism.

    During a trip to India in 2010, they made an offhand prayer to the Hindu gods to bless them with their first child, and nine months later, a chubby boy named Leo was born, healthy and right on time. This second pregnancy, which was a surprise, came almost a year after Leo’s birth and had been going just as well, until those pains started.

    DEANNA FEI: All that was in my head was, I think I lost my baby. I had a miscarriage. And when the nurses and doctors said things like, congratulations, would you like to take a picture of her, I almost felt like it was a kind of farce. And both my husband and I had this feeling of, this isn’t how a baby gets born.

    WILLIAM BRANGHAM: She was a baby girl, weighing just one pound, nine ounces, barely a quarter of her brother’s birth weight.

    One doctor described her skin as — quote — “gelatinous.” Because she’d arrived so early, she had few of the normal functions or immunities babies develop in utero, so she had to live enclosed in this glass incubator in a neonatal intensive care unit. Her parents were even reluctant to give her a name at first.

    DEANNA FEI: She was really hard to look at. I mean, everything about her to me felt like, I don’t know if she’s supposed to be here. And I don’t know if she’s going to be here, because what we also heard from the beginning, along with the congratulations, was, she might not survive one month, one week, one day.

    There was a part of me that felt like, it’s kind of the mother in me thinking, like, do I need to let her go? Is it selfish to hold onto this idea of this baby, when maybe she just isn’t meant to survive?

    WILLIAM BRANGHAM: Even though the next days only got worse — there was bleeding in her brain, and then a collapsed lung — they did name her. They called her Mila. Hope started setting in.

    PETER GOODMAN, Father of Mia: When we realized that we could put our hand inside the incubator and give her access to my pinkie finger, and she would squeeze it and hold on, once I got to see her eyes and realized that she looked a lot like our boy, and once I started to see her really fight for her own life, I mean, the nurses said day one — and I thought, you must be making this up for my benefit — she’s really feisty, they said.

    WILLIAM BRANGHAM: Three weeks in, Fei was able to hold Mila for the first time.

    At week nine, Mila breathed without life support. And a month later, she was going home. She was three months old. Once there, she seemed to thrive, hitting all her major milestones, and showing no signs of the brain damage some premature babies experience.

    Goodman was back at work. He was an editor at The Huffington Post, which is owned by AOL, when some corporate news broke that hit very close to home.

    Tim Armstrong, AOL’s CEO, announced he had to trim his employees’ retirement benefits because of high health insurance costs, but who he blamed for those costs sparked a media frenzy.

    Armstrong said quote: “We had two AOL-ers that had distressed babies that were born that we paid a million dollars each to make sure those babies were OK in general. So, when we had the final decision about what benefits to cut because of the increased health care costs, we made the decision, and I made the decision, to basically change the 401(k) plan.”

    PETER GOODMAN: It was clear that he was talking about my kid. And friends of mine in the newsroom came through in the course of the day and they said, somewhat embarrassed, he’s talking about your kid, isn’t he?

    DEANNA FEI: It sounded extremely dehumanizing, and it had no relation to the daughter who was in front of me. She had actually started taking her first steps just that week.

    And that was a huge milestone for us, because, of course, every milestone brought so many new worries, where every time she achieved one milestone, we should start to worry, is she ever going to do the next one? You know, once she crawls, is she ever going to cruise? If she cruises, will she ever walk? And then she took her first steps and then this happened, and all of the trauma just kind of came rushing back to me.

    WILLIAM BRANGHAM: The couple felt shamed, then angry. Fei channeled her anger into a blistering piece in Slate called “My Baby and AOL’s Bottom Line.”

    She wrote: “Our daughter has already overcome more setbacks than most of us have endured in the span of our lives. Having her very existence used as a scapegoat for cutting corporate benefits was one indignity too many.”

    DEANNA FEI: There was the implication that we had used more than our fair share of health benefits. There was the implication that somehow her care was optional, because Tim Armstrong portrayed her as this outsized burden on the corporate balance sheets. And he also implied that the company had done more than it needed to do in paying for her care.

    WILLIAM BRANGHAM: Armstrong, who declined to comment for this story, did call Goodman and Fei to apologize, and he eventually reversed the decision to reduce his employees’ 401(k) plans.

    But Goodman was done with the company. He left AOL for The International Business Times. After her piece in Slate went viral, Fei started hearing from others who’d been blamed by their bosses for having costly medical care, things like cancer treatment or major surgeries.

    DEANNA FEI: The truth is, until recently, I was one of those people whose eyes would glaze over at a term like health privacy.

    WILLIAM BRANGHAM: Deanna’s book, “Girl in Glass,” is both a memoir and an impassioned plea to not let what happened to her family happen to others.

    DEANNA FEI: These are risks that are extraordinary for any individual family, but they are completely predictable in the aggregate. And that’s the point of health insurance.

    WILLIAM BRANGHAM: Lawrence Gostin is a professor of global health law at Georgetown University.

    He says employers should never blame or embarrass employees who get sick or even be in a position to do so.

    LAWRENCE GOSTIN, Georgetown Law: The lesson is that you have no business knowing the confidential health information of your employees, that you should make sure that there’s a strong firewall between you, as the employer making employment decisions, and health care decisions and health insurance decisions.

    That needs to be separated, and that comes to me loud and clear.

    WILLIAM BRANGHAM: Fei and Goodman also say employees need to demand their rights to privacy, just as Mila, who is now 2, is learning to demand what she wants. And it’s chocolate ice cream.

    Mila has continued to grow and thrive and has so far shown none of the ill effects Fei or any parent of a premature child worry about.

    DEANNA FEI: You know, these days, I think it is hard to escape this term that I hated when she was first born, which is the term miracle child, because we were just hours removed from her birth, and hearing all the odds against her, when people would come to us and say, oh, well, she will be a miracle, she’s going to be your miracle child. Just wait and see.

    And I finally reached a point where I have to say, you’re right. She is. She’s amazing, and no one can take that away from her. She’s earned that. If anyone has earned that label, she has earned it.

    WILLIAM BRANGHAM: She’s still young, so Mila may face health challenges in the future. It’s hard to tell at this point. But for a story that began in catastrophe, Mila’s parents are glad this chapter of their lives is a happy one.

    For the PBS NewsHour, I’m William Brangham in Brooklyn, New York.

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    Jayla studies on a computer at the shelter where she lives in Los Angeles, California February 9, 2011. School on Wheels uses volunteers to tutor homeless children in shelters, parks, motels, and two centers. There has been a surge in the number of homeless children in Los Angeles in the last five years, due to persistent unemployment and mounting foreclosures. Picture taken February 9, 2011.  REUTERS/Lucy Nicholson (UNITED STATES - Tags: SOCIETY EDUCATION) - RTR2JZUO

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    GWEN IFILL: The economy may be recovering from the great recession, but a new report finds many have been left behind, especially children.

    The findings from the Annie E. Casey Foundation show 22 percent of U.S. children were living in poverty in 2013. That’s compared to 18 percent in 2008. Those rates were nearly double among African-American and Native American children, with problems most severe in the South and the Southwest.

    Some of those conclusions also echo a recent analysis by the Pew Research Center. It found black children were almost four times as likely as white children to be living in poverty.

    Joining me to discuss the cause and the effect of these sobering numbers are Patrick McCarthy, the president and CEO of the Annie E. Casey Foundation, and Mark Hugo Lopez of the Pew Research Center.

    Mark Hugo Lopez, why these populations in particular, why are they suffering?

    MARK HUGO LOPEZ, Pew Research Center: Well, when you take a look at unemployment rates particularly, you will see that, for African-Americans in June, unemployment was 9.6 percent. For whites, it was 4.5 percent.

    That’s almost — the unemployment rate for African-Americans is almost double that of whites. And that’s an important part of explaining the story of why many children live in poverty. Many of their parents either are not fully employed, are unemployed or can’t find work.

    GWEN IFILL: Now, Patrick McCarthy, some people might think this wasn’t surprising. We know in some ways that minority populations are at a disadvantage, yet when you look at the numbers overall, in fact, fewer white children are in poverty.

    Why are the numbers heading in the wrong — opposite directions?

    PATRICK MCCARTHY, President, Annie E. Casey Foundation: Well, I think there’s a number of reasons that we have to look at here.

    The economy, as it’s recovered, certainly has produced jobs for some populations, but we know that the recession took out a lot of lower-skilled jobs and low-wage jobs that had been held by African-Americans and Latinos.

    And as the economy has recovered, although a lot of the jobs that had been restored are low-wage jobs, the folks who lost their jobs, who have had kind of a precarious grasp of those jobs, are having a much harder time getting employed again.

    GWEN IFILL: Well, here’s one thing which struck me, which is that we’re not talking just about percentages. Right? We’re talking absolute numbers.

    MARK HUGO LOPEZ: That’s right; 14.7 million children live in poverty.

    And when you take a look at the Hispanic children in poverty, that number is about five million. For black children, those numbers are about 4.2 million. So, really, when we’re talking children in poverty, a significant share, more than half, are either black or Hispanic children.

    But we’re also seeing some other big changes. As you noted, the number of white children living in poverty has declined. It looks like it might even be below the number of black children in poverty, which would be a first in at least 30 or 40 years. And for Hispanics, there are more Hispanics living in poverty. And that’s been the case since 2007, particularly for children.

    GWEN IFILL: Patrick McCarthy, let’s talk about two states.


    GWEN IFILL: Mississippi, Minnesota.

    Mississippi is the worst state by these measures, and Minnesota is the best. What’s the difference?

    PATRICK MCCARTHY: Well, there are a lot of differences that go into this.

    Obviously, there are kind of large macroeconomic differences between the two states. They have very different economies. We know that, just as we have been discussing, African-American families in particular are suffering after the recession. Mississippi has a much higher number of African-American families living in Mississippi compared to Minnesota.

    We actually think also that there are differences in how states made policy choices. We know not only Minnesota but a number of states in the Northeast and Midwest have made their policy choices. We know that not only Minnesota, but a number of the states in the Northeast, the Midwest, have made choices around providing health care, providing early childhood education, providing a bridge to jobs, providing supports for folks who do become unemployed, and that makes a difference as well.

    So it’s partially the economic forces at play, the kinds of jobs that are available in those states, and it’s partially the policy choices that states make.

    GWEN IFILL: So, a policy choice, for instance, might be prizing deficit reduction over social welfare programs.

    MARK HUGO LOPEZ: That’s right, and social welfare programs that, say, might even be focused on children.

    So, some states have done some policy choices, as Patrick has noted, that have been emphasizing more broadly what’s happening in the state and less so to help children particularly.

    GWEN IFILL: Let’s talk about the long-term effect of these kinds of numbers, first of all, educational attainment.

    PATRICK MCCARTHY: So, one of the things that I think we sometimes miss when we talk about the numbers, and they seem so large, and talk about percentages, is we lose what it means to be in poverty, the day-to-day grind of not being sure you’re going to be able to take care of your kids, the inability to find a job that you can rely on week after week after week, having to figure out at the end of the month do you pay this bill or that bill, the kind of stress that takes on you as not only a worker and as an individual, but as a parent, which then begins to affect the children.

    They’re living in an environment where there’s a lot of stress. Put on top of that the fact that one in seven American children are living in neighborhoods of high poverty, so they’re surrounded by other people who are struggling with the same kinds of issues, often with poor schools, the a safe place to play, surrounded by crime.

    Then you start to see the long-term effects of that on children, trauma, chronic stress, et cetera, that literally starts to narrow their opportunity, make it tougher for them to be successful in school, long-term research showing impacts even on their health as they become adults. So poverty is the driver of many, many of the social ills that this country faces.

    GWEN IFILL: What would you add to that?

    MARK HUGO LOPEZ: When we take a look at the long-running effects of poverty, particularly when it comes to, say, labor market opportunities, what are these young people going to be trained for? What sort of jobs will they be able to hold? And when it comes to completing college, for many of them, they may end having to try to work to help to support their parents or their other siblings who are still under the age of 18.

    So, poverty could put a lot of stress, particularly when you think about Hispanic children, many of them who go on to college say that one of the reasons why they do not stay in college is because they have got to return home to help family.

    GWEN IFILL: What are the policy solutions, if there are any, if this is identified to be a major problem?

    PATRICK MCCARTHY: So, we think there are three things that we ought to look at. And we need to start with thinking about a two-generation strategy, by which we mean simultaneously investing in families and parents and in the children themselves.

    So the three things that we think you need to do is, number one, recognize we’re in a transitional economy, and so it’s tough for especially folks without a lot of skills to make enough money to support their families. So, we have got to think about things like expanding the Earned Income Tax Credit, the child tax credit, recognizing the importance of unemployment benefits and other supports for families, so they can have the economic means to take care of their kids.

    Second, we have to recognize they are both workers and they are parents, so we have got to help them have the social and emotional skills they need to do right by their kids. And, third, we need to invest heavily, in my view, especially for children who are in poverty, in early childhood programs, in quality preschool, in quality early education, so they get on that path towards opportunity.

    GWEN IFILL: Patrick McCarthy, president and CEO of the Annie E. Casey Foundation, and Mark Hugo Lopez of Pew Research Center, thank you both for the numbers and the story behind the numbers.

    MARK HUGO LOPEZ: Thank you.

    PATRICK MCCARTHY: Thank you.

    The post Why minority kids are being left behind by the economic recovery appeared first on PBS NewsHour.

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    U.S. Republican presidential candidate Rick Santorum speaks to supporters at Savre Lanes in Menasha, Wisconsin, April 2, 2012. Santorum is in Wisconsin for the primary which happens April 3. REUTERS/Darren Hauck (UNITED STATES - Tags: ELECTIONS POLITICS) - RTR3096R

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    JUDY WOODRUFF: Now the next in our series of interviews with the candidates running for president in 2016.

    Tonight, we sit down with former U.S. Senator Rick Santorum of Pennsylvania, who made a run for the Republican nomination in 2012, and he is trying again.

    Welcome, Senator Santorum.

    RICK SANTORUM Republican Presidential Candidate: Thank you, Judy. Good to be with you.

    JUDY WOODRUFF: So, we were just listening to that report about Americans joining the fight against ISIS.

    To you, what’s the greater threat to this country, ISIS or Iran?

    RICK SANTORUM: I think ISIS is the more near-term threat, obviously the jihadis that they encourage to attack here in the United States and obviously the hot war that’s going on in the Middle East.

    But, clearly, the long-term threat is Iran, and I have been saying that really for the better part of 12 years. When I was in the Senate, I authored bills on sanctioning Iran. I was talking about their nuclear program and how an Iranian nuclear program is really the worst possible thing that can happen to this country. There really isn’t any threat that’s more dangerous, that’s more existential than Iran with the ability to use a nuclear weapon, maybe use it as an EMP, use it as a dirty bomb, use it through terrorists, whatever the case may be.

    I have no doubt that, unlike other nuclear powers, Iran is a country that is driven by a theocracy that will use that nuclear weapon against America.

    JUDY WOODRUFF: And all your Republican opponents agree with you on that. They don’t like that deal either.

    However, Senator Scott — or Governor Scott Walker is saying that, on the first day he became president, he would be willing to go to war against Iran if necessary. Do you agree with him on that?

    RICK SANTORUM: I have been very, very clear from the very beginning of looking at Iran, and looking at their theology, looking at what their objective is, looking at what they say.

    One of the things we should have learned from history, is actually pay attention to what leaders say they’re going to do, because sometimes and many times, when they’re given the capability, they actually do it.

    And if you listen to what Iran is saying — and even just the other day — where they talk about we’re going to rule America, we’re going to wipe out America, we’re going to destroy America, now we’re giving them the capability. I mean, there is no doubt, with this plan, we are putting them on a path to have the capability to do just that.

    JUDY WOODRUFF: And so what about going to war?

    RICK SANTORUM: The answer is, if I — when I become president, from the day after I get — I’m elected president, I will be working with our allies.

    I have no doubt, no doubt that Iran will be in violation of this agreement multiple times by the time I’m elected president.

    JUDY WOODRUFF: Well, in the last presidential election — let’s talk about that — you ran a strong campaign. You came in second to Mitt Romney, a distant second, but you came in second.

    RICK SANTORUM: Won 11 states. That’s pretty respectable.

    JUDY WOODRUFF: This year, you not only are running against more candidates. You’re running against more people who are committed conservatives, people like Mike Huckabee, like Ted Cruz, Ben Carson, Scott Walker.

    What does Rick Santorum bring that they don’t?

    RICK SANTORUM: Well, I would say several things, number one, experience on national security, which is a huge deal.

    This is an issue I have been wrestling with now with eight years on the Armed Services Committee, a lot of experience in this area, someone who has got a track record and is prepared to lead.

    And, you know, three months ago, I was in ISIS magazine, on the American version, under the title, “In the Words of Our Enemy,” and had a picture of me and a quote from me. The enemy knows who I am. I know who they are. And I think at a time when our country is facing this kind of severe threat, having someone with experience in this area is important.

    Second, I announced from a factory floor in Western Pennsylvania. And I think our message of bringing manufacturing back to this country, helping blue-collar Americans and lower- and middle-income Americans have good-paying jobs and be able to rise, it’s going to be — and our platform of how we’re going to do that is different than everybody else in the field.

    JUDY WOODRUFF: But, Senator, at this point, you know all of these people I have named and others are running ahead of you in the polls. If you don’t make that cut to be the 10 candidates on the stage for that first debate that FOX News is sponsoring in a couple of weeks, what are you going to do?

    RICK SANTORUM: I will keep going back to Iowa and keep hustling and campaigning.

    What I found out — four years ago, we had a straw poll in Iowa. I finished fourth, almost fifth, and it didn’t have very much impact. The person who won didn’t win a delegate. The person who came in with tens of millions of dollars and was at the top of the polls this time four years ago didn’t win a delegate.

    The guy that win a bunch of delegates, I was the person who really focused on what the goal is. And the goal is not polls in February — in — excuse me — in July, but results in February.

    JUDY WOODRUFF: Let’s talk some issues.

    John Kasich, as you know, announced today. He became the 16th Republican to jump in the race. He’s putting a lot of emphasis on income inequality. There’s a new report out by the Annie E. Casey Foundation that says 22 percent of American children today are living in poverty.

    First of all, do you accept that number, and, second, what would you do about it?

    RICK SANTORUM: I would suspect that the vast majority of those 22 million kids living in poverty are living in…

    JUDY WOODRUFF: Twenty-two percent.

    RICK SANTORUM: Twenty-two percent — excuse me — living in poverty are living in broken homes.

    If you — I’m actually one of the few politicians who walks around holding up two books at my town hall meetings, one, Robert Putnam, a liberal sociologist from Harvard, and Charles Murray, a libertarian with the American Enterprise Institute, and talk about those two books from the far left and the far right.

    I think both come down to the same conclusion, that the reason the middle is hollowing out, the reason people aren’t able to rise is fundamentally a breakdown in the family structure in America and the consequence of that.

    And, as you know, I’m someone who has really focused long and hard for a lot of years. I wrote a book 10 years ago called “It Takes a Family.” And what we need to do as a society, and to some degree even as a government, to try to help reknit the American family.

    And so I agree with John Kasich. That’s a big issue. I agree that there’s — that children’s ability to rise in America today is not what it should be and not what we should expect in America. And we have got some really solid ideas to create a stronger economy, as well as to try to help stabilize and support stronger families.

    JUDY WOODRUFF: Immigration. After Donald Trump made his announcement that he was running for president and he spoke about Mexican immigrants bringing drugs and crime and being rapists, you did say later that you didn’t agree with him, but it took you two weeks to come out and make a statement.

    RICK SANTORUM: No, I made a statement, actually, whenever I was asked about it.

    I did disagree with what he said, but I agree that the issue is an important issue to be discussed. And, in fact, I was — I’m the only person in this race who’s actually put out a comprehensive plan on immigration control that deals with both illegal and legal immigration.

    And there’s — there are a lot of — again, to me, it goes with, how are we going to create a better opportunity for lower-skilled workers in America, many of those poor children you’re talking about, who are not going to be able to go to college? How are we going to create the opportunity for them to rise in society?

    And so we have put together not just an economic plan that deals with a whole host of things, including, by the way, increasing the minimum wage, which I’m one of the few Republicans that is in favor of, but also an immigration plan that says let’s quit bringing over a million legal immigrants a year, as well as hundreds of thousands, if not millions illegal immigrants, almost all of whom are unskilled, into this country to compete against the workers right now who see their wages flatlining and the opportunity for them to rise decreasing in America.

    And so you can look at the immigration issue, and we have, according to the number, 35 million legal and illegal immigrants have come into this country in the last 20 years. That can be a good thing or a bad thing.

    But the idea that you can’t have a discussion about whether this — whether we should limit immigration because that makes you xenophobic or jingoistic is wrong. We need to look at it from the standpoint of what’s best for the economy and what’s best for the American worker.

    JUDY WOODRUFF: We don’t have time to discuss it now, but we know more Mexicans are leaving the country now to go back to Mexico than are coming.


    In fact, the majority of — the majority of people that are coming into this country illegally now are visa overstays. They’re not Mexicans coming across the border. You’re right.

    JUDY WOODRUFF: Former Senator Rick Santorum, thank you for talking with us.

    RICK SANTORUM: My pleasure, Judy. Thank you.

    JUDY WOODRUFF: Appreciate it.

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    fighting islamic state

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    JUDY WOODRUFF: Tonight: an exclusive story from Iraq on American citizens, civilians, fighting the Islamic State group. Many are former U.S. military, but some have never seen a battle before.

    Special correspondent Marcia Biggs reports.

    MARCIA BIGGS: American boots are back on the ground in Iraq. This time, they’re volunteers, U.S. military veterans on the front lines against the Islamic State, and among them, one woman; 25-year-old Samantha Johnston was a private in the Army for two years before, she left to be a stay-at-home mom to her three children.

    When the Islamic State dominating the news last year, she says she sat in her North Carolina home, watching videos of their atrocities and felt compelled to join the fight.

    SAMANTHA JOHNSTON, American volunteer: Something inside of me just snapped, and I couldn’t allow myself to sit down and do nothing, when all of these children here are in trouble, and I and me and my family are just living happily in America.

    MARCIA BIGGS: She made contact with other volunteers through social media sites. And three months ago, she packed her bags and flew to Iraq, where she volunteered with the Kurdish army, the Peshmerga, in the fight against I.S. She says she’s become close to the Kurdish soldiers in her unit, even listing herself on Facebook by a Kurdish name.

    SAMANTHA JOHNSTON: They became my family. And I plan to stay here for as long as I can, as long as they need me to be here.

    MARCIA BIGGS: She spends her days training for battle, but has not yet seen any combat. Back in her Army days, her job was making maps for deployed units, but she never got the chance to go overseas.

    SAMANTHA JOHNSTON: I really wanted to be deployed, but my unit never deployed.

    MARCIA BIGGS: Is that why you’re here?

    SAMANTHA JOHNSTON: Probably. It’s probably one of the many reasons I’m here.

    MARCIA BIGGS: And she’s not the only one. Officials at the U.S. State Department believe that more than 150 Americans have voluntarily traveled to Iraq and Syria to fight in the ongoing conflict.

    KEITH BROOMFIELD, American volunteer: I’m here as Gelhat Rumet. I’m from the Boston area, from Lynn.

    MARCIA BIGGS: Just last month, 36-year-old Keith Broomfield became the first American known to die while fighting I.S. He was killed near the Syrian town of Kobani.

    JEREMY WOODARD, American volunteer: The next village is right over there. That is I.S.’ home flag.

    MARCIA BIGGS: Many of the volunteers we met are military veterans, like 29-year-old Jeremy Woodard, who spent years fighting in Iraq and Afghanistan, but struggled back home.

    JEREMY WOODARD: It was hard to get a job. You barely can get a job at McDonald’s flipping a burger. They look at you, they see your resume for serving in the U.S. Army honorably, but they look at you like you’re a hazard, you know, you’re going to hurt somebody.

    MARCIA BIGGS: When I.S. fighters swept through Iraq last summer, Woodard also left family behind, jumping at the chance to get involved in the fight, in honor of his fellow soldiers who fought and died in the U.S. war in Iraq.

    JEREMY WOODARD: All those people who got killed over here for fighting for a cause, I didn’t want them to die in vain.

    MAN: There’s been a lot of intense fighting going on.

    MARCIA BIGGS: Woodard’s unit has seen some combat, fighting alongside the Peshmerga. Back in April, they established this defensive line, after a fierce battle with I.S. fighters, a force these volunteers say is one to be reckoned with.

    MAN: We don’t recognize them as terrorists. We actually recognize them as an actual Army. They’re well-trained, sophisticated. Whenever they get into battle, it’s well — very disciplined manner.

    MARCIA BIGGS: Despite never serving in the military, Danny was one of the volunteers who was wounded in that battle, shot in the leg.

    MAN: Are you ready to die for this?

    MAN: Am I ready to die for this? Well, I have been out here for the last seven months already. I pretty much made up my mind to go ahead and help out these people, help out those people that aren’t able to help themselves. So, if that will be a matter of fact to do so, then, hey, it is what it is.

    MARCIA BIGGS: The volunteers say they’re here out of moral obligation. They’re not even being paid. And while it’s not technically illegal, the U.S. State Department is adamant that it doesn’t support their participation in this conflict.

    But for these Americans, it wasn’t even a question.

    JUSTIN SMITH, American volunteer: I’m having a great time out here. I feel more comfortable here than I ever felt in America.

    MARCIA BIGGS: After serving in Iraq, Justin Smith says he suffered from post-traumatic stress disorder. Several attempts at treatment failed, and he finally sold everything he owned to buy a one-way ticket back. He says Iraq seems like paradise compared to the hell of staying in the U.S.

    JUSTIN SMITH: In the States, there is too much idle time, too much time just doing nothing or sitting around and drinking, or anything like that. It’s better here. Like I have said countless times, I get to do my job. I love my job.

    MARCIA BIGGS: Do you think you can ever go back to the U.S.?

    JUSTIN SMITH: Probably. I mean, I won’t like it, but I will have to go back eventually.

    MAN: I don’t think I could leave for good.

    MARCIA BIGGS: While the Peshmerga doesn’t officially allow foreigners to volunteer, local authorities often look the other way when volunteers arrive. And they have been largely embraced, sometimes simply out of Kurdish hospitality.

    But one Kurdish officer told us that, while he appreciates the volunteers, this is not what they need from the United States.

    1st Lt. Daban Kawa: We don’t need exactly people to come fight for us. We need weapons. We need equipment, supplies from American government, from the — from different countries.

    MARCIA BIGGS: We asked Jeremy why he thinks it’s his business to fight in a war that the U.S. is not directly waging.

    JEREMY WOODARD: It should be everybody’s business. If it doesn’t get stopped over here, it’s going to keep spreading.

    MARCIA BIGGS: Do you think there are so many ISIS sleeper cells in the United States?

    JEREMY WOODARD: I believe it. I think there’s quite a few.

    MARCIA BIGGS: Why do you believe that?

    JEREMY WOODARD: I mean, that’s a good question. I mean, they keep claiming that they’re there. I mean, who knows. It’s a possibility that they’re not. But, honestly, I believe that they are.

    MARCIA BIGGS: So why not be in the us searching out sleeper cells?

    JEREMY WOODARD: I mean, this is where the fight is right now. It’s got to get controlled here.

    MARCIA BIGGS: Johnston faces a firestorm of controversy over leaving behind her 5-year-old and her 3-year-old twins to volunteer in a war on the other side of the world, where we’re told I.S. fighters have put a $300,000 price on her head.

    SAMANTHA JOHNSTON: I see these refugee children. I see just the normal poor children here, and I think of my children. And my children are happy. They’re safe. They’re fed. They have more than they need. And they’re OK.

    MARCIA BIGGS: You said, “My kids have everything they need,” but they don’t have their mom.

    SAMANTHA JOHNSTON: They don’t, but I will spend the rest of my life making that up to them.

    MARCIA BIGGS: You cried all the way to the airport?

    SAMANTHA JOHNSTON: I don’t want to think about it. That was the hardest day of my life. I will never leave them again when I come back, never.

    Every day is a battle not to come back. Every day, I — I look at prices to fly back. But I have a — I have a goal here, and I can’t just give up.

    MARCIA BIGGS: It’s a goal and a cause they all believe in. But it’s also an escape.

    JEREMY WOODARD: It’s an escape, yes. It’s like a vacation here. It’s kind of sick to say. After I graduated, I went straight to the Army. I was 17 when I went in. And I just know war. That’s it.

    I’m still searching. Searching for what, I don’t know, searching for a part of myself, where I belong. I belong in a place like this.

    MARCIA BIGGS: For those still searching, the fight against I.S. provides yet another war.

    For the PBS NewsHour, I am Marcia Biggs in Northern Iraq.

    JUDY WOODRUFF: Since our interview, Samantha Johnston left Iraq for Europe and posted on her Facebook page that, although it is — quote — “time to start heading back to my family,” she indicated that she will be returning to Iraq.

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    Nine-year-old Tumelo shows off antiretroviral (ARV) pills before taking his medication at Nkosi's Haven, south of Johannesburg November 28, 2014. Nkosi's Haven provides residential care for destitute HIV-positive mothers and their children, whether HIV-positive or not. Nkosi's Haven is named after Nkosi Johnson, the young AIDS activist who passed away on International Children's Day on June 1, 2001. December 1 is World AIDS Day. Picture taken November 28.  REUTERS/Siphiwe Sibeko (SOUTH AFRICA - Tags: HEALTH) - RTR4G62Y

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    GWEN IFILL: Patients, advocates and scientists are hailing new studies that show the value of getting AIDS drugs to people early and often.

    The three-decade-long fight against AIDS has seen a series of breakthroughs in recent weeks, showing momentum in the push for an HIV cure. Yesterday, at the 2015 International AIDS Society Conference in Vancouver, researchers detailed some dramatic findings. They confirmed that, for people with HIV, starting treatments with antiretroviral drugs early did prevent AIDS-related illness and deaths.

    Until now, there had been concern that starting such therapy too early might increase patients’ risk of cardiovascular and renal disease. That news came on top of another surprising development, as doctors at the conference described the case of a French teenager. The so-far unidentified girl was born with HIV, and received antiretroviral treatment until she was 6. Twelve years later, she’s still free of the virus. It appears to be the first confirmed long-term remission in a child infected from birth.

    MICHEL SIDIBE, Executive Director, UNAIDS: People were saying that we were foolish dreamers, that we were even naive.

    GWEN IFILL: And that followed word last week that the U.N. reached its 2015 goal of providing access to HIV treatment for 15 million people worldwide, nine months ahead of schedule.

    MICHEL SIDIBE: And they said it was too costly. But we have been able to demonstrate that they were wrong. And they were saying that the costs will never go down.

    GWEN IFILL: The report also said that a once inconceivable goal, ending the AIDS epidemic, is in sight by the year 2030.

    So let’s look closer at the growth of treatment, the push to dramatically expand it to unheard-of levels and what these drugs have meant to people coping with the still-incurable disease.

    Deborah Birx is the point person for the government as the U.S. global AIDS coordinator. She joins us from Vancouver, where the conference is still under way. And Justin Goforth is a nurse and director of outreach for the Whitman-Walker Health care clinic here in Washington. He was diagnosed with HIV back in 1992.

    Dr. Birx let’s talk about these numbers, which are quite stunning. We’re talking about a 48 percent decrease in HIV infections in children just since 2009. That’s in 21 priority countries. What is the significance of this?

    DR. DEBORAH BIRX, U.S. Global AIDS Coordinator: It really shows that when we focus and work together, we can achieve amazing goals.

    So, under the global plan that was launched by PEPFAR and UNAIDS just a few short years ago, it really mobilized governments and communities to really move forward in an organized and focused way to have this dramatic change in the number of new infections in pediatrics.

    GWEN IFILL: Justin Goforth, you were hands-on every single day dealing with this for some years. How has it played out in a health clinic like yours, which serves so many people in a highly affected community?

    JUSTIN GOFORTH, Whitman-Walker Health: It’s been quite an evolution of course with the technology and science around HIV.

    We really needed to get to a point that we didn’t just have effective treatments, but that we had treatments that could actually be managed within a daily life of the people we take care of. And that’s where we’re at.

    And that’s why things are changing so quickly and it’s so important to pay attention to the issue, because if you can get in care and stay in care on treatment, it is a manageable chronic illness.

    GWEN IFILL: And that’s what’s happened with you?

    JUSTIN GOFORTH: That’s correct. It’s been since 1992.

    In, I think, ’96, I was taking at least 40 pills a day. That was five times a day, three times a day, had to be exactly eight hours apart with a full meal. Nobody eats like that. Two times a day had been to be with a completely empty stomach.

    They were effective, but they were toxic and not really manageable in people’s lives. And that’s not where we are. Where we are today is the majority of the people we take care of take one pill a day and manage their illness very effectively and plan on living full lives.

    GWEN IFILL: Dr. Birx, many of the findings that you have been talking about in Vancouver have to do with children worldwide, where there has been great impact over the years, especially among the youngest.

    Tell me about the significance of how soon you begin to act and provide this medication for children.

    DR. DEBORAH BIRX: Well, both children and adults, so it’s been incredibly exciting to be back in Vancouver.

    As you heard there from Justin, we had 19 years ago in this very city the announcement of highly effective treatment. And for myself and many clinicians, that was when we were actually able to keep our patients alive. So the patients that made to it 1996, if you were in the developed world, you were able to actually live effectively. And that was so extraordinary.

    To be back here 19 years later and here now, through the really groundbreaking trial that was done around the world, the START trial, it says, if we start people early, they can live full and productive lives, no matter where they are. So that theme of that conference, which was one hope, one world, can finally be realized with this new trial results.

    And we are so excited to translate that science immediately into programs through PEPFAR.

    GWEN IFILL: You also were — part of your role, also, Dr. Birx, was to provide antiretrovirals for 15 million people by the year 2015, and you got there early. How did that happen?

    DR. DEBORAH BIRX: You know, that is so extraordinary, because when UNAIDS said that we were going to get to 15 — by 15 in 2011, everyone was incredibly doubtful.

    And those of us who could really see the vision were really excited about translating that vision into practice. And I think, through the funding of the Global Fund and the funding through PEPFAR, and it’s really — it’s new collaborations and partnerships with host governments and civil society allowed us all to really sprint in a way we didn’t know we were capable of doing.

    And so to say now that we have the last piece of the puzzle and the last tool that will really allow us to move and move back into this sprint mode to really reach people as quickly as we can, not only with effective therapy, which, as — but as what Justin said, not only effective, but a therapy that can be utilized as a community so that people can stay on treatment and thrive. And so this really is a unique opportunity.

    GWEN IFILL: Justin Goforth, in order to treat, in order provide this therapy, this wonderful technology, people have to be willing to take an early diagnosis as well. Has that changed over time? The numbers are not so positive here in Washington, D.C.

    JUSTIN GOFORTH: If you look over time, our numbers actually are getting tremendously better.

    I believe we had about 500 new infections last year, according to the new data that was out, and five to 10 years ago, that was easily 1,000 to 1,500 or for new infections. So, we have changed the number of new infections dramatically. That’s really a lot about getting a lot of people tested, those folks that HIV-positive into care.

    We have lots of data to suggest that it’s really difficult to change people’s behaviors.

    GWEN IFILL: Yes.

    JUSTIN GOFORTH: But getting them into care and on treatment actually doesn’t just keep that person healthy and well for a life span; it also prevents them from infecting other individuals.

    That’s an historic marriage of two — public health prevention and treatment all coming together at the same time. And having a manageable treatment was necessary to get to the point that we could use this as prevention.

    And so that’s what, I think, is really see — we’re seeing a turnaround in the numbers in all of our urban centers in the United States, but particularly here in D.C., where we used to be seen as the worst of the worst. That’s not the case actually more with our new numbers.

    GWEN IFILL: Dr. Birx, 2030, you’re talking about getting to zero. What is the possibility of that and how do you get there?

    DR. DEBORAH BIRX: Well, we’re talking about ending AIDS as a public health threat, so we certainly want all of our HIV positives, the 37 million people living with HIV right now, to know their status and to thrive and to be on medication so they can thrive.

    To get there to the end is that we’re going to require us to bring all our prevention tools to the table and expand them in an appropriate way in absolute partnership with the community, and I think we have been using the Whitman-Walker example. You can see what that clinic and its community outreach has been able to do.

    We want to translate what the Whitman-Walker clinic and others have been able to do in Washington, D.C., to every city, every village and every community around the globe. And you can see from what we just heard from Justin, it’s possible.

    GWEN IFILL: Dr. Deborah Birx, U.S. global AIDS coordinator, and Justin Goforth, the director of outreach at the Whitman-Walker Clinic here in Washington, thank you both very much.

    JUSTIN GOFORTH: My pleasure.

    DR. DEBORAH BIRX: Thank you, Gwen.

    The post How early treatment has changed the death sentence of AIDS appeared first on PBS NewsHour.

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    news wrap

    Watch Video | Listen to the Audio

    JUDY WOODRUFF: President Obama invoked the Iraq War today during a defense of the recent nuclear deal with Iran. He said those who oppose the deal are like the people who rushed the U.S. into war with Iraq.

    He spoke in Pittsburgh at the Veterans of Foreign Wars national convention.

    PRESIDENT BARACK OBAMA: We’re hearing the echoes some of the same policies and mind-set that failed us in the past. Some of the same politicians and pundits that are so quick to reject the possibility of a diplomatic solution to Iran’s nuclear program are the same folks who were so quick to go to war in Iraq and said it would take a few months.

    We know the consequences of that choice, and what it cost us in blood and treasures.

    JUDY WOODRUFF: The president also pressed Congress today to help with funding for the Veterans Affairs Department. It’s been a little over a year since the VA was rocked by scandal over excessive wait times. He said he’s still not satisfied with the changes hospitals have made in fixing veterans’ care.

    GWEN IFILL: An uncle of the man who opened fire on military facilities in Chattanooga, Tennessee, has been in custody overseas since a day after the attack. The uncle of Mohammad Youssuf Abdulazeez lives in Jordan, where other relatives have also been questioned by authorities. Abdulazeez spent several months in the kingdom last year.

    In Washington, Republican Senator John McCain asked the general tapped to be the next Army chief about arming recruiters.

    GEN. MARK MILLEY, Chief of Staff, U.S. Army – Designate: I think that’s complicated legally, and there’s issues involved throughout the country. But we will have to come to grips with that. And it certainly should be…

    SEN. JOHN MCCAIN (R), Arizona: If the legal part of it can be resolved, do you think that they should under certain conditions be armed?

    GEN. MARK MILLEY: I think, under certain conditions, both on military bails and in out-stations, recruiting stations, reserve centers, that we should seriously consider it. In some cases, I think it’s appropriate.

    GWEN IFILL: President Obama pledged today the U.S. will do everything in its power to protect American military members from attacks like last week’s.

    JUDY WOODRUFF: A prosecutor in Texas says it’s too early to tell what happened to a woman who died in police custody last week. Sandra Bland was found dead in her jail cell three days after she was arrested. Her death was originally ruled a suicide, but authorities are now treating the case as if it were a murder investigation.

    Authorities also released a surveillance video showing no movement outside her cell until medical personnel arrived on the scene.

    GWEN IFILL: Two-term Ohio Governor John Kasich has become the 16th Republican to enter the 2016 presidential race. The former congressman is known for his record of fiscal conservatism. As chairman of the House Budget Committee, he helped secure a balanced budget deal in 1997. Kasich officially announced his candidacy today at Ohio State University in Columbus, with his family at his side.

    GOV. JOHN KASICH Republican Presidential Candidate: I will promise you that my top priority will get this country on the path to fiscal independence, strength, and we will rebuild the economy of this country, because creating jobs is our highest moral purpose, and we will move to get that done!


    GWEN IFILL: In other campaign news, Donald Trump lashed out at fellow Republican presidential contender Lindsey Graham, who has been critical of the New York businessman. Before a crowd of about 500 people in South Carolina, Trump called the Palmetto State senator a “total lightweight” — unquote — and read what he said was Graham’s cell phone number aloud from a piece of paper.

    Trump said Graham gave him the contact information years ago, when the two were more friendly.

    JUDY WOODRUFF: A federal appeals court in Chicago overturned some of the most sensational corruption convictions of former Illinois Governor Rod Blagojevich. He’s currently serving a 14-year sentence after he was convicted in 2011 of trying to sell President Obama’s former Senate seat to the highest bidder. Prosecutors could appeal the ruling or decide to retry Blagojevich on the dropped counts.

    GWEN IFILL: Voters headed to the polls in small numbers today in Burundi, where protests and violence dampened the turnout. At least two people, a policeman and a civilian, were killed in a string of explosions and gunfire that rocked the capital overnight. In spite of that, most polls managed to open on time. Opposition groups are boycotting the election in protest of the current president’s decision to run for a third term.

    JUDY WOODRUFF: A mass funeral was held in Southeastern Turkey for victims of yesterday’s suicide bombing in Suruc, near the border with Syria. Crowds of mourners wept and shouted over the flag-draped coffins as they were laid out; 32 people died and 100 were injured when the blast ripped through a rally of young political activists. Meanwhile, Turkey’s prime minister announced the suspect had ties to Islamic State terrorists, but refrained from identifying the individual.

    GWEN IFILL: Dozens of mayors and governors from major cities around the world gathered at the Vatican today to demand bold action on climate change. The summit was designed to increase pressure on national leaders ahead of climate negotiations in Paris later this year. Last month, Pope Francis released a landmark environmental encyclical, urging the world to do more to fight human-induced global warming.

    JUDY WOODRUFF: New research suggests older women with mild memory problems worsen twice as quickly as men. That was in a report presented today at an international conference on Alzheimer’s disease here in Washington. Women make up nearly two-thirds of all Alzheimer’s cases in the U.S., but scientists say they are still baffled as to why the disease disproportionately affects so many more women than men.

    GWEN IFILL: Stocks fell on Wall Street today after several disappointing corporate earnings reports. The Dow Jones industrial average lost 181 points to close at 17919. The Nasdaq fell more than 10 points and the S&P 500 slipped nine points.

    The post News Wrap: Obama likens Iran deal opposition to Iraq war push appeared first on PBS NewsHour.

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    The cast of the Broadway play "Ragtime" performs a scene from the play, during the 1998 Tony Award Ceremonies at Radio City Music Hall in New York, June 7. "Ragtime" won six awards in the 130th annual Tony Awards show. - RTXI9JY

    The cast of the Broadway play “Ragtime” performs a scene from the play during the 1998 Tony Award Ceremonies at Radio City Music Hall in New York, June 7. “Ragtime” won six awards in the 130th annual Tony Awards show. Photo by Jeff Christensen/Reuters

    E.L. Doctorow, an author beloved for his works of historical fiction including “Ragtime,” “World’s Fair,” “Billy Bathgate” and “The March,” died Tuesday of complications from lung cancer, according to his son.

    Doctorow grew up in the Bronx in New York City and attended the Bronx High School of Science. Doctorow said early encouragement from his teachers had helped him pursue writing in an interview with Roger Rosenblatt at the 92nd St. Y in New York City. He attended Kenyon College, then served in the U.S. Army from 1954-55 as a corporal stationed in Germany.

    Doctorow’s work interweaved characters and historical details from both past and present, lending new perspective to both. His novel “The Book of Daniel” (1971), his third book and one of his first widely-known works, told the story of a couple loosely based on Julius and Ethel Rosenberg, who were executed by the U.S. for treason in 1953.

    He drew public acclaim for his novel “Ragtime” (1975), which explored life in New York City in the years before World War I. “It works so well that one devours it in a single sitting as if it were the most conventional of entertainments,” Christopher Lehmann-Haupth of The New York Times wrote in a review of the book shortly after it was published. The novel would later be adapted into a Broadway musical by Stephen Flaherty, Lynn Ahrens and Terrence McNally.

    His novel “World’s Fair” (1985) drew on his own experiences, forming what Doctorow called “a portrait of the artist as a very young boy.” David Leavitt of The New York Times wrote in a 1985 review that “World’s Fair” contained “dazzling prose” in its exploration of the nature of memory:

    By flaunting the artificial line dividing the true from the imagined, Mr. Doctorow not only suggests in ”World’s Fair” that the process of remembering is by definition a process of invention, he rejects altogether the notion that imagination and memory are ever pure of each other.

    Doctorow’s described his process in an interview with The Paris Review. He said that having begun a project, he usually had no idea where it was going to end:

    It’s not a terribly rational way to work. It’s hard to explain. I have found one explanation that seems to satisfy people. I tell them it’s like driving a car at night: you never see further than your headlights, but you can make the whole trip that way.

    President Obama called Doctorow “one of America’s greatest novelists” in a tweet Tuesday night. “His books taught me much, and he will be missed,” he wrote.

    He was the Winner of twp Pen/Faulkner Awards, the National Book Critics Circle Award, the PEN Saul Bellow Award, a National Humanities Medal and the Gold Medal for Fiction as well as a finalist for the National Book Award and the Pulitzer Prize.

    The post E.L. Doctorow, acclaimed author of historical fiction, dies at 84 appeared first on PBS NewsHour.

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    Registered nurse Stephen Van Dyke treats a patient while on a home health care visit on March 23, 2012 in Arvada, Colorado. The Supreme Court will hear oral arguments next week on whether the 2010 health law can require most Americans to have health insurance starting in 2014. Van Dyke works for the Dominican Sisters Home Health Agency, a non-profit that performs some 25,000 home visits each year in the Denver area. It provides free home nursing care to patients with chronic diseases, helps them to better manage their disabling illnesses and provides custodial services with the aim of keeping patients in their homes and out of more expensive nursing home care. (Photo by John Moore/Getty Images)

    Medicare does cover skilled nursing care, which can be delivered in a home setting. But its coverage was never designed to be a long-term solution. Photo by John Moore/Getty Images

    Editor’s Note: Journalist Philip Moeller, who writes widely on health and retirement, is here to provide the Medicare answers you need in “Ask Phil, the Medicare Maven.” Send your questions to Phil.

    Your Medicare Questions

    Medicare rules and private insurance plans can affect people differently depending on where they live. To make sure the answers here are as accurate as possible, Phil is working with the State Health Insurance Assistance Program (SHIP) and the Medicare Rights Center (MRC).

    Karen – W.Va.: My Mom is 88, and my Dad turns 90 this year. They have been relatively healthy until this past year when my Dad began to have small strokes and my Mom fell and broke her hip. She is now also struggling with cerebral amyloid angiopathy, which is causing many symptoms similar to a stroke. Both are disoriented, having severe difficulty with their long and short term memories and some trouble also communicating their thoughts. Neither of them is able to care for each other or themselves or are able to be left alone. My sister, who lives not far from them, has been looking after them almost 24/7 for the last seven months. I live at a distance, have many responsibilities in my life and can only come briefly from time to time. Our situation is not sustainable. In-home care is needed if they are going to remain in their home. Up until now, they have been living independently and would like to stay in their apartment, which they own. My sister says she has explored home care for them, but Medicare has told her they will only pay for skilled care, that is, nurses, rehab etc., which they have both used and Medicare did cover it. I read your qualifications in the PBS piece and my parents certainly qualify in the four categories you name, but my sister is hitting road blocks with Medicare who say they do not cover simple home care under any conditions. Am I understanding what you are saying correctly — do they have some home care in their Medicare coverage? If so how do we get around this roadblock? Who should we be talking to? Thanks so much for any help you can offer. We are quite desperate at this point.

    Phil Moeller: This is one of the most significant real-life issues that growing numbers of older Americans and their grown children face. Millions of families will be in Karen’s situation. And we do not have the answers for them. Very few families can afford private long-term care insurance. Medicare certainly does not cover long-term custodial care in nursing homes or other institutional settings. Medicaid is the default provider of long-term care in this country. But older patients need to spend down nearly all of their assets to qualify for Medicaid, and the process of doing do is not only daunting in terms of paperwork, but often demeaning and embarrassing to proud Americans who have worked all their lives. They might be forgiven for feeling they deserve better than to be effectively forced into welfare to become wards of the state and placed in homes that, with all due respect, can easily become warehouses for the elderly poor.

    Medicare does cover skilled nursing care, which can be delivered in a home setting. But its coverage was never designed to be a long-term solution. For example, skilled care in a nursing facility gets very expensive after the first 20 days, with a co-insurance cost exceeding $150 a day for days 21 to 100. After that, patients must pay ALL expenses, which would be akin to simply moving into an expensive assisted-living facility.

    Skilled care at home can be cheaper for everyone, but again, is not something that Medicare designed as an ongoing, long-term benefit. In Medicare’s online description of its in-home care services, this seems to me to be the key issue that Karen’s parents face: “You’re not eligible for the home health benefit if you need more than part-time or ‘intermittent’ skilled nursing care.” It defines intermittent care being required less than seven days a week or less than eight hours a day. I do agree with Karen and her sister that, with the help of her parents’ doctors, they should be able to make a case for Medicare insuring her parents’ receipt of skilled in-home care, but only as a stop-gap approach. She should get in touch with a local affiliate of the National Association of Area Agencies on Aging, a consortium of non-profits around the country. Ask for a list of home health agencies willing to provide Medicare-covered services. These agencies should know the ropes of intermittent care and should be able to tell you the types and duration of care that will comply with Medicare’s rules.

    However, Karen’s parents clearly are in decline. She needs to look for a longer-term solution even if in-home skilled care is approved. Whatever the definition of intermittent may be, her parents will need more than this, and perhaps they will need it soon.

    Jane – Calif.: I am a retired federal employee. I retired at age 60 in 2010. I will be turning 65 in October 2015. I am eligible for Medicare as I paid into that. I am now covered by good medical insurance as part of my retirement package. I have two daughters who are also covered by my medical insurance, so I plan to remain in the insurance program I have, possibly for eight more years since my younger daughter is just 18. My question is: I plan to enroll in Medicare Part A, but do I need part B? It seems redundant. And how does Medicare look at my medical insurance since it isn’t due to my current employment, but my former employment?

    Phil Moeller: Jane mentions being currently employed but says nothing about whether she could get health coverage from this job and how this would compare with her retiree coverage. Perhaps she already has done this comparison and concluded it’s best for her to stick with the retiree health coverage from her former employer, which includes coverage of her two daughters. Whether Jane needs Part B for herself is something she should determine by finding out more details of her retiree health plan. Retiree health plans generally require retirees to get Medicare. This is because the plans are designed to work with Medicare so that Medicare becomes the primary payer of covered insurance claims, and the retiree plan becomes the secondary payer. If the person has a claim, their secondary often pays most or even all of what Medicare does not pay. But for this to work, the person needs to have Parts A and B. Some retiree plans also have components that support Medicare Advantage plans and Part D prescription drug coverage. These are details Jane’s former employer should be able to brief her about.

    As a federal retiree, Jane also may have access to the only retiree health plan that the Medicare Rights Center (MRC) says may not require her to get Part B. The Federal Employee Health Benefits Program (FEHBP) has a rich menu of possible retiree benefits. Sorry for all the initials but writing out Federal Employee Health Benefits Program hurts my wrists, and perhaps your eyes as well. Anyhow, Jane does not identify her retirement plan, but if it’s in the FEHBP family, she should look into it. Here’s what the MRC has to say:

    • If you are enrolled in a health maintenance organization (HMO) under FEHBP, you may find that the HMO provides such comprehensive coverage that you do not need to enroll in Part B. You should evaluate your benefits before making a decision not to take Part B. Be aware however, that in an HMO, you may be limited in which doctors, hospitals and pharmacies you will be covered to go see. You will generally pay more to see out-of-network doctors. Having Part B through original Medicare could increase your access to providers; most doctors and hospitals in the country take original Medicare.

    • If you are enrolled in a fee-for-service plan under FEHBP, you may find it better to take Medicare because your plan waives most Medicare deductibles, coinsurance and copayments (except for prescription drugs) for people who have Part B. As a result, FEHBP fee-for-service plan enrollees with both Parts A and B find that they have little or no out-of-pocket expenses.

    Lastly, Jane should be aware that while it might be possible for her to do without Part B for now, she might face stiff penalties later should she decides she needs it. Her monthly Part B premium could be hit with a late enrollment penalty that equals 10 per cent of the premium for each year she is late in enrolling. And it would last for the rest of her life. Ouch!

    Barbara: My sister had a massive stroke about a year ago and is in a nursing home. Her Medicare ran out a few months ago. Does her coverage renew every year or is it a one-time thing?

    Phil Moeller: I’m guessing here that Barbara does not mean her sister’s Medicare policy actually expired, but that Medicare stopped covering expenses for her stay in a skilled nursing facility (SNF). I also don’t know what “flavor” of Medicare her sister has. Basic Medicare only covers 20 days of skilled nursing facility care and then tags patients with a $157.50 daily coinsurance fee for days 21 to 100. After that, all costs must be paid by the patient. Some Medigap policies help with the coinsurance payment. Medicare Advantage plans may improve on basic Medicare but she’d need to check with her plan insurer. Once her sister has gone 60 days with no Medicare services, her skilled nursing facility “spell of illness” would reset, according to SHIP counselors who help answer Ask Phil questions. Then she could apply again for covered skilled nursing facility care. If Barbara’s sister has limited financial resources, she might qualify for Medicare Savings Programs to help her with Medicare costs.

    Susan – N.Y.: I am currently getting physical therapy. But I am planning to have back surgery in August. If I do my post-operative recovery in the hospital, is there any limit to how much physical therapy I can have (that is, because I’ve already used some of my allotted annual amount in the out-patient physical therapy just to keep me ambulatory enough before the back surgery)?

    Phil Moeller: I have always wanted to be able to say that Medicare is a pain in the back. Now, all I need is for someone to send me a question about problems with their derrière! There is a $1,940 cap on physical therapy on charges that Medicare will cover, but there may be exceptions should Susan’s doctor and physical therapist request additional therapy. Remember that basic Medicare only pays 80 percent of covered charges.

    The post Medicare coverage for aging parents’ care is not nearly enough appeared first on PBS NewsHour.


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