Tag: states

Blue states put the brakes on health care for undocumented immigrants

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“It frustrates me because it’s not based on any kind of policy decision other than dollars,” said Connecticut state Rep. Jillian Gilchrest, a Democrat who is spearheading a bill to expand Medicaid to all undocumented kids this year. “The budget document outlines your priorities as a state. As we’re looking at all the various things we need to fund, this should be top of mind.”
The intra-party debate comes as the Biden administration and Democrats at the national level grapple with how to expand health care access for noncitizens — who make up just 6 percent of the U.S. population but 23 percent of the uninsured — in a divided Congress.
Hopes of a public health insurance option, a hallmark of Biden’s presidential campaign, were dashed during debates over what became the Inflation Reduction Act. Instead, House Republicans just passed legislation that would add work requirements to Medicaid — a move that could leave an additional 600,000 Americans uninsured, according to the Congressional Budget Office.
Against that federal backdrop, progressive state lawmakers are trying to take up the mantle, using their own dollars to push policies for undocumented immigrants that were until recently outside mainstream Democratic thinking and inch toward universal coverage.
“The idea that health care is something everybody should have access to has shifted in the last decade or so,” said Kelly Whitener, an associate professor at the Georgetown University McCourt School of Public Policy’s Center for Children and Families. “How to get there is the hard part — and I think the cost barrier is a real one.”
In Nevada, Democrats have slashed a $300 million proposal to expand Medicaid to all undocumented immigrants to a $90 million policy that would cover those up to age 26 — with further cuts on the table. Even if legislators can agree on the price tag, Republican Gov. Joe Lombardo has not said whether he will sign it into law.
In Minnesota, where Democrats control the governor’s mansion and both chambers of the legislature for the first time in a decade, lawmakers are debating whether to extend state-funded Medicaid coverage to undocumented children or spend an extra $39 million to cover all undocumented immigrants as they balance a host of other priorities, such as K-12 schools, affordable housing and child care.
And in Connecticut, lawmakers in 2021 expanded Medicaid coverage for undocumented children up to age 8. Last year, they expanded the program to age 12. While a bill was introduced this year that would have allowed coverage up to age 26, costing the state about $15 million a year, it was whittled down to age 15, at a cost of $3 million.

Immigrant advocates — frustrated with the state’s incremental approach to expanding coverage — are pushing in the final weeks of the legislative session for an extra $5 million they say would allow them to cover all kids up to age 18. Connecticut Gov. Ned Lamont, a Democrat, said during a Wednesday forum that he was comfortable with extending the program to age 15.
“Well, the advocates are saying, ‘Not enough,’” Lamont said. “I get it. That’s their job, but I think we’re making progress every day.”
Democrats who favor incremental coverage expansion argue they are being methodical and chafe at the accusation that it signals a lack of political will.
“That’s just flat out nonsense,” said Connecticut state Sen. Cathy Osten, the Democrat who co-chairs the legislature’s appropriations committee. “We just want to roll out the program correctly.”
Illinois offers a cautionary tale for those concerned about costs. The number of undocumented adults who have signed up for Medicaid under the state’s coverage expansions exceeded the actuarial firm Milliman’s projections, according to the Department of Healthcare and Family Services. And, according to the state’s most recent public data, between March 2022 and February 2023, the program paid nearly twice — $189 million more — in claims for covered adults than Milliman projected, the department said.
“There’s historically been an assumption that takeup would be slow and low, that people won’t necessarily know that coverage is available, or if they are aware that coverage is newly available, they might be reluctant to enroll,” Whitener said. “But it is not playing out that way in every state.”
Beyond Illinois, California, Maine, Massachusetts, New Jersey, New York, Oregon, Rhode Island, Vermont and Washington state have all expanded Medicaid to undocumented children. Some of those states also provide benefits to adults, either through Medicaid or the state health insurance exchange. Undocumented immigrants, as well as legal immigrants who have been in the country for less than five years, do not qualify for federal Medicaid money.
And Utah’s GOP legislature this year passed a bill expanding health coverage to undocumented kids through its Children’s Health Insurance Program after it was amended to include a $4.5 million cap, data review requirements and a sunset clause. Rep. Jim Dunnigan, a Republican, said he helped kill the proposal last year, but after extensive conversations with the bill’s Democratic sponsor, he co-sponsored the legislation this spring and shepherded it through the House, where it passed 64-7, with 52 Republicans in support.
“Some of my more conservative colleagues said … ‘If you structure it properly, we have a heart. We have a heart for kids,’” Dunnigan said. “Frankly, I was surprised at some of them. But I give them credit because they were willing to listen to what the bill was actually trying to accomplish.”

Proponents of the policies argue that while undocumented coverage expansions require significant ongoing funding, the dollars represent only a small part of their state’s budget and will save money in the long run by encouraging people to receive preventive care and keep people out of emergency rooms, reducing uncompensated care costs. They also argue the move will bring equity to mixed-status families where some people are eligible for health care and others are not, and that immigrants pay taxes that go to fund these types of programs.
But some lawmakers — in addition to having concerns about the cost — fear that opening up coverage will lead to an influx of undocumented immigrants from surrounding states, though several studies examining the so-called “magnet effect” of health care benefits have found that people move primarily for better housing, family reasons and jobs. They also argue that expanding the program too quickly could burden the state’s health care infrastructure and create problems that could leave people without coverage.
In Maryland, Democratic leadership scuttled a bill this year that would have allowed undocumented immigrants to purchase plans through the state’s health insurance exchange, saying the issue needed more study.
“What you have is a group of people who have identified a solution to a part of the problem and, I think because of their passion and their desire to see the health care needs met, they don’t necessarily understand why we want to look at all of the options available to us,” Maryland Senate Finance Committee Chair Melony Griffith, a Democrat, told reporters last month. “We want to make sure we’re meeting the needs of the most vulnerable, and getting the most out of the investments the state makes.”
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( With inputs from : www.politico.com )

May 9, 2023
Avril Haines told a Senate panel it’s “almost a certainty” China and Russia would use a U.S. debt default to demonstrate “chaos” in the United States.

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DNI Avril Haines also noted significant impacts from the recent leak of classified Pentagon documents.

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( With inputs from : www.politico.com )

May 4, 2023
BJP can be defeated nationally only when it is defeated in states: Sachin Pilot

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Jaipur: Senior Congress leader Sachin Pilot on Wednesday said the BJP can be defeated at the national level only when it is defeated in the states and asked “everyone” to work together to achieve this.
“It is necessary to defeat BJP in different states. We can defeat BJP at the national level only when we defeat them in the states. That is why everyone needs to work together,” Pilot said at an Eid-related event here.
The former deputy chief minister of Rajasthan also expressed confidence that the Congress party will win the Karnataka assembly election and will form the government in the state.

Pilot, who has been locked in a power tussle with Chief Minister Ashok Gehlot, said assembly elections will be held next in Rajasthan, Madhya Pradesh and Telangana and political meetings will begin in these states in a few months.
He said mutual harmony and brotherhood should be maintained during the election campaign.
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( With inputs from www.siasat.com )

May 3, 2023
Movie ‘The Kerala Story’ an attempt to destroy state’s communal harmony: Ruling CPI(M)

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Thiruvananthapuram: The ruling CPI(M) and opposition Congress in Kerala on Friday lashed out against the controversial upcoming movie ‘The Kerala Story’, saying freedom of expression was not a licence to spew venom in society, and the film was an attempt to destroy the communal harmony of the state.
‘The Kerala Story’, written and directed by Sudipto Sen, is portrayed as “unearthing” the events behind “approximately 32,000 women” allegedly going missing in the southern state. The film falsely claims they converted, got radicalised and were deployed in terror missions in India and the world.
In a strongly-worded Facebook post, Culture and Youth Affairs minister Saji Cheriyan said the movie was part of the Sangh Parivar propaganda to implement “their tried-and-tested method of creating unrest” among the communities by spewing venom in society.

“Kerala is a state which is known for communal harmony… This movie could be seen as an attempt by the Sangh Parivar to destroy the secular fabric of the state… This is a conspiracy to divide and create unrest in society,” Cheriyan said.
The Congress party urged the government not to give permission to screen the controversial movie as it aimed to create “communal divisions in society through false claims”.
Leader of Opposition in the State Assembly V D Satheesan rejected the claims of the movie makers and said it was clear that the intention of the upcoming movie was to tarnish the image of the state at the international level.
“Permission should not be given to screen the film which falsely claims that 32,000 women in Kerala have been converted into Islam and became members of ISIS,” the Congress leader said.
‘The Kerala Story’, starring Adah Sharma, is set to be released in cinemas on May 5.

Cheriyan said freedom of expression was not a licence to spew venom in society. “We will consider legal action against such fake propaganda,” he added.
Satheesan also said this was not an issue of freedom of expression but part of an attempt to implement the Sangh Parivar agenda of creating divisions in the society by casting aspersions on minority groups.
“No one should think that Kerala can be divided by spewing the poison of communalism,” he said, adding that the state would stand united — as has been its tradition — against this “deliberate move to foster religious rivalry”.
The Democratic Youth Federation of India (DYFI), the youth wing of the ruling CPI(M), also lashed out against the film and said its trailer itself hurt religious sentiments.
The DYFI in a Facebook post alleged that the medium of cinema was being misused by the makers of the movie to create communal divisions in society and to tarnish the image of the state.
The Left outfit also sought stern action against the film.
In a press note issued earlier this week, the filmmakers announced the release date with a poster that shows a burqa-clad woman with a tagline “Uncovering the truth that was kept hidden.”
The film’s writer-director Sudipto Sen’s earlier movies are ‘Aasma’, ‘Lucknow Times’ and ‘The Last Monk’.
‘The Kerala Story’ is backed by Sunshine Pictures Private Limited, founded by Vipul Amrutlal Shah, who serves as the producer, creative director and co-writer on the film.
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( With inputs from www.siasat.com )

April 28, 2023
Gun Violence Is Actually Worse in Red States. It’s Not Even Close.

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I run Nationhood Lab, a project at Salve Regina University’s Pell Center for International Relations and Public Policy, which uses this regional framework to analyze all manner of phenomena where regionalism plays a critical role in understanding what’s going on in America and how one might go about responding to it. We knew decades of scholarship showed there were large regional variations in levels of violence and gun violence and that the dominant values in those regions, encoded in the norms of the region over many generations, likely played a significant role. But nobody had run the data using a meaningful, historically based model of U.S. regions and their boundaries. Working with our data partners Motivf, we used data on homicides and suicides from the Centers for Disease Control for the period 2010 to 2020 and have just released a detailed analysis of what we found. (The CDC data are “smoothed per capita rates,” meaning the CDC has averaged counties with their immediate neighbors to protect victims’ privacy. The data allows us to reliably depict geographical patterns but doesn’t allow us to say the precise rate of a given county.) As expected, the disparities between the regions are stark, but even I was shocked at just how wide the differences were and also by some unexpected revelations.

The Deep South is the most deadly of the large regions at 15.6 per 100,000 residents followed by Greater Appalachia at 13.5. That’s triple and quadruple the rate of New Netherland — the most densely populated part of the continent — which has a rate of 3.8, which is comparable to that of Switzerland. Yankeedom is the next safest at 8.6, which is about half that of Deep South, and Left Coast follows closely behind at 9. El Norte, the Midlands, Tidewater and Far West fall in between.

For gun suicides, which is the most common method, the pattern is similar: New Netherland is the safest big region with a rate of just 1.4 deaths per 100,000, which makes it safer in this respect than Canada, Sweden or Switzerland. Yankeedom and Left Coast are also relatively safe, but Greater Appalachia surges to be the most dangerous with a rate nearly seven times higher than the Big Apple. The Far West becomes a danger zone too, with a rate just slightly better than its libertarian-minded Appalachian counterpart.

When you look at gun homicides alone, the Far West goes from being the second worst of the large regions for suicides to the third safest for homicides, a disparity not seen anyplace else, except to a much lesser degree in Greater Appalachia. New Netherland is once again the safest large region, with a gun homicide rate about a third that of the deadliest region, the Deep South.
We also compared the death rates for all these categories for just white Americans — the only ethno-racial group tracked by the CDC whose numbers were large enough to get accurate results across all regions. (For privacy reasons the agency suppresses county data with low numbers, which wreaks havoc on efforts to calculate rates for less numerous ethno-racial groups.) The pattern was essentially the same, except that Greater Appalachia became a hot spot for homicides.
The data did allow us to do a comparison of white and Black rates among people living in the 466 most urbanized U.S. counties, where 55 percent of all Americans live. In these “big city” counties there was a racial divergence in the regional pattern for homicides, with several regions that are among the safest in the analyses we’ve discussed so far — Yankeedom, Left Coast and the Midlands — becoming the most dangerous for African-Americans. Big urban counties in these regions have Black gun homicide rates that are 23 to 58 percent greater than the big urban counties in the Deep South, 13 to 35 percent greater than those in Greater Appalachia. Propelled by a handful of large metro hot spots — California’s Bay Area, Chicagoland, Detroit and Baltimore metro areas among them — this is the closest the data comes to endorsing Republican talking points on urban gun violence, though other large metros in those same regions have relatively low rates, including Boston, Hartford, Minneapolis, Seattle and Portland. New Netherland, however, remained the safest region for both white and Black Americans.
The data suppression issue prevented us from calculating the regional rates for just rural counties, but a glance at a map of the CDC’s smoothed county rates indicates rural Yankeedom, El Norte and the Midlands are very safe (even in terms of suicide), while rural areas of Greater Appalachia, Tidewater and (especially) Deep South are quite dangerous.
So what’s behind the stark contrasts between the regions?

In a classic 1993 study of the geographic gap in violence, the social psychologist Richard Nisbett of the University of Michigan, noted the regions initially “settled by sober Puritans, Quakers and Dutch farmer-artisans” — that is, Yankeedom, the Midlands and New Netherland — were organized around a yeoman agricultural economy that rewarded “quiet, cooperative citizenship, with each individual being capable of uniting for the common good.”
Much of the South, he wrote, was settled by “swashbuckling Cavaliers of noble or landed gentry status, who took their values . . . from the knightly, medieval standards of manly honor and virtue” (by which he meant Tidewater and the Deep South) or by Scots and Scots-Irish borderlanders (the Greater Appalachian colonists) who hailed from one of the most lawless parts of Europe and relied on “an economy based on herding,” where one’s wealth is tied up in livestock, which are far more vulnerable to theft than grain crops.
These southern cultures developed what anthropologists call a “culture of honor tradition” in which males treasure their honor and believed it can be diminished if an insult, slight or wrong were ignored. “In an honor culture you have to be vigilant about people impugning your reputation and part of that is to show that you can’t be pushed around,” says University of Illinois Urbana-Champaign psychologist Dov Cohen, who conducted a series of experiments with Nisbett demonstrating the persistence of these quick-to-insult characteristics in university students. White male students from the southern regions lashed out in anger at insults and slights that those from northern ones ignored or laughed off. “Arguments over pocket change or popsicles in these Southern cultures can result in people getting killed, but what’s at stake isn’t the popsicle, it’s personal honor.”
Pauline Grosjean, an economist at Australia’s University of New South Wales, has found strong statistical relationships between the presence of Scots-Irish settlers in the 1790 census and contemporary homicide rates, but only in Southern areas “where the institutional environment was weak” — which is the case in almost the entirety of Greater Appalachia. She further noted that in areas where Scots-Irish were dominant, settlers of other ethnic origins — Dutch, French and German — were also more violent, suggesting that they had acculturated to Appalachian norms. The effect was strongest for white offenders and persisted even when controlling for poverty, inequality, demographics and education.
In these same regions this aggressive proclivity is coupled with the violent legacy of having been slave societies. Before 1865, enslaved people were kept in check through the threat and application of violence including whippings, torture and often gruesome executions. For nearly a century thereafter, similar measures were used by the Ku Klux Klan, off-duty law enforcement and thousands of ordinary white citizens to enforce a racial caste system. The Monroe and Florence Work Today project mapped every lynching and deadly race riot in the U.S. between 1848 and 1964 and found over 90 percent of the incidents occurred in those three regions or El Norte, where Deep Southern “Anglos” enforced a caste system on the region’s Hispanic majority. In places with a legacy of lynching — which is only now starting to pass out of living memory — University at Albany sociologist Steven Messner and two colleagues found a significant increase of one type of homicide for their 1986-1995 study period, the argument-related killing of Blacks by whites, that isn’t explained by other factors.
Those regions — plus Tidewater and the Far West — are also those where capital punishment is fully embraced. The states they control account for more than 95 percent of the 1,597 executions in the United States since 1976. And they’ve also most enthusiastically embraced “stand-your-ground” laws, which waive a person’s obligation to try and retreat from a threatening situation before resorting to deadly force. Of the 30 states that have such laws, only two, New Hampshire and Michigan, are within Yankeedom, and only two others — Pennsylvania and Illinois — are controlled by a Yankee-Midlands majority. By contrast, every one of the Deep South or Greater Appalachia-dominated states has passed such a law, and almost all the other states with similar laws are in the Far West.
By contrast, the Yankee and Midland cultural legacies featured factors that dampened deadly violence by individuals. The Puritan founders of Yankeedom promoted self-doubt and self-restraint, and their Unitarian and Congregational spiritual descendants believed vengeance would not receive the approval of an all-knowing God (though there were plenty of loopholes permitting the mistreatment of indigenous people and others regarded as being outside the community.) This region was the center of the 19^th-century death penalty reform movement, which began eliminating capital punishment for burglary, robbery, sodomy and other nonlethal crimes, and today none of the states it controls permit executions save New Hampshire, which hasn’t killed a person since 1939. The Midlands were founded by pacifist Quakers and attracted likeminded emigrants who set the cultural tone. “Mennonites, Amish, the Harmonists of Western Pennsylvania, the Moravians in Bethlehem and a lot of German Lutheran pietists came who were part of a tradition which sees violence as being completely incompatible with Christian fellowship,” says Joseph Slaughter, an assistant professor at Wesleyan University’s religion department who co-directs the school’s Center for the Study of Guns and Society.
In rural parts of Yankeedom — like the northwestern foothills of Maine where I grew up — gun ownership is widespread and hunting with them is a habit and passion many parents instill in their children in childhood. But fetishizing guns is not a part of that tradition. “In Upstate New York where I live there can be a defensive element to having firearms, but the way it’s engrained culturally is as a tool for hunting and other purposes,” says Jaclyn Schildkraut, executive director of the Rockefeller Institute of Government’s Regional Gun Violence Research Consortium, who formerly lived in Florida. “There are definitely different cultural connotations and purposes for firearms depending on your location in the country.”
If herding and frontier-like environments with weak institutions create more violent societies, why is the Far West so safe with regard to gun homicide and so dangerous for gun suicides? Carolyn Pepper, professor of clinical psychology at the University of Wyoming, is one of the foremost experts on the region’s suicide problem. She says here too the root causes appear to be historical and cultural.

“If your economic development is based on boom-and-bust industries like mineral extraction and mining, people come and go and don’t put down ties,” she notes. “And there’s lower religiosity in most of the region, so that isn’t there to foster social ties or perhaps to provide a moral framework against suicide. Put that together and you have a climate of social isolation coupled with a culture of individualism and stoicism that leads to an inability to ask for help and a stigma against mental health treatment.”
Another association that can’t be dismissed: suicide rates in the region rise with altitude, even when you control for other factors, for reasons that are unclear. But while this pattern has been found in South Korea and Japan, Pepper notes, it doesn’t seem to exist in the Andes, Himalayas or the mountains of Australia, so it would appear unlikely to have a physiological explanation.
As for the Far West’s low gun homicide rate? “I don’t have data,” she says, “but firearms out here are seen as for recreation and defense, not for offense.”
You might wonder how these centuries-old settlement patterns could still be felt so clearly today, given the constant movement of people from one part of the country to another and waves of immigrants who did not arrive sharing the cultural mores of any of these regions. The answer is that these are the dominant cultures newcomers confronted, negotiated with and which their descendants grew up in, surrounded by institutions, laws, customs, symbols, and stories encoding the values of these would-be nations. On top of that, few of the immigrants arriving in the great and transformational late 19^th and early 20^th century went to the Deep South, Tidewater, or Greater Appalachia, which wound up increasing the differences between the regions on questions of American identity and belonging. And with more recent migration from one part of the country to another, social scientists have found the movers are more likely to share the political attitudes of their destination rather than their point of origin; as they do so they’re furthering what Bill Bishop called “the Big Sort,” whereby people are choosing to live among people who share their views. This also serves to increase the differences between the regions.
Gun policies, I argue, are downstream from culture, so it’s not surprising that the regions with the worst gun problems are the least supportive of restricting access to firearms. A 2011 Pew Research Center survey asked Americans what was more important, protecting gun ownership or controlling it. The Yankee states of New England went for gun control by a margin of 61 to 36, while those in the poll’s “southeast central” region — the Deep South states of Alabama and Mississippi and the Appalachian states of Tennessee and Kentucky — supported gun rights by exactly the same margin. Far Western states backed gun rights by a proportion of 59 to 38. After the Newtown school shooting in 2012, not only Connecticut but also neighboring New York and nearby New Jersey tightened gun laws. By contrast, after the recent shooting at a Nashville Christian school, Tennessee lawmakers ejected two of their (young black, male Democratic) colleagues for protesting for tighter gun controls on the chamber floor. Then the state senate passed a bill to shield gun dealers and manufacturers from lawsuits.
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( With inputs from : www.politico.com )

April 23, 2023
Health care access for trans youth is crumbling — and not just in red states

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The impact of gender-affirming care bans — inflamed by the rhetoric on the right about “child grooming” — is rippling beyond Republican-controlled states, making it harder everywhere for transgender youth to receive care and physicians to provide it, eight doctors who provide gender-affirming care to transgender youth told POLITICO. The Human Rights Campaign and the Southern Poverty Law Center, which have been tracking attacks against doctors, report similar findings.
Even in states without bans, providers said death threats, harassment, fears of litigation and, in some cases, a lack of support from institutions have created a chilling effect that undermines their ability to provide care.
“I got an email telling me that I’m evil, I’m foolish, my work is opposing God, that I harm children, that I’m going to hell, and that I should die,” said Meredithe McNamara, an assistant professor of pediatrics who specializes in adolescent medicine at Yale University. “The threats, the harassment, the constant fear of, ‘Did I say that right? Is that OK? Should I have said that differently? Did I present my position in a public space as effectively as possible, and also did I say anything that is going to get my family targeted in some way?’”
Physicians in states where gender-affirming care remains legal said they now spend significant chunks of patient visits either batting down misinformation from parents or talking through kids’ mental health concerns related to the new laws. The bans outlawing therapies in nearly a third of the country threaten to overwhelm clinics in blue states, like Minnesota, that already have waiting lists of anywhere from several months to more than a year and have left red-state providers grappling with how to care for their young transgender patients under the bans.
“We think about this affecting kids who live in [ban] states, but it’s affecting kids everywhere and it’s affecting care everywhere,” said Angela Kade Goepferd, medical director of the Gender Health Program at Children’s Minnesota. “It affects the families in the states where care is banned, and it affects the families in the states where the care is not.”’
And the bans keep coming: North Dakota Gov. Doug Burgum on Wednesday signed a law banning gender-affirming care for transgender youth. Nebraska lawmakers are poised to enact a similar ban after legislation passed a second round of debate earlier this month. Missouri Attorney General Andrew Bailey’s emergency regulation requiring transgender youth and adults complete a long checklist before receiving gender-affirming care is scheduled to take effect this week. And Montana Gov. Greg Gianforte is expected to soon sign a ban after legislators adopted his proposed amendments last week over the pleas of their transgender colleague.
“I’ve sat down and met with transgender youth and adults. I understand their struggles are real, and my heart goes out to them. I firmly believe that, as with all of God’s children, Montanans who struggle with their gender identity deserve love, compassion, and respect,” Gianforte wrote in a letter to Montana’s Republican legislative leadership last week. But, he argued, it is “right and appropriate” to restrict access to hormones and surgery to adults.
Gianforte and other conservatives argue that kids aren’t mature enough to make serious, life-altering medical decisions, even with parental consent, and have expressed concerns about the long-term outcomes of such interventions.

While some doctors, especially those early in their careers, said the bans have inspired them to work harder and continue providing this kind of care, others who are older said they have considered quitting or retiring early — though they acknowledge doing so would make it even harder for their patients to receive care. There are an estimated 300,000 transgender youth in the U.S. and about 60 comprehensive gender clinics for children and adolescents, though care can also be provided outside of those settings, according to the Human Rights Campaign and the Williams Institute, a think tank that researches sexual orientation and gender identity law at the UCLA School of Law.
The pediatricians told POLITICO that part of their ethos is being an advocate for children, but the threats have left them worried about their personal safety, and the safety of their families, patients and hospitals. Four of the doctors interviewed were granted anonymity because of fears about threats to their safety, their clinic, their patients or their own family, or because they were not authorized to speak by their institution, in some cases because of the threats.
But some of the doctors said they feel that by staying quiet they are protecting their institution’s safety but letting down their patients.
“I know many of my colleagues feel like when we’re doing what they need us to do for our protection and our institution’s protection, many of us also feel like we’re letting the community who needs us the most down,” a blue state pediatrician said.
Those willing to speak on the record said they were doing so either because they had no family, had talked through the possible risks with their spouses and children, or because they felt protected and supported to speak publicly by their hospital or clinic.
“As our legislature also votes to advance constitutional carry, and as AR-15s are incredibly easy to get, there’s a non-zero chance somebody might kill me, and I know that. I don’t like it. At least I would die standing up for my values, but I’ve had to make peace with that,” said Alex Dworak, associate medical director of family medicine at OneWorld and assistant professor of family medicine at University of Nebraska Medical Center.
Targeting physicians is not new: The ’70s and ’80s saw a wave of attacks against abortion clinics, including 110 cases of arson, firebombing or bombing. Three people were killed inside a Colorado Planned Parenthood in 2015. And just last year, an under-construction abortion clinic in Casper, Wyo. was set on fire.
While Arkansas was the first state to enact a gender-affirming care ban in 2021 — after the legislature overrode then-Republican Gov. Asa Hutchinson’s veto — doctors told POLITICO that the threats didn’t begin in earnest until the following year when Boston Children’s was targeted on social media and received several bomb threats over the summer and fall.
In 2023, those threats have continued as more red states approve bans as part of a broader agenda that includes preventing transgender people from participating in sports or using bathrooms in accordance with their gender identity and restricting access to drag shows.
According to the Southern Poverty Law Center, which tracks hate speech, 24 hospitals and clinics that provide gender-affirming care to transgender youth have been targeted on social media over the last year, resulting in bomb threats, death threats to medical staff and temporary suspensions of services. And the Human Rights Campaign said the attacks have steadily increased.
“We launched our gender health program at Children’s Minnesota in 2019 — the front page of our Star Tribune here in Minneapolis — and barely a peep,” Goepferd said. “We have really been, up until recently, able to provide good, high-quality care in a way that we would all want to, regardless of what speciality in pediatrics we were in.”
Every major medical association, including the American Medical Association, the American Academy of Pediatrics and the American Psychological Association, supports the use of gender-affirming care to treat transgender people with gender dysphoria, or the feelings of discomfort or distress some transgender people experience when their bodies don’t align with their gender identity. For transgender youth, that typically includes social support, mental health help, puberty blockers, hormone therapy and, very rarely, gender-affirming surgery.
Those who oppose gender-affirming care argue that kids should wait until they are adults to make the decision to take hormones or undergo surgery, and that the science around such treatments is unsettled.
“Children suffering discomfort with their sex are best served by compassionate mental health care that enables them to live comfortably in their bodies and with their true identities as male or female,” Matt Sharp, senior counsel and director of the Center for Legislative Advocacy at the conservative legal powerhouse Alliance Defending Freedom, which has helped conservative lawmakers draft trans-focused bills, said in a statement. He added that the organization will “continue to protect children from harmful, irreversible, and unnecessary medical procedures.”
The American Medical Association, the American Academy of Pediatrics and the American Psychological Association have released statements, published op-eds and documents in support of gender-affirming care and provided coaching and technical assistance to state-level affiliates that they say are closer to the legislative process and better suited to testifying at hearings. But several providers said they need more support.
“Right now, individual providers show up in public spaces and we feel like we get seen as lone actors, and that we don’t have the backing of large credible institutions, and that’s a really scary reality,” McNamara said. “It’s no longer like, so-and-so who speaks for the American Medical Association says this. It’s this person who you’ve never heard of is here — and it makes us much easier to target.”
Jack Resneck Jr., president of the American Medical Association, said that the association “stands in vehement opposition to governmental attempts to criminalize or otherwise impede on clinical decision-making.” Resneck added that the AMA has worked with state medical associations to oppose gender-affirming care bans since legislation first emerged in 2020 and has also been involved in legal challenges.
Mark Del Monte, the American Academy of Pediatrics’ chief executive officer and executive vice president, called gender-affirming care “vital to the health and wellbeing of our gender-diverse patients.”
Doctors in blue states also said they are happy to see legislatures enact so-called shield laws protecting access to gender-affirming care — as California, Colorado, Illinois, Massachusetts, New Mexico and Washington have done — but some worry those policies will not hold up in court.
These doctors said they’re also worried about whether they will have the capacity to provide care to out-of-state patients given that most have waitlists that are several months long.
“It makes me worried about how we can adequately meet the needs of patients and families both here in Washington who have been on our waiting list for many months, but also so many patients and families that are uprooting their lives to be able to continue care,” said Gina Sequeira, co-director of Seattle Children’s Gender Clinic.
Broadly, the doctors worry about the future practice of gender-affirming care. They say that not only is the chilling effect from the bans stymieing research and collaboration, but also they fear that it will dissuade future doctors from going into an already small field and prevent doctors from receiving training.
“I am hopeful that I can be a quiet country doc and not have this be a part of my life. That is my hope, that this is not forever,” a red state pediatrician said. “But it’s hard to see that. It’s hard to see that future.”
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( With inputs from : www.politico.com )

April 23, 2023
Mob lynching: SC issues notice to Centre, states on plea seeking fair compensation policy

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New Delhi: The Supreme Court on Friday sought response from Centre and state governments on a PIL seeking direction to adopt uniform and fair compensation policy for victims of mob lynching in the country.
A bench of Justices K.M. Joseph and B.V. Nagarathna noted that writ petition, filed by Indian Muslims for Progress and Reforms, has been filed in public interest seeking inter alia the implementation of the directions issued by this court in the case of Tehseen S. Poonawalla v. Union of India and others (2018).
Advocate Javed R. Shaikh, counsel for the petitioner, drew the court’s attention to the pertinent passage in the aforesaid judgment wherein it was directed that the states shall frame a scheme for the purpose of providing victim compensation in cases of lynching/mob violence under Section 357A of the Code of Criminal Procedure, 1973.

He submitted that certain states have formulated a scheme while many of the states have not done so till date.
“It was further submitted that the said judgment had given guidelines as to the manner in which the victim compensation scheme had to be formulated inasmuch as the state governments have to give due regard to the nature of the bodily injury, psychological injury and loss of earnings including other opportunities such as loss of educational opportunities and expenses incurred on account of the suffering due to the mob lynching/ mob violence”, noted the top court, in its order.
“In this regard it was submitted that the endeavour of the petitioner is to seek implementation of the directions issued by this court in the aforesaid judgment and further to have as far as possible a uniform policy for grant of exgratia compensation to the victims of hate crime/mob lynching”.
After hearing the counsel, the bench said: “We issue notice to the respondents. The respondents are directed to file their respective affidavits with regard to the implementation of the directions issued in the aforesaid case and the manner in which it has been done. The said affidavit shall be filed within a period of eight weeks from the date of the service of notice.”

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( With inputs from www.siasat.com )

April 21, 2023
Baltics blast China diplomat for questioning sovereignty of ex-Soviet states

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The Baltic states of Estonia, Lithuania and Latvia are demanding an explanation from Beijing after China’s top envoy to France questioned the independence of former Soviet countries like Ukraine.
Lu Shaye, China’s ambassador to France, said in an interview on Friday with French television network LCI that former Soviet countries have no “effective status” in international law.
Asked whether Crimea belongs to Ukraine, Lu said that “it depends how you perceive the problem,” arguing that it was historically part of Russia and offered to Ukraine by former Soviet leader Nikita Khrushchev.
“In international law, even these ex-Soviet Union countries do not have the status, the effective [status] in international law, because there is no international agreement to materialize their status as a sovereign country,” he said.
The comments sparked outrage among Estonia, Lithuania and Latvia — three former Soviet countries.
Latvian Foreign Minister Edgars Rinkēvičs said in a tweet that his ministry summoned “the authorized chargé d’affaires of the Chinese embassy in Riga on Monday to provide explanations. This step is coordinated with Lithuania and Estonia.”
He called the comments “completely unacceptable,” adding: “We expect explanation from the Chinese side and complete retraction of this statement.”
Margus Tsahkna, Estonia’s foreign minister, called the comments “false” and “a misinterpretation of history.”

Gabrielius Landsbergis, Lithuania’s foreign minister, shared the interview on Twitter with the comment: “If anyone is still wondering why the Baltic States don’t trust China to “broker peace in Ukraine,” here’s a Chinese ambassador arguing that Crimea is Russian and our countries’ borders have no legal basis.”
Kyiv also pushed back strongly against the ambassador’s comments.
“It is strange to hear an absurd version of the ‘history of Crimea’ from a representative of a country that is scrupulous about its thousand-year history,” Mykhailo Podolyak, an adviser to Ukrainian President Volodymyr Zelenskyy’s office, said in a tweet on Sunday. “If you want to be a major political player, do not parrot the propaganda of Russian outsiders.”
EU foreign policy chief Josep Borrell called the remarks “unacceptable” in a tweet on Sunday. “The EU can only suppose these declarations do not represent China’s official policy,” Borrell said.
France in a statement on Sunday stated its “full solidarity” with all the allied countries affected, which it said had acquired their independence “after decades of oppression,” according to Reuters. “On Ukraine specifically, it was internationally recognized within borders including Crimea in 1991 by the entire international community, including China,” a foreign ministry spokesperson was quoted as saying.
The foreign ministry spokesperson also called on China to clarify whether the ambassador’s statement reflects its position or not.
The row comes ahead of a meeting of EU foreign ministers in Luxembourg on Monday, where relations with China are on the agenda.

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#Baltics #blast #China #diplomat #questioning #sovereignty #exSoviet #states
( With inputs from : www.politico.eu )

April 21, 2023
Centre directs states to set up 100 food streets; To grant Rs 1 cr as aid per street

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New Delhi: The Union Health Ministry, in collaboration with the Union Ministry of Housing and Urban Affairs, has written to the states and Union Territories to develop 100 food streets in 100 districts across the country.
The initiative is being taken up as a pilot project to create an example for other such streets to come up across the country to ensure safe and hygienic food practices.
The project aims to encourage safe and healthy practices among food businesses and community members, thus reducing foodborne illnesses and improving overall health outcomes, the Union Health Ministry said in a statement.

In a letter to the states, Union Health Secretary Rajesh Bhushan and Ministry of Housing and Urban Affairs Secretary Manoj Joshi highlighted that “easy access to safe and hygienic food is vital for the good health of citizens”.
“Safe food practices not only promote the ‘eat right campaign’ and food safety but will improve hygiene credibility of local food businesses, boost local employment, tourism and, in turn, the economy. It also leads to a cleaner and greener environment,” the letters stated.
Street foods have traditionally been an integral part of Indian society and are present all across the country. They represent the rich local tradition of cuisine, the statement said.
These not only provide a daily diet at affordable prices to millions but also direct employment to a large number of people while supporting the tourism industry, it added.
However, it noted that safety and hygiene remain a matter of concern at street food outlets and hubs.

With rapid urbanisation, while these hubs have led to easy access to food, it has aggravated food contamination and associated health issues due to unhygienic and unsafe practices.
This initiative will be implemented through the National Health Mission in collaboration with the Union Ministry of Housing and Urban Affairs. The Food Safety and Standards Authority of India (FSSAI) will lend technical support, the statement said.
Financial assistance to the states and Union Territories in the form of Rs 1 crore per food street or district will be provided to fill the critical gaps, it added.
The assistance will be provided under the National Health Mission in the 60:40 or 90:10 ratio on the condition that standard branding of these food streets will be done following FSSAI guidelines.
Municipal corporations, development authorities and district collectors at the state level will take major initiatives to ensure convergence in terms of financial resources and physical infrastructure.
Various other initiatives such as training of food handlers and independent third-party audits have been taken to enhance safety standards.
Schemes such as Support to Urban Street Vendors, a component of the Ministry of Housing and Urban Affairs’ Deendayal Antyodaya Yojana – National Urban Livelihoods Mission, have also been taken up.
In addition, the states and Union Territories can also conduct training programmes for street vendors to orient them on food safety, hygiene maintenance and waste disposal.
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#Centre #directs #states #set #food #streets #grant #aid #street
( With inputs from www.siasat.com )

April 20, 2023
SC gives 3 more months to states, UTs to provide ration cards to left-out migrant labourers

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New Delhi: The Supreme Court on Thursday granted another three months time to all states and Union territories to provide rations cards to migrant labourers registered on the e-shram portal for availing benefits of “benevolent schemes” of the government.
The top court posted the matter for further hearing on October 3 and asked the Centre to file a status report.
A bench of justices MR Shah and Ahsanuddin Amanullah said, “At present, we give further three months’ time to the concerned State/UT to undertake the exercise to issue ration cards to the left out registrants on e-Shram portal by giving wide publicity and the concerned State/UT to approach them through the office of the concerned Collector of the District, so that more and more registrants on e-Shram portal are issued the ration cards and so that they may get the benefit of the benevolent schemes floated by the UOI and the State Government including the benefit under the National Food Security Act.”

It said, “We appreciate the exercise undertaken by the UOI with the assistance of the respective States/UTs for registration of the migrants/unorganized workers on e-Shram portal.”
It noted that 28.60 crores migrants/unorganized workers are registered on e-Shram portal which is a “commendable job” but added that out of 28.60 registrants on e-Shram portal, 20.63 crores are registered on ration card data.
“Meaning thereby, the rest of the registrants on e-Shram are still without ration cards. Without the ration card a migrant/unorganized labourer or his family members may be deprived of the benefit of the schemes and may be the benefit under the National Food Security Act,” it said.
The bench said that being a welfare State, it is therefore the duty of the state/Union territory concerned to see that the remaining registrants on e-Shram, who are still not registered on ration card data and who are not issued the ration cards, they are issued ration cards and the exercise for issuance of ration cards is required to be expedited.
“As the Union of India and the concerned State/UT now already have the data of the registrants on e-Shram portal and will be having the required information, the State/UT shall reach to them so that they can be issued the ration cards and that their names are registered on ration card data,” it said.

The top court’s order came on an application filed by petitioners Anjali Bhardwaj, Harsh Mander and Jagdeep Chhokkar who had sought that ration to the migrant labourers be given irrespective of the quota of ration under the NFSA.
The bench noted the submission of advocate Prashant Bhushan, appearing for the petitioners, that approximately more than 10 crore people are deprived of the benefit of National Food Security Act due to non-issuance of the ration cards which as such is due to the fact that at present census of 2011 is being implemented and that after 2011 population has increased.
Additional Solicitor General Aishwarya Bhati, appearing for the Centre, said that against the total target of 38,37,42,394 migrants, 28,86,23,993 have already registered their names on e-Shram portal.
She submitted that the e-Shram portal was launched on August 26, 2021 by the Ministry of Labour and Employment, which is meant to register and support the unorganised/migrant workers by providing them with a Universal Account Number (UAN).
The government said the Ministry of Labour and Employment has developed a Standard Operating Procedure (SOP) to share e-Shram portal data with states and Union territories.
It said that approximately 3.82 crore e-Shram registrants are also found to be beneficiary under PM-Kisan Samman Nidhi.
The government submitted that the benefit of Pradhan Mantri Shram Yogi Mann-Dhan Yojana (PM-SYM) has been given to the eligible migrants and each state has its own policies for issuance of the ration card.
The top court had earlier said migrant workers play a very vital role in building the nation and their rights cannot be ignored.
It had also asked the Centre to devise a mechanism so that they receive food grains without ration cards.
Earlier, the top court had issued a slew of directions to authorities on a plea of the three activists seeking welfare measures for migrant workers and ordered states and Union territories to frame schemes for providing free dry rations to them till the Covid pandemic lasted and said the Centre will have to allocate additional food grains.
It had also directed states and Union territories to register all establishments and license all contractors under the law and ensure that the statutory duty is imposed on the contractors to give particulars of migrant workers.
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#months #states #UTs #provide #ration #cards #leftout #migrant #labourers
( With inputs from www.siasat.com )

April 20, 2023