Book ReviewsThe Forked Path – by T. R. ThompsonOctober 11, 2021Book Reviews / fantasy / horrorThe Forked Path, by T.R. Thompson, is Book 2 of the Wraith Cycle. I highly recommend that you read Book 1, The Blood Within the Stone, before jumping into Book 2. This second book picks up not long after the first one ends, and there is an assumption that readers will already be familiar with (most) of the characters. It can be really difficult to write a book review about the second book in a series without unintentionally revealing spoilers. I’ll try my best to avoid mentioning them. In the first book, Wilt was using the type of magic that a wielder uses. This magic was used by the Black Robes in Redmondis. In short, welds are used to get into other’s minds. Wilt’s friend Higgs is a crafter. They create objects that enhance their weilder’s abilities. That said, there were times when Wilt used older magic, of the kind that had been forbidden. It was a magic that connects to animals and the trees in the Tangle (a place that often includes danger). Without giving away any spoilers, at the start of this book, Wilt has been using the older magic for what might be too long a time-span. Some of Wilt’s friends are traveling with him – but not in the way you might assume. There are conversations that happen amongst them, which could involve everyone or just a few of them. At times, Wilt’s friends are the only ones keeping him from delving too deep into magic. The Tangle was mentioned in the previous book as a scary place that was dangerous to enter. In this second book, it is as though the Tangle has had enough of the humans. Those who enter now risk death. Nearby towns also face the wrath of nature. In the meantime, back in Redmondis, those who survived the end of the first book are trying to change the way that magic is taught. There were originally three groups of students: weilders, crafters, and guards. Under the guidance of a man who knows quite a bit about the old ways, these three groups combine to learn from each other. There are also some new, and very interesting characters that have been added. One is a very young being who seems to belong to the Tangle. Two others are much older people who have continued to use the magic of the old ways, the magic that had been forbidden. Wilders can do things that most Weilders cannot. It comes at the risk of losing themselves to the wildness of that type of magic, in part, because they eventually become more comfortable in their wild form than their human one. A small group is sent from Redmondis to a very large city, in an effort to speak with the King. A weilder, a crafter, and a guard take an unusual form of transport, and have to fight their way into the city. Once there, they discover that the … I’m going to say “battle”… that recently happened also negatively affected the city they arrive at. Without giving anything away, I will say that some of the loose ends from the first book are resolved. Some of Wilt’s friends, who had traveled with him, find different paths to take. The party who went to the large city are young people who are unsure what they are supposed to do and are troubled by the amount of displaced people who all hope the city can hold and house them. Somewhere in the mix, a plot is hatched by a man who wants to become empowered. The decisions he makes end up affecting Wilt, who must use his magic to save himself from a very dire situation. There are times when I was convinced that Wilt was one of the “good guys”. Unfortunately, it appears that he is falling into the same risk as the wilders – and might end up losing himself. There is a strong temptation to allow the magic to satiate its hunger. Several of the characters are grieving the loss of loved ones. I found it interesting to see how each of them tried to cope with that loss in their own way. A few of them get reunited with the person they lost, but in situations that are not the same as before. This is a story where people are struggling. It is also a story of people who, despite everything, find the path they were meant to take. The Forked Path – by T. R. Thompson is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... The Blood Within The Stone – by T.R. ThompsonSeptember 21, 2021Book Reviews / fantasyThe Blood Within the Stone is Book 1 of the Wraith Cycle. In it, T.R. Thompson gives the reader a dark and creepy story that exists in what I would consider a fantasy world. The magic in this world is unlike anything I’ve seen before in either a book or movie. This is not a book for children – but adults who enjoy a mix of fantasy, magic, and horror will enjoy this book as much as I did. It starts with a poem. Four lines that rhyme and whisper hints about something beyond the reader’s knowledge. One really quick way to get my attention is to give me poetry, especially a poem that appears to hold a secret. The Blood Within the Stone is a book that I found difficult to put down. I quickly became so invested in the characters that I needed to know what would happen to them. The scene is set with a short passage that describes “when the trees cease their chatter and the shadows lie heavy on the leaves”. A lone guard is afraid of the darkness and what it might hold. It turns out, the guard has good reason to be nervous. The reader starts inside the head of Wilt, a boy who is attempting to complete a test that involves stealing something from the local Blacksmith. If he successfully completes the test, he might be invited to join the thieves guild. Wilt had been a thief for most of his life, it seems. Plenty of other children resort to this dangerous work as well. Greystone seems to have an abundance of homeless children. Things do not go as expected. Some time ago, Wilt met a younger boy named Higgs (who was attempting to pick Wilt’s purse). Instead of beating up Higgs, Wilt took Higgs with him, fed the very skinny boy, and found him a safe place to sleep for the night. The two eventually became inseparable. It turned out that Higgs had some excellent thief skills of his own – especially when it came to finding food. It turns out that Wilt has a special ability that lets him get inside other people’s heads. He can read their thoughts, and tends to use that information to enhance his ability to steal purses from people without being caught. Wilt doesn’t know where this ability came from, and doesn’t seem interested in finding out. One day, the head of the thieves guild (which both Wilt and Higgs have become a part of) alerts Wilt that a Prefect from Redmondis would be visiting Graystone. In short, the boys track them, but are noticed. Not willing to give up, they continue tracking the Prefect, along with the other two robed people accompanying him. Wilt and Higgs watch from above, and discover that there was no Prefect. In the Prefect’s place was a Sister, one of nine women who are connected to each other’s minds, and who are incredibly brutal. Greystone holds a festival that includes a physical game between two teams. It is a mix of rugby and “capture the flag”. It was an exciting part of the book, described so well that I felt as though I was among the people in the stands who were cheering the team they bet money on. Wilt ends up playing on one of the teams. The game ends in a frightening and ominous way. Without providing any “spoilers”, I will say that Wilt and Higgs end up going on a journey, traveling by wagons to Redmondis. A kind man helps Wilt to recover from an injury. He teaches both Wilt and Higgs how to hone their already existing magic skills. I found the way magic works in this book to be interesting and unique; a mix of the natural with risk of an underlying darkness that one could lose control to. Old magic that had been forbidden. Wilt accidentally learns how easy it could be to give in to that darkness. Eventually, the caravan ends up at the gates of Redmondis, an imposing place with rock walls. Wilt, Higgs, and the other initiates file into a courtyard, where they eventually are separated. The Cantors choose students based on their skills. Eventually, they are led to a dormitory where they share a room with a roommate. Things get pretty boring for a while for Wilt. Higgs, on the other hand, has figured out how to use his skills to obtain hard to find items and good food. In time, things get more dangerous. Both of the boys start using magic they learned from the kind man who was part of the caravan. They didn’t know it yet, but they were going to need it. Things quickly become very dark and dangerous. Would Wilt be strong enough to use his magic skills to fight against evil? Or would he dive into the deeper, darker, unknown magic from far below? I am looking forward to finding out how the story unfolds in Book Two of The Wraith Cycle. The Blood Within The Stone – by T.R. Thompson is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Stories From The Kitchen – Various AuthorsAugust 19, 2021Book Reviews / fictionStories from the Kitchen is part of the Everyman’s Pocket Classics collections of stories. I found this book in a thrift store. Each story in this book centers itself around food. A few of them contain recipes. The stories are written by authors whose names you might recognize. My copy of the book had an inscription on the inside cover, which was written in 2017. It was written to someone named Jason from “Dad & Leah”. The short message read: “Take time to enjoy XO”. As I read my way through the stories in this book, I realized that some are focused on families and how they interact. “Best Quality”, by Amy Tam, could be viewed as a story about a Chinese-American family celebrating Chinese New Year. A daughter (who is an adult) helps her mother find the best quality crabs in Chinatown. They start picking out crabs, when a second crab grabs onto the one they selected. The second one was not good quality, but ended up in their bags anyway. But, there’s more to it than that. The story also includes traditions about the Chinese New Year dinner; the daughter’s memory about the first time she watched her mother throw a live crab into a pot of boiling water; and ideas about who – exactly – counts as family. Old arguments resurface. “Potatoes and Love”, by Nora Ephron, focuses almost entirely on her love of potatoes. She notes that there are certain times when a specific type of potato dish should be made. Miss that window, and it isn’t the same. There are some recipes included in the story that a reader could easily use to make the potato dishes that she describes. The story is also about the stages of a romance. She recommend that you must make crisp potatoes at the beginning is that “if you don’t make them in the beginning, you never will.” There is a lot of work involved in the two crisp potato dishes she discusses. The middle is when you go to the potato drawer in your kitchen to find that the potatoes have gone bad. One has a terrible odor and is leaking, and the others are sprouting. You throw them out and settle for pasta. Also in the middle, is when your lover decides to go low-carb, preventing you from serving potatoes. The end is when the relationship is over, and you wish there was someone around who could make you mashed potatoes. Alas, it is too late for that. “Sorry Fugu”, by T.C. Boyle, is the story of Albert, the restaurant owner (and chef) who hopes to please a caustic food critic named Willa Frank. She visits restaurants, tastes the food, and leaves. Then, she writes a scathing review that puts both the restaurant – and the food – in a very unpalatable light. One day, Willa Frank arrives at Albert’s restaurant. The story is about the efforts made by himself and his staff to please the cantankerous food critic. Not every story in the book is delightful. “Short Friday”, written by Isaac Bashevis Singer, is the story of Schmul-Leibele (a tailor) and his wife Shoshe. They are devoutly Jewish, and want to make a feast to celebrate Short Friday. Shoshe made a lot of food the night before the holy day. Her husband eats some of it that night, but there is plenty of food. To me, it gives the feeling of a fairy-tale by the Brother’s Grimm. There was something the couple forgot to do before falling asleep, and this brings about their demise. I highly recommend this collection of short stories about food. None of them take very long to read, and each are separate from the rest. Those who enjoy cooking could attempt to reproduce the recipes that are provided in detail in some of the stories. As for me, the best part of this collection is that it enables me to “experience” foods that I cannot safely eat. Those who know me well are aware of my multitude of food allergies. In real life, my choices about what to eat are very limited. Stories like these offer an escape from my food-related limitations. #Blaugust2021 Stories From The Kitchen – Various Authors is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Geeks – by Jon KatzAugust 8, 2021Book Reviews / non fictionGeeks was published in 2000, which feels like a very long time ago. It is a non-fiction book about two computer-savvy young men in the 1990s who used technology to “make it possible to change their lives and alter their destiny”. Some part of this book were originally published in Rolling Stone before the book was published. My copy of this book is hardcover and is smaller than a standard hardcover book. It is not nearly as bright as the one posted at the top of this book review. That difference could be due to the fact that it came from a local used book store. Before you get into the actual story, the book includes several definitions of the word “geek”. The introduction is a mini non-fiction story that briefly goes over the author’s description of how he ended up writing this book (and the Rolling Stone articles before it). Geeks follows the lives of Jesse and Eric, two 19-year-old geeks who lived in Idaho. They eventually decide to move to Chicago, where they thought they would have a much easier life. It doesn’t work out the way they hoped it would. The most interesting part of this book, at least to me, are the descriptions of the computers the young men were using. If you were about the same age as Jesse and Eric back in the 1990’s you may feel some nostalgia about how things used to be. People who too young to have memories of that time will probably be horrified by how limited those computers seem today. Here is a description from an early part of the book: Jesse’s computer was a Pentium II 300, Asus P2B (Intel BX chipset) motherboard: a Matrix Millenium II AGP; 160 MB SDRAM with a 15.5 GB total hard-drive space; a 4X CD-recorder; 24X CD-ROM; a 17-inch Micron monitor. Plus a scanner and printer. A well-thumbed paperback – Katherine Dunn’s novel Geek Love – served as his mousepad.Eric’s computer: an AMD K-6 233 with a generic motherboard; an S3 video card, a 15-inch monitor; a 2.5 GB hard drive with 36 MB SDRAM. Jesse wrangled those parts from work. Jesse worked for a computer store. His job was pretty flexible, and he was allowed to play video games on store computers while waiting for someone to bring in something that needed repair. Eric worked at an Office Max. It would have been really easy to abscond with a random computer part or two at one of those computer repair places back in the day. I say this as a person who, back in the mid-to-late 1990’s, was dating a guy who worked in an IT department. He managed to gather up enough discarded parts to build me a PC computer. The guys had linked their computers and played Quake II together. Jesse listened to music and answered ICQ questions while playing. Jon Katz said that somebody called and asked about ordering an ID card – which Jesse could supply. People paid $50 for it. Others emailed MP3s to him, or software and upgrades to Quake and Doom I. I guess what I’m trying to say is this book provides some vivid examples of how the world has changed. It was a time when people who knew a decent amount about computers and the early internet could get a job pretty much anywhere. Jesse and Eric were able to move from Idaho to the outskirts of Chicago and rent an apartment for a pittance of what that would cost today. Geeks – by Jon Katz is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Black Spire – by Delilah S. DawsonAugust 2, 2021Book Reviews / science fictionBlack Spire was written by Delilah S. Dawson. It was released in 2019. I was given the Barnes & Noble exclusive edition of this book, which contains a painting of Black Spire Outpost. The painting opens up into what is meant to look like a hand drawn map of the location. At the start of the book, Vi Moradi is sent out on a mission given to her by General Leia Organa. Vi is a Resistance spy, and hadn’t entirely recovered from her previous mission. She was caught by the First Order and tortured by one of them. She managed to turn her torturer, Captain Cardinal, against the First Order. In short, this was discovered, and he was nearly killed. Vi brought him back with her. General Organa wants to send Vi Moradi to Batuu, but only if she is ready. It is not a vacation, but an important strategic location. After Vi agrees to go, General Organa informs her that she has been assigned a partner. His name is Archex. General Organa explains that this is the same man who tortured Vi. He has been rehabilitated. There is, of course, an explanation. General Organa feels that Vi and Captain Cardinal (who has now reverted to his name before he was part of the First Order) have things in common. She wants Vi to not only lead the mission, but to find out useful information from her former torturer. Vi agrees to go. Their ship crash lands on Batuu, and they awaken after someone has stolen most of their belongings. A droid that accompanied them now has some parts missing. They have no food, and very little shelter. As time goes on, Vi finds employment at a place that goes through scrap metal (and other tossed away items). The owner appears to somehow just know things. A woman who is a co-worker points out that he is hoping to find some relics in the debris that has been gathered. The implication is that he might be force-sensitive. Archex (previously Captain Cardinal) is having a rough time. His body wasn’t entirely healed before the mission, and the crash landing caused more injuries. He is in a lot of pain, but trying to hide it from Vi. Archex longs for the drugs that he was issued while in the First Order. A painkiller would be nice. One of the key characters is Oga, proprietress of Oga’s Cantina. As Vi interacts with more of the locals, she learns that Oga is not one to be messed with. She has a small, but very dangerous, group of thugs that will do her bidding. Vi’s biggest concern is that the people of Batuu believe that their little part of the universe is too small to be noticed. Most feel like the war between The First Order and the Resistance is far away. Eventually, The First Order shows up. I’m leaving out many parts of the story so as to avoid spoilers. What I can say is that I absolutely loved this story. It has a cast of interesting characters (which I will leave you to discover). There are moments of fun and also parts where things get seriously intense. In my opinion, some of the characters are seeking redemption for mistakes they made in the past. Black Spire made me feel as though I was walking around in Batuu, a few steps behind the characters. I read this book not long after visiting the Star Wars part of Disneyland with my husband. The entire area has cast members who roleplay as people who grew up on Batuu, or who arrived there from somewhere else. Speak with any of them, and they will tell you about their life. We went to Batuu shortly before COVID-19 broke out across the world. While in the thick of a crowd, I spotted a woman wearing an orange jacket, despite the day being warm. She had a blue streak in her black hair. When I made eye contact with her she put her finger to her lips to say “shhh”. I nodded as we passed each other by. I had no idea who she was until I looked at the cover of Black Spire. It turns out I “met” Vi Moradi when both of use were visiting Batuu. I would love to return to the little outpost someday. #Blaugust2021 Black Spire – by Delilah S. Dawson is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... The Stoplight Mice – by Tom McNellisJuly 20, 2021Book Reviews / Children's booksThe Stoplight Mice features a boy named Sneakers and his horse, Quicksilver. This is a children’s book that provides a fun example of how to do collaborative problem solving. It is a useful skill to learn, especially when surrounded by people who don’t seem to know how to fix a problem themselves. Sneakers and Quicksilver visit Grumpyburg, which looks like a modern-day town or city. The people there are unhappy and unwilling to work with each other. There is a traffic jam in Grumpyburg, with each driver demanding that the other driver move out of the way for them. The people of Grumpyburg didn’t understand how to take turns. Sneakers finds two people who had the skills necessary to build a stoplight for Grumpyburg. They worked together, but didn’t quite solve the problem. A tiny mouse named Melody knew what to do to make the stoplight work properly. The people of Grumpyburg were not listening to the mice because they were small, and considered to be unimportant. I think this is something that happens with a lot of children. Their ideas are overlooked because they are small and young, and the adults around them think they know better. The Stoplight Mice story shows that no matter a person’s age, or their size, they can still make a difference. The colorful illustrations in The Stoplight Mice are delightful and enhance the story for children who are still learning to read. The inspiration for this story came from bedtime stories that Tom McNellis created for his daughter. The Stoplight Mice – Tom McNellis is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites (unless you are the author of this book).... Thirteen Reasons Why – by Jay AsherOctober 20, 2020Book Reviews / fictionThirteen Reasons Why is a story about a teenager named Hannah Baker who died from suicide. Before ending her life, she recorded a series of cassette tapes in which she explained some of what happened to her that influenced her decision. She arranged to have those tapes sent to the people who had hurt her. This book was becoming popular at a time when I was working in a bookstore. Thirteen Reasons Why was located in the teen/young adult section. There was a day when one of my managers pointed out Jay Asher to me as he stood in the teen/young adult aisle, counting the number of copies of his book that were on the shelf. To be clear, this is an extremely common thing for writers to do. He eventually noticed us, turned around, and waved hello before going back to counting books. Years later, I found a hardcover autographed copy of the book in a thrift store. I live in a college town, and students who are moving back home for the summer tend to donate items that they don’t want to bring back home with them. My best guess is that someone did not want their parents to find this book and assume that their offspring was considering suicide. My visit to the thrift store happened after Netflix launched a TV series based on the book. Some found the series to be controversial because it depicted Hannah’s way of ending her life in graphic detail. (Netflix later removed that scene.) I have not watched the TV series that was based on the book. As such, this review is based entirely on the book itself The majority of Thirteen Reasons Why comes to the reader from the viewpoint of Clay Jensen. He received a mysterious box on his front porch that was addressed to him. Inside was a series of cassette tapes. There was no return address on the box. I’m not entirely certain what year the story takes place it, but it is clear that it is long after it was common for teenagers to record music on cassette tapes to share with a friend or with someone they were dating. We called them “mix tapes” back in the day. Clay doesn’t have anything that he could play the tapes on. Fortunately, his father has what I would have called a “boombox” in the garage. It is here that Clay starts playing the tapes, becoming more and more nervous and upset the more he listen to them. The instructions left by Hannah on the first tape include some warnings. If you received the box of tapes, it meant that you were on at least one of them. Those who find themselves on a tape are to listen to the rest before boxing up the tapes and mailing them to whoever is the focus of the tape after theirs. Failure to send the box of tapes to the next person would result in having all of the tapes released publicly. If that happened, all of the bad deeds and secrets on the tapes would spread. That’s a really potent threat that ensured that the tapes would be passed on. Clay “borrows” a Walkman – the kind that plays cassette tapes – from a friend (without the friend’s knowledge). He embarks on an extremely emotional and stressful journey listening to Hannah’s tapes while walking to different locations on a map that matches where the events of a specific tape happened. The reader learns that Hannah made those maps herself and pushed them into the lockers of the people who she talked about on the tapes. Clay shoved the map into his backpack and was able to dig it out of there. I thought it was really clever of Jay Asher to convey Hannah’s story via cassette tape. There is something really personal about listening to someone’s recorded voice. Having that voice on a cassette tape – a physical, tangible, object – increases the intensity of the shared audio moment. Clay spends several hours focusing on the tapes. Which one was he on? What did he do that hurt Hannah? I could feel his anxiety and nauseousness as he listened to the tapes. What makes this even more dramatic is that Clay really liked Hannah, and they only had a brief moment together before she passed away. The majority of the rest of the book comes to the reader from the viewpoint of Hannah. I found this very interesting because it gives her a voice and allows her to explain what she was thinking, and feeling, before she died. This can only happen in a fictional situation. In reality, people who lose a loved one to suicide are often left with more questions than answers. Without going into “spoilers” I will say that it wasn’t one incident that caused Hannah to decide end her life. Instead, it was a snowball of bullying and bad situations that really hurt her. Thirteen reasons why, each one explained in great detail, on either the A or B side of a cassette tape. While Clay is listening to the tapes, he starts making connections between what Hannah is describing and the confusing things that he saw happen in the months and days before she died. None of those situations made sense to him until after he listened to the tapes and heard Hannah’s side of the story. According to Wikipedia, Thirteen Reasons Why was released in 2007, long after the days when teenagers listened to music on tapes (or CDs, for that matter). Today, people of all ages mostly listen to digital music, and to podcasts of a variety of topics, online. It would be extremely difficult for a person who is a teenager today to follow in the fictional Hannah’s footsteps by recording their pain on a series of cassette tapes. To the best of my knowledge, stores don’t sell packages of cassette tapes anymore, or the Walkman or “boombox” to play the tapes on. I think Jay Asher chose wisely when he decided to have Hannah tell her story through the cassette tapes. Doing so made a nice contrast between Hannah’s recorded voice and the voice in Clay’s head as he agonized about what the tapes would reveal. In addition, he picked a means of sending a note to those Hannah left behind that could not be easily imitated by the teens of today. One big lesson that can be learned from stories like the one in Thirteen Reasons Why is valuable regardless of the age of the reader. Be kind. You cannot always know, for certain, what’s going through another person’s mind, or what is troubling them. A small moment of kindness can potentially make a big difference in the life of a person who is suffering. There are resources for people who are thinking about suicide. The National Suicide Prevention Hotline provides free and confidential support for people in distress, twenty-four hours a day, and all seven days of the week. You can speak to someone in English or in Spanish. They also can connect with people who are deaf or hard of hearing. Thirteen Reasons Why – by Jay Asher is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Father-Mucker – by Greg OlearJuly 28, 2020Book Reviews / fictionFather-mucker is a work of fiction from the viewpoint of Josh Lansky. He (tries) to make his living by pitching ideas to magazines and movie studios. He is a stay-at-home dad who is currently parenting his two young children by himself while his wife is on a business trip. Things do not go as planned. This book is, at times, hilarious. It also offers some interesting insights and commentary on parenting, modern culture, politics, and the problems that come when rumors spread. The title of this book confused my dyslexic brain, and I had to stop and take a closer look at it. The meaning of the title is explained in the story by the main character. It’s not anywhere near as bad a meaning as you may have suspected it would be. Josh and his wife, Stacy, have two preschoolers. Roland is autistic, and his primary interests are “states” (as in the individual states that make up the United States) and light fixtures. He enjoys looking at catalogs and online photos of lamps, bathrooms, and big houses – especially if he can find out what state the house is located in. Maude is the younger sibling. She is very demanding and speaks as though she is royalty. She is physically tough, and Josh thinks she might become a linebacker someday. Near the beginning of the story, Josh gets an email from a parenting magazine that has accepted one of his pitches. They will pay him to do an interview with a former punk-rocker who is now a father. Josh’s son happens to have the punk-rocker’s daughter in his class at preschool. Josh is instantly elated, and then realizes that it might not be easy to find a way to interview the former punk-rocker. All he knows is that Roland really likes the musician’s daughter. Of course, Josh posts this good news on Facebook. His friends are a group of mommies who have set up play-dates at one of their homes. Josh is an honorary mommy. Some of the interesting social commentary starts while Josh is on Facebook. For example, someone he follows plays a game that involves killing vampires. It is the type of game that automatically posts the player’s kills. These types of annoying posts were common back in the earlier days of Facebook. Josh wonders if the number of kills his friend has is a high number, or a low one. He considers the idea that that maybe the friend was actually killing vampires. Josh hadn’t finished his coffee yet. Later, Josh opens a magazine and thinks about the ridiculous names that celebrities choose for their children. Apple. Pilot Inspektor. He later thinks about movie stars who “boink babysitters”… and then, sometimes, divorce their wives and marry the babysitter. At the play-date, one of the mommies quietly tells Josh that she believes that his wife, Stacy, is having an affair. This rumor, of course, has him second-guessing his entire marriage. Sleep deprived and exhausted from being the only parent to his children for several days in a row, Josh struggles with this news. After the play-date ends, Josh returns home with Maude. (Earlier that day, he took Roland to preschool). The babysitter that Josh scheduled to come over and watch Maude arrives. She is twenty-six years old and still in college. He finds her to be ditzy, childish, and annoying. She wants a raise. Josh does not give her a raise. The purpose of the babysitter is to entertain Maude so Josh can go with Roland on a class field trip to a pumpkin patch. To his surprise, the punk-rocker dad is among the other parents who accompany their kids on this field trip. Josh is extremely nervous about how to approach the guy and ask for an interview. And then, all hell breaks loose… for a while. A meltdown occurs. There are difficult choices to be made. Josh must decide whether or not to believe the rumor about his wife cheating on him. He goes back and forth on this, often via flashbacks of unrelated things that happened years ago. As a writer, his mind is searching for the clues he now things he missed. Could she have started seeing one of her ex-boyfriends again? If so… which one? More rumors are spread. Could the husband of one of the mommies be having an affair? The mommy group (Josh included) discuss a rumor about two people who live in town that – supposedly – had sex with each other in a public place while having an affair. It’s like high-school, all over again. A clique of board and frustrated people are spreading gossip in an effort to harm others, to make themselves look better in comparison, or just to pass the time. By the end, the rumors get resolved. The truth is revealed. Some of it was predictable (even for the characters), and some was a mystery right up until the end. I won’t spoil the ending by revealing the outcome. Overall, Father-Mucker is a fast moving story, from the viewpoint of an exhausted dad who is struggling with being a (functionally) single parent for several days in a row. Parents who read this will probably relate to the difficulties and absurdities of potty-training, children throwing tantrums, and the high-pitched scream of a child who has been hurt by another kid in the play-group. As I mentioned, there’s a lot of social commentary about rumors, celebrity quirks, Facebook statuses (and the proper way to respond to them). There are brief glimpses of what Josh and Stacy went through while trying to get Roland on an IEP, and memories about what their life was like before children. I ended up liking Josh Lanksy more than I might have expected. I kept wanting things to work out for him, and hoping that he would, eventually, be able to get some sleep. Father-Mucker by Greg Olear is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... The Great Influenza – by John M. BarryJuly 18, 2020Book Reviews / non fictionThe full title of this book is The Great Influenza – The Story of the Deadliest Pandemic in History. I started reading it during the COVID-19 pandemic. It was a book I’d been meaning to read long before COVID hit, and now seemed like a very appropriate time to start. The influenza pandemic happened about 100 years before the COVID-19 pandemic did. There are so many similarities between how people back then reacted to influenza and how people today are reacting to COVID-19. The book is not for everyone, particularly those who are already overwhelmed by everything involved with the COVID-19 pandemic. That said, I recommend the book to those who happen to enjoy reading about science, and health, and history. The book is presented in a way that resembles a narrative. In other words, it is not just a dry pile of facts and figures. John M. Barry did an excellent job of making scientists and doctors who were involved in trying to stop the spread of influenza into relatable, interesting, people. He noted their skill set, their personalities, and their quirks. I learned a lot from this book. It was astonishing how little we have learned between the influenza pandemic and today. “Spanish Flu” The influenza pandemic was, at the time, referred to as the “Spanish Flu”. But, it didn’t start in Spain. Instead, it started in the United States, in rural Kansas. The pandemic started just before the United States got involved in World War I. The governments of the countries that allied with the United States imposed strict rules about what could, and could not, be published in newspapers, played in movie theaters, or sung. The goal was to prohibit anything that might reduce to morale of the troops. Spain stayed out of the war – or, at least, did not join it – for a long time. As such, the newspapers in the country were free to write whatever was newsworthy. Many people first heard about the influenza pandemic after reading about it in Spanish newspapers. At the time, Spain was one of the countries that had been hit by the virus. People (outside of Spain) started calling the virus “Spanish flu”. The book shows evidence that the influenza virus began in rural Kansas, and spread from there to Camp Funston in Fort Riley, Kansas. The enlisted went from there to other camps, some of which were in France. Young men, from different areas of the United States, were packed into quarters that were not designed to accommodate so many people. Influenza spread through the military very quickly. Today, the (impeached) President of the United States calls COVID-19 “The Chinese Virus“, or “Kung Flu“. It is clear that the COVID-19 virus began spreading in Wuhan, China. But, that’s no excuse for the President to refer to the virus in such racist terms. Overloaded Hospitals The hospitals during the influenza pandemic were as overloaded as the ones today that were hit by a surge of COVID-19 patients. In both cases, people did not understand what they were seeing when it started. Back then, the doctors thought their patients had pneumonia, or that it was “only influenza”. They had no way of knowing how bad this particular strain of influenza actually was, but understood that most influenza cases were mild. Today, doctors diagnosed many patients with pneumonia, when it turned out they most likely had COVID-19. Some were turned away from hospitals (in the United States, for sure, perhaps in other countries) because they weren’t considered sick enough for a bed. Access to testing was problematic, and there are many people who had COVID-19 but were never tested. Meanwhile, the (impeached) President Trump has asked his “people” to slow down the testing. Back then, doctors and nurses were dying as they attempted to provide care for overloaded wards of influenza cases. Today, doctors and nurses are getting sick with COVID-19 as they beg their governors, representatives, senators, and (impeached) president to provide them with enough PPE to keep them safe. Sadly, back then and now, morgues were filled to capacity and hospitals had to find other places to store bodies. In both cases, casket makers were unable to make enough to keep up with the need. Then, and now, people were dying at home. In 1918, part of the problem that people were afraid to help neighbors who had influenza. This was especially true in places where there was a high death rate. It should be noted that President Woodrow Wilson was strongly emphasizing that hospital beds should be reserved for the troops. Doctors and nurses were recruited and sent to camps to help treat enlisted men who had caught influenza. The result was that American civilians were dealing with a doctor and nurse shortage. There was also no infrastructure set up to properly remove the bodies of the deceased. Some families placed the bodies of their dead loved one on the porch. Others had no option but to put the person in a corner, or leave them on the bed they died in. Spouses were sleeping on that bed, and I cannot imagine the level of trauma that caused. Today, there are people dying at home from COVID-19. Their family members are calling paramedics, but the person dies before the ambulance can arrive. In 1918, cities sent out wagons which were used to collect the dead. Police came to the door of the houses of the deceased and put the bodies into the wagon. Again, coffins were scarce, so some bodies were in bags. A few were in boxes that were definitely not coffins. Today, there is a man in Houston, Texas, who is collecting the bodies of the dead. He has a contract with the county, the police, and various funeral homes. Mask Slackers The idea of wearing a mask to prevent the spread of a virus seems to annoy some people. That was true one-hundred years ago, and sadly, is true today. Back then, the Red Cross, which was an extremely helpful force in fighting the influenza pandemic, had women make gauze masks. The surgeons at the time wore gauze masks. So, the prevailing thought was the gauze masks would also help other people to prevent spreading the virus. It should be noted that this effort began after the influenza pandemic had spread widely across the United States. Members of the Red Cross set up tables and tried to hand masks to every un-masked person who walked by. Police at the time were allowed to insist that a “mask slacker” wear a mask. Those without masks had to pay a fine, and could be arrested. Today, a quick glance at social media will reveal that we have plenty of “mask-slackers” who like to gather together in large groups, unmasked, and not engaging in social distancing. They are clearly much more aggressive about their resistance to mask wearing than were like-minded people in 1918. To my knowledge, there aren’t any places in the United States today where people can be fined or arrested for refusing to wear a mask. It is possible that some states or counties are considering it. Today, we wear masks when we want to shop at a grocery store. Back then, people stood outside the store and shouted their order loud enough for the shop workers inside the store to hear them. Another option was to write down a list of what they wanted to buy, leave the list near the door, and wait. Science Takes Time The most frightening thing I learned from this book is how long it can take for scientists to develop a vaccine. The scientists of one-hundred years ago had disadvantages to overcome. Few had managed to create a vaccine – for anything. They had to start from scratch while trying to develop an influenza vaccine. Meanwhile, some doctors still believed that it was “only influenza”, and assumed the virus wasn’t very serious. My assumption is, as the death toll rose, at least some of the doctors realized they were mistaken about how dangerous influenza actually was. Shortly before the influenza virus started infecting people, a huge change was made in regards to the determination of who could be considered a doctor. The medical universities in the United States started out as for-profit. Today, we would probably call them “diploma mills”. The purpose of these schools was to create revenue, which was used to pay the professors salaries. Medical students learned from lectures or books, but never once actually saw a patient. Heaven help the first patient those doctors attempted to treat! Those who truly wished to practice medicine in the United States traveled to Europe to attend their medical schools. Those schools actually taught students the knowledge and skills they would need as a doctor. These students worked on cadavers and, eventually patients, before graduating. In short, what happened was the “diploma mills” were examined by someone who not only had plenty of knowledge about medicine, but also had no qualms about giving the schools the bad grades they deserved. Many closed after that, unable to meet the new criteria. Some merged with real medical schools. Johns Hopkins was formed around this time. Today, as I write this book review, we are approximately six months into the COVID-19 pandemic. We have some wonderful doctors and nurses, but they are suffering from not being able to obtain the PPE that they need in order to prevent catching the virus. There are several different companies that are attempting to develop a COVID-19 vaccine. Science takes it own time, however, and there is no way to be certain when a vaccine will become available. Meanwhile, the death toll continues to rise. Looking Ahead The version of The Great Influenza that I read was published in 2005. It includes a new Afterword that I found to be extremely informative. It delves into SARS, H1N1, and other corona viruses. In addition, John M. Barry offered advice about what the United States should do in order to be prepared for a new pandemic. At the time, Barry stated that we were not prepared at all. He recommended that the United States start making their own vaccines, and not depend upon other countries to supply us with it. In 2004, the United States was relying on Great Brittan for vaccines, and faced a problem when Great Brittan cut the total doses available outside of their country by 50%. Berry also emphasized “surveillance” in the form of what we may recognize as contract tracing. The earlier we identify a new virus, he wrote, the better chance we have to develop and distribute a vaccine. My hope is that the next President of the United States will take the time to read The Great Influenza and learn lessons from it. There is potential that we could have a new President in January of 2021. That person will have the opportunity to put plans in place to prepare for the next pandemic – while continuing to fight this one. Based on what we have seen, the current (impeached) President has little to no interest in protecting Americans from COVID-19. The Great Influenza – by John M. Barry is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... The Sovereignties of Invention – by Matthew BattlesJanuary 26, 2020Book Reviews / fictionThe Sovereignties of Invention is a book of short stories – all of which are at least somewhat creepy. Matthew Battles does a good job of keeping readers in a state of curiosity and wonder, which sometimes leads to dread and horror. This may not be the book for everyone, but I really enjoyed it. If you like stories that include strange situations that leave the reader wondering what happens next, this is the book for you. My favorite story in this book is called “The Gnomon”. It takes place at a technology convention, where everyone is walking around wearing lanyards with little plastic pockets that serve as their admission passes. The Gnomon is a black box that has no discernible ports, no lights, and absolutely no one there to explain what it does. It becomes a topic of conversation as people try to figure out what it might be. Then, it starts following the people who are attending the conference on social media. There is a point where the story goes from an interesting puzzle to true horror. The reader is never given a specific explanation of what The Gnomon is, or why it suddenly reacts the way it did. The first story in the book is called “The Dogs in Trees.” It involves a situation where people are noticing that dogs have started appearing in trees. At first, it seems like a quirky story, but it slowly becomes very disconcerting. Only the dogs seem to know why they’ve taken to the trees. A story called “I After the Cloudy Doubly Beautifully” had me interested in it just from the title alone. A librarian was given the tax of clearing out the “X cage” – a repository of things that didn’t quite fit anywhere else. The librarian finds a mechanical translator machine, that involves ball bearings with letters on them that are spun around inside a glass dome. A ticker tape comes out with the words that it makes. The machine can translate back and forth into several languages. The librarian starts translating things from one language, to another, to yet another one. I found myself wondering what the final translation would sound like. But, something happens before the librarian is finished with the machine. There are other stories that I have not mentioned and will leave the reader to discover for themselves. The Sovereignties of Invention is filled with glimpses of strange and beautiful things that can also be creepy and unnerving. I found myself thinking about these stories long after I’d finished reading the book. The Sovereignties of Invention – by Matthew Battles is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... PodcastsDr. U Visits Again – Episode 094November 30, 2021Podcasts / Words of JenFor NaPodPoMo 2021, I decided to do something different than I’ve done in the past. Each episode I release in November of this year include pieces of an old, hand-written journal which I had to create as part of my student teaching experience in 1997. I read “Dr. U Visits Again” on Episode 094 of Words of Jen (the 1997 series). If you enjoyed this episode please consider supporting me on Ko-fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/woj094.mp3Podcast: Play in new window | DownloadSubscribe: RSS... Making Copies – Episode 092November 28, 2021Podcasts / Words of JenFor NaPodPoMo 2021, I decided to do something different than I’ve done in the past. Each episode I release in November of this year include pieces of an old, hand-written journal which I had to create as part of my student teaching experience in 1997. I read “Making Copies” on Episode 092 of Words of Jen (the 1997 series). If you enjoyed this episode please consider supporting me on Ko-fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/woj092.mp3Podcast: Play in new window | DownloadSubscribe: RSS... Scheduling – Episode 091November 27, 2021Podcasts / Words of JenFor NaPodPoMo 2021, I decided to do something different than I’ve done in the past. Each episode I release in November of this year include pieces of an old, hand-written journal which I had to create as part of my student teaching experience in 1997. I read “Scheduling” on Episode 091 of Words of Jen (the 1997 series). If you enjoyed this episode please consider supporting me on Ko-fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/woj091.mp3Podcast: Play in new window | DownloadSubscribe: RSS... Learning New Things – Episode 090November 25, 2021Podcasts / Words of JenFor NaPodPoMo 2021, I decided to do something different than I’ve done in the past. Each episode I release in November of this year include pieces of an old, hand-written journal which I had to create as part of my student teaching experience in 1997. I read “Learning New Things” on Episode 090 of Words of Jen (the 1997 series). If you enjoyed this episode please consider supporting me on Ko-fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/woj090.mp3Podcast: Play in new window | DownloadSubscribe: RSS... The Beginning of the End – Episode 089November 24, 2021Podcasts / Words of JenFor NaPodPoMo 2021, I decided to do something different than I’ve done in the past. Each episode I release in November of this year include pieces of an old, hand-written journal which I had to create as part of my student teaching experience in 1997. I read “The Beginning of the End” on Episode 089 of Words of Jen (the 1997 series). If you enjoyed this episode please consider supporting me on Ko-fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/woj089.mp3Podcast: Play in new window | DownloadSubscribe: RSS... The End of the Beginning – Episode 088November 23, 2021Podcasts / Words of JenFor NaPodPoMo 2021, I decided to do something different than I’ve done in the past. Each episode I release in November of this year include pieces of an old, hand-written journal which I had to create as part of my student teaching experience in 1997. I read “The End of the Beginning” on Episode 088 of Words of Jen (the 1997 series). If you enjoyed this episode please consider supporting me on Ko-fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/woj088.mp3Podcast: Play in new window | DownloadSubscribe: RSS... Conferences – Episode 087November 22, 2021Podcasts / Words of JenFor NaPodPoMo 2021, I decided to do something different than I’ve done in the past. Each episode I release in November of this year include pieces of an old, hand-written journal which I had to create as part of my student teaching experience in 1997. I read “Conferences” on Episode 087 of Words of Jen (the 1997 series). If you enjoyed this episode please consider supporting me on Ko-fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/woj087.mp3Podcast: Play in new window | DownloadSubscribe: RSS... Dr. U Visits – Episode 086November 21, 2021Podcasts / Words of JenFor NaPodPoMo 2021, I decided to do something different than I’ve done in the past. Each episode I release in November of this year include pieces of an old, hand-written journal which I had to create as part of my student teaching experience in 1997. I read “Dr. U Visits” on Episode 086 of Words of Jen (the 1997 series). If you enjoyed this episode please consider supporting me on Ko-fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/woj086.mp3Podcast: Play in new window | DownloadSubscribe: RSS... Seminar – Episode 085November 19, 2021Podcasts / Words of JenFor NaPodPoMo 2021, I decided to do something different than I’ve done in the past. Each episode I release in November of this year include pieces of an old, hand-written journal which I had to create as part of my student teaching experience in 1997. I read “Seminar” on Episode 085 of Words of Jen (the 1997 series). If you enjoyed this episode please consider supporting me on Ko-fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/woj085.mp3Podcast: Play in new window | DownloadSubscribe: RSS... Better Day – Episode 084November 18, 2021Podcasts / Words of JenFor NaPodPoMo 2021, I decided to do something different than I’ve done in the past. Each episode I release in November of this year include pieces of an old, hand-written journal which I had to create as part of my student teaching experience in 1997. I read “Better Day” on Episode 084 of Words of Jen (the 1997 series). If you enjoyed this episode please consider supporting me on Ko-fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/woj084.mp3Podcast: Play in new window | DownloadSubscribe: RSS... Diablo II: ResurrectedDiablo II: Resurrected – ClipsAugust 22, 2021Diablo II: Resurrected / Diablo II: Resurrected Open BetaI had a lot of fun playing the Diablo II: Resurrected Open Beta. There has been a bit of a learning curve as I learn how to use an Xbox Series S controller and navigate the Xbox menus. The game itself, however, feels intuitive and I am thrilled to have had the opportunity to play the Open Beta. One of the cool things that Xbox allows is for players to take short clips of their game play. The clips last for approximately 30 seconds, so you have to learn to time it well. Players can also take screenshots. Both of those things are really easy to do. The difficult part was trying to figure out how to get them off the Xbox S and onto my Mac Mini computer. I’m not adept enough to explain this properly. There is an Xbox app you can put on a tablet. In short, players can use that to view all of their screenshots and clips, and get the option of saving them or deleting them. My husband helped me figure out how to get the Xbox app to let me pull out the screenshots and clips, and stick them into the Photos app on my tablet. From there, I was able to upload them to my Mac Mini. The most difficult part of making a very short video out of clips was finding software that would let me do it. When I record my Diablo III game play, I use a piece of software called ScreenFlow. It will record whatever it sees on my computer monitor after I tell it to start recording. Unfortunately, it is not possible to upload clips from Xbox (or anywhere else) into that software. I ended up having to use iMovie to put together a few clips from the Diablo II: Resurrected Open Beta. Working with iMovie is not at all intuitive. Fighting with it long enough to put together clips that total to about a minute and a half was manageable. Exporting it to my desktop made everything else on my computer run extremely slowly until it was done. Anyway, that’s how I was able to record, stitch together, and create a video of clips from Xbox S. #Blaugust2021 Diablo II: Resurrected Clips is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Diablo IIISeason 24: Act III Bounties and Greater RiftsNovember 22, 2021Diablo III / Diablo VideosIn this video, my Barbarian started on Torment IV difficulty. She ran through a set of Act III Bounties, and then ran through some Greater RIfts. The goal was to complete Chapter IV. I was having a bit of a problem with Greater Rift 20. I tried it (off camera) and failed – missing it my one second. Things would have been easier if I had a full set, but I didn’t have one. To get the last parts of the Immortal King’s set – the “freebie set” this season for Barbarians – I had to complete Chapter IV. After running through a set of Act III Bounties on Torment IV difficulty, and gaining more Paragon Points, I decided it was time to make a second attempt at Greater Rift 20. Achievement earned in this video: Soloing In Style: Reach Greater Rift Level 20 Solo.Stay Classy: Complete one of the following Class Sets at level 70. Objective completed in this video: Great Expectations: Reach Greater Rift Level 20 Solo. Greater Rift Keystones drop from Rift Guardians in Nephalem Rifts. (Chapter IV) Once again, I got a new personal best. This time it was for Tier 20 – 14:13 on the Solo Barbarian (No Six Piece Set) Leaderboard! My previous personal best was Tier 15 – 9:30. I have now completed Chapter IV of the Season Journey. Next, I need to decide if I want to end my Season 24 here, or if I want to push forward and do more. If you enjoyed this video, please consider supporting me on Ko-fi. Thank you!... Season 24: Keywardens and UrzaelNovember 8, 2021Diablo III / Diablo VideosIn this video, I worked my way through more of the Chapter IV objectives. Half of them were done. I made progress by killing all the Keywardens and then killing Urzael. I was currently playing on Torment II – but had to move it to Torment IV in order to complete more objectives. Objectives completed in this video: Key Decisions: Slay Odeg the Keywarden at level 70 on Torment IV difficulty or higher. Odeg the Keywarden can be found in Act I in the Fields of Misery. (Chapter IV)Key Wee: Slay Sokahr the Keywarden at level 70 on Torment IV difficulty or higher. Sokahr the Keywarden can be found in Act II in the Dahlgur Oasis.(Chapter IV)Keeping It Low Key: Slay Xah’Rith the Keywarden at level 70 on Torment IV difficulty or higher. Xah’Rith the Keywarden can be found in Act III in Stonefort.(Chapter IV)The Key to Success: Slay Nekarat the Keywarden at level 70 on Torment IV difficulty or higher. Nekarat the Keywarden can be found in Act IV in the Garden of Hope 2nd Tier.(Chapter IV)Toss It Up: Kill Urzael at level 70 on Torment IV difficulty or higher. (Chapter IV) If you enjoyed this video, please consider supporting me on Ko-fi. Thank you!... Season 24: The Butcher and 3 Greater RiftsOctober 29, 2021Diablo III / Diablo VideosIn this video, I attempted to find the Diablo 2: Resurrected Barbarian transmog (but couldn’t find it in Diablo III). After that, I worked on the Chapter IV objectives, killed The Butcher, and ran a Nephalem Rift and three Greater Rifts. Objectives completed in this video: Exquisiteness: Reforge a weapon property to a socket at the Mystic. (Chapter IV)Rift and Roll: Finish a level 70 Nephalem Rift on Torment I difficulty or higher. (Chapter IV)…Is Another Man’s Treasure: Use Kanai’s Cube to upgrade a rare item to legendary quality. (Chapter IV)Gains: Kill the Butcher at level 70 on Torment II difficulty or higher. (Chapter IV) I didn’t see this pop up when I was recording the video, because I typically don’t look at the chat while recording. To my surprise, I got on the Solo Barbarian Leaderboard, twice! One was for Tier 12 – 9:12, and the other was for Tier 12 9:12 (No Six Piece Set). I was only wearing four of the Immortal Kings set. The same thing happened after I completed Tier 13! This was now my new personal best. I finished Tier 13 9.04 and got on the Solo Barbarian Leaderboard. I also got on the Solo Barbarian Leaderboard (No Six Piece Set) for completing Tier 13. It happened again after I completed Tier 15 9:30 on the Solo Barbarian Leaderboard and on the Solo Barbarian (No Six Piece Set) Leaderboard. Achievements earned in this video: Butchering The Butcher: Kill the Butcher at level 70 on Torment I difficulty or higher.Kick Out The Gems: Level one Legendary Gem to level 5.Soloist: Reach Greater Rift Level 15 Solo. If you enjoyed this video, please consider supporting me on Ko-Fi. Thank you!... Season 24: Rakanoth and IzualOctober 12, 2021Diablo III / Diablo VideosAfter hitting Level 70, and picking up more pieces of the Immortal Kings set, my Barbarian was ready to fight. She killed Rakanoth, and Izual on Master difficulty. Objectives completed in this video: Natural Light: Kill Rakanoth at level 70 on Master difficulty or higher. (Chapter III)Another Chance: Kill Izual at level 70 on Master difficulty or higher. (Chapter III)The Rock: Craft a Gem of Imperial or greater quality at the Jeweler. Socketing an Emerald into your weapon increases your Critical Hit Damage, and is a big damage boost. (Chapter III)Master: Complete a Nephalem Rift on Master difficulty or higher. (Chapter III) Achievement Earned: Riftomania: Finish a level 70 Nephalem Rift. Finishing these Objectives means I completed Chapter III and got more pieces of the Immortal King’s set. If you enjoyed this video, please consider supporting me on Ko-Fi. Thank you!... Rathma’s Gift BountyOctober 11, 2021Diablo III / Events/BountiesThat moment when… your Barbarian considers becoming a Necromancer for Halloween… This screenshot was taken when I was almost done with the Rathma’s Gift Bounty (in Diablo III). It is located in Briarthorn Cemetery, which is in Act V. The way to complete this Bounty is to fight the enemies who guard glowing containers, and then open the containers to let the skeletons out. Your character will gain more skeleton “Followers” right up until you open the last glowing container. Before that, these dark colored skeletons will break things and attack enemies with you. Once you open the last container – all of the skeletons disappear. I took this screenshot because I was amused by the way my Barbarian was standing there, looking as though he could see a benefit to having a lot of skeleton minions. The Scoundrel, who is surrounded by the skeletons, might see things differently. Rathma’s Gift Bounty is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Season 24: To Level 70!October 2, 2021Diablo III / Diablo VideosIn this video, I was determined to get my Barbarian to level 70. I managed to get there by doing a set of Act I Bounties. Fighting skeletons, zombies, and spiders is fun! Achievements earned in this video: Upper Body Work: Reach level 70 in the Season.Above & Beyond: Reach level 70. Objective earned in this video: Above & Beyond: Reach level 70. (Chapter II)The Little Things That Count: Craft a level 70 Ring or Amulet. (Chapter II)Level I Seasonal Cubist: Extract a Legendary power using Kanai’s Cube. (Chapter III) I have now completed Chapter II of the Season Journey. Doing so gives me two pieces of the “freebie set”. In Season 24, the Barbarian gets pieces of the Immortal Kings set. If you enjoyed this video, please consider supporting me on Ko-Fi. Thank you!... Season 24: Act IV Bounties AgainSeptember 27, 2021Diablo III / Diablo VideosIn this video, which was recorded the day before Diablo II: Resurrected launched, my Barbarian started at level 67. The goal was to get her to 70, but I didn’t quite make it. This time, I sent my Barbarian to Act IV, and discovered that two of the Bounties offered involved some of what I think is new content. One led to the Upper Realm of Infernal Fate (which I completed in a previous video). The other led to Realm of Unbending Fate, which I had yet to enter. Objective completed (off camera): Maximum Efficiency: Raise the Blacksmith, Jeweler, and Mystic to level 12. (Chapter II) I have been enjoying these new areas in Act IV. Going through them makes completing a set of Bounties more interesting than before. I’m not sure when these areas were added to Diablo III, but am happy they exist. If you enjoyed this video, please consider supporting me on Ko-Fi. Thank you!... Season 24: Lower and Upper Realms of Infernal FateSeptember 19, 2021Diablo III / Diablo VideosAfter completing the Lower and Upper Realms of Cursed Fate, my Barbarian ran through the Lower and Upper Realms of Infernal Fate. As before, these Realms blend into each other, giving the player a lot of variety of monsters and terrain to fight in. In this video, my Barbarian started at Level 65, hoping to hit 70. By the end of the video, she was level 67. I think these two areas (and the previous ones) are new content. Or, at least, they are new to me. They provide an interesting way to level up in an area that feels new. If you enjoyed this video, please consider supporting me on Ko-Fi. Thank you!... Season 24: Lower and Upper Realms of Cursed FateSeptember 16, 2021Diablo III / Diablo VideosIn this video, my Barbarian started at level 62. I didn’t feel like doing Bounties or Nephalem Rifts. On accident, I found what I thought was brand new content – and I sent my Barbarian there. There is a section of the Act IV map that has four areas that seemed new to me. In this video, my Barbarian completed the Lower Realm of Cursed Fate, and the Upper Realm of Cursed Fate. The areas in them flow into each other, which adds to the variety of monster as well as location. It took longer than expected to get through, but it had the benefit of leveling up my Barbarian a little bit more. If you enjoyed this video, please consider supporting me on Ko-Fi. Thank you!... Season 24: Diablo and SiegebreakerSeptember 12, 2021Diablo III / Diablo VideosAfter finally hitting Level 60, my Barbarian was ready to fight Diablo and Siegebreaker. Doing so would not only help her level up some more, but also are required to complete part of the Season Journey. It took longer than expected for my Barbarian to finish what she set out to do. The objectives required Hard difficulty (or higher). I was on Expert difficulty, but went back to Hard difficulty thinking that would speed things up. One mistake I made was jumping into a portal that was a Bounty while on my way to fight Diablo. Another was that my Barbarian was wearing bracers that produced extra monsters when you hit a shrine or pylon. The Bounty included shrines, so this made things take longer than expected. To my surprise, it seemed like the fight dynamics against Diablo – and against Siegebreaker – had been updated. Both of them moved around a lot more than they previously did. These changes made the battles really fun! Objectives completed in this video: Innocence: Kill Diablo at level 60 or higher on Hard difficulty or higher. (Chapter II)Living Siege Engine of Hell: Kill the Siegebreaker Assault Beast at level 60 or higher on Hard difficulty or higher. (Chapter II) If you enjoyed this video, please consider supporting me on Ko-Fi. Thank you!... Pocket CampAnimal Crossing Pocket Camp: Lolly’s Celestial CookieNovember 29, 2021Animal Crossing Pocket CampLolly’s Celestial Cookie is one of many cookies that players can obtain by spending 50 Leaf Tickets for one cookie. Lolly’s Celestial Cookie was released on August 1, 2020, and stayed available through October 30, 2020. The game reissues cookies, so there is a chance this one could reappear at the Fortune Cookie Stand. In the screenshot above, my Pocket Camp character looks a little displeased by how much it will cost to obtain all of the items that come from this type of Fortune Cookie. Here are some of the thing that come from Lolly’s Celestial Cookies: luminous bamboo soaring stars starlit path starry flowerbed sparkling bench starry yukata celestial lantern There are some items that I still need to get when this cookie is reissued. There are three classes that connect to the items that come from Lolly’s Celestial Cookie. Starry Night is the first of three classes that include items from Lolly’s Celestial Cookie. The Starry Night class requires the luminous bamboo, soaring stars, and starry yukata. This is what the Starry Night class looks like at the start. Here is what the Starry Night class looks like after the player puts the right items on the highlighted squares. Success! There are two more classes in this series. I skipped them because I didn’t have some of the items. I took some screenshots of my Animal Crossing Pocket Camp friends using the Celestial items. Bluebear and Sprinkle on the starry bench. Bluebear and Rosie on the starry bench. Rodeo and Flurry on the starry bench. Bud and Goldie on the starry bench. Rodeo stands next to the starry bench that Apollo and Bud are using. Flurry and Jay share the starry bench. Each holds a blue fan with stars on it. My Pocket Camp character is standing on the starlit path and is holding the celestial lantern. Animal Crossing Pocket Camp – Lolly’s Celestial Cookie is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Animal Crossing Pocket Camp: Celeste’s Ginkgo CaféNovember 21, 2021Animal Crossing Pocket CampCeleste’s Ginkgo Cafe started on August 30, 2020, and ended on September 19, 2020. It is an event where Celeste asks the player to grow rare Mini Ginkgo Seeds and Gingko Maidens, as well as Ginkgo themed awards. This event has a very strong fall-like theme. Celeste: Oh, pardon me! Celeste: The trees turning yellow are so pretty that I didn’t pay attention to where I was and stumbled here… Celeste: Autumn revolves around leaves changing colors and the harvest. It’s also a time for reflection. Celeste: This is a special occasion, so I’d love to relax with some coffee and enjoy the plethora of colors. Celeste: Eureka! What are your thoughts on opening a pop-up café here at this campsite? Celeste: Colorful leaves, coffee, sweets… These are all of the fall essentials I look forward to! Celeste: I think everyone at the campsite will appreciate it too! Celeste: I tend to get quite sleepy during the daytime… so if you could help me out, I’d really appreciate it! Celeste: Thank you! By the way, my brother Blathers, gave me a mini ginkgo tree recently. Blathers is another owl character in Animal Crossing Pocket Camp. His main purpose is guiding players through maps that result in useful prizes. The player has to collect the map first, and then spend a specific resource to play through it. Celeste: I found out that rare ginkgo maiden insects are attracted to this type of plant. Celeste: Who would have thought? And they’re also quite rare! Celeste: Gazing at mini ginkgoes and ginkgo maidens from a café terrace would make for a picturesque scene. Celeste: I’d love it if you could grow mini ginkgoes in your garden and catch the insects that gather there! Celeste gave me some y.-mini-ginkgo seeds+ and some y.-mini-ginkgo seeds. One grows faster than the other. Event on now! Celeste’s Ginkgo Café This sign shows what two of the rare creatures look like. It also shows that the player can eventually exchange mini ginkgo plants for prizes that are connected to this event. My Pocket Camp character is standing in their garden. Five mini-ginkgo plants have grown. Each one has attracted either a red or yellow rare creature. I caught some red gingko maidens and some yellow ginkgo maidens. These are exchanged for prizes. Prizes earned during Celeste’s Gingko Café event ginkgo café chair plum dessert coffee set fall ginkgo leaf Players needed to collect a certain amount of fall ginkgo leaves in order to earn additional prizes. chestnut harvest hat This is what the chestnut harvest hat looks like on my Animal Crossing Pocket Camp character. Here is an above view of the chestnut harvest hat. fallen fall leaves fall red-brick rug berry fall dessert set ginkgo café table Task complete! The next part of the event required the player to collect gold ginkgo maiden bugs and silver ginkgo maiden bugs. It was still possible to collect the previous colors, if you needed more of them in order to earn prizes. lime dessert coffee set citrus fall dessert set fall maidenhair trees ginkgo café coffee stand park clock I took some screenshots of the Celeste’s Gingko Café items. My Pocket Camp character stands in front of the beginning of a café. Goldie is sitting in one of the chairs and enjoying coffee. The table is set for two with a plum dessert coffee set. There is a table of berry fall dessert set in the background. My Pocket Camp character stands in front of the beginning of a café. There is a café table with a tablecloth. There are two café chairs near the table, and one black chair off to the side. Behind the table is a yellow ginkgo plant in a brick pot. In front of the table are two sections of fall leaves on the ground, with red bricks on either side of them. My Pocket Camp character has added four maidenhair ginkgo trees in the background. My Pocket Camp character stands in front of a (mostly) complete café. It is missing a few chairs. I added the ginkgo café coffee stand behind the tables and in front of the trees. I was eventually able to add more café chairs. The black chair is not part of the café set, but it matched well enough. I added the park clock to this fancy little outdoor café. This was the final configuration of Celeste’s Ginkgo Café. I made it less cluttered by rearranging the items and removing the ones that were not actually part of the event. All tasks complete! Celeste’s Gingko Café Classes The first class is called Ginkgo Terrace. The recommended furniture for this class included one ginkgo café chair and one yellow mini ginkgo plant in a pot. Both of those are part of the café items. It also required a bistro table, which I did not have. Cyrus is the only one who can craft a bistro table. This class requires the player to put all three of the required items into the proper spaces. The highlighted squares show where the player needs to put specific items. Success! Ginkgo Terrace 2 is the second class in this series. All of the items that are recommended for this class come from Celeste’s Ginkgo Café. They include: ginkgo café chair, ginkgo café table, plum dessert coffee set, and berry fall dessert set. Here is an overhead view of Ginkgo Terrace 2. The highlighted squares show where the required items go. Success! Ginkgo Terrace 3 is the final class in the series. Ginkgo Terrace 3 requires several items from Celeste’s Ginkgo Café event. This includes: citrus fall dessert set, fall maidenhair trees, lime dessert coffee set, ginkgo café stand, park clock – and more. An overhead view of the Ginkgo Terrace 3 class. The highlighted squares are where the player needed to place specific items. Animal Crossing Pocket Camp: Celeste’s Ginkgo Café is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Animal Crossing Pocket Camp: Haunted Scavenger HuntOctober 14, 2021Animal Crossing Pocket CampThe Haunted Scavenger Hunt followed the Fishing Tourney (Goldfish), which came after Isabelle’s Creek Cooldown. Both of those events fit together well, because they both had something to do with water. The Haunted Scavenger Hunt, however, didn’t match. To me, it felt like maybe it was originally intended to be a Halloween event. The Haunted Scavenger Hunt started on August 21, 2020, and ended on August 28, 2020. Every scavenger hunt in Animal Crossing Pocket Camp requires the player to collect a whole lot of Gyroidites. They are little fabricated things that the player must go find and pick up. Collect the right amount of them, and you can have Cyrus craft one of the event items for you. Repeat the process until you get them all! Prizes earned during the Haunted Scavenger Hunt haunted candles haunted tatami rug haunted TV haunted lantern haunted willow tree haunted shoji screen haunted well haunted tokonoma Here is what all of the Haunted Scavenger Hunt items look like when you put them all together. There were three event classes that players could do if they had some of the event items. Haunted Garden 1 is the first class in the series. Haunted Garden 1 required the haunted candles, haunted lantern, and a bamboo screen. (The screen is not part of the Haunted Scavenger Hunt collection.) Lottie shows the player the items they need in order to pass this class. Lottie and Kiki stand near my Pocket Camp character. Behind them are some items that are already placed. The highlighted spaces show where the player must put the necessary items. Lottie and Kiki are pleased. I have passed this class! Haunted Garden 2 is the second class in the series. The event items required for this class include: haunted well, haunted lantern, haunted shoji screen, and haunted candles. Several items have already been placed before the class begins. Most of them belong to the Haunted Scavenger Hunt. The rest appear to be from Isabelle’s Creek Cooldown. The highlighted spaces show where the player must put the necessary items. Success! Haunted Garden 3 is the final class in this series. This class requires the following items: haunted TV, haunted tokonoma, haunted candles, and haunted willow tree. All of these items are ones that the player could obtain by collecting Haunted Gyroidites during the Haunted Scavenger Hunt. The floating wisps item is part of the Haunted Scavenger Hunt, but it cannot be obtained by collecting Haunted Gyoridites. To obtain it, players had to spend 130 Leaf Tickets. I didn’t have that many, so I never got this item. wooden bucket The wooden bucket is not part of the Haunted Scavenger Hunt items. It is not unusual for a class to require something unrelated to the current event. This class is also in the dark, to highlight the items that glow. Unlike the previous dark room, this one take place outdoors. As such, it is a little bit easier to see the items that have already been placed. The highlighted parts show which items the player needed to put into this room. I didn’t have the floating wisps, so I put in a different kind of wisp instead. It was enough for me to pass this class. The Haunted Scavenger Hunt theme did not match well with the previous two events. This does not bother me, because I enjoy creepy things. If you place these items into your Campsite, the Animal visitors will use them. For example, it is possible for one of them to get inside the haunted well and pop out at random times! Animal Crossing Pocket Camp: Haunted Scavenger Hunt is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Animal Crossing: Pocket Camp – Fishing Tourney (Goldfish)September 29, 2021Animal Crossing Pocket CampThe Fishing Tourney (Goldfish) event started on August 12, 2020, and ended on August 20, 2020. It followed the Isabelle’s Creek Cooldown event. This Fishing Tourney has players fishing for three different kinds of goldfish. Chip: Oh boy, it’s finally here… “Fishing Tourney (Goldfish)”! The purpose of this event is to catch as many goldfish as possible. The fish are only available in one of the two areas in the game where players can fish. When a Fishing Tourney is open, the fish that count are sparkly. Players receive one free Fishing Tourney net, which they can use to catch a lot of Tourney fish all at once. two red wakin goldfish ranchu goldfish two ranchu goldfish black wakin goldfish two black wakin goldfish I used the free Fishing Tourney net to catch a bunch of goldfish at the same time. Fishing Tourney (Goldfish) Rewards goldfish hairpin red-wakin aquarium black-wakin aquarium ranchu aquarium goldfish paper lantern goldfish aquarium A goldfish aquarium B goldfish screen icosahedral aquarium Fishing Trophy wood fish trophy bronze fish trophy silver fish trophy gold fish trophy Fishing Tourney (Goldfish) Happy Homeroom classes Elegant Aquarium is the first of three classes that connect to the Fishing Tourney (Goldfish) event. It requires the red-wakin aquarium, the goldfish hairpin, and the goldfish paper lantern. Here is what this class looks like at the start. The room is dark, and the items glow. The highlighted items are ones that the player had to place. Success! Elegant Aquarium 2 class required more items than the previous class did. This class requires goldfish aquarium B, goldfish aquarium A, goldfish screen, and black-wakin aquarium. The room is dark in order to highlight all of the glowing aquariums and other objects. Here is an overhead view of the aquariums that were required for this class. The player needed to add the ones that are now highlighted. Success! Elegant Aquarium 3 is the final class that connects to the Fishing Tourney (Goldfish). Once again, it is a dark room with glowing items inside it. This class requires: goldfish aquarium A, goldfish screen, goldfish paper lantern, icosahedral aquarium, red-wakin aquarium and ranchu aquarium. Here’s an overhead view of the Elegant Aquarium 3 class. Players needed to place the highlighted items. Success! Animal Crossing: Pocket Camp – Fishing Tourney (Goldfish) is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Animal Crossing: Pocket Camp – Isabelle’s Creek CooldownSeptember 15, 2021Animal Crossing Pocket CampIsabelle’s Creek Cooldown began on July 28, 2020, and ended on August 9, 2020. Isabelle is a special character who guides new players through the variety of things they can do in the game. In addition, Isabelle sometimes comes to the player’s campsite and starts a new event. Isabelle’s Creek Cooldown is the first of three events that are connected to each other. All of the events in Animal Crossing: Pocket Camp start with special flowers. Players must plant them in their gardens, then return to collect the rare creatures (bugs) that find them. Prizes are distributed based on how many bugs the player caught. Isabelle: Summer is definitely one of my favorite seasons, but the heat can certainly leave me feeling groggy. Isabelle: At the very least, I need to find a way to cool off for a few hours… Isabelle: So, I came up with a really great idea! Isabelle: Why not create a creekside area where everyone at the campsite can come to cool off for a bit? Isabelle: I’m going to give you some seeds to start, so go ahead and plant them in your garden. Isabelle gave my Pocket Camp character 5 bags of purple starflower + seeds. and 5 bags of purple starflower seeds. The ones with the + grow super fast! Isabelle: Once these flowers bloom, they’re sure to attract plenty of creek fireflies. The goal is to keep planting the event-specific flowers and then come back and collect the rare creatures that landed on them. The number of bugs is what grants the player prizes, which usually match the theme of the event. Task complete! My Pocket Camp character and Isabelle are standing on a path in my garden. The plants directly in front of them are not done growing yet. Off screen are the five purple starflower+ seeds that grow much faster than the rest. I picked the fireflies off of them, and got enough to earn a reward. This process takes place, over and over again, until the event ends of the player earns all the rewards. I earned two stardust fans. These items are required in order to complete a set of quests. I earned a bamboo-boat lantern! Task complete! My Pocket Camp character is wearing a straw beach hat and a white beach dress. Those items were not part of the event, but might have connected to a previous one. Here are what the fireflies that were attracted by the purple starflower plants looked like. Task complete! The flowers in the above screenshot are pink starflowers. I was able to earn some prizes by planting them, but I don’t think I got all of the rewards. The event ended before I could do that. Here are some other rewards that are connected to Isabelle’s Creek Cooldown: river stepping-stones flowing-river rug three-tier lantern A river rock dancing fireflies three-tier lantern B red standing umbrella riverside veranda A There were classes that required some of the items that players could earn during this event. Creek Cooldown was the first class. It only required a few items. The highlighted items are the ones that the player needed to place. One of them is Cool-Stone Riverbank (highlighted rocks in the background). I must have obtained at least one of them, but cannot find the screenshot. The other two are River Stepping-Stones, and I’m certain I earned two of them. Success! Creek Cooldown 2 was the second class. Creek Cooldown 2 required the river rock, river stepping-stones, red standing umbrella, and three-tier lantern A. Some of those items were also used in the Creek Cooldown class. An overhead look at the Creek Cooldown 2 class. The required items are highlighted. Success! I put some of the Creek Cooldown items into my campsite. Goldie seems to be enjoying these items. More of the Creek Cooldown items were added to the same space after I earned them. I like how these items, when put together with a few more that fit the theme, felt very peaceful. Isabelle: We’d all be sad and sweaty if it weren’t for you. Thanks for making this possible, Ownka! A small scene appears when the Creek Cooldown event is over. Animal Crossing: Pocket Camp – Isabelle’s Creek Cooldown is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Animal Crossing: Pocket Camp – Cool Scoop Scavenger HuntAugust 31, 2021Animal Crossing Pocket CampThere is a pattern to the events on Animal Crossing: Pocket Camp. It starts with planting flowers for prizes. Next is a Fishing Tourney (for more prizes). The last one is a scavenger hunt where the player collects gyordites and uses them to craft prizes. Usually, there is a theme that runs through all three events. This time, that didn’t happen. This series of events started with Gulliver’s Port Resort, where players collected items to make that resort in their campground. The Fishing Tourney Pirate Life followed. Players caught special, sparkling, fish and traded them for pirate-themed prizes. The Cool Scoop Scavenger Hunt focuses on ice cream. One of these things is not like the other! The screenshots in this blog post are from July of 2020. Players had to go from one location to another and gather up all the cool scoop gyordites that they could find. The gyrodites are only available during the event. A certain number of them is one of the things required for players to craft the prizes associated with this part of the event. Prizes earned during the Cool Scoops Scavenger Hunt: creamy-cone holder ice-cream-shop table blue ice-cream cart sherbet-cone holder pink ice-cream cart There were more prizes available, but I didn’t manage to collect enough cool scoop gyordites before the event ended. I missed out on the Ice Cream Shop cart that looked different from the other two carts. One item could only be purchased with Leaf Tickets (the in-game currency). It wanted 150 of them, and I didn’t have it. Most, if not all, of the Animal Crossing Pocket Camp events include classes that the player can take. The classes disappear after the event ends. To pass the class, the player needs to obtain specific items. Cool Scoop Parlor is the first of three event-related classes. Cool Scoop Parlor 1 required the ice-cream-shop table and the creamy-cone holder. It also required players to craft a Candy Gingham Shirt, which was not part of the event. Success! Cool Scoop Parlor 2 also required the ice-cream-shop table. Additional items include the blue ice-cream cart, and the sherbet-cone holder. It also required a cream soda – which players had to craft. My Pocket Camp character is thinking about where to put the required items for this class. The highlighted objects are the ones that were required for this class. Success! Cool Scoop Parlor 3 required Creamy-cone holder. It also wanted the Ice-Cream-Shop cart (which I did not have). It sometimes is possible to pass the class without having everything needed. It also required the menu chalkboard, which players had to craft. My Pocket Camp character is trying to figure out how to pass this class. The highlighted areas are the ones where the required items are supposed to go. I didn’t have the Ice-Cream-Shop cart. When that happens, the game suggests an item that the player should put instead. So, I ended up with a table that had a large umbrella over it. Not quite a success, but good enough! Animal Crossing: Pocket Camp – Cool Scoop Scavenger Hunt is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Animal Crossing: Pocket Camp – Fishing Tourney Pirate LifeAugust 27, 2021Animal Crossing Pocket CampThere are three parts to an event in Animal Crossing: Pocket Camp. The first one involves planting flowers and capturing rare creatures. The second one is a Fishing Tourney. The third is a scavenger hunt. Fishing Tourney Pirate Life started on July 11, 2020, and ended on July 19, 2020. It began shortly after Gulliver’s Port Resort ended. The screenshots in this blog post were taken in July of 2020. The game gives the player an announcement when a new Fishing Tourney begins. The theme connects to the previous event. Sometimes, the theme matches well. In this case, my campsite had been turned into a Port Resort. This Fishing Tourney gives players the opportunity to obtain pirate-related loot. It works! Chip: Oh boy, it’s finally here… “Fishing Tourney (Pirates)”! All of the Fishing Tourneys work the same way. The player needs to go fishing in the place the Fishing Tourney is held. (There is another location player can fish from – but fish caught there won’t count.) There is a timer on how long a player can fish – meaning that the Tourney fish will disappear after a short span of time. The player then hands over the Tourney Fish they caught to Chip who will measure them. Prizes can be earned. I caught two Bering wolffish! I earned a wood fish trophy. Chip: Now, let’s see here. What have I got for ya… Players needed to collect a number of mariner’s anchors in order to complete a series of quests. There are prizes that can be obtained by those who gather enough mariner’s anchors before the event ends. Here is what the fish in the Fishing Tourney (Pirates Life) event looked like: smalltooth sand tiger great barracuda two great barracuda I used a Fishing Tourney net. Players get one for free at the start of a Fishing Tourney. I caught a Bering wolffish, some great baracuda and some smalltooth sand tigers. I’m not sure if the number I caught includes only what was in the net, or if it includes the fish I pulled out of water before deploying the net. Bering wolffish two smalltooth sand tigers Here are the prizes that players can earn while doing this Fishing Tourney: pirate tee and vest wooden box eye patch black bandana I now had the right items to complete one of the classes that connected to this Fishing Tourney. The first Pirate Life class required the wooden box, pirate tee and vest, and black bandanna. The required items go into the spots that have a transparent rectangle on them. Success! I have been assigned the rank of Amateur Rank 9! Here are more of the prizes that come from the Pirate’s Life Fishing Tourney: barrel chair barrel table pirates’ treasure map pile of Bells For those who have never played an Animal Crossing game – Bells are the in-game currency. There are many ways to earn Bells in the game. This particular pile of Bells is only cosmetic, and cannot be used to buy something with. I now had all the items that are necessary to complete the second Pirate Life class. Success! pirates’ bounty pirate skull banner stack of barrels I now had everything necessary to complete the Pirate Life 3 class. My Pocket Camp character is thinking about where to place the items. This is what the Pirates Life 3 class looks like after everything has been properly placed. Success! I earned three medals in each of the Pirate Life classes. The Fishing Tourney (Pirate Life) shared some quest goals that carried over from the Port Resort event. As such, I was able to obtain some rewards that were part of each event just by completing quests. white resort bench Here is the white bench in the middle of my Port Resort. Fishing Trophies I already posted the wooden fishing trophy in this blog post. Somehow, I failed to get a screenshot of the next one, the bronze fishing trophy. silver fish trophy After the Fishing Tourney Pirate Life ended, I got this announcement of my results. I earned a gold fish trophy. It was time to take a rest! Rod’s adventure cookie One of the rewards for completing all of the quest goals was a Rod’s adventure cookie. Players earn it. Usually, the special cookies cost Leaf Tickets (a type of currency that players can earn – or purchase with real money). To open a fortune cookie, a player’s character must eat it. There is always a short fortune inside, just like in real world fortune cookies. There will be a prize inside (that usually looks way too big to fit into a cookie). I got a pirate captain hat! A pirate’s life for me! The Port Resort part of my campground has been taken over by the Pirate Life items. Animal Crossing: Pocket Camp – Fishing Tourney Pirate Life is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Animal Crossing: Pocket Camp – ButterfliesAugust 21, 2021Animal Crossing Pocket CampOne of the most relaxing things to do in Animal Crossing: Pocket Camp is to catch bugs. The types of bugs are swapped in or out, depending on the season. There are sometimes events that require players to catch a certain number of a specific type of bug. The butterflies are the most interesting to me. There is a surprising amount of variety to them! purple butterfly Andromeda satyr Cairns Birdwing blushing phantom peacock butterfly paper kite butterfly common bluebottle giant blue swallowtail Madagascan sunset moth emperor butterfly purple swallowtail stresemanni swallowtail #Blaugust2021 Animal Crossing: Pocket Camp – Butterflies is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Animal Crossing Pocket Camp: Gulliver’s Port ResortAugust 11, 2021Animal Crossing Pocket CampGulliver’s Port Resort started on June 30, 2020, and ended on July 4, 2020. The event started like all the other events do. Players had to collect special seeds, plant them in their garden, and hope that rare creatures appeared. Gulliver: Ahoy there! The name’s Gulliver. Gulliver: Maybe you knew that. Maybe we’ve met. You land-legs all look alike to me. I get hit on the head a lot! Gulliver: Anyway, maybe you know I do exports. And I’m known to rustle up some goodies from time to time. Gulliver: Well, it so happens I got my talons on something unbelievable in my last haul – paper-petal seeds! So far, every time an animal friend invites themselves to my campsite, it is because they want something from me. Gulliver usually can be found at Sunburst Island (the one with the bugs). He has his own boat, which he sends to other islands to retrieve things. The player must fill up the boat with items before Gulliver can send it off. Some time later, the boat returns with souvenirs. Each one will cost some Leaf Tickets. Gulliver: These things take me back. I’ve laid eyes on many a scintillating flower in my travels… Gulliver: Yep. Journeying harbor to harbor, seeing the flowers lined up out of port like an array of cannons… Gulliver: Fish-flakes! All that nautical nostalgia’s sailed me right into a brilliant idea! Gulliver: Let’s recreate the maritime magic of a port resort right here and now! Gulliver: You ever heard of dailycrabs? Rare hermit crabs with shells as precious as undersea treasure. Gulliver: They gather around paper-petals, so we wanna track some down… and reel ’em in! Er, with a bug net! Gulliver: Their shells’ll be real nice for our post-resort experience. Sardines! I’ve got some decor ideas already! Gulliver: So, do you know all about how to go about catching these dallycrabs? Orange dallycrab Pink dallycrab Task complete! Gulliver: Well done, generous sailor. The screenshots above pretty much show everything you need to know about how this part of the event works. Gather flower seeds by going around and giving things to animal friends (including those in your campsite). Plant the seeds in your garden. Water them when needed (unless a friend got to it already). Collect the rare creatures. Harvest flowers. Repeat. Here are the rewards I earned for collecting orange and pink dallycrabs: pink paper-petal seeds+ seaside-vacation shades mariner’s anchor The mariner’s anchor items are required in order for players to collect enough to complete the special quests. Collecting mariner’s anchors gives the players special rewards. For example, a starfish hairpin. seaside-vacation dress Task complete! My character is wearing the starfish hairpin and the seaside-vacation dress. seaside-vacation shirt port-resort table seaside-vacation juice A Once you collect up (or craft) certain items that are related to a limited-time event, you can use them to take a class. The concept is a little wonky, but it does give you some good rewards if you successfully complete it. The first class related to Gulliver’s Port Resort event is the one shown above. I had collected the seaside-vacation shirt, and the seaside-vacation juice A. To get the little pot of pink paper-petals, you have to get in your garden and exchange some of those flowers for ones inside a flower pot. Here is what the first class looks like with the required items placed. This the face my Pocket Camp character makes after successfully completing a class. I have reached Amateur Rank 8. Eventually, the game introduces new paper-petal flowers. The new ones are yellow instead of pink. They attract different colored dallycrabs. Gold dallycrab Silver dallycrab Here are some of the rewards for collecting gold and silver dallycrabs: seaside-vacation juice B post-resort lounge chair white resort bench post-resort fence A Here is what the Port Resort Class 2 looks like after the player successfully completes it. Once again, my Pocket Camp character makes that face after successfully completing a class. post-resort fence B post-resort balcony post-resort arch Here is what the third – and final – Post Resort class. The game gives players duplicate items as prizes. The player might need to make use of them in the classes. Here is another view of the third Post Resort class when it is successfully completed. After the player finishes all the tasks, there is a short scene that appears. Here is a view of the Post Resort items in my campsite at night. Here is a view of the Post Resort items in my campsite during the day. Gulliver: Ahoy there, friend. I figure it’s time I weighed anchor and got back to my usual work. Gulliver: Well, shuck my clams! You’ve still got dallycrabs and paper-petals to give away? I’ll take them, of course. Gulliver: You’ll find a reward waiting in your mailbox. Check for it later! Gulliver: See you around! Animal Crossing Pocket Camp: Gulliver’s Port Resort is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Animal Crossing Pocket Camp: Harmony Scavenger HuntJuly 31, 2021Animal Crossing Pocket CampThe Harmony Scavenger Hunt started on June 21, 2020. It was connected to Lottie’s Wedding Expo and the Fishing Tourney (Wedding) events. The Harmony Scavenger Hunt ended on June 28, 2020. When the Harmony Scavenger Hunt started, the game gave the players a look at what kinds of items they would be able to obtain by participating in the Scavenger Hunt. Here is a close up look at what the bebop gyoridites for this scavenger hunt look like. Each scavenger hunt includes a unique type of gyoridites. Players get to keep the ones that they did not use up by the end of the event. Players must collect a specific number of them for each of the items they want to craft. There are quests that the player can complete simply by picking up a certain number of bebop gyroidites. Doing so gives the player a wedding bells item, which is required in order to complete a different set of quests. Here are the items I obtained by collecting bebop gyroidites and crafting items: do melody button re melody button mi melody button fa melody button so melody button la melody button ti melody button high do melody button I started putting the melody buttons into my campsite, as I crafted them. To my surprise, two of the animal friends in my campsite decided to stand on them while holding hands. I eventually put all of the melody buttons into my campsite. In this screenshot, one animal friend is standing on the first melody button. It was fun to return see what animal friends were standing on the buttons every time I returned to my campsite. Animal Crossing Pocket Camp: Harmony Scavenger Hunt is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Other Video GamesDragon Mania Legends: Dusk Dragons CollectionNovember 17, 2021Dragon Mania Legends / Other Video GamesThe Dusk Dragons Collection is one of many collections that players can complete in Dragon Mania Legends. All of the dragons in this collection have the Dusk element. Each of the dragons also has one additional element. The reward for completing this collection is 15 Gems. At the time I completed this collection, only 9.0% of players had completed it. I don’t typically set out to complete a collection all at once. Instead, I try and figure out what dragons I can breed to get the dragons that I don’t have yet. There are many other things you can do with the dragons in Dragon Mania Legends. This is what a Fungus Dragon Egg looks like. The Dragon Mania Legends Wiki says that the Fungus Dragon is a normally-breedable dragon. It can be obtained by breeding together two Dragons that together have the Shadow and Plant Elements. Players must be Level 44 before they can breed a Fungus Dragon. You’ve collected a new dragon! It’s surprising the Fungus Dragon is SO popular considering the strange smell it emits. The other dragons must think it’s a REALLY “fun-guy”! This is what a Fungus Dragon hatchling looks like. It has the Dusk Element and the Plant Element, so it can be placed in either a Dusk Habitat or a Plant Habitat. Fungus Dragons are Common. I failed to take a screenshot of what the baby Fungus Dragon looks like in a Habitat. It looks exactly like the little hatchling in the above screenshot. This is what an adult Fungus Dragon looks like. The mushroom on its head has grown a stem. It has several smaller mushrooms growing on its head, back, and tail. There are some green areas that look as though a fungus is growing on it in places. This is what a Reaper Dragon Egg looks like. The Dragon Mania Legends Wiki says the Reaper Dragon is a normally-breedable dragon which can be obtained by breeding two Dragons who together have the Shadow and Metal Elements. Players must reach Level 44 before they can breed a Reaper Dragon. You’ve collected a new dragon! The Reaper Dragon may look intimidating, but it’s a very friendly fellow. It greets this trainer by wagging its tail whenever he comes home… So, THAT’S how all those scratches appeared on the kitchen floor! This is what a baby Reaper Dragon looks like. This dragon has the Dusk Element and the Metal Element, so it could be placed into either a Dusk Habitat or a Metal Habitat. I had some room in the Dusk Habitat, so that is where I decided to put this dragon. This is what an adult Reaper Dragon looks like. Its horns have grown much bigger and they are curved now. There are at least three tombstones growing on this dragon’s back. Red roses, on brown vines, grow around them and down the dragon’s tail. The scythe on the end of its tail has grown sharper. The Reaper Dragon’s eyebrows have become larger, giving it a menacing look. This is what a Dark Matter Dragon egg looks like. The Dragon Mania Legends Wiki says the Dark Matter Dragon is a normally-breedable Dragon which can be obtained through the breeding of two Dragons who together have the Shadow and Energy Elements. A player must be Level 44 before they can breed a Dark Matter Dragon. You’ve collected a New Dragon! This trainer would doubt the presence of the Dark Matter Dragon, if not for the gravitational pull it exerts on any and all cookies in his house. This is what a Dark Matter Dragon hatchling looks like. It has the Dusk Element and the Energy Element. It can be placed into either a Dusk Habitat or an Energy Habitat. The Dark Matter Dragon is Common. Here is a baby Dark Matter Dragon in a Dusk Habitat. It looks just like it did as a hatchling. This dragon’s head and back are covered in an unnatural looking fire. The top of its head is dark purple and red and its mouth is light blue. Its body uses the same colors. The Dark Matter Dragon’s eye matches its glowing egg. This is what an adult Dark Matter Dragon looks like. It has grown larger and can now curl up part of its snake-like body. The flames that start at its head and move down the edge of its spine are more prominent. Its colors are the same as before. The eye of this dragon gives it an angry look. This is what a Nightmare Dragon Egg looks like. The Dragon Mania Legends Wiki says the Nightmare Dragon is a normally-breedable Dragon. It can be obtained from breeding two Dragons that together have the Shadow Element and the Void Element. Players must be Level 44 before they can breed a Nightmare Dragon. This is what a Nightmare Dragon hatchling looks like. It has the Dusk Element and the Void Element, so it can be placed into either a Dusk Habitat or a Void Habitat. The Nightmare Dragon is Common. This is what a baby Nightmare Dragon looks like. There are spikes growing out of its head, that appear to be poking through a leather helmet. It’s face resembles a skull. The back of this dragon looks like it is made up of leather straps that have been attached to the bottom half with rivets. The yellow bottom half of the dragon has stitches. The tail of the Nightmare Dragon resembles a small chainsaw. This is what an adult Nightmare Dragon looks like. The spikes on his head now look like razor blade. His face still looks like a skull. This dragon glares at you. The body of the dragon has gotten longer, and has a second curl to its snake-like body. The bottom of its tail now clearly looks like a chainsaw. (Groovy!) Dragon Mania Legends: Dusk Dragons Collection is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Kitchen Scramble App: PhyllodophiaOctober 11, 2021Kitchen Scramble / Other Video GamesPhyllodophia is the fifteenth town in the Kitchen Scramble game. The recipes in this town appear to be based on Greek cuisine. The town has a goddess who seems to be the one who is in charge. It’s been a while since I’ve done a Kitchen Scramble blog post. The main reason for the delay was that I got a new iPad Mini. It did not keep my progress in Kitchen Scramble, so I had to work my way through the game until I got to Phyllodophia. The good news is that the game updated and runs a lot smoother than it did before. Pepper: Would you look at all this produce? It’s so fresh! I feel like a kid in a candy store at a market like this! Goddess of Love: Yes, our island is known for high quality produce. Do you not just love it? I certainly do, but then again, I am the Goddess of Love. Pepper: Wow, a goddess?! Well, I’m Pepper, and I love food so much that I have my own food truck! Stop by and I’ll cook something for you! The new recipes for Level 340 are: Steamed Rice Greek Salad Gyro This screen was added sometime between when I had to stop playing the game and when I started up again. It shows that I got three stars in Level 340. A player can earn one, two, or three stars. In my experience, I am usually able to fill up the first star, and sometimes the second. The third one is harder to fill. I got three stars on Level 340! Goddess of Love: That was delightful! You are quite the cook.You know, I am in the midst of planning a wedding and I’m still looking for a caterer… Pepper: I’d love to cater a wedding! That is, if you’re offering! Goddess of Love: Fantastic. But I am considering one other caterer. After I try their food too, I’ll make a decision. The new recipes for Level 341 are: Olives Hummus Tzatsiki I earned three stars on level 341! I got three stars on Level 341! The new recipe for Level 342 is: Shwarma Plate I got three stars on Level 342! The new recipe for Level 343 is: Veggie Gyro Mother & Baby: I’m really looking forward to attending this wedding. The planner organized a daycare for the children! She’s so thoughtful. The Kitchen Scramble Wiki says that this character is named “Mother & Baby”. The two of them have merged into one being, it seems. Kitchen Scramble names most of its characters based on what they do. For example, there are characters named Fashionista, Race Car Driver, and Fisherman. There is also one named Grandma and another named Grandpa (who are spouses). It sounds like the game considers “Grandma” and “Grandpa” to be professions. As such, “Mother & Baby” are also …. a profession? Somehow? To me, this feels really icky and I think they should have given the mom and her baby names. That said, I really like the idea that the Goddess of Love, who is intending to hold a wedding, cares enough about the attendees to realize that at least one of them would have difficulty attending if there wasn’t an option for daycare. That’s pretty cool! Pepper: Well that’s good to hear… I do hope she decides soon about who will cater the wedding! I got three stars on Level 343! No new recipes were added in Level 344. I got three stars in Level 344! Goddess of Love: My heavens, the closer a wedding gets, the more there is to do! So many decisions to make, and so little time! Goddess of Love: Your dishes are divine! But I loved Caper’s Cuisine too. How will I ever make up my mind? Pepper: Oh no! Of all the foods on all of the islands… I know about the food at Caper’s Cuisine, if you can even call it that. Caper’s Cuisine is the name of the food truck run by Pepper’s rival, Candace. The game makes it clear that Pepper uses fresh foods, and Candace puts “chemicals” into her foods. I think the concept the story writers were going for was to encourage people to eat healthy foods. In Mozzarama, Candace got caught injecting “a strange green liquid” into some old tomatoes, and she dumped chemical waste into the river. In Mangotango Bay, Candace installed an underground pipe in her restaurant that spewed out pollution into the waters of the reef, causing the fish to leave. Kitchen Scramble definitely is telling a story about why healthy foods are good for not only the people who eat them, but also for the environment. I also get the feeling that emphasizing the pollution and contamination that comes from the actions of Candace emphasizes the harm that some companies choose to do in an effort to make more money. There’s one more thing that the above conversation between Goddess of Love and Pepper that makes me wonder. Who is Goddess of Love marrying? She hasn’t mentioned the name of her (soon-to-be) spouse. Maybe she’s officiating the marriage of an unnamed, happy, couple? If Goddess of Love is organizing her own marriage, it makes sense to have her make all the decisions herself. Who could possibly be better at figuring out what a wedding reception needed than a Goddess of Love? The new recipe for Level 345 is: Greek Pizza I got two stars on Level 345! So far, I’ve been unable to get more than two stars on Level 345. My best guess is that I need to collect enough Kitchen Scramble bucks to purchase the Premium Gold Shawarma Machine. It works faster than the medium upgrade version, and gives three batches of Shawarma instead of two. The new recipe for Level 356 is: Dessert Pizza I got three stars on Level 346! The new recipe for Level 347 is: Stuffed Tomato I got three stars in Level 347! The new recipe for Level 348 is: Tabbouleh I got three stars on Level 348! The new recipes for Level 349 are: Veggie Dolmas Dolmas I got three stars on Level 349! I completed the “Serve 200 Gyros” Location Goal! The reward is ten Tokens. Players can earn one Token for each star they fill in on a level (for the first time). Tokens are used to get though Toll Gates, which block access to the second half of a town. The new recipe for Level 350 is: Baklava I got three stars on Level 350! Fashionista: Could you make me a quick Greek Salad for lunch? I have a dress fitting soon… I’m in the bridal party for this huge wedding! Moonshiner: You’re in the bridal party? Me too! I’m the maid of honor! Isn’t that great? Fashionista: But, your fashion sense is so… Hang on, did you say that YOU are the maid of honor? Moonshiner: Yep, isn’t that great?! We’ll get to spend so much time together, you and me! The new recipe for Level 351 is: Falafel I got three stars in Level 351! I have now completed the first half of Phyllodelphia. There is a Toll Booth that blocks the player from moving into the second half of Phyllodelphia. To get past it, a player must have collected a certain number of Tokens. I had enough to pass the Toll Gate. The new recipes for Level 352 are: Spanakopita Kreatopita I got three stars in Level 352! Moonshiner: Gosh, you sure looked pretty in your dress. I just felt kinda funny. Fashionista: Nonsense, dear! I admit I was surprised, but you looked so natural in the ensemble. You must model for me some time. The new recipe for Level 353 is: Greek Custard Pie I got three stars in Level 353! This level required players to serve Kreatopita to at least four customers. I got three stars in Level 354! Goddess of Love: The more food I sample, the harder it becomes to decide! How could it be so difficult? Candace: How hard could it possibly be? My food is perfect. Maybe you’re the problem. Goddess of Love: How dare you! We’ll I have finally made my decision, thanks to your attitude. The implication here is that Goddess of Love has become so angry at Candace’s attitude that she decided that Pepper should be the one who will cater the wedding. The new recipe for Level 355 is: Dessert Yogurt I got three stars in Level 355! The new recipe for Level 356 is: Spanakorizo I got two stars on Level 356! Goddess of Love: The other caterer was so rude! It’s like she believed I was not good enough for her food! Pepper: Well, things haven’t been going her way lately. Maybe she’s just fed up. Goddess of Love: No matter. I would be honored if you would serve your food at the wedding. It will be love at first bite! Pepper: It would be my pleasure! And it sounds like some of my regular customers will be there too! I got three stars on Level 357! This level required players to serve at least three Dessert Pizzas to customers. I got three stars on Level 358! I got three stars on Level 359! I got three stars on Level 360! This level required players to serve at Greek Custard Pie to at least three customers. I got three stars on Level 361! I got three stars on Level 362! In Level 362, most of the customers wanted a pizza. I got two stars in Level 363! In this level, players had to serve at least 15 Tzatziki to customers. This is not easy to do, in part because not all of the customers asks for Tzatzku. You can’t give customers something they didn’t ask for. I got three stars on Level 364! Candace: You know that old saying, “If you can’t beat ’em, join ’em?” Pepper: What do you mean? Candace: People keep choosing your food over my perfectly engineered flavors. I have to find out why! Candace: Let’s just say you’ll be seeing more of me at the Chef Academy this spring. Now this is interesting! Candace was once teaching at Chef Academy, but she failed all of her students, and was let go. In addition, she had a tendency to say really mean things to Pepper. Could it be that Candace is going to attend Chef Academy as a student? By the time I was done with Phyllodolphia, I had served over 3000 customers. There is one more goal to complete – which requires serving more Baklava to customers. If I finish that one, I’ll update this blog post. This is what the second half of Phylodophia looked like when I was finished with it. Kitchen Scramble App: Phyllodophia is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Neko Atsume: Honey PotAugust 30, 2021Neko Atsume / Other Video GamesNeko Atsume is a game where players attempt to attract cats to their home/yard. The only way to do it is put out items that the cats might be interested in playing with. Some of the cats enjoy the Honey Pot. The flavor text of the Honey Pot says: The inside of this jar keeps a constant temperature for storing sweet things: e.g., honey and snoozing cats. Most of the screenshots in this blog post were taken in 2017. Pickles Pepper Bolt Ginger Pumpkin Princess Chocola #Blaugust2021 Neko Atsume: Honey Pot is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Neko Atsume: Temari BallAugust 25, 2021Neko Atsume / Other Video GamesNeko Atsume is a game where the entire goal is to attract cats to your home/yard. The only way to do it is to put out items that the cats might be interested in playing with. Some cats enjoy the Temari Ball. The flavor text on the Temari Ball says: Real Temari Balls are fine pieces of Japanese folk art fashioned from layers of fabric. This one’s made for cats. Most of the screenshots in this blog post were taken in 2017. Caramel Dottie Lexy Marshmallow Patches Peaches Smokey Spud Snowball Sooty Neko Atsume: Temari Ball is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Seekers Notes: Mysterious Friend CollectionAugust 23, 2021Other Video Games / Seekers NotesSeekers Notes is a game where the player becomes the Seeker and must find hidden objects that the townspeople lost. The town of Darkwood is under a curse, and things go missing. Most quests in the game are “one-offs” that end when a player completes a collection. The Mysterious Friend Collection is part of a series of quests that are part of the Performer’s Path event. This one takes place after the player finishes the Creative Environment Collection. The screenshots in this blog post are from July of 2021. Amy: Seeker, have you seen my grandpa? I waited for my friend for almost an hour, but he didn’t come to the rehearsal. I’m afraid he won’t come to the concert either. I’m so upset – I want to go home with Grandpa. Seeker: I’m so sorry, Amy! Congratulations! You completed a stage challenge and get Glove as a reward! I completed the quest line for the first bubble in this part of the Performer’s Path event. Blacksmith: What’s going on?! My little star is so disappointed. Did Pete run himself ragged and forget about everything? Let’s treat Amy to her favorite cornflower sorbet and find out more about the situation. Pete is one of the other children in Darkwood. He is the son of Darkwood’s toymaker. I found the cornflower sorbet! Blacksmith: That’s news to me! My Amy cheered up after eating a couple of spoonfuls and sorbet and said Pete wasn’t even her partner! Do you know a boy named Rudy? My granddaughter says she met him recently. Amy: No way! Pete never would’ve agreed to participate in a sentimental play. I thought all boys were like that, but Rudy turned out to be a big fan of the classics. Take a look at our playbill! One unique thing in Seekers Notes is that the more you play through (and successfully find all the hidden objects in) a specific location – the more you level it up. The Music Hall was now at the Connoisseur rank. This matters mostly for locations that are part of a limited-time event, as part of completing the event requires players to level up the location all the way. Congratulations! You completed the stage challenge and get Bohemian Snack as a reward! I have now filled in two of the bubbles in this section of the Performer’s Path event. I found the playbill! Amy: Rudy was planning to perform alone, but when he met me, he revised the show to include us both. If it weren’t for him, I never could have mustered the courage to go on stage! But now it seems like I won’t be getting on stage either way. Blacksmith: Amy is sad again and can’t utter a single word. Well, my mother used to say some fresh clean water can wash all your troubles away! I’ll go help Amy wash her face, but I need to find a towel first… I found the towel! Blacksmith: Oh, you found such a beautiful and soft towel! Amy will enjoy drying her pale cheeks with it after she washes up. And the color is so bright! She’ll perk up right away when she sees it! Amy: Grandpa has asked me to tell him more about Rudy to help me find him, but I can’t get my thoughts together. I wanted to show you Rudy’s gift – a fun little frog that reads poems – but it seems to have vanished too. I found the frog toy! Amy: Oh, you found my toy! Thank you! This little frog reminded me that Rudy always stayed in character, acting out his role from the play. I’ve never seen him without a cape and mask before, and he also had an interesting accent! Blacksmith: It’s too bad Amy hasn’t seen her friend without a mask, but if Rudy had an accent, we should start our search with the families that are new to the area. There aren’t many of them in Darkwood. Let’s look for their addresses in the directory! Congratulations! You completed the stage challenge and get a Captain’s Wheel as a reward! The Performer’s Path section with the creatures that the Seeker must placate has been updated. There are now three out of five bubbles filled in. Blacksmith: Great! All of these families have children Amy’s age. What if the boy got a bad grade, and his parents are making him study right now? Together we can convince them to let him go out for a night. Blacksmith: I’m starting to worry, Seeker. We didn’t find a Rudy in any of the families. Maybe he made up that name when he introduced himself to Amy. But why his he playing this game of cat and mouse? No, I don’t think any of the kids lied to us. Helen: What a sad story! Poor Amy, I can only imagine how much energy and aspiration she’s put into this performance. I’m sure her friend didn’t do this on purpose. Let’s look for his name in the student registry! To obtain the student registry, the Seeker must collect a certain number of objects. Those objects are dropped by creatures that the seeker must placate by giving them specific items. Clicking on the blue arrow allows the player to complete the Mysterious Friend collection. Helen: Alas, either the name isn’t real or Amy mixed it up, but, according to the registry, there are no boys Amy’s age named Rudy in Darkwood. Congratulations! You completed the stage challenge and get Chocolate Present as a reward! I have now filled in two of the six bubbles on the part of the Performer’s Path that shows a decorated box. Seekers Notes: Mysterious Friend Collection is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Neko Atsume: Manta Gel MatAugust 18, 2021Neko Atsume / Other Video GamesNeko Atsume is a game where the player attempts to attract cute, cartoon, cats to their home/yard. Place items that you think the cats might enjoy, and wait to see what they do with it! The flavor text on the Manta Gel Mat says: A cushion-like gel mat with the just-right cool temperature. Do not release into the ocean. The Manta Gel Mat was one I selected when the weather in real life started getting hot. It was one of many cooling mat items that I put out for the cats to use. Not all cats use the Manta Gel Mat, but the ones that did looked exceptionally comfortable on it. Sunny Cocoa Bolt Socks Sooty Chip Fred Snowball #Blaugust2021 Neko Atsume: Manta Gel Mat is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Seekers Notes: Placating Performer’s Path CreaturesAugust 16, 2021Other Video Games / Seekers NotesSeekers Notes is a game where the player becomes the Seeker and is tasked with finding lost objects. It includes puzzles, locations where you need to find all the hidden objects, and a creepy storyline. In order to complete a collection in a time-limited event, the player must placate three creatures that are part of the event. Each one can drop the items that the next-in-line wants. These screenshots were taken in July of 2021. This placating creatures chain of quests is interwoven with the Creative Environment series of quests. The player needs to successfully locate all necessary hidden objects in the Music Hall. If successful, the area might drop an item needed by the first of the three creatures that are part of the event. Every event works the same way when it comes to placating creatures. Find all the objects in the special location of the event. Hope it drops the thing the first creature wants. The first creature wants one specific item. The second one wants two specific items that the first one drops. The third one wants three of the specific item dropped by the second one. There is a leaderboard that counts how many times a player placates these creatures. I’m not sure why the game creators felt the need to add that. The purpose of placating creatures is that they (eventually) give the player the “extra” items they need to complete a collection. Helen: Mac Boop-Boop-a-Doop has been holding his guitar in his wings for several hours without putting it down. Mac’s enthusiasm is laudable, but it’s difficult for other performers to rehearse because of his loud singing. Maybe he’ll take a break to eat a juicy snack. To obtain a Juicy Snack, players must successfully complete the Music Hall location. It might drop one Juicy Snack – or none at all. Mac Boop-Boop-a-Doop requires one Juicy Snack at a time. He will require more than the two you give him at first, so keep feeding him! Helen: I can imagine how much energy it takes to play and sing nonstop for several hours in a row. No wonder Mac couldn’t resist the juicy snack we offered him. The performers are grateful to us! Congratulations! You’ve successfully placated the creature: Mac Boop-Boop-a-Doop. Mac Boop-Boop-a-Doop: Beginning artists have a lot to learn from Mac Boop-Boop-a-Doop! This tireless musician often misses the strings of his guitar and sings choruses out of tune, but all the flaws of his playing are made up for by the passion and sincerity that Mac puts into it! Placating item: Juicy Snack. Antoine: Miss Ostriss believes that her look alone deserves thunderous applause. If you ignore her once, you won’t be able to outrun this resentful ostrich! Let’s give her gorgeous roses. Miss Ostriss: A concert fasionista who’s hungry for attention. Miss Ostriss requires 2 Gorgeous Roses. The only way to get them is to placate Mac Boop-Boop-a-Doop two times. He will drop Gorgeous Roses each time you give him a Juicy Snack. Congratulation! You’ve successfully placated the creature: Miss Ostriss. Antoine: Phew, I think I’m safe now, thank you! Honestly, Miss Ostriss’s jewelry, hat and feathers may blend into all the flamboyant concert attire, so its best to always keep a bouquet at close hand. Miss Ostriss: If you lost part of your concert costume shortly before a performance, there is a high probability that this item was borrowed by Miss Ostriss. This feathered lady loves to spend time in dressing rooms and try on new hats and jewelry. Placating item: Gorgeous Roses. Colonel Hammerstrike: Wild Gracius is harmless, though he does resemble a lion. Performers consider his appearance at rehearsals a good omen. But if Gracius has fallen asleep on the stage, interfering with the performance, then a confetti popper will help. Wild Gracius: An extravagant creature with feline traits. Wild Gracius requires three confetti poppers. The only way to get them is to placate Miss Ostriss. To placate her, the player has to placate Mac Boop-Boop-a-Doop. To placate him, a player needs to successfully complete the Music Hall location. Fortunately, players only have to do this one time through in order to complete this series of quests. But, that’s not the end! The entire process needs to be repeated enough times to give the player the extra items that are needed to finish a collection. Congratulations! You’ve successfully placated the creature: Wild Gracius. Colonel Hammerstrike: The confetti popper work Wild Gracius up, and he stretched and left in search of a more comfortable place to rest. Thank you for your help, Seeker. The performers can continue their rehearsal. Congratulations! You completed the state challenge and get a Vibrant Mocktail as a reward. I have now completed one part of the event that involves placating creatures. #Blaugust2021 Seekers Notes: Placating Performer’s Path Creatures is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Neko Atsume: Cake BoxAugust 14, 2021Neko Atsume / Other Video GamesNeko Atsume is a cute game where the player attempt to attract adorable cartoon cats to visit them. To do this, the player needs to put items into their home and/or yard that the cats might like. The Cake Box one of them. The flavor text on the Cake Box says: A sweet box like this is sure to pique a cat’s curiosity. Here is what the Cake Box looks like when it is placed in your home or yard. Based on how the cats use the Cake Box, I’m going to assume it smells really good! Willow Peaches Sunny Patsy Socks Ginger Bandit #Blaugust2021 Neko Atsume: Cake Box is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Neko Atsume: Sugary StyleAugust 7, 2021Neko Atsume / Other Video GamesThere are several styles of homes/yards that are available in Neko Astume. One of them is called Sugary Style. The entire area has a variety of sugary treats. Players can add items that fit the theme. The screenshots in this blog post are from 2016. What will the Neko Atsume cats do if I give them a Tower of Treats to climb on? Willie and Fred are on the top tier of the Tower of Treats. Princess is on the bottom tier. Patches is on the Biscuit Mat. Socks is on the top tier of the Tower of Treats, and Dottie and Lexy are on the bottom tier. Pumpkin is squished into the Glass Vase. Patches is still on the Biscuit Mat. Smokey is on the top tier of the Tower of Treats, and Pickles and Lexy are on the bottom tier. Lexy, Socks and Fred Breezy, Bolt, Socks and Sunny Bolt, Sunny, and Mack Socks is on the Biscuit Mat. Lexy and Socks are on the Tower of Treats. Tubbs has eaten all the food in dish. Tubbs is my favorite Neko Atusme cat. He reminds me of all of the very large cats on Instagram. Black and white cats on the Tower of Treats! Smokey, Socks, and Gabriel have taken it over. Tabitha is on the Biscuit Mat. Dottie, Sunny, and Fred are on the lower tier of the Tower of Treats. Shadow is on the Biscuit Mat. Bolt is on the top tier of the Tower of Treats. Breezy and Spooky are on the lower tier. Sunny is squished into the Glass Vase. What’s going on inside the house? Dottie, Spots, Pickles, and Shadow are taking are all taking a nap. Spud, Patches, Apricot, Socks, and Lexy are somewhere between wide awake and getting ready to nap. Spud is napping inside a bed. Snowball is wide awake! Sunny is sleeping on top of a bed. Speckles has shoved themselves into a cake box, and Ginger seems to be having a very hard day. #Blaugust2021 Neko Atsume: Sugary Style is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Seekers Notes: Creative Environment CollectionAugust 4, 2021Other Video Games / Seekers NotesSeekers Notes is an app game where the player becomes the Seeker and is tasked with finding lost items. The game includes finding hidden objects and hoping a quest item will drop upon a successful complete. There is a creepy story line that goes along with each quest. Every so often, Seekers Notes offers players a connected series of quests that the player must finish in order to get the entire storyline. These are only available for a limited time. Creative Environment is the first quest. When there is a special event happening, the game gives the player a series of very decorative panels that connect to things in the event. The main purpose is to make it easy for a player to see how much progress they made – and how much is left to complete. The first panel focuses on leveling up the Music Hall location. The second panel shows the player their progress in completing the quests that are part of the special event. Helen: Seeker, you’ll need Diva’s Fans to explore the Music Hall. Here are 10 access passes for now. Helen is the Mayor’s assistant. She gives out many of the quests in the game. At times, it seems like her efforts are what holds the cursed town of Darkwood together. Foundation Day Concert! Darkwood is a very old town, and the people like to celebrate its Foundation Day. It gives them a reason to put on a concert for everyone to enjoy. Amy: Happy Foundation Day, Seeker! I hope you’ll come to the gala concert. My friend and I worked really hard to prepare a fun musical number! Amy is one of the children in Darkwood. She is being raised by her grandfather. I found the key to the Music Hall! The first thing a player must do is unlock the Music Hall. It is the location that the player will be required to play through multiple times, in order to receive specific items that are needed to complete quest chains. In order to access the Music Hall, the player must successfully complete any location in the game that they have already unlocked. The key to each location can be used once – and the location stays open after that. Helen: Oh, you found the key! Visiting a concert hall is a great way to end the day. But, in the morning you can sign up for a fascinating tour of the building. I’m sure you’ll love it! Congratulations! You unlocked the location! When I make Seekers Notes blog posts, I avoid putting in images that show the inside of the locations. Doing so could be considered a spoiler. It would show a player what the special items they must find look like. Music Hall: As it turns out, Darkwood is home to many world-famous stars! There are many theories that thry to explain why local artists are so successful, but they all have something in common. The truth is, anyone in Darkwood is allowed to perform on stage: the desire to please the audience and improve one’s acting skills is greatly encouraged. One of the places where every aspiring performer can express themselves was and still is the Music Hall. Newly unlocked locations start at the Novice level. I found a scrapbook! Amy: In this scrapbook, I keep clippings from posters and newspapers that mention the artists I love. By the way, I noticed that all of my idols come from families of stars! Amy: I really enjoy singing and dancing, which is why I often perform at school concerts and for my family. But there have never been any artists in my family. I even made a special family tree. I found the family tree! Amy: This tree lists not just my family member’s names, but also their interests. Turns out they’ve all loved creating things and working with their hands. Should I do something similar? I found a brooch! Blacksmith: How did I manage to drop the brooch? Thank you for finding it. My wife’s mother made it herself. There had been no jewelers in her family before her, but Beatrice became one against all odds! She is a good example for Amy. The Blacksmith is Amy’s grandfather. Antoine: Where did I leave my script yesterday? To be honest, it’s not good enough to regret losing it, but still… Ah, it was a mistake for me to write for the stage – playwriting isn’t my thing after all. I found a script! Antoine: Oh, here’s my play! Thank you. Wait a second… Did someone make edits to it? This is outrageous! Although…They’re genius! How didn’t I come up with these ideas myself? A plot twist like this will blow everyone’s minds. Adrian Bloom: Recently fate gifted me with the best melody of my life! I heard it coming from a room with an old piano. I wrote it down on the first sheet of paper I could find, but then I lost it somehow. Adrian Bloom makes perfumes. Victory! The Music Hall location is now at Amateur level. I found the music score! Adrian Bloom: Yes, I recognize my notes – this is the melody! I remember how I ran into the hall expecting to see the creator of this magical melody, but there was no one there. That’s how I knew it was my muse playing for me! Congratulations! You completed the stage challenge and get Lightning in a Bottle as a reward! The first “bubble” in the image above is now filled in. I have now collected almost all of the items required for the Creative Environment quest. The small boxes contain items that the player must obtain by placating monsters. Gather enough of those, and the player can make the last quest item appear. Flower Girl: What a pity! I spent the whole week working on the design for my costume, but now I can’t find my sketch! If I don’t give the design to the seamstress immediately, she won’t be able to make it in time. I was able to find the Flower Girl’s design for her costume, but failed to take a screenshot of it. Flower Girl: The wind blew the sheet of paper off the table, but someone placed it carefully on the windowsill. Oh, is this really my costume? I see some big changes that will make the dress more comfortable for dancing. Incredible! I have now completed the Creative Environment series of quests. Congratulations! You’ve assembled this collection: Creative Environment. Seekers Notes: Creative Environment Collection is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you! #Blaugust2021... Out of Spoons (Chronic Illness)Health Care Under Biden-Harris – February 2021November 25, 2021health insurance / Out of SpoonsPhoto by Glen Carrie on Unsplash The Biden-Harris Administration has put in effort to make it easier for people to receive the health care they need. There is an emphasis on making sure that minority and/or vulnerable groups of people are protected. This is a huge difference from the Trump-Pence Administration, that greatly restricted access to health care. In this blog post, I have provided a collection of information about what the Biden-Harris Administration did regarding access to health care. This includes physical and mental health care. I also included information from outside of the Administration. February 1, 2021 – February 28, 2021 February 1, 2021: Center for Reproductive Rights posted News titled: “Biden Administration Rescinds Global Gag Rule”. From the News: President Joseph Biden has rescinded the “Global Gag Rule” – a devastating anti-abortion policy that has undermined the health and rights of women around the world. The rule denied funding for foreign organizations providing abortion information or services.The president took the action as part of a series of executive orders aimed to improve access to affordable health care in the U.S. and around the world. Other measures included reopening the Health Insurance Marketplace, taking steps to restore Medicaid and the Affordable Care Act, and directing the Department of Health and Human Services to consider rescinding regulations that limited the Title X family planning program.“Today the Biden Administration took an important first step towards righting the Trump administration’s tremendous wrongs impacting access to reproductive health, rights, and justice,” said Nancy Northup, President and CEO of the Center for Reproductive Rights. “In revoking the Global Gag Rule and acting to rescind the Domestic Gag Rule, President Biden is stopping policies that were intended to force reproductive health centers, in the U.S., and around the world, to stop providing and referring for abortion services.”……What has been the Global Gag Rule’s impact?The Gag Rule’s impacts have been many: It has decreased access to abortion care and information as well as to contraceptive care. It has interfered in the patient-provider relationship and caused cuts to family planning programs. It has silenced advocates of reproductive health and rights and reduced community outreach by health workers……In imposing the policy, the U.S. also abdicated its important role in advancing human rights, while infringing on other nations’ sovereignty. The Gag Rule undermines the U.S.’s commitments to international health and rights initiatives such as the International Conference on Population and Development (ICPD) Programme of Action and the UN’s Sustainable Development Goals.The rule also infringes on many of the human rights enumerated in international human rights treaties, including the rights to health, life, information, privacy, and equality. As the Center’s report notes, “Denying women access to services only needed by women, such as abortion, is a form of discrimination against women.”..…The U.S. is the world’s largest single donor to global health efforts. many nongovernmental organizations (NGOs) depend on U.S. funding – to the tune of some $12 billion per year, according to a March 2020 report from the Government Accountability Office (GAO) – and thus have been forced to comply with the Gag Rule. But many health care organizations opted to decline U.S. funding rather than comply. The GAO documented 54 such organization which were then forced to reduce programs that worked to improve health outcomes in countries around the world.Along with family planning and reproductive health, many organizations impacted by the rule provide services pertaining to HIV and AIDS, tuberculosis, nutrition, water and sanitation, and maternal and child health care among other service. By forcing a choice between denial of funding or a reduced scope of care, the rule has resulted in increases in maternal deaths, unsafe abortions, and incidents of HIV and AIDS, as well as the breakdown of coalitions and partnerships that provide reproductive health care in poor and rural regions. Rescinding the harmful Global Gag Rule is a vital first step in restoring the U.S.’s commitment to the health and human rights of women and girls around the world.Center for Reproductive Rights February 1, 2021: Speaker of the House Nancy Pelosi posted a Press Release titled: “Pelosi, Schumer File Joint FY2021 Budget Resolution to Give Congress Additional Legislative Tool to Pass Urgently-Needed COVID Relief”. From the Press Release: House Speaker Nancy Pelosi and Senate Majority Leader Chuck Schumer today announced they have filed a joint budget resolution for Fiscal Year 2021 that gives Congress an additional legislative tool to pass the urgently-needed bipartisan COVID relief legislation that enacts President Biden’s comprehensive American Rescue Plan which helps defeat the virus and provide workers and families the resources they need to survive the pandemic while the vaccine is distributed to every American. Introduction of a joint budget resolution is the first step to potentially enacting a Budget Reconciliation bill, one legislative tool available to Congress to quickly pass bipartisan COVID relief legislation. The Resolution outlines the “reconciliation instructions” for each House and Senate committee, or how much can be spent in their jurisdiction. If both the House and the Senate pass identical Budget Resolutions (which do not require a Presidential signature), both chambers can begin work on the Reconciliation bill that is signed by the President. According to an analysis of research from the Congressional Research Service, reconciliation bills have been passed by the Senate on a bipartisan basis 17 times in recent years, including to pass the bipartisan Children’s Health Insurance Program (CHIP) in 1997… Specifically, the Joint Budget Resolution Speaker Pelosi and Leader Schumer filed offers instructions to the relevant Congressional Committees to provide relief including but not limited to: Immediate relief for individuals and families throughout 2021 including $1,400 per-person and per-child direct payments, an extension of Unemployment Insurance programs through September 2021 with a $400/week federal enhancement and $350 billion in critical state, local, Tribal, and territorial fiscal relief. The resolution would also provide funds to greatly increase health care coverage to Americans that have lost it through no fault of their own during the pandemic. Funding to help defeat the coronavirus including through support for vaccines, testing and public health programs. It also includes funding to help K-12 schools safely re-open and provides cricial support for the child care system. Relief funds for the millions of Americans struggling to make rent and mortgage payments, as well as those experiencing homelessness. The resolution also includes funding for transit agencies deeply impacted by the pandemic and support for the use of the Defense Production Act to expand domestic production of supplies critical to beating the coronavirus. Additional relief for our nation’s small businesses and hard-hit industries through increased funding for EIDL Advance grants, the creation of a dedicated grant relief program for restaurants, expanded PPP assistance for nonprofits and digital media services, more funds for Save Our Stages grants to independent live venues, independent movie theaters and cultural institutions and new community navigator technical assistance to help connect underserved communities. Funding for crucial unvestments in broadband and distance learning and relief for Amtrak and the aviation sector struggling with declining revenues and volumes due to COVID-19. Funding for the FEMA Disaster Relief Fund to ramp up the President’s national vaccination program and provide flexible, targeted assistance to state, local, Tribal, territorial and the District of Columbia governments, as well as those individuals hit hardest by the pandemic. Support for hungry families through programs like SNAP, WIC, and Pandemic-EBT. This also includes critical funding for the food supply chain and the Agricultural Depatment’s lending and financial assistance programs to support farmers across the country. Health care and other support to meet the needs of veterans during the coronavirus pandemic. These funds will support vaccine distribution, expanded mental health care, enhanced telehealth capabilities, extended support for veterans who are homeless or in danger of becoming homeless, PPE and suppliesfor clinical employees, and improved supply chain management. Critical funding for the Indian Health Service, Administration for Native Americans, Bureau of Indian Affairs, Bureau of Indian Education and Native American housing programs to maintain essential health, education and social services and mitigate the negative impact of the COVID-19 pandemic on Native communities. Funding to the Economic Development Administration and environmental justice grants to help low-income, minority communities who have been hardest hit by COVID. Funding for critical programs to aid in the global response to and recovery from the pandemic. These instructions include significant funding for humanitarian assistance and Global Health programs. February 2, 2021: The White House posted a FACT SHEET titled: “President Biden Announces Increased Vaccine Supply, Initial Launch of the Federal Retail Pharmacy Program, and Expansion of FEMA to Reimbursement to States”. From the FACT SHEET: As the U.S. surpasses 26 million COVID-19 infections, President Biden took additional steps today to implement his comprehensive National Strategy to combat the COVID-19 pandemic. These steps include increasing the vaccine supply to states, Tribes, and territories and increasing funding to jurisdictions to help turn vaccines into vaccinations. And, the President announced that starting next week, the first phase of the federal pharmacy program will launch and select pharmacies nationwide will start offering vaccinations for their communitiesThese new steps will help meet the President’s goal of administering 100 million shots in 100 days and expand access to vaccines to more Americans in the coming weeks.The President is taking the following actions today:Expanding Vaccine Supply: Building on last week’s announcement, the Biden-Harris Administration will increase overall, weekly vaccine supply to states, Tribes, and territories to 10.5 million doses nationwide beginning this week. This is a 22% increase since taking office on January 20. The Administration is committing to maintaining this as the minimum supply level for the next three weeks, and we will continue to work with manufacturers in their efforts to ramp up supply.Launching First Phase of the Federal Retail Pharmacy Program for COVID-19 Vaccination: As part of the Biden-Harris Administration’s efforts to increase access to COVID-19 vaccines, starting on February 11, those eligible for the vaccine will have the opportunity to be vaccinated at select pharmacies across the country through the Federal Retail Pharmacy Program for COVID-19 Vaccination. This program is a public-private partnership with 21 national pharmacy partners and networks of independent pharmacies representing over 40,000 pharmacy locations nationwide… …It is a key component of the Administration’s National Strategy to expand equitable access to vaccines for the American public.As the first phase of this program launches, select retail pharmacies nationwide will receive limited vaccine supply to vaccinate priority groups at no cost. The Centers for Disease Control and Prevention (CDC) worked with states to select initial pharmacy partners based on a number of factors including their ability to reach some of the populations most at risk for severe illness from COVID-19. Americans should check their pharmacy’s website to find out if vaccine is available as supply will be limited in the initial phase. More information is available at cdc.gov/covid19.Increasing Reimbursements to States: Central to the Biden-Harris Administration’s COVID-19 National Strategy is ensuring states, Tribes, territories, and jurisdictions have the resources they need to defeat the virus. That’s why, in his second day in office, President Biden directed the Federal Emergency Management Agency (FEMA) to fully reimburse states for the cost of National Guard Personnel and emergency costs. Today, President Biden is announcing that the administration will go even further, retroactively reimbursing states for fully FEMA-eligible services – including masks, gloves, emergency feeding actions, sheltering at risk populations, and mobilization of the National Guard – back dated to the beginning of the pandemic in January of 2020. This reimbursement is estimated to total $3.5 billion and is only a small share of the resources to that states need to fight this pandemic – including for testing, genomic sequencing, and mass vaccination centers. To fully support states, Tribes, and territories’ needs to contain the pandemic and vaccinate their populations, President Biden is requesting $350 billion from Congress in American Rescue Plan… White House February 2, 2021: Center for Reproductive Rights posted News titled: “Center Cheers Reintroduction of the Black Maternal Health Momnibus Act in U.S. Congress”. From the News: The Center for Reproductive Rights joined partner organizations to support today’s reintroduction of the Black Maternal Health Momnibus Act of 2021 – a package of 12 bills to advance inclusive and accessible maternal health care, especially for Black and Indigenous people who are most impacted by the U.S. maternal health crisis.The Center was deeply involved in the coalition effort to create and advance the Momnibus, providing legal expertise, analysis, and technical assistance in crafting the legislation. Through its Maternal Health & Rights Initiative, the Center advocates for laws and policies to improve access to safe and respectful maternal health care, like the Momnibus.“This bill package is critical and long overdue. It’s unacceptable that mothers in the U.S. are dying at the highest rate of any developed country, and those mothers are largely Black and Indigenous,” said Jennifer Jacoby, Federal Policy Council at the Center for Reproductive Rights. “The Momnibus signals to Black and Indigenous birthing people that they will not be left behind any longer – not in this pandemic, not ever. Congress must act now to pass this much-needed legislation.”The U.S. is facing a worsening maternal health crisis marked by high rates of maternal mortality and morbidity, especially for Black and Indigenous birthing people who experience far higher rates of pregnancy-related death and complications than their white counterparts.The Momnibus of 2021 is being introduced in the U.S. House of Representatives by members of the Black Maternal Health Caucus, including Representatives Lauren Underwood (D-IL) and Alma Adams (D-NC), and in the Senate by Cory Booker (D-NJ). The Momnibus was first introduced in 2020 with Vice President Kamala Harris as the lead sponsor in the Senate.Maternal Health Crisis in the U.S.The bills in the Momnibus and other maternal health legislation – like proposed bills requiring states to extend Medicaid coverage up to at least one year postpartum – seek to address racial disparities in maternal health care.The U.S. has the highest maternal mortality ration in the developed world and is one of only 13 countries where maternal mortality is rising. According to the Centers for Disease Control and Prevention (CDC), Black and Indigenous women are approximately three times more likely to die from pregnancy-related complications than white women and twice as likely to suffer from serious pregnancy complications.The racial disparities in pregnancy outcomes are linked to discrimination and social and economic inequalities that Black and Indigenous birthing people are more likely to face, including poverty, structural racism, lack of access to health care, and implicit biases. Lack of basic health care services for people who are working to make ends meet contributes to this disparity particularly in states that have opted out of Medicaid expansion.The COVID-19 pandemic is putting additional strain on the health care system and further exacerbating the U.S. maternal health care crisis. Pregnant people may be at greater risk for experiencing severe illness from COVID-19 and there is a growing concern that overburdened health systems have even less capacity to meet maternal health needs, especially in Black and Indigenous communities where people are experiencing much higher rates of severe COVID-19 infection and death…Center for Reproductive Rights February 2, 2021: President Biden issued a Presidential Action titled: “Executive Order on Restoring Faith in Our Legal Immigration Systems and Strengthening Integration and Inclusion Efforts for New Americans“. Here is a portion of the Executive Order: …Sec. 4. Immediate Review of Agency Actions on Public Charge Inadmissibility. The Secretary of State, the Attorney General, the Secretary of Homeland Security, and the heads of other relevant agencies, as appropriate, shall review all agency actions related to the implementation of the public charge ground of inadmissibility in section 212(a)(4) of the Immigration and Nationality Act (INA), 8. U.S.C. 1182(a)(4), and the related ground of deportability in section 237(a)(5) of the INA, 8. U.S.C. 1227(a)(5). They shall, in considering the effects and implications of public charge policies, consult with the heads of relevant agencies, including the Secretary of Agriculture, the Secretary of Health and Human Services, and the Secretary of Housing and Urban Development. (a) This review should: (i) consider and evaluate the current effects of these agency actions and the implications of their continued implementation in light of the policy set forth in section 1 of this order; (ii) identify appropriate agency actions, if any, to address concerns about the current public charge policies’ effect on the integrity of the Nation’s immigration system and public health;and (iii) recommend steps that relevant agencies should take to clearly communicate current public charge policies and proposed changes, if any, to reduce fear and confusion among impacted communities. (b) Within 60 days of the date of this order, the Secretary of State, the Attorney General, and the Secretary of Homeland Security shall each submit a report to the President describing any agency actions identified pursuant to subsection (a)(ii) of this section and any steps their agencies intend to take or have taken, consistent with subsection (a)(iii) of this section… What does this mean? The short answer is, this section of this executive order is an attempt to remove the Trump Administration’s harmful public charge rule. CBS News posted an article about it in February of 2020. The article was titled: “Trump’s controversial “public charge” rule takes effect, reshaping legal immigration”. The article was written by Camilo Montoya-Galvez. From the article: The Trump administration on Monday began enforcing stringent income-based requirements for green cards and certain visas, instituting the most ambitious unilateral effort in recent history to change the nation’s legal immigration system.After multiple legal barriers blocking the implementation of the new requirements were cleared by the conservative-leaning Supreme Court, most green card applicants in the U.S. and abroad will now be subjected to a redefined “public charge” test. Under the rules by the Departments of State and Homeland Security, immigration officials have more power to deny applications from petitioners they deem are, or could become, an economic burden on the country.The sweeping policy change, one of the administration’s top immigration priorities, is expected to block the entry of hundreds of thousands of people, disproportionately affecting prospective immigrants from Asia, Africa and Latin America, according to experts….…Under the new regulation, caseworkers would consider enrollment in the widely used Supplemental Nutrition Assistance Program (SNAP), certain federally funded Medicaid benefits and a variety of forms of government-subsidized housing, including the popular Section 8 vouchers.Officials would deem an immigrant a “public charge” and deny the application if they determine he or she is more likely than not to use one of the considered benefits for 12 months or longer over the span of three years. On certain occasions, those deemed a “public charge” could post a bond for an amount no less than $8,100.To determine whether prospective immigrants are likely to become a “public charge”, caseworkers would also take into account their income, assets, age, educational skills, English language proficiency, health and other factors. Since those expected to be affected by the rule are not eligible for most public benefits because they are not U.S. citizens or permanent residents, critics of the regulation say it is designed to severely restrict immigration based on those factors… CBS News February 2, 2021: National Organization for Women (NOW) posted a Press Release titled: “NOW Calls for Boycott of South Carolina in Response to Abortion Ban. From the Press Release: The National Organization for Women (NOW) has called for a boycott against the state of South Carolina in the wake of the state Senate passage of legislation that would ban abortions when a fetal heartbeat is detected. The call is joined by the State President of NOW in South Carolina, Annette Bethel, and members of the Columbia NOW Chapter.The Columbia Chapter of NOW, under the leadership of Bethel, won the bid in 2019 to host the National NOW Conference in Columbia in 2022. Bethel notes that a significant economic impact due to the loss of a national conference – and perhaps with other organizations and companies joining in the boycott – would be felt. NOW is the largest grassroots feminist activist organization in the country, with hundreds of chapters in every state and the District of Columbia, and with hundreds of thousands of members and contributing supporters.The fetal heartbeat bill is designed to virtually ban abortion in the State of South Carolina – it is unconstitutional. Many women do not know they are pregnant when a fetal heartbeat can first be detected; this generally occurs between six and eight weeks after conception. The Legislation would also make it a felony crime if a doctor performs an abortion after a heartbeat has been detected, carrying with it a two-year prison sentence. Similar legislation in other states has been permanently enjoined or found unconstitutional. This bill, should it become law, in all likelihood will be challenged in court.The South Carolina House is reported to be likely to approve the legislation and the Governor, a Republican, has vowed to sign it into law. A majority of Americans support abortion rights and have done so for decades. The 1973 U.S. Supreme Court in Roe v. Wade protects access to abortion care as a matter of privacy under the Due Process Clause of the Fourteenth Amendment. A woman may obtain an abortion during the first three months of pregnancy without government interference. Under Roe, the right to decide is classified as fundamental, requiring a standard of strict scrutiny, the highest level of judicial review in any legal challenge. Fetal heartbeat laws do not hold up under strict scrutiny. NOW has long advocated for protecting the right of persons to decide whether or when to have children. This is a decision that should be made by the individual, not by legislators. And until the state of South Carolina takes action to reverse this unconstitutional act, NOW and the power of its grassroots network will be taking its financial support elsewhere.NOW February 2, 2021: Planned Parenthood posted a press release titled: “Planned Parenthood Applauds Biden-Harris Immigration Executive Actions”. From the press release: Today, President Biden signed executive actions to bring critical and long-overdue reforms to the immigration system. Included in these actions is beginning the process to end the so-called “public charge” rule – which forces many immigrants and their children to make the impossible choice between accessing health care and other lifesaving services or risking their status and their safety – and creating a task force charged with reuniting migrant families separated at the border. These actions are a critical continuation of the Biden-Harris administration’s efforts to end the dehumanization and xenophobia that became central tenets of the Trump administration’s immigration policy……Under the “public charge” rule, people can be denied entry into the U.S. or an adjustment in their immigration status (i.e. obtaining a green card), simply because they have received certain public benefits in the past — including health care, nutrition assistance, and public housing — or were judged likely to use benefits in the future. It is designed to keep families separated, and to scare immigrants already in the U.S. and their families from accessing health care and other basic needs, including those to which they are legally entitled. The public charge rule cannot be stopped immediately, as the administration must go through the full regulatory process to roll it back, but it is starting the process while working to address its chilling effect and direct agencies to encourage immigrants and their families to use critical public benefits. The Trump administration separated more than 5,500 children from their families and ultimately deported 1,400 parents without their children. While the Biden-Harris administration formally ended the policy that allowed these horrors last week, the new task force has a critical mission: More than 600 separated parents have yet to be reached — and still more have been found but not reunited with their children… Planned Parenthood February 3, 2021: President Biden issued a Presidential Action titled: “A Proclamation on National Teen Dating Violence Awareness and Prevention Month, 2021“. From the Proclamation: This February, during National Teen Dating Violence Awareness and Prevention Month, we stand with those who have known the pain and isolation of an abusive relationship, and we recommit to ending the cycle of teen dating violence that affects too many of our young people.Together, it’s on all of us to raise the national awareness about teen dating violence and promote safe and healthy relationships.Dating violence transcends gender, race, religion, ethnicity, sexual orientation, and socioeconomic status. It takes many forms, among them physical, sexual, and emotional abuse, bullying, and shaming, which can occur in person or through electronic communication and social media. The spiral of violent dating relationships can lead to depression, anxiety, drug and alcohol use, as well as suicidal thoughts. Victims, especially young women, transgender, and gender nonconforming youth who face higher rats of violence, may suffer lifelong consequences. Many young people do not report the abuse for fear of retribution or unwarranted embarrassment. The pattern of abuse often continues to future relationships.My Administration encourages all Americans to lead by example by promoting healthy relationships, protecting our teens from abuse, and ensuring they have access to good help and support.If you or someone you know is involved in an abusive relationship of any kind, immediate and confidential support is available by visiting loveisrespect.org, calling 1-866-331-9474 (TTY: 1-800-787-3224), or texting “loveis” to 22522. For additional information and resources on dating violence, please visit VetoViolence.CDC.gov.NOW, THEREFORE I, JOSEPH R. BIDEN JR., President of the United States of America, by virtue of the authority vested in me by the Constitution and laws of the United States, do hereby proclaim February 2021 as National Teen Dating Violence Awareness and Prevention Month. I call upon all Americans to support efforts in their communities and schools, and in their own families, to empower young people to develop healthy relationships throughout their lives and to prevent and respond to teen dating violence. It’s on all of us…President Joseph R. Biden Jr. February 3, 2021: The White House COVID-19 Response Team issued a Press Briefing titled: “Press Briefing by White House COVID-19 Response Team and Public Health Officials“. From the Press Briefing: MR. ZIENTZ: Good morning everyone. A week ago, in our first COVID-19 response briefing, we committed to providing you with transparent science-based and up-to-date information about the pandemic. I hope that five briefings in, we’re starting to establish a pattern of providing the American people with the facts they need about the crisis and our response, driven by our experts and scientists. We act every day based on the fact that we already have more than 440,000 fellow Americans who have died, 26 million Americans infected, and our ways of life totally upended. In his first full day in office, President Biden laid out a comprehensive national strategy to defeat this virus and get back to our way of life. On vaccinations, President Biden put it simply when he said, “We need to increase vaccine supply and get it out the door as fast as possible. We need to mobilize more medical units to get more shots in people’s arms. And we need to create more places where Americans can get vaccinated.” The President set a goal to deliver 100 million shots in his first 600 days. Today I want to give you an update on our execution against that goal. We will also hear a state-of-the-pandemic update from Dr. Walensky and an update on the latest science from Dr. Fauci. We will then open it up for questions. Since entering office two weeks ago, the Biden administration has taken aggressive steps to activate the full resources of the federal government to improve our vaccination supply. First, we have increased vaccine supply to states, tribes, and territories by over 20 percent. Second, we are providing visibility on supply on a rolling three-week basis so governors and local leaders have the ability to plan and maximize the number of needles in arms. Third, we secured the equipment required to extract a sixth dose from every Pfizer vial of vaccine. and fourth, we’re purchasing an additional 200 million doses to ensure that every American can get vaccinated. And the data shows that we are making progress. As you can see on our vaccination progress report, our seven-day average daily doses administered is, as you can see in the dark blue bar on the right, now averaging over 1.3 million shots per day for the period from January 27th through February 2nd. We are on track to meet the President’s goal of 100 million shots in 100 days. Notably, yesterday, the Department of Veterans Affairs delivered its one-millionth shot, ensuring those who served our country are among the first protected from this deadly virus. We are encouraged by this progress to increase supply, but we will continue to push for every opportunity to do more. At the President’s directions, we have an all-of-government effort to provide all Americans with access to get more places to get vaccinated. Americans need more access to more places to get vaccinated. Today I want to update you on establishing and supporting community vaccination centers across the country. These centers are helping to provide new, more efficient places for people to get vaccinated. First, the federal government is expediting financial support to bolster community vaccination sites nationwide, including in states like Georgia, North Carolina, and Wisconsin. As of today, FEMA has provided more than $1.7 billion to 27 states, localities, tribes, and territories. This funding covers critical steps in the vaccination process, including transportation and storage equipment, supplies needed to administer vaccines, and safety equipment like PPE and masks. Second, we’re deploying personnel to provide technical assistance to support vaccination sites nationwide and provide additional staff from the federal government. FEMA has already assigned over 600 staff to this effort, including experts in logistics, IT, and registration, with over 350 of these staff deployed directly to the vaccination sites across the country. The federal government is now supporting thousands of National Guard members who are providing support to sites in 39 states, including 800 trained vaccinators. And CDC is providing on-the-ground technical assistance in jurisdictions across the country. And, third, we are building new community vaccination centers across the country. The Department of Defense will dedicate substantial personnel and resources to help manage many of these new sites. The profile of these community vaccination sites will vary by community need. You’ll see big centers and stadiums, sites in school gyms and community centers, mobile units in rural areas and outer boroughs, pop-up sites in parking lots and other locations. We are working with state and local health departments to meet the communities they serve, where they are, in places they know, with people they trust. And we’ll encourage all vaccination centers to collaborate with community-based organizations and others who can help communities with the greatest need. Today I’m pleased to announce the federal government will partner with the state of California to launch two new community vaccination centers: one in East Oakland and the second in the east side of Los Angeles — two of the communities most hard hit by this pandemic. In the east side of Los Angeles, we’ll launch a large site on the campus of California University — California State University-Los Angeles. This is one of the most diverse public universities in the country, serving a large Latino community. And we’re opening a new center at Oakland Coliseum adjacent to the communities of Eastmont and Elmhurst, which have some of the lowest health scores in the state. Both centers will be staffed primarily by a federal workforce from agencies such as FEMA, DOD, U.S. Department of Agriculture, and HHS. In all of this work, we’re advancing equity. FEMA has partnered with CDC to launch vaccination sites that use processes and are located in places that promote equity, deploying CDC’s Social Vulnerability Index. These sites in California are just the beginning. We are working with — in partnership in states across the country to stand up new sites, and we’ll have more to say on that in the coming weeks. So, across the first two weeks, we’ve activated a whole-of-government response. We have increased vaccine supply, and we are ensuring that all Americans in every community have more places to get vaccinated. Now let me turn to Dr. Walensky — Dr. Walensky for a state of the pandemic. Dr. Walensky. DR. WALENSKY: Thank you very much. I’m delighted to be back with you today, and I want to make sure we have time for questions, so I will be brief in my remarks. As I said Monday, cases and hospital admissions continue to decrease, and we now appear to be in a consistent downward trajectory for both of these important outcomes. COVID-19 cases have declined steadily since hitting a peak on January 8th, dropping 13.4 percent to an average of nearly 144,000 cases per day from January 26th to February 1st. Cases are now back to the level we were before Thanksgiving. Similarly, new hospital admissions have continued to decline since they peaked on January 5th, decreasing 4.1 percent to an average of approximately 11,400 admissions per day from January 25 to January 31. While deaths have continued to increase, their pace appears to be slowing, with the average number of deaths increasing 1 percent to slightly more than 3,100 deaths per day from January 26th to February 1st. And the recent decline in hospitalizations gives us hope that the number of deaths should start to decrease in the coming weeks. Although we have seen declines in cases and admissions and a recent slowing of deaths, cases remain extraordinarily high — still twice as high as the peak number of cases over the summer. And the continued proliferation of variants — variants that likely have increased transmissibility, that spread more easily — threatens to reverse these recent trends. Based on contact tracing and recent — of recent variant cases, not wearing masks and participating in in-person social gatherings have contributed to the variant spread. We must take prevention, intervention seriously. Now is not the time to let our guard down. Keep taking steps to protect each other: Wear a mask; maintain social distancing; avoid travel, crowds and poorly ventilated spaces. And please get vaccinated when it is your turn. And this Sunday, remember: Whichever team you’re rooting for and whichever commercial is your favorite, please watch the Super Bowl safely, gathering only virtually or with the people you live with. The CDC recently posted guidance on how to safely enjoy the game. Thank you. I’ll turn it to Dr. Fauci. DR. FAUCI: Thank you very much, Dr. Walensky. I want to make just a couple of points related to questions and issues that have been brought up over the past couple of days to help clarify it, and I’ll be very brief. We have heard from studies emanating out of the AstraZeneca platform that, in the UK, they’re talking about the possibility, since their data seems to show this, that if you prolong the interval between the first and second dose — in fact, even go with a single dose — you can get good results. And, in fact, the interval between the first and second dose can now be measured in months. With — according to their own data, that is actually a favorable response. We certainly respect that the UK scientists and health officials are going by their data and letting their own data for their own platform dictate their policy. The question is asked often: “Then why don’t we do the same thing with our candidates that are now being distributed to people in the United States?” And the response is simple: We also are going very much by the data and the science that has emanated out of very large clinical trials. As you all are aware, the Moderna trial, with 30,000 people, and the Pfizer trial, with 44,000 people, indicate to us that maximum responses are given with a prime followed by a boost — 21 days with Pfizer and 28 days with Moderna. Now, we know that sometimes, out of circumstances beyond the control of people, that they may not make it at exactly the day of 21 day and 28 day. And as we know from the CDC, under those special circumstances, that it is okay if you get the second dose in either four to six weeks later. That doesn’t mean that we want to do it at six weeks later. It means that under special circumstances, it’s better to delay that couple of weeks than not do it at all. But we feel strongly that we will go by the science, which has dictated for us the optimal way to get the 94 to 95 percent response, which is, in fact, durable for the period of time that we’ve been following it. One other thing I want to mention: We live in a global community, and it is encouraging to see that other countries are coming out with results from their own vaccine trial, such as the Russian trial that we heard about a day or two ago; the UK and European Union, which are now putting vaccines into people, according to the data that they’ve accumulated; the Chinese trials, et cetera. We, in the United States, as I mentioned in a speech I gave a couple of weeks ago to the World Health Organization Executive Board, that we are back on the global scene. We reentered into our arrangement with the WHO, and we are part of COVAX. So I just want to remind people that this is a global effort, and the more we get the virus controlled globally — and we will be part of that process as part of the global community — the better off we will be. Because I’ve said it many times, and I’ll close by saying it again: We have to be concerned about the mutants. Viruses will not mutate well if you don’t give them the opportunity to replicate in a very large way. Namely, if you have an open playing field for the virus, they will replicate, and they will mutate. The best way to prevent that is the implementation of the public health measures that Dr. Walensky just mentioned, both home and abroad, as well as the implementation of the administration of vaccines, as effectively and efficiently and as quickly as we possibly can. So I’ll stop there and hand it back to Jeff. MR. ZIENTS: Well, thank you, Dr. Fauci and Dr. Walensky. You have heard from our experts. I want to reiterate, we are at war with this virus. It is clearly a national emergency, and we are doing all we can. But it is critical that Congress does its part as well. We need Congress to quickly pass the American Rescue Plan to provide the funding we need to continue to scale up our vaccination program, as well as for more testing, more genomic sequencing, and more emergency supplies. And we must give families, schools, businesses, and state and local leaders the support they need to fight the pandemic. This will not be easy. Vaccinating everyone in America is one of the greatest operational challenges we’ve ever faced, and we will not stop working until this mission is complete… February 3, 2021: President Biden issued “A Proclamation on American Heart Month, 2021“. From the Proclamation: Tragically, heart disease continues to be a leading cause of death in the United States. It affects Americans of all genders, races, and ethnicities. Yet despite being one of the country’s most constly and deadly diseases, it is among the most preventable. During American Heart Month, we recommit to fighting this disease by promoting better health, wellness, and prevention awareness in our communities.Heart disease can impact anyone, but risk factors such as high cholesterol, high blood pressure, physical inactivity, obesity, tobacco use, and alcohol abuse can increase the likelihood of developing the disease. By adopting a few healthy habits, each of use can reduce our risk. Avoiding tobacco, moderating alcohol consumption, making balanced and nutritious meal choices, and staying active can help prevent or treat conditions that lead to heart disease. Adults with heart conditions are also at increased risk of severe illness from COVID-19, which makes it even more important to follow these suggestions.We have seen the death rate from heart attacks rise dramatically during the COVID-19 pandemic because people are delaying or not seeking care after experiencing symptoms. It is important not to ignore early warning signs like chest pain, palpitations, shortness of breath, and sudden dizziness. And the symptoms of a heart attack can be different for men and women, an often-overlooked fact that can impact when people seek care. For more resources and information, follow your health care provider’s advice or visit www.CDC.gov/HeartDisease.My Administration is committed to supporting Americans in their efforts to achieve heart health. Under the Affordable Care Act, many insurance plans cover preventive services like blood pressure and obesity screening at no out-of-pocket cost to the patient. By protecting and expanding access to quality, affordable health care, we will work tirelessly to provide all Americans with the care they need to prevent and treat heart disease.We are also committed to closing the racial disparities in cardiovascular health. Despite an overall decline in death rates for heart disease, risk of heart disease death differs by race and ethnicity, and Black Americans continue to have the highest death rate for heart disease. Increased awareness and access to care will help reduce these staggering and unacceptable statistics.This month, we also honor the health care professionals, researchers, and heart health advocates who save our fellow Americans’ lives with their hard work. Every day, they put themselves on the front lines of our fight against heart disease, as well as the scourge of COVID-19……In acknowledgement of the importance of the ongoing fight against cardiovascular disease, the Congress, by Joint Resolution approved December 30, 1963, as amended (36 U.S.C. 101), has requested that the President issue an annual proclamation designating February as “American Heart Month.”…President Joseph R. Biden Jr. February 3, 2021: The American College of Obstetricians and Gynecologists (ACOG) posted news titled: “Maternal Immunization Task Force and Partners Urge That COVID-19 Vaccine be Available to Pregnant Individuals”. From the News: All pregnant individuals who choose to receive the COVID-19 vaccine must be allowed to do so in alignment with their state and local vaccination allocation plan. This includes the estimated 330,000 health care workers who are pregnant and should be allowed to receive the vaccine as part of vaccine distribution plans. Reports of pregnant individuals being refused vaccination are concerning.Pregnant individuals who otherwise meet the criteria for COVID-19 vaccines should not be denied the opportunity to be vaccinated, should they choose to do so. Although a conversation with a clinician may be helpful for patients to aid in their decision-making, it should not be required prior to vaccination.As the COVID-19 vaccine rollout continues, use must reflect the vaccines’ federal regulatory authorization as well as information and recommendations from the U.S. Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, and expert healthcare organizations.Currently, available data demonstrate that pregnant individuals are at increased risk of more severe illness and death due to COVID-19 than their non-pregnant counterparts… Providing pregnant individuals with the opportunity to be vaccinated can be critical to allowing them to protect themselves, particularly if their occupation puts them at increased risk of contracting the virus or if they have underlying and comorbid conditions. When pregnant individuals are excluded from the opportunity to decide whether to be vaccinated, it not only violates their bodily autonomy, it also puts them at risk of severe outcomes and death related to COVID-19 illness. Excluding this critical population at increased risk of severe illness and death related to COVID-19 is unethical.In the interest of allowing pregnant individuals who would otherwise be considered a priority population for vaccines to make their own decisions regarding their health, our groups strongly recommend pregnant individuals should be free to make their own decision in conjunction with their clinical care team. All pregnant individuals must be supported in their decision about COVID-19 vaccination, whether they choose to receive the vaccine, or they opt to decline.ACOG February 3, 2021: Speaker of the House Nancy Pelosi posted a Press Release titled: “Floor Speech on Senate-Passed Budget Resolution, A Key Step in Enacting the Urgently-Needed Biden COVID Relief Package”. From the Press Release: …Madam Speaker, we just left a meeting with President Biden, where we had a discussion about how this legislation meets the needs of the American people. As our colleagues may be aware, early this morning, before 6:00 a.m., the Senate passed a budget bill which is identical in instruction to the bill we sent there. We had the debate on that bill on Wednesday. It passed with a strong vote in the House, and then went to the Senate. It will – it comes back to use now, and we’re addressing it.So, that’s what brings us to the Floor now. What brings us to the Floor now is the opportunity to crush the virus, to put vaccines in the arms of the American people, money in the pockets of the American people, children safely in schools, people back in their jobs. We an do that following the science and good governance to make it happen. We must do that in a way that addresses the disparities. It’s almost sinful to see how the disparity in access to some of the vaccines and everything that happened up until now.As I mentioned the other day in the debate on the budget bill, the GAO has put out a report that at least 90 percent of their recommendations to the Trump Administration on how to address the COVID crisis were ignored – 27 out of 31 were ignored. This legislation, again, based on science and knowledge and respct for all of the people in our society and in our country, addresses many of those concerns in a more current way as now we have more access to vaccines and people more willing to participate because they have hope. And that’s what this legislation does.It gives us hope. It is a reconciliation bill, which means we can pas it with just 51 votes in the Senate. It would be my hope that we don’t have to use it as a reconciliation bill, that we will be able to have bipartisanship, with a facing of the facts of what is needed to meet the needs of the American people, both in this body and in the United States Senate. But in order to have a guarantee that the people’s needs will be met, we’re passing this legislation today.So, I hope we will have a very strong vote in favor of crushing teh virus, money in the pockets, people back to work and children, children, children safely in school….Speaker of the House Nancy Pelosi February 4, 2021: American College of Obstetricians and Gynecologists (ACOG) posted News titled: “Medical Experts Continue to Assert that COVID Vaccines Do Not Impact Fertility” The following is a statement from the American College of Obstetricians and Gynecologists (ACOG), the American Society for Reproductive Medicine (ASRM), and the Society for Maternal-Fetal Medicine (SMFM):“Throughout the COVID-19 pandemic, patients have had questions about the impact of the virus on their health. Now, as the rollout of the COVID vaccines progresses, patients similarly have questions about whether the vaccine is right for their individual health needs.“As experts in reproductive health, we continue to recommend that the vaccine be available to pregnant individuals. We also assure patients that there is no evidence that the vaccine can lead to loss of fertility. While fertility was not specifically studied in the clinical trials of the vaccine, no loss of fertility has been reported among trial participants or among the millions who have received the vaccines since their authorization, and no signs of infertility appeared in animal studies. Loss of fertility is scientifically unlikely.”ACOG February 4, 2021: American Medical Association posted a Press Release titled: “AHA, AMA, ANA release PSA urging Americans to take COVID-19 vaccine”. From the Press Release: Together, the American Hospital Association (AHA), American Medical Association (AMA), and American Nurses Association (ANA) released a public service announcement today urging the American public to get the COVID-19 vaccination when it is their turn. The PSA stresses that COVID-19 vaccines are safe, effective and help us all as we work together to defeat COVID-19. Today’s effort continues the work the three associations have done over the past year to increase public acceptance of the essential actions to curb the spread of COVID-19, which also include: wearing a mask, practicing physical distancing and washing hands frequently. The organizations have released several previous PSAs encouraging the public to adhere to these critical public health measures, which will be increasingly important as more communicable COVID-19 variants appear and spread in the U.S.As national associations representing physicians, nurses, and hospital health system leaders, the AHA, AMA, and ANA remain committed to supporting the rigorous scientific and regulatory process, establishing safe and effective processes for administering vaccines to all who are eligible and choose to get vaccinated, and to making critical information about vaccines available as it is released…AHA, AMA, ANA February 8, 2021: The White House COVID-19 Response Team posted a Press Briefing titled: “Press Briefing by White House COVID-19 Response Team and Public Health Officials“. From the Press Briefing (up to the point where questions were asked and answered): ACTING ADMINISTRATOR SLAVITT: Good morning, and welcome to the COVID Response update. Thank you for joining us. I’m Andy Slavitt, White House Senior Advisor for the COVID Response Team. Now, we’ve been battling this pandemic for the better part of a year. More than 450,000 Americans’ lives have been taken, we’ve separated from our friends and family, thousands of schools and businesses have been sitting empty, and Americans have had their lives turned upside down by the pandemic. Meanwhile, millions of Americans are doing everything in their power to put the country and the world back on the right course. Millions of you are wearing masks, and the evidence Dr. Walensky has discussed here demonstrates that in communities where that happens, lives are being saved. That needs to continue and improve in the face of the threats we confront. We know that millions of Americans are also waiting patiently to be vaccinated. Today, I want to begin the briefing by updating you on what is happening while you’re waiting. In the weeks and months that you are waiting, the nation’s efforts are being spent focused on many who are most at risk of hospitalization and death from this virus: the elderly, seniors, frontline health care workers, and many essential workers. According to a recent CDC report, the Long-Term Care Program has administered now over 4.8 million doses to more than 3.7 million of our most vulnerable. Those who were dying in large number over the last year are now on a path to protection. And in skilled nursing facilities that have had at least one vaccination clinic, an estimated median of almost 80 percent of residents have received at least one dose of vaccine. As vaccinations at these facilities are completed, that will mean that many more lives are saved, many more vaccines that can be moved into the inventory for the next priority groups. And in total, of the over 40 million doses that have been administered, over 17 million doses have been administered to people 65 or older. Now, this is a great representation of the American spirit of generosity and American selflessness because our ability to vaccinate millions of the elderly, seniors, and healthcare workers is a testament to a society that has put our parents and grandparents, those who have served us, and those who continue to sacrifice for us on the frontlines of the healthcare system first. Now at the same time, we need to step up efforts to increase vaccinations of racial and ethnic communities that have suffered disproportionately. Health equity is a cornerstone of all our work, and we’ll be talking more about progress there in upcoming briefings. Even with that perspective in progress, we understand that the process moves more slowly than anyone would like. But each day, we are putting forth efforts to increase vaccine supply, including by use of the Defense Production Act; to create more places to get vaccinated, including new large community vaccination centers and retail pharmacies; and mobilize more vaccinators by allowing retired physicians and nurses and deploying the military. This is a national emergency and the approach we are taking reflects this. We are putting every resource and tool that the federal government has into this battle, and we’re taking a whole-of-government – indeed, a whole-of-country approach. As soon as the Congress puts the American Rescue Plan on the President’s desk, we will be able to further increase this effort. We understand this is a long journey, but thanks to the sacrifice of so many of you and the step-by-step plan we are executing, for many of our most vulnerable Americans, the risk of death is being reduced. And we are committed to leaving no stone unturned. With that, I’ll turn it over to Dr. Walensky for a state-of-the-pandemic update and Dr. Fauci for the latest in science before we answer your questions. Dr. Walensky. DR. WALENSKY: Thank you so much, Andy. I’m so glad to be back and joining you today. Today, I’m going to give you a brief update on the pandemic. As I mentioned on Friday, despite trends moving in the right direction, we remain in a very serious situation. COVID-19 continue to affect too many people, as we continue to mourn all of those lives that have been lost. Cases have continued to decline over the last four weeks. An average 119,900 new cases were reported between January 31st and February 6th. That’s a drop of nearly 20 percent from the prior week, but still dramatically higher than the last summer’s peak. We must continue to drive these cases down. New COVID-19 hospital admissions also continued to decline. An average of 9,977 admissions per day were reported between January 30th and February 5th, a decline of nearly 17 percent from the week prior. This is promising, but hospitalizations also remain incredibly high. Over 83,000 Americans are hospitalized right now with COVID-19 – much higher than the summer and fall. Today, we are reporting that COVID-19 deaths increased 2.4 percent to an average of 3,221 deaths per day from January 31st to February 6th. As I mentioned on Friday, sometimes delays in reporting can lead to fluctuations in the data. This is the case for the average number of deaths reported today, which includes a delayed report of 1,570 confirmed deaths from one state. These deaths were reported last week, but actually had occurred over the prior several months. We may continue to see the variation in daily deaths for different reasons, including reporting delays. We are continuing to watch these data closely. And although hospital admissions and cases consistently – are consistently dropping, I’m asking everyone to please keep your guard up. The continued proliferation of variants remains of great concern and is a threat that could reverse the recent positive trends we are seeing. As of February 7th, 699 variant cases have been confirmed across 34 states, with 690 of these cases being the B117 variant, the variant first reported in the UK. Please continue to war a mask and stay six feet apart from people you don’t live with. Avoid travels, crowds, and poorly ventilated spaces. And get vaccinated when it is available to you. I recognize that the pandemic has taken an enormous toll on all of us. But if we all work together and take these preventative steps, we can finally turn the tide. Thank you. I look forward to your questions, and I will now turn things over to Dr. Fauci. Dr. Fauci? DR. FAUCI: Thank you very much, Dr. Walensky. I’d like to address, briefly, two issues that have come up for discussion over the last several days, and one is the question of: Given the fact that there is a greater demand than there is supply, should we be putting all our effort into getting the first dose into people, with less emphasis on the second dose? Now, the reason for that – I have explained in the past – because the science has shown in both of the vaccines that we have currently available, the Moderna and the Pfizer – strong data indicates that a prime boost gives a maximum response of 94 to 95 percent efficacy. But the question has arisen, “Why not study in detail whether or not you can get away with a single dose?” It is not an unreasonable thing to suggest a study. The only issue is that the practicality of that really makes that a situation that I don’t think is able to be done for the following reason: If you look at the number of people that would be required in a study to answer that question – again, one versus two – with the currently available vaccines, the time it took to get information on the phase three and the number of people – that that study, with all due respect, would take several months to get a meaningful answer. At that time, the amount of vaccine that would be available would almost be making that question somewhat of a moot point. So then let’s ask ourselves – the question is: What do we know about one dose versus two dose? And the data, I think, are important to present. We know from the original studies that, following a single dose of either the Moderna or Pfizer, you had a response that gave you a neutralizing antibody above the threshold of protection. So it did give some degree of protection. And the question was: It was protection, clearly, against the wild type. However, the boost, either 21 or 28 days later, was tenfold higher. So it went, for example, from 1 to 100 to well over the 1,000 in the titer. The reason that’s important: not only because of the height of the response and the potency of the response, but as you get to that level of antibody, you get a greater breadth of response. And by “breadth of response,” we mean it covers not only the wild type and currently circulating virus, but also the variants that we see circulating, particularly the 117 and the 351. So it’s not just a matter of potency; it’s a matter of the breadth of what you can cover. The other theoretical issue that could be problematic with regard to only a single dose: that if you get a suboptimum response, the way viruses respond to pressure, you could actually be inadvertently selecting for more mutants by a suboptimum response. So, for that reason, we have continued to go by the fact that we feel the optimum approach would be to continue with getting as many people on their first dose as possible, but also making sure that people, on time, get their second dose. And finally, one thing I want to emphasize: As we know, and we’ve heard, and it’s true, that the projection is that the 117 lineage would likely become dominant in the United States by the end of March. Please remember that the efficacy of the currently utilized vaccines — the two mRNA — are a quite effective against the 117 lineage. So, underscoring what Dr. Walensky just said, the two things that we can do is, A, make sure we adhere to the public health measures that Dr. Walensky just mentioned, and, B, get as many people vaccinated as quickly as we possibly can. That’s the best defense against the evolution of variants. I’ll stop there, and back to you, Andy… February 8, 2021: National Organization for Women posted a Press Release titled: “NOW is Proud to Support the Black Maternal Health Momnibus Act” From the Press Release: NOW is proud to endorse the Black Maternal Momnibus Act of 2021, a historic legislative package unveiled today by Representatives Lauren Underwood (IL-14) and Alma Adams (NC-12), Senator Cory Booker (D-NJ), and members of the Black Maternal Health Conference.The Black Maternal Health Momnibus Act of 2021 will build on existing maternal health legislation, like policies to extend postpartum Medicaid coverage, with 12 bills to comprehensively address every dimension of America’s maternal health crisis. It makes investments in social determinants of health, community-based organizations, the growth and diversification of the perinatal workforce, improvements in data collection, and support for moms and babies exposed to climate change-related risks. In addition to direct efforts to improve Black maternal health outcomes, the Momnibus focuses on high-risk populations, including veterans, incarcerated people, Native Americans, and other women and birthing people of color. The United States has the highest pregnancy-related death rate in the developed world and the only rate that is rising. The maternal mortality rate is significantly higher among Black women, who are three to four times more likely than white women to die from pregnancy-related complications. Other birthing people of color, including Hispanic, Native American, and AAPI women, also suffer from disproportionate rates of adverse maternal health outcomes……The Black Maternal Health Momnibus Act is composed of 12 individual bills. The legislation will provide funding to community-based organizations working to improve maternal health outcomes and promote equity, invest in programs to support maternal mental health, and much more.NOW February 9, 2021: The White House issued a FACT SHEET titled: “President Biden Announces Community Health Centers Vaccination Program to Launch Next Week and Another Increase in States, Tribes & Territories Vaccine Supply“. From the FACT SHEET: As the U.S. surpasses 26 million COVID-19 infections, President Biden is taking additional steps today to speed up vaccinations across the country. The President announced the launch of the Federally Qualified Health Center program that will provide more vaccines for Community Health Centers that are reaching our underserved and most vulnerable communities. And, the administration will increase the vaccine supply to states, Tribes, and territories by 5% over last week, for a total of a 28% increase since President Biden came into office three weeks ago.These new steps will help meet the President’s goal of administering 100 million shots in 100 days and ensure that vaccines are administered equitably.The President is taking the following actions today:Launching First Phase of the Federally Qualified Health Center Program for COVID-19 Vaccination: As part of the Biden-Harris Administration’s efforts to ensure that the nation’s hardest hit populations are receiving the vaccine, starting the week of February 15, Federally Qualified Community Health Centers (FQHCs) will begin directly receiving vaccine supply. Many people know these as Community Health Centers. Community Health Centers provide primary care services in underserved communities across the country. There are more than 1,300 Community Health Centers serving almost 30 million people across the country. Two-thirds of the population that these centers serve are living at or below the federal poverty line and 60% are racial and/or ethnic minorities. The program will be phased in, with the first centers able to start ordering vaccines as early as the week of February 15. The initial phase will include at least one Community Health Center in each state, expanding to 250 centers in the coming weeks.This program is part of a broader effort to ensure all communities are being reached in the national push to get people vaccinated. Community Vaccination Centers in underserved areas, the retail pharmacy program, mobile clinics, and efforts to increase vaccine confidence are also key tools to help states and communities vaccinate their most vulnerable populations. More information on this program is available at www.hrsa.gov/coronavirus/health-center-program.Expanding Vaccine Supply: Building on last week’s announcement, the Biden-Harris Administration will increase overall, weekly vaccine supply to states, Tribes, and territories to 11 million doses nationwide beginning this week. This is a 28% increase since taking office on January 20. The Administration is committing to maintaining this as the minimum supply level for the next three weeks, and we will continue to work with manufacturers in their efforts to ramp up supply.White House February 9, 2021: A Press Briefing titled: “Press Briefing by White House COVID-19 Response Team and Public Health Officials” was issued. From the Press Briefing: MR. ZIENTS: Thank you for joining us. I’m Jeff Zients, White House COVID Coordinator. I’m pleased to be joined today by Dr. Marcella Nunez-Smith, Chair of the Biden-Harris COVID-19 Health Equity Task Force. We’ve just completed our weekly call with governors from around the country who – where we provided updated on our efforts to defeat COVID-19. President Biden has laid out a comprehensive national strategy to tackle this pandemic. The national strategy utilizes all of the powers and resources of the federal government, working closely with state and local leaders, tribal leaders, and those on the frontlines in communities across the country. Central to the strategy is getting all Americans vaccinated as quickly and equitably as possible. Increasing vaccine supply, increasing the number of vaccinators, and providing more places for people to get vaccinated, including supporting local and state partners in their efforts to get needles in arms: all three are critical. Today, we’re taking new actions on vaccine supply and on the number of places for people to get vaccinated. I’ll start with our efforts on vaccine supply. When we came into office three weeks ago, the weekly delivery was 8.6 million doses. And today we’re announcing that we will increase weekly vaccine doses going to states, tribes, and territories to 11 million. So that is a total of a 28 percent increase in vaccine supply across the first three weeks. I know Americans are eager to get vaccinated, and we’re working with manufacturers to increase the supply of vaccines as quickly as possible. As supply ramps up, we’re also creating new convenient locations for vaccinations. These include standing up community vaccination centers, deploying mobile vaccine units, and launching new programs with pharmacies. Today, we are announcing another step in this effort, focused on some of our hardest-hit populations. Starting next week, we will begin a new program with federally qualified health centers, or as many people know them, “community health centers.” Community health centers provide primary care services in underserved areas, reaching almost 30 million people. Under this new program we will begin directly sending vaccine supply to community health centers, enabling them to vaccinate the people they serve. Community health centers are an important part of our broader strategy to ensure we are reaching everyone with our response. I will turn it over to Dr. Nunez-Smith to provide more information on the community health center program, but before I do, I want to mention another important point that we discussed in our governors meeting today. Equity is core to our strategy to put this pandemic behind us, and equity means that we are reaching everyone, particularly those in underserved and rural communities and those who have been hit hardest by this pandemic. But we cannot do this effectively at the federal level without our partners on the state and local level sharing the same commitment to equity. They need to lead this work, as they know their communities better than anyone. Through efforts like community vaccination centers located in the hardest-hit areas, mobile units, the community health center program we’re launching today, and efforts to build vaccine confidence, we are providing tools to communities around the country to do this work. And we look forward to partnering with them to ensure equity. Over to Dr. Nunez-Smith, who will provide more information on the community health center program. Dr. Nunez-Smith. DR. NUNEZ-SMITH: Thanks so much, Jeff. You know, as Jeff said, we are providing a suite of tools to state and local leaders as they work to reach their underserved and hardest-hit populations. We are very excited about the announcement of this additional program today towards that effort. So, as you just heard, we are very excited to be partnering with federally-qualified health centers, also known as community health centers. They do provide really substantial primary care services across many underserved areas. You know, in our country there are more than 1,300 community health centers spanning every U.S. state and territory, and serving over 30 million people. Two thirds of their patients live at or below the federal poverty line, and 60 percent of patients at community health centers identify as racial or ethnic minorities. So, in addition to the doses that have already been allocated to states and then additionally through the pharmacy program, we will begin shipping doses directly to these community health centers. We will be starting with a phased approach and will ramp up over time. But we anticipate a subset of FQHCs or community health centers to be able to start ordering vaccines as soon as next week. Ultimately, in this initial program phase, we plan to reach 250 community health centers. And again, across this initial phase, our goal is to allocate 1 million doses during this phase. That’s 500,000 first doses and 500,000 second doses. You know, to Jeff’s point, equity is our North Star here. This effort that focuses on direct allocation to the community health centers really is about connecting with those hard-to-reach populations across the country. So this includes people who are experiencing homelessness, you know, agricultural and migrant workers, residents of public housing, and those with limited English proficiency. And as always, we plan to be very inclusive across jurisdictions. So in this initial phase, we will include at least one community health center in each state and territory. You know, as the program further scales, vaccines will become available to all 1,400 community health centers across states and territories should they want to participate. So as we said, this new community health center program is just one tool to reach underserved communities, and it really does build on other efforts like the community vaccination centers, mobile clinics, and the pharmacy program. And a really critical part of this work is also addressing vaccine confidence, which we know is lower in underserved communities than it is for the national average. So the tools that we are deploying at the federal level are meant to aid state and local leaders, but are in no way a substitute for the important work that they must lead on the ground to address equity. So we look forward to continue to work hand in hand with our partners and provide the federal resources necessary to ensure that everyone gets vaccinated. So thank you for your time. With that, I’ll turn it back over to you, Jeff… February 10, 2021: A Press Briefing titled: “President Biden Announces Members of the Biden-Harris Administration COVID-19 Health Equity Task Force“. From the Press Briefing: The COVID-19 Health Equity Task Force will provide recommendations for addressing health inequities caused by the COVID-19 pandemic and for preventing such inequities in the future. As the COVID-19 pandemic continues to plague the country, it has had a disproportionate impact on some of our most vulnerable communities. Shortly after COVID-19 was first identified in the United States, disparities in testing, cases, hospitalizations, and mortality began to emerge. These inequities were quickly evident by race, ethnicity, geography, disability, sexual orientation, gender identity, and other factors. President Biden and Vice President Harris have released a National Strategy to combat the pandemic that has equity at its core. To help ensure an equitable response to the pandemic, the President signed an executive order on January 21 creating a task force to address COVID-19 related health and social inequities. This Task Force is chaired by Dr. Marcella Nunez-Smith. Today, President Biden and Vice President Harris announced the following individuals to serve as non-federal members of the Biden-Harris COVID-19 Health Equity Task Force. Individuals selected by the President are: Mayra Alvarez of San Diego, CAJames Hildreth of Nashville, TNAndrew Imparato of Sacramento, CAVictor Joseph of Tanana, AKJoneigh Khaldun of Lansing, MIOctavio Martinez of New Braunfels, TXTim Putnam of Batesville, INVincent Toranzo of Pembroke Pines, FLMary Turner of Plymouth MNHomer Venters of Port Washington, NYBobby Watts of Goodlettsville, TNHaeyoung Yoon of New York, NY The twelve Task Force members represent a diversity of backgrounds and expertise, a range of racial and ethnic groups, and a number of important populations, including: children and youth; educators and students; health care providers, immigrants; individuals with disabilities; LGBTQ+ individuals; public health experts; rural communities; state, local, territorial, and Tribal governments; and unions. As Chair, Dr. Nunez-Smith will also ask six additional Federal agencies to be represented on the COVID-19 Health Equity Task Force as federal members. This includes the United States Department of Agriculture, Department of Education, Department of Health and Human Services, Department of Housing and Urban Development, Department of Justice, and Department of Labor. The Task Force is charged with issuing a range of recommendations to help inform the COVID-19 response and recovery. This includes recommendations on equitable allocation of COVID-19 resources and relief funds, effective outreach and communication to underserved and minority populations, and improving cultural proficiency within the Federal Government. Additional recommendations include efforts to improve data collection and use, as well as a long-term plan to address data shortfalls regarding communities of color and other underserved populations. The Task Force’s work will conclude after issuing a final report to the COVID-19 Response Coordinator describing the drivers of observed COVID-19 inequities, the potential for ongoing disparities faced by COVID-19 survivors, and actions to ensure that future pandemic responses do not ignore or exacerbate health inequities… February 10, 2021: Lambda Legal posted news titled: “Foster Youth and LGBTQ Advocacy Groups Celebrate Biden Administration’s Agreement to Halt Discriminatory HHS Rule Change in Response to Legal Challenge“. From the news: Lawsuit Challenges Trump-Era Regulation Axing Prohibition on Basis of Sexual Orientation, Gender Identity, and Religion by Service Providers in HHS’s $500 Billion Grant Programs.In response to a lawsuit filed by a foster youth alumni group as well as LGBTQ service and advocacy organizations, the U.S. Department of Health and Human Services (HHS) has agreed to a court order that immediately stayed the effective date of a discriminatory Trump-era rule. If it were to go into effect, that rule would have eliminated essential protections preventing service providers from discriminating on the basis of sexual orientation, gender identity, religion, and other characteristics when providing HHS grant-funded services.In response to the plaintiff groups’ motion to stay or enjoin the rule, the Biden-Harris administration agreed to postpone the rule’s effective date, stated that the Trump-era policy is under review, and agreed to advise the court on its progress. The court order – issued on Tuesday – postpones the effective date of the rule for 180 days, until August 2021.“We are thrilled to see this Administration taking immediate steps to prioritize the safety and wellbeing of the communities that HHS is charged with protecting, particularly when it comes to their ability to access the critical services that HHS funds. If this Trump administration rule were to ever become law, our plaintiffs – youth and alumni in foster care and advocacy organizations dedicated to safety and equity for LGBTQ children and families, LGBTQ youth experiencing homelessness, and LGBTQ seniors – would be harmed, along with other youth and families who would face potential denial of services and discrimination.” said Currey Cook, Lambda Legal Senior Counsel and Youth In Out-Of-Home Care Project Director.The lawsuit was filed on February 2 by Lambda Legal, Democracy Forward, and Cravath, Swaine & Moore LLP on behalf of foster youth and alumni group, Facing Foster Care in Alaska (FFCA) and three LGBTQ advocacy organizations – Family Equity, True Colors United, and SAGE.In response to the agreed stay of the rule, the groups issued the following joint response:“There was simply no excuse for the Trump administration’s unlawful policy sanctioning taxpayer-funded discrimination against people who receive services from HHS grant programs, including youth and families in the child welfare system, youth experiencing homelessness and older adults, among vulnerable populations.We commend the Biden-Harris administration for hitting pause on this harmful and unlawful Trump-era rule, and hope that it will move forward expeditiously to ensure that all persons receive equal treatment under the law.”Lambda Legal February 10, 2021: A Press Briefing titled: “Press Briefing by White House COVID-19 Response Team and Public Health Officials“. From the Press Briefing: MR. ZIENTS: Good morning. Three weeks ago, the President launched his comprehensive whole-of-government strategy to tackle the COVID-19 pandemic. Central to that strategy is getting shots into the arms of the American people. We’ve been making steady progress over the past few weeks, getting more vaccine supply, getting more vaccinators on the ground, and creating more places to get vaccinated. We are on track to meet the President’s goal of delivering 100 million shots in his first 100 days in office. Today I want to give you an update on our execution against that goal. We’ll also hear from Dr. Nunez-Smith, get a state-of-the-pandemic update from Dr. Walensky, and an update on the latest science from Dr. Fauci. We’ll then open it up for questions. The President has made clear that we’re not going to solve this crisis overnight, but we are using every tool at our disposal to make progress in our effort to put this pandemic behind us. First, we continue to take steps to increase the vaccine supply and get it out the door as fast as the manufacturers can make it. Yesterday we announced another increase in the weekly allocations of vaccine doses to states, tribes, and territories. We have achieved a 28 percent increase in the first three weeks of the administration. We’re helping states administer the supply more efficiently and equitably by providing them with visibility into the supply they will receive over the coming three weeks. Second, we’re mobilizing teams to get shots in arms. At the President’s direction, we’re moving quickly to get more vaccinators on the ground, including retired doctors and nurses. We’ve deployed hundreds of personnel across the federal government, from FEMA to USDA to HHS and other federal agencies, to support vaccination operations nationwide. And we have plans to deploy thousands more. Third, we’re creating more places where Americans can get vaccinated. To do so, we’ve expedited financial support to bolster community vaccination centers nationwide, with over $3 billion in federal funding across 35 states, tribes, and territories. We’re putting equity front and center, partnering with states to increase vaccinations in the hardest-hit and hardest-to-reach communities. We’ve launched efforts to get more vaccines to pharmacies and community health centers. And we’re building new vaccination centers from the ground up, in stadiums, community centers, school gyms, and parking lots across the country. And the data show that these efforts are working. As you can see in our vaccination progress report, our seven-day average daily doses administered is now 1.5 million shots per day, up from 1.1 million only two weeks ago. But let me be very clear: We have much more work to do. This is just the start. Today we have two updates on how we continue to increase the number of places to get vaccinated and ensure our response is equitable. First, we are building new vaccination sites. Last week, we announced new mass vaccination centers in California. And today I’m pleased to announce that we’ll partner with the state of Texas to build three new major community vaccination centers in Dallas, Arlington, and Houston — communities hit hard by the pandemic. In Houston, we’re building a major site at NRG Stadium; in South Dallas, a new site at Fair Park; and in Arlington, a site at AT&T Stadium. Together, these sites will be capable of administering more than 10,000 shots in arms a day. We are deploying federal teams immediately to work hand in hand with the state and local jurisdiction. We appreciate Governor Abbott, Representative Sheila Jackson Lee, Representative Eddie Bernice Johnson, Representative Mark Veasey, and Representative Ron Wright. Local mayors and county leaders are also part of this partnership. We expect these sites to start getting shots in arms beginning the week of February 22nd. Importantly, FEMA has partnered with CDC to launch these and other vaccination sites that use processes and are in locations that promote equity, deploying CDC’s social vulnerability index. Second on this point, we continue to put equity at the center of our work more broadly, guided by Dr. Marcella Nunez-Smith. Today we’re pleased to announce the members of our Health Equity Task Force. Ensuring that we reach every person in our response is something that the President and Vice President feel very strongly about. On his second day in office, President Biden signed an executive order to create this task force. And we could not have picked a better leader in Dr. Nunez-Smith to help drive this work. I also want to note that Vice President Harris’s work in the Senate informed the development of the mission and work of the Health Equity Task Force. Then, Senator Harris introduced the COVID-19 Racial and Ethnic Disparity Task Force Act to gather data about disproportionally affected communities and provide recommendations combat the racial and ethnic disparities in the COVID-19 response. Today, that vision becomes a reality as we create this task force to help lead our national response. So now I’ll turn it over to Dr. Nunez-Smith. Dr. Nunez-Smith… …DR. NUNEZ-SMITH: So, thank you, Jeff. And good morning to everyone. You know, shortly after COVID-19 was first identified in the United States, we began to see disparities in testing, in cases, and in rates of hospitalization and mortality. And these inequities were quickly evident by race, ethnicity, geography, disability, sexual orientation, gender identity, and other factors. You know, as the pandemic has progressed over the past year, so too have the inequities. And over the fast — the past few months, we’ve seen new disparities emerge — you know, most notably with regards to access to therapeutics and vaccines. So, absolutely, make no mistake about it: Beating this pandemic is hard work. And beating this pandemic while making sure that everyone in every community has a fair chance to stay safe or to regain their health, well, that’s the hard work done the right way. So President Biden and Vice President Harris have made it clear since the beginning that they are committed to centering their administration’s COVID-19 response on equity. And as Jeff mentioned, Vice President Harris set a blueprint for how to advise this commitment during her time in the Senate. And President Biden not only agreed with the necessity of such a task force — you know, as Jeff said, he signed an executive order requiring its formation in his first full day in office. Next slide, please. And today, that vision for our federal COVID-19 Health Equity Task Force officially becomes a reality. Not only am I humbled and honored that President Biden has asked me to serve as the chair of this COVID-19 Health Equity Task Force, but I am truly excited to share that the President has announced the 12 individuals he has selected to serve as non-federal members. These individuals were identified through conversations with stakeholder groups, on recommendation by organizations and individuals, and through the visible effort and expertise they have lent to their communities in the fight against COVID-19. And their bios are available on the Department of Health and Human Services website. But in addition to their noteworthy backgrounds and expertise, these individuals represent a range of racial and ethnic groups and also key constituencies, including children and youth; educators and students; healthcare providers; immigrants; individuals with disabilities; LGBTQ-plus individuals; public health experts; rural communities; state, local, territorial, and tribal governments; and unions. And in my discretion as chair of this task force, I will be asking representatives from the Departments of Agriculture, Education, Health and Human Services, Housing and Urban Development, Justice, and Labor to sit on this task force, as well, to offer their critical perspective on some of the most effective levers we can pull in our efforts for COVID-19 health equity. Next slide, please. Just a quick word on the actual work of this task force. This advisory body is charged with issuing a range of recommendations to help inform the COVID-19 response and recovery. So this includes thinking about the equitable allocation of COVID-19 resources and relief funds; you know, effective outreach and communication to underserved and minoritized populations; and improving cultural responsiveness within the federal government. You know, additional recommendations will advise on efforts to improve our data collection and use, as well as a long-term plan to address data shortfalls regarding communities of color and underserved populations. And the work of the task force will conclude after issuing a final report to the COVID-19 response coordinator on the drivers of observe (inaudible) COVID-19 inequities, the potential for ongoing disparities facing COVID-19 survivors, and actions to ensure that future pandemic responses do not ignore or exacerbated health inequities. We want everyone to feel connected to this work. So, in addition to this COVID-19 Health Equity Task Force, the administration has already begun — will, of course, continue. And that will include the launch of a series of constituent listening sessions to engage with key communities whose voices we know are so important to (inaudible) conversation about equity. We will always, always (inaudible) endeavor to engage with every community to inform (inaudible) necessary to drive positive change… …MR. ZEINTS: We’re having a bit of technical difficulty. Why don’t we do this: Why don’t we go to Dr. Walensky, sort through those technical difficulties. We’ll come back to you at the end for you to complete your remarks. So let’s go to Dr. Walensky on the state of the pandemic. Dr. Walensky. DR. WALENSKY: Great, thank you so much, Jeff. And thanks to all of you again for being with us today. Cases and new hospital admissions continue to fall. Deaths have decreased slightly in the most recent seven days. And we are watching these data closely. Because cases, hospitalizations, and deaths remain high, and because we are still losing more than a thousand Americans daily to this disease, we must continue to take every action we can to protect our loved ones and our communities. One of the simple things we can all do, one thing that will make the biggest difference, is to wear a mask. I know some of you are both tired of hearing about masks, as well as tired of wearing them. Masks can be cumbersome. They can be inconvenient. And I also know that many of you still have questions about masks. You may be unsure if they work, what kind is best, and whether two masks are better than one. We’ve learned a lot about masks over the past year. Today, I want to share with you some new science that is emerging about masks and what we know now that we didn’t know when the pandemic started. The science is clear: Everyone needs to be wearing a mask when they are in public or when they’re in their own home but with people who do not live in their household. This is especially true with our ongoing concern about new variants spreading in the United States. Masks offer two kinds of protection. When I wear a mask, it protects you and it protects me. But to get the most protection possible, we all have to wear them. Research has demonstrated that COVID-19 infections and deaths have decreased when policies that require everyone to wear a mask have been implemented. So with cases, hospitalizations, and deaths still very high, now is not the time to roll back mask requirements. I have also seen very — many well-meaning people wearing masks that do not fit well or fit incorrectly. In fact, recent survey data from Porter Novelli found that among adults who reported wearing masks in the past week, half said they wore their masks incorrectly in public. New data released from CDC today underscore the importance of wearing a mask correctly and making sure it fits closely and snugly over your nose and mouth. In this new study, researchers used experiments in the laboratory, not the real world, to assess how different strategies to improve the fit of masks impacts masks’ ability to block aerosolized particles emitted during a simulated cough, as well as to reduce exposure to aerosol particles emitted during simulated breathing. The size of the aerosol particles in the experiment were designed to mimic the respiratory droplet particles most important for person-to-person transmission of SARS-CoV-2, the virus that causes COVID-19. Specifically, the experiments compared the performance of no mask, a single cloth face mask, and a single medical procedure mask with two approaches to improve the mask fit of the surgical mask: wearing a cloth mask over the procedure mask, and knotting and tucking the ear loops of the medical procedure mask. In the study, wearing any type of mask performs significantly better than not wearing a mask, and well-fitting masks provided the greatest performance both at blocking emitted aerosols and exposure of aerosols to the receiver. In the breathing experiment, having both the source and the receiver wear masks modified to fit better reduced the receiver’s exposure by more than 95 percent, compared to no mask at all. These experimental data reinforce CDC’s prior guidance that everyone two years of age or older should wear a mask when in public and around others in the home — in the home, not living with you. We continue to recommend that masks should have two or more layers, completely cover your nose and mouth, and fit snugly against your nose and the sides of your face. I want to be clear that these new scientific data released today do not change the specific recommendations about who should wear a mask or when they should wear one, but they do provide new information on why wearing a well-fitting mask is so important to protect you and others. Based on this new information, the CDC is updating the mask information for the public on the CDC website to provide new options on how to improve mask fit. This includes wearing a mask with a moldable nose wire, knotting the ear loops on your mask, or wearing a cloth mask over a procedure or disposable mask. There are also new options available to consumers, called “mask fitters” — small, reusable devices that cinch a cloth or medical mask and that can create a tighter fit against the face and thus improve mask performance. The bottom line is this: Masks work, and they work best when they have a good fit and are worn correctly. Importantly, as per our usual guidance, masks should be used in combination with other prevention measures to offer you and your community the most protection from COVID-19. Stay at least six feet apart from other people you don’t live with, avoid crowds and travel, and wash your hands often. When we take all of these prevention steps and wear masks that fit well, we protect ourselves and we take care of each other. I also want to follow up on a question I received during Monday’s briefing from Kaitlan Collins. I was asked about CDC’s best estimate on the prevalence of variant cases in the United States based on current case data and volume of sequencing. Our latest estimate nationally is that between 1 and 4 percent of cases in the United States are due to the B117 variant, the variant most frequently found in the United States. It’s important to note that some states have seen higher numbers of variant cases, and thus the proportion attributable to B117 in these states is likely to be higher than in other states. We do not believe the variants are distributed equally across the country at this time. And with that, I will say thank you, and I will look forward to your questions and pass it back to Dr. Fauci. Dr. Fauci? DR. FAUCI: Thank you very much, Dr. Walensky. I would like to just take a couple of minutes to preemptively answer three types of questions that I have been asked over the last several days that I believe are important to address preemptively because they will come up. The first relates to the fact that many states, cities, and locations, who have gone from 1A to 1B, will soon or already — or have already gone into the 1C of the phase. Within 1C are persons 16 to 64 years of age with underlying conditions, including those that might be immunosuppressed because of certain drugs such as glucocorticoids or corticosteroids for diseases like autoinflammatory diseases or allergic diseases. There has been a number of individuals who feel that they should not get vaccinated because of those underlying conditions. I want to set the record straight for these individuals because they are more vulnerable to the more severe effects of if they do get infected. Therefore, they are the very people who should get vaccinated. When you think in terms of having an immunosuppressed state — for example, if you’re on glucocorticoids for rheumatoid arthritis or you’re on some of the monoclonal antibodies that block the markers of inflammation — that under those circumstances, if that’s where you are, there is not a safety issue with regard to the vaccine. Safety issues in immunosuppressed individuals relate to live, attenuated vaccines which are contraindicated in people who are immunosuppressed. There is no safety reason not to get vaccinated. So for those who are thinking of getting vaccinated or soon will come up for vaccination, this is something that would be beneficial to you. The only potential downside might be that you might not have as robust a response to the vaccine as if you had a normal immune response. But clearly, getting a less-than-optimal response is much better than no response at all. And I’m sure we’ll be getting back to this question as more vaccines become available and more people in that category will be ready to get vaccinated. The next is the question of the vaccination of children, namely pediatrics and pregnant women. As we all know, these were not included in the original clinical trials that led to the EUA for the two vaccines that are currently available. But I want to point out that since the EUA and under the EUA, approximately 20,000 pregnant women have been vaccinated with no red flags, as we say, and this is being monitored by the CDC and the FDA. So that’s where we’re going there. With regard to children and pregnant women, as I mentioned on a prior discussion with this group, the fact remains that we will be starting clinical trials, and some have already started. We will not need to do tens of thousands of people; we will need just enough measured in hundreds to thousands for safety and whether or not we induce an immune response that is equivalent to the immune response that has been proven to be protective under the trials that have now shown to be 94 to 95 percent effective. And finally, the last issue relates to something that Dr. Walensky just said about the prevalence of the B117 or UK variant. The models tell us that this very well might become dominant in the United States by the end of March. That being the case, we should not despair at that because there are things that we can do to prevent that. It is not outside of our power to do that. For example, the vaccines that we are using clearly are effective against this. We know that from in-vitro correlate studies, as well as for vaccines that are other candidates. So the two things that we can do are some of the things that Dr. Walensky just mentioned: wearing of masks, avoiding congregate settings, keeping your distance, and washing your hands — together, when vaccine becomes available to you, to please get vaccinated. So I’ll hand it back to you, Jeff. MR. ZIENTS: Well, thank you, Dr. Fauci. And, Dr. Nunez-Smith, I understand that you were at the end of your comments. So hopefully the technical issues are behind us and you’ll be available for questions. I just want to pick up where you left off, and that is that equity is core to our strategy to put this pandemic behind us. And we’re grateful to you for your expertise and leadership. Through efforts like community vaccination centers located in the hardest-hit areas, mobile units, the community health center program we announced yesterday, along with efforts to build vaccine confidence, we are providing tools to communities around the country to do this work. After this briefing, Dr. Nunez-Smith and I will join Governor Cuomo to announce two new community vaccination centers in underserved communities in the state of New York, another example of this work coming to life on the ground. With that, let me open it up for questions… February 10, 2021: American Medical Association posted a Press Release titled: “Health care, employer groups announce principles for universal coverage”. From the Press Release: Today, a broad coalition of health care and employer groups called for achieving universal health coverage by expanding financial assistance to consumers, bolstering enrollment and outreach efforts, and taking additional steps to protect those who have lost or are at risk of losing employer-based coverage because of the economic downturn caused by the COVID-19 pandemic.The Affordable Coverage Coalition encompasses groups representing the nation’s doctors, hospitals, employers and health insurance providers that collectively serve hundreds of millions of American patients, consumers, and employers. The joint commitment by such a broad array of interests is a significant milestone on the path toward universal coverage which has remained an elusive goal within the U.S. healthcare system.“While we sometimes disagree on important issues in health care, we are in total agreement that Americans deserve a stable health care market that provides access to high-quality care and affordable coverage for all,” the organizations said in a joint statement of principles. “Achieving universal coverage is particularly critical as we strive to contain the COVID-19 pandemic and work to address long-standing inequities in health care access and outcomes.”Kim Keck, president and CEO of the Blue Cross Blue Shield Association said, “While the country has made enormous strides in expanding coverage over the past decade, we must close the remaining gaps. Having health coverage means people can get the care they need, when they need it, so they can live healthier, more secure lives.” The groups included in the coalition are: America’s Health Insurance Plans, American Academy of Family Physicians, American Benefits Council, American Hospital Association, American Medical Association, Blue Cross Blue Shield Association, Federation of American Hospitals, and U.S. Chamber of Commerce.AMA The organizations support the following steps to make health coverage more accessible and affordable: Protect Americans who have lost or are at risk of losing employer-provided health coverage from becoming uninsured.Make Affordable Care Act (ACA) premium tax credits and cost-sharing reductions more generous, and expand eligibility for them.Establish an insurance affordability fund to support any unexpected high costs for caring for those with serious health conditions or to otherwise lower premiums or cost-sharing for ACA marketplace enrollees.Restore federal funding for outreach and enrollment programs.Automatically enroll and renew individuals eligible for Medicaid and premium-free ACA marketplace plans.Provide incentives for additional states to expand Medicaid, in order to close the low-income coverage gap. February 11, 2021: Department of Health and Human Services (HHS) posted a Press Release titled: “Biden Administration purchases additional doses of COVID-19 vaccines from Pfizer and Moderna“. From the Press Release: The U.S. Department of Health and Human Services (HHS) and Department of Defense (DOD) have purchased an additional 100 million doses of COVID-19 vaccines from both Pfizer Inc. and Moderna Inc. to help meet demand for COVID-19 vaccines in the United States. The orders placed today bring the vaccine purchased by the U.S. government from these two companies to a total of 600 million doses, enough to vaccinate 300 million people. Each company is delivering 300 million doses in regular increments through the end of July 2021. Each company will leverage U.S.-based manufacturing capacity to fill, finish and ship vials as the bulk material is produced. “As the President directed, we are expanding our supply of COVID vaccines to protect people as quickly as possible,” said Acting HHS Secretary Norris Cochran. “These purchases will allow us to accelerate our vaccination efforts to get shots into the arms of the American people. While we rapidly ramp up the pace of vaccinations, I encourage everyone to take actions now to protect themselves and their families: wear a mask, wash your hands often, and practice physical distancing.” The companies began manufacturing doses of their vaccines at the same time that clinical trials were getting underway last year. Beginning the complex process of scaling up to large-scale manufacturing in parallel with clinical trials expedited the traditional vaccine development timeline so that initial doses could begin shipping when the U.S. Food and Drug Administration (FDA) granted emergency use authorization. The vaccine is available at no cost. Vaccine administration costs for private-sector administration partners are being covered by healthcare payers: private insurance, Medicare or Medicaid, and an HHS program to cover COVID-19 costs for the uninsured which is reimbursing providers at Medicare rates from the Provider Relief Fund. The Biomedical Advanced Research and Development Authority (BARDA), part of the HHS Office of the Assistant Secretary for Preparedness and Response, collaborated with the DOD Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense (JPEO-CBRND ) and Army Contracting Command to provide approximately $2 billion for the additional doses of the Pfizer-BioNTech vaccine, bringing the total purchase from Pfizer to approximately $6 billion. BARDA, JPEO-CBRND and Army Contracting Command also collaborated to provide up to approximately $1.65 billion to Moderna, bringing the total federal investment in Moderna’s vaccine development, clinical trials, manufacturing and purchase to approximately $5.75 billion. Moderna’s vaccine was co-developed with scientists from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, with NIAID also supporting the vaccine’s nonclinical studies and clinical trials. BARDA supported phase 2/3 clinical trials, vaccine manufacturing scale up and other development activities for this vaccine. Moderna’s Phase 3 clinical trial began July 27 as the first government-funded Phase 3 clinical trial for a COVID-19 vaccine in the U.S. and enrolled approximately 30,000 adult volunteers who did not have COVID-19. An independent data safety monitoring board overseeing the Phase 3 clinical trial reviewed the trial data and concluded that the vaccine was safe, prevented disease in 94 percent of the volunteers who received the vaccine, reduced the severity of illness in the small percentage of volunteers who contracted COVID-19, and was generally well tolerated. The Phase 3 clinical trial for the Pfizer-BioNTech vaccine enrolled approximately 43,000 adult volunteers in the U.S. who did not have COVID-19. The clinical trial showed that the vaccine was safe, prevented disease in approximately 95 percent of the volunteers who received the vaccine, reduced the severity of illness in the five percent of volunteers who contracted COVID-19 and was generally well-tolerated. The clinical studies of both vaccines are ongoing to gather additional data such as the vaccines’ efficacy in younger populations, the duration of immunity after vaccination, and the impact of vaccination on transmissibility of the virus. Messenger RNA vaccines take advantage of the process that cells use to make proteins in order to trigger an immune response and build immunity to a virus. In contrast, most vaccines use weakened or inactivated versions or components of a disease-causing virus to stimulate the body’s immune response to create antibodies. HHS and DOD have contracted with four other companies to expedite development and production of vaccines that use a variety of vaccine platform technologies and are manufacturing COVID-19 vaccine doses while clinical trials are underway. If any of these other vaccine candidates are authorized by the FDA for emergency use, HHS and DOD can negotiate agreements with the respective companies to purchase additional vaccine doses to meet the demand in the United States. HHS February 12, 2021: Department of Health and Human Services posted a Press Release titled: “2021 Special Enrollment Period for Marketplace Coverage Starts on Healthcare.gov Monday, February 15“. From the Press Release: SEP allows consumers to enroll in health coverage during the COVID-19 Public Health EmergencyToday, in accordance with the Executive Order signed by President Biden, the Centers for Medicare & Medicaid Services (CMS) is announcing that the Special Enrollment Period (SEP) for the Health Insurance Marketplace® will officially be available to consumers in the 36 states that use the HealthCare.gov platform on Monday, February 15, and will continue through Saturday, May 15. At least 13 States plus the District of Columbia, which operate their own Marketplace platforms, have decided to offer a similar opportunity.The COVID-19 Public Health Emergency has affected millions of people throughout the country, and many Americans remain uninsured or underinsured and need access to affordable health coverage. The SEP will allow individuals and families to enroll in the health coverage they need. Consumers who are uninsured can take this opportunity to look for coverage and find out if they qualify for financial assistance to help pay for health insurance. Currently 9 out of 10 consumers enrolled in coverage through HealthCare.gov receive financial help and 75 percent of consumers can purchase a plan for $50 or less per month after financial assistance. In addition, all of the plans at HealthCare.gov cover essential health benefits, such as primary care visits, and cover many preventive care services with no out-of-pocket costs to the consumer.“President Biden was clear: we need to strengthen the Affordable Care Act and give more Americans access to health care, especially during this pandemic, which has further demonstrated the importance of having the right coverage. This Special Enrollment Period will give Americans who need affordable, quality health insurance an opportunity to get covered, and we encourage folks to head to HealthCare.gov starting on Monday to explore their options,” said HHS Acting Secretary Norris Cochran.Beginning today, CMS is launching outreach efforts through stakeholders and partners to get ready and amplify education and awareness across communities. A consumer-facing education campaign will launch on Monday, February 15, including broadcast, radio and digital advertising. The campaign will focus most on increasing awareness among the uninsured that there is an SEP available now and raise awareness among the uninsured about affordable options for coverage and the availability of assistance to pay for premiums for those that qualify. CMS will communicate with current enrollees to let them know they can also take advantage of this opportunity.This SEP is one of the Biden Administration’s first steps in pursuing health equity across the country. Collaborating closely with community partners, CMS will focus its outreach and education efforts on reaching groups that historically have experienced lower access to health coverage and greater disparities in health outcomes. These efforts include placing advertisements in media used by targeted audiences as well as developing partnerships with media outlets that engage communities of color. CMS is working with several organizations, including those that focus on helping the uninsured and other vulnerable communities, to ensure consumers get timely and accurate information about the SEP.CMS intends to release data on consumer activities during the SEP for each month as consumers apply and enroll in coverage. The first report is anticipated in early March, which will cover consumers who applied and enrolled through this SEP in February and have coverage starting March 1. CMS intends to release a report for each month, February, March, and April shortly after the month ends and then a final report after May 15 covering the full period…HHS February 12, 2021: Speaker of the House Nancy Pelosi posted a Press Release titled: “Pelosi Statement on the CDC’s School Reopening Guidance”. From the Press Release: “The CDC’s new and welcomed school re-opening guidance accelerates the urgency for Congress to pass President Biden’s American Rescue Plan.“There is no higher priority than ensuring that our children and teachers can return safely to school, as soon as possible. But without strong assistance from Congress, our schools cannot afford to enact the science-based safety precautions required – particularly in low-income, under-resourced communities that were already struggling before the pandemic. Yet, Republicans in Congress are attempting to block and hold this funding hostage.“Our House Committees are working expeditously to draft and pass by the end of the month President Biden’s American Rescue Plan legislation, which makes a strong and necesary $130 billion investment for safe school re-opening and for our K-12 students. The funding will be used to repair ventilation systems, reduce class sizes and implement social distancing, purchase PPE, hire support staff and take robust meaures to help students make up for lost classroom time. At the same time, the legislation secures an additional $7 billion to close the digital divide, especially important for students and teachers in communities at high risk – which the Republicans oppose.“The Democratic Congress and Biden-Harris Administration are united in our mission to keep our students, educators and their families safe from the vicious coronavirus, while ensuring equity for all children to get the education and the support that they need and deserve.”Speaker of the House Nancy Pelosi February 13, 2021: National Security Advisor Jake Sullivan posted a Statement titled: “Statement by National Security Advisor Jake Sullivan“. From the Statement: The mission of the World Health Organization (WHO) has never been more important, and we have deep respect for its experts and the work they are doing every day to fight the COVID-19 pandemic and advance global health and health security. That is why President Biden rejected and reversed the Trump Administration’s decision to disengage from the WHO. But re-engaging the WHO also means holding it to the highest standards. And at this critical moment, protecting the WHO’s credibility is a paramount priority. We have deep concerns about the way in which the early findings of the COVID-19 investigation were communicated and questions about the process used to reach them. It is imperative that this report be independent, with expert findings free from intervention or alteration by the Chinese government. To better understand this pandemic and prepare for the next one, China must make available its data from the earliest days of the outbreak. Going forward, all countries, including China, should participate in a transparent and robust process for preventing and responding to health emergencies — so that the world learns as much as possible as soon as possible.National Security Advisor Jake Sullivan February 16, 2021: American College of Obstetricians and Gynecologists (ACOG) posted News titled: “Medicaid Coverage Extension Fast-Tracked Through House”. From the News: On February 12, the House Committee on Energy and Commerce advanced fast-track legislation to enable states to more easily extend Medicaid coverage to 12 months postpartum. This critical step for women’s health comes after years of passionate and vocal advocacy from ACOG members and staff and works toward ACOG’s key goals of reducing maternal mortality in the United States.The United States is the only industrialized nation in which maternal mortality rates are increasing; approximately 700 maternal deaths occur in the United States each year, of which an estimated 60% are preventable. With over 30% of maternal deaths occurring between one week and one year postpartum, extending Medicaid coverage up to 12 months postpartum is an invaluable step toward reducing preventable maternal deaths and increasing access to care.The fast-tracked legislation would create a state plan option under the Medicaid program that would enable states to provide 12 months of postpartum coverage for individuals with a Medicaid-covered birth. This is a welcome and necessary change from the current federal mandate of 60 days of coverage after the end of pregnancy, as one year of postpartum coverage is a leading recommendation of state maternal mortality review committees and has been endorsed by more then 275 national and state-based organizations. The state plan option would create an easier glidepath for implementation, eliminating the need for a Section 1115 waiver… ACOG February 15, 2021: President Joseph R. Biden posted a Statement titled: “Statement by President Joe Biden on the 2021 Special Health Insurance Enrollment Period Through HealthCare.gov“. From the Statement: Health care is a right, not a privilege. No one should have to lay awake at night staring at the ceiling wondering what they are going to do to get the care they need or to pay the bills if a family member gets sick. That is why I will do everything in my power to ensure that all Americans have access to the quality, affordable health care they deserve – and the peace of mind it brings.That is especially critical in the midst of a deadly pandemic that has already taken the lives of more than 470,000 of our fellow Americans and infected more than one out of every 12 additional Americans, often with devastating consequences to their health.Starting today and running through May 15, 2021, we are opening HealthCare.gov for all Americans to have the opportunity to sign up for health insurance. Now, everyone will be able to use a special enrollment period to help secure some peace of mind as we work to beat the pandemic and strengthen and build on the Affordable Care Act.As more Americans get covered, it is encouraging to see Congress moving quickly to pass the American Rescue Plan, which will ramp up testing, tracing, and our national vaccination program to get shots into as many arms as possible as quickly as we can. The American Rescue Plan will also take big steps to lower health costs and expand access to care for all Americans, including those who have lost their jobs. It will increase federal subsidies and decrease premiums in order to ensure that no one pays more than 8.5 percent of their income to purchase meaningful and comprehensive health coverage. And it incentivizes states to expand coverage to an additional four million people with low incomes, and provides states the opportunity to extend coverage for a year to low-income women who have recently given birth.I encourage everyone who needs health insurance to go to HealthCare.gov from today through May 15. If you already have coverage, then help your family and friends to sign up and enroll.We will get through this crisis if we look out for one another and work together to expand coverage, lower cost, and ensure that health care truly is a right for all Americans.President Joseph R. Biden Jr. February 15, 2021: Speaker of the House Nancy Pelosi posted a Press Release titled: “Pelosi Statement on President Biden Expanding Access to Health Care”. From the Press Release: Speaker Nancy Pelosi issued this statement on President Biden’s opening of a special enrollment period through the Affordable Care Act for Americans to access health care during the pandemic:“Access to health care is a matter of life-or-death, as our nation has tragically seen during the devistation of the coronavirus pandemic and economic crisis. President Biden’s actions to expand access to health care through the Affordable Care Act will be a lifeline for potentially millions during their time of need, protecting the health and financial security of those who have lost their health insurance through no fault of their own.“At the same time, our House Committees are advancing and preparing to pass Biden American Rescue Plan, which will take the action needed to defeat this pandemic, putting shots in people’s arms, money in their pockets, children back to school and people back to work. With nearly half a million Americans having died, over 27 million having been infected and tens of millions without jobs, it is imperative that we send this legislation to President Biden’s desk to be signed as soon as possible.“Together with the Biden-Harris Administration, the Democratic Congress will continue to work to save lives and livelihoods, and to protect the right of all Americans to affordable, quality health care.”Speaker of the House Nancy Pelosi February 16, 2021: White House Press Secretary Jen Psaki posted a Statement titled: “Statement by White House Press Secretary Jen Psaki on Cases of Ebola“. From the statement: Infectious diseases are transnational health and national security threats. While the world is reeling from the ongoing COVID-19 pandemic, Ebola has again emerged, simultaneously, in both Central and West Africa. The world cannot afford to turn the other way. We must do everything in our power to respond quickly, effectively, and with commensurate resources to stop these outbreaks before they become largescale epidemics.President Biden has been briefed on the situation in both Central and West Africa, and his prayers are with the families of those who have died and those who are impacted by Ebola, COVID-19, and other ongoing global health challenges. The Biden Administration will do everything in its power to provide U.S. leadership to stop these outbreaks, working with the affected governments, the World Health Organization, the African Union and the African Centres for Disease Control and Prevention, and neighboring states.On February 16, National Security Advisor Jake Sullivan spoke with the Ambassadors of Guinea, Democratic Republic of Congo, Sierra Leone, and Liberia to the United States to convey the United States willingness to work closely with the governments of affected countries, and neighboring countries whose citizens would be at risk of the current outbreak spread. Mr. Sullivan emphasized President Biden’s commitment to provide U.S. leadership to strengthen health security and create better systems for preventing, detecting, and responding to health emergencies.Outbreaks require swift and overwhelming response in order to avoid catastrophic consequences. Since the 2014 Ebola epidemic in West Africa, the United States has endeavored to elevate and prioritize health security assistance with partners through the Global Health Security Agenda and with strong support from Congress. We cannot afford to take our foot off the gas – even as we battle COVID, we must ensure capacity and financing for health security worldwide. President Biden’s first National Security Memorandum directed that U.S. leadership in health security and global health be elevated, prioritized, and strengthened. The United States stands ready to do everything in its power to ensure a robust global response and to stop these outbreaks.White House Press Secretary Jen Psaki February 17, 2021: The White House posted a FACT SHEET titled: “FACT SHEET: President Biden Announces New Actions to Expand and Improve COVID-19 Testing“. From the FACT SHEET: As part of his National Strategy for the COVID-19 Response and Pandemic Preparedness, President Biden announced today a series of new actions to expand COVID-19 testing, improve the availability of tests, and better prepare for the threat of variants. As the Administration is working around the clock to vaccinate the population, we need to continue what we know works to protect public health: universal masking, physical distancing, and robust testing. These down payments will serve as a bridge to comprehensive testing investments in the American Rescue Plan.Today, President Biden announced that the Biden-Harris administration will:Expand COVID-19 Testing for Schools and Underserved Populations: The Department of Health and Human Services (HHS), in partnership with the Department of Defense (DOD), will make a $650 million investment to expand testing opportunities for K-8 schools and underserved congregate settings, such as homeless shelters. HHS will establish regional coordinating centers to organize the distribution of COVID-19 testing supplies and partner with laboratories across the country, including universities and commercial labs, to collect specimens, perform tests, and report results to the relevant public health agencies. Too often, testing can be hard to implement in non-medical settings or it can be hard for schools or other congregate settings to find the right partner to make testing work. These coordinating centers will identify existing testing capacity, match it up to an area of need, and fund that testing.Increase Domestic Manufacturing of Testing Supplies:The Centers for Disease Control and Prevention (CDC) will invest nearly $200 million to identify, track, and mitigate emerging strains of SARS-CoV-2 through genome sequencing. This down payment will increase CDC’s sequencing more than threefold from about 7,000 samples per week to approximately 25,000. Increasing samples will improve our ability to detect emerging variants and understand their spread with greater precision. Expanded testing is critical to support more genomic sequencing, because sequencing only occurs after a COVID-19 test comes up positive.These investments are only the beginning of what is needed to expand testing nationwide and get the pandemic under control. The American Rescue Plan will invest $50 billion to expand and support testing, including in priority settings like schools and shelters, and invest in U.S. testing capacity so that public health officials can track the virus in real time and Americans can efficiently get results.White House February 17, 2021: A Press Briefing titled: “Press Briefing by White House COVID-19 Response Team and Public Health Officials“. From the Press Briefing: MR. ZIENTS: Good morning, everybody. It’s been 27 days since the President launched his comprehensive whole-of-government strategy to beat the COVID-19 pandemic. Central to the strategy is vaccinating all Americans. When we started this work 27 days ago, we inherited many challenges: There was not enough vaccine supply. There were not enough vaccinators to help get shots in arms. And there were not enough places to get vaccinated. And 27 days later, while we’ve made a lot of progress, there is a long road ahead. We’re executing our strategy across multiple fronts, and that execution is yielding results. Today I will give you the latest update on our execution in those three key areas: vaccine supply, number of vaccinators, and places to get vaccinated. We’ll also hear from Dr. Walensky on the state of the pandemic, Dr. Fauci on the latest science, Dr. Nunez-Smith on our equity work, and Carole Johnson, White House Testing Coordinator, will discuss important progress on testing. First, I’ll start with vaccine supply. We’ve acted aggressively to increase the vaccine supply. Yesterday we announced another increase in the weekly allocations of vaccine doses to states, tribes, and territories from 11 million doses last week to 13.5 million doses this week. That’s an increase in vaccine allocations of 57 percent during the first four weeks of the Biden-Harris administration. In addition, we’re doubling the weekly vaccine supply to local pharmacies from 1 million to 2 million doses. And thanks to the President’s leadership, we’re on track to have enough vaccine supply for 300 million Americans by the end of July. Second, we’re mobilizing teams to get shots in arms. We signed an order to allow retired doctors and nurses to give shots. Today we’ve deployed over 700 federal personnel as vaccinators. The federal government is funding 1,200 National Guard members who are serving as vaccinators. For the first time, we have activated over 1,000 members of the military to support community vaccination sites, and we’ve deployed an additional 1,000 federal personnel to support community vaccination sites in operational roles. We continue to take action to increase the number of vaccinators and federal support teams. Third, we’re creating more places where Americans can get vaccinated. We’ve expanded financial support to bolster community vaccination centers nationwide, with over $3 billion in federal funding across 40 states, tribes, and territories. We’re bringing vaccinations to places communities know and trust — community centers, high school gyms, churches, and stadiums nationwide. And we’re standing up innovative, high-volume, federally run sites that can give over 30,000 shots a week. We’ve also launched efforts to get vaccines to pharmacies and community health centers. And the data shows that we’re making progress. As you can see in our weekly vaccination progress report, our seven-day average daily dose administered is now 1.7 million average daily shots per day, up from 1.1 million only four weeks ago. Our seven-day daily average of 1.7 million compares to an average of 892,000 the week before President Biden took office. That is almost double in just four weeks. Throughout this work, we’re putting equity front and center, partnering with states to increase vaccinations in the hardest-hit and hardest-to-reach communities; increasing supply to convenient and trusted locations like community health centers; deploying mobile units; and improving data collection so that we have a better understanding of the inequities currently experienced. Let me be very clear: We have much more work to do on all fronts, but we are taking the actions we need to beat this virus. There is a path out of this pandemic. But how quickly we exit this crisis depends on all of us. That’s why I encourage everyone to take the advice of Dr. Walensky, Dr. Fauci, and Dr. Nunez-Smith. Follow the public health guidance. Wear masks, social distance, and get vaccinated when it’s your turn. We will do everything we can as a federal government to defeat this virus, but it will take all of us stepping up to do our part. With that, let me turn it over to Dr. Walensky. Dr. Walensky. DR. WALENSKY: Thank you. I’m so glad to be back with you today to share the latest information on the status of the pandemic. Let’s first begin with an overview of the data, and then I want to briefly discuss with you what CDC knows about recently detected COVID-19 variants and what we’re doing in response. COVID-19 cases have now been declining for five weeks. The seven-day average in the past week — cases have decreased nearly 22 percent to an average of slightly more than 86,000 cases per day. Similarly, new hospital admissions have been consistently declining since early January, with a 21 percent decline in the seven-day average over the past week, averaging approximately 7,700 cases per — admissions per day. We continue to see the daily number of reported deaths fluctuate. The latest data indicate deaths declined by 0.6 percent to an average of 3,076 deaths per day from February 9th to February 15th. These numbers are a painful reminder that we have — of all those we have lost and continue to lose — our family members, our friends, our neighbors, and our co-workers — to this pandemic. While cases and hospitalizations continue to move in the right direction, we remain in the midst of a very serious pandemic, and we continue to have more cases than we did, even during last month’s — last summer’s peak. And the continued spread of variants that are more transmissible could jeopardize the progress we have made in the last month if our — if we let our guard down. As of yesterday, we have confirmed 1,277 cases of the B117 variant across 42 states, including the first case of the B117 variant with the E484K substitution that had previously been found in the UK. Nineteen cases of B1351 variant have been found across 10 states, and three cases of the P1 variant has been found in two states. Reflective of our commitment to communicate openly and often about the latest science on variants today, CDC is releasing two studies in the Morbidity and Mortality Weekly Report, as well as a commentary in the Journal of the American Medical Association, on variants specifically. In the MMWR reports, one study describes the different ways eight people in Minnesota were infected with the B117 variant that emerged late last year in the UK. None of the eight individuals had traveled to the UK, but three of them appeared to have been infected during international travel to other destinations, and three during travel to California. One person was exposed to the virus in their home and another in their community. The second report examines the initial spread of the B1351 variant in Zambia, where the average number of daily confirmed COVID-19 cases increased sixteen fold from December to January, which coincided with the detection of the B1351 variant in specimens collected in December. The B1351 variant was first detected in South Africa. And Zambia shows substantial commerce and tourism linkages with South Africa, which may have contributed to the transmission of this variant across the two countries. In the JAMA viewpoint, co-authored by Dr. Fauci, we provide a synopsis of what we know about the primary variants circulating in the United States and the interagency steps the federal government is taking to address these variants. I know these variants are concerning, especially as we’re seeing signs of progress. I’m talking about them today because I am concerned too. Fortunately, the science to date suggests that the same prevention of actions apply to these variants. This includes wearing a well-fitting mask that completely covers your nose and mouth; social distancing when around others who don’t live with you; avoiding travel, crowds, and poorly ventilated spaces; washing your hands often; and getting vaccinated when the vaccine is available to you. It is more important than ever for us to do everything we can to decrease the spread in our communities by increasing our proven measures that prevent the spread of COVID-19. Fewer cases means fewer opportunities for the variant to spread and fewer opportunities for new variants to emerge. Finally, a quick comment on masking. As I stated last week, the science is clear: Consistently and correctly wearing a mask is one of the most effective tools we have to stop the spread of COVID-19. For reasons supported by science, comfort, cost, and practicality, the CDC does not recommend routine use of N95 respirators for protection against COVID-19 by the general public. Abundant scientific laboratory data, epidemiologic investigations, and large population-level analyses demonstrate that masks now available to the general public are effective and are working. And there is little evidence that, when worn properly, well-fitting medical and cloth masks fail in disease transmission. CDC continues to recommend the use of masks that have two or more layers, that completely cover your nose and mouth, and that fit snugly and comfortably over your nose and the side of your face. Thank you, and I look forward to your questions. I will now turn it over to Dr. Fauci. Dr. Fauci? DR. FAUCI: Thank you very much, Dr. Walensky. I’d like to spend the next couple of minutes addressing an issue that we have been asked about continually since the successful demonstration of the high efficacy of the vaccines that are currently being implemented right now in our country: the mRNA vaccines of Pfizer and of Moderna. And the question is — we do know now that we have a 94 to 95 percent efficacy in preventing clinically recognizable disease, but the looming question is: If a person gets infected, despite the fact that they’ve been vaccinated — we refer to that as a “breakthrough infection” — does that person have the capability of transmitting the infection to another person? Namely, does vaccine prevent transmission? And I had mentioned to you that we, together with the Moderna company — and the Pfizer group is going to do it also — are also going to be looking at the viral load in the nasal pharynx to determine if, in fact, a person who’s vaccinated but has a breakthrough infection, compared to a person who’s unvaccinated and has an asymptomatic infection, is there a difference in the viral load? That will be very important. What has happened over the past couple of weeks is there have been some studies that are pointing into a very favorable direction that will have to be verified and corroborated by other studies. But let me spend a minute to just describe it to you. The real question is: Is there a relationship between viral load and transmissibility? We know from ample studies over many years with HIV is that there’s a direct correlation between the viral load that an individual has — usually measured in the blood — and the likelihood that they will or will not transmit their infection, for example, to a sexual partner. The lower the viral load, the less likelihood of transmissibility. The higher the viral load, the higher the likelihood of transmissibility. Well, when you’re dealing with COVID-19, you’re talking about viral load in the nasopharynx. So a study has just come out about a week and a half ago from Spain that directly looked at it with a group of 282 clusters of infections. And what it showed, in a Lancet article that came out on February the 2nd, was something that we were hoping we would see: that there was a direct correlation with the viral load and the efficiency of transmission, very much the same as what we’ve seen in diseases like HIV, only now it’s in the nasopharynx. In other words, higher viral load, good transmissibility; lower viral load, very poor transmissibility. Now, together with that is another study that came out on February the 8th on an online journal, which I believe is worthy of being noted here — even though, as I mentioned, you want corroboration with other studies. It was a study from Israel. It looked at the following question: If, in fact, you assume that decreased viral load is due — will result in a decreased transmission, when you follow breakthrough infections in the individuals in Israel who had been vaccinated, compared to infections in individuals who were not, there was a markedly diminished viral load in those individuals who were vaccinated but had a breakthrough infection, compared to individuals who were not. It’s very interesting the Israelis were able to do that study. It is noteworthy that when you look at the amount of vaccinations per hundred people — mainly how many vaccinations were given per hundred people — Israeli — Israel is way up there, with 78 doses per 100 people, compared to the United States, which is 16.7 doses per 100 people. So we have been hearing and seeing in the press that Israel has a remarkable diminution in cases associated with the efficiency of their vaccine. The reason I bring this out to you is that it is another example of the scientific data starting to point to the fact that vaccine is important not only for the health of the individual — to protect them against infection and disease, including the variants that Dr. Walensky has mentioned just a moment ago — but it also has very important implications from a public health standpoint for interfering and diminishing the dynamics of the outbreak. So the bottom-line message is one that you just heard from Dr. Walensky that I said the last few times that we had these press briefings, and that is: When your turn to get vaccinated comes up, get vaccinated. It’s not only good for you and your family and your community, it will have a very important impact on the dynamics of the outbreak in our country. And with that, I’ll hand it over to Dr. Nunez-Smith. DR. NUNEZ-SMITH: DR. NUNEZ-SMITH: Thank you so much, Dr. Fauci. So, over these past few weeks, you know, I’ve been — it’s been a great pleasure to be here giving updates in how we’re centering equity in our response. You know, spent time describing the critical need for data, in particular from states and localities, you know, to guide an equitable response. And last week, I introduced you to the individuals selected for the COVID-19 Health Equity Task Force, a group that will convene to develop recommendations to inform the work. So today, just very briefly, I wanted to zoom out a little bit and, just at a high level, describe some of the elements of an equitable COVID-19 response that we’ve built and that we are building so far. So in terms of the federal COVID-19 response, we have developed robust efforts in three key areas on the continuum of COVID-19 impact, and that’s vaccination, treatment, as well as testing. So first, vaccination, as we’ve been discussing so far today, is just critical. And the federal programs — those include the community health center partnerships, retail pharmacy program, the community vaccination centers, and the mobile vaccination sites — those are being executed to make sure we also reach the hardest hit. And we’re working directly with state and local leadership on these programs. So second, I want to spend a little time today discussing equity in COVID-19 treatment options. We have been working very closely with the Food and Drug Administration to discuss the promise and the potential of three antibody therapies authorized for emergency use. And in brief, these therapies have been shown to reduce hospitalization and improve outcomes for high-risk patients diagnosed with COVID-19. You know, the potential for these therapies is especially high in the communities that have been most affected by the pandemic. And in fact, the 25 locations currently participating in the administration’s rollout of these therapies include 32 percent of the American population, and also includes significant racial and ethnic diversity. You know, from Houston, to Detroit, L.A., to Atlanta — in coordination with community leaders in these areas, we have the ability to reach 38 percent of the black community, 42 percent of the Hispanic/Latino community, and 41 percent of the Asian community in the country. And we also have reached into rural populations. So with regard to these therapies in particular, we will continue to keep you updated. And then third, we have been hard at work developing robust efforts in COVID-19 testing as well. And so, with that, I want to pass it over to my colleague, Carole Johnson, to describe the latest developments in the efforts to streamline and increase COVID-19 testing. Carole. MS. JOHNSON: Thank you, Dr. Nunez-Smith, for your leadership on testing, on equity, and on so much more. I’m really delighted to be here with you today. I’m Carole Johnson, the COVID Response Team Testing Coordinator. For the last three years, I served as a Human Services Commissioner for the state of New Jersey, providing healthcare and social services for our most vulnerable residents. So when COVID came early and quickly to our state, I experienced firsthand the difference access to accurate, affordable testing could make in slowing the spread. I’m here today because while we’re working around the clock to vaccinate folks, we also need to continue doing what we know works to protect public health, and that includes robust testing. We need to test broadly and rapidly to turn the tide of this pandemic. But we still don’t have enough testing and we don’t have enough testing in all the places it needs to be. Today, we’re taking a critical step along that path. Thanks to Pre- — President Biden’s leadership and his commitment to testing, we’re announcing that the federal government will invest $1.6 billion in three key areas: supporting testing in schools and underserved populations, increasing genomic sequencing, and manufacturing critical testing supplies. First, we’ll invest $650 million for testing to begin to help schools with reopening and to reach underserved populations. While this funding will serve as a — only as a pilot until the American Rescue Plan is enacted, we want to act quickly to help get support underway in these priority settings. The Department of Health and Human Services will use these funds to create regional coordinating centers that will partner with labs to leverage their underutilized testing capacity. They’ll use that capacity to support schools, underserved communities, and congregate settings. Too often, testing can be hard to implement in non-medical settings or it can be hard to find the right partner to make testing work. These coordinating ceters — centers will help match lab capacity with demand from schools, congregate settings like homeless shelters or other underserved populations. These are places that typically don’t have the resources or the bandwidth to build partnerships with academic or commercial testing labs, and that’s where the government can be a facilitator. We’ll identify existing testing capacity, match it to an area of need, and support and fund that testing. Second, we’ll invest almost $200 million to rapidly expand genomic sequencing to identify, track, and stop the COVID-19 variants that we’ve all heard and talked much about. Essentially, genomic sequencing is the process that tells us which COVID variants are in the country. And this surge in funding will result in a threefold increase in CDC’s genomic sequencing capacity to get us to 25,000 samples a week. As a result, we’ll identify COVID variants sooner and better target our efforts to stop the spread. We’re quickly infusing targeted resources here because the time is critical when it comes to these fast-moving variants. Finally, we’ll address the shortage in testing supplies. Talk to anyone who has focused on COVID testing over the last year, and they’ll tell you the same thing: Our nation faces a shortage of critical supplies and raw materials, including pipette ti- — tips; the specialized paper used in antigen tests; and the specialized molded plastics needed to house testing reagents, as a couple of examples. So our administration will invest $815 million in building and surging domestic manufacturing capacity of these critical testing supplies. We need to build — to build the capacity to produce these materials or we’ll continue to face shortages that will sidetrack our work in expanding access to testing. To be clear, these resources are a significant help in the short term, but they are far from what’s necessary to meet the need for testing in communities across the country. They are merely a bridge until Congress passes the American Rescue Plan to fully expand testing and ensure that any American can get a test when they need one. With that, I’ll turn it back over to Jeff. MR. ZIENTZ: Well, thanks, Carole, and thanks, team. I want to emphasize the importance of testing. Carole just laid out the case, but I just want to add my two cents here. We have too little capacity for diagnostic screening and genomic sequencing. It can take way too long to get a test and there are too many barriers to widespread testing and screening. Quality, affordable testing can be important to reopening our businesses and schools, and keeping them open. And genomic sequencing testing is how we will spot variants early, before they spread. So we need to make a significant investment and ramp up testing across the country. We’re using available funds, so we can pilot programs and make progress. But make no mistake: We need the American Rescue Plan to double testing capacity, promote innovation, and drive down costs per tests. Finally, before we open it up for Q&A, I want to make one last point. We know that millions of Americans have lost their health insurance as a result of this pandemic. This week, the administration opened a Special Enrollment Period to get more people covered. Between now and May 15th, Americans can go to Healthcare.gov and enroll in quality, affordable healthcare. We encourage people to check out their options and to take steps to protect you and your family. With that, let’s open it up to questions. Press Briefing February 17, 2021: Department of Health and Human Services posted a Press Release titled: “Biden Administration Announces Actions to Expand COVID-19 Testing“. From the Press Release: As part of President Biden’s National Strategy for the COVID-19 Response and Pandemic Preparedness – PDF, the U.S. Department of Health and Human Services (HHS) is announcing new actions to expand COVID-19 testing capacity across the country. These actions will improve the availability of tests, including for schools and underserved populations; increase domestic manufacturing of tests and testing supplies; and better prepare the nation for the threat of variants by rapidly increasing virus genome sequencing.First, the Administration will expand COVID-19 testing for schools and underserved populations. HHS will partner with the Department of Defense (DOD) to make a $650 million investment to expand testing opportunities for K-8 schools and underserved congregate settings, such as homeless shelters, directly through new coordination “hubs.” HHS and DOD will establish regional coordinating centers to organize COVID-19 increased testing capacity, and to partner with laboratories, including universities, across the country to collect specimens, perform the tests, and report results to the relevant public health agencies for up to 25 million additional tests per month. This effort will bring more testing to teachers, staff, and students—an important step to support President Biden’s plan to re-open schools for in-person learning.Second, the Administration will ramp up the domestic manufacturing of testing supplies and raw materials to address testing shortages. HHS and DOD will make an $815 million investment to increase domestic manufacturing of testing supplies and raw materials, including filter pipette tips, nitrocellulose used in antigen point-of-care tests, and specific injected molded plastics needed to house testing reagents. These investments will help create more domestic sources and expand existing facilities to increase production capacity.Third, the Administration, through Centers for Disease Control and Prevention (CDC), will rapidly increase genomic sequencing of the virus to better prepare for the threat of variants and slow the spread of disease. CDC will invest nearly $200 million to expand genomic sequencing capabilities, including bioinformatics, reporting, and modeling, to increase sequencing three-fold per week. This is integral to identifying new variants of SARS-CoV-2, the virus that causes COVID-19, and preventing and mitigating their spread. CDC will leverage large commercial laboratories, academic and research institutions, small-to-medium commercial laboratories, and federal laboratories to increase sequencing capacity to-scale and as needed, based on the trajectory of the COVID-19 pandemic.“The Department of Health and Human Services is committed to ensuring that we expand COVID-19 testing capabilities and invest in a diverse array of testing technology, capacity, and human resources to identify and contain the spread of the virus. As part of the President’s national strategy to combat COVID-19, we will deploy every available resource to ensure that more individuals and families have access to testing options during this unprecedented time and that our nation is prepared to contain and prevent the spread of possible variants,” said HHS Acting Secretary Norris Cochran.HHS February 17, 2021: Speaker of the House Nancy Pelosi posted a Press Release titled: “Coronavirus Relief Checks Boosted Economy, Republicans Want to Stop it From Happening Again”. From the Press Release: Retail Sales Surged in January as a Direct Result of the $600 Stimulus Checks After months of troubling economic reports, January finally saw a glimmer of hope: a surge in retail sales as a result of the $600 direct payments to the American people. These strong retail numbers prove once again that direct payments not only provide urgently-needed relief, they also boost our economy. It is critical that we build on this boost by putting $1,400 stimulus checks in the pockets of struggling Americans – an essential part of the Biden Administration’s American Rescue Plan. The country is looking for action, for progress, and for solutions to the crises we are facing. Unfortunately, Congressional Republicans “overwhelmingly oppose” proposed relief plans and, instead of proposing ideas to help our country out of this crisis, Republicans have been attempting to cut benefits for millions of Americans. Through their relentless opposition to additional help for hardworking American families and small business owners across the country, Republicans are disregarding economic experts and ignoring the will of the American people. But, this is not a moment in the country when obstructionism from the GOP will be rewarded. Experts Across the Political Spectrum Agree: Trump’s own Chairman of the Council of Economic Advisers told CNN he “absolutely” supports the framework of President Biden’s stimulus plan and Moody’s Analytics found the plan will create 10 million additional American jobs between 2021 and 2022. The American People Support Additional Relief: More than 75% of Americans support an additional round of $1,400 stimulus checks and more than 65% support a comprehensive package including state and local aid, expanded unemployment insurance, and more. If Republicans won’t listen to experts or to their own constitutients, perhals they can follow common sense. The American people and small businesses across the country are struggling to make ends meet. A survey from the Federal Reserve foudn that 9 million small business owners fear their businesses won’t survive the pandemic without more government relief. The direct payments have proven time and again their efficacy in supporting the American people while also stimulating our economy and helping businesses in need. The $1,400 direct relief payments included in the American Rescue Plan will help families, small businesses and local economies, and it is supported by a bipartisan majority of the country. It’s time for Republicans to listen to reason and get out of the way. February 18, 2021: White House posted a Fact Sheet titled: “President Biden to Take Action on Global Health through Support for COVAX and Calling for Health Security Financing“. From the Fact Sheet: As the virus continues to spread throughout the world, and with new variants emerging, the facts are clear that it is critical that we vaccinate as many people as possible, as quickly as possible. Tomorrow at the G7, the President will announce that he is taking concrete steps to improve the health and the safety of Americans by protecting vulnerable populations worldwide. He will also call on G7 partners to prioritize a sustainable health security financing mechanism aimed at catalyzing countries to build the needed capacity to end this pandemic and prevent the next one.COVID has shown us that no nation can act alone in the face of a pandemic. Today, President Biden is taking action to support the world’s most vulnerable and protect Americans from COVID-19.Using money appropriated by a bipartisan Congressional vote in December 2020, the United States will provide an initial $2 billion contribution to Gavi, the Vaccine Alliance for the COVAX Advance Market Commitment, the innovative financing instrument of the COVAX Facility, which supports access to safe and effective vaccines for 92 low- and middle-income economies.The United States will also take a leadership role in galvanizing further global contributions to COVAX by releasing an additional $2 billion through 2021 and 2022, of which the first $500 million will be made available when existing donor pledges are fulfilled and initial doses are delivered to AMC countries. In close cooperation with Gavi, this additional $2 billion in funding will serve to expand COVAX’s reach. We also call on our G7 and other partners to work alongside Gavi, to bring in billions more in resources to support global COVID-19 vaccination, and to target urgent vaccine manufacturing, supply, and delivery needs.Finally, at the G7 President Biden will reaffirm the U.S. commitment to global health security and advancing the Global Health Security Agenda. All countries should have the capability to prevent, detect, and respond to outbreaks. The COVID-19 pandemic and ongoing outbreaks of Ebola in the Democratic Republic of the Congo and Guinea highlight the need for sustainable health security financing to catalyze country capacity to prevent biological catastrophes.Today, the President is announcing that he will:Protect the most vulnerable, protecting America: The United States’ contribution is designated to help Gavi prevent, prepare for, and respond to coronavirus through vaccine procurement and delivery for the world’s most vulnerable. In partnership with Gavi, the bulk of these funds will be targeted to support direct vaccine procurement, and a portion will also support broader country readiness and vaccine service delivery. Encourage the global community to action: Under President Biden, the United States will take a leadership role in galvanizing new donor commitments toward the COVAX Facility. The next $2 billion of support from the US government, which will be additional to today’s initial $2 billion contribution, will be released as we work with other donors to elevate pledge commitments. The goal is clear: vaccinate vulnerable populations, and reach those without other options. This funding from the Administration will enable Gavi to address urgent needs, while also supporting efforts to diversify and increase contributions from other donors in 2021.Fact Sheet February 18, 2021: Lambda Legal posted news titled: “Lambda Legal Hails Introduction of the Equality Act“. From the news: “e need the absolute clarity of the Equality Act, and we need it now: nearly 50 years of waiting for federal action is long enough.”Today, U.S. Rep. David Cicilline (D-RI) and U.S. Sen. Jeff Merkley (D-OR) announced the introduction of the Equality Act, federal legislation that will update existing federal nondiscrimination laws, including the Civil Rights Act of 1964 and the Fair Housing Act, to confirm that discrimination based on sexual orientation or gender identity is unlawful discrimination based on sex. The Equality Act clarifies that sex discrimination laws to prohibit LGBTQ discrimination in employment, housing, credit, education, and other areas, explicitly extends sex discrimination protections to public accommodations and federally funded programs.Lambda Legal CEO Kevin Jennings issued the following statement:“Lambda Legal applauds the re-introduction of the Equality Act, long past-due federal legislation which provides clear, comprehensive, and explicit protections for LGBTQ people in federal law. Coupled with President Biden’s early action applying the U.S. Supreme Court’s ruling in Bostock v. Clayton County to all federal laws currently prohibiting sex discrimination, we can see true equality on the horizon. And it can’t happen soon enough: the LGBTQ community has been asking Congress for protections since Reps. Bella Abzug and Ed Koch first introduced the Equality Act of 1974 years ago, and nearly fifty years of waiting is long enough.“LGBTQ people across the country remain vulnerable to discrimination on a daily basis and too often have little recourse. Without comprehensive federal protections the basic rights of LGBTQ people vary state to state. In some instances, individuals lose rights and protections the moment they cross into a neighboring state, underscoring that the current patchwork of protections for LGBTQ people is inadequate. In addition, as evidenced by the thousands of phone calls to our Help Desk we receive every year, many employers, landlords and lenders still haven’t gotten the message that discrimination is just wrong, which is why we need the absolute clarity of the Equality Act, and we need it now.”The Equality Act makes clear that federal law comprehensively prohibits discrimination based on an individual’s sexual orientation or gender identity. It also updates the public accommodations law to add protections from discrimination in public places and services on the basis of sex, race, color, national origin, and religion where those protections are not already in existing law, such as for retail stores, transportation services like airports, taxis and bus stations, and service providers like accountants.The Equality Act was first introduced in 2015 by U.S. Representatives David Cicilline (D-RI) and John Lewis (D-GA) and Senators Jeff Merkley (D-OR), Tammy Baldwin (D-WI) and Cory Booker(D-NJ)…Lambda Legal February 18, 2021: Planned Parenthood posted a press release titled: “BREAKING: South Carolina Passes First Abortion Ban of 2021; Lawsuit Filed”. From the Press Release: South Carolina politicians ignore dire need for COVID-19 pandemic relief, passing abortion ban that includes provisions targeting sexual assault survivorsMoments ago, South Carolina politicians passed the first abortion ban of 2021 – a ban on abortion at six weeks of pregnancy. A legal challenge and request for emergency relief is imminent. Planned Parenthood South Atlantic and Greenville Women’s Clinic, represented by Planned Parenthood Federation of America, the Center for Reproductive Rights, and the law firm Burnette Shutt & McDaniel, P.A. intend to sue in federal court by the end of today, as this abortion ban is to take effect as soon as Gov. Henry McMaster signs int into law. By banning abortion at just six weeks of pregnancy, before many people know they’re pregnant, the law targets South Carolinians who already struggle to access health care.This legislation could ban almost all abortions for the nearly 1 million South Carolinians of reproductive age. Under this law, even sexual assault survivors will be barred from having an abortion after approximately six weeks of pregnancy unless doctors report their names to law enforcement, potentially over the survivor’s objection. It is the latest in a concerning trend of state politicians passing extreme abortion bans and restrictions aimed at eliminating abortion access and overturning the constitutional right to abortion established by Roe v. Wade.In less than two months, state politicians have introduced or filed abortion bans and restrictions at a staggering pace— more than 200 bills to restrict or ban abortion and counting, more than 40 percent seeking to ban abortion at various points of pregnancy…Planned Parenthood February 18, 2021: Center for Reproductive Rights posted News titled: “South Carolina Passes First Abortion Ban of 2021; Lawsuit Filed”. From the News: South Carolina politicians ignore dire need for COVID-19 pandemic relief, passing abortion ban that includes provisions targeting sexual assault survivors.Moments ago, South Carolina politicians passed the first abortion ban of 2021 – a ban on abortion at six weeks of pregnancy. A legal challenge and request for emergency relief is imminent. Planned Parenthood South Atlantic and Greenville Women’s Clinic, represented by Planned Parenthood Federation of America, the Center for Reproductive Rights, and the law firm Burnette Shutt & McDaniel, P.A. intend to sue in federal court by the end of today, as this abortion ban is set to take effect as soon as Gov. Henry McMaster signs it into law. By banning abortion at just six weeks of pregnancy, before many people know they are pregnant, the law targets South Carolinians who already struggle to access health care.This legislation could ban almost all abortions for the nearly 1 million South Carolinians of reproductive age. Under this law, even sexual assault survivors will be barred from having an abortion after approximately six weeks of pregnancy unless doctors report their names to law enforcement, potentially over the survivor’s objection. It is the latest in a concerning trend of state politicians passing extreme abortion bans and restrictions aimed at eliminating abortion access and overturning the constitutional right to an abortion established by Roe v. Wade.In less than two months, state politicians have introduced or filed abortion bans and restrictions at a staggering pace – over 200 bills and counting to restrict or ban abortion, have of which seek to ban abortion…Center for Reproductive Rights February 18, 2021: American College of Obstetricians and Gynecologists (ACOG) posted News titled: “ACOG Releases Guidance on Health Care for Transgender and Gender Diverse Individuals”. From the News: Obstetrician-gynecologists should be aware of the unique needs of transgender individuals and should be prepared to assist them with preventative health care in safe and affirming environments, according to a new Committee Opinion released by the American College of Obstetricians and Gynecologists (ACOG). Heath Care for Transgender and Gender Diverse Individuals was prepared jointly by ACOG’s Committee on Gynecologic Practice and Committee on Health Care for Underserved Women. This document provides clinical guidance for caring for transmasculine and transfeminine patients and information to assist obstetrician-gynecologists in offering inclusive patient care. The Committee Opinion notes that the majority of medications used for gender transition are common and can be safely prescribed by a wide variety of health care professionals with appropriate training and education, including, but not limited to, obstetrician-gynecologists, family or internal medicine physicians, endocrinologists, psychiatrists, and advanced practice clinicians. “With at least 1.4 million adults and 150,000 youths living in the United States who identify as transgender, obstetrician-gynecologists should work to make their offices open and inclusive to all patients, and should be prepared to provide all individuals with compassionate, evidence-based care,” said Beth Cronin, MD, FACOG, one of the authors of the Committee Opinion. Additional findings of the Committee Opinions include: Fertility and parenting desires should be discussed early in process of transition, before the initiation of hormone therapy or gender affirming surgery.Gender-affirming hormone therapy is not effective contraception. Sexually active individuals who do not wish to become pregnant or cause pregnancy in others should be counseled about the possibility of pregnancy if they are having sexual activity that could result in pregnancy.To guide preventative medical care, any anatomical structure present that warrants screening should be screened, regardless of the patient’s gender identity. The Committee Opinion notes that pregnancies are still possible during and after transitioning, so contraceptive counseling is crucial to prevent unintended pregnancies. In addition, acknowledging that transmasculine individuals may pursue and achieve pregnancy, the Committee Opinion notes that pregnancy can be a gendered experience and may lead to feelings of dysphoria or isolation for some patients. Obstetrician-gynecologists caring for these patients should be aware of language used, should be prepared to counsel patients about when to restart testosterone therapy, and should consider referrals for mental health support if needed. Recognizing the importance of clinical guidance to assist in the delivery of care to transgender and gender diverse individuals, the Committee Opinion also discusses the many barriers to health care that this population commonly faces and the steps that obstetrician-gynecologists can take to create a welcoming, inclusive environment… …ACOG opposes discrimination on the basis of gender identity, urges public and private health insurance plans to cover necessary services for individuals with gender dysphoria; and advocates for inclusive, thoughtful, and affirming care for transgender individuals. February 19, 2021: The White House posted a Press Briefing titled: “Press Briefing by White House COVID-19 Response Team and Public Health Officials“. From the Press Briefing: ACTING ADMINISTRATOR SLAVITT: Good morning. Thank you for joining our COVID-19 Response briefing. First, I want to start by saying that our hearts go out to the people in Texas, Louisiana, and across the country who have been impacted by the severe weather this week. Now, I want to give an update on how severe weather across the country has impacted vaccine deliveries and administration, and how we intend to catch up. As of now, we have a backlog of about 6 million doses due to the weather. All 50 states have been impacted. The 6 million doses represents about three days of delayed shipping, and many states have been able to cover some of this delay with existing inventory. So let me first walk you through the situation and then tell you how we, as an entire nation, will have to pull together to get back on track. There are three places along the distribution chain that have been impacted by the weather. First, FedEx, UPS, and McKesson — our logistics and distribution teams — have all faced challenges as workers have been snowed in and unable to get to work to package and ship the vaccines, kits, and the required diluent. Second, road closures have held up delivery of vaccines at different points in the distribution process, between manufacturing sites to distribution, and to shipping hubs. Third, more than 2,000 vaccine sites are located in areas with power outages, so they’re currently unable to receive doses. General Perna’s guidance to the team was to ensure safety of personnel, preservation of the vaccines and supplies, and constant communication with the states. Because of 72-hour cold chain constraints, we don’t want to ship doses to those locations and have them sitting at a site where they might expire. So the vaccines are sitting safe and sound in our factories and hubs, ready to be shipped out as soon as the weather allows. Now, as weather conditions improve, we’re already working to clear this backlog. 1.4 million doses are already in transit today, and we anticipate that all the backlog doses will be delivered within the next week, with most being delivered within the next several days. And we expect we will be able to manage both this backlog and the new production coming online next week. With everybody’s hard work and collective effort, we will be able to catch up, but we understand this will mean asking more of people. UPS and FedEx both will support Saturday deliveries tomorrow. We are working with the jurisdictions to see which ones are able to take Saturday deliveries. The packaging plant for Moderna vaccines is just now coming online. Roads are being cleared for the workforce to leave their homes. They’re working today through Sunday to package the backlogged orders, and will put the vaccines and ancillary supplies on aircraft on Sunday night for Monday-through-Wednesday delivery. As we get back on track, we’re asking states, sites, and ventilate — and vaccinators to help us catch up and to get Americans vaccinated. We know many Americans are awaiting their second dose, and many more, their first dose. We’re asking vaccine administration sites to extend their hours even further and offer additional appointments, and to try to reschedule the vaccinations over the coming days and weeks as significantly more supply arrives. States and vaccination sites are going to want to be prepared for the additional volume. Whatever reduction we see in our seven-day average this week in vaccinations from the weather, if we all work together — from the factory, all the way to the vaccinators — we will make up for it in the coming week. I want to personally thank the men and women who have continued to keep our operations up and running throughout this storm and have been working 24 by 7 with the states, and with local vaccination sites. And my thoughts remain with all of those impacted. I’ll be happy to answer any questions about this topic. But before we turn it over to Dr. Walensky and Dr. Fauci, I do want to briefly touch on our work to stand up more federally run sites. Even as we manage the weather, on the one hand, we are pushing ahead with plans to get more vaccines to more places to get more Americans vaccinated. Today, I’m pleased to announce we’ll be opening five additional vaccination centers: one in Pennsylvania and four in Florida. In Florida, we will stand up four major new community vaccination centers, in partnerships with the state, in Orlando, Miami, Jacksonville, and Tampa. These sites will have the capacity to vaccinate a total of 12,000 individuals per day in total. In Pennsylvania, we’re announcing a major new community vaccination center at the Pennsylvania Convention Center in Philadelphia. This site will have the capacity to deliver 6,000 doses per day. Selection of all of these sites is based on a CDC-FEMA framework that has been developed to target vaccinations to those who are most vulnerable. The goal is to launch vaccination sites that use processes and are in locations that promote equity and deploy the CDC’s Social Vulnerability Index. The federal government will be deploying teams immediately to work hand in hand with state and local jurisdictions to get these sites set up, and we expect both — we expect them all to be up and running in the next two weeks. So that’s a brief status from the White House COVID Response Team here. We’ll have more announcements to come next week. Now, with that, I will turn it over to Dr. Walensky to overview a state of the pandemic and public health. Dr. Walensky. DR. WALENSKY: Thank you so much. I’m delighted to be back with you today. I have new information to share from CDC regarding ongoing safety monitoring of the COVID-19 vaccines. But before I go into those findings, I want to provide a brief overview of the latest data on the pandemic. We continue to see a five-week decline in COVID cases, with cases decreasing 69 percent in the seven-day average since hitting a peak on January 11th. The current seven-day average of approximately 77,000 cases is the lowest recorded since the end of October but still higher than the height of last summer’s peak. Like new COVID-19 cases, the number of new hospital admissions continues to drop. The seven-day average of new admissions on February 16th, approximately 7,200, represents a 56 percent decline since the January 9th peak. As I reported on Wednesday, the number of deaths continues to fluctuate. The latest data indicate that deaths have declined modestly in the past week to an average of approximately 2,700 per day. These numbers are a stark reminder of the thousands of lives lost to this pandemic. Another reminder of the devastating impact of the pandemic has had on our country was brought into clear view yesterday in a report released by the CDC on the provisional life expectancy in the first half of 2020. The report found that life expectancy was at its lowest level in 15 years, dropping by a full year compared to the life expectancy in 2019. This represents a substantial decline in life expectancy in our nation. Importantly, like the populations most heavily affected by this pandemic, the declines in life expectancy were again most pronounced in certain racial and ethnic minority groups. The largest declines in life expectancy occurred in non-Hispanic black persons, dropping 2.7 years — levels not seen since 2001. And Hispanic persons had lost the second largest life expectancy, dropping 1.9 years. These findings, though not surprising, are sobering and representative of the continued need to take this pandemic, and actions to stop the spread of COVID-19, seriously. Now more than ever, with continued spread of variants that stand to threaten the progress we are making, we must recommit to doing our part to protect one another: wear a well-fitting mask, social distant, avoid travel and crowds, practice good hand hygiene, and get vaccinated when the vaccine is available to you. I also want to spend a moment talking about vaccine safety. To date, more than 41 million people in the United States have received at least one dose of the COVID-19 vaccine, but we continue to hear that people might be reluctant to roll up their sleeve because they are worried about adverse effects. I will reiterate: The CDC is committed to monitoring vaccine safety and frequently reporting on what we know. Today, CDC is releasing a study in the Morbidity and Mortality Weekly Report that describes findings from our COVID-19 vaccine safety monitoring in the United States from December 14th through January 13th, 2021. During the first month of vaccinations, approximately 1.6 million people enrolled in V-safe, CDC’s new phone-based COVID-19 vaccine safety monitoring system. Among those enrolled, 71 percent reported pain where the shot was given, 34 percent reported fatigue, and 30 percent reported a headache. These are common with most vaccines, and they typically resolve within a day or two of vaccination. It’s important to know that about half the people don’t feel very well after getting their second dose. This should not deter you from getting your second dose, but you need to have a light day of activity after getting vaccinated. There were also rare reports of severe allergic reactions like anaphylaxis, a serious but treatable reaction. In fact, there were 4.5 cases of anaphylaxis per 1 million doses given during this time — a rate similar to what we’ve seen in other commonly used vaccines. In the first month of experience, a total of 113 deaths were reported of which approximately 65 percent were among long-term care facility residents. A thorough review of the available data indicated that these deaths were not related to the COVID-19 vaccine. And the death rate in this population, though truly sad and unfortunate, was consistent with the expected background death rate in this demographic. I want to emphasize that we’ve implemented the most comprehensive vaccine safety monitoring system program in our history, and the data released from the CDC today are reflective of this effort. We will continue to closely monitor these events and report back as further data emerge. I want to be sure that you know the facts and not the myths about the vaccine safety — about vaccine safety. The fact is they are safe and they will save lives. And that is why we are committed to working with state and local public health partners, as well as partners in the private sector, to support getting people vaccinated and quickly and as safely as possible. To help advance our collective efforts to scale up vaccines in communities, on Monday, CDC is convening a three-day virtual National Forum on COVID-19 Vaccine. The forum will bring together a broad range of governmental and non-governmental partners to share information and best practices on how to build trust and confidence in COVID-19 vaccines; how to use data to optimize vaccine implementation; and how to provide practical, real-world experience on how to increase vaccination capacity in communities, especially for those at increased risk of COVID-19 and for those who may face barriers to vaccination. I’m excited about this forum and the rich dialogue it will stimulate. And I invite those who are involved in vaccine efforts to register and attend this important meeting. Thank you. As always, I look forward to your questions. But before that, I’ll turn it over to Dr. Fauci. Dr. Fauci. DR. FAUCI: Thank you very much, Dr. Walensky. What I’d like to do is to just take a couple of minutes, very briefly, reviewing the status of the vaccines and vaccine trials that we have, but then to, as I’ve done in the past, pick out a question that I believe is being asked more frequently to try and preemptively address it and perhaps generate some discussion. With regard to the trials that we have: As you know, the U.S. government had been involved in the development of and/or facilitation of the testing of three separate platforms represented by six different companies. You’re all aware of the data of the Moderna and the Pfizer-BioNTech, which have their EUA now, having shown a 94 to 95 percent efficacy. Right now, as we speak, the data from the Johnson study — which, as you know, showed a 72 percent efficacy in the United States, but was also done in South Africa and Latin America and showed a diminished efficacy against the variant, but very good against severe disease — that is being reviewed at the FDA for the U.S. data. And on February the 26th, the FDA will consult with their independent Advisory Committee, their VRBPAC, and we should be hearing from them soon. With regard to the AstraZeneca and the Novavax, those trials are both fully enrolled. These are event-driven decisions, so when they reach a certain amount of events, they will then look at the data and make decisions as to whether or not to go ahead with a request for an EUA. So, having said that, let me just now, very briefly, address a question that is a very relevant question that we are now more commonly being asked: If you look at the existing trials — those that have already gotten an EUA, and those that we anticipate and hope will get and EUA — when will we be able to say we can vaccinate children — children in the high school range and children in the elementary school range? You know from Pfizer that they started off with the trial of 44,000 individuals, down to 16-year-olds and then progressed it down to 12-year-olds. So what they’re going to be doing in April — starting in April, they are going to be studying 12-year-olds down to five- to six-year-old. That will take likely one year to get the information on that — likely not until the first quarter. However, we anticipate data on high-school-age individuals, namely individuals 12 years old to 17 years old, by the beginning of the fall. Maybe not exactly coinciding with the first day of school, but sometime in the fall, we will have that. Moderna, as you know, started off with already 18-year-old. They are now currently enrolling 12- to 17-year-olds. So let me take a moment to explain the process of how you get relevant information regarding these younger individuals. This is a representative trial, which very likely will reflect other trials. It’s a 3,000-person trial. So, right off, you’re not dealing with the 30,000- and 44,000-person trial that gave the efficacy signal in the original Moderna and Pfizer study. What the trial is, is the trial is what’s called a “non-inferiority by immunogenicity,” which is a lot of big words to really mean what they’re asking: Is it safe in the children, and does it induce an immune response that’s comparable or not inferior to the immune response that we know is associated with efficacy in the other trials? And that’s the way that trial will go. And then, we’re starting, by the end of March, they will do what’s called an “age de-escalation study.” We’re already enrolling on the 12 to 17. They will go to the 6 to 12, then 2 to 6, then 6 months to 2 years. Again, we will likely get information for high schoolers at some time in the fall, but it is, I would say, more than unlikely we will not have data on elementary school children until at least the first quarter of 2022. Similar types of approaches are being taken by the other candidates, the other companies, namely J&J, Novavax, and AZ. So, the bottom line of all of this is as follows: It is highly likely that sometime in the fall, we will have data that will give us the capability of saying the safety and comparable efficacy in children 12 to 17, 18 years old. Again, the final decisions we always leave to the FDA. I’m trying to give you a roadmap of what likely will happen. But then also, with the studies that I just mentioned, to getting the information to make the decision in elementary school children almost certainly will not be firmed down until the first quarter of 2022. I will stop there and hand it back to Andy… Press Briefing February 19, 2021: Planned Parenthood posted a Press Release titled: “Court Will Block South Carolina Abortion Ban One Day After Gov. McMaster Signed It Into Law”. From the Press Release: Today, a federal district court announced that it will temporarily block a law passed yesterday in South Carolina that bans abortion before many people know they’re pregnant. The law took effect yesterday after Gov. Henry McMaster signed it into law. If this abortion ban had been allowed to stay in effect, abortion would have essentially been banned for nearly 1 million South Carolinians of reproductive age. The emergency lawsuit was filed by Planned Parenthood South Atlantic and Greenville Women’s Clinic, represented by Planned Parenthood Federation of America, the Center for Reproductive Rights, and the law firm Burnette Shutt & McDaniel.This ban is the latest in a worrisome trend of state politicians passing extreme legislation like abortion bans aimed at eliminating abortion access and overturning the constitutional right to abortion established in Roe v. Wade. In fewer than two months, state politicians have introduced abortion bans and medically unnecessary restrictions at a staggering pace – more than 200 bills and counting to restrict or ban abortion, with more than 40% seeking to ban abortion at various points of pregnancy…Planned Parenthood February 19, 2021: Center for Reproductive Rights posted News titled: “Court Will Block South Carolina Abortion Ban One Day After Gov. McMaster Signed It Into Law”. From the News: Today, a federal district court announced that it will temporarily block a law passed yesterday by South Carolina that bans abortion before many people know they’re pregnant. The law took effect yesterday after Gov. Henry McMaster signed it into law. If this abortion ban had been allowed to stay in effect, abortion would have essentially been banned for nearly 1 million South Carolinians of reproductive age. The emergency lawsuit was filed by Planned Parenthood South Atlantic and Greenville Women’s Clinic, represented by Planned Parenthood Federation of America, the Center for Reproductive Rights, and the law firm Burnette Shutt & McDaniel.This ban is the latest in a worrisome trend of state politicians passing extreme legislation like abortion bans aimed at eliminating abortion access and overturning the constitutional right to abortion established in Roe v. Wade. In fewer than two months, state politicians have introduced abortion bans and medically unnecessary restrictions at a staggering pace – more than 200 bills and counting to restrict or ban abortion, with more than 40% seeking to ban abortion at various points of pregnancy…Center for Reproductive Rights February 19, 2021: Planned Parenthood posted a Press Release titled: “Planned Parenthood Federation of America Applauds President Biden’s Historic Choice to Head CMS“. From the Press Release: Today, President Biden announced his intent to name Chiquita Brooks-LaSure as administrator of the Centers for Medicare & Medicaid Services (CMS), who would make history as the first Black woman to lead the agency. This news follows previous announcements of Xavier Becerra, Dr. Vivek Murthy, and other experienced public health champions to lead the country’s health and COVID-19 efforts. After years of Trump administration attacks, the CMS administrator role will be critical to protect and advance sexual and reproductive health care and rights for all people in this country……CMS is the office within the Department of Health and Human Services that directly oversees Medicaid and Medicare, and implements the Affordable Care Act. Medicaid is a crucial women’s health program. Women compromise the majority of adult Medicaid enrollees, and women of color comprise the majority of women enrolled in Medicaid. Two-thirds of women covered by Medicaid are in their reproductive years.Planned Parenthood Through CMS, the Biden-Harris administration must: Fully roll back harmful policies from the Trump administration, including by affirming Medicaid patients’ right to access care from providers they know and trust – like Planned Parenthood health centers – and eliminating discriminatory work and cost-sharing requirements that make it harder for enrollees to gain and maintain coverage. Go beyond stopping harm and start making progress for sexual and reproductive health and rights by incentivizing the remaining states to expand Medicaid, strengthening the safety net provider network, and more. Help protect people against the physical, emotional, and economic consequences of COVID-19 with comprehensive relief that invests in public health care programs and safety net providers. Help reckon with systemic racism, injustice, and state-sanctioned violence in this country, including making progress on the Black maternal health crisis through expanding comprehensive Medicaid coverage to 12 months postpartum. The Biden-Harris administration has already taken some important first steps. In their initial days, they issued an executive order to strengthen Medicaid and the Affordable Care Act (ACA), directing HHS to review and consider whether to rescind approvals of harmful Medicaid programs that cut off access to care, setting in motion the process for relevant agencies to start rolling back harmful policies like the Trump administration’s birth control rules and more. They recently reaffirmed their commitment to protect patients’ right to choose the provider they know and trust by publicly opposing Texas Gov. Greg Abbott’s attempt to block Texas Medicaid patients from accessing care at Planned Parenthood health centers. They have also taken steps toward rescinding discriminatory Medicaid work requirements that have caused thousands to lose health coverage and make it harder for people to access the care they need.Chiquita Brooks-LaSure has a long history of working to expand access to health care as a policy expert and thought leader, and her work will be critical to advancing this mission. She has spent more than two decades honing her health policy expertise and has previously served the nation in the White House, in Congress, and at CMS. Planned Parenthood Federation of America is ready to work with Brooks-LaSure and the entire Biden-Harris team — in the days, weeks, and years ahead — to advance the health and rights of all communities…Planned Parenthood February 21, 2021: American Medical Association posted a Statement titled: “AMA, AHA, ANA urge continued vigilance as U.S. exceeds 500,000 COVID-19 deaths”. From the Statement: The following statement is attributable to: American Medical Association, American Hospital Association, American Nurses Association. “Today’s milestone is a grim one – but one we, as leaders in health care, urge you to recognize. In three months, the number of Americans who have died of COVID-19 has doubled. We mourn the loss of 500,000 people in this country, a toll that has left gaping holes in the lives of those they left behind. We also recognize the significant declines in life expectancy (PDF) our country has experienced, largely as a result of the pandemic. We urge you to remain vigilant in taking precautions to limit the spread of COVID-19. With new, more contagious variants of the virus circulating throughout the U.S., now is not the time ti let your guard down and scale back on the measures that we know will work to prevent further illnesses and death – wearing masks, practicing physical distancing, and washing hands.“Though we’re face-to-face with the grim toll that COVID-19 is taking on our lives and loved ones, there’s also hope for the future as millions of people across the country are getting vaccinated and additional vaccines are on the way. We encourage everyone to get the COVID-19 vaccine when it’s your turn. Vaccines are safe, effective, prevent illnesses and safe lives, and are key to protecting you from COVID-19 and ending the pandemic.”AMA February 22, 2021: American Medical Association posted a Press Release titled: “Joint statement on Supreme Court decision to review Title X ‘gag rule'”. From the Press Release: Joint statement from: American Medical Association, Planned Parenthood Federation of America, National Family Planning & Reproductive Health Association, American Civil Liberties Union, Essential Access Health “We welcome the U.S. Supreme Court’s decision to review the Ninth Circuit’s erroneous opinion upholding a Trump administration rule that imposed drastic changes on the Title X federal family planning program. This rule continues to bring immense harm to people across the country who depend on affordable reproductive health care like birth control, breast and cervical cancer screenings, and STI testing and treatment, among other essential health services that Title X provides. Tragically, but predictably, this disproportionately impacts Black and Brown patients who are more likely to face the worst health and economic impacts from the COVID-19 pandemic.“In a petition, to the high court last fall, we urged a review of the Title X ‘gag rule,’ which, among many harmful restrictions, inappropriately interferes with the patient-physician relationship and conflicts with the ethical obligations of physicians and other health care providers—ultimately jeopardizing patient access to safe care.“Title X has an essential role in ensuring that all Americans—regardless of where they live or how much money they make—have access to comprehensive reproductive health care. We remain committed to securing a swift outcome, whether from the Court or the Biden administration, that will protect Title X patients, physicians, providers, and the health of the nation from further irreparable harm imposed by the current rule.”AMA February 22, 2021: Centers for Medicare & Medicaid Services posted a Press Release titled: “CMS Offers Comprehensive Support to the State of Texas to Combat Winter Storm”. From the Press Release: The Centers for Medicare & Medicaid Services (CMS) announced today that efforts are underway to support Texas in response to severe winter storms that have affected the state over the past several days. On February 17, 2021, Health and Human Services Acting Secretary Norris Cochran declared a public health emergency (PHE) for Texas retroactive to February 11, 2021. CMS is working to ensure hospitals and other facilities can continue operations and provide access to care despite the effects of the storm. Below are key administrative actions CMS is taking in response to the PHE declared in Texas:Waivers and Flexibilities for Hospitals and other Healthcare Facilities: CMS has already waived many Medicare, Medicaid and CHIP requirements for facilities because of the pandemic. The CMS Dallas Survey & Enforcement Division, under the Survey Operations Group, will consider other provider-specific requests for healthcare facilities in Texas.These waivers work to provide continued access to care for beneficiaries. CMS announced last month a new web-based tool that streamlines access for providers in documenting and submitting waiver requests and PHE-related inquiries. Access to that web-based tool can be found at https://cmsqualitysupport.servicenowservices.com/cms_1135Dialysis Care: CMS is helping patients obtain access to critical life-saving services. The Kidney Community Emergency Response (KCER) program has been activated and is working with the End Stage Renal Disease (ESRD) Network: Network 14 –Texas to assess the status of dialysis facilities in potentially impacted areas. The program will assess issues such as generators, alternate water supplies, education and materials for patients, and more. Patients are educated to have an emergency supply kit on hand including important personal, medical, and insurance information; contact information for their facility, the ESRD NW hotline number, and contact information of those with whom they may stay or for out-of-state contacts in a waterproof bag. They have also been instructed to have on hand supplies to follow a three-day emergency diet……Ensuring Access to Care in Medicare Advantage and Part D: During a PHE, Medicare Advantage Organizations must take steps to maintain access to covered benefits for beneficiaries in affected areas. These steps include allowing Parts A and B and supplemental Part C plan benefits to be furnished at specified non-contracted facilities and waiving, in full, requirements for gatekeeper referrals where applicable. Part D plan sponsors are allowed to take certain actions to ensure pharmacy access during a disaster or state of emergency.Special Enrollment Opportunities: CMS encourages people who are seeking health insurance coverage to take advantage of the Federal Health Insurance Exchange special enrollment period currently available now through May 15 on HealthCare.gov…Additionally, individuals who were eligible for another special enrollment period during the Federal Emergency Management Agency (FEMA)-declared emergency period may also qualify for another SEP to gain coverage based on when their coverage could have started if they had been able to enroll sooner……Medicare regulations provide a special enrollment period for certain Medicare beneficiaries who reside in the area where an emergency/disaster declaration has been made (or rely on help making health care decisions from someone who lives in the affected area). Medicare beneficiaries who were eligible for another enrollment period, but did not make an election as a result of the emergency, will be able to make the missed enrollment election during the declared emergency/disaster or up to two months after the end of the emergency/disaster.Medical equipment and supplies replacements: Under the COVID-19 waivers, CMS suspended certain requirements necessary for Medicare beneficiaries who have lost or had damage to their durable medical equipment, prosthetics, orthotics and supplies because of the PHE. This will help to make sure that beneficiaries can continue to access the medical equipment and supplies they rely on each day. Medicare beneficiaries can contact 1-800-MEDICARE (1-800-633-4227) for assistance.Current COVID-19 Waivers: CMS has compiled a list of current Waivers already available for health care providers to use during the COVID-19 PHE. These waivers remain available to providers in the State of Texas who have been affected by the consequences of the winter storm. The New 1135 Emergency Waiver and Public Health Emergency (PHE)-related Inquiries Web Tool launched on the CMS Waiver and Flexibilities webpage: https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waiversDisaster Preparedness Toolkit for State Medicaid and CHIP Agencies: CMS developed an inventory of Medicaid and CHIP flexibilities and authorities available to states in the event of a disaster. CMS will provide technical assistance to the state upon request in accessing any needed flexibilities. The Toolkit also includes resources for Medicaid beneficiaries to assist them connect to helpful resources during the emergency. Nursing home reporting to the National Healthcare Safety Network (NHSN): CMS expects that nursing home providers will continue to accurately report COVID-19 cases to the NHSN. However, in light of the public health emergency in Texas, CMS will not impose civil money penalties for non-reporting through March 4, 2021, as residents continue to be displaced amid power and water concerns. Any facility that requires extended repairs or arrangements should contact its State Survey Agency to ensure proper coordination with CMS.3-Day Prior Hospitalization: Using the authority under Section 1812(f) of the Act, CMS is issuing a separate waiver of the statutory requirement for a 3-day prior inpatient hospitalization for coverage of a Skilled Nursing Facilities (SNF) Part A stay, which provides temporary emergency coverage of SNF services without a qualifying inpatient hospital stay, for those people who experience dislocations, or are otherwise affected by the public health emergency.Emergency Preparedness Requirements: Providers and suppliers are expected to have emergency preparedness programs based on an all-hazards approach. CMS has prepared webinars on emergency preparedness requirements, including topics such as emergency power supply; 1135 waiver process; Best Practices & Lessons Learned from past disasters; Helpful Resources; and more…CMS February 22, 2021: Speaker of the House Nancy Pelosi posted a Press Release titled: “Pelosi Statement on Biden Executive Actions on Relief for Small Businesses”. From the Press Release: Washington, D.C. – Speaker Nancy Pelosi issued this statement on executive actions taken by the Biden-Harris Administration to increase equitable assistance for small businesses:“Today, President Biden has extended a lifeline that will make a difference for struggling small businesses, save American jobs and power the American economy, while promoting equity and fairness across Main Street.“These vital reforms will expand access to the Paycheck Protection Program to the hardest-hit businesses that anchor our low and middle-income and communities of color. Importantly, they will ensure that sole proprietors, which are overwhelmingly women and minority-owned and also serve our immigrant communities, are not left behind. The Biden Administration’s reforms will also build on recent PPP successes in increasing assistance to businesses with ten or fewer employees in underserved and rural areas and through community-based lenders that specialize in serving those markets.“As President Biden advances these actions, the House is preparing this week to pass the President’s American Rescue Plan: transformative legislation to crush the virus and deliver urgently needed relief. We urge Republicans in Congress to join us in support of this necessary relief package for families and small businesses in their communities and throughout the country.”Speaker of the House Nancy Pelosi February 22, 2021: Speaker of the House Nancy Pelosi posted a Press Release titled: “Pelosi Statement on 500,000 American Coronavirus Deaths”. From the Press Release: Speaker Nancy Pelosi issued this statement after our nation passed the tragic milestone of having lost half a million American lives to the coronavirus:“The loss of 500,000 American lives from the coronavirus is an horrific human toll of staggering proportions and incomprehensible sadness. Every life lost is a profound tragedy that we mourn and that breaks America’s heart.“Members of Congress join Americans in prayer for the lives lost or devastated by this vicious virus. As we pray, we must act swiftly to put an end to this pandemic and to stem the suffering felt by so many millions. “With the passage of President Biden’s American Rescue Plan this week, the American people will know that Help Is On The Way.”Speaker of the House Nancy Pelosi February 23, 2021: National Organization for Women posted a Press Release titled: “Pass the Equality Act NOW”. From the Press Release: This week’s anticipated vote on the Equality Act brings the federal government one step closer to codifying something that an overwhelming majority of Americans believe is long overdue. Discrimination against LGBTQIA+ people in employment, housing, credit, education, public spaces and services, federally funded programs and jury service must be against the law. Until all of us are equal, none of us are equal. From Secretary of Transportation Pete Buttigieg making history as the first openly gay Cabinet member to the nomination of Rachel Levine for assistant secretary of health, who if confirmed would become the first openly transgender federal official – this administration is demonstrating the value of the LGBTQIA+ community by placing them in some of the highest roles in government. It’s time for Congress to step up to the plate by passing the Equality Act. Polls show support for the Equality Act at more than 70 percent, but after passing the House in 2019, it stalled in the Republican-controlled Senate. Now, with Democrats in the majority, and the tie-breaking vote cast by Kamala Harris, who co-sponsored the bill for years, we expect a different outcome. The Equality Act will fix a broken patchwork of current laws that haphazardly protects some people from some discrimination in some places—leaving millions of LGBTQIA+ people without protection, essential services, and access to justice.In 29 states, Americans can still be evicted from their homes, denied service in a restaurant or a wedding cake in a bakery, or be turned down for a loan because of their gender identity. And a future administration could refuse to apply existing civil rights law to the wide range of areas where discrimination occurs, including education, housing, and health care. NOW calls on Republicans to join House Democrats in voting for the Equality Act, and for a similar bipartisan majority to rise up in the Senate. We must repair the flaw in our legal system that perpetuates discrimination on the basis of sex, sexual orientation, and gender identity. Pass the Equality Act—NOW.NOW February 24, 2021: The White House posted a FACT SHEET titled: “FACT SHEET: President Biden Announces New Actions to Deliver Masks to Communities Hit Hard by the Pandemic“. From the FACT SHEET: As part of his National Strategy to defeat COVID-19, President Biden announced a new effort to make masks more easily available to communities hard hit by the pandemic. The Administration will deliver more than 25 million masks to over 1,300 Community Health Centers across the country as well as 60,000 food pantries and soup kitchens, reaching some of the nation’s most vulnerable populations. The Centers for Disease Control and Prevention (CDC) recommends mask wearing as a critical step to help slow the spread and protect people from getting COVID-19, but many low-income Americans still lack access to this basic protection.Today, President Biden is announcing that, over the next few weeks, the Biden-Harris Administration will:Deliver masks to community health centers. The Department of Health and Human Services (HHS), in partnership with the Department of Defense (DoD), will deliver millions of masks to Federally Qualified Community Health Centers across the country. These approximately 1,300 health centers will be eligible to receive high-quality masks for free. Two-thirds of the people served by Community Health Centers are living in poverty, 60% are racial and/or ethnic minorities, and nearly 1.4 million are unhoused. Anyone in the community will be eligible to pick up masks from their local Community Health Center. Recipients will be encouraged to take an individually wrapped package of two masks for each person in their household. The staff of the Community Health Centers will distribute the masks to recipients.Distribute masks through the nation’s food bank and food pantry system. The Department of Defense (DOD), working with the Department of Agriculture (USDA), will deliver masks to many of the nation’s roughly 300 food banks. These food banks reach a vast network of 60,000 food pantries, soup kitchens, and other food distribution points where masks will be distributed to individuals and families. Recipients will be encouraged to take an individually wrapped package of two masks for each person in their household.About the masks:These masks will be no cost, high-quality, washable, and consistent with the mask guidance from the CDC. All of these masks will be made in America, and will not impact availability of masks for health care workers.The masks will be available beginning in March and into May. As a result of these actions, an estimated 12 to 15 million Americans will receive masks. More than 25 million masks total will be distributed.White House February 24, 2021: A “Press Briefing by White House COVID-19 Response Team and Public Health Officials” was posted on the White House website. From the Press Briefing: MR. ZIENTZ: Thank you for joining us. I want to begin by acknowledging that we have passed a grim milestone in this pandemic: Half a million people dead from COVID-19. This pandemic has touched each of us. So many have lost loved ones. We’ve been separated from our friends and families. Too many of our businesses and schools have been closed for way too long. President Biden is clear: We are at war with this virus, and we’re using every resource at our disposal to defeat it. We’re keeping equity at the front and center of our response, partnering with states, tribes, and territories to increase vaccinations in the hardest-hit and hardest-to-reach communities – increasing supply to convenient and trusted locations, like community health centers; deploying mobile units to meet people where they are; and improving data collection so that we have a better understanding of the inequalities currently experienced. Today we’re announcing action we’re taking ti ensure an equitable response. In the month of March, we will begin to deliver masks to food banks and community health centers around the country. These are nationwide networks that serve populations hit hard by the pandemic. While masks are widely available in many different shapes and sizes, many low-income Americans still lack affordable access to this basic protection. That’s why we’re taking this important action to keep Americans safe. We will deliver more than 25 million masks across the country. These masks will be available at more than 1,300 community health centers and at 60,000 food pantries nationwide. Any American who needs a mask will be able to walk into these health centers or food pantries and pick up high-quality, American-made masks. These masks will be available at no cost. They’ll be well-fitting cloth masks available in children’s and adult sizes, and they can be washed for reuse — all consistent with CDC guidance, and all made in the USA. Once again, our decisions here have been made with equity at the center. Not all Americans are wearing masks regularly. Not all Americans have access. And not all masks are equal. With this action, we are helping to level the playing field, giving vulnerable populations quality, well-fitting masks.When President Biden delivered his inaugural address, he made a very clear request to the country: Mask up. And he’s taken action to require masks in federal buildings, on federal lands, and on public transportation, like planes, trains, and buses.The action we’re announcing today is a targeted step to help Americans respond to the President’s challenge to mask up to protect themselves and their fellow Americans.As we encourage people to continue to mask up, we’re focused on vaccinating people quickly and equitably. Today, I will give you the latest update on our execution on vaccinations in the three key areas that we’re focused on: more vaccine supply, more vaccinators, and more places to get vaccinated.First, on vaccine supply: Yesterday, we announced the fifth consecutive week of supply increases to states, tribes, and territories, from 8.6 million doses when we took office to 14.5 million doses this week. That’s an increase in vaccine allocations to states of nearly 70 percent during the Biden-Harris administration.The Retail Pharmacy Program we launched a few weeks ago has performed well so far. And this week, we will increase the allocation to pharmacies to 2.1 million doses. So, with 14.5 million doses allocated to states, tribes, and territories and 2.1 million through the federal Retail Pharmacy Program, we’ve nearly doubled weekly supply of doses in just five weeks.Second, we’re mobilizing teams to get shots in arms. We’ve deployed over 800 federal personnel as vaccinators. And the federal government is now funding 1,200 National Guard members to serve as vaccinators. We’ve also deployed 1,000 federal personnel to support community vaccination sites in operational and support roles.Third, we continue creating more places where Americans can get vaccinated. We’ve now expanded financial support to bolster community vaccination centers nationwide, with over $3.6 billion in FEMA funding to 44 states, tribes, and territories for vaccination efforts. We’re bringing vaccinations to places communities know and trust: community centers, high school gyms, churches, and stadiums nationwide.And we continue to work with states to set up innovative, high-volume, federally run sites that can each give over 30,000 shots a week. These sites are up and running in California and are ramping up in Texas, Florida, and Pennsylvania.We’ve also launched federal programs to get vaccines to pharmacies and local community health centers. As we’ve always said, we’re committed to providing clarity on our progress, and that includes when we hit bumps in the road.Last week, we got hit with the very severe weather, which impacted the vaccination supply chain — from manufacturing, to shipping, to the ability to get shots in arms. The manufacturers, the shipping firms, the states, the tribes, the territories, and pharmacies worked to overcome these challenges.And despite all the temporary weather-related delays, our seven-day average daily doses administered is at 1.4 million. And we’ve already caught up on the weather-related shipping backlog.Teams worked throughout last weekend to pack and ship doses. On Monday, yesterday, 7 million doses — two days ago — 7 million doses were delivered. That, coupled with the 14.5 million doses allocated this week, results in record supply going to the states. We’ve encouraged states to get needles into arms by extending vaccine clinic hours, offering services 24 hours a day where possible, adding weekend appointments, and having more staff on hand.On this point, I want to stress that if states do not have the staff to work around the clock and on the weekends, the federal government stands ready to help. I also want to spend a couple minutes on our plans for the Johnson & Johnson vaccine, which is currently pending approval for emergency use authorization by the FDA. Yesterday, I again updated and reviewed with our nation’s governors our plans to distribute the Johnson & Johnson vaccine if the EUA is granted. The governors are carefully planning their efforts and getting ready for the possible new vaccine. If authorized, we are ready to roll out this vaccine without delay. Our distribution approach will mirror the current allocations process across jurisdictions, pharmacies, and community health centers.If an EUA is issued, we anticipate allocating 3 to 4 million doses of Johnson & Johnson vaccine next week. Johnson & Johnson has announced it aims to deliver a total of 20 million doses by the end of March. We’re working with the company to accelerate the pace and timeframe by which they deliver the full 100 million doses, which is required by contract by the end of June.While we await the FDA’s decision, we want the American people to know that we’re doing the work so that if the EUA is granted, we will waste no time getting this lifesaving vaccine into the arms of Americans.With that, let me turn it over to Dr. Walensky to talk about the state of the pandemic.Dr. Walensky.DR. WALENSKY: Thank you, Jeff. I’m again delighted to be with you today. We continue to see trends heading in the right direction. In the past week, average daily cases declined 25 percent to approximately 64,000 cases per day. This is slightly less than the summer peak of 67,000 daily cases reported last July. While this is good news, cases still remain high, and we continue to watch these data closely. We also see continued declines in new hospital admissions for the most recent week. An average of 6,500 patients with COVID-19 were admitted per day, a decrease of 16 percent from the week prior. The number of reported deaths is also dropping with a seven-day average of slightly less than 2,000 per day. This represents a 35 percent decline compared to the prior week.On Monday, I announced that we were kicking off our three-day National COVID-19 Vaccine Forum, and since that time, we’ve had an extraordinary few days.Our final tally — we’ve virtually assembled over 12,000 participants from across the United States, representing state, tribe, local, and territorial governments, private sector partners, medical and public health institutions, community-based organizations, faith-based groups, and educators, among others.The discussions and presentations from over 100 speakers showcased promising practices and critical scientific information for those involved in vaccination efforts in communities across the nation. I’d like to share a few examples of what we’ve learned over the last three days. First, trust and community confidence are cornerstones of our national vaccine efforts. Trusted voices are critical to building confidence in vaccines and addressing misinformation. Our community leaders are often those trusted voices. We heard from national, state, and local health leaders about communication and public education campaigns they are deploying to combat myths and disinformation, and instill confidence and interest in COVID-19 vaccines, as well as tools and strategies healthcare providers can use when talking with their patients about COVID-19 vaccination. For example, we learned about a new communications campaign in New Orleans that is grounded in the local flavor and culture as a way to resonate with the city’s residents.Second, one of the most powerful benefits of the forum was learning about on-the-ground experiences and new innovations to expand vaccination efforts. We heard about creative ways providers and volunteers have been getting vaccinations into communities using boats, ferries, and snowmobiles in Alaska; leveraging emergency medical services to provide vaccinations to homebound individuals in Indiana; and using awareness campaigns, featuring trusted elders and healthcare workers, in the Cherokee Nation of Oklahoma.Finally, forum sessions taught us that every person, community, faith-based organization, governmental and non-governmental partner, and business has a role to stop — to play in supporting our nation’s COVID-19 vaccination strategy.We learned about faith-based efforts, like the outreach to people of color being led by the Metropolitan International Church in Nashville, Tennessee, where faith ambassadors engage with local clergy to help spread accurate information on COVID-19 vaccines to these high-risk communities.We also heard about successful public-private partnerships, like in San Diego, where vaccination “super sites,” like the one in Petco Park Stadium, are vaccinating thousands of people a day; and in Colorado, where there is a government-private partnership — the Champions for Vaccine Equity task force — where the health department and 10 medical Champions of color are working with and through community-based organizations to create opportunities for listening and sharing information about COVID-19 vaccines.These are just a few of many practical innovations and solutions shared during the forum. And I want to let you know that all of these sessions, as well as resources and materials, will be posted on the CDC website following the forum. I encourage you to check it out when you’re able.Next, I would like to take a moment to highlight the progress made so far in our efforts to rapidly expand and open sequencing nationally, including through our $200 million investment announced last week. This work is more important than ever, given the continued spread of COVID-19 variants in the United States. As of February 23rd, we now have identified nearly 1,900 cases of B117 variant in 45 states, 46 cases of B1351 variant in 14 states, and 5 cases of the P1 variant in four states.The pace of our genomic sequencing has scaled up from about 400 samples a week, when I started as CDC Director, to now more than 9,000 samples as of the week of February 20th. We are continuing to increase this pace with our state public health and private lab partners with a goal of 25,000 samples per week in the coming weeks. The increased volume of sequence information is helping us to better understand the diversity of variants circulating in the United States, where they are located, and how they are spread. With the samples in hand, we can then scientifically examine how variants impact vaccines and therapeutics moving forward.Finally, I want to say that we are proud to be partners in the announcement made today about sending masks to underserved and vulnerable populations. One of the most impactful things we can do is wear a mask, and this is so important during this critical period where cases are declining but variants that spread more easily are increasing throughout our country.CDC continues to recommend that everyone two years of age or older wear a mask when in public and around others in the home not living with you. The mask you should wear should have two or more layers, completely cover your nose and mouth, and fit snugly against your nose and the sides of your face. It’s essential that you wear your mask correctly and that it fits well in order to get the most protection. By wearing masks in combination with social distancing, washing your hands, avoiding crowds and travel, and getting vaccinated when it’s available, we can bring an end to this pandemic.Thank you. I, of course, look forward to your questions, but I’ll first turn things over to Dr. Fauci.Dr. Fauci.DR. FAUCI: Thank you very much, Dr. Walensky. What I’d like to do over the next couple of minutes is just update you on an important component of the spectrum of COVID-19 disease. If I can have the first slide.Many of you are now aware of what had long been called “long COVID.” But actually, what that really is is post-acute sequelae of SARS-CoV-2 infection, which we’re now referring to as “PASC,” or P-A-S-C. The reason I’m bringing it up with you today will become apparent in just a minute or two. Just to refresh your memory, the symptoms of this include fatigue, shortness of breath, sleep disorders, fevers, GI symptoms, anxiety and depression, and what some have been referring to as brain fog, or an inability or a difficulty in concentrating or focusing. Remember, these are post-acute sequelae — after the virus essentially has been cleared from the body. And actually, new symptoms sometimes arise well after the time of infection, or they evolve over time and they may persist, as I’ll get to in a moment, for months and can range from mild annoying to actually quite incapacitating. The magnitude of the problem is not yet fully known.Next.There have been a number of papers that have described in some detail large cohorts. Here is one from China, which was published online on January 8th, in more than 1,700 patients who actually had been hospitalized. I point out that you can get this post-acute syndrome even in individuals who did not require hospitalization. The six-month follow-up showed a variety of signs and symptoms, shown here, with many having fatigue and weakness — as I mentioned on the prior slide — sleep difficulties, anxiety or depression. And the greater proportion of patients with more severe illness had impaired lung diffusion capacity. Next.Most recently, in a study from the University of Washington that appeared just a few days ago, it was found really now something alarming: that approximately 30 percent of the patients who are enrolled at the University of Washington reported persistent symptoms for as long as nine months after illness. Fatigue was the most common reported symptom, and persistent symptoms were reported by one third of outpatients with mild disease. Next slide. What we did — “we” being an interagency group: the NIH, the CDC, and others — put together a workshop in Rockville, just a little bit north of Washington, D.C., on December the 3rd and the 4th of last year, in which we looked at various organ systems and brought in experts in all of these areas — cardiovascular, pulmonary, renal, neurologic, immunologic, and pediatrics — to scope out the kinds of things that we would need to be looking at with this puzzling syndrome. Now, the reason I’m bringing it up at this press conference — next slide — is that just yesterday, on February the 23rd, the NIH launched a new initiative to study this PASC, or post-acute sequelae. Now, looking back a bit in December of last year, the Congress provided $1.15 billion in funding over four years for the NIH to support research looking into this. And I’m happy to say that yesterday there was the first in what will be a series of research opportunity announcements released for NIH initiative on this puzzling syndrome. The research studies will be looking at SARS-CoV-2 recovery cohorts, some that are already established and some that will be established. They’ll be looking at large data banks from resources, such as electronic health records and health symptoms. And they’ll be studying a number of biological specimens.And finally, on the last slide, there are selected questions that this initiative hopes to answer, and they are important: What does the spectrum of recovery from this infection look like across all the entire population — young individuals, middle-aged, elderly? How many people continue to have symptoms of COVID-19 or even, as we’ve seen, develop new symptoms that they did not have even as part of their acute infection? Importantly, what is the underlying biological cause of these prolonged symptoms? We refer to that as pathogenesis. What makes certain people vulnerable, while others recover fully and quickly and have no sequelae? And finally, does SARS-CoV-2 infection trigger changes in the body that actually increase the risk, later on, of such abnormalities, such as chronic heart or brain disorders? A lot of important questions that are now unanswered that we hope, with this series of initiatives, we will ultimately answer. So I’ll stop there and hand it back to Jeff. MR. ZIENTS: Well, thank you, Doctors Fauci and Walensky. Why don’t — why don’t we open it up for questions… February 24, 2021: President Joseph R. Biden Jr. posted a Notice titled: “Notice on the Continuation of the National Emergency Concerning the Coronavirus Disease 2019 (COVID-19) Pandemic“. From the Notice: CONTINUATION OF THE NATIONAL EMERGENCY CONCERNING THE CORONAVIRUS DISEASE 2019 (COVID-19) PANDEMICOn March 13, 2020, by Proclamation 9994, the President declared a national emergency concerning the coronavirus disease 2019 (COVID-19) pandemic. The COVID-19 pandemic continues to cause significant risk to the public health and safety of the Nation.For this reason, the national emergency declared on March 13, 2020, and beginning March 1, 2020, must continue in effect beyond March 1, 2021. Therefore, in accordance with section 202(d) of the National Emergencies Act (50 U.S.C. 1622(d)), I am continuing the national emergency declared in Proclamation 9994 concerning the COVID-19 pandemic.This notice shall be published in the Federal Register and transmitted to the Congress.President Joseph R. Biden Jr. February 24, 2021: President Joseph R. Biden Jr. posted an Executive Order titled: “Executive Order on the Revocation of Certain Presidential Actions“. From the Executive Order: By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows: Section 1. Revocation of Presidential Actions. The following Presidential actions are revoked: Executive Order 13772 of February 3, 2017 (Core Principles for Regulating the United States Financial System), Executive Order 13828 of April 10, 2018 (Reducing Poverty in America by Promoting Opportunity and Economic Mobility), Memorandum of January 29, 2020 (Delegation of Certain Authority Under the Federal Service Labor-Management Relations Statute), Executive Order 13924 of May 19, 2020 (Regulatory Relief To Support Economic Recovery), Memorandum of September 2, 2020 (Reviewing Funding to State and Local Government Recipients of Federal Funds That Are Permitting Anarchy, Violence, and Destruction in American Cities), Executive Order 13967 of December 18, 2020 (Promoting Beautiful Federal Civic Architecture), and Executive Order 13979 of January 18, 2021 (Ensuring Democratic Accountability in Agency Rulemaking)… Here is some context about why one of those Presidential Actions was revoked: Executive Order 13828 “Reducing Poverty in America by Promoting Opportunity and Economic Mobility” was issued by (then) President Trump on April 10, 2018. On April 11, 2021, CBS News posted an article titled: “Trump signs executive order pushing work requirements for welfare recipients”. From the article: President Donald Trump signed an executive order Tuesday that aims to add and strengthen work requirements for public assistance and other welfare programs.The order, signed in private, promotes “common-sense reforms” that policy adviser Andrew Bremberg said would reduce dependence on government programs……The order focuses on looking for ways to strengthen existing work requirements and exploring new requirements for benefits such as food stamps, cash and housing assistance programs.…Most people who use the Supplemental Nutrition Assistance Program, or SNAP, who are able to hold jobs do work, but they don’t earn enough to pay for food and cover other expenses. According to 2015 data from the Department of Agriculture, 44 percent of the total households using the SNAP program had someone in the family earning money……In January, officials announced that states would be able to impose work requirements for Medicaid. And they’ve proposed tightening the existing requirements that able-bodied adults who want to receive SNAP benefits for more than three months at a time must work in some capacity……The administration has also been exploring more stringent work requirements for those who receive assistance under the Temporary Assistance for Needy Families program, as well as minimum weekly work hours for those who receive housing assistance……Such requirements could have dire consequences for those already experiencing barriers to finding, and keeping, a job, including single mothers who can’t afford child care, people who lack access to transportation and those who suffer from mental illness…CBS News February 25, 2021: Speaker of the House Nancy Pelosi posted a Press Release titled: “Floor Speech on the Equality Act”. From the Speech: Speaker Nancy Pelosi delivered remarks on the Floor of the House of Representatives in support of H.R. 5, the Equality Act, which will extend federal anti-discrimination protections for sexual orientation and gender identity. Below are the Speaker’s remarks: …Mr. Speaker, I rise to join our entire Caucus in saluting Congressman David Cicilline, our long-time champion of the Equality Act, who has been courageous, relentless and persistent in his leadership on this legislation. We are proud to bring this important legislation to the House Floor under the leadership of the most diverse House Democratic Majority, nearly 70 percent women, people of color, and LGBTQ, with 224 co-sponsors on this legislation. Mr. Speaker, many of use were gathered together nearly five years ago to first introduce the Equality Act. That day in the LBJ Room on the Senate side, named after the President who fought for and signed the Civil Rights Act, we stood with an icon of the civil rights struggle, our colleague, John Lewis, the Conscience of the Congress. The Civil Rights Act is a sacred pillar of freedom in our country. It is not amended lightly. So, how proud were we to be with our beloved John Lewis and the Congressional Black Caucus, many of whom are here now, Maxine Waters, and others, Mr. Green, thank you, as they gave their imprimature to the opening of the Civil Rights Act to end discrimination against LGBTQ Americans. As we remember John Lewis’s life, we remember his words, spoken at the Pride parade in Atlanta shortly before being diagnosed with cancer. He said, “We are one people and one family. We all live in the same house.” As we prepare to pass this landmark legislation, we must salute the countless advocates, activists, outside organizers and mobilizers who have, for decades, demanded the full rights of all Americans. Personally, my thoughts are with my friends, the late Phyllis Lyon and Del Martin, who shared their lives together for decades. I have spoken of them with their photo here on the Floor year in and year out. They were mentors of so many of us in San Francisco who for decades were engaged in civic engagement on many issues related to LGBTQ rights. They were an inspiration, teaching us to take pride, and I say that with pride. When people say to me, ‘It’s easy for you to support LGBTQ equality because you’re from San Francisco where people are so tolerant’ Tolerant, to mean, that’s a condescending word. This is not about tolerance. This is about respect. This is about taking pride. For Phyllis and Del and the older LGBTQ couples, for the LGBTQ workers striving to provide for their families, and for LGBTQ youth struggling to find their place, this is a historic, transformative moment of pride. Here in the House, this pride goes – this pride goes back many years. When we first got the Majority in 2006 and 2007, as we took office, House Democrats had four goals relating to equality. Passing a comprehensive hate crimes bill, and when I say comprehensive, I mean LGBTQ T. People said to us at the time ‘Take out the “T” and you can pass this bill in a minute.’ I said take – ‘if we take out the “T” we are not going to pass this bill in 100 years, because we are not bringing it up without the word transgender in the bill.’ We passed the bill with the help of – the lead of Barney Frank, our former colleague, and the family of Matthew Shepard, who came here, touched our hearts, got the votes to help us pass the legislation. Then, we had ‘Don’t Ask, Don’t Tell” and under the leadership of President Obama and the courage of so many Members, Patrick Murphy, our former colleague, an Iraq combat vet leading the way here, we repealed “Don’t Ask, Don’t Tell”. Thank you, President Obama. Securing marriage equality was done for us by the courts. I took great pride in attending the oral arguments that day when it was argued in the courts and what a victory it was for libery and justice in our country when that decision came down. Next on the agenda was somethign called ENDA, ending discrimination in the workplace. Well, it’s really called the Employment Non-Discrimination Act, hence ENDA. But then, with the successed that we had, it was why are we just talking about the workplace? Why aren’t we talking about every place in our society? And hence came forth – ENDA became the Equality Act, finally, fully ending anti-LGBTQ discrimination on employment, education, housing, credit, jury service and public accomodations. It removes all doubt that sexual orientation and gender identity warrant civil rights protection in every arena of American life, codifying the recent decision made by the U.S. Supreme Court Bostock case. It takes a momentous step towards full equality that brings our nation closer to the founding promise of liberty and justice for all, enshrined in the Preamble of our Constitution by our Founders in their great wisdom, also in our pledge to the flag. And it is sadly necessary. I wish that it weren’t. Sometimes I just wonder why it is, but it is sadly necessary because many members of the national LGBTQ community we live in states where, though they have a right to marry, they have no state-level non-discrimination protections in other areas of life. In more than 20 states, Mr. Speaker, LGBTQ Americans do not have specific protections against being denied housing because of their sexual orientation or gender identity, and over 30 states lack protections regarding access to education. And nearly 40 states lack protections regarding jury service. Passing the Equality Act in the last Congress was historic, a day for hope and happiness for millions. Now, with a Democratic Senate Majority and President Biden in the White House and Vice President Harris there as well, we will oass it once more and we will not stop fighting until it becomes a law. We will never stop fighting until the Equality Act becomes law. Let me conclude by returning to John Lewis and recalling his words spoken on this House Floor on the passage of the Equality Act for the first time. John Lewis said, “We have a decision to end discrimination and set all of our people free,’ and set all of our people free. today with this legislation, we have an opportunity to set all of our people free and to advance the future of justice, equality and dignity for all. With that, I urge a strong bipartisan vote for the Equality Act, salute Mr. Cicilline and Senator Merkley on the Senate side for their leadership, commend the distinguished Chair of the Judiciary Committee for, once again, bringing this to the Floor. Thank you, Congresswoman for your leadership on this issue as well… Speaker of the House Nancy Pelosi February 25, 2021: Planned Parenthood posted a Press Release titled: “U.S. House Approves Historic Legislation to Halt LGBTQ+ Discrimination”. From the Press Release: Today, the U.S. House of Representatives voted 224-206 to approve the historic Equity Act (H.R.5). As an inclusive and compassionate sexual and reproductive health care provider, Planned Parenthood applauds this historic legislation to protect and strengthen the civil rights of LGBTQ+ people across the country.Currently, our federal civil rights do not explicitly protect LGBTQ+ people in the United States, leaving people vulnerable to discrimination in health care, employment, housing, credit, public spaces and services, education, federally assisted programs, and jury service. In 30 states, LGBTQ+ people can be fired, refused housing, or denied services simply because of who they are. The Equality Act – which was introduced by Rep. David Cicilline (D-RI) and passed today with bipartisan support – can begin to change that……The Equality Act will prohibit discrimination on the basis of sex, sexual orientation, gender identity, sex stereotypes, pregnancy and childbirth across many systems, including health care. People do not live single issue lives and the Equality Act recognizes that a single instance of discrimination may have more than one basis. By expanding some of our civil rights laws to include protection on the basis of sex for the first time and including additional public spaces and services where discrimination is prohibited, all people will be better protected from the myriad and insidious forms of sex discrimination.Planned Parenthood is proud to provide health care to LGBTQ+ people across the country, including services such as breast and cervical cancer screenings, STI testing and treatment, birth control, and abortion. Planned Parenthood is an essential and irreplaceable provider of gender-affirming hormone therapy and health care for transgender and nonbinary patients, especially in areas outside of major cities, where Planned Parenthood health centers we are often the only provider of these services. Over 300 Planned Parenthood health centers in 39 states and the District of Columbia currently offer gender-affirming hormone therapy for transgender patients, and some also provide puberty blockers. Many health centers also offer pre-exposure prophylaxis (PrEP) a daily pill that can help reduce transmission for people who are at high risk for HIV – and post exposure prophylaxis (PEP) – a series of pills that, if taken within 72 hours of being exposed to HIV, can lower your chances of getting it.We know that LGBTQ+ people experience high rates of discrimination from medical providers: In a 2017 survey, nearly 30% of transgender people surveyed said a doctor or health care provider refused to treat them due to their gender identity. LGBTQ+ people also experience discrimination when interacting with police, applying for jobs, and more; LGBTQ+ people of color report discrimination at twice the rates of their white counterparts across these kinds of situations. The frequent harms experienced by LGBTQ+ people of color are compounded because they face multiple forms of discrimination at the same time.While the Biden-Harris administration must continue to undo the harm done by the previous administration – by rescinding the refusal of care rule, for example – the Equality Act will help us move forward by making clear that these kinds of attacks are not acceptable. Planned Parenthood February 26, 2021: White House posted a Press Briefing titled: “Press Briefing by White House COVID-19 Response Team and Public Health Officials“. From the Press Briefing: ACTING ADMINISTRATOR SLAVITT: Thank you for joining us for our White House COVID Response briefing. I have a few important updates for you this morning, and then I will turn to Doctors Fauci and Walensky. FIrst, on our efforts to mobilize the country to defeat COVID-19, and second, on our progress in supporting 100 community vaccination centers nationwide to vaccinate more people, more quickly, and more equitably. Before I get there, let me begin by taking stock of where we are. Even as we have crossed the grimmest of milestones – the loss of over 500,000 American lives – we are pulling together as a country. In the time since the President has taken office, we’ve now double the pace of vaccinations and are rapidly on our way to vaccinating many of the people most at risk of dying or being hospitalized from COVID-19, with nearly one in five adults and nearly half of Americans over 65 having received their first shot. What is important and what I want to cover today is that any progress is a result of the hard work of many – people and entities working together for the greater good: vaccine manufacturers, Pfizer and Moderna; distribution partners at McKesson, FedEx, and UPS; governors, mayors, county officials, and their health departments; the thousands of providers, pharmacies, and members of the military; FEMA; and other states and federal employees that had been part of this vaccination effort. And, of course, all the people in science in the NIH, NIAID, the CDC, BARDA, and FDA. This is all one effort. There is so much more to do, but one thing that has become clear is that while none of us on our own could defeat COVID-19, all of us working together can. And today I want to highlight what people across America can contribute to this cause at this critical time. From day one, President Biden has been pulling the country together to unify against the virus. This begins with Congress. We cannot defeat this virus as rapidly as we need to without action from Congress. Today, the House will start the vote process on the American Rescue Plan. This legislation will enable Americans across the country to defeat COVID-19 and get back to normal life more quickly. The bill is critical to allowing us to do some things that we all need to do to defeat this virus: needed funding to make schools safer to open; the ability to stay ahead of the virus as it mutates by funding greater sequencing; testing and tracing to contain outbreaks and stay ahead of new variants; addressing supply shortages; investing in high-quality treatments for people with COVID-19; providing paid sick leave and other support to contain the spread of the virus; and providing relief to the communities hardest hit by the disease. We urge the Senate to quickly follow and pass this legislation. Just as Congress is taking action, so too are the nation’s private and civil sectors and the small and large companies that are at the heart of our economy and provide jobs to so many. One of the benefits of being and providing honest and clear communication with the public about the challenges we face are all of the people who raise their hands and offer to help. Since the President’s first day on the job 37 days ago, he’s called us to come together and defeat this as a nation. Since January 20th, we have been engaging in literally hundreds of conversations with hundreds of companies who are eager to help put an end to COVID-19, get people safely back to work, rehire workers, and grow the economy, as the President outlined in his national strategy to defeat COVID-19. So today, the administration is announcing a new partnership with America’s leading business organizations to enlist the full force of the private sector to defeat COVID-19 with a call to action. The Biden administration is joining with the Chamber of Commerce; leaders of the black, Latino, and Asian business community; the National Association of Manufacturers; and the Business Roundtable to call on businesses, big and small, to promote three critical efforts across the country. Our call asks three things of America’s businesses to increase the safety of employees, customers, and the community, and will help us put a more rapid end to this pandemic. First, require masking and social distancing to protect workers, customers, and others on their premises. Second, reduce barriers to vaccinations. Make a plan to get employees vaccinated and make it easier for employees to get vaccinated by providing incentives, like paid time off or compensation for employees to get vaccinated when it’s their turn. Third, communicate with customers and educate the public about the benefits of masking and vaccinations. We are asking businesses to amplify CDC messages about masking and vaccinations on their products, properties, and websites. Through these partner organizations, step-by-step resources to help businesses operate safely will be available. HHS and CDC are collaborating with them so they can take advantage of our research and approaches to talking about vaccines and vaccinations most effectively. Together, we hope to reach hundreds of thousands of businesses, representing over 100 million people, to promote efforts to stop the spread of COVID-19. This afternoon at 4:00 p.m., I will be hosting a call with thousands of business owners to lay out this call to action and ask for their help and participation. But the work has already begun. Since we’ve arrived, we have had over 250 conversations with business leaders in sectors as diverse as technology, retail, social media, medical products, airlines, health insurance, hospitals, utilities, and we’re having more every day. Each of them has something valuable to add. Ford and The Gap are producing and donating millions of masks. Professional sports leagues and the live events industry have offered their more than 100 stadiums and venues to local communities to be used as vaccination sites. Retailers like Best Buy, Target, and Dollar General all are giving more than a half a million workers paid time off or compensating employees who get vaccinated. Uber, PayPal, and Walgreens are teaming up to provide $10 million worth of free rides to vaccination sites. And Lyft is partnering with CVS and the YMCA to provide 60 million free or discounted rides to vaccination sites. In both of these efforts, we are encouraging organizations to target the benefits to people who need them the most so communities hit hardest bounce back. CVS has also agreed to improved access and appointment times for people looking for vaccines and special efforts to reserve vaccine appointments. This is critical to health equity. The utility company, Avangrid, has committed to include more — to include public health information in more than 3 million paper bills. These are examples, but examples that others can replicate in addition to their own unique efforts. Our call to action today will ask companies to make similar, unique commitments that bring their unique skills and resources to the problem of keeping Americans safe and ending the pandemic as quickly as possible while also following the lead of these other companies. Over the coming weeks, the Biden administration will highlight more innovative ways, and America’s private sector is rising to the challenge as we put this crisis to bed by working together. Let me talk now about the progress we’re making to reach the President’s goal — to reach the President’s goal of 100 community vaccination centers within the next — within his first month in office. Thanks to the incredible work of FEMA, the Department of Defense, and colleagues across the government, since January 20, the Biden-Harris administration has already supported the establishment or expansion of 441 community vaccination centers across 37 states, territories, and the District of Columbia. Over the past month, we’ve provided 171 sites with federal personnel. We’ve deployed nearly 3,500 total personnel nationwide to support vaccination operations, including expert logisticians, vaccinators, greeters, clerks, and others in support roles. Personnel are assigned from agencies across the federal government, including FEMA, CDC, DOD, National Guard, and the Forest Service, Department of Interior, Veterans Affairs Department, and the Army Corps of Engineers. A hundred and seventy-seven sites have received federal funding, and the President — and at the President’s direction, FEMA is reimbursing 100 percent of costs for vaccination operations. This funding covers critical supplies, staffing, training, and transportation needs that support increased vaccination distribution and administration. Sixty-two sites have received federal equipment, from folding chairs to containers to dry ice. The federal government has provided a range of equipment to meet state, tribal, territory, and local needs, and help establish and expand sites. This will get done in the details. Thank you to everyone involved in these efforts. The President is visiting a federally established community vaccination site today in Houston, Texas. This site opened yesterday and has the capacity to vaccinate 6,000 people per day. And today we’re announcing two new federal vaccination sites, one in North Carolina and the other in Illinois. Starting in two weeks, the United Center in Chicago will be used to vaccinate up to 6,000 people per day. And in North Carolina, a new site in Greensboro will have the capacity to vaccinate 3,000 people per day. The selection of both of these sites was based on a CDC-FEMA framework developed to target those most vulnerable. The goal is to launch vaccination sites that use processes and are in locations that promote equity, deploying the CDC’s Social Vulnerability Index. In closing, I want to come back to the important milestone of where we are this week, with over 50 million shots that have been administered since President Biden took office — 50 million shots in 37 days. That’s ahead of our target, even with the setbacks we faced during the recent winter storm, which devastated millions of people in the Midwest and in the South. As the President has said, if we do the right things and we have the right plan, we will get things moving. We’ve doubled the pace of administering shots in six weeks. We’ve increased vaccine distribution to near — to nearly — to states by nearly 70 percent. And nearly 60 percent of people over 75 now have received at least one shot; that was 14 percent six weeks ago. Close to 50 percent of people over 65 have at least one shot now; that was 8 percent six weeks ago. I want to repeat that: 8 percent of people over 65 and now 50 per- — six weeks ago had received their first shot. Now that’s close to 50 percent. That’s important because people over 65 accounted for 80 percent of COVID-19 deaths, and 75 percent of people who live in long-term care facilities have gotten their first dose, and those cases are at the lowest level since reporting began in May. So, yes, we are making progress, but we are not there yet, and there’s lots of hard work to do. But I want to thank everybody — everybody across the country that’s been involved in helping us make this progress. And with that, I will turn it over to Dr. Walensky. DR. WALENSKY: Thank you so much, Andy. I’m glad to be back with you today. Let’s get started on an overview of the pandemic. Over the last few weeks, cases and hospital admissions in the United States had been coming down since early January, and deaths had been declining in the past week. But the latest data suggests that these declines may be stalling, potentially leveling off at, still, a very high number. We at CDC consider this a very concerning shift in the trajectory. The most recent seven-day average of cases — approximately 66,350 — is higher than the average I shared with you on Wednesday. In fact, cases have been increasing for the past three days compared to the prior week. And while deaths tend to fluctuate more than cases and hospital admissions, the most recent seven-day average — approximately 2,000 per day — is slightly higher than the seven-day average earlier in the week. We are watching these concerning data very closely to see where they will go over the next few days. But it’s important to remember where we are in the pandemic. Things are tenuous. Now is not the time to relax restrictions. Although we have been experiencing large declines in cases and admissions over the past six weeks, these declines follow the highest peak we have experienced in the pandemic. So I want to be clear: Cases, hospital admissions, and deaths all remain very high, and the recent shift in the pandemic must be taken extremely seriously. CDC has been sounding the alarm about the continued spread of variants in the United States, predicting that variants such as the B117 variant, which is thought to be about 40 percent — 50 percent more transmissible than the wild-type strain, would become the predominant variant of COVID-19 by mid-March. We may now be seeing the beginning effects of these variants in the most recent data. Our estimates now indicate that B117 accounts for approximately 10 percent of cases in the United States — up from 1 to 4 percent a few weeks ago — and prevalence is even higher in certain areas of the country. And earlier this week, new research came out about additional emerging variants in New York — the B1526 variant — and in California — the B1427 variant — that also appear to spread more easily and are contributing to a large fraction of current infections in those areas, adding urgency to the situation. We may be done with the virus, but clearly, the virus is not done with us. We cannot get comfortable or give in to a false sense of security that the worst of the pandemic is behind us — not now; not when mass vaccination is so very close — when what we need to prevent this is truly imminent. We must continue to be vigilant and committed to consistently taking the steps we — work to stop the spread of COVID-19. Where the pandemic goes from here is dependent on our collective behavior and resolve to do our part to protect ourselves, our families, and our communities. Together, we have the capacity to avoid another surge in our nation. I know people are tired; they want to get back to life, to normal. But we’re not there yet. Give us time we need to get more vaccines into our communities and to get more people vaccinated. This is our path out. Here in the United States, over 46 million people, or 14 percent of the population, have already received at least one dose of the vaccine. And so many more of you are ready to roll up your sleeves as soon as vaccine becomes available to you, and, indeed, more vaccine is on the way. We are at the precipice of having another vaccine in our toolboxes: the Johnson & Johnson COVID-19 vaccine. Like many of you, I’m excited about news that another safe and effective vaccine option could be coming as quickly as next week. We are closely watching FDA’s advisory committee today and the actions they may take today and tomorrow on this vaccine. Following FDA’s actions, CDC’s Advisory Committee on Immunization Practices, or ACIP, is prepared to meet over the weekend and continue — the same data being discussed at FDA’s advisory meeting. Then, ACIP will make recommendations for the use of the vaccine, and I will stand by to review them and ready to sign. Having an additional safe and effective vaccine will help protect more people faster. I look forward to the ACIP discussion, receiving their recommendations, and sharing with you about ACIP’s recommendations and our next steps moving forward. Thank you. I look forward to your questions. And with that, I will turn things over to Dr. Fauci. DR. FAUCI: Thank you very much, Dr. Walensky. I’m going to give now a brief update on the science, particularly focusing on the vaccine. If I can go to the first slide. This is the slide that I’ve shown to this group before. But just building on what Dr. Walensky just said, we really are looking forward with the very positive anticipation to the final determination of the VRBPAC and the FDA concerning the Johnson & Johnson or Janssen vaccine. What this means from the data we looked at: that we now have three highly effective vaccines. Importantly, each of them are very effective against severe disease, and virtually all of them say that you look at the data, and it’s clear that you get essentially no hospitalizations or deaths in any. This is very good news. So, again, we have three candidates now that are in play. We look forward to the results, as Dr. Walensky said. This should be forthcoming, hopefully within the next day or two, together with the recommendations about how it is to be utilized. In addition, on this particular slide, there are other candidates that have fulfilled enrollment, and we’re looking forward with them too. The bottom line is that the more vaccines that have high efficacy that we can get into play, the better there is. Next slide. Now, one of the things that was mentioned by Dr. Walensky is the fact that we have variants that are in play. We have the 117 that is increasing in its prevalence now in the country, with modeling telling us that, by the end of March, it might be the overwhelming candidate for — not candidate, but the overwhelming strain that is actually spreading. We also have the others that Dr. Walensky mentioned: the 427 in California, the 526 in New York. We must address these. There are a couple of ways of doing that. Let’s take a look at the 351 that has attracted a lot of attention, which was originally in South Africa, is not dominant at all here in the United States, but we need to pay attention to it. One of the ways to do that is to make a version of the vaccine, which actually directly addresses the particular variant in question. Could I have the next slide? And what we’ve seen: that, just two days ago, that the Moderna company began the clinical trials to booster the — to provide booster shots for the variant from South Africa. What they did, actually, as the first step to beginning these trials, which will begin in mid-March, they sent material to the NIH for a phase one study. Next slide. Now, if you take a look at this, what this will be is that it’s a variant-specific vaccine candidate, which we’re referring to as mRNA 1273.351, with the 351 designated that is against specifically the variant which is a 351, which was first identified in South Africa. And as I mentioned, we will conduct a phase one study, which we will begin in mid-March, in both naive and previously vaccinated adults. Next slide. On this last slide, I show you the two cohorts to just give you an example of what the prototype model approach that is being taken when you want to directly address a specific variant. One of these studies — the cohort one — will be in previously vaccinated volunteers, namely looking at individuals — and again, this is a phase one study — not looking at efficacy, but looking at safety and immunogenicity. And that is the way things will likely go over the next several months as this company and others approve, namely taking a look at can you induce a level of antibodies specifically against the variant in question. In this case, it’s the 351. And as you can see, the first cohort is in previously vaccinated volunteers, and the second cohort is in individuals who are either unvaccinated and not previously infected to determine if you were going to have a vaccine program that would be specifically directed against this particular variant, how would you design it. And this is the way to go. I want to make one comment that I believe is important. One would ask: Are you going to have to do this with every variant? Because we cannot determine now where the 526 or the 427 or other variants will go. So there are two ways — actually three ways — one that’s common to both — that you address these variants. First and foremost is to continue what Dr. Walensky mentioned at the close of her comments: to continue to double down on the public health measures that prevent the transmission. Because, as I’ve said often, and it’s true in virology, that viruses will not mutate if you don’t give them the opportunity to spread and replicate. So public health measures are paramount. Secondly, you can go after the specific mutants, the specific variants, as I’ve shown here. But there’s another way to do it, and this has to do somewhat indirectly with what we heard yesterday from Albert Bourla, who is the CEO of Pfizer, when he was talking about the idea of maybe yet again another boost, meaning the higher the titer of antibody against even the wild type will have spillover effects in mitigating the problem that is created by the variants. And we know that from experience with the 351, in which the effect of vaccination was diminished by multiple fold, but it wasn’t obliterated because of the cushion of a high level of antibody. So, a couple of things going on: A, you can directly address it specifically, or you can get as high a robust response from the vaccine in question that would have an effect on the variant. So let me stop there and hand it back to Andy. ACTING ADMINISTRATOR SLAVITT: Thank you. And before we turn to the — for questions, I want to maybe pose a question to Dr. Fauci. This — thank you for providing all of us with an overview of the strategy to stay ahead of and target variants as needed on an ongoing basis, but I want to ask a simple question: If you are someone who today is contemplating whether or not you should get a vaccination, should any of this cause you to delay your thinking about getting a vaccination until some of these developments occur, or should people go out and quickly and hastily get their vaccines? DR. FAUCI: Overwhelmingly, the latter, Andy. Right now, get vaccinated. The vaccine that’s available to you, get that vaccine. It is important to get as many people vaccinated as quickly and as expeditiously as possible. A very firm answer to that question. ACTING ADMINISTRATOR SLAVITT: Okay. Thank you for clarifying that. All right, let’s go to questions. February 26, 2021: Centers for Reproductive Rights posted News titled: “Tennessee’s Medically Unsound ‘Abortion Reversal’ Law Remains Blocked by Federal Courts”. From the News: Today, a federal court in Tennessee issued a preliminary injunction, blocking a state law that would have forced doctors to provide false and misleading information to their patients about the potential to “reverse” a medication abortion; the unproven claim has no basis in credible medical research. This injunction comes after the court issued a temporary restraining order against the law last year.This law was an attempt by politicians to erode the trust between patients and their providers by forcing doctors to lie to patients and share misinformation that isn’t backed up by credible science. Had it gone into effect, providers would have been forced to share misinformation with patients – telling them it may be possible to “reverse” a medication abortion – at least 48 hours in advance of providing a medication abortion and again after the patient has taken the first medication, as well as post signs throughout their health centers informing patients about abortion “reversal” in large, bold print. Providers who refused to comply would have faced criminal prosecution for a Class E felony, punishable by up to six years in prison, and health centers would have faced a $10,000 daily fine for failure to display the required signs.“Reversal” laws are opposed by leading medical organizations, including the American Medical Association (AMA), the Society of Family Planning, and the American College for Obstetricians and Gynecologists (ACOG). In fact, the AMA is a party to a lawsuit in North Dakota challenging a similar “reversal” law.In today’s preliminary injunction, Judge William Campbell, Jr., U.S. District Court for the Middle District of Tennessee said: “In the Court’s view, misleading an undecided patient into beginning a procedure that may have unalterable consequences by suggesting she can ‘reverse’ it later is not a result desired by either side.”…Center for Reproductive Rights February 26, 2021: Centers for Medicare & Medicaid Services posted a Press Release titled: “Biden Administration Strengthens Requirements that Plans and Issuers Cover COVID-19 Diagnostic Testing Without Cost Sharing and Ensures Providers are Reimbursed for Administering COVID-19 Vaccines to Uninsured”. From the Press Release: In accordance with the Executive Order President Biden signed on January 21, 2021, the Centers for Medicare & Medicaid Services (CMS), together with the Department of Labor and the Department of the Treasury, (collectively, the Departments) issued new guidance today removing barriers to COVID-19 diagnostic testing and vaccinations and strengthening requirements that plans and issuers cover diagnostic testing without cost sharing.This guidance makes clear that private group health plans and issuers generally cannot use medical screening criteria to deny coverage for COVID-19 diagnostic tests for individuals with health coverage who are asymptomatic, and who have no known or suspected exposure to COVID-19. Such testing must be covered without cost sharing, prior authorization, or other medical management requirements imposed by the plan or issuer. For example, covered individuals wanting to ensure they are COVID-19 negative prior to visiting a family member would be able to be tested without paying cost sharing. The guidance also includes information for providers on how to get reimbursed for COVID-19 diagnostic testing or for administering the COVID-19 vaccine to those who are uninsured.This announcement clarifies the circumstances in which group health plans and issuers offering group or individual health insurance coverage must cover COVID-19 diagnostic tests without cost sharing, prior authorization, or other medical management requirements to include tests for asymptomatic individuals without known or suspected exposure to COVID-19. In addition, the guidance confirms that plans and issuers must cover point-of-care COVID-19 diagnostic tests, and COVID-19 diagnostic tests administered at state or locally administered testing sites. The Departments have received many questions about plan and issuer responsibility to cover COVID-19 diagnostic testing for individuals who are asymptomatic and have no known or suspected recent exposure to COVID-19. Today’s guidance clarifies that plans and issuers generally must cover, with no cost sharing, COVID-19 diagnostic tests regardless of whether the patient is experiencing symptoms or has been exposed to COVID-19 when a licensed or authorized health care provider administers or has referred a patient for such a test. Additionally, plans and issuers are prohibited from requiring prior authorization or other medical management for COVID-19 diagnostic testing.This guidance also reinforces existing policy regarding coverage for the administration of the COVID-19 vaccine and highlights avenues for providers to seek federal reimbursement for costs incurred when administering COVID-19 diagnostic testing or a COVID-19 vaccine to those who are uninsured. One such existing program is through the Provider Relief Fund program, which has a separate effort for providers to submit claims and seek reimbursement on a rolling basis for COVID-19 testing, COVID-19 treatment, and administering COVID-19 vaccines to uninsured individuals (the HRSA COVID-19 Uninsured Program)… The HRSA Uninsured Program has already reimbursed providers more than $3 billion for the testing and treatment of uninsured individuals, and expects to see vaccine administration claims as states scale up their vaccination efforts. To further build awareness about the availability of this program, this announcement seeks comment on strategies to connect those without insurance to care from providers participating in this fund…CMS February 27, 2021:The White House posted a Statement titled: “Statement by President Joe Biden on Emergency Use Authorization of the Johnson & Johnson COVID-19 Vaccine“. From the Statement: Today, after a rigorous, open, and objective scientific review process, the Food and Drug Administration issued an emergency use authorization for a third safe and effective vaccine to help us defeat the COVID-19 pandemic — the Janssen COVID-19 (Johnson & Johnson) vaccine. This is exciting news for all Americans, and an encouraging development in our efforts to bring an end to the crisis.We know that the more people get vaccinated, the faster we will overcome the virus, get back to our friends and loved ones, and get our economy back on track. Thanks to the brilliance of our scientists, the resilience of our people, and the eagerness of Americans in every community to protect themselves and their loved ones by getting vaccinated, we are moving in the right direction. I look forward to speaking more about today’s news and updating the American people on our progress this coming week.But I want to be clear: this fight is far from over. Though we celebrate today’s news, I urge all Americans — keep washing your hands, stay socially distanced, and keep wearing masks. As I have said many times, things are still likely to get worse again as new variants spread, and the current improvement could reverse. My Administration will not make the mistake of taking this threat lightly, or just assuming the best: that’s why we need the American Rescue Plan to keep this fight going in the months ahead.There is light at the end of the tunnel, but we cannot let our guard down now or assume that victory is inevitable. We must continue to remain vigilant, act fast and aggressively, and look out for one another — that is how we are going to reach that light together.White House This blog post will be updated if and when additional relevant information is found. Health Care Under Biden-Harris – February 2021 is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Everything You Need to Know about the Texas Abortion LawSeptember 5, 2021Out of Spoons / Public HealthTexas Flag by Pete Alexopoulos on Unsplash A Texas abortion law made its way to the Supreme Court of the United States. Typically, the entire Supreme Court would schedule the case for a hearing, listen to arguments made by both sides, question the hell out of the lawyers, and then take time to make a decision. Instead, the conservative members of the court chose to drop the ball and allow Texas to enforce a six-week abortion ban. How did we get here? The vote was 5-4. Those who voted against the Texas six-week abortion ban include Chief Justice John Roberts (nominated by President George W. Bush), Stephen Breyer (nominated by President Bill Clinton), Sonia Sotomayor (nominated by President Barack Obama), and Elena Kagen (nominated by President Barack Obama). Those who voted to harm everyone in Texas who has a uterus include: Clarence Thomas (nominated by President George Bush), Samuel Alito (nominated by President George W. Bush), Neil M. Gorsuch (nominated by President Donald J. Trump), Brett Kavanaugh (nominated by President Donald J. Trump), and Amy Coney Barrett (nominated by President Donald J. Trump). In short, a one-term president, who had been impeached twice by Congress, packed the court with three justices of his choice before losing the 2020 election. As such, it makes total sense for President Biden to increase the size of the court with his own choices for justices. Doing so could flip the Supreme Court to outnumber Trump’s extremely conservative justices. If it was okay for Trump to pack the court – then it is okay for Biden to do it. What should you know about the Texas six-week abortion ban? The law is called S.B. 8. It is called the “Texas Heartbeat Act”. The purpose of this bill is to prevent a pregnant person from having an abortion. The bill itself uses the word woman throughout it, but it will also affect trangender men who have a uterus and who can get pregnant. The law is also going to affect anyone under the age of 18 who becomes pregnant. The Centers for Disease Control and Prevention posted a report that states that the average age of menarche (menstruation) in 2017 was 11.9. That means an eleven-year-old in Texas could become pregnant and be prevented from having an abortion. Keep in mind that was the average age of starting a period. Some children who have a uterus could start earlier than eleven-years-old. Planned Parenthood explains that pregnancy is times measured by “gestational age”, which starts on the first day of your last period. The first two weeks are when a person is menstruating. About two weeks later, the egg is released from their ovary. The average menstrual cycle lasts 28 days. During weeks three and four, (if the egg has been fertilized), it will move down the fallopian tube and start dividing. It reaches the uterus about three to four days later. About six days after fertilization, it attaches to the lining of the uterus. A pregnancy has occurred – but most people don’t have any recognizable signs that they are pregnant by six weeks. That’s the main problem with limiting abortion to before six weeks of gestation. By the time the pregnant person understands that they are pregnant – Texas has already prohibited them from having an abortion. Another terrible (and misinformed) part of S.B. 8 has to do with the idea of a fetal “heartbeat”. That term is often used in bills that are designed to prevent pregnant people from having an abortion. The reason the “heartbeat” is included in these bills is to sound as though it were science. (It is not science.) NPR reported that the Texas abortion law reads: “A physician may not knowingly perform or induce an abortion on a pregnant woman if the physician detected a fetal heartbeat for the unborn child.” The law defines “fetal heartbeat” as “cardiac activity or the steady and repetitive rhythmic contraction of the fetal heart within the gestational sac.” NPR asked physicians about this. Dr. Nisha Verma (an OB-GYN) said: “When I listen to an patient’s heart, the sound I’m hearing is caused by the opening and closing of cardiac valves. The sound generated by an ultrasound in very early pregnancy is quite different”, she said. “At six weeks of gestation, those valves don’t exist. The flickering that we’re seeing on the ultrasound that early in the development of the pregnancy is actually electrical activity, and the sound you ‘hear’ is actually manufactured by the machine.” In short, the Texas bill is full of lies. It was based on “fetal heartbeat”, which is absolutely impossible at six-weeks of gestation. Another physician NPR spoke with, Dr. Jennifer Kerns (OB-GYN) clarified that the correct scientific term for six weeks of development is “embryo” – not fetus. The Louisiana Department of Health makes it clear that an embryo does not become a fetus until week eight (ten weeks after the last normal menstrual period.) S.B. 8 gets worse. The American Civil Liberties Union (ACLU) pointed out the following: “… The law includes a bounty-hunting scheme, encouraging private individuals to sue anyone in Texas who violates the law. A reward of at least $10,000 will be given to anyone who successfully sues a doctor, health center worker, or any person who helps someone obtain an abortion after six weeks of pregnancy. Lawsuits may be filed against a broad range of people, including abortion funds providing financial assistance to patients, health center staff, and even a member of the clergy who assists an abortion patient… The ACLU also stated that “Texas’ ban is different because it allows private individuals to enforce the ban rather than state officials. Anti-abortion politicians designed the law this way to try and insulate it from federal court review…” This is absolutely terrifying. First, the “bounty-hunter” stands to make $10,000 if they can successfully sue someone who provides an abortion or seeks one. Texas Tribune reported that the Texas Workforce Commission announced that the U.S. Department of Labor notified the commission that the state’s unemployment rate fell below the threshold to continue the benefits. The last of the extended assistance will be given through the week of September 11, 2021. When that assistance disappears, it is possible that some people will feel desperate enough to try and get that $10,000. That could mean lying about a neighbor who isn’t even pregnant and insisting that the person is seeking an abortion. It could mean suing everyone in a health care clinic that provides abortion – just because they happen to work there. It could mean a pregnant person who miscarries could be sued for failing to carry the baby to term. It could mean the doctor whom the pregnant person sought out for help with a miscarriage could also be sued for providing the medical help that was necessary. Of course, despicable people who are very rich could also decide to become a “bounty-hunter”. The law doesn’t limit who can win a bunch of money by lying about a person being pregnant, or trying to sue the person who miscarried, or the doctors who helped that person. The difference is the rich people don’t need the money and would be targeting people they don’t happen to like. When I think of the words “bounty-hunter”, I think about the Star Wars movies and TV shows. I think about the “wild west” where “bounty-hunters” went after people who stole someone’s horses or robbed a bank. People who are pregnant – or who can potentially get pregnant – and who live in Texas will now have to worry about “bounty hunters” interfering with their lives. Everything You Need to Know about the Texas Abortion Law is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... My County Issued a Mask MandateSeptember 1, 2021Out of Spoons / Public Healthwoman wearing a mask in a grocery store by Anna Shvets on Pexels The county I live in has issued an indoor mask mandate. It started today. I rarely go outside anymore because I have two auto-immune disorders. When I do leave the house, I am almost always the only one wearing a mask. According to my county’s Department of Public Health, the mask mandate is in response to a surge of COVID-19 cases that are described as the highest number of COVID-19 patients that the county has ever had. Part of the reason for the mask mandate is to enable hospitals to have room for people who need treatment for heart attacks, broken bones, or cancer (as a few examples). I’m not going to say which county I live in, but will disclose that it is somewhere in California. The mask mandate applies to not only those who are not vaccinated, but also those who are. An order has been issued that makes it clear that failing to adhere to the order is “a public nuisance subject to citation, abatement, or both, as well as a misdemeanor punishable by fine, imprisonment, or both.” This is not new. In 1918, there was an influenza pandemic. The United States issued a mask mandate. Back then people who were not wearing a mask, or who were wearing their mask improperly (below their chin, for example), were given 30-day jail sentences. Those who could afford it could pay a $10 bail and be released. My county now requires that masks be worn over the mouth and nose in all indoor settings. It includes gatherings, workplaces, offices, retail stores, restaurants, bars, fitness centers, theaters, museums, personal care services, family entertainment centers, and government offices serving the public. Businesses must now require everyone who wants to enter to wear face coverings. The business must post signs at the door to make it clear that people must wear a mask if they want to go inside. Students, teachers, and others working at in-person schooling, will be required to wear a mask while indoors. Personally, I am relieved to hear this news. The mask mandate will help prevent the spread of COVID-19. It makes the county a little bit safer for people like me who have weak immune systems. People who need to go to the hospital for non-COVID health issues will have a chance to get the care they need. I cannot help but wonder what things would be like today if the United States government issued a mask mandate right at the start of the COVID-19 pandemic. So many lives could have been saved. Anti-maskers are probably going to get angry about my county’s mask mandate. I recommend they get used to ordering their groceries to be delivered to their homes. They should also expect to pay fines for being maskless inside a store or business. My County Issued a Mask Mandate is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... I’m TiredAugust 30, 2021Out of Spoons / Spoonie Writingsleeping woman by Kinga Cichewicz on Unsplash I’m tired. So very, very tired. All the time. Maybe you are too, but for different reasons. I’m tired of having chronic illnesses that have no cure. Both of them are auto-immune diseases. Antihistamines provide temporary peace from airborne allergens, but it doesn’t last long. It does nothing for my food allergies. Fibromyalgia causes muscle pain and memory issues (“fibro fog”) that leave me struggling to find the right words. Constant pain causes exhaustion. I’m tired. I’m tired of living in a world where covid is still spreading. I took a chance and got vaccinated. Luckily, my immune system was able to handle it. I worry for those who have immune systems more fragile than mine, and for kids who are too young to get the vaccine. The World Health Organization (WHO) noted that the global rollout of covid-19 vaccines is progressing at “two alarmingly different speeds”. Less than 2 percent of adults are fully vaccinated in most low-income countries compared to almost 50 percent in high-income nations. The longer this is true, the longer we will all be stuck living in a world where covid is spreading. I’m tired of the people who choose to spread covid. Every time a group of anti-maskers get together to protest mask requirements, it makes me tired. They gather in groups and shout, droplets spewing out of their mouths and noses, and potentially spreading covid. These people are the reason why we can’t have nice things, as the saying goes. We can’t end the pandemic unless every physically healthy person is vaccinated. Until then, there is a need for everyone to wear masks. I’m tired of waiting for the anti-maskers to grow up and do the right thing. I’m tired of fighting an ant invasion. California is in a drought. When this happens, ants come into people’s homes, in search of water. They’ll happily take any crumb of food they can find, too. We put down ant poison, and that worked for a while. Eventually they learned to avoid it. Since then, I’ve been spraying the ants with disinfectant (like the kind you would use to clean sinks and toilets). It works, but I’m going through it fast. The house is very clean, but even that doesn’t entirely stop the ants from coming in. We can no longer leave a few, rinsed, dishes in the sink overnight. The ants find them. I’m tired from spending so much energy trying to keep the Borg of the insect world outside. #Blaugust2021 I’m Tired is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Tennessee’s Bathroom Bill was BlockedJuly 22, 2021Out of Spoons / Public HealthPhoto by Tim Mossholder from Pexels Everybody needs to pee. Holding in your pee for too long causes health problems. That’s one of many cruelties of “bathroom bills” that prohibit people who are transgender or non-binary from using a public restroom. Holding in your pee causes health problems What happens if you have no choice other than to hold in your pee? The answer to that question comes from Lamia Gabal, MD, a board-certified urologist. “Holding in pee is a complex series of interactions between your bladder muscle and your pelvic floor muscles, which make up the urinary sphincter,” Dr. Gabal said. “Chronically holding in your pee can overstretch your bladder and lead to muscle weakness.” Planned Parenthood points to a number of ways to prevent having a urinary tract infection (UTI). One piece of advice says: “Pee when you need to. Don’t hold it.” Cleveland Clinic says that a urinary tract infection can be easily treated with antibiotics. If it isn’t treated or if the person stops taking the medication early, this type of infection can lead to a more serious infection, like a kidney infection. In short, “bathroom bills” are a public health problem because they prohibit people who are transgender, non-binary (or both) from being able to pee when their bodies need to. Cruelty is the entire point of “bathroom bills”. How did the Business Bathroom Bill happen? It starts with Senate Bill 1224 (SB 1124) which was titled: “AN ACT to amend Tennessee Code Annotated, Title 4; Title 5; Title 6; Title 7; Title 49 and Title 68, relative to public facilities”. The purpose of this bill was to harm people who are transgender. Here is what SB 1124 said: SECTION 1. Tennessee Code Annotated, Title 68, Chapter 120, Part 1, is amended by adding the following as a new section: (a) A public or private entity or business that operates a building or facility open to the general public and that, as a matter of formal or informal policy, allows a member of either biological sex to use any public restroom within the building or facility shall post notice of the policy at the entrance of each public restroom in the building or facility. (b) Signage of the notice must be posted in a manner that is easily visible to the person entering the public restroom and must meet the following requirements: (1) Be at least eight inches (8″) wide and six inches (6″) tall; (2) The top-one third (1/3) of the sign must have a background color of red and state “NOTICE” in yellow text, centered in that portion of the sign; (3) The bottom two-thirds (2/3) of the sign must contain in boldface, block letters the following statement centered on that portion of the sign: THIS FACILITY MAINTAINS A POLICY OF ALLOWING THE USE OF RESTROOMS BY EITHER BIOLOGICAL SEX, REGARDLESS OF THE DESIGNATION ON THE RESTROOM (4) Except as provided in subdivision (b)(2), have a background color of white with type in black; and (5) Be located on a door to which the sign must be affixed or have its leading edge located not more than one foot (1′) from the outside edge of the frame of a door to which the sign must be affixed. (c) If an entity or business is notified that it is not in compliance with this section, the entity or business has thirty (30) days in which to comply before any action is taken against the entity or business. (d) As used in this section: (1) “Policy” means the internal policy of a public or private entity or such policy as the result of a rule, ordinance, or resolution adopted by an agency or political subdivision of this state; and (2) “Public restroom”: (A) Includes a locker room, shower facility, dressing area, or other facility that is: (i) Open to the general public; (ii) Designated for a specific biological sex; and (iii) Excludes a unisex, single-occupant restroom or family restroom intended for use by either biological sex. SECTION 2. This act takes effect July 1, 2021, the public welfare requiring it. What does this really mean? There’s a whole lot of willful ignorance and cruelty to unpack here. I’m going to start by critiquing the sign that the Tennessee legislature wanted to force businesses to post on bathrooms doors. The top part of the sign must be red, and the word NOTICE on that part of the sign must be yellow. Those colors, when put on a sign, typically indicates that there is something dangerous nearby (or past the point of where the sign is located). The purpose of forcing businesses to use up printer ink to post these horrible signs on every bathroom, locker room, etc., is to sneakily cause people to subconsciously start equating people who are transgender or non-binary as “dangerous”. That intent is further emphasized by forcing the businesses to put an awkwardly worded sentence in BOLD TEXT that is really confusing to read. “THIS FACILITY MAINTAINS A POLICY OF ALLOWING THE USE OF RESTROOMS BY EITHER BIOLOGICAL SEX, REGARDLESS OF THE DESIGNATION ON THE RESTROOM” That wording, following the “danger danger” part at the top of the sign, was designed to not only make people afraid of encountering a transgender or nonbinary person in a public bathroom, but also to make them think they would be in great danger if that happened. That is an extremely harmful message because it could persuade a transphobic person to enact violence upon someone whom they think is in the wrong bathroom. I’d also like to point out the part of the sign (that is in bold text) is extremely confusing. Trans women are women, and should use the women’s bathroom. Trans men are men, and should use the men’s bathroom. The sign isn’t there to protect people who are transgender, though. It’s there to rile up transphobic people in an effort to further “other” people who are not cis-gendered. A similar type of discriminatory rules were enacted in the 1940s. Those rules were called Jim Crow laws, which were intended to cause harm to Black people. The Jim Crow laws segregated bathrooms, water fountains, and where people could sit on buses, based on whether the person was white or Black. Today’s anti-trans laws are not identical to the Jim Crow laws. However, both had the purpose of discriminating against entire groups of people simply for being who they are. This is how the Tennessee legislators voted on SB 1124: SB 1124 is the Senate version of the bill. HB 1182 is the House version of the bill. The primary sponsor of HB 1182 is Tim Rudd (Republican). He represents District 34. His term ends in 2022. SB 1124 was sponsored by Paul Rose. He represents District 32. His term ends in 2024. The vote on both bills is posted on the same page. Here is who voted AYE on HB 1182: Rebecca Alexander (R)Charlie Baum (R)Clark Boyd (R)Rush Bricken (R)Scotty Campbell (R)Dale Carr (R)Michele Carringer (R)Glen Casada (R)Scott Cepicky (R)Mark Cochran (R)Michael G. Curcio (R)Tandy Darby (R)Rick Eldridge (R)Andrew Farmer (R)Ron M. Gant (R)Johnny Garrett (R)Rusty Grills (R)Curtis Halford (R)Mark Hall (R)Kirk Haston (R)David Hawk (R)Patsy Hazelwood (R)Esther Helton (R)Gary Hicks (R)Tim Hicks (R)John B. Holesclaw Jr. (R)Dan Howell (R)Bud Hulsey (R)Chris Hurt (R)Curtis G. Johnson (R)Sabi ‘Doc’ Kumar (R)Justin Lafferty (R)William Lamberth (R)Tom Leatherwood (R)Mary Littleton (R)Susan Lynn (R)Eddie Mannis (R)Debra Moody (R)Jerome Moon (R)Dennis Powers (R)John Ragan (R)Bob Ramsey (R)Tim Rudd (R)Iris Rudder (R)Lowell Russell (R)Jerry Sexton (R)Paul Sherrell (R)Robin Smith (R)Mike Sparks (R)Bryan Terry (R)Todd Warner (R)Terri Lynn Weaver (R)Mark White (R)Sam Whitson (R)Ryan Williams (R)Jason Zachary (R)Speaker Cameron Sexton (R) Here is who voted NAY on HB 1182: Bill Beck (D)Kent Calfee (R)Karen D. Camper (D)Jesse Chism (D)John Ray Clemmons (D)Barbara Cooper (D)Vincent Dixie (D)Bob Freeman (D)Yusuf Hakeem (D)G.A. Hardaway (D)Torrey C. Harris (D)Jason Hodges (D)Darren Jernigan (D)Gloria Johnson (D)London Lamar (D)Harold M. Love, Jr. (D)Sam McKenzie (D)Larry J. Miller (D)Antonio Parkinson (D)Jason Potts (D)Jason Powell (D)Johnny Shaw (D)Mike Stewart (D)Dwayne Thompson (D) Here is who voted either “present” or “not voting”: John Gillespie (R)Pat Marsh (R)Ron Travis (R) Here is who voted AYE on SB 1182: Mike Bell (R)Janice Bowling (R)Richard Briggs (R)Rusty Crowe (R)Todd Gardenhire (R)Ferrell Haile (R)Joey Hensley (R)Ed Jackson (R)Jack Johnson (R)Becky Duncan Massey (R)Frank S. Niceley (R)Mark Pody (R)Bill Powers (R)Shane Reeves (R)Kerry Roberts (R)Paul Rose (R)Steve Southerland (R)Art Swann (R)Dawn White (R) Here is who voted NAY on SB 1182: Raumesh Akbari (D)Heidi Campbell (D)Brenda Gilmore (D)Sara Kyle (D)Katrina Robinson (D)Jeff Yarbro (D) Here is who voted either “present” or “not voting”: Page Walley (R) On April 30, 2021, CNN posted an article titled: “Tennessee legislature passes bill requiring some businesses to post signs indicating inclusive bathroom policy”. It was written by Devan Cole and Veronica Stracqualursi. From the article: Tennessee is a step away from requiring some businesses in the state to post signs indicating that they allow transgender and other non-binary people to use the bathroom in their establishment that matches their gender identity, a policy LGBTQ advocates say is “offensive and humiliating” for members of the community and could lead to harassment……While the legislation is reminiscent of the so-called bathroom bills a few years back — when Republican lawmakers around the country pushed to restrict trans students from using the bathrooms that corresponded to their gender identities — it doesn’t explicitly ban trans people from using the facility that matches their gender identity, but it is still harmful to trans people, LGBTQ advocates stress. They argue the signage could inadvertently lead to harassment of trans people and businesses with inclusive policies.It also comes at a time when GOP-controlled states have been passing laws that advocates say restrict trans rights.Tennessee’s GOP-controlled Senate passed HB 1182 on Thursday by a party-line vote of 21-4. The House previously passed the bill by a vote of 62-25 and the legislation now heads to Republican Gov. Bill Lee……Though the legislation doesn’t define what “biological sex” means, the term has been used by conservative lawmakers around the country to refer to one’s sex as determined at the time of birth based on their reproductive biology and genetics. While sex is a category that refers broadly to physiology, a person’s gender is an innate sense of identity. The factors that go into determining the sex listed on a person’s birth certificate may include anatomy, genetics and hormones, and there is broad natural variation in each of these categories.For this reason, the language of “biological sex,” as used in this legislation, can be overly simplistic and misleading… On May 17, 2021, Human Rights Campaign posted a press release titled: “Tennessee Gov. Bill Lee Signs Anti-Transgender ‘Business Bathroom Bill’ into Law”. It was written by Wyatt Ronan. From the press release: Today, Tennessee Gov. Bill Lee signed House Bill 1182 (SB 1224) into law, a discriminatory bill that aims to prevent transgender people from using restrooms aligned with their gender identity by requiring businesses with “formal or informal” policies of allowing transgender people to use the appropriate restroom to post offensive and humiliating signage……HB 1182 (SB 1224) is part of the 2021 “Slate of Hate” rippling through the Tennessee state legislature. This anti-transgender bill is the fourth discriminatory piece of legislation signed by Governor Lee this session, following SB 228 an anti-transgender sports ban, SB 1229, a sweeping anti-LGBTQ education, bill, and HB 1233, anti-transgender student bathroom bill. These anti-equality bills are being pushed by national extremist groups and peddled by lawmakers in Tennessee in an effort to sow fear and division.The governor has not yet taken action on SB 126 (HB 1027), an unnecessary regulation of life-saving, best practice medical care for transgender youth.Human Rights Campaign President Alphonso David issued the following statement in reaction to Gov. Lee signing HB 1182:“Gov. Lee’s decision to sign HB 1182 will cause real harm to transgender Tennesseans. Denying transgender people the ability to access a bathroom consistent with their gender identity is degrading and dehumanizing – and can have real health and safety consequences. Gov. Lee and Tennessee lawmakers are determined to discriminate against the transgender community and roll back the clock on equality instead of focusing on real problems facing Tennesseans. To be clear – Tennessee residents will suffer economic, legal, and reputational consequences of these bills and we will hold those who are indoctrinating hate into our laws accountable.” On May 25, 2021, News 4 Nashville posted an article titled: “Nashville DA won’t prosecute new bathroom bill”. It was written by Chuck Morris. From the article: Nashville’s District Attorney General Glenn Funk said his office will not enforce the new bathroom equality bill signed by Tennessee Gov. Bill Lee earlier this month.The bill requires any public or private entity or business that allows a member of either sex to use a public restroom to post a sign stating either sex, regardless of designation, can use that restroom.“I believe every person is welcome and valued in Nashville,” Funk said in a statement. “Enforcement of transphobic or homophobic laws is contrary to those values. My office will not promote hate.”Lee told reporters the bill promotes “equality in bathrooms”, despite the prohibition against transgender people using multi-person facilities that don’t align with their sex at birth……LGBTQ advocates have said the legislation is discriminatory. The Human Rights Campaign said its the first bill restricting bathroom use by transgender people signed in any state in about five years… I posted that article in this blog post to point out that if the Nashville Attorney General has decided not to enforce the “Business Bathroom Bill”, no one else in Nashville will be able to enforce it, either. This is good news for transgender people and the businesses who welcome them. As I mentioned earlier in this blog post – everyone needs to pee. On June 10, 2021, WKRN.com posted an article titled: “Nashville DA can refuse to enforce transgender bathroom sign law, lawyers say”. It was written by Gerald Harris. From the article: Davidson County District Attorney Glenn Funk is not backing down on his decision not to enforce the controversial transgender bathroom sign legislation once it becomes law July 1.This is despite backlash from Republican lawmakers including East Tennessee Representative John Ragan who said the action from Funk is “offensive.”The law requires businesses to notify the public if their bathrooms are inclusive.“Every person is welcomed and valued in Nashville. Enforcement of transphobic and homophobic laws is contrary to those values. My office will not promote hate,” Funk said in a letter.Abby Rubenfeld, a Nashville Civil Rights attorney with Rubenfeld Law Office said, “General Funk’s response was completely appropriate, I mean he has limited resources, he has to make priorities about enforcement of laws and that’s just the accepted part of his job.”There’s been continued outcry from Republican lawmaker who say it’s there job to write the laws and it’s Funk’s job to enforce them……It’s unclear how the law will be enforced or if any other district attorney will also refuse to enforce the law… Here come the lawsuits On June 25, 2021, the Tennessee American Civil Liberties Union (ACLU) posted a press release that stated the following: The American Civil Liberties Union of Tennessee and the ACLU filed a lawsuit in federal court today challenging a new, first-of-its-kind Tennessee law that would require businesses and other entities that allow transgender people to use the restroom that matches their gender to post a government-prescribed warning sign.The lawsuit, filed on behalf of business owners in Nashville and Chattanooga who object to the stigmatizing message they would be required to display, states that the law violates the First Amendment and asks the court for a preliminary injunction to stop enforcement of the law while the lawsuit proceeds.“Forcing businesses to display a stigmatizing message for political expedience is unconstitutional,” said Hedy Weinberg, ACLU of Tennessee executive director. “Furthermore, by targeting the transgender community, these government-mandated signs marginalize and endanger transgender individuals. Tennessee should be embracing and protecting all Tennesseans, not passing unconstitutional discriminatory laws.”The lawsuit was filed on behalf of Kye Sayers, owner of the Sanctuary performing arts and community center in Chattanooga, and Bob Bernstein, owner of Fido restaurant in Nashville. Both businesses have informal policies allowing customers to determine which restroom is appropriate for them, and have not had any complaints or concerns raised about their restroom policies.“Sanctuary was founded specifically to create a safe space for transgender and intersex people and their families in a state that can be unwelcoming to LGBTQ people,” said plaintiff Kye Sayers. “I am against posting offensive signs that stigmatize and deny the existence of transgender and intersex people at our center. These signs undermine Sanctuary’s very mission and send the exact opposite of the welcoming message we try to convey in everything we do.“As a former journalist, I believe strongly in free speech. Politicians have no right to force me to post a controversial, ideologically-motivated and inaccurate sign in my place of business,” said plaintiff Bob Bernstien. “I have worked hard to create a welcoming environment for all in the restaurants that I own, and I don’t intend to stop now.”If the law goes into effect, any business that fails to prevent transgender and intersex people from using the restroom that most aligns with who they are would be forced to post signs with the word “NOTICE” in yellow on a red background at the top, followed by text stating “THIS FACILITY MAINTAINS A POLICY OF ALLOWING THE USE OF RESTROOMS BY EITHER BIOLOGICAL SEX, REGARDLESS OF THE DESIGNATION ON THE RESTROOM,” or face criminal charges……While courts have recognized that businesses can be required to display factual and noncontroversial information, they have repeatedly ruled that forcing a business owner to display a sign for the sole purpose of promoting a political viewpoint is unconstitutional… A Copy of the lawsuit was posted by the Tennessee ACLU: The Plaintiffs are: Bongo Productions, LLC, Robert Bernstein, Sanctuary Performing Arts LLC, and Kye Sayers The Defendants are: Carter Lawrence, Tennessee State Fire Marshal, in his official capacityChristopher Bainbridge, Director of Codes Enforcement, in his official capacityGlenn R. Funk, District Attorney General for the 20th Judicial District, in his official capacity, and Neal Pinkson, District Attorney General for 11th Judicial District, in his official capacity The lawsuit went to the United States District Court For the Middle District of Tennessee Nashville Division. Here are some key portions of the lawsuit: …Plaintiffs are Tennessee businesses and service providers and their owners. They serve the public, and provide public access to their restrooms. Plaintiffs welcome transgender customers, clients, and staff, and allow transgender people to use the restroom or facilities that accord with their gender identity. …Plaintiffs do not want to display this notice. They do not agree with this characterization of their policies, and they do not want to convey the Tennessee General Assembly’s controversial and stigmatizing message to customers, clients, and staff. Under newly enacted H.B. 1182/S.B. 1224, 112th Gen. Assemb., 1st Reg. Sess. … Plaintiffs – and many other businesses or public entity in Tennessee that allows transgender people to use the appropriate public restroom – will be required to post a controversial and misleading warning notice advising that “THIS FACILITY MAINTAINS A POLICY OF ALLOWING THE USE OF RESTROOMS BY EITHER BIOLOGICAL SEX, REGARDLESS OF THE DESIGNATION ON THE RESTROOM.”… If H.B. 1182 is allowed to go into effect, Plaintiffs and all other similarly situated businesses and entities open to the public in Tennessee will be forced to either display this government-mandated warning notice, or risk being charged with a Class B misdemeanor for violating the Tennessee building code, with a maximum penalty of six months in prison or $500. By forcing Plaintiffs to display a government-mandated warning notice with which they disagree, the Act violates the Plaintiffs First Amendment right against compelled speech. Plaintiffs bring this action to challenge the constitutionality of the Act. Unless enjoined by this Court, the Act will take effect on July 1, 2021, irreparably harming Plaintiffs and their customers, clients, and staff, and violating Plaintiffs’ constitutional rights... Here is a portion of the lawsuit under “Factual Allegations – Legislative History of H.B. 1182”: …The legislative history shows that the Act is intended to apply to entities that allow transgender people to use a restroom facility that accords with their gender identity, rather than the sex they were assigned at birth. During the legislative debates on H.B. 1182, the sole justification offered by its sponsor, Representative Tim Rudd, was that the bill was necessary to “protect [] women and children against” people who could “tak advantage of policies, executive orders, or legislation [] that [] allow the ‘opposite biological sex’ to enter a restroom, shower, or locker room.” He explained, with “new …giving transgenders more rights … I don’t want women… or children calling me next year how they have been raped or molested “ During a subsequent committee meeting, Representative Rudd stated that “a woman has the right to know whether a man is going to be in her bathroom and vice versa for a man.” This too was a reference to transgender people using the restrooms that accord with their gender identity. When questioned by other representatives about the need for this bill, Representative Rudd responded that the bill was suggested by a constituent at a fundraiser, and he felt the bill was needed because of the executive orders regarding rights for transgender people “coming out of Washington.” There was no testimony offered in support of the bill. The committee nonetheless voted to move the bill forward. During House floor debates on March 29, Representative Mike Stewart asked about the public policy underlying H.B. 1182. Representative Rudd once more responded that with the new executive orders and policies from Washington, it would be “good to put on notice.” He also stated that it is “shocking and a danger to people that enter a bathroom marked ‘men’ or ‘women and someone of the opposite sex is standing there, which could scare people and provoke violence.”… Here is another key part of the lawsuit: …Transgender people are frequent targets of harassment and face widespread discrimination in all facets of life. Being forced to use restrooms that do not align with their gender puts transgender people at greater risk of harassment or violence, and also causes psychological and physical harm. Policies that allow transgender people to use the correct sex-designated restroom – the restroom that best matches their identity – do not legalize harassment, stalking, violence, or sexual assault. Nor do these policies change the sex-segregated nature of these facilities. In other words, allowing transgender people to use restrooms and other facilities that align with their gender identity simply ensures that everuone has access to spaces that match who they are. These policies do not permit unfettered access for anyone, regardless of sex, to spaces restricted to one sex. Law enforcement officials and sexual assault advocates in states and cities with policies that prohibit discrimination based on transgender status, including with respect to use of single-sex facilities, have rejected the contention that these policies cause safety problems. Plaintiffs recognize that people who are transgender may need to use the restroom while out in public, just like everyone else. Plaintiff Bongo has sex-designated restrooms and has informal policies allowing transgender people to use the restrooms that align with their gender identity. Plaintiff Sanctuary does not have sex-designated restrooms at this time, but will shortly, and intends to allow transgender people to use the restrooms that align with the sex they know themselves to be… …In order to avoid being subject to the Act’s compelled speech requirements, Plaintiffs would need to change their policies to bar transgender people from using the restrooms that accord with their gender identity. They do not wish to do so… …Plaintiffs do not have anyone guarding their restroom doors to ask for their birth certificates, inspect anyone’s genitals, or interrogate any other aspect of their sex. They do not even know how they would attempt to do so without gross intrusions into the privacy of their employees, customers, and clients. Yet, unless they do so, Plaintiffs and indeed all other businesses and other entities with restroom facilities open to the public throughout Tennessee will be required to display the specific sign required by the Act… Fido has sex-designated multi-user restrooms. Mr. Bernstein is concerned that the Act’s required warning notice will create confusion for his customers, clients, and employees. Based on the legislative history of the Act, Plaintiffs Bongo and Mr. Bernstein are reasonably concerned that the Act applies to them, because they allow all women, including transgender women, to use the women’s restroom, and all men, including transgender men, to use the men’s restroom. Plaintiff Sanctuary has two multi-user restrooms that are not presently sex-designated. Anyone is welcome to use any of Sanctuary’s restrooms. Sanctuary intends to being operating a cafe next month, and will then have to display a sex designation on its two multi-user restrooms because such a designation will be required by municipal building codes. Sanctuary and Ms. Sayers are reasonably concerned that the Act applies to Sanctuary now because its all-gender multi-facilities are not “excluded” under the Act’s definition of covered entities. They are also concerned that the Act will apply to Sanctuary in the future once it adds a sex designation on its multi-user restrooms. At that time, Sanctuary will allow all women, including transgender women, to use the women’s restroom, and all men, including transgender men, to use the men’s restrooms… Here is what this lawsuit is asking the judge for: Issue a preliminary injunction, later to be made permanent, restraining Defendants, their employees, agents and successors in office from enforcing the Act;Enter a judgement declaring that the Act is unconstitutional under the First Amendment to the United States Constitution;Award Plaintiffs their reasonable costs and attorney’s fees pursuant to 42 U.S.C. § 1988; andGrant such other or further relief as the Court deems just, proper, and equitable. On June 30, 2021, Tennessean posted an article titled: “Mike Curb joins fight against Tennessee anti-trans bathroom signage bill with federal suit”. It was written by Mariah Timms. From the article: A contentious Tennessee bill requiring businesses to post signs if they allow transgender people to use the bathroom of their choosing is facing another attack in the courts.Mike Curb, music industry heavy-hitter and former California lawmaker, called the law discriminatory and hostile when announcing a new federal lawsuit filed Wednesday……The first-of-its-kind law requires businesses to post signs about transgender-friendly bathrooms and is expected to take effect July 1. It was signed by Gov. Bill Lee in May……So far, legal pushback to the law has come from the business community.The new suit, filed Wednesday in federal district court on behalf of Curb Records and the Mike Curb Foundation, joins a volley from the American Civil Liberties Union and its Tennessee chapter in the same court last week on behalf of two business owners. They’re suing Lee, the state fire marshall Carter Lawrence, Metro Nashville Codes Director William B. Herbert IV and Davidson County District Attorney Glenn Funk.Funk said in May he will not press charges against anyone refusing to post the signs, sparking criticism from conservative lawmakers.Deeming the law “transphobic,” Funk said his office would not “promote hate.”……Violations would be misdemeanors and could lead to up to six months if jail time and a maximum fine of $500, according to Tennessee code.“The required notice serves no legitimate or rational purpose and solves no actual problem. Instead, it seeks to conscript Tennessee businesses and other institutions to spread the State’s preferred message of fear and intolerance towards transgender people and to falsely portray them as a threat to the safety and privacy of other members of the public”, Wednesday’s lawsuit argues. “In doing so, it also forces businesses like Curb Records and many other Tennessee employers to violate federal law, which prohibits discrimination against transgender employees… On July 10, 2021, The Tennessee Star posted an article titled: “Record Label of Popular Christian Band Sues Tennessee over Trans Bathroom Law”. It was written by Peter D’Abrosca. From the article: The record label behind one of America’s most popular Christian bands, along with several country music artists, is suing Tennessee over the state’s new transgender bathroom signage law.Mike Curb, former Republican lieutenant governor of California who also earns Curb Records in Nashville, have filed a federal lawsuit challenging HB 1182, which requires Tennessee businesses to post signage that says “this facility maintains a policy of allowing the use of restrooms by either biological sex regardless of the designation of the restroom” if the business intends to allow both sexes to use the same bathroom, locker room, dressing rooms, or other typically-single sex areas.Curb and his record label are listed as the plaintiffs in the lawsuit… A copy of the lawsuit can be read on SCRIBD. Here are some key points: The Plaintiffs are: Curb Records Inc. and Mike Curb The Defendants are: William Lee, as Governor of Tennessee, in his official capacityCarter Lawrence, as Commissioner of the Tennessee Department of Commerce and Insurance, in his official capacityWilliam Herbert IV, as Director of the Nashville Department of Codes and Building Safety, in his official capacityand Glen Funk, as District Attorney General for the 20th Judicial District of Tennessee, in his official capacity The lawsuit was filed in the United States District Court for the Middle District of Tennessee Nashville Division. Here are some key parts of the lawsuit: Plaintiffs Curb Records, Inc. and the Mike Curb Foundation bring this federal constitutional challenge to Tennessee Public Chapter No. 453, signed into law on May 17, 2021, and referred to herein as the “Compelled Sign Law.”… The Compelled Sign Law forces businesses and other public and private entities in Tennessee to post an inflammatory, false, offensive, and discriminatory notice on any multi-user restroom that is open to the public if the business permits transgender individuals to use that restroom based on their gender identity, just as other employees, customers, and visitors are permitted to do. The state-mandated notice requires such businesses to falsely state that they permit the use of restrooms by “either biological sex, regardless of the designation on the restroom,” which falsely and offensively conveys that a transgender woman is not a woman and that a transgender man is not a man. The required notice serves no legitimate or rational purpose and solves no actual problem. It instead seeks to conscript Tennessee businesses and other institutions to spread the State’s preferred message of fear and intolerance towards transgender people and to falsely portray them as a threat to the safety or privacy of members of the public. In doing so, it also forces businesses like Curb Records and many other Tennessee employers to violate federal law, which prohibits discrimination against transgender employees. The first Amendment to the United States Constitution forbids Tennessee from compelling Plaintiffs and other private entities to express the State’s discriminatory message. And under the Constitution’s Supremacy Clause, the Compelled Sign Law is preempted by federal law and for that independent reason is void and unenforceable… Another key part is called Enactment of the Compelled Sign Law …HB 1182, which would become the Compelled Sign Law, was introduced in the Tennessee General Assembly on February 10, 2021. The primary sponsor was Representative Tim Rudd. The bill passed in the House of Representatives on March 29, 2021, and passed in the Senate on April 29, 2021. HB 1182 was signed into law by Governor Bill Lee on May 17, 2021… Part of this section reiterates what the Compelled Sign Law is, and the rules about it that businesses would be forced to follow. (I’ve got that in an earlier part of this blog post). …During a hearing on the Compelled Sign Law before the House Public Services Subcommittee, Representative Rudd stated that the bill as necessary to “protect [] women and children against” people who could “tak advantage of policies, executive orders, or legislation [] that [] allow the ‘opposite biological sex’ to enter a restroom, shower, or locker room.” Representative Rudd further stated that with “new … giving transgenders rights… I don’t want women… or children calling me next year how they have been raped or molested “. During a later hearing, Representative Rudd stated that the bill was suggested by a constituent at a fundraiser, and that the bill was necessary to respond to executive orders regarding rights for transgender people “coming out of Washington”. The Compelled Sign Law was enacted amid a flurry of hostile legislation targeting transgender people during the 2021 Tennessee legislative session. Including the Compelled Sign Law, Governor Lee signed a total of five bills into law that specifically single out transgender Tennesseans for various forms of discrimination. No other state has enacted so many bills targeting transgender people in a single legislative session. Other Tennessee legislation targeting transgender people adopted in 2021 includes laws (1) banning gender-affirming healthcare for transgender youth, (2) prohibiting transgender students from competing in sex-specific school sports based on their gender identity, (3) authorizing lawsuits against public schools when a student, teacher, or school employee encounters a “member of the opposite sex” in a shared school restroom or changing facility, and (4) requiring school districts to notify parents of any instruction on sexual orientation or gender identity and allow them to opt their children out of such instruction. The legislative history of the Compelled Sign Law further demonstrates that, in addition to singling out transgender people for adverse treatment, the Compelled Sign Law was not enacted to address any real problem or actual public need… Impact of the Compelled Sign Law on Curb Records, the Mike Curb Foundation, and Businesses and Institutions that Support Fair and Equal Treatment of Transgender Persons …Both Curb Records and the Foundation have as core values anti-discrimination and respect for diversity. Both entities seek to promote equality and inclusion for all. This includes equal treatment of transgender persons. Both entities maintain a policy of nondiscrimination based on sex and transgender status with respect to their employees, customers, and visitors. The Compelled Sign Law stigmatizes transgender persons and encourages members of the public to view transgender persons as inferior or as a threat to their safety or privacy. It does so by requiring entities that allow transgender women to use the women’s restrooms and transgender men to use the men’s restrooms to post a false and misleading notice stating that persons of “either biological sex” are permitted to use such restrooms “regardless of the designation on the restroom”. The Compelled Sign Law also increases the risk that transgender persons will be subjected to violence, harassment, or discrimination; and seeks to deny transgender persons full and equal access to employment and educational opportunities and places open to the public. The Compelled Sign Law promotes the creation of a hostile climate for transgender individuals in public places including workplaces in Tennessee that maintain nondiscriminatory access to restrooms. It seeks to foster a culture of fear, hostility, and rejection of transgender people and to discourage businesses, schools and universities, government agencies, and other institutions to treat transgender employees, students, customers, and visitors in a fair and nondiscriminatory manner. Curb Records and the Foundation do not wish to convey that damaging and intolerant message to their employees, customers, visitors, or to the general public at large, and they do not wish for their facilities to be commandeered by the State to spread that message. The Compelled Sign Law interferes with Curb Records and the Foundation’s businesses and charitable interests and risks driving away customers and visitors that they want to attract by forcing them to convey a message that conflicts with their corporate values of inclusion, diversity, equality, and respect for all people… Here is what the plaintiffs are asking the Judge for: To declare the Compelled Sign Law violates the First Amendment of the United States Constitution, both facially and as applies to Plaintiffs, and may not be enforced by Defendants and/or any other Tennessee state and/or local official.Declaring that the Compelled Sign Law is preempted by federal law and therefore is void under the Supremacy Clause, U.S. Const. art. VI, cl. 2, and may not be enforced by Defendants and/or any other Tennessee state and/or local official.Declaring that the Compelled Sign law violates the Equal Protection Clause of the Fourteenth Amendment of the United States Constitution, both facially and as applied to Plaintiffs, and may not be enforced by Defendants and/or any other Tennessee state and/or local official.Preliminarily and permanently enjoining enforcement of the Compelled Sign Law by Defendants; their officers, employees and agents; and all individuals under any Defendant’s supervision, direction, or control; and all persons acting in concert or participation with any Defendant.Awarding Plaintiffs their costs, expenses, and reasonable attorneys’ fees according to 42 U.S.C. 1988 and any other applicable laws; andGranting such other and further relief as the Court deems just and proper. On July 7, 2021, GLBTQ Legal Advocates and Defenders (who are defending Curb Records, Inc. and Mike Curb Foundation), filed for a motion for preliminary injunction. It was sent to Chief Judge Crenshaw and Magistrate Judge Holmes. From the motion: Plaintiff’s Curb Records, Inc. (“Curb Records”) and Mike Curb Foundation (“the Foundation”) move this Court to preliminarily enjoin enforcement of Tennessee Public Chapter No. 453, which they refer to as the “Compelled Sign Law” or “the Law.”… The Law requires all businesses and other entities with restrooms open to the public with formal or informal policies that allow transgender people to use the restroom that accords with their identity to post a stigmatizing and demeaning warning sign stating: “NOTICE: THIS FACILITY MAINTAINS A POLICY OF ALLOWING THE USE OF RESTROOMS BY EITHER BIOLOGICAL SEX, REGARDLESS OF THE DESIGNATION ON THE RESTROOM.”… The Compelled Sign Law forces Plaintiff’s businesses to post highly visible red and yellow signs in conspicuous locations that express a message that is the opposite of the welcoming and inclusive message they wish to express to everyone, including to any transgender employees and customers… Instead, the law compels Curb Records and the Foundation to publicly endorse a climate of fear and non-acceptance of transgender people that contradicts the companies’ values. In doing so, the Compelled Sign Law violates settled First Amendment law and, unless enjoined, will cause Plaintiffs to suffer irreparable harm to their business interests and to their fundamental right not to be compelled by the government “to speak a particular message.”… …The Compelled Sign Law also puts Plaintiff Curb Records as an employer subject to Title VII in the position of being forced to violate federal law. Curb Records must comply with Title VII’s prohibition against discrimination against any transgender people… As such, Curb Records must, and does, permit any transgender workers to use restrooms consistent with their gender identity. But if Curb Records complies with the Law by posting required signage, it will violate Title VII by subjecting any transgender workers to disparate treatment and to a hostile work environment. Under settle law, when a state law conflicts with a federal law, as the Compelled Sign Law does here, federal law controls, and the state law may not be enforced… …Plaintiff Curb Records asks this Court to enjoin enforcement of the Compelled Sign Law to avoid the serious penalties that would result from its enforcement… …Defendants will suffer no injury from an injunction. An injunction will merely maintain the status quo. The state has no compelling interest in enforcing the Compelled Sign Law by requiring anyone, including Plaintiffs, to post misleading and discriminatory notices on the public restrooms of businesses… Here is Judge Aleta A. Trauger’s decision on the case filed by Tennessee’s ACLU: (on July 9, 2021) …The State of Tennessee has enacted a law ordering the plaintiffs to say something that they do not wish to say, in furtherance of a message they do not agree with. The plaintiffs challenge that law on the basis that the First Amendment typically does not permit such a mandate unless it is narrowly tailored to satisfy a compelling government purpose. Because the plaintiffs are likely to succeed on their challenge to that law and because allowing the law to be enforced while this litigation proceeds would harm them irreparably, the court will grant a preliminary injunction against the law’s enforcement…. Here is another key part of the decision: …As the court has held, each of the factors guiding the decision to grant a preliminary injunction favors granting such an injunction here. The plaintiffs are likely to succeed on the merits; if they are not granted a preliminary injunction now, they will be harmed in a way that cannot be repaired; and requiring the State of Tennessee to abide by the U.S. Constitution, sooner rather than later, vindicates the public interest in rule by law and the acceptance by States, of constitutional government. The court, therefore, has little difficulty concluding that the preliminary injunction should issue… On July 9, 2021, NBC News posted an article titled: “Judge blocks Tennessee’s transgender bathroom sign law”. It was written by Jo Yurcaba. From the article: A federal judge blocked a Tennessee law that required businesses to post a notice if they allow transgender people to use bathrooms that match their gender identity.Two weeks ago, the American Civil Liberties Union filed a lawsuit on behalf of two business owners – who own Sanctuary, a performing arts and community center in Chattanooga, and Fido, a restaurant in Nashville, among other businesses – in an effort to block the law from taking effect July 1. Judge Aleta A. Trauger of the U.S. District Court for the Middle District of Tennessee granted a preliminary injunction against the law while litigation proceeds.“Restaurants and performing spaces are businesses, but that is not all they are; they are also among the most important physical locations in which communities – so often consigned, in this era, to electronic space – can gather and grow together in a manner rooted in a particular neighborhood, in a particular city, in a particular state,” Trauger wrote.“The plaintiffs have presented evidence that they have strived to be welcoming spaces for communities that include transgender individuals and that the signage required by the Act would disrupt the welcoming environments that they wish to provide,” Trauger continued. “That harm would be real, and it is not a harm that could simply be remedied by some award at the end of litigation.”……The suit is one of two filed against the law. The other was filed last week by Mike Curb, a Nashville record label owner, who is represented by GLBTQ Legal Advocates and Defenders… This was a big win for one of the court cases that was challenging the “Compelled Sign Law”. The other case has not yet been granted an injunction. It is unclear to me whether or not the preliminary injunction can be applied to both cases. In a state like Tennessee, which has passed a multitude of laws that are harmful to people who are transgender – it is good to see a win against the “Compelled Sign Law”. Tennessee’s Bathroom Bill was Blocked is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Health Care Under Biden-Harris Administration – January 2021July 7, 2021health insurance / Out of SpoonsPhoto by René DeAnda on Unsplash The Biden-Harris Administration has been making it easier for people to receive the health care they need. This is a huge change from the Trump-Pence Administration, that greatly restricted access to health care. This blog post is a timeline that covers health care starting on Inauguration Day. It includes federal and state regulations and decisions about health care, and calls from health-related organizations for more to be done. It also includes some of the harmful decisions made by Republicans. January 20, 2021 – January 30, 2021 January 20, 2021: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Looks Forward to Working With the Biden-Harris Administration to Advance Reproductive Freedom”. From the press release: Today, President-elect Joe Biden and Vice President-elect Kamala Harris will be sworn in – providing a critical opportunity to protect and expand reproductive freedom as we work to undo the damage the Trump administration has done to our fundamental rights. With the help of NARAL members and our organization’s largest-ever electoral program, voters turned out in historic numbers to make their voices heard and send President-elect Biden and Vice President-elect Harris to the White House, electing a ticket that has vowed to fight for reproductive freedom……As we turn the page on four years of unyielding attacks on our rights and freedoms we must remain vigilant as threats persist, working on the federal and state level to protect and expand reproductive freedom whenever possible. It’s critical that the Biden-Harris administration demonstrate its commitment to protecting and expanding access to comprehensive reproductive healthcare – including abortion care – and upholding sexual and reproductive rights in the United States and around the world by: Expanding access to reproductive healthcare by removing harmful and medically unnecessary restrictions on medication abortion care during COVID-19;Initiating a comprehensive FDA review of medication abortion – a safe, effective, FDA-approved option for ending an early pregnancy – so that people’s access to care reflects science, not politics;Rescinding Trump’s executive actions limiting access to care, including the dangerous global gag rule, the domestic gag rule and attacks on comprehensive coverage;Ensuring that the president’s budget advances reproductive freedom and excludes discriminatory restrictions on abortion coverage; andNominating and appointing judges and executive branch officials with positive records on reproductive freedom, health, rights, and justice. On the campaign trail, President-elect Biden outlined his commitment to protecting and expanding reproductive freedom by vowing to work to safeguard Roe v. Wade, only appoint judges who will respect Roe, support the repeal of racist and discriminatory Hyde Amendment, and use executive action to protect and expand access to abortion and contraception, including reversing Trump’s global and domestic gag rules. The Biden-Harris administration heads the White House at a critical time in the fight for reproductive freedom. Thanks to the Trump administration stacking the court with judges hostile to reproductive freedom, our fundamental rights are in peril. Anti-choice politicians remain determined to criminalize abortion – putting the advancement of their political goals above the health and well-being of the American people. Just before Election Day, Donald Trump and Senate Republicans jammed through the confirmation of Amy Barrett, a judge with a record of hostility towards the legal right to abortion, to the Supreme Court.Barrett’s presence on the Court solidifies an anti-choice supermajority on the bench that could threaten our fundamental rights for decades. Dozens of cases that put Roe and access to abortion care at risk are making their way to the Supreme Court. Last week, Justice Barrett and the anti-choice majority on the bench once again demonstrated their hostility towards reproductive freedom when they ruled to reinstate a restriction forcing people to travel to a health center to access medication abortion during the still raging COVID-19 pandemic. January 20, 2021: President Biden issued a executive order titled: “Executive Order on Protecting the Federal Workforce and Requiring Mask-Wearing”. From the executive order: By the authority vested in me as President by the Constitution and the laws of the United States of America, including section 7902(c) of title 5, United States Code, it is hereby ordered as follows:Section 1. Policy. It is the policy of my Administration to halt the spread of coronavirus disease 2019 (COVID-19) by relying on the best available data and science-based public health measures. Such measures include wearing masks when around others, physical distancing, and other related precautions recommended by the Centers for Disease Control and Prevention (CDC). Put simply, masks and other public health measures reduce the spread of the disease, particularly when communities make widespread use of such measures, and thus save lives.Accordingly, to protect the Federal workforce and individuals interacting with the Federal workforce, and to ensure the continuity of Government services and activities, on-duty on or-site Federal contractors, and other individuals in Federal buildings and on Federal lands should all wear masks, maintain physical distance, and adhere to other public health measures, as provided in CDC guidelines.Sec. 2. Immediate Action Regarding Federal Employees, Contractors, Buildings, and Lands. (a) The heads of executive departments and agencies (agencies) shall immediately take action, as appropriate and consistent with applicable law, to require compliance with CDC guidelines with respect to wearing masks, maintaining physical distance, and other public health measures by: on-duty or on-site Federal employees; Federal contractors; and all persons in Federal buildings or on Federal lands.(b) The Director of the Office of Management and Budget (OMB), the Director of the Office of Personnel Management (OPM), and the Administrator of General Services, in coordination with the President’s Management Council and the Coordinator of the COVID-19 Response and Counselor to the President (COVID-10 Response Coordinator), shall promptly issue guidance to assist heads of agencies with implementation of this section….Sec. 3. Encouraging Masking Across America. (a) The Secretary of Health and Human Services (HHS), including through the Director of the CDC, shall engage, as appropriate, with State, local, Tribal, and territorial officials, as well as business, union, academic and other community leaders, regarding mask-wearing and other public health measures, with the goal of maximizing public compliance with, and addressing any obstacles to, mask-wearing and other public health best practices identified by CDC……Section 5. Federal Employee Testing. The Secretary of HHS through the Director of the CDC, shall promptly develop and submit to the COVID-19 Response Coordinator a testing plan for the Federal workforce. This plan shall be based on community transmission metrics and address the populations to be tested, testing types, frequency of testing, positive case protocols, and coordination with local public health authorities for contact tracing… January 20, 2021: American Medical Association (AMA) posted a press release titled: “AMA applauds Biden Administration on first-day executive actions”. From the press release: The American Medical Association (AMA) today applauded the Biden Administration’s first-day actions that tackle the COVID-19 pandemic and climate change, re-engage with the World Health Organization (WHO), and advance racial equity, among other policies. The executive orders, memoranda, and other actions are the first steps on issues critical to improving the health of the nation.Addressing the COVID-19 pandemic Launching a “100 Days Masking Challenge”Re-engaging with the WHOCoordinating a unified federal response to COVID-19 “Defeating COVID-19 requires bold, coordinated federal leadership and strong adherence to the public health steps we know stop the spread of this virus – wearing masks, practicing physical distancing, and washing hands,” said AMA President Susan R. Bailey, MD. “We are pleased by the Biden Administration’s steps today, including universal mask wearing within federal jurisdictions, providing federal leadership for COVID-19.”Rejoining the Paris Agreement on climate change“Rejoining the Paris Climate Agreement is a critical step to demonstrate American leadership in the prevention of the devastating health harms of climate change,” Dr. Bailey said. “Climate change has massive public health implications, with disproportionate impacts on vulnerable populations, including children, the elderly, and the poor. We are encouraged by today’s action by the Biden Administration to rejoin the world community in this monumental global effort.”Immigration issues Rescinding the exclusion of undocumented aliens from the censusPreserving and fortifying the Deferred Action for Childhood Arrivals (DACA) programRescinding the immigration ban on Muslim countries “The AMA strongly opposed the previous administration’s efforts to rescind DACA and was part of the successful Supreme Court case overturning that decision,” said Dr. Bailey. “Today, thousands of Dreamers are working in, or training to join, health care professions and our country is in need of their services in the fight against COVID-19. Giving Dreamers certainty about their legal status is a critical step in the right direction by the Biden Administration. People with DACA status contribute to a diverse and culturally responsive physician workforce, which benefits all patients.”Prohibiting workplace discrimination on the basis of gender identity or sexual orientation“The AMA believes that LGBTQ+ individuals must be protected from workplace discrimination in order to prevent negative health outcomes,” said Dr. Bailey. “We were proud to join 15 other leading health organizations in an amicus brief to the Supreme Court in the recent Title VII case, and we are encouraged by today’s action by the Biden Administration to ensure equality. The AMA supports access to quality, evidence-based health care for all people, regardless of gender or sexual orientation, and we will continue to work diligently at all levels to expand access to health care, reduce stigma in treating patients with unique needs, and break down discriminatory barriers to care.” January 20, 2021: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Dear Colleague on President Biden’s Day One Executive Actions”. From the press release: Dear Democratic Colleague,Today, when President Joe Biden and Vice President Kamala Harris took the oath of office, it was a breath of fresh air for our democracy, for American and for our future. Happily, today, Senator Chuck Schumer became the Majority Leader of the Senate.Now, our Democratic House Majority will work to deliver progress For the People – to honor Joe Biden’s promise that “Help is On the Way.” Working with the Biden-Harris Administration and the new Democratic Majority in the Senate, we will ensure that our nation will recover from the coronavirus and economic crisis. And we will Build Back Better in a way that will advance justice, equality and progress for all Americans.We must get to work immediately – which is why I am pleased to support President Biden’s Day One Executive Actions to meet the needs of the American people, which will start by addressing the coronavirus. These Executive Actions will: Crush the coronavirus: by launching a unified, all-of-government response to increase mask-wearing and other science-based steps to stop the virus’s spread. It also takes specific action to address the disproportionate impact on communities of color, while recognizing the importance of re-engaging with the international community.Deliver urgent economic relief: by extending moratoriums on evictions, foreclosures and student loan payments.Combat the climate crisis: by rejoining the historic Paris Climate Agreement and rolling back Trump’s special interest, dirty energy Executive Actions.Honor our nation’s diverse heritage: by protecting Dreamers and TPS and DED recipients, rescinding the Muslim ban and taking bold action to end anti-LGBTQ discrimination.Advance racial equality: by launching a whole-of-government initiative to promote racial equity… January 21, 2021: Center for Reproductive Rights posted a statement titled: “CEO Nancy Northup’s Statement on the Inauguration of Joseph R. Biden Jr., as the 46th President of the United States”. From the statement: Today’s inauguration of Joseph R. Biden as the 46th president of the United States presents an urgent opportunity to put human needs and human rights at the center of a new U.S. domestic and foreign policy. It is also a barrier-breaking day, as Vice-President Kamala Harris becomes the first Black American, and the first South Asian American to hold the office.The urgency of this moment is abundantly clear. People are suffering and dying of COVID-19, the U.S. economy is in turmoil, and armed insurrectionists bearing racist symbols stormed the U.S. Capitol two weeks ago. The opportunity is now to roll-back the harms of the past four years and move forward with the vision of reproductive rights for all. President Biden ran on a platform that embraced America’s diversity as its greatest strength, promised to address human rights wherever they are under threat, and committed to protect and advance reproductive health, rights, and justice.We urge President Biden to take quick and decisive action to reverse the Trump administration’s harmful policies and to move forward on this critical agenda. Specifically, we call on the new administration to: Promote the health and well-being of women and girls in U.S. foreign policy: Rescind the Global Gag Rule: This policy bans federal funding to international healthcare providers if they provide counsel or advocate for abortion access, even when they use a separate funding source to do so. Restore reporting on sexual and reproductive health and rights in the State Department’s annual country reports on human rights. Restore funding to United Nations Population Fund (UNFPA) and rejoin and restore funding to the World Health Organization (WHO). UNFPA is the lead U.N. agency focused on sexual and reproductive health. The WHO coordinates high-impact research and sets global standards on sexual and reproductive health and rights. Stop wrongly implementing the Helms Amendment while pushing for its Congressional repeal: For nearly 50 years, the Helms Amendment barred U.S. foreign aid from being used for abortion services “as a method of family planning”. Prior administrations have wrongly treated this as a total ban on abortion care, even in cases of rape, incest, or the endangerment of life or health. Rescind Trump Era Regulations, including the Domestic Gag Rule, which prohibits clinics receiving Title X family planning funds from referring patients for abortion services, regulations that allow health care workers to deny reproductive health services and information, and regulations that allow employers and universities to deny contraceptive coverage to their employees and students. Promote reproductive health policies guided by science, not ideology: The FDA should take the same approach to allowing access to medication abortion by telemedicne, in line with its approach to other drugs. Support policies to end racial disparities in maternal health care by launching an interagency task force on maternal care, promoting expansion of Medicaid coverage to at least one year postpartum, and championing passage of the Black Maternal Health Momibus Act. In addition to taking these actions that are within the power of the executive branch, we also call on President Biden to champion legislation to address the abortion access crisis. Since 2011, states have enacted over 500 restrictions on abortion access. These come on top of policies that deny insurance coverage for abortion to those who receive their health insurance from the federal government, including Medicaid. Restrictions on abortion access and coverage have fallen disproportionately on Black, Indigenous, and people of color, people living on low incomes, and young people. Congress must address the abortion access crisis and long-standing injustice of the Hyde Amendment by passing the Women’s Health Protection Act and the EACH Woman Act.As the Biden administration combats the devastating coronavirus pandemic, it must also move forward to advance reproductive rights because the need for access to the full range of reproductive healthcare – including contraception, maternal health care, and abortion care – does not abate in a pandemic… January 21, 2021: The White House posted an executive order titled: “Executive Order on Ensuring an Equitable Pandemic Response and Recovery”. From the executive order: By the authority vested in me as President by the Constitution and the laws of the United States of America, and in order to address the disproportionate and severe impact of coronavirus disease 2019 (COVID-19) on communities of color and other underserved populations, it is hereby ordered as follows:Section 1. Purpose. The COVID-19 pandemic has exposed and exacerbated severe and pervasive health and social inequities in America. For instance, people of color experience systemic and structural racism in many facets of our society and are more likely to become sick and die from COVID-19. The lack of complete data, disaggregated by race and ethnicity, on COVID-19 infection, hospitalization, and mortality rates, as well as underlying health and social vulnerabilities, has further hampered efforts to ensure an equitable pandemic response. Other communities, often obscured in the data, are also disproportionatley affected by COVID-19, including sexual and gender minority groups, those living with disabilities, and those living at the margins of our economy. Observed inequities in rural and Tribal communities, territories, and other geographically isolated communities require a place-based approach to data collection and the response. Despite increased State and local efforts to address these inequities, COVID-19’s disparate impact on communities of color and other underserved populations remain unrelenting.Addressing this devastating toll is both a moral imperative and pragmatic policy. it is impossible to change the course of the pandemic without tackling it in the hardest-hit communities. In order to identify and eliminate health and social inequities resulting in disproportionately higher rates of exposure, illness, and death, I am directing a Government-wide effort to address health equity. The Federal Government must take swift action to prevent and remedy differences in COVID-19 care and outcomes within communities of color and other underserved populations.Sec. 2 COVID-19 Health Equity Task Force. There is established within the Department of Health and Human Services (HHS) a COVID-19 Health Equity Task Force (Task Force).(a) Membership. The Task Force shall consist of the Secretary of HHS; an individual designated by the by the Secretary of the HHS to Chair the Task Force (COVID-19 Health Equity Task Force Chair); the heads of such other executive departments, agencies, or offices (agencies) as the Chair may invite, and up to 20 members from sectors outside the Federal Government appointed by the President……Mission and Work.(i) Consistent with applicable law and as soon as practicable, the Task Force shall provide specific recommendations to the President, through the Coordinator of the COVID-19 Response and Counselor to the President (COVID-19 Response Coordinator), for mitigating the health inequities caused or exacerbated by the COVID-19 pandemic and for preventing such inequities in the future…. January 21, 2021: The White House posted an executive order titled: “Executive Order on Protecting Worker Health and Safety”. From the executive order: By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:Section 1. Policy. Ensuring the health and safety of workers is a national priority and a moral imperative. Healthcare workers and other essential workers, many of whom are people of color and immigrants, have put their lives on the line during the coronavirus disease 2019 (COVID-19) pandemic. It is the policy of my Administration to protect the health and safety of workers from COVID-19.The Federal Government must take swift action to reduce the risk that workers may contract COVID-19 in the workplace. That will require issuing science-based guidance to help keep workers safe from COVID-19 exposure, including with respect to mask-wearing; partnering with State and local governments to better protect public employees; enforcing worker health and safety requirements; and pushing for additional resources to help employers protect employees.Section 2. Protecting Workers from COVID-19 Under the Occupational Safety and Health Act. The Secretary of Labor, acting through the Assistant Secretary of Labor for Occupational Safety and Health, in furtherance of the policy described in section 1 of this order and consistent with applicable law, shall:(a) issue, within 2 weeks of the date of this order and in conjunction or consultation with the heads of any other appropriate executive departments and agencies (agencies), revised guidance to employers on workplace safety during the COVID-19 pandemic;(b) consider whether any emergency temporary standards on COVID-19, including with respect to masks in the workplace, are necessary, and if such standards are determined to be necessary, issue them by March 15, 2021;(c) review the enforcement efforts of the Occupational Safety and Health Administration (OSHA) related to COVID-19 and identify any short-, medium-, and long-term changes that could be made to better protect workers and ensure equity in enforcement;(d) launch a national program to focus OSHA enforcement efforts related to COVID-19 on violations that put the largest number of workers at serious risk or are contrary to anti-retaliation principles; and(e) coordinate with the Department of Labor’s Office of Public Affairs and Office of Public Engagement and all regional OSHA offices to conduct, consistent with applicable law, a multilingual outreach campaign to inform workers and their representatives of their rights under applicable law. This campaign shall include engagement with labor unions, community organizations, and industries, and place a special emphasis on communities hit hardest by the pandemic.Sec. 3. Protecting Other Categories of Workers from COVID-19. (a) The Secretary of Labor, acting through the Assistant Secretary of Labor for Occupational Safety and Health consistent with applicable law, shall:(i) coordinate with States that have occupational safety and health plans approved under section 18 of the Occupational Safety and Health Act (Act) (29. U.S.C. 667) to seek to ensure that workers covered by such plans are adequately protected from COVID-19, consistent with any revised guidance or emergency temporary standards by OSHA; and(ii) in States that do not have such plans, consult with State and local government entities with responsibility for public employee safety and health and with public employee unions to bolster protection from COVID-19 for public sector workers.(b) The Secretary of Agriculture, the Secretary of Labor, the Secretary of Health and Human Services, the Secretary of Transportation, and the Secretary of Energy, in consultation with the heads of other appropriate agencies, shall, consistent with applicable law, explore mechanisms to protect workers not protected under the Act so that they remain healthy and safe on the job during the COVID-19 pandemic.(c) The Secretary of Labor, acting through the Assistant Secretary of Labor for Mine Safety and Health, shall consider whether any emergency temporary standards on COVID-19 applicable to coal and metal or non-metal mines are necessary, and if such standards are determined to be necessary and consistent with applicable law, issue them as soon as practicable… January 21, 2021: Georgetown University Health Policy Institute Center For Children and Families posted a blog titled: “The Tennessee Waiver: Block Grant, Aggregate Cap, or Windfall?” It was written by Andy Schnieder and Allexa Gardner. From the blog post: …Since its enactment in 1965, Medicaid has guaranteed federal funding to participating states for the costs of health and long-term care services to low-income children, adults, individuals with disabilities, and the elderly. State spending on covered services for eligible individuals is matches by the federal government on an open-ended basis at an average rate of 65 percent. The more that states have to spend in order to meet the needs of their low-income residents, the more the federal government will match those state expenditures. This open-ended matching is particularly important during times of natural disasters or public health emergencies (think pandemic). Of course, if there is no state spending, then by definition there is no federal matching.TennCare III jettisons this arrangement……The federal government will continue to match Tennessee’s Medicaid spending at its regular matching rate but only up to a fixed amount each year, for each of the next 10 years. That amount – let’s call it a cap – can be adjusted up (or down) if enrollment grows (or declines) more than 1 percent. The per enrollee spending amounts used to make this adjustment grow at a generous rate of over 5 percent annually for the first five years; after that, both the caps and the adjustment amounts will be renegotiated, creating significant uncertainty for state policymakers, providers, and beneficiaries.Capping federal Medicaid spending had been former Administrator Verma’s North Star. Early in her tenure, she set forth her vision in a speech to state Medicaid directors. She strongly supported the Trump Administration’s 2017 effort to enact a Medicaid cap, which fell short of Senate passage by one vote. Having failed to change the Medicaid statute through the legislative process, former Administrator Verma had been trying since early 2018 to rewrite it by Executive Branch fiat, her calls for humility in government to the contrary notwithstanding. In Tennessee, she finally found a willing partner……The former Administrator’s ideological fixation on capping Medicaid spending is crystal clear. But why would a state with among the highest rates of uninsurance and rural hospital closures in the nation decide to let the federal government dump the risk of increases in health and long-term care costs in the middle of a pandemic – much less lock itself into a a 10-year limit on federal funds knowing that medical care inflation is completely unconstrained?In a nutshell: free federal finds. Under the demonstration, if Tennessee spends less during a year than the cap for that year, it gets to keep 55 percent of the federal share of “savings” – without spending a dime of its own money……Medicaid is a federal-state matching program. If a state spends its own funds on behalf of an eligible individual for a covered service, the federal government matches that expenditure. But there has to be a state expenditure. If a state doesn’t spend money purchasing covered services on behalf of Medicaid beneficiaries, the federal government doesn’t pay any matching funds. Both the state and the federal government save, in proportion to their regular federal-state shares. Under TennCare III, the state will be able to draw down federal matching dollars even though it has not made an expenditure of its own funds……There is, of course, a legal way to improve the health of low-income Tennesseans and their communities. It’s called Medicaid expansion. And it comes with a statutory 90 percent federal matching rate, considerably more generous than Tennessee’s regular 66 percent matching rate. If Tennessee took up Medicaid expansion, there would be less need to refinance Community and Faith-based clinics for the uninsured, because there would be 260,000 fewer uninsured Tennesseans. January 22, 2021: The White House posted a statement titled: “Statement from President Biden and Vice President Harris on the 48th Anniversary of Roe v. Wade”. From the statement: Today marks the 48th anniversary of the U.S. Supreme Court’s landmark ruling in Roe v. Wade.In the past four years, reproductive health, including the right to choose, has been under relentless and extreme attack. We are deeply committed to making sure everyone has access to care – including reproductive care – regardless of income, race, zip code, health insurance status, or immigration status. The Biden-Harris Administration is committed to codifying Roe v. Wade and appointing judges that respect foundational precedents like Roe. We are also committed to ensuring that we work to eliminate maternal and infant health disparities, increase access to contraception, and support families economically so that all parents can raise their families with dignity. This commitment extends to our critical work on health outcomes around the world. As the Biden-Harris Administration begins in this critical moment, now is the time to rededicate ourselves to ensuring that all individuals have access to the health care they need. January 22, 2021: Planned Parenthood posted a press release titled: “Planned Parenthood Celebrates 48th Anniversary of Roe v. Wade, Calls for Further Action”. From the press release: Today, on the 48th anniversary of Roe v. Wade, Planned Parenthood Federation of America commemorates this important milestone and calls for robust action to protect and expand abortion access nationwide. Statement from Alexis McGill Johnson, president and CEO, Planned Parenthood Federation of America:Today marks 48 years since the Supreme Court’s Roe v. Wade decision, which established the legal right to an abortion. Yet, nearly half a century later, abortion is a right in name only for millions of people across the country. As reproductive justice organizations have said for years, Roe is the floor, not the ceiling. Without access to abortion, this right is meaningless. Now is the time for President Biden and our elected officials in states across the country to take necessary and immediate action to ensure that everyone, no matter their race, income, or ZIP code, has access to safe and legal abortion… January 22, 2021: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Releases Statement on the 48th Anniversary of Roe v. Wade”. From the press release: On the 48th anniversary of the Supreme Court’s landmark ruling in Roe v. Wade, NARAL Pro-Choice America President Ilyse Hogue issued the following statement:“We celebrate the anniversary of Roe v. Wade at a pivotal moment in the fight for reproductive freedom. The landmark decision and the legal right to abortion are on the line like never before, thanks to the efforts of anti-choice state lawmakers trying to chip away at abortion access at every turn, and Donald Trump and Mitch McConnell’s work to stack the court with judges hostile to our fundamental rights.We must work together to ensure that reproductive freedom is a reality for every body – no matter who they are, where they live, or how much money they make. For 48 years, Roe has been a vital part of keeping us on the path to realizing this vision for our future.The Biden-Harris administration embodies a new and welcome era of leadership – one that has committed to taking bold action to safeguard reproductive freedom and connected reproductive rights to the fight for justice and equity. As we work to undo the damage done by Trump and anti-choice politicians, we must carry the guiding principle that Roe is the floor, not the ceiling for the vision we espouse for this country. Fighting to ensure abortion remains legal is critical, but it is only the tip of the iceberg.NARAL and our more than 2.5 million members across the country will not stop fighting until every body is free to make their own decisions about pregnancy and parenting, free from political interference.”Any day, the Supreme Court could decide to review a case on Mississippi’s 15-week abortion ban, which directly challenges Roe v. Wade and violates nearly 50 years of Supreme Court precedent. If Roe fell tomorrow, 24 states would likely take action to prohibit abortion outright. Ten states already have “trigger bans” in place, which would ban abortion immediately if Roe is overturned. If Roe is rolled back and states are able to ban abortion, the consequences would be devastating. Scenarios about punishing and interrogating pregnant people and healthcare providers aren’t far fetched – they’re already happening. Pregnant people across the country are already charged or prosecuted for experiencing pregnancy loss, for struggling with substance use during pregnancy, for self-managing abortion care, or even a suspicion of it. Black, Indigenous, and people of color (BIPOC); those in rural areas; and those with low incomes are disproportionately the focus of these cruel overreaches.Despite the anti-choice movement’s relentless efforts to overturn Roe and criminalize abortion, they are widely out of touch with the values of the majority. Across the United States, the vast majority of people believe that abortion should be legal. Polling shows that 77% of Americans support Roe, and there is no state in the country where banning abortion is popular. January 22, 2021: The American College of Obstetricians and Gynecologists (ACOG) posted a news release titled: “ACOG Statement on the 48th Anniversary of Roe v. Wade”. From the news release: The following is a quote from Eva Chalas, MD, FACOG, FACS, President of the American College of Obstetricians and Gynecologists (ACOG):“Forty-eight years ago this week, the United States Supreme Court handed down its landmark decision in Roe v. Wade. As we reflect on the anniversary of this historic case, it is also imperative to reflect on the future. The American College of Obstetricians and Gynecologists supports the availability of high-quality reproductive health services for all patients. Today and every day, ACOG reaffirms our commitment to ensuring our members can practice evidence-based medicine free from political interference, intimidation, and threat of criminal penalties, and that their patients can access the full range of essential reproductive health care.” January 22, 2021: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Statement on the 48th Anniversary of Roe v. Wade”. From the press release: Speaker Nancy Pelosi released the following statement marking the 48th anniversary of Roe v. Wade:“For 48 years, Roe v. Wade has been a cornerstone of health and equal rights for all American women. This landmark decision protects a woman’s fundamental right to make her own reproductive health decisions.“Nearly half a century later, Roe v. Wade is settled law. Yet, due to relentless Republican attacks in states across the country, it is hanging on by a thread, threatening to drag American women back to a dark, dangerous and deadly past. These harmful attacks challenge our nation’s bedrock values and significantly undermine women’s health and economic security, particularly women of color and those in low-income communities. But with the tireless voices and activism of women across the country, these Republican efforts must continue to fail.“Our new, unified Democratic government will continue working to strengthen women’s comprehensive health care, to reduce unintended pregnancies, to lower maternal and infant mortality and to safeguard every woman’s personal right to decide when and how to start a family. On this anniversary, we renew our commitment to build on the legacy of Roe v. Wade so that we can protect a woman’s right to choose and defend women’s hard-won freedoms, now and always.” January 22, 2021: Centers for Disease Control and Prevention (CDC) posted a Morbidity and Mortality Weekly Report (MMWR) titled: “Vaccination Coverage with Selected Vaccines and Exemption Rates Among Children in Kindergarten – United States, 2019-20 School Year”. From the summary of the report: What is already known about this topic?State immunization programs conduct annual kindergarten vaccination assessments to monitor school-entry vaccination coverage with all state-required vaccines.What is added by this report? For the 2019-20 school year, national coverage was approximately 95% for diptheria and tetanus toxiods, and acellular pertussis; measles, mumps and rubella; and varicella vaccines. The national exemption rate remained low at 2.5%What are the implications for public health practice?Disruptions caused by the COVID-19 pandemic are expected to reduce vaccination coverage in the 2020-2021 school year. Increased follow-up of undervaccinated students is needed from schools and immunization programs to maintain the high vaccination coverage necessary to protect students in preparation for schools returning to in-person learning. January 22, 2021: National Women’s Law Center posted a resource titled: “The Equality Act of 2021: Expanding Antidiscrimination Protections for LGBTQ People and Women”. From the resource: While the Supreme Court’s marriage decision in 2015 and workplace rights decision in 2020 expanded explicit protections for LGBTQ people, there is still much to be done to ensure equal treatment under the law. Federal law and the majority of states lack explicit non-discrimination protections for LGBTQ people in housing, at school, and elsewhere, leaving many open to discrimination.The Equality Act would amend the Civil Rights Act of 1964 and other key federal nondiscrimination laws to provide clear, explicit protections clarifying that the prohibitions against sex discrimination include discrimination based on sexual orientation and gender identity. These protections would apply in the context of housing, public accommodations, credit, federally funded programs (including education), and federal jury service. In line with the Supreme Court’s decision in Bostock, the Equality Act would make clear that discrimination against LGBTQ individuals in all of these settings is unlawful.The protections the Equality Act would provide are vital for LGBTQ individuals across many areas of their lives. For example, 8% of LGBTQ individuals and 29% of transgender individuals reported that healthcare professionals refused to see them based on their actual or perceived sexual orientation or gender identity. Further, nearly one quarter of transgender respondents said they did not seek necessary healthcare for fear they would be mistreated based on their trans identity.As a further example, transgender women of color also face pervasive housing discrimination – with 31% of Black transgender women and 27% of Native transgender women reporting being denied a home or apartment in the past year because they were transgender.The Equality Act would also close longstanding gaps in federal law and for the first time prohibit discrimination on the basis of sex in public spaces, services, and all federally funded activities, providing important new legal protections for women and LGBTQ individuals. Finally, the Act would expand the scope of what kinds of entities count as a place of public accommodation, thereby creating new protected entities including race and national origin. January 24, 2021: Georgetown University Health Policy Institute Center for Children and Families posted a blog titled: “Biden Administration Promises Predictability on Future Extensions of the Public Health Emergency”. It was written by Tricia Brooks. From the blog: In a recent letter to Governors, Acting Health and Human Services Secretary Norris Cochran signaled that the COVID-19 public health emergency (PHE) “will likely remain in place for the entirety of 2021.” Moreover, the letter assures states that when a determination is made to terminate the PHE or let it expire. HHS will provide states with 60 days’ notice. By law, a PHE is limited to a 90-day period but it can be terminated early or extended. The Biden Administration’s announcement is a big deal because our nation’s public health response to the pandemic, as well as efforts to support families and shore up the economy, are inextricably linked to PHE.Enhanced federal funding for Medicaid would continue through March 2022.For state budgets, the announcement provides greater certainty of the 6.2 percentage point increase in the Medicaid Federal Medical Assistance Percentage (FMAP) until the end of the quarter in which the PHE expires or is terminated. If extended through the entirety of 2021, the earliest the PHE would expire would be January 16, 2022, meaning states can count on the FMAP bump through March 2022 (three-quarters of most states’ fiscal years.)Continuous enrollment in Medicaid would continue through January 2022.To claim the enhanced match, states must continue to meet the conditions of the maintenance of effort (MOE) provisions in the Family First Coronavirus Response Act. Importantly, the MOE protects Medicaid enrollees with continuous coverage until the end of the PHE and prohibits states from rolling back eligibility or imposing new administrative barriers to enrollment. Initially, HHS issued guidance in the form of FAQs that also disallowed states from reducing benefits or increasing cost-sharing. But those protections were shattered when HHS rammed through an interim final rule in early November, reversing aspects of its prior guidance without going through the rulemaking process that incorporates public comment before finalizing a new regulation… January 25, 2021: President Biden posted a Presidential Action titled: “Executive Order on Enabling All Qualified Americans to Serve Their Country in Uniform”. From the Presidential Action: By the authority vested in me as President of the Constitution and the laws of the United States of America, it is hereby ordered as follows:Section 1. Policy. All Americans who are qualified to serve in the Armed Forces of the United States (“Armed Forces”) should be able to serve. The All-Volunteer Force thrives when it is composed of diverse Americans who can meet the rigorous standards for military service, and an inclusive military strengthens our national security.It is my conviction as Commander in Chief of the Armed Forces that gender identity should not be a bar to military service. Moreover, there is substantial evidence that allowing transgender individuals to serve in the military does not have any meaningful negative impact on the Armed Forces. To that end, in 2016, a meticulous, comprehensive study requested by the Department of Defense found that enabling transgender individuals to serve openly in the United States military would have only a minimal impact of military readiness and healthcare costs. The study also concluded that open transgender service has had no significant impact on operational effectiveness or unit cohesion in foreign militaries.On the basis of this information, the Secretary of Defense concluded in 2016 that permitting transgender individuals to serve openly in the military was consistent with military readiness and with strength through diversity, such that transgender service members who could meet the required standards and procedures should be permitted to serve openly. The Secretary of Defense also concluded that it was appropriate to create a process that would enable service members to take steps to transition gender while serving.The previous administration chose to alter that policy to bar transgender persons, in almost all circumstances, from joining the Armed Forces and from being able to take steps to transition gender while serving. Rather than relying on the comprehensive study by a nonpartisan federally funded research center, the previous administration relied on a review that resulted in a policy that set unnecessary barriers to military service. It is my judgment that the Secretary of Defense’s 2016 conclusions remain valid, as further demonstrated by the fact that, in 2018, then-service Chief of Staff of the Army, Chief of Naval Operations, Commandant of the Marine Corp, and Chief of Staff of the Air Force all testified publicly to the Congress that they were not aware of any issues of unit cohesion, disciplinary problems, or issues of morale resulting from open transgender service. A group of former Unites States Surgeons General, who collectively served under Democratic and Republican Presidents, echoed this point, stating in 2018 that “transgender troops are medically fit as their non-transgender peers and that there is no medically valid reason – including a diagnosis of gender dysphoria – to exclude them from military service or to limit their access to medically necessary care.”Therefore, it shall be the policy of the United States to ensure that all transgender individuals who wish to serve in the United States military and can meet the appropriate standards shall be able to do so openly and free from discrimination.Sec. 2. Revocation. The Presidential Memorandum of March 23, 2018 (Military Service by Transgender Individuals), is hereby revoked, and the Presidential Memorandum of August 25, 2017 (Military Service by Transgender Individuals), remains revoked… January 25, 2021: Speaker of the House Nancy Pelosi posted a press release titled: “Pelosi Statement on President Biden Executive Order Reversing Trump Transgender Service Ban”. From the press release: Speaker Nancy Pelosi issued this statement on President Biden’s Executive Order directing agencies to reverse the Trump transgender military ban and immediately prohibit involuntary separations, discharges and denials of reenlistment or continuation of service on the basis of gender identity or under circumstances relating to gender identity:“Today is a day of great hope and progress for thousands of heroes in our military and indeed for our entire country, as the Trump transgender ban is thrown into the trashbin of history. Led by President Biden, America is restoring our proud pledge: that no one with the strength and bravery to serve in the U.S. military should be turned away because of who they are.“The Trump ban was a cruel and arbitrary decision designed to humiliate transgender Americans who have stepped forward to serve our country. The Biden-Harris Administration and Democratic Congress will continue to reverse this and other discriminatory actions that weaken our military readiness and betray our core American values.“Democrats’ defense strategy will be dictated by the priorities of security, stability, peace and American values – not the hate and prejudice that defined the Trump presidency.” January 26, 2021: Kaiser Family Foundation (KFF) posted an article titled: “How Quickly We Need To Ramp Up Vaccinations To Get To Herd Immunity”. It was written by Drew Altman. From the article: The country needs to ramp up vaccinations rapidly if we are to reach herd immunity by, say, July 4th our Independence Day, Labor Day, or even by the beginning of next year.Some basic math and assumptions paint the picture:We need to average 2.4 million doses a day starting now to reach the point where 70% of the population is vaccinated by July 4th (assuming two doses needed per person), There are many estimates out there of what’s needed for herd immunity, and that’s probably the bare minimum. It’s also harder than it sounds, because kids aren’t being vaccinated right now, so we need to reach the vast majority of adults, which means overcoming hesitancy where it exists.It’s 1.9 million doses to reach it by Labor Day.And 1.2 million doses per day if we achieve the goal by January 1, 2022……Last Friday, the Centers for Disease Control and Prevention (CDC) reported 1.6 million vaccinations were given across the U.S. and yesterday the Biden administration revised its goal to 1.5 million shots per day for the first 100 days. If the administration uses that time to begin putting measures in place such as mobile vaccination clinics, mass vaccination sites, more pharmacy-based vaccination and other steps described in the Biden strategy to replace the current broken vaccination non-system with one that works, it seems reasonable to expect a ramp up in the numbers of shots in arms after that. Increasing to two three milion vaccinations per day by late Spring or early Summer seems doable….…the limited factor may be the supply of vaccine. That too seems somewhat hopeful with J+J/Jansen and then others from AstraZeneca and Novavax expected to come on line. And, the J&J vaccine is expected to be a single dose rather than two, so it would mean fewer overall doses are needed. Still, the biggest mystery remains what the supply of vaccine is expected to be and when new approved vaccines will be ready, even if everything breaks favorably. January 26, 2021: Planned Parenthood posted a press release titled: “New Planned Parenthood Issue Brief Examines Social Health Needs Among Women of Reproductive Age”. From the press release: Today, as the Biden-Harris administration announced “bold and ambitious steps to root out inequity,” Planned Parenthood Federation of America published “What About Her? – Assessing Social Determinants of Health Among Women of Reproductive Age,” an issue brief focused on the unique ways that women of reproductive age are affected by the social determinants of health (SDOH), those conditions of the environments in which people live, play, work, and age that affect a wide range of health risks and outcomes……The brief’s key finding is that women of reproductive age report being very or somewhat comfortable discussing their SDOH-related needs within the health care setting, including with a primary care physician (PCP), a general practitioner, or a Planned Parenthood provider. In fact, women are just as comfortable discussing SDOH-related needs with a Planned Parenthood provider as discussing needs with a PCP or other general care provider……Notably, the “What About Her? brief found that two populations report greater comfort in discussing their SDOH-related needs with a Planned Parenthood provider: Women of color, as compared to white women; andWomen with lower annual incomes, as compared to women with higher annual incomes. This is particularly true among women of reproductive age with annual incomes of less than $25,000 per year… …Other important findings highlighted in the brief are: More than two-thirds of women of reproductive age say it is very or somewhat hard to pay for the very basics, such as food, medical care, housing, and heating. While the types of social needs among women of reproductive age varies, the most commonly reported areas of need for assistance are: Having enough food for themselves or their family (23 percent); Utilities (17 percent); Transportation (17 percent); Employment or help finding a job (15 percent); Childcare (12 percent); and Housing/having a steady place to live (8 percent). Black, Asian/Pacific Islander, and Hispanic women of reproductive age are more likely to report needing SDOH-related support in many areas: Black women of reproductive age report the highest need for SDOH support in all surveyed areas except for intimate partner violence (IPV), where non-Hispanic white women report the highest rate of need for support. Asian/Pacific Islander women of reproductive age report lower need for support with childcare and utilities, and are more likely than other women of color to report support needs related to IPV… January 26, 2021: The White House posted a Fact Sheet titled: “Fact Sheet: President Biden Announces New Steps to Boost Vaccine Supply and Increase Transparency for States, Tribes, and Territories”. From the Fact Sheet: Administration to Purchase Additional 200 Million Doses to Be Delivered This SummerJust over a year since the first COVID-19 case was confirmed in the United States, the nation has hit another grim milestone in the pandemic, reaching 25 million infections and counting. The pace in which this virus has spread throughout the U.S. is staggering and with new variants emerging, the spread is not slowing any time soon. That’s why it is critical that we vaccinate as many people as possible, as quickly as possible.President Biden has a comprehensive National Action Strategy to put the pandemic behind us and he and the COVID-19 response team are aggressively implementing it. Today, the President is announcing bold steps that will help meet the goal of administering 100 million shots in 100 days and ramp up vaccine supply as fast as possible. As a result of these actions, the federal government will have enough vaccine supply for the entire U.S. population by the end of the summer.The President is taking the following actions today: An Increase in Weekly Vaccine Supply to States, Tribes, and Territories: The Biden-Harris Administration will increase overall, weekly vaccine supply to states, Tribes and territories from 8.6 million doses to a minimum of 10 million doses. This increase of 1.4 million doses per week will allow millions more Americans to get vaccinated sooner than previously anticipated. The Administration is committing to maintaining this as the minimum supply level for the next three weeks. Increased transparency for States, Tribes, and Territories to Help Their Vaccination Efforts: The Biden-Harris Administration is taking action to provide states, Tribes and territories with a reliable three-week supply look-ahead. The Department of Health and Human Services will provide will provide allocation estimates for the upcoming three weeks as opposed to the one week look-ahead that they previously received. This increased transparency will give and local leaders greater certainty around the supply so that they can plan their vaccination efforts and administer vaccines effectively and efficiently. Purchase 200 Million Additional Doses to be Delivered This Summer, Double the Nation’s Vaccine Supply: President Biden directed his COVID-19 Response Coordinator to work with HHS to increase our total vaccine supply for the American people. The Biden-Harris Administration is working to purchase an additional 100 million doses of each of the two Food and Drug Administration-authorized vaccines – Pfizer and Moderna. This increases the total vaccine order for the U.S. by 50%, from 400 million to 600 million with these additional doses expected to deliver this summer. With these additional doses, the U.S. will have enough vaccine to fully vaccinate 300 million Americans by the end of this summer. January 27, 2021: Kaiser Family Foundation (KFF) posted news titled: “Vaccine Monitor: Nearly half of the Public Wants to Get a COVID-19 Vaccine as Soon as They Can or Has Already Been Vaccinated, Up across Racial and Ethnic Groups Since December”. From the news: Most Convincing Messages to Promote Vaccination Highlight Effectiveness at Preventing Illness and a Return to Normal Life; Hearing about Rare Allergic Reactions and Side Effects May Discourage Some.New KFF Dashboard Features Key Data and Insights from the Vaccine MonitorWith millions of Americans getting their first COVID-19 vaccinations, the public’s eagerness to get a vaccine is rising across racial and ethnic groups, though Republicans and rural residents remain the most reluctant groups, the latest KFF COVID-19 Vaccine Monitor reports.Based on a survey fielded just before President Biden took office, the latest Monitor report shows nearly half (47%) of the public want to get the vaccine as soon as they can or have already been vaccinated. That is significantly higher than the third (34%) of the public in the most-eager “as soon as possible” category in December.An additional 31% say they want to “wait until it has been available for a while to see how it is working for others” before getting it themselves. One in five (20%) are more reluctant to get vaccinated, including 7% who say they will only get the vaccine “if required to do so for work, school, or other activities,” and 13% who say they will “definitely not” get it.The share who have already been or want to get vaccinated “as soon as possible” is up among Black, Hispanic, and White adults, though White (53%) adults remain more likely than Black (35%) and Hispanic (42%) adults to say so. Black (43%) and Hispanic (37%) adults are more likely than White adults (26%) to say they want to “wait and see” before getting vaccinated.Similarly, there has been a shift toward greater enthusiasm for getting vaccinated across urban, suburban, and rural areas, though rural residents remain most hesitant. Democrats and Independents also show increased enthusiasm, though Republicans’ views are little changed since December.The Monitor shows that Republican and rural residents are now the groups most likely to say they either definitely won’t get a vaccine or would only do so if required……About a third (32%) of health care workers – a priority group for getting vaccinated – say they have gotten at least their first dose of a vaccine, and a quarter (26%) want to get it as soon as possible. Another quarter (28%) want to wait and see before getting vaccinated, while small shares say they would only get it if required (5%) or definitely wont get it (36%)……Nearly half (47%) of the public now say that they have personally received at least one vaccine dose or know someone who has, though these experiences aren’t spread out evenly across groups. White adults (51%) are more likely than those who are Black (38%) or Hispanic (37%) to have either been vaccinated or know someone who has, and those with annual household incomes of at least $90,000 are almost twice as likely as those with incomes under $40,000 to say so (65% vs. 33%)……A third (34%) of those who have not yet been vaccinated have heard one of three inaccurate claims about the vaccine and either believe the misinformation or aren’t sure if it is true. For example, nearly one in five (19%) say that they have heard that the vaccine includes live COVID-19 virus and believe that it is true (8%) or that they heard that and aren’t sure if its true (11%). Small shares report the same about the vaccine causing infertility (3% believe, 9% aren’t sure) and about having to pay out-of-pocket to get the vaccine (4% believe, 8% aren’t sure)… January 27, 2021: Planned Parenthood posted a press release titled: “100 Organizations Call for Swift Expansion of Reproductive Health, Rights, and Justice by Biden Administration in Ad Published in Washington Post”. From the press release: Today, the Blueprint for Sexual and Reproductive Health, Rights, and Justice, representing more than 199 bold, progressive organizations, published a full-page ad in the Washington Post highlighting top priorities for the Biden-Harris administration to swiftly expand access to sexual and reproductive health, rights, and justice. The ad highlights actions from the Blueprint First Priorities, which are among the most pressing needs to improve reproductive health, rights, and justice – including abortion access – in the U.S. and around the world… The Blueprint for Sexual and Reproductive Health, Rights, and Justice includes the following information: 1 On day one, the president must issue an executive order unequivocally stating his commitment to protect and expand access to comprehensive reproductive health care, uphold sexual and reproductive rights, including abortion care, in the U.S. and around the world, and rescind or revoke prior executive actions limiting access to care. This executive order must: Clearly and explicitly state that the president is committed to comprehensive sexual and reproductive health care, including abortion; that everyone should be able to decide for themselves when, whether and how to start their families, the right to raise their families in a safe and healthy environment, free from government interference; that politicians have interfered with personal decision-making and bodily autonomy by passing harmful laws and regulations that restrict access to care both domestically and around the world; that these policies restriction access to care have fallen hardest on Black people, Indigenous people, and many more people of color; and that no one should be denied access to comprehensive reproductive health care; including abortion, because of how much money they make, where they live, the source of their insurance or health care, or the religious or personal beliefs of others; Revoke the January 23, 2017 Presidential Memorandum Regarding the Mexico City Policy and clarify what is permitted under current law to ensure access to comprehensive reproductive health care, including foreign assistance for abortion, to the maximum extent allowed; Rescind Executive Order 13535 Patient Protection and Affordable Care Act’s Consistency with Longstanding Restrictions on the use of Federal Funds for Abortion; Direct the Secretary of Health and Human Services to issue guidance to lift the FDA’s in-person dispensing requirement for mifepristone for the duration of the public health emergency, consistent with similar directives and waivers issued to reduce risk of COVID-19; and Direct all executive departments and agencies to rescind other harmful policies and regulations, and take proactive steps to protect care, including but not limited to those actions listed under sections 5 and 6. 2 Upon assuming office, the president must make a public statement that the U.S. will re-engage on a global scale to advance the health and rights of individuals worldwide, and take action to re-engage fully with the United Nations, including re-joining and re-funding the World Health Organization, and re-funding the UN Population Fund (UNFPA), the UN’s sexual and reproductive health agency. 3 As a budget is a reflection of priorities, the president’s budget must demonstrate a commitment to sexual and reproductive health; That includes investing in the following domestic and international programs at the designated amounts: At least $1.66 billion for global family planning and reproductive health programs, including $111 million for UNFPA; Significant increased investments in the International Organizations and Programs account, and to vital global health programs, including for maternal, newborn, and child health, the President’s Emergency Plan for AIDS Relief (at least $5.5 billion), the Global Fund to Fight AIDS, Tuberculosis and Malaria (at least $1.56 billion), USAID HIV programs (at least $350 million); At least double the National Institutes of Health and United States Agency for International Development funding available for the research and development of contraceptives and multipurpose prevention technologies; $100 million to restore navigator funds and marketing funds to promote open enrollment, and remove anti-abortion language and policies from navigator program notices of funding opportunity; $150 million for the Teen Pregnancy Program; $150 million for the Personal Responsibility Education Program (PREP); $954 million for the Title X Family Planning Program; $850 million for the Title V Maternal & Child Health Services Block Grant $100 million for the CDC Safe Motherhood and Infant Health Initiative; and $100 million for the Surveillance for Emerging Threats to Mothers and Babies Initiative. End the Hyde Amendment and related restrictions, and ensure that everyone has abortion coverage, regardless of their income or source of insurance, and commit to veto legislation that extends, reiterates, or incorporates the Hyde Amendment and related restrictions, including annual appropriations bills; Eliminate the Weldon Amendment and commit to veto legislation that would expand it or make it permanent; Remove the Helms Amendment and commit to veto legislation that extends, reiterates, or incorporates the Helms Amendment; Modify the Siljander Amendment to prohibit the use of U.S. funds to lobby against abortion; Remove the Kemp-Kasten Amendment and replace it with a blanket prohibition on U.S. funding going to coercive activities in U.S. foreign assistance, in line with the ICPD; Eliminate unnecessary restrictions on the U.S. contribution to UNFPA, including the requirement to segregate the U.S. contribution, such that none of the U.S. contribution may be used for abortion, none of the U.S. contribution may be used in China, and the dollar-for-dollar withholding for any funding UNFPA provides to China; Eliminate the Livingston Amendment, which allows organizations that receive certain government grants to refuse to offer the full range of contraception based on their religious objections; Eliminate all funding for abstinence-only until marriage programs, including the Title V “Sexual Risk Avoidance Education” program. 4 As personnel is also a reflection of priorities, the president must nominate and appoint individuals for executive branch positions who are experts in their field, committed to the core mission of the agency, and possess a positive record on reproductive health, rights, and justice, and who will contribute to the diversity of the executive branch. 5 Upon assuming office, the president must immediately halt all non-final regulations that will limit access to reproductive health care, including abortion. Further, within forty-five days of assuming office, the administration must initiate the process of rescinding regulations below (including designating them in the respective agency unified agendas as being in the pipeline for repeal): Compliance with Statutory Program Integrity Requirements, otherwise known as the “Domestic Gag Rule,” decimating the evidence-based and historically bipartisan Title X family planning program, which previously served nearly 4 million people, the vast majority of whom (80%) have low or no incomes. Religious Exemptions and Accommodations for Coverage of Certain Preventative Services Under the Affordable Care Act and Moral Exemptions and Accommodations for Coverage of Certain Preventative Services under the Affordable Care Act, allowing virtually any employer or university to deny coverage for contraception in a drastic departure from previous regulations that ensured 61.4 million had coverage; Nondiscrimination in Health and Health Education Programs and Activities, Delegation of Authority, revising the regulations for the Section 1557 Health Care Rift Law to undermine the statute’s protections, including by providing a narrow interpretation of “sex discrimination” that excludes people from protections and that is in direct conflict with the recent Supreme Court ruling in Bostock v Clayton County; Protecting Statutory Conscience Rights in Health Care, Delegation of Authority, otherwise known as the “Refusal of Care Rule,” unlawfully and dramatically expanding existing refusal laws to encourage heath care workers to deny care and information; the rule was vacated by several federal district courts in late 2019 and is currently on appeal in the 2nd and 9th U.S. Circuit Courts of Appeals; Inadmissibility Based on Public Charge Grounds expanding and weaponizing the concept of “public charge” to discourage immigrants from accessing basic services and public programs; Pre-Existing Condition Insurance Plan Program, excluding DACA recipients from benefits under the ACA, including tax credits, cost sharing, and the marketplaces; and Patient Protection and Affordable Care Act; Exchange Program Integrity, imposing onerous and arbitrary requirements on insurance issuers that offer health plans that include abortion coverage on the ACA marketplace. 6 Within 90 days of assuming office, the president must institute the following changes in policy and practice including, where appropriate, issuing guidance: The FDA must review the REMS for mifepristone to determine whether a REMS remains necessary, or whether the goals and elements should be modified or removed from the approved strategy to best reflect scientific evidence and real-world use; The Department of Health and Human Services must protect patients’ choice of reproductive health care provider, in part by reinstating 2016 guidance reaffirming Medicaid’s free choice of provider provisions, and ensuring that states may not exclude qualified providers of reproductive health care from Medicaid for reasons unrelated to their qualifications, including their provision of abortion care; The Department of Health and Human Services must issue guidance on 1332 wavers aimed at improving access to health benefits and services. The guidance should be designed to encourage states to expand coverage for new populations (such as DACA recipients and undocumented immigrants) and to add benefit, and should affirm that waiver applications that do not comply with the four statutory guardrails of comparable services, affordability, number of people covered, and deficit neutrality will be denied; The administration must use every mechanism at its disposal to encourage states to extend Medicaid and CHIP coverage to at least 12 months postpartum, including by issuing guidance, while ensuring continued Maintenance of Effort (MOE); As part of a broader overhaul of the immigration detention system, including closure of all family detention centers and a significant reduction in detention overall, the Department of Homeland Security must issue a directive immediately prohibiting ICE and CBP from detaining any person during pregnancy or postpartum recovery, and medically vulnerable person, or a primary caregiver of a child, and requiring immediate release from detention of any person found to be pregnant or medically vulnerable; The Office of Refugee Resettlement (ORR) must rescind a 2008 policy that requires ORR involvement in abortions and issue new guidance to ensure that all care facilities provide minors with timely, confidential access to family planning services, including pregnancy tests and comprehensive, non-directive information about and access to reproductive health services, such as abortion and contraception, including emergency contraception. It must also protect minors’ confidentiality and ensure their timely access to courts to seek judicial authorization for abortion, if needed; The Centers for Medicare and Medicaid Services must issue guidance to state Medicaid programs that federal law does not mandate the use of Explanation of Benefits and initiate a public and private stakeholder effort to develop additional recommendations and guidance to balance the need for consumer protections with the need for confidentiality, especially when it comes to sensitive health services; Office of the Global AIDS Coordinator must make it clear that PEPFAR funds can be used to pay for contraceptive commodities to ensure individuals living with and at risk for HIV have access to a full range of voluntary contraception options and to make the promise of integrated HIV and family planning services a reality for countless more adolescent girls and young women; The State Department must champion sexual and reproductive health and rights (SRHR) in UN meetings and multilateral forums, including by adopting and advancing comprehensive definitions of SRHR and comprehensive sex education, promoting the inclusion of diverse civil society experts in multilateral forums and on official U.S. delegations, ensuring participants from around the world are granted visas to engage in convenings at UN headquarters, the Organization of American States, World Bank and other multilateral institutions located in the U.S., and prioritizing participating and serving on the Executive Board of UN Specialized Agencies related to sexual and reproductive health and rights, including WHO, and encouraging the expansion of their programs and policies globally; The administration must establish an Interagency Taskforce and issue regulations to encourage the development of a culture of equity, dignity, respect, and empowerment in health care systems, whereby accountability mechanisms are encouraged and implemented across systems to address discriminatory care, disrespect, mistreatment, and abuse of pregnant individuals based on race, age, sex (including gender identity and sexual orientation), ability, immigration status, insurance coverage, perceived socioeconomic status, and other factors; The president must rescind and undo actions taken pursuant to Executive Order 13798 Promoting Free Speech and Religious Liberty, which set the stage for expanding the use of religion to discriminate against people seeking reproductive health care, including the rules that allow employers to deny birth control coverage to their employees, and the creation of the HHS Conscience and Religious Freedom Division which emboldens discrimination and refusals of care; and The Department of Justice must not investigate, arrest, or prosecute individuals under the federal criminal code for any act or omission for their own pregnancy, and must end its policies and practices that place people at risk of criminal charges for any act or omission with respect to their own pregnancy. Such acts or omissions include, but are not limited to: self-managing or attempting to self-manage an abortion; failing to seek medical help when they miscarry, have a stillbirth, or experience any pregnancy loss, no matter its cause; using substances, whether prescribed, over-the-counter, or criminalized, during pregnancy. January 27, 2021: The American College of Obstetricians and Gynecologists (ACOG) posted a joint statement titled: “ACOG and SMFM Joint Statement on WHO Recommendations Regarding COVID-19 Vaccines and Pregnant Individuals”. From the statement: The American College of Obstetricians and Gynecologists (ACOG) and the Society of Maternal-Fetal Medicine (SMFM) are aware of the World Health Organization’s (WHO) recommendations to withhold COVID-19 vaccines from pregnant individuals unless they are at high risk of exposure. ACOG and SMFM continue to stress that both COVID-19 vaccines currently authorized by the U.S. Food and Drug Administration should not be withheld from pregnant individuals who choose to receive the vaccine. ACOG’s and SMFM’s current guidance on the COVID-19 vaccine in pregnant patients remains in place.Despite efforts by ACOG and SMFM to advocate for their inclusion, clinical trials that informed the emergency use authorization (EUA) of the vaccines did not include pregnant individuals. However, preliminary developmental and reproductive toxicity (DART) studies for both the Pfizer-BioNtech and Moderna vaccines are encouraging, with no safety signals reported. DART animal studies provide the first safety data to help inform the use of these vaccines in pregnancy until there are more data in this specific population. These studies do not indicate any adverse effects on female reproduction or fetal/embryonal development. ACOG and SMFM strongly urge manufacturers and federal agencies to collect and report data regarding the use of these vaccines in pregnancy. Data have demonstrated that symptomatic pregnant individuals with COVID-19 are at increased risk of more severe illness and death compared with nonpregnant peers. Many pregnant individuals have medical conditions known to put them at further increased risk of severe illness and complications. Therefore, given clear evidence of the dangers of COVID-19 in pregnancy, an absence of data demonstrating adverse effects associated with the vaccine in pregnancy, and in the interest of patient autonomy, ACOG and SMFM recommend that pregnant individuals be free to make their own informed decisions regarding COVID-19 vaccination.This decision should consider a number of factors, including the available information about the safety and efficacy of the vaccine and consideration of a lack of data regarding the use of the vaccine during pregnancy. Additional considerations include the level of activity of the pandemic in the community, the potential efficacy of the vaccine, and the potential risk and severity of maternal disease. While pregnant individuals are encouraged to discuss vaccination considerations with their clinical care team when feasible, documentation of such a discussion should not be required prior to receiving a COVID-19 vaccine.As physicians who care for pregnant individuals, and as vaccine rollout expands to other eligible populations, ACOG and SMFM continue to firmly assert that pregnant individuals should be given the opportunity to make their own decision as to whether to receive the COVID-19 vaccine and that barriers should not be put in place to prevent access and hinder the ability of pregnant people to protect themselves from a virus that could potentially be life-threatening. January 27, 2021: National Women’s Law Center posted a resource titled “100 Wins, 100 Days: Decisive Actions to Advance Gender Justice”. (For the purpose of this blog post, I will highlight the portions that focuse on health and/or health care.) From the resource: The first 100 days of a new administration are critical. Against the back drop of a country plagued by the COVID-19 crisis, under attack by white supremacists, and reeling from the after effects of a hostile Trump administration, we spent the first 100 days of the Biden-Harris administration fighting to redefine what it means to be safe, to enshrine dignity in our policies and laws, and to advance gender equality for all… …For Health Care: Show a commitment to protecting and expanding access to reproductive health care, including abortion. (IN PROGRESS)Rescind the Trump administration rule allowing a range of health care personnel, including receptionists and ambulance drivers, to refuse to help people seeking care, including abortion and sterilization.Issue new rulemaking that rescinds and replaces the Trump administration rules that allow virtually any employer or university to deny birth control coverage otherwise required by the Affordable Care Act.Undo the Trump administration’s rollback of critical protections against discrimination in health care, restore and strengthen health care non-discrimination protections.Eliminate the harmful budgetary riders that restrict access to reproductive health care, namely the Weldon and Hyde Amendments, and pass a budget with a $954 million for the nation’s family planning program (Title IX).Rescind the devastating global and domestic gag rules, which have jeopardized care for millions of patients in the United States and around the world. (IN PROGRESS)Issue guidance to lift the FDA’s in-person dispensing requirement for mifepristone for the duration of the public health emergency, consistent with similar directives and waivers issued to reduce risk of COVID-19 (DONE)Establish an interagency task force or a high-level office to develop a coordinated federal response to the ongoing crisis in access to reproductive health care crisis, with a particular focus on communities who are most impacted.Restore the HHS Office of Civil Rights to its original mission of enhancing and protecting the health and well-being of all Americans, including by closing the “Conscience and Religious Freedom Division,” which was solely focused on emboldening health care providers to use personal beliefs to discriminate against patients.Reopen and investigate complaints alleging the state of California and University of Vermont Medical Center violated federal laws simply for protecting individuals’ access to abortion. While investigating, immediately halt the unprecedented enforcement of taking $200 million in Medicaid funds quarterly from the state of California.Rescind the Trump administration’s rule intended to take insurance coverage of abortion away from people enrolled in qualified plans in the Affordable Care Act marketplaces.Protect patients’ choice of reproductive health care provider, ensuring that states may not exclude qualified providers of reproductive health care from Medicaid for reasons unrelated to their qualifications, including provision of abortion care.Strengthen access to Medicaid coverage for people with low incomes by rescinding the January 2018 Opportunities to Promote Work and Community Engagement Among Medicaid Beneficiaries State Medical Director guidance, denying all pending proposals, and withdrawing all approvals.Issue guidance on Affordable Care Act section 1332 waivers aimed at improving access to health benefits and services. The guidance should be designed to encourage states to expand coverage for new populations, such as DACA recipients and undocumented immigrants, and to add benefits, and should affirm that waiver applications that do not comply with the four statutory guardrails of comparable services, affordability, number of people covered, and deficit neutrality will be denied. (IN PROGRESS) Establish an Interagency Taskforce and issue regulations to encourage the development of a culture of equity, dignity, respect, and empowerment in health care systems, whereby accountability mechanisms are encouraged and implemented across systems to address discriminatory care, disrespect, mistreatment, and abuse of pregnant individuals based on race, age, sex (including gender identity and sexual orientation), ability, immigration status, insurance coverage, perceived socioeconomic status, and other factors.Strengthen Medicaid programs and maintenance of effort requirements and end policies that undermine them. Incentivize states to expand Medicaid and family planning services, and subsidize higher reimbursement rates for providers. (IN PROGRESS)Expand financial support for health care providers and ensure that any future COVID relief package does not include restrictions on abortion care.Pass the Access to Contraception for Servicemembers and Dependents Act, which ensures that all servicemembers and their dependents who rely on the military for health care have comprehensive contraceptive coverage and counseling.Pass the Equal Access to Contraception for Veterans Act, which provides birth control at no-cost for veterans accessing care through the Department of Veteran Affairs. (IN PROGRESS)Pass the Access to Birth Control Act, which addresses inequities to health care services, including sexual, reproductive, and maternal health services, for immigrants.Pass the COVID Community Care Act, which addresses disparities in the containment of COVID in underserved communities.Pass the Black Maternal Health Momnibus Act, which will fill gaps in existing legislation to comprehensibly address multiple dimensions of the Black maternal health crisis in America. (IN PROGRESS)Pass the EACH Act, which would repeal the Hyde Amendment and related abortion coverage restrictions, ensuring that anyone who gets care or insurance through the federal government will be covered for all pregnancy-related care, including by abortion. By lifting the bans that deny abortion coverage, the EACH Act ensures that the decision to have an abortion does not depend on a person’s income or how they are insured. (IN PROGRESS)Pass the Women’s Health Protection Act, which would protect the right to access abortion care by creating a safeguard against bans and medically unnecessary restrictions that do not apply to similar medical care. January 27, 2021: Kaiser Family Foundation (KFF) posted news titled: “Nearly 9 Million Uninsured Americans Could Get Free or Subsidized Health Insurance if the Biden Administration Re-Opens ACA Marketplace Enrollment in Response to COVID-19”. From the news: Four million uninsured people could get an ACA bronze plan with no premium payment and 4.9 million others could get subsidies to offset the cost of such a plan if the Biden Administration were to re-open ACA marketplace enrollment, a KFF analysis finds.The 8.9 million people eligible for free or reduced-cost coverage represent nearly 60 percent of the approximately 15 million uninsured people in the U.S. who could shop for health insurance coverage on the ACA Marketplaces, the analysis finds. Compared to the general non-elderly population, the uninsured people in these categories are more likely to be young adults aged 19-34, Hispanic, non-native English speakers, lacking internet access, high-school educated and working in service industries such as arts, entertainment and recreation.Those eligible for free bronze plans are also more likely than the general non-elderly population to be unemployed or working part-time, and to live in rural areas. More than half of them live in Texas, Florida, North Carolina, or Georgia.Free or reduced-cost bronze ACA plans generally carry steep deductibles, requiring policy holders to pay thousands of dollars for care out of pocket before coverage kicks in. However, the analysis finds that about 2 of every 3 uninsured people who are eligible for a free ACA bronze plan have household income low enough to be eligible for significantly lower deductibles if they purchase a more expensive silver plan instead.Based on campaign pledges, President Biden is expected to move towards reopening Marketplace enrollment as soon as this week, for example by announcing a COVID-19 special enrollment opportunity (SEP). His administration is also expected to direct more resources to marketing and outreach, following several years in which the Trump administration pared back such efforts.The findings of the new analysis can inform government agencies or navigators engaged in outreach and marketing efforts. Uninsured people who are eligible for subsidies to buy Marketplace plans may be unaware of their options or need help understanding the tradeoffs.KFF researchers estimate that more than $1 billion in unspent federal user fee revenue has accumulated that could be used by the new administration to invest in changes that would make it easier for consumers to enroll in health coverage… January 28, 2021: Planned Parenthood posted a press release titled: “New Planned Parenthood and University of Utah Study Reveals Additional Options for Emergency Contraception”. From the press release: A new study shows that patients may have a new option when it comes to emergency contraception. Today, the New England Journal of Medicine published results from a randomized controlled trial investigating the effectiveness of two intrauterine devices (IUDs) when used as emergency contraception. Conducted by researchers at the University of Utah Health in close partnership with Planned Parenthood Association of Utah, the three-year study found that Liletta – a levonorgestrel 52 mg IUD – is no less effective as an emergency contraceptive method as Paragard, the copper IUD. The findings represent a clear advance in clinical practice and patient access to care – providing another highly effective option for patients who seek emergency contraception and ongoing birth control.Up till now, there had been little data on the effectiveness of hormonal IUDs as a standalone emergency contraception method. Best practices had recommended that patients who had unprotected sex before placement of the Liletta or Mirena IUD as an emergency contraceptive up to five days after unprotected sex, but it also demonstrates that only one method of emergency contraception is required to prevent unintended pregnancy……The study, supported by the National Institutes of Health and carried out at six Planned Parenthood health centers in Utah, found: The Liletta IUD is no less effective than Paragard as an emergency contraceptive following unprotected intercourse in the previous five days.The Liletta IUD is effective on its own – with no need to supplement with an oral emergency contraception – as an emergency contraceptive.The Liletta IUD can be used as a quick-start method of birth control, meaning that it can become effective at any day of the menstrual cycle, as long as there is a negative pregnancy test prior to having it placed. While all participants of the study – conducted between 2016 and 2019 – received Liletta, its findings would also apply to Mirena, a levonorgestrel 52 mg IUD as well… January 28, 2021: The White House posted a statement titled: “FACT SHEET: President Biden to Sign Executive Orders Strengthening Americans’ Access to Quality, Affordable Health Care” From the statement: The Biden-Harris Administration will open a Special Enrollment Period for Americans to sign up for health coverage and roll back attacks on the Affordable Care Act, Medicaid, and access to reproductive health care.After four years of attempts to strip health care from millions of Americans, President Biden will sign two millions of Americans, President Biden will sign two executive actions that will begin to restore and strengthen Americans’ access to quality, affordable health care. The Biden-Harris administration will re-open enrollment to the Health Insurance Marketplace, take additional steps to strengthen Medicaid and the Affordable Care Act, and protect women’s health. These actions demonstrate a strong commitment by the Biden-Harris Administration to protect and build on the Affordable Care Act, meet the heath care needs created by the pandemic, reduce health care costs, protect access to reproductive health care, and make our health system easier to navigate and more equitable.For President Biden, this is personal. He believes that every American has a right to the peace of mind that comes with knowing they have access to affordable, quality health care. Because of the Affordable Care Act, over 100 million people will no longer have to worry that an insurance company will deny coverage or charge higher premiums just because they have a pre-existing condition. Roughly 20 million additional Americans obtained the security that comes with health insurance, and young people transitioning from school to a job can stay covered by their parents’ plan until age 26.As we continue to battle COVID-19, it is even more critical that Americans have meaningful access to affordable health care. The actions the President is taking today complement the commitment he made in the American Rescue Plan to make health insurance coverage more affordable for millions of Americans. Reliable and affordable access to health insurance doesn’t just benefit families’ health; it is a critical source of economic security and peace of mind for all.Today’s actions include:Strengthening Medicaid and the Affordable Care Act. This Executive Order takes critical steps to reverse attacks on and strengthen Medicaid and the Affordable Care Act, so they can continue to provide access to live-saving care for millions of Americans. Based on this Executive Order, it is expected that the Department of Health and Human Services (HHS) will open HealthCare.gov for a “Special Enrollment Period,” from February 15, 2021, – May 15, 2021. This Special Enrollment Period will give Americans that need health care coverage during this global pandemic the opportunity to sign up.The President will also direct federal agencies to reconsider rules and other policies that limit Americans’ access to health care and consider actions that will protect and strengthen that access.Agencies are directed to re-examine: Policies that undermine protections for people with pre-existing conditions, including complications related to COVID-19;Demonstrations and waivers under Medicaid and the ACA that may reduce coverage or undermine the programs, including work requirements;Policies that undermine the Health Insurance Marketplace or other markets for health insurance; Policies that make it more difficult to enroll in Medicaid and the ACA; andPolicies that reduce affordability of coverage or financial assistance, including for dependents. As part of their reviews, agencies will consider whether to take additional actions to strengthen and protect access to health care.Protecting Women’s Health at Home and Abroad. Across the country and around the world, people – particularly women, Black, Indigenous and other people of color, LGBTQ+ people, and those with low incomes – have been denied access to reproductive health care. President Biden is also issuing a Presidential Memorandum to protect and expand access to comprehensive reproductive health care. The memorandum reflects the policy of the Biden-Harris Administration to support women’s and girls’ sexual and reproductive health and rights in the United States, as well as globally. Like memoranda issued by President Clinton and President Obama, it immediately rescinds the global gag rule, also referred to as the Mexico City Policy, which bars international non-profits that provide abortion counseling or referrals from receiving U.S. funding. In recognition of the additional work necessary to protect access to reproductive health care, President Biden’s memorandum also directs the Department of Health and Human Services to take immediate action to consider whether to rescind regulations under its Title X family planning program. January 28, 2021: President Biden tweeted: “This afternoon I took action to restore and strengthen Americans’ access to quality, affordable health care. The issue is personal to me – and now more than ever, I’m committed to ensuring everyone has access to the care they need.” The tweet included a photo of President Biden at signing an executive order. January 28, 2021: The White House posted “Executive Order on Strengthening Medicaid and the Affordable Care Act”. From the executive order: By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:Section 1. Policy. In the 10 years since its enactment, the Affordable Care Act (ACA) has reduced the number of uninsured Americans by more than 20 million, extended critical consumer protections to more than 100 million people, and strengthened and improved the Nation’s healthcare system. At the same time, millions of people who are potentially eligible for coverage under the ACA or other laws remain uninsured, and obtaining insurance benefits is more difficult than necessary. For these reasons, it is the policy of my Administration to protect and strengthen Medicaid and the ACA and to make high-quality health care accessible and affordable for every American.Sec. 2 Special Enrollment Period. The coronavirus disease 2019 (COVID-19) pandemic has triggered a historic public health and economic crisis. In January of 2020, as the COVID-19 pandemic was spreading, the Secretary of Health and Human Services declared a public health emergency. In March of 2020, the President declared a national emergency. Although almost a year has passed, the emergency continues – over 5 million Americans have contracted the disease in January 2021, and thousands are dying every week. Over 30 million Americans remain uninsured, preventing many from obtaining necessary health services and treatment. Black, Latino and Native American persons are more likely to be uninsured, and communities of color have been especially hard hit by both the COVID-19 pandemic and the economic downturn. In light of the ongoing COVID-19 pandemic, the Secretary of Health and Human Services shall consider establishing a Special Enrollment Period for uninsured and under-insured Americans to seek coverage through the Federally Facilitated Marketplaces, pursuant to existing authorities, including sections 18031 and 18041 of title 42, United States Code, and section 155.420(d)(9) of title 45, Code of Federal Regulations, and consistent with applicable law.Sec. 3. Immediate Review of Agency Actions (a) The Secretary of the Treasury, the Secretary of Labor, the Secretary of Health and Human Services, and the heads of all other executive departments and agencies with authorities and responsibilities related to Medicaid and the ACA (collectively, heads of agencies) shall, as soon as practicable, review all existing regulations, orders, guidance documents, policies, and any other similar agency (collectively, agency actions) to determine whether such agency actions are inconsistent with this policy set forth in section 1 of this order. As part of this review, the heads of agencies shall examine the following:(i) policies or practices that may undermine protections for people with pre-existing conditions, including complications related to COVID-19, under the ACA;(ii) policies or practices that may undermine the Health Insurance Marketplace or the individual, small group, or large group markets for health insurance in the United States;(iv) policies or practices that may present unnecessary barriers to individuals and families attempting to access Medicaid or ACA coverage, including for mid-year enrollment; and(v) policies or practices that may reduce the affordability of coverage or financial assistance for coverage, including for dependents.(b) Heads of agencies shall, as soon as practicable and as appropriate and consistent with applicable law, consider whether to suspend, revise, or rescind – and, as applicable, publish for notice and comment proposed rules suspending, revising or rescinding – those agency actions identified as inconsistent with the policy set forth in section 1 of this order.(c) Heads of agencies shall, as soon as practicable and as appropriate and consistent with applicable law, consider whether to suspend, revise, or rescind – and, as applicable, consider whether to take any additional actions to more fully enforce the policy set forth in section 1 of this order.Sec. 4. Revocation of Certain Presidential Actions and Review of Associated Agency Actions. (a) Executive Order 13765 of January 20, 2017, (Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal), and Executive Order 13813 of October 12, 2017 (Promoting Healthcare Choice and Competition Across the United States), are revoked.(b) As part of the review required under section 3 of this order, heads of agencies shall identify existing agency actions related to or arising from Executive Orders 13765 and 13813. Heads of agencies shall, as soon as practicable, consider whether to suspend, revise, or rescind – – and as applicable, publish for notice and comment proposed rules suspending, revising, or rescinding – any such agency actions, as appropriate and consistent with applicable law and the policy set forth in section 1 of this order… January 28, 2021: Speaker of the House Nancy Pelosi (Democrat – California) posted a press release titled: “Pelosi Statement on President Biden Executive Actions Strengthening Health Care”. From the press release: Speaker Nancy Pelosi issued this statement on the Executive Actions announced by President Biden today to strengthen Americans’ access to quality, affordable health care:“The coronavirus pandemic and economic crisis have demonstrated with heartbreaking clarity that access to health care is a matter of life-or-death. President Biden’s Executive Actions are a lifeline for millions of American families and a clear sign that our nation now has the leadership in the White House to turn these crises around. “These Executive Actions represent a 180-degree reversal from the assault on health care waged by Donald Trump and Republicans in the courts and Congress in the middle of the pandemic. In stark contrast, President Biden is restoring and expanding access to health care in a way that promotes equity and justice for working families, those who have lost jobs, seniors, women in need of reproductive health care at home and abroad, and more. In particular, opening a special enrollment period will enable potentially millions of Americans who have lost their health insurance through no fault of their own to access care.“The Democratic Congress applauds these lifesaving actions, and we will continue to work to protect and improve affordable, quality health care – during this pandemic, and in the months and years to come. January 28, 2021: Georgetown University Health Policy Institute Center For Children and Families posted a blog titled: “Biden Administration Announces It Will Reopen Federal Marketplace Enrollment”. It was written by Edwin Park. From the blog: Today, January 28, 2021, President Biden signed an executive order establishing a new special enrollment period for the Affordable Care Act’s marketplaces in most states, in order to increase health coverage during the COVID-19 pandemic. The special enrollment period will begin February 15, 2021 and run through May 15, and like the annual open enrollment period, will likely be available to anyone who is eligible a marketplace plan. (The special enrollment period will apply in the 30 with federally-facilitated marketplaces and the 6 states with state-based marketplaces using the federal platform. In these 36 states, the annual open enrollment period for 2021 had previously closed on December 15, 2020. The remaining 15 states and the District of Columbia with state-based marketplaces could potentially reopen enrollment through the new special enrollment periods as well but that will be a state-by-state choice.)This special enrollment period could facilitate the enrollment of many more people in marketplace plans, particularly if it is supported by a coordinated, well-financed advertising, marketing, outreach and consumer assistance campaign. Such an effort would significantly increase public awareness of the new special enrollment period and help guide families through the application, enrollment, and selection process. According to the Kaiser Family Foundation in 2021, nearly 9 million people are estimated to be eligible for subsidized marketplace coverage but remain uninsured. But a Kaiser Family Foundation poll in December 2020 found that only 14 percent of Americans who buy insurance on their own or are uninsured were aware of the annual open enrollment period deadline for the marketplace in their state.This is due, in part, to the Trump Administration’s significant reduction in spending on marketing, outreach, and consumer assistance activities related to the Affordable Care Act over the last four years. As a result, new marketplace enrollment has fallen every year since 2016. The Trump Administration’s failure to reverse course during the COVID-19 pandemic was particularly egregious, as millions of families lost their jobs and their employer sponsored insurance… January 28, 2021: Center on Budget and Policy Priorities posted a blog titled: “Biden Directs Federal Agencies to Reconsider Trump Policy Under Which Thousands Lost Medicaid Coverage”. It was written by Hannah Katch. From the blog: The Biden Administration today released an executive order directing federal agencies to “reconsider rules and other policies that limit Americans’ access to health care and consider actions that will protect and strengthen that access.” The order specifically requires the Department of Health and Human Services to re-examine a Trump Administration policy encouraging states to take Medicaid coverage away from people who don’t meet harsh work requirements, which led to large coverage losses but didn’t increase employment. The Department should act quickly to rescind this policy.Under the Trump policy, announced in 2018, states could submit proposals for demonstration projects letting them take coverage away from people who didn’t document that they worked or participated in work activities like job training for a specified number of hours each month – something that the federal government never previously permitted. The Trump Administration approved proposals from 12 states, though only Arkansas fully implemented its demonstration (until a federal court struck it down). In the seven months that the Arkansas policy was in effect, more than 18,000 people – nearly 1 in 4 of those subject to the new rules – lost their coverage.Other states, too, would have suffered large coverage losses if they had fully implemented their demonstration projects. New Hampshire was on track to take coverage away from nearly 17,000 people – about 40 percent of those subject to the pending rules – before state policymakers on a bipartisan basis halted the policy. Similarly, some 80,000 Michiganders – nearly 1 in 3 of those subject to work requirements – were in danger of losing coverage is a court hadn’t stopped the policy. In all three states, the number of people who were set to lose coverage exceeded the estimates of the presumed target population: people who weren’t working or eligible for an exemption. This indicates that working people and people who should have been exempt from the new rules almost certainly lost or risked losing coverage due to red tape.Large coverage losses, including among people who are working or who should be eligible for exemptions, are unavoidable under these policies. People with disabilities and other serious needs – especially mental health conditions or substance use disorders – lose coverage because they struggle with paperwork to claim exemptions. Working people lose coverage due to both paperwork barriers and the nature of low-wage work, like fluctuating hours. (That’s why nearly half of working low-income adults wouldn’t be able to document at least 80 hours of work each month, as many state demonstrations required.) And when people lose coverage, they face financial hardship and lose access to medications and other needed care, which can be catastophic for those with chronic physical or mental health conditions.Taking away coverage also fails to help people find and keep jobs. One study found evidence that people losing Medicaid under Arkansas’ policy became uninsured, but no evidence that the policy increased employment……To execute today’s action, the Department of Health and Human Services should quickly rescind the Trump Administration’s letter to states encouraging work requirement policies, revoke approval for those state policies where they are in effect, and petition the Supreme Court to dismiss pending litigation on this matter, since the policy is no longer in effect anywhere. January 28, 2021: The White House posted a presidential action titled: “Women’s Health at Home and Abroad”. From the presidential action: MEMORANDUM FOR THE SECRETARY OF STATE, THE SECRETARY OF DEFENSE, THE SECRETARY OF HEALTH AND HUMAN SERVICES, THE ADMINISTRATOR OF THE UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENTSection 1. Policy. Women should have access to the healthcare they need. For too many women today, both at home and abroad, that is not possible. Undue restrictions of the use of Federal funds have made it harder for women to obtain necessary healthcare. The Federal Government must take action to ensure that women at home and around the world are able to access complete medical information, including with respect to their reproductive health.In the United States, Title X of the Public Health Services Act (42. U.S.C. 300 – 300a-6) provides Federal funding for family planning services that primarily benefit low-income patients. The Act specifies that Title X funds may not be used in programs where abortion is a method of family planning, but places no further abortion-related restrictions on recipients of Title X funds. See 42 U.S.C. 300a-6. In 2019, the Secretary of Health and Human Services finalized changes to regulations governing the Title X program and issued a final rule entitled “Compliance With Statutory Program Integrity Requirements,” 84. Fed. Reg. 7714 (March 4, 2019) (Title X Rule), which prohibits recipients of Title X funds from referring patients to abortion providers and imposes other onerous requirements on abortion providers. The Title X Rule has caused the termination of Federal family planning funding for many women’s healthcare providers and puts women’s health at risk by making it harder for women to receive complete medical information.It is the policy of my Administration to support women’s and girls’ sexual and reproductive health and rights in the United States, as well as globally. The Foreign Assistance Act of 1961 (22 U.S.C. 2151b(f)(I)), prohibits nongovernmental organizations (NGOs) that receive federal funds from using those funds “to pay for the performance of abortions as a method of family planning or to motivate or coerce any person to practice abortions.” The August 1984 announcement by President Reagan of what has become known as the “Mexico City Policy” directed the United States Agency for International Development (USAID) to expand this limitation and withhold USAID family planning funds from NGOs that use non-USAID funds to perform abortions, provide advice, counseling, or information to legalize abortion or make abortion services more easily available.These restrictions were rescinded by President Clinton in 1993, reinstated by President George W. Bush in 2001, and rescinded by President Obama in 2009. President Trump substantially expanded these restrictions by applying the policy to global health assistance provided by all executive departments and agencies (agencies). These excessive conditions on foreign and development assistance undermine the United States’ efforts to advance gender equality globally by restricting our ability to support women’s health and programs that prevent and respond to gender-based violence. The expansion of the policy has also affected all other areas of global health assistance, limiting the Unites States’ ability to work with local partners around the world and inhibiting their efforts to confront serious health challenges such as HIV/AIDS, tuberculosis, and malaria, among others. Such restrictions on global health assistance are particularly harmful in light of the coronavirus disease 2019 (COVID-19) pandemic. Accordingly, I hereby order as follows:Sec. 2 Revocations and Other Actions. (a) The Secretary of Health and Human Services shall review the Title X Rule and any other regulations governing the Title X program that impose undue restrictions on the use of Federal funds or women’s access to complete medical information and shall consider, as soon as practicable, whether to suspend, revise, or rescind, or publish for notice and comment proposed rules suspending, revising, or rescinding , those regulations, consistent with applicable law, including the Administrative Procedures Act.(b) The Presidential Memorandum of January 23, 2017 (The Mexico City Policy), is revoked.(c) The Secretary of State, the Secretary of Defense, the Secretary of Health and Human Services, the Administrator of USAID, and appropriate officials at all other agencies involved in foreign assistance shall take all steps necessary to implement this memorandum, as appropriate and consistent with applicable law. This shall include the following actions with respect to conditions in assistance awards that were imposed pursuant to the January 2017 Presidential Memorandum and that are not required by the Foreign Assistance Act or any law…(d) The Secretary of State, the Secretary of Defense, the Secretary of Health and Human Services, and the Administrator of USAID, as appropriate and consistent with applicable law, shall suspend, revise, or rescind any regulations, orders, guidance documents, policies, and any other similar agency actions that were issued pursuant to the January 2017 Presidential Memorandum.(e) The Secretary of State and the Secretary of Health and Human Services, in a timely and appropriate manner, shall withdraw co-sponsorship and signature from the Geneva Consensus Declaration (Declaration) and notify other co-sponsors and signatories to the Declaration and other appropriate parties of the United States’ withdrawal… January 28, 2021: Center for Reproductive Rights posted a statement titled: “CEO Nancy Northup’s Statement on President Biden’s Executive Order”. From the statement: Today, President Joe Biden issued an executive order repealing the Global Gag Rule that had been re-issued and greatly expanded during the Trump Administration; beginning the repeal of the Title X rule; withdrawing the U.S. co-sponsorship and signature from the Geneva Consensus Declaration; and restoring funding to United Nations Population Fund (UNFPA). This follows President Biden’s announcement last week to rejoin the World Health Organization.The following is a statement for Nancy Northrup, president and CEO of the Center for Reproductive Rights on this executive order:Today the Biden administration took an important first step towards righting the Trump administration’s tremendous wrongs impacting access to reproductive health, rights, and justice. In revoking the Global Gag Rule and acting to rescind the Domestic Gag Rule, President Biden is stopping policies that were intended to force reproductive health centers, in the U.S. and around the world, to stop providing and referring for abortion services. The Biden administration also disavowed the disgraceful anti-abortion and anti-LGBTQI+ “declaration” that the Trump administration co-sponsored in October and ordered the State Department to take the steps to restore funding to UNFPA and to ensure that there are adequate funds to support women’s reproductive and sexual health needs globally… January 28, 2021: U.S. Department of Health and Human Services (HHS) posted news titled: “HHS Announces Marketplace Special Enrollment Period for COVID-19 Public Health Emergency”. From the news: In accordance with the Executive Order issued today by President Biden, the U.S. Department of Health and Human Services (HHS) through the Centers for Medicare & Medicaid Services (CMS) announced a Special Enrollment Period (SEP) for individuals and families for Marketplace coverage in response to the COVID-19 Public Health Emergency, which has left millions of Americans facing uncertainty and exceptional circumstances while millions of while millions of Americans have experienced new health problems during the pandemic. This SEP will allow individuals and families in states with Marketplaces served by the HealthCare.gov platform to enroll in 2021 health insurance coverage. Beginning February 15, 2021, and through May 15, 2021, these Marketplaces will operationalize functionality to make this SEP available to all Marketplace-eligible consumers who are submitting a new application or updating an existing application. State-based Marketplaces (SBMs) operating their own platform have the opportunity to take similar action within their states.“The Department is committed to ensuring that we deploy every available resource during the Public Health Emergency. This Special Enrollment Period will ensure that more individuals and families have access to quality, affordable health coverage during this unprecedented time,” said HHS Acting Secretary Norris Cochran.The SEP will be offered to consumers applying for new coverage or updating an existing application through HealthCare.gov, the Marketplace call center, or through direct enrollment channels. Coverage is prospective, with coverage beginning the first day of the month following the date of plan selection… January 28, 2021: Centers for Medicare & Medicaid Services posted news titled: “2021 Special Enrollment Period in response to the COVID-19 Emergency”. From the news: The Coronavirus disease 2019 (COVID-19) national emergency has presented unprecedented challenges for the American public. Millions of Americans are facing uncertainty and millions of Americans are experiencing new health problems during the pandemic. Due to the exceptional circumstances and rapidly changing Public Health Emergency (PHE) impacting millions of people throughout the US every day, many Americans remain uninsured or underinsured and still need affordable health coverage. In accordance with the Executive Order issued today by President Biden, the Centers for Medicare & Medicaid (CMS) determined that the COVID-19 emergency presents exceptional circumstances for consumers in accessing health insurance and will provide a Special Enrollment Period (SEP) for individuals and families to apply and enroll in the coverage they need. This SEP will be available to consumers in the 36 states served by Marketplaces that use the HealthCare.gov platform, and CMS will conduct outreach activities to encourage those who are eligible to enroll in health coverage. CMS strongly encourages states operating their own Marketplace platforms to make a similar enrollment opportunity available to consumers in their states.Starting on February 15, 2021, and continuing through May 15, 2021, Marketplaces using the HealthCare.gov platform will operationalize functionality to make a SEP available to all Marketplace-eligible consumers who are submitting a new application or updating an existing application. These consumers will newly be able to access the SEP through a variety of channels: through HealthCare.gov directly, the Marketplace call center, or direct enrollment channels. Additionally, consumers can work with a network of over 50,000 agents and brokers who are registered with the Marketplace, along with over 8,000 trained assisters, ready to assist consumers with their application for coverage.To promote the SEP and ensure that a broad and diverse range of consumers are aware of this implementation, CMS will conduct an outreach campaign in cooperation with community and stakeholder organizations, focused on education and awareness of this new opportunity to enroll in English, Spanish, and other languages. CMS outreach efforts will include considerable awareness building efforts to encourage the uninsured and those who come to HealthCare.gov to explore coverage to continue the process and enroll. CMS plans to spend $50 million on outreach and education, on a mix of tactics to increase awareness, including advertisments on broadcast, digital, and an earned media.Some consumers may already be eligible for other existing SEPs, Medicaid, or the Children’s Health Insurance Program (CHIP) – they can visit Healthcare.gov now to find out if they can enroll in this new SEP. Starting February 15, consumers seeking to take advantage of this SEP can find out if they are eligible by visiting HealthCare.gov, and are no longer limited to calling the Marketplace call center to access this SEP. Consumers who are eligible to enroll under this SEP will be able to select a plan with coverage that starts prospectively the first of the month after plan selection. Consumers will have 30 days after they submit their application to choose a plan. Current enrollees will be able to change to any available plan in their area without restriction to the same level of coverage as their current plan. In order to use this SEP, current enrollees will need to step through their application and make any changes if needed to their current information and submit their application in order to receive an updated eligibility result that provides the SEP before continuing on to enrollment. This SEP opportunity will not involve any new application questions, or require consumers or enrollment partners to provide any new information not otherwise required to determine eligibility and enroll in coverage. In addition, consumers won’t need to provide any documentation of a qualifying event (e.g., loss of a job or birth of a child), which is typically required for SEP eligibility.As always, consumers found eligible for Medicaid or CHIP will be transferred to their state Medicaid and CHIP agencies for enrollment in those programs. January 28, 2021: NARAL Pro-Choice posted a press release titled: “NARAL Pro-Choice America Applauds President Biden’s Action to Expand Reproductive Freedom”. From the press release: Today, President Joe Biden took executive action to end the global gag rule, roll back the domestic gag rule, restore funding for the United Nations Population Fund (UNFPA), and withdraw the United States from the anti-choice, anti-LGBTQ Geneva Consensus Declaration. The global gag rule, also known as the Mexico City policy, is a harmful and discriminatory policy that prevents non-governmental organizations that receive U.S. global health assistance from using their own, private funds for abortion referrals or to provide abortion care. The Biden-Harris administration announced plans to roll back the Trump administration’s domestic gag policy that strips Title X funding from reproductive health and abortion care providers in the United States. The Department of Health and Human Services must begin the work to rescind this policy immediately so that family planning providers in every community have the resources they need to resume their critical work……In one of his first acts as president, Donald Trump announced a further expansion of the global gag rule from previous iterations implemented under Republican administrations. This move was the beginning of the Trump administration’s four-year-long effort to undermine reproductive freedom and to roll back our fundamental rights. Research has shown that the global gag rule prevents people from accessing a wide range of critical health information and the healthcare they need and want. The reduced effectiveness of global health assistance as a result of the policy puts the lives of women, girls, LGBTQI+ people, BIPOC people, and other groups who face systemic barriers to care at risk. Amid the ongoing COVID-19 global pandemic, this draconian policy exacerbates global health challenges.President Biden also took several actions to roll back other harmful Trump-era policies with global impact including ending the United States’ involvement in the Geneva Consensus Declaration (GCD). The GCD is an attempt from the Trump administration to undermine international consensus around sexual and reproductive health and rights.Additionally, President Biden restored U.S. funding to UNFPA, which plays a critical role as the largest multilateral provider of family planning and reproductive health services with operations in more than 155 countries. Republican administrations and members of Congress often target the U.S. contribution to UNFPA and the Trump administration took things farther than any previous administration by cutting off all funding to the agency.In addition to the unprecedented breadth of the Trump administration’s global gag rule and global anti-choice agenda, the Trump administration also implemented a sweeping domestic gag policy that stripped Title X Family Planning Program funding from healthcare providers who – in addition to other services – provide abortion care or referrals for abortion care.While the Biden-Harris administration’s actions today undoubtedly expand reproductive freedom, it’s critical that this administration demonstrate its commitment to protecting and expanding access to comprehensive reproductive healthcare – including abortion care – and upholding sexual and reproductive rights in the United States and around the world by: Expanding access to reproductive healthcare by removing harmful and medically unnecessary restrictions on medication abortion care during COVID-19;Initiating a comprehensive FDA review of medication abortion – a safe, effective, FDA-approved option for ending an early pregnancy – so that people’s access to care reflects science, not politics;Rescinding Trump’s other executive actions that limit access to care, including refusals of healthcare and attacks on contraception coverage;Ensuring that the president’s budget advances reproductive freedom and excludes discriminatory restrictions on abortion coverage like the Hyde and Helms amendments;Nominating and appointing judges and executive branch officials with positive records on reproductive freedom, health, rights, and justice. January 28, 2021: NARAL Pro-Choice America posted a press release titled: “NARAL Pro-Choice America Denounces Anti-Choice Lawmakers in the South Carolina Senate for Passing Extreme Ban on Abortion”. From the press release: Today, anti-choice lawmakers in South Carolina state Senate passed an extreme and unconstitutional bill to ban abortion before many people even know they’re pregnant. The bill passed by a 30-13 vote and will now head to the state House of Representatives for consideration.Nearly 7,000 South Carolinians have lost their lives to COVID-19, and over 427,000 cases have been reported in the last year. Republican state senators’ decision to make attacking reproductive freedom their top priority in the 2021 legislative session reflects an increasingly extreme Republican Party that couldn’t be more out of touch with the needs of its constituents – not to mention the 77% of Americans who support Roe v. Wade and the legal right to abortion……Recent polling of South Carolina voters in key state Senate districts 31, 33, and 41 found that a large majority (67%) of voters believe that abortion should be legal and that the government should not prevent a woman from making that decision for herself.In South Carolina, 71% of women live in counties with no abortion clinic. With Roe in the crosshairs, the stakes for women, people who are pregnant, and families are higher than ever. South Carolina already has some of the most severe restrictions on reproductive freedom in the United States, which include forcing a pregnant person to wait 24 hours before they can access abortion care and subjecting people to mandatory biased counseling. These restrictions disproportionately harm BIPOC, low-income, and rural communities, and are part of a coordinated effort by the Radical Right to maintain white patriarchal control at all costs. January 28, 2021: The American College of Obstetricians and Gynecologists (ACOG) posted information titled: “Women’s Preventive Services Initiative Receives Five-Year Grant Extension”. From the information: The American College of Obstetricians and Gynecologists (ACOG) is pleased that the U.S. Health Resources and Services Administration has awarded ACOG a five-year cooperative agreement to continue the work of the Women’s Preventative Services Initiative (WPSI), a coalition of national health professional organizations and consumer and patient advocates with expertise in women’s health across the lifespan to develop, review, and update recommendations for preventive healthcare service, including HRSA-sponsored Women’s Preventive Services Guidelines. These HRSA-adopted recommendations help ensure that women receive a comprehensive set of preventive services without having to pay a co-payment, co-insurance or deductible… January 29, 2021: National Women’s Law Center posted a resource titled: “The Biden-Harris Administration’s First Action on Reproductive Health Care Is A Win, But They Must Do So Much More to Expand Access to Abortion and Birth Control”. From the resource: On January 28, 2021, President Biden took his first official action to start addressing dire gaps in access to reproductive health care. He issued a presidential memorandum to reverse select dangerous policies put into place by the Trump Administration, in recognition of the extraordinary harm done to sexual and reproductive rights, health, and justice in the last four years.But while this was an important first action, it is not enough. The Biden-Harris Administration needs to move quickly to address other harmful Trump policies restricting access to reproductive health care. And the Biden-Harris Administration needs to go beyond just undoing the harm of the last four years; they need to move us forward to protect and expand access to reproductive health care.The Presidential Memorandum of January 28, 2021:President Biden issued a presidential memorandum (PM) to rescind the devastating global gag rule, which bars foreign non-profits from receiving any U.S. global health assistance if they provide information, referrals, or services for legal abortion or advocate for the legalization of abortion in their country, even if these activities were supported solely with non-U.S. funds. The global gag rule has blocked health care access, stifled local advocacy efforts, and undermined reproductive rights worldwide.The PM also takes the important first action of directing the Secretary of Health and Human Services to consider rescission of the harmful domestic gag rule. The domestic gag rule prevents grant recipients in the nation’s Title X family planning program from providing nondirective options counseling to pregnant patients or referring to abortion providers, and allows Title X projects to refuse to provide the broad range of contraceptive methods.This step is critical to ensuring that patients are no longer blocked by these rules from getting the care and information they need when they seek family planning care. While necessary, these actions are not sufficient to truly address the fact that across large swaths of the country, people are unable to access essential reproductive health care, jeopardizing their health, economic security, futures, and lives.Here are additional actions the Biden-Harris Administration must take over the coming weeks to protect and expand access to reproductive health care, especially abortion.Additional immediate actions needed to undo the harm of the Trump AdministrationSuspend In-Person Dispensing Requirements for Medication Abortion During the PandemicThe Biden Administration must issue guidance to suspend in-person dispensing requirements for medication abortion for the duration of the public health emergency. Requiring people to make an unnecessary trip to a health center during a pandemic puts their health at serious risk. Yet despite the risk, and despite the fact that all major medical groups, including the American Medical Association (AMA) and American College of Obstetricians and Gynecologists (ACOG), support lifting the requirement, the Supreme Court allowed the Trump Administration to reinstate the FDA’s requirement for medication abortion to be dispensed in-person only. The Biden Administration must act quickly to stop enforcement. The FDA should also initiate a full review of the restrictions placed on medication abortion to ensure patient access is based on the latest science and medical evidence.Rescind the Trump Administration Refusal of Care RuleThe Trump Administration finalized a rule that gives sweeping new rights to virtually any individual or entity involved in patient care to refuse to help people seeking health care. The refusal of care rule targets patients seeking reproductive health care, particularly abortion and sterilization, and LGBTQ+ patients. The Biden Administration must act quickly to rescind this rule and ensure health care entities do not use personal beliefs to deny patients care.Rescind the Trump Administration Rule Intended to Eliminate Private Insurance Coverage of AbortionThe Trump Administration finalized a rule placing onerous and arbitrary requirements on insurance companies that offer plans with abortion coverage on the ACA marketplaces. This rule is intended to make it so burdensome for insurance companies to offer abortion coverage that they drip abortion coverage from their plans, ultimately eliminating abortion coverage from the ACA marketplace altogether. The Biden Administration must rescind this harmful rule.Undo the Trump Administration Rollback of Critical Health Care Non-Discrimination ProtectionsThe Trump Administration finalized a rule that rolled back critical protections against discrimination in health care, leaving patients more vulnerable to discrimination, more likely to be confused about their rights, and less likely to seek out care. The rule puts people’s lives in danger and is especially harmful to those living at the intersection of impacted communities. The rule specifically targets abortion care by imposing religious and abortion exemptions and further stigmatizes care. The Biden Administration must rescind this rule and restore and strengthen health care non-discrimination protections. No one should face discrimination in health care.Additional immediate actions needed to move us forwardStrike the Hyde and Weldon Amendments from the President’s BudgetThe President’s budget must eliminate the Hyde and Weldon amendments. These dangerous policy riders are included in the annual appropriations process and are intended to erect barriers to abortion care for Black, Indigenous, and other communities of color, LGBTQ+ people, as well as people with low-incomes. The Hyde Amendment denies abortion coverage to individuals enrolled in Medicaid. The Weldon amendment threatens policymakers with the loss of critical federal dollars if they seek to protect their residents’ access to abortion. The Trump Administration attempted to dramatically expand the reach of the Weldon Amendment to punish states that ensure abortion coverage and to allow health care providers to deny patients abortion care. As President Biden’s January 28 PM acknowledged “ndue restrictions on the use of Federal funds have made it harder for women to obtain necessary healthcare.” It is beyond time for these injustices to be righted and for both of these policies to go.Create an Interagency Task Force or High Level Office on Reproductive Health CareThere is a reproductive health care crisis in this country, which is compounded by the COVID-19 crisis and underlying systemic racism. The crisis was undeniably worsened by the Trump Administration, but the cause of the crisis goes deeper and cannot be solved by a single agency or by merely reversing the harms of the Trump Administration. The Biden-Harris Administration should establish a White House Interagency Task Force on Reproductive Health Care – or a similar high level office – to develop a coordinated federal response to the crisis, with a particular focus on communities who are most impacted… January 29, 2021: U.S. Department of Health and Human Services posted news titled: American Rescue Plan Lowers Health Insurance Costs for Americans Who May Have Lost Their Job”. From the news: As part of the American Rescue Plan (ARP) signed by President Biden, the Centers for Medicare & Medicaid Service (CMS) is again lowering the cost of health insurance and opening more pathways for Americans to obtain affordable and comprehensive health coverage. Starting July 1, 2021, consumers who received or are approved to receive unemployment compensation for any week beginning in 2021 may be able to find even lower cost plans and save extra money on out-of-pocket expenses through HealthCare.gov.To take advantage of these additional savings, consumers who received or have been approved for unemployment compensation in 2021 need to visit HealthCare.gov to submit a new application or update their existing application to maximize the savings they can get for the rest of 2021. An average of three out of five eligible uninsured Americans can access $0 plans after advance payments of tax credits and an average of four out of five current HealthCare.gov consumers will be able to find a plan for $10 or less per month after advance payments of tax credits CMS encourages current consumers who have received unemployment income for any week beginning in 2021 to update their application and enrollment between July 1 and August 15 to maximize the savings on their Marketplace coverage for the rest of the year.The Biden-Harris Administration is focused on providing relief to millions of families who need to access health insurance coverage because they have been impacted by job losses or underemployment during the pandemic,” said HHS Secretary Xavier Becerra. “The Administration has made it easier than ever for Americans to enroll in an affordable, comprehensive health insurance plans through HealthCare.gov thanks to the increased financial assistance provided through the American Rescue Plan. We encourage consumers who have received unemployment compensation in 2021 to visit the Marketplace to see if they qualify to save money on their health insurance premiums and out-of-pocket costs.”“We are doing everything we can to remove financial barriers to comprehensive health care,” said CMS Administrator Chiquita Brooks-LaSure. “The American Rescue Plan provides consumers with additional savings and will make coverage even more attainable for those most in need. We welcome people who received unemployment benefits in 2021 to check out their health coverage options on HealthCare.gov on July 1.” January 30, 2021: Centers for Disease Control and Prevention (CDC) posted a press release titled: “CDC requires wearing of face masks while on public transportation and at transportation hubs”. From the press release: As the COVID-19 pandemic continues to surge in the United States, CDC is implementing provisions of President Biden’s Executive Order on Promoting COVID-19 Safety in Domestic and International Travel and will require the wearing of masks by all travelers into, within, or out of the United States, e.g., on airplanes, ships, ferries, trains, subways, buses, taxis, and ride-shares. The mask requirement also applies to travelers in U.S. transportation hubs such as airports and seaports; train, bus, and subway stations; and any other areas that provide transportation.Transportation operators must require all persons onboard to wear masks when boarding, disembarking and for the duration of travel. Operators of transportation hubs must require all persons to wear a mask when entering or on the premises of a transportation hub. This action is to further prevent spread of the virus that causes COVID-19 and to further support state and local health authorities, transportation partners, and conveyance operators to keep passengers, employees and communities safe.Today’s order from CDC is part of a comprehensive, science-driven, U.S. government response to the COVID-19 pandemic. One component of the whole-of-government response is taking actions related to reducing virus spread through travel. Transmission of the virus through travel has led to – and continues to lead to – interstate and international spread of the virus.“America’s transportation systems are essential,” said CDC Director Dr. Rochelle P. Walensky, MD, MPH. “Given how interconnected most transportation systems are across our nation and the world, when infected persons travel on public conveyances without wearing a mask and with others who are not wearing masks, the risk of interstate and international transmission can grow quickly.”Traveling on public transportation increases a person’s risk of getting and spreading COVID-19 by brining people in close contact with others, often for prolonged periods, and exposing them to frequently touched surfaces. Face masks help prevent people who have COVID-19, including those who are pre-symptomatic or asymptomatic, from spreading the virus to others. Masks also help protect the wearer by reducing the chance they will breathe respiratory droplets carrying the virus……This order will be effective on February 2, 2021… This blog will be updated if and when I find additional relevant information from credible sources. Health Care Under Biden-Harris Administration – January 2021 is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... The ACA is Here to Stay!June 27, 2021health insurance / Out of SpoonsHealthcare in Scrabble letter next to a green fern by Total Shape on Pexels A brief history of how the Patient Protection and Affordable Care Act came to be, and a review of the lawsuits that tried to destroy it. On June 17, 2021, The Associated Press reported that the Supreme Court rejected the latest major Republican-led effort to kill the national health care law known as “Obamacare”. The result is that the Supreme Court preserved insurance coverage for millions of Americans. Also on June 17, 2021, Politico posted an article titled: “Supreme Court tosses lawsuit challenging Obamacare”. It was written by Susannah Luthi and Josh Gerstein. From the article: The Supreme Court on Thursday threw out a lawsuit threatening the entirety of the Affordable Care Act, finding that Republican-led states behind the case did not have legal ground to challenge the landmark health care law.The 7-2 decision, which preserves health insurance for millions and the law’s popular protections for preexisting conditions, may serve as the final chapter in the decade-long legal assault on the Affordable Care Act, arriving as President Joe Biden seeks to build on the law’s coverage provisions. It’s also the final blow to former President Donald Trump’s pledge to rip up his predecessor’s signature health care law, after his administration had supported the red states who brought the lawsuit… How did the Supreme Court Justices Decide this Case? The case was called California Et Al. v. Texas Et AL. The case was argued before the Supreme Court on November 10, 2020, and decided on June 17, 2021. From the syllabus portion of the decision: The Patient Protection and Affordable Care Act as enacted in 2010 required most Americans to obtain minimum essential health insurance coverage and imposed a monetary penalty upon most individuals who failed to do so. Amendments to the Act in 2017 effectively nullified the penalty by setting its amount to $0. Subsequently, Texas (along with over a dozen States and two individuals) brought the suit against federal officials, claiming that without the penalty the Act’s minimum essential coverage provision, codified at 26 U.S.C. §5000A(a), is unconstitutional.They sought a declaration that the provision is unconstitutional, a finding that the rest of the Act is not severable from §5000A(a) both unconstitutional and not severable from the rest of the Act. The District Court determined that the individual plaintiffs had standing. It also found §5000A(a) both unconstitutional and not severable from the rest of the Act. The Fifth Circuit agreed as to the existence of standing and the unconstitutionality of §5000A(a), but concluded that the District Court’s severability analysis provided insufficient justification to strike down the entire Act. Petitioner California and other States intervened to defend the Act’s constitutionality and to seek further review.Held. Plaintiffs do not have standing to challenge §5000A(a)’s minimum essential coverage provisions because they have not shown a past or future injury fairly traceable to defendants’ conduct enforcing the specific statutory provision they attack as unconstitutional….…(a) The Constitution gives federal courts the power to adjudicate only genuine “Cases” and “Controversies.” … To have standing, a plaintiff must “allege personal injury fairly traceable to the defendant’s allegedly unlawful conduct and likely to be redressed by the requested relief.”… No plaintiff has shown such an injury “fairly traceable” to the “allegedly unlawful conduct” challenged here……(b) The two individual plaintiffs claim a particularized individual harm in the form of past and future payments necessary to carry the minimum essential coverage that §5000A(a) requires. Assuming this pocketbook injury satisfies the injury element of Article III standing, it is not “fairly traceable” to any “allegedly unlawful conduct” of which the plaintiffs complain… …Without a penalty for noncompliance, §5000A(a) is unenforceable. The individuals have not shown that any kind of Government action or conduct has caused or will cause the injury they attribute to §5000A(a). The Court’s cases have consistently spoken of the need to assert an injury that is the result of a statute’s actual or threatened enforcement, whether today or in the future… …Here, there is only the statute’s textually unenforceable language.Unenforceable statutory language alone is not sufficient to establish standing, as the redressability requirement makes clear. Whether an injury is redressable depends on the relationship between “the judicial relief requested” and the “injury” suffered… … The only relief sought regarding the minimum essential coverage provision is declaratory relief, namely, a judicial statement that the provision challenged is unconstitutional. But just like suits for every other type of remedy, declaratory-judgement actions must satisfy Article III’s case-or-controversy requirement……Article III standing requires identification of a remedy that will redress the individual plaintiffs’ injuries… …No remedy exists here. To find standing to attack an unenforceable statutory provision would allow a federal court to issue what would amount to an advisory opinion without the possibility of an Article III remedy. Article III guards against federal courts assuming this kind of jurisdiction……The Court also declines to consider Federal respondents’ novel alternative theory of standing first raised in its merits brief on behalf of the individuals, as well as the dissent’s novel theory on behalf of the states, neither of which was directly argued by plaintiffs below nor presented at the certiorari stage……(c) Texas and the other state plaintiffs have similarly failed to show that the pocketbook injuries they allege are traceable to the Government’s allegedly unlawful conduct… …They allege two forms of injury: one indirect, one direct.(1) The state plaintiffs allege indirect injury in the form of increased costs to run state-operated medical insurance programs. They say the minimum essential coverage provision has caused more state residents to enroll in the programs. The States, like the individual plaintiffs, have failed to show how that alleged harm is traceable so the Government’s actual or possible action in enforcing §5000A(a), so they lack Article III standing as a matter of law.But the States have not shown that the challenged minimum essential coverage provision, without any prospect of penalty, will injure them by leading more individuals to enroll in these programs. Where a standing theory rests on speculation about the decision of an independent third party (here an individual’s decision to enroll in a program like Medicaid), the plaintiff must show at least “that third parties will likely act in predictable ways”… …Neither logic nor evidence suggests that an uninforcable mandate will cause state residents to enroll in valuable benefit programs that they would otherwise forgo. It would require far stronger evidence than the States have offered here to support their counterintuitive theory of standing, which rests on a “highly attenuated chain of possibilities.”……(2) The state plaintiffs also claim a direct injury resulting from a variety of increased administrative and related expenses allegedly required by §5000A(a)’s minimum essential coverage provision. But other provisions of the Act, not the minimum essential coverage provision, impose these requirements. These provisions are enforced without reference to §5000A(a). No one claims these other provisions violate the Constitution. The Government’s conduct in question is therefore not “fairly traceable” to enforcement of the “allegedly un-lawful” provision of which the plaintiffs complain…Reversed and remanded. Breyer, J., delivered the opinion of the Court, in which Roberts, C. J., and Thomas, Sotomayor, Kagan, Kavanaugh, and Barrett, J.J., joined. Thomas, J., filed a concurring opinion. Alto,J., filed a dissenting opinion, in which Gorsuch J., joined. What Came Before this Case? Ballotpedia provided the following overview of Obamacare: 2010 July 2009: House Democrats introduced the Affordable Health Care for America Act, the precursor to the Affordable Care Act. The House passed the bill on November 7, 2009: with the votes of 219 Democrats and one Republican (Representative Joseph Cao – R-La.). Thirty-nine Democrats and 176 Republicans voted against the bill. December 24, 2009: The Senate passed its version of the bill 60-39, with all Democrats voting in favor of the bill and all Republicans but one voting against it (Senator Jim Bunning – R-Ky). January 1, 2010: The federal government begins providing tax credits for small business offering health insurance to employees. January 2010: Republican Scott Brown of Massachusetts won a special election to fill the seat of Senator Ted Kennedy (D-Mass), who had died in August of 2009. With the election of Brown, Senate Democrats would not have the 60 votes to overcome a Republican filibuster on a new bill. A majority of the House Democratic Caucus agreed to pass the Senate bill as long as subsequent budget-related changes to the bill could be made via the reconciliation process. Reconciliation bills only need 50 Senate votes to pass and are not subject to filibuster. March 21, 2010: The House passed the Senate bill with 178 House Republicans opposing the bill’s passage along with 34 Democrats, while 219 Democrats voted in favor, leaving the final vote 219-212. The House passed the reconciliation package on the same day by a vote of 220-211. March 23, 2010: President Obama signed the Senate bill. March 25, 2010: The Senate approved the reconciliation bill by a vote of 56-43. March 30, 2010: President Obama signed the reconciliation bill. The two bills together are referred to as the Patient Protection and Affordable Care Act (PPACA), the Affordable Care Act (ACA), or Obamacare. July 1, 2010: The Temporary Pre-existing Condition Insurance Plan is established, offered by either the federal government or individual state governments. The program provides coverage for individuals with pre-existing conditions until 2014. July 1, 2010: Deadline for HealthCare.gov to be established as a minimally functioning website to educate consumers on coverage options. July 1, 2010: The federal government begins collecting a 10 percent excise tax on indoor tanning services. September 23, 2010: The requirement for insurers to allow adult children to remain on a parent’s health insurance plan until age 26 begins. September 23, 2010: Insurance plans are prohibited from setting lifetime coverage limitations. September 23, 2010: The requirement for insurers to allow appeals with an external review process begins. September 23, 2010: New plans established after this date are required to cover a standard set of health benefits (the 10 essential health benefits). Healthcare.gov provided information about the 10 essential health benefits: Ambulatory patient services (outpatient care you get without being admitted to a hospital)Emergency servicesHospitalization (like surgery and overnight stays)Pregnancy, maternity, and newborn care (both before and after birth)Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)Prescription drugsRehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)Laboratory servicesPreventative and wellness services and chronic disease managementPediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits). Additional benefits plans must also include: birth control coverage; breastfeeding coverage Essential health benefits are minimum requirements for all Marketplace plans. Specific services covered in each broad benefit category can vary based on your state’s requirements. Plans may offer additional benefits, including: dental coverage; vision coverage; medical management programs (for specific needs like weight management, back pain, and diabetes) 2011 January 1, 2011: The requirement for insurers to provide rebate each year if a minimum portion of premiums was not spent on medical services begins.January 1, 2011: Health savings accounts can be used for certain purposes. According to HealthCare.gov, health savings accounts (HSA) are a type of savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses. By using untaxed dollars in a Health Savings Account (HSA) to pay for deductibles, copayments, coinsurance, and some other expenses, you may be able to lower your overall health care costs. HSA funds generally may not be used to pay premiums. While you can use the funds in an HSA at any time to pay for qualified medical expenses, you may contribute to an HSA only if you have a High Deductible Health Plan (HDHP) – generally a health plan (including a Marketplace plan) that only covers preventative services before the deductible. March 23, 2011: The first round of grants are provided to states for the establishment of health insurance exchanges. 2012 September 23, 2012: The requirement for all insurers to provide a uniform summary of care and benefits to consumers begins. 2013 January 1, 2013: Deadline for states to notify the U.S. Department of Health and Human Services whether they will form their own exchanges or join the federal exchange.July 1, 2013: Deadline for grants and loans to be awarded to start-up co-ops, nonprofit, member-run health insurance companies designed by the ACA. 2014 January 1, 2014: States begin to be allowed to expand Medicaid coverage to childless adults under 65 earning incomes up to 138 percent of the federal poverty level.January 1, 2014: Deadline for individuals to obtain health insurance to avoid paying a tax penalty.January 1, 2014: Insurance companies no longer allowed to place annual limits on the amount they pay out for benefits.March 31, 2014: Months spend without health insurance begin to be counted toward the tax penalty. 2015 January 1, 2015: Employers with more than 100 employees assessed fees, per employee, for not providing health insurance options. 2016 January 1, 2016: Employers with 50 – 99 employees assessed fees, per employee, for not providing health insurance options. A List of Obamacare Lawsuits National Federation of Independent Business v. Sebelius Argued March 26, 27, 28, 2012 – Decided June 28, 2012 The National Federation of Independent Business (NFIB) describes itself as “the voice of small business, advocating on behalf of America’s small and independent business owners, both in Washington, D.C., and in all 50 state capitals. NFIB is nonprofit, nonpartisan, and member-driven.” They were founded in 1943. Ballotpedia provided some background on this case. The Patient Protection and Affordable Care Act, also known as the Affordable Care Act (ACA) or Obamacare, was enacted with the primary aim of expanding health insurance coverage to more people. To that end, the law required most individuals to acquire and maintain minimum health insurance coverage or be penalized. It also required states to expand eligibility for their Medicaid programs to all individuals with incomes up to 138 percent of the federal poverty level. If the state refused to expand, the law said that the federal government could completely withhold its portion of Medicaid funding from the state.Less than two months after the law was enacted, a federal lawsuit was filed in Florida, consisting of 26 states, two individuals, and an independent organization. The following plaintiffs joined: The Attorneys General of Arizona, Indiana, Mississippi, Nevada, North Dakota, Alabama, Colorado, Florida, Idaho, Louisiana, Michigan, Nebraska, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Washington, Georgia, Alaska, Ohio, Wisconsin, Kansas, Maine, Iowa, and Wyoming: Mary Brown and Kaj Ahlburg; and the National Federation of Independent Business. The lawsuit was brought to the federal District Court for the Northern District of Florida by Florida state Attorney General Bill McCollum on March 23, 2010.The lawsuit challenged the Affordable Care Act for the Northern District of Florida ruled on January 31, 2011, that the individual health insurance mandate exceeded Congress’ authority. It also ruled that the individual mandate could not be severed from the rest of the Affordable Care Act, thus striking the entire act. However, it found in favor of the federal government with regard to the Medicaid expansion.The federal government appealed the ruling, which then went to the Eleventh Circuit Court of Appeals. The Eleventh Circuit affirmed in part and reversed in part the judgement of the lower court. It agreed that the Medicaid expansion provision was not unconstitutionally coercive and that the individual mandate was unconstitutional. However, the Eleventh Circuit held that “the individual mandate could be severed without invalidating the remainder of the ACA”… The Supreme Court released its decision on June 28, 2012. Here is part of the syllabus: Congress enacted the Patient Protection and Affordable Care Act in order to increase the number of Americans covered by health insurance and decrease the cost of health care. One key provision is the individual mandate, which requires most Americans to maintain “minimum essential” health insurance coverage. 26 U.S.C. §5000A. For individuals who are not exempt, and who do not receive health insurance through an employer or government program, the means of satisfying the requirement is to purchase insurance from a private company. Beginning in 2014, those who do not comply with the mandate must make a “hared responsibility payment” to the Federal Government. 5000A(b)(1). The Act provides that this “penalty” will be paid to the Internal Revenue Service with an individual’s taxes, and “shall be assessed and collected in the same manner” as tax penalties. §5000A(c), (g)(1).Another key provision of the Act is the Medicaid expansion. The current Medicaid program offers federal funding to States to assist pregnant women, children, needy families, the blind, the elderly, and the disabled in obtaining medical care… The Affordable Care Act expands the scope of the Medicaid program and increases the number of individuals the States must cover. For example, the Act requires a state to provide Medicaid coverage by 2014 to adults with incomes up to 133 percent of the federal poverty level, whereas many States now cover adults with children only if their income is considerably lower, and do not cover childless adults at all… The Act increases federal funding to cover the States’ costs in expanding Medicaid coverage… But if a State does not comply with the Act’s new coverage requirements, it may lose not only the federal funding for those requirements, but all of its federal Medicaid funds…Twenty-six States, several individuals and the National Federation of Independent Business brought suit in Federal District Court, challenging the constitutionality of the individual mandate and the Medicaid expansion. The Court of Appeals for the Eleventh Circuit upheld the Medicaid expansion as a valid exercise of Congress’s spending power, but concluded that Congress lacked authority to enact the individual mandate. Finding the mandate severable from the Act’s other provisions, the Eleventh Circuit left the rest of the Act intact.Held. The judgment is affirmed in part and reversed in part.1 Chief Justice Roberts delivered the opinion of the Court with respect to Part II, concluding that the Anti-Injunction Act does not bar this suit.The Anti-Injunction Act provides that “no suit for the purpose of restraining the assessment or collection of tax shall be maintained in any court by any person,” 26 U. S. C. §7421(a), so that those subject to a tax must first pay it and then sue for a refund. The present challenge seeks to restrain the collection of the shared responsibility payment from those who do not comply with the individual mandate. But Congress did not intend the payment to be treated as a “tax” for purposes of the Anti-Injunction Act. The Affordable Care Act describes the payment as a “penalty” not a “tax”. That label cannot control whether the payment is a tax for purposes of the Constitution, but it does determine the application of the Anti-Injunction Act. The Anti-Injunction Act therefore does not bar this suit.2 Chief Justice Roberts concluded in Part III-A that the individual mandate is not a valid exercise of Congress’s power under the Commerce Clause and the Necessary and Proper Clause…(a) The Constitution grants Congress the power to “regulate Commerce”… The power to regulate commerce presupposes the existence of commercial activity to be regulated. This Court’s precedent reflects this understanding: As expansive as this Court’s cases construing the scope of the commerce power have been, they uniformly describe the power as reaching “activity“… The individual mandate, however, does not regulate existing commercial activity. It instead compels individuals to become active in commerce by purchasing a product, on the ground that their failure to do so affects interstate commerce.Construing the Commerce Clause to permit Congress to regulate individuals precisely because they are doing nothing would open a new and potentially vast domain to congressional authority. Congress already possesses expansive power to regulate what people do. Upholding the Affordable Care Act under the Commerce Clause would give Congress the same license to regulate what people do not do. The Framers knew the difference between doing something and doing nothing. They gave Congress the power to regulate commerce, not to compel it. Ignoring that distinction would undermine the principle that the Federal Government is a government of limited and enumerated powers. The individual mandate thus cannot be sustained under Congress’s power to “regulate Commerce”….(b) Nor can the individual mandate be sustained under the Necessary and Proper Clause as an integral part of the Affordable Care Act’s other reforms. Each of this Court’s prior cases upholding laws under that Clause involved exercise of authority derivative of, and in service to, a granted power. … The individual mandate, by contrast, vests Congress with the extraordinary ability to create the necessary predicate to the exercise of an enumerated power and draw within its regulatory scope those who would otherwise be outside of it. Even if the individual mandate is “necessary” to the Affordable Care Act’s other reforms, such a mandate is “necessary” of federal power is not a “proper” means for making those reforms…3 Chief Justice Roberts concluded in Part III-B that the individual mandate must be construed as imposing a tax on those who do not have health insurance, if such a construction is reasonable.The most straightforward reading of the individual mandate is that it commands individuals to purchase insurance. But, for the reasons explained, the Commerce Clause does not give Congress that power. It is therefore necessary to turn to the Government’s alternative argument: that the mandate may be upheld as within Congress’s power to “lay and collect Taxes.”… In pressing its taxing power argument, the Government asks the Court to view the mandate as imposing a tax on those who do not buy that product. Because “every reasonable construction must be restored to, in order to save a statute from unconstitutionality,” … the question is whether it is “fairly possible” to interpret the mandate as imposing such a tax…4 Chief Justice Roberts delivered the opinion of the Court with respect to Part III-C, concluding that the individual mandate may be upheld as within Congress’s power under the Taxing Clause…(a) The Affordable Care Act describes the “hared responsibility payment” as a “penalty,” not a “tax”. That label is fatal to the application of the Anti-Injunction Act. It does not, however, control whether an exaction is within Congress’s power to tax. In answering that constitutional question, this Court follows a functional approach, isregarding the designation of the exaction, and viewing its sub-stance and application.”…(b) Such an analysis suggests that the shared responsibility payment may for constitutional purposes be considered a tax. The payment is not so high that there is really no choice but to buy health insurance; the payment is not limited to willful violations, as penalties for unlawful acts are; and the payment is collected solely by the IRS through the normal means of taxation…. None of this is to say that payment is not intended to induce the purchase of health insurance. But the mandate need not be read to declare that failing to do so is unlawful. Neither the Affordable Care Act nor any other law attaches negative legal consequences to not buying health insurance, beyond requiring a payment to the IRS. And Congress’s choice of language – stating that individuals “shall” obtain insurance or pay a “penalty” – does not require reading §5000A as punishing unlawful conduct. It may also be read as imposing a tax on those who go without insurance…(c) Even if the mandate may reasonably be characterized as a tax, it must still comply with the Direct Tax Clause, which provides: “No Capitation, or other direct, Tax shall be laid, unless in Proportion to the Census or Enumeration herein before directed to be taken.”… A tax on going without health insurance is not like a capitation or other direct tax under this Court’s precedents. it therefore need not be apportioned so that each State pays in proportion to its population.5 Chief Justice Roberts, joined by Justice Breyer and Justice Kagan, concluded in Part IV that the Medicaid expansion violates the Constitution by threatening States with the loss of their existing Medicaid funding if they decline to comply with the expansion…(a) The Spending Clause grants Congress the power “to pay the Debts and provide for the… general Welfare of the United States.” … Congress may use this power to establish cooperative state-federal Spending Clause programs. The legitimacy of Spending Clause legislation, however, depends on whether a State voluntarily and knowingly accepts the terms of such programs…. ” Constitution simply does not give Congress the authority to require the States to regulate”…. When Congress threatens to terminate other grants as a means of pressuring the States to accept a Spending Clause program, the legislation runs counter to this Nation’s system of federalism.(b) Section 1396c gives the Secretary of Health and Human Services the authority to penalize States that choose not to participate in the Medicaid expansion by taking away their existing Medicaid funding… The threatened loss of over 10 percent of a State’s overall budget is economic dragooning that leaves the States with no real option but to acquiesce in the Medicaid expansion. The Government claims that the expansion is properly viewed as only a modification of an existing program, and that this modification is permissible because Congress reserved the “right to alter, amend, or repeal any provision” of Medicaid… But the expansion accomplishes a shift in kind, not merely degree. The original program was designed to cover medical services for particular categories of vulnerable individuals. Under the Affordable Care Act, Medicaid is transformed into a program to meet the health care needs of the entire nonelderly population with income below 133 percent of the poverty level. A State could hardly anticipate that Congress’s reservation of the right to “alter” or “amend” the Medicaid program expansion thus violates the Constitution by threatening States with the loss of their existing Medicaid funding if they decline to comply with the expansion.(c) The constitutional violation is fully remedied by precluding the Secretary from applying §1396c to withdraw existing Medicaid funds for failure to comply with the requirements set out in the expansion… The other provisions of the Affordable Care Act are not affected. Congress would have wanted the rest of the Act to stand, had it known that States would have a genuine choice whether to participate in the Medicaid expansion…6 Justice Ginsburg, joined by Justice Sotomayor, is of the view that the Spending Clause does not preclude a Secretary from withholding Medicaid funds based on a State’s refusal to comply with the expanded Medicaid program. But given the majority view, she agrees with THE CHIEF JUSTICE’s conclusion in Part IV-B that the Medicaid Act’s severability clause, 42 U. S. C. §130, determines the appropriate remedy. Because THE CHIEF JUSTICE finds the withholding – not the granting – of federal funds incompatible with the Spending Clause, Congress’ extension of Medicaid remains available to any State that affirms its willingness to participate. Even absent 1303’s command, the Court would have no warrant to invalidate the funding offered by the Medicaid expansion, and surely no basis to tear down the ACA in its entirety. When a court confronts an unconstitutional statute, its endeavor must be to conserve, not destroy, the legislation… Roberts, C.J., announced the judgement of the Court and delivered the opinion of the Court with respect to Parts I, II, and III-C, in which Ginsburg, Breyer, Sotomayor, and Kagan, J.J., joined; and an opinion with respect to Parts III-A, III-B, and III-D. Ginsburg, J. filed an opinion concurring in part and dissenting in part, in which Sotomayor, J. joined, and in which Beyer and Kagan, J.J., joined as to Parts I, II, III, and IV. Scalia, Kennedy, Thomas, and Alito, J.J., filed a dissenting opinion. Thomas, J. filed a dissenting opinion. Burwell v. Hobby Lobby Stores, Inc. Argued March 25, 2014 – Decided June 30, 2014 Ballotpedia provided information about Burwell v. Hobby Lobby Stores, Inc. The Patient Protection and Affordable Care Act, also known as the Affordable Care Act or Obamacare, mandated that insurance plans must cover preventative healthcare – which the U.S. Department of Health and Human Services later interpreted to include contraception – at no cost. Employers that didn’t provide this benefit in their health insurance plan would face fines. Religious organizations argued that being required to cover birth control violated religious freedoms. Religious employers and nonprofits were exempted from the requirement, but religious for-profit corporations were not.Hobby Lobby, a company that describes itself as “operating… in a manner consistent with Biblical principals,” sued the secretary of health and human services, Kathleen Sebelius, on September 12, 2012. The company sought exemptions from coverage of four different contraceptives – two emergency morning-after pills and two intrauterine devices (IUDs) – on the basis that those contraceptives violated their religious beliefs. The company did not argue against providing other forms of contraception.The district court denied the company’s request for a preliminary injunction against enforcement of the mandate, a judgement that was affirmed upon review by a two-judge panel of the Tenth Circuit Court of Appeals. The Supreme Court also denied the request, at which point Hobby Lobby requested – and was granted – a hearing by the full Tenth Circuit Court. The Tenth Circuit reversed the opinion of a two-judge panel and ruled in favor of Hobby Lobby, holding that closely held religious corporations were protected by both the Religious Freedom Restoration Act and the First Amendment of the United States Constitution.Similarly, Conestoga Wood Specialties was a company owned by a Mennonite family who objected to contraceptives that could potentially cause an abortion. In July 2013, the Third Circuit Court of Appeals ruled against Conestoga Wood Specialties on the grounds that for-profit corporations cannot engage in religious exercise.To resolve the discrepancy, the Supreme Court granted certiorari on November 25, 2013, and oral argument on March 24, 2014. By the time the case made it to the Supreme Court, Kathleen Sebelius was no longer the Secretary of the U.S. Department of Health and Human Services. Sylvia Mathews Burwell was sworn in as the 22nd Secretary of Health and Human Services on June 9, 2014. The Supreme Court limited oral arguments to the following question: “Whether RFRA allows a for-profit corporation to deny its employees the health coverage of contraceptives to which the employees are otherwise entitled by federal law, based on the religious objections of the corporation’s owners.” RFRA is the Religious Freedom Restoration Act. It was passed by Congress in 1993. It is described this way: Religious Freedom Restoration Act of 1993 – Prohibits any agency, department, or official of the United States or any State (the government) from substantially burdening a person’s exercise of religion even if the burden results from a rule of general applicability, except that the government may burden a person’s exercise of religion only if it demonstrates that application of the burden to the person: (1) furthers a compelling governmental interest; and (2) is the least restrictive means of furthering that compelling governmental interest. The Supreme Court ruled on Burwell v. Hobby Lobby Stores, Inc., on June 30, 2014. From the syllabus: The Religious Freedom Restoration Act of 1993 (RFRA) prohibits the “Government substantially burden a person’s exercise of religion even if the burden results from a rule of general applicability” unless the Government “demonstrates that application of the burden to the person – (1) is in furtherance of a compelling governmental interest; and (2) is the least restrictive means of furthering that compelling governmental interest.”… (b) As amended by the Religious Land Use and Institutionalized Persons Act of 2000 (RLUIPA), RFRA covers “any exercise of religion, whether or not compelled by, or central to, a system of religious belief.”…At issue here are regulations promulgated by the Department of Health and Human Services (HHS) under the Patient Protection and Affordable Care Act of 2010 (ACA), which, as relevant here, requires specified employers’ group health plans to furnish “preventative care and screenings” for women without “any cost sharing requirements.”… Congress did not specify what types of preventative care must be covered; it authorized the Health Resources and Service Administration, a component of HHS, to decide… …Nonexempt employers are generally required to provide coverage for the 20 contraceptive methods approved by the Food and Drug Administration, including the 4 that have an effect of preventing an already fertilized egg from developing any further by inhibiting its attachment to the uterus…. NOTE: The description of the 4 contraceptive methods “…that have an effect of preventing an already fertilized egg from developing any further by inhibiting its attachment to the uterus…” is entirely incorrect. On May 1, 2013, LiveScience posted an article titled: “How Does Plan B Work?” It was written by Rachael Rettner. From the article: …The drug mainly prevents pregnancy by stopping the release of an egg from the ovary, and by preventing the fertilization of an egg. Dr. Christopher Estes, assistant professor of obstetrics and gynecology at the University of Miami Miller School of Medicine, told MyHealthNewsDaily in a 2011 interview. While the drug causes changes to the lining of the uterus, it does not interfere with the implantation of a fertilized egg, Estes said. In fact, in order to stabilize the pregnancies of women who’ve suffered miscarriages, doctors give a drug very similar to Plan B, Estes said.The drug will not work if a woman is already pregnant. (It has no effect on an existing pregnancy, according to Teva.) Emergency contraception will not cause an abortion… Planned Parenthood posted information about IUD’s (Intrauterine Device): There are 5 different brands of IUDs that are FDA approved for use in the United States: Paraguard, Mirena, Kyleena, Liletta, and Skyla. These IUDs are divided into two types: copper IUDs (Paraguard) and hormonal IUDs (Mirena, Kyleena, Liletta, and Skyla)……Both copper IUDs and hormonal IUDs prevent pregnancy by changing the way sperm cells move so it can’t get to an egg. If sperm can’t make it to an egg, pregnancy can’t happen.The Paraguard IUD uses copper to prevent pregnancy. Sperm doesn’t like copper, so the Paraguard IUD makes it almost impossible for sperm to get to that egg.The hormones in Mirena, Kyleena, Liletta, and Skyla IUDs prevent pregnancy in two ways: 1) they thicken the mucus that lives on the cervix, which blocks and traps the sperm, and 2) the hormones also sometimes stop eggs from leaving your ovaries (called ovulation), which means there’s no egg for a sperm to fertilize. No egg, no pregnancy… Now that I’ve provided accurate information about these forms of birth control – that absolutely do not prevent “an already fertilized egg from developing any further by inhibiting its attachment to the uterus”, we can return to the syllabus of the Supreme Court. …Religious employers, such as churches, are exempt from this contraceptive mandate. HHS has also effectively exempted religious nonprofit organizations with religious objections to providing coverage for contraceptive services. Under this accommodation, the insurance issuer must exclude contraceptive coverage from the employer’s plan and provide plan participants with separate payments for contraceptive services without imposing any cost-sharing requirements on the employer, its insurance plan, or its employee beneficiaries.In these cases, the owners of three closely held for-profit corporations have sincere Christian beliefs that life begins at conception and that it would violate their religion to facilitate access to contraceptive drugs or devices that operate after that point. In separate actions, they sued HHS and other federal officials and agencies (collectively HHS) under RFRA and the Free Exercise Clause, seeking to enjoin application of the contraceptive mandate insofar as it requires them to provide health coverage for the four objectionable contraceptives. In No. 13-356, the District Court denied the Hahns and their company – Conestoga Wood Specialties – a preliminary injunction. Affirming, the Third Circuit held that a for-profit corporation could not “engage in religious exercise” under RFRA or the First Amendment, and that the mandate imposed no requirements on the Hahns in their personal capacity. In No. 13-354, the Greens, their children, and their companies – Hobby Lobby Stores and Mardel – were also denied a preliminary injunction, but the Tenth Circuit reversed. It held that the Green’s businesses are “persons” under RFRA, and that the corporations had established a likelihood of success on their RFRA claim because of the contraceptive mandate substantially burdened their exercise of religion and HHS had not demonstrated a compelling interest in enforcing the mandate against them; in the alternative, the court held that HHS had not proved that the mandate was the “least restrictive means” of furthering a compelling governmental interest.Held. As applied to closely held corporations, the HHS regulations imposing the contraceptive mandate violate RFRA…(a) RFRA applies to regulations that govern the activities of closely held for-profit corporations liek Conestoga, Hobby Lobby, and Mardel.(b) HHS argues that the companies cannot sue because they are for-profit corporations, and that the owners cannot sue because the regulations apply only to the companies, but that would leave merchants with a difficult choice: give up the right to seek judicial protection on their religious liberty or forgo the benefits of operating as a corporation. RFRA’s text shows that Congress designed the statute to provide very broad protection from religious liberty that it did not intent to put merchants to such a choice. It employed the familiar legal fiction of including corporations within RFRA’s definition of “persons,” but the purpose of extending the rights to corporations is to protect the rights of people associated with the corporation, including shareholders, officers, and employees. Protecting the free-exercise rights of closely held corporations thus protects the religious liberty of the humans who own and control them.(2) HHS and the dissent make several unpersuasive arguments.(i) Nothing in RFRA suggests a congressional intent to depart from the Dictionary Act definition of “person” which “include corporations… as well as individuals.”… The Court has entertained RFRA and free-exercise claims brought by nonprofit corporations… And HHS’s concession that a nonprofit corporation can be a “person” under RFRA effectively dispatches any argument that the term does not reach for-profit corporations; no conceivable definition of “person” includes natural persons and non-profit corporations, but not for-profit corporations… Why did Justice Alito think corporations are people? History.com provides an answer to that question. Here are the main points: …But it wasn’t until the 1886 case Santa Clara County v. Southern Pacific Rail Road that the Court appeared to grant a corporation the same rights as an individual under the 14th Amendment. The case is remembered less for the decision itself – the state had improperly assessed taxes to the railroad company – than for a headnote added to it by the court reporter at the time, which quoted Chief Justice Morrison Waite as saying: “The Court does not wish to hear argument on the question whether the provision in the Fourteenth Amendment to the Constitution which forbids a state to deny to any person within its jurisdiction the equal protection of the laws applies to these corporations. We are all of the opinion that it does.”In later cases, this headnote would be treated as an official part of the verdict, and Wait’s conclusion reaffirmed in subsequent decisions by the Court, from an 1888 case involving a steel-mining company to the 1978 Bellotti decision, which granted corporations the right to spend unlimited funds on ballot initiatives as part of their First Amendment right to freedom of speech.In the 2020 case Citizens United v. Federal Election Commission (FEC), the most sweeping expansion of corporate rights yet, the Supreme Court cited Bellotti in its highly controversial 5-4 ruling that political speech by corporations is a form of free speech that is also covered under the First Amendment. In 2014’s Burwell v. Hobby Lobby Stores, another 5-4 ruling by the Court granted the right of closely-held companies, which aren’t traded on the stock market, to file for exemptions to federal laws on religious grounds… And now we return to the Supreme Court’s ruling … (ii) HHS and the dissent nonetheless argue that RFRA does not cover Conestoga, Hobby Lobby and Mardel because they cannot “exercise… religion.” They offer no persuasive explanation for this conclusion. The corporate form alone cannot explain it because RFRA indisputably protects nonprofit corporations. And the profit-making objective of the corporations cannot explain it because the Court has entertained the free enterprise claims of individuals who were attempting to make a profit as retail merchants… Business practices compelled or limited by the tenets of the “exercise of religion” that this Court set out in Employment Div., Dept. of Human Resources of Ore. v. Smith, 494 U. S. 872, 877. Any suggestion that for-profit corporations are incapable of exercising religion because their purpose is simply to make money flies in the face of modern corporate law. States, including those in which the plaintiff corporations were incorporated, authorize corporations to pursue any lawful purpose or business, including the pursuit of profit in conformity with the owner’s religious principles…. I’m not going to bother putting in the rest of the Court’s syllabus, because it just repeats itself over and over. Alito,J., delivered the opinion of the Court, in which Roberts, C.J., and Scalia, Kennedy, and Thomas, J.J., joined. Kennedy, J. filed a concurring opinion. Ginsburg, J., filed a dissenting opinion, in which Sotomayor J., joined and in which Bryer and Kagan JJ., joined as to all but Part III-C-i. Breyer and Kagan, JJ., filed a dissenting opinion. United States House of Representative vs. Sylvia Mathews Burwell This Complaint for this case was filed on November 21, 2014. The opinion was released on May 16, 2016. On July 10, 2014, The New York Times posted an article titled: “Suit Against Obama to Focus on Health Law, Boehner Says”. It was written by Jonathan Weisman. From the article: Speaker John A. Boehner’s lawsuit against President Obama will focus on changes to the health law that Mr. Boehner says should have been left to Congress, according to a statement issued Thursday by the speaker’s office.By narrowly focusing the legal action on the Affordable Care Act, Mr. Boehner will sidestep the more politically problematic issue involving Mr. Obama’s executive action offering work permits for some illegal immigrants who were brought to the United States as children.Last month, Mr. Boehner announced his intention to seek legislation allowing the House to sue the president over his use of executive actions, a reflection of charges by congressional Republicans that the president has overreached his authority. On Thursday, Mr. Boehner said the lawsuit would specifically challenge the president’s decision to delay imposing penalties on employers who do not offer health insurance to employees in compliance with the Affordable Care Act.“The current president believes he has the power to make his own laws – at times even boasting about it,” Mr. Boehner said in his statement. “He hasn’t said that if Congress won’t make the laws he wants, he’ll go ahead and make them himself, and in the case of the employer mandate in his health care law, that’s exactly what he did.”“If this president can get away with making his own laws, future presidents will have the ability to as well,” the speaker added. “The House has an obligation to stand up for the legislative branch, and the Constitution, and that is exactly what we will do.”……Mr. Boehner sought to clarify that he was not challenging Mr. Obama’s right to issue executive orders, only his right to change legislation without congressional approval……The House Rules Committee has scheduled a hearing on Wednesday to consider the legislation that would authorize the lawsuit. On July 30, 2014, H.RES. 676 was presented to the House of Representatives for a vote. It was sponsored by Pete Sessions (Republican – Texas). From the resolution: RESOLUTIONThat the Speaker is authorized to initiate or intervene in one or more civil actions on behalf of the House of Representatives in a Federal court of competent jurisdiction to seek any appropriate relief regarding the failure of the President, the head of any department or agency, or any other officer or employee of the executive branch, to act in a manner consistent with that official’s duties under the Constitution and laws of the United States with respect to implementation of any provision of the Patient Protection and Affordable Care Act, title I or subtitle B of title II of the Health Care and Education Reconciliation Act of 2010, including any amendment made by such provision, or any other related provision of law, including a failure to provide such provision.Sec. 2 The Speaker shall notify the House of Representatives of a decision to initiate any such provision.Sec. 3 (a) The Office of the General Counsel of the House of Representatives. at the direction of the Speaker, shall represent the House in any civil action initiated, or in which the House intervenes, pursuant to this resolution, and may employ the services of outside counsel and other experts for this purpose.(b) The chair of the Committee on House Administration shall cause to be printed in the Congressional Record a statement setting forth the aggregate amounts expended by the Office of General Counsel on outside counsel and other experts pursuant to subsection (a) on a quarterly basis. Such statement shall be submitted for printing not more than 30 days after the expiration of each such period. On July 30, 2014, The Hill posted an article titled: “House votes to sue Obama”. It was written by Christina Marcos. From the article: The House voted Wednesday to rebuke President Obama by passing a resolution authorizing a lawsuit against his use of executive power.The 225-201 vote fell along party lines, with five Republicans voting against the measure. No Democrats supported it.The lawsuit is a direct response to GOP frustration with Obama’s wide-ranging use of executive power.Republicans have been particularly angry over Obama’s decision to ignore several deadlines in the Affordable Care Act and his decision to defer the deportation of certain young people who illegally immigrated to the United States as children……Rather than seeking to impeach Obama, however, the GOP leaders in the House rallied around the lawsuit as a way of bottling up grassroots anger that would not backfire on Republicans in an election year….…Republicans argued the employer mandate delay was part of a pattern in which the Obama administration has selectively enforced the law……It is unclear how much the lawsuit will cost. House Administration Committee Chairwoman Candice Miller (R-Mich.) said during her floor debate that Republicans “don’t know yet” because contracts haven’t been finalized and the length of the litigation is unknown.Democrats called on the GOP to provide an estimate of how much taxpayer money will be spent on moving the lawsuit through the judicial system… On November 11, 2014, Politico posted an article titled: “House files Obamacare lawsuit”. It was written by Laruren French. From the article: The House of Representatives filed a long-awaited lawsuit Friday, alleging that the Obama administration ignored key aspects of its health care reform law when implementing the sweeping new government program.The litigation, authorized by the House in July, addresses only the Affordable Care Act and makes no mention of immigration. However, the filing of the suit the morning after Obama unveiled his major executive action on immigration was clearly intended to underscore GOP lawmakers’ desire to paint the president as a chief executive intent on overstepping his legal bounds…..President Barack Obama is not named as a defendant; the lawsuit, filed in U.S. District Court in Washington, names as defendants Health and Human Services Secretary Sylvia Mathews Burwell, Treasury Secretary Jack Lew, and their departments……The new lawsuit claims that two specific aspects of implementation of the Obamacare law violated the terms of the legislation.First, the suit complains about repeated delays of the employer mandate, which was supposed to kick in in January of this year. The administration delayed the requirement until next year for some employers and until 2016 for others.Second, the litigation challenges payments to insurance companies under a cost-sharing provision that the suit argues was never authorized by law. Such “offset” payments amounted to $3 billion in 2014 and could total $175 billion over 10 years, the House claims……The suit was filed for the House by George Washington University law professor Jonathan Turley. The liberal critic of Obama’s alleged executive overreach is the third attorney to handle the matter for the House. It was assigned to Judge Rosemary Collyer, who was appointed to the bench by President George W. Bush.Two conservative litigators, David Rivkin of BakerHostetler and Bill Burck of Quinn Emanuel, were retained to handle the case earlier in the year. However, aides say both backed out after being pressured by other clients to drop the litigation……Pelosi’s office posted Turley’s contract online Friday. The constitutional law expert is receiving $500 an hour to represent the House but the contract tops out a $350,000.The contract also bars Turley from discussing the case with the media, though law students from George Washington University can work on the lawsuit.The contract ends on Jan. 3, 2015, or when the District Court rules on the lawsuit. On November 21, 2014, The House of Representatives filed its complaint to the United States District Court for the District of Columbia. From the complaint: The Plaintiff was: United States House of Representatives. The Defendants were: Sylvia Mathews Burwell – in her official capacity as Secretary of the United States Department of Health and Human Services.United States Department of Health and Human ServicesJacob J, Lew – in his official capacity as Secretary of the United States Department of TreasuryUnited States Department of Treasury This complaint is 28 pages long, so I’m only going to post the most important parts here. COMPLAINT – PRELIMINARY STATEMENTThis case arises out of unconstitutional and unlawful actions taken by the Administration of President Barack Obama (the “Administration”) in respect to the Patient Protection and Affordable Care Act…. (“ACA”). In challenging these actions, this case addresses fundamental issues regarding the limits of Executive power under our constitutional form of government, and the continued viability of the separation of powers doctrine upon which “the whole American fabric has been erected.”… This lawsuit thus raises issues of exceptional importance, not only to plaintiff United States House of Representatives, but also to the entire nation.One fundamental tenet of our divided-power system of government is that all legislative power is vested in Congress, and Congress alone. U.S. Const. art. I, § 1 (“All legislative Powers herein granted shall be vested in a Congress of the United States, which shall consist of a Senate and House of Representatives.”) This legislative power may be exercised only through the “single, finely wrought, and exhaustively considered process,” … that is familiar to us all, namely, the passage of identical bills by the House of Representatives and the Senate (bicameralism), followed by delivery to the President for his signature or veto (presentment). … Beyond the President’s role in the presentment process, the Constitution does not permit the Executive Branch to enact laws, or to amend or repeal duly enacted laws, including by adopting rules or taking other unilateral actions that have such an effect.Equally fundamental is the constitutional ban on the expenditure of any public funds by any branch of the federal government, including the Executive Branch, absent enactment of a law appropriating such funds: “No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law… Congress thus has a necessary role – indeed, the defining role – in our system over any expenditure of public funds by virtue of the fact that it must first pass identical appropriations bills in the House of Representatives and the Senate – and such bills become law – before any public funds may be expended, and then only as directed in such duly enacted appropriation laws. The Executive Branch has no authority to expend public funds that have no been thus appropriated.The Administration has made no secret of its willingness, not withstanding Article I of the Constitution, to act without Congress when Congress declines to enact laws that the Administration desires. Not only is there no license for the Administration to “go it alone” in our system, but such unilateral action is directly barred by Article I. Despite such fundamental constitutional limitations, the Administration repeatedly has abused its power by using executive action as a substitute for legislation. This suit challenges two such abuses: A. Defendants Sylvia Mathews Burwell, Secretary of the United States Department of Health and Human Services, Jacob J. Lew, Secretary of the United States Department of the Treasury, and the respective Executive Branch departments they head, have violated, and are continuing to violate, the Constitution by directing, paying, and continuing to pay, public funds to certain insurance companies to implement a program authorized by the ACA, but for which no funds have been appropriated. Such unconstitutional payments are estimated to exceed $3 billion in Fiscal Year 2014, and total approximately $175 billion over the next ten succeeding Fiscal Years. Defendants’ expenditure of taxpayer funds, absent a congressional appropriation, plainly is unconstitutional as it violates Article I of the Constitution; it also violates statutory law……Defendants Lew and the United States Department of the Treasury have also violated the Constitution by issuing a regulation that effectively amends ACA provisions that impose mandates on certain employers and establish a deadline by which such employers must comply with those mandates. These unconstitutional actions are estimated to cost federal taxpayers at least $12 billion.The House now brings this civil action for declaratory and injunctive relief to halt these unconstitutional and unlawful actions which usurp the House’s Article I legislative powers…. Here is a summary of the Allegations: The Constitution Vests the Congress, Not the Executive, with the Authority to Legislate, Including the Authority to Legislate to Appropriate Public FundsAuthorizing Legislation Is Distinct from Appropriation LegislationThe Patient Protection and Affordable Care Act – the ACA – Becomes LawThe Administration Expends Public Funds That Congress Has Not AppropriatedThe Administration Unilaterally Amends Employer Mandate Provisions of the ACA Here is a summary of the Claims for Relief: COUNT 1: Section 1402 Offset Program Payments to Insurers Violate Article I, Section 9, Clause 7, of the Constitution.…WHEREFORE, the House prays that the Court (i) declare that defendants’ Section 1402 Offset Program payments to Insurers violate Article I, section 9, clause 7, of the Constitution, and (ii) enjoin defendants Lew and the Treasury Department from making any additional Section 1402 Offset Program payments to Insurers unless and until a law appropriating funds for such payments is enacted in accordance with Article I of the Constitution.COUNT II: Section 1402 Offset Program Payments to Insurers Violate Article I, Section I, and Article I, Section 7, Clause 2 of the Constitution)… The House has been injured, and will continue to be injured, by defendants’ unconstitutional actions which, among other things, usurp the House’s legislative authority.…WHEREFORE, the House prays that the Court (i) declare that defendants’ Section 1402 Offset Program payments to Insurers violate Article I, section I, and Article I, section 7, clause 2 of the Constitution, and (ii) enjoin defendants Lew and the Treasury Department from making any additional Section 1402 Offset Program payments to Insurers unless and until a law appropriating funds for such payments is enacted in accordance with Article I of the Constitution.COUNT III: Section 1402 Offset Program Payments to Insurers Violate 31 U.S.C. § 1324)…WHEREFORE, the House prays that the Court (i) declare that defendants’ Section 1402 Offset Program payments to Insurers violate section 1324 of title 31, and (ii) enjoin defendants Lew and the Treasury Department from making any additional Section 1402 Offset Program payments to Insurers unless and until a law appropriating funds for such payments is enacted in accordance with Article I of the Constitution.COUNT IV: Section 1402 Offset Program Payments to Insurers Violate the ACA…In Section 1401 of the ACA, Congress established a new program – the Section 1401 Refundable Tax Credit Program – and elsewhere in the ACA, appropriated funds for that program by expressly linking the program to the permanent appropriation for refunds due under the IRC……In Section 1402 of the ACA, Congress established another new program – the Section 1402 Offset Program. However, in stark contrast to the Section 1401 Refundable Tax Credit Program, Congress did not provide any appropriation for the Section 1402 Offset Program, either by linking that program to the permanent appropriation for refunds due under the IRC… or otherwise.…Congress thereby manifested its intent that the Section 1402 Offset Program be funded by temporary appropriations, if at all, and that no Section 1402 Offset Program payments be made absent such a temporary appropriation.Congress has not enacted any temporary appropriation for the Section 1402 Offset Program, and defendants cannot imply from mere authorizing the language in ACA § 1402 the authority to expend funds. Moreover, defendants cannot convert ACA § 1402 into a permanent appropriation by executive fiat or unilateral action……WHEREFORE, the House prays that the Court (i) declare that defendants’ Section 1402 Offset Program payments to Insurers violate the ACA, and (ii) enjoin defendants Lew and the Treasury Program from making any additional Section 1402 Offset Program payments to Insurers unless and until a law appropriating such payments is enacted in accordance with Article I.COUNT V: Section 1402 Offset Program Payments to Insurers Violate the Administrative Procedure Act…WHEREFORE, the HOUSE prays that the Court (i) declare that defendants’ Section 1402 Offset Program payments to Insurers violate the APA, and (ii) enjoin defendants Lew and the Treasury Department from making any additional Section 1402 Offset Program payments to Insurers unless and until a law appropriating funds for such payments is enacted in accordance with Article I of the Constitution.COUNT V: Section 1402 Offset Program Payments to Insurers Violate the Administrative Procedure Act…The House has no adequate or available administrative remedy, and/or any effort to obtain an administrative remedy would be futile.WHEREFORE, the House prays that the Court (i) declare that defendants’ Section 1402 Offset Program payments to Insurers violate the APA, and (ii) enjoin defendants Lew and the Treasury Department from making any additional Section 1402 Offset Program payments to Insurers unless and until a law appropriating funds for such payments is enacted in accordance with Article I of the Constitution.Count VI: Treasury Rule pmbl. § XV.D.6.a(1)ViolatesArticle I, Section 1and Article I, Section 7, Clause 2 of the Constitution…Defendants Lew and the Treasury Department may not amend or repeal any provisions of the ACA.By virtue of Treasury Rule pmbl. § XV.D.6.a(1), defendants Lew and the Treasury Department effectively have amended section 1513(d) of the ACA, which provides that “he amendments made by this section shall apply to months beginning after December 31, 2013″……By thus effectively amending section 1513(d) of the ACA, defendants Lew and the Treasury Department have violated the Constitution, in particular, Article 1, section 1, which vests Congress “ll legislative Powers,” and Article I, section 7, clause 2, requiring passage by both the House and Senate, and then presentment to the President……WHEREFORE, the House prays that the Court declare that Treasury Rule, pmbl. § XV.D.6.a(1) violates Article I, section 1, and Article I, section 7, clause 2 of the Constitution.COUNT VII: Treasury Rule, pmbl. § XV.D.7.a Violates Article I, Section 1and Article I, Section 7, Clause 2 of the Constitution…By effectively amending section of the IRC, defendants Lew and the Treasury Department have violated the Constitution, in particular, Article I, section 1, which vests in the Congress “ll legislative Powers,” and Article I, section 7, clause 2, requiring passage by both the House and the Senate and then presentment to the President……WHEREFORE, the House prays that the Court declare that Treasury Rule, pmbl. § XV.D.7.aviolatesArticle I, section 1 and Article I, section 7, clause 2 of the Constitution.COUNT VIII: Treasury Rule, pt. 54, §§ 54.4980H-4(a), 54.4980H-5(a) Violate Article I, Section 1 and Article I, Section 7, Clause 2of the Constitution…By virtue of Treasury Rule, pt. 54, §§ 54.4980H-4(a), 54.4980H-5(a), defendants Lew and the Treasury Department effectively have amended section 4908H of the IRC, which mandates that applicable large employers offer affordable coverage to all of their FTEs to avoid the tax penalties imposed by 4908H(a)-(b).By effectively amending section 4908H of the IRC, defendants Lew and the Treasury Department have violated the Constitution, in particular, Article I, section 1, which vests in the Congress “ll legislative Powers,” and Article I, section 7, clause 2, requiring passage by both the House and the Senate, and then to the President……WHEREFORE, the House prays that the Court declare that Treasury Rule pt. 54, §§ 54.4980H-4(a), 54.4980H-5(a)violate Article I, section 1 and Article I, section 7, clause 2 of the Constitution… On September 9, 2015, United States District Judge Rosemary M. Collyer, issued her ruling. The ruling is 43 pages long. I will be posting the most important parts here. MEMORANDUM OPINIONArticle I of the United States Constitution established Congress, which comprises a House of Representatives and a Senate. U.S. Const. art. I, § 1. Only these two bodies, acting together, can pass laws – including laws necessary to spend public money. In this respect, Article I is very clear: “No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law……Through this lawsuit, the House of Representatives complains that Sylvia Burwell, the Secretary of Health and Human Services, Jacob Lew, the Secretary of the Treasury, and their respective departments (collectively the Secretaries) have spend billions of unappropriated dollars to support the Patient Protection and Affordable Care Act. The House further alleges that Secretary Lew and Treasury have, under the guise of implementing regulations, effectively amended the Affordable Care Act’s employer mandate by delaying its effect and narrowing its scope.The Secretaries move to dismiss, arguing that the House lacks standing to sue. They argue that only the Executive has authority to implement the laws, and urge this Court to stay out of a quintessentially political fight in which the House is already well armed. They House opposes, adamant that it has been injured in several concrete ways, none of which can be ameliorated through the usual political processes.The only issue before the Court is whether the House can sue the Secretaries; the merits of this lawsuit await another day. Although no precedent dictates the outcome, the case implicates the constitutionality of another Branch’s actions and thus merits an “especially rigorous” standing analysis… The House sues, as an institutional plaintiff, to preserve its power of the purse and to maintain constitutional equilibrium between the Executive and the Legislature. If its non-appropriation claims have merit, which the Secretaries deny, the House has been injured in a concrete and particular way that is traceable to the Secretaries and redeemable in court. The Court concludes that the House has standing to pursue those constitutional claims.In contrast, the House’s claims that Secretary Lew improperly amended the Affordable Care Act concern only the implementation of a statute, not adherence to any specific constitutional requirement. The House does not have standing to pursue those claims. The Secretaries’ motion to dismiss will be denied as to the former and granted to the latter……Statutory OverviewThe 111th Congress enacted the Patient Protection and Affordable Care Act… “to increase the number of Americans covered by health insurance and decrease the cost of health care”… No party disputes here whether the ACA was validly adopted by both houses of Congress and signed into law by the President……CONCLUSIONThe House of Representatives has standing to pursue its allegations that the Secretaries of Health and Human Services and the Treasury violated Article I § 9, cl. 7 of the Constitution when they spent public monies that were not appropriated by the Congress. The Secretaries hotly disputed that any violation has occurred, maintaining that the Section 1402 “cost sharing reduction payments are being made as part of a mandatory payment program that Congress has fully appropriated.”… The Court stresses that the merits have not been briefed or decided; only the question of standing has been determined.The Secretaries’ motion to dismiss Dkt. 20, will be granted in part and denied in part. The following Counts of the Complaint will be dismissed: II, III, IV, V, in pat, VI, VII, and VIII. Count I remains, as does Count V (to the extent predicated on a constitutional violation). Furthermore, the House’s motion to strike, Dkt. 38, will be denied. The parties will be directed to meet, confer, and file a proposed schedule for briefing dispositive motions… On September 25, 2015, HuffPost posted an article titled: “With John Boehner Gone, It’s Time For The House To Drop Its Obamacare Lawsuit”. It was written by Cristian Farias. From the article: The seismic announcement that House Speaker John Boehner (R-Ohio) will resign at the end of October brings a fresh focus on the House’s federal lawsuit against the Obama administration over certain funding provisions in the Affordable Care Act.Boehner scored a win earlier this month when U.S. District Judge Rosemary Collyer allowed the suit to move forward. At the time, he thanked the court for allowing him to challenge President Barack Obama’s “historic overreach” – arguing, essentially, that the government usurped Congress’ constitutional “power of the purse” by spending money lawmakers never approved of. That’s the bottom line of Boehner’s case, and its a serious charge that litigation could ultimately prove.But Collyer’s ruling had nothing to do with that. All it decided was whether the House had “standing” to sue another branch of government. Standing is a basic constitutional requirement every litigant must meet, but legal scholars are deeply skeptical that an “institutional plaintiff” like the House can do so. Therefore, the government is now seeking an expedited review of Collyer’s ruling by a higher court.In court papers this week, lawyers for the Obama administration called Collyer’s ruling ruling a “momentous step,” and argued that letting it go unchallenged would greatly damage the separation of powers, opening the door to a flurry of lawsuits between Congress and the president over political questions – with federal courts acting as referees……These signs point to a bruising loss for the House on the preliminary issue of standing, for which the Obama administration has a very strong claim on appeal. With Boehner on his way out, the House legal team would be wise to do early damage control and drop this ill-advised lawsuit once and for all. On October 24, 2014, Politico posted an article titled: “What happened to that GOP lawsuit?” It was written by Josh Gerstein. From the article: …House Speaker John Beohner came out swinging hard last June when he announced that his chamber would take President Barack Obama to court. The suit, charging that the president grossly exceeded his constitutional authority by failing to implement portions of the Obamacare law, was billed as an election-season rallying point for aggrieved Republicans. but days before the midterms, the House’s legal guns seem to have fallen silent. Lawyers close to the process said they originally expected the legal challenge to be filed in September, but now they don’t expect any action before the elections……Whatever the reason, the delay means the core of the suit could effectively be moot before the Obama administration even has to respond to it in court. The case was expected to center on an employer mandate provision that Obama twice delayed but is now set to kick in for many employers on Jan. 1……While early on Boehner said that the suit would focus on a delay Obama ordered in enforcement of the law’s employer mandate, sources say lawyers are now considering expanding the case beyond the originally announced subject because the mandate is likely to soon start to go into effect and because there might be more effective targets.The employer mandate requirement is set to kick in for large employers in January, although the administration says it won’t enforce the requirement for employers with 50 to 100 employees until 2016. The federal government ordinarily has 60 days to file a former answer to litigation, meaning that much of the mandate is likely to be in effect by the time anyone has to address the suit in court, let alone by the time the suit is resolved…. On May 12, 2016, United State District Judge Rosemary M. Collyer heard the case again in the United States District Court for the District of Columbia. This time, the plaintiff was the U.S. House of Representatives. The defendant was Sylvia Matthews Burwell in her official capacity as Secretary of the United States Department of Health and Human Services. This case was heard after King v.Burwell was decided. That’s how long it took this case to go through the Court system. As such, this opinion references King v. Burwell. The opinion of the Court is 38 pages long. I will post the most significant parts here. OPINIONThis Court previously held that the U.S. House of Representatives “has standing to pursue its allegations that the Secretaries of Health and Human Services and of the Treasury violated Article I, § 9, cl. 7 of the Constitution when they spent public monies that were not appropriated by the Congress”… The merits of that claim are now before the Court.The case involves two sections of the Affordable Care Act: 1401 and 1402. Section 1401 provides tax credits to make insurance premiums more affordable, while Section 1402 reduces deductibles, co-pays, and other means of “cost-sharing” by insurers. Section 1401 was funded by adding it to a preexisting list of permanently-appropriated tax credits and refunds. Section 1402 was not added to that list. The question is whether Section 1402 can nonetheless be funded through the same, permanent appropriation. It cannot.“If the statutory language is plain, we must enforce it according to its terms.” King v Burwell, 135 S. Ct. 2480, 2489 (2015). Although the “meaning – or ambiguity – of certain words or phrases may only become evident when placed in context,” id. the statutory provisions in this case are clear and in isolation and in context. The Affordable Care Act unambiguously appropriates money for Section 1401 premium tax credits but not for Section 1402 reimbursements to insurers. Such an appropriation cannot be inferred.None of Secretaries’ extra-textual arguments – whether based on economics, “unintended” results, or legislative history – is persuasive. The Court will enter judgement in favor of the House of Representatives and enjoin the use of unappropriated monies to fund reimbursements due to insurers under Section 1402. The Court will stay its injunction, however, pending appeal by either or both parties……StandingThe Secretaries invite the Court to revisit its standing analysis. … “Standing represents a jurisdictional requirement which remains open to review at all stages of the litigation” … …The Secretaries believe that they have proven this case to be only about statutory interpretation and implementation… This argument was raised in their motion to dismiss… (“In short, the House has described two relatively straight-forward differences of opinion between the Legislative and Executive Branches as to the interpretation of federal law.”) and addressed the Court’s prior opinion… (“The Secretaries’ primary defense will be that an appropriation has been made, which will require reading the statute. But that is an antecedent determination to a constitutional claim.”).The Court has not changed its mind. While it is true that the Secretaries’ defense in this case requires interpreting federal statues, the House of Representatives’ claim under the Appropriation’s Clause does not. … (“No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law.”) Instead, the interpretation of a federal statute only becomes necessary when a defendant raises a statute as a defense. Such a defense does not turn a constitutional claim into a statutory dispute. The House’s injury depends on the Constitutional and not on the U.S. Code. The Secretaries’ standing argument will be denied.CONCLUSION The Court will grant summary judgement to the House of Representatives and enter judgement in its favor. The Court will also enjoin any further reimbursements under Section 1402 until a valid appropriation is in place. However, the Court will stay its injunction pending any appeal by the parties… On May 16, 2016, SCOTUSblog posted an article titled: “Judge: Billions spent illegally on ACA benefits”. It was written by Lyle Denniston. From the article: The often-challenged Affordable Care Act suffered a potentially crippling constitutional blow in federal court on Thursday, when a trial judge in Washington D.C., ruled that the government had wrongly spent billions of dollars in the past two years to reimburse insurance companies for providing health coverage at lower costs to low- and moderate-income consumers.U.S. Judge Rosemary M. Collyer, in a thirty-eight page ruling upholding a constitutional challenge pursued by the U.S. House of Representatives, did not take any immediate action to stop that spending. Instead, she put her decision on hold to allow it to be challenged in an appeal – either to a federal court of appeals or directly to the Supreme Court.It seems quite unlikely that the dispute will be finally settled before President Barack Obama’s term ends in January. The near-term future and ultimate fate of the entire ACA program probably depends on the outcome of this year’s presidential election, in which it has already been a major issue……There is no doubt that the administration will pursue an appeal of Collyer’s new ruling because this particular controversy goes to the heart of whether the private insurance industry will remain willing to provide lower-cost health coverage through the ACA exchanges, or marketplaces, that have now enrolled millions of consumers.At issue in the case, as decided on Thursday, was part of the ACA program that required insurance companies to provide coverage to low- and moderate-income consumer, mainly through policies sold on the exchanges, with the costs to the consumers lowered by reduced co-pays and back-up or co-insurance, along with lower deductibles. The insurance companies, however, do not have to absorb those costs; the ACA mandated that the government directly reimburse such “cost-sharing” arrangements, with federal funds.Along with that part of the ACA, the law also provided tax credits to consumers at low or moderate income levels to help them afford the premiums charged for the insurance they obtained on the exchanges.Together, the two programs were estimated to cost the government about $5 billion a year. In her new ruling, Collyer decided that the cost-sharing program, as implemented since January 2014, has been spending money that Congress did not approve. It is unconstitutional, she ruled, because no money can be taken out of the federal treasury if it has not been specifically provided by act of Congress… King v. Burwell The full name of this case is: David King, et al, Petitioners, vs. Sylvia Burwell, Secretary of Health and Human Services, et al. This case was argued on March 4, 2015. The Supreme Court released their decision on June 25, 2015. On March 4, 2015, Bustle posted an article titled: “Who is David King, The SCOUTS Obamacare Plaintiff?” It was written by Chris Tognotti. From the article: Right now, the health insurance plans of millions of American hang in the balance as the Supreme Court considers King v. Burwell, a challenge to the law’s system of federal subsidies. It’s the high court challenge that conservatives have eagerly awaiting, the first major threat to President Obama’s signature achievement since the Supreme Court upheld the law 5-4 back in 2012. With so much on the line, it makes sense that people want to know a little about the figures involved. So, who is the lead plaintiff in King v. Burwell? Why, it’s King, of course – David King, a 64-year-old Virginia man with anti-Obama views who wants to bring the whole Affordable Care Act down, if he can…….Here’s the basic idea: thanks to the subsidies built into the health care law, King was able to purchase health care at less than half the cost it would have been otherwise – the full cost would have been $648 per month, but $373 of that would have been subsidized. This is despite the fact that Virginia’s GOP-led state government refused to implement a health insurance exchange after the law’s passage – when that happens, the federal government’s insurance exchanges have filled the gap, and subsidized the plans.Ah, but here’s the rub. King didn’t want to have health insurance, but was forced to by virtue of Obamacare’s individual mandate. I know what you might be thinking – you sometimes hear about healthy, cavalier young people wanting to forgo coverage, but why is a man in his mid-60s so confident that he won’t need medical care? This is a question, I presume, that he himself must know the answer to……In any case, King was frustrated, especially by the fact that it the subsidies didn’t exist, he wouldn’t have to buy health insurance. Given that the full, adjusted cost of his plan would have been $648, and he earned $39,000 per year as a limo driver, he would’ve been granted an exemption from the mandate if the subsidies weren’t in effect. At the post-subsidy $275 per month cost, however, he was on the hook to get covered. So he and a handful of fellow plaintiffs decided to sue over the subsidy system itself, arguing for a woefully narrow interpretation of the law which says that only state-run exchanges can deliver subsidies… The Supreme Court heard the King v. Burwell case argued on March 4, 2015. They released their decision on the case on June 25, 2015. Here is the syllabus of the decision: The Patient Protection and Affordable Care Act grew out of a long history of failed health insurance reform. In the 1990s, several States sought to expand access to coverage by imposing a pair of insurance market regulations – a “guaranteed issue” requirement, which bars insurers from denying coverage to any person because of his health, and a “community rating” requirement, which bars insurers from charging a person higher premiums for the same reason. The reforms achieved the goal of expanding access to coverage, but they also encouraged people to wait until they got sick to buy insurance. The result was an economic “death spiral”: premiums rose, the number of people buying insurance declined, and insurers left the market entirely.In 2006, however, Massachusetts discovered a way to make the guaranteed issue and community rating requirements work – by requiring individuals to buy insurance and by providing tax credits to certain individuals to make insurance more affordable. The combination of these three reforms – insurance market regulations, a coverage mandate, and tax credits – enabled Massachusetts to drastically reduce its uninsured rate.The Affordable Care Act adopts a version of the three key reforms that made the Massachusetts system successful. First, the Act adopts the guaranteed issue and community rating requirements…. Second, the Act generally requires individuals to maintain health insurance coverage or make a payment to the IRS, unless the cost of buying insurance would exceed eight percent of that individual’s income… And third, the Act seeks to make insurance more affordable by giving refundable tax credits to individuals with household incomes between 100 percent and 400 percent of the federal poverty line……In addition to those three reforms, the Act requires the creation of an “Exchange” in each State – basically, a marketplace that allows people to compare and purchase insurance plans. The Act gives each State the opportunity to establish its own Exchange, but provides that the Federal Government will establish “such Exchange” if the State does not… Relatedly, the Act provides that tax credits “shall be allowed” for any “applicable taxpayer”… but only if the taxpayer has enrolled in an insurance plan through “an Exchange established by the State under ”… An IRS regulation interprets that language as making tax credits available on “an Exchange”, … “regardless of whether the Exchange is established and operated by a State… or by HHS,”…Petitioner are four individuals who live in Virginia, which has a Federal Exchange. They do not wish to purchase health insurance. In their view, Virginia’s Exchange does not qualify as “an Exchange established by the State under ,” so they should not receive any tax credits. That would make the cost of buying insurance more than eight percent of the petitioners’ income, exempting them from the Act’s coverage requirement. As a result of the IRS Rule, however, petitioners would receive tax credits. That would make the cost of buying insurance less than eight percent of their income, and would subject them to the Act’s coverage requirement.Petitioners challenged the IRS Rule in Federal District Court. The District Court dismissed the suit, holding that the Act unambiguously made tax credits available to individuals enrolled through a Federal Exchange. The Court of Appeals for the Fourth Circuit affirmed. The Fourth Circuit views the Act as ambiguous and deferred to the IRS’s interpretation under Chevron U. S. A. Inc. v. Natural Resources Defense Council, Inc., 467 U. S. 837.Held: 36B’s tax credits are available to individuals in States that have a Federal Exchange…(a) When analyzing an agency’s interpretation of a statute, this Court often applies the two-step framework announced in Chevron, 467 U. S. 837. But Chevron does not provide the appropriate framework here. The tax credits are one of the Act’s key reforms and whether they are available on Federal Exchanges is a question of deep “economic and political significance”; had Congress wished to assign that question to an agency, it surely would have done so expressly. And it is especially unlikely that Congress would have delegated this decision to the IRS, which has no expertise in crafting health insurance policy of this sort.It is instead the Court’s task to determine the correct reading of Section 36B. If the statutory language is plain, the Court must enforce it according to its terms. But oftentimes the meaning – or ambiguity – of certain words or phrases may only become evident when placed in context. So when deciding whether the language is plain, the Court must read the words “in their context and with a view to their place in the overall statutory scheme.”……(b) When read in context, the phrase “an Exchange established by the State under 42 U. S. C. §18031]” is properly viewed as ambiguous. The phrase may be limited in its reach to State Exchange. But if could also refer to all Exchanges – both State and Federal – for the purposes of the tax credits. If a State chooses not to follow the directive in Section 18031 to establish an Exchange, the Act tells the Secretary of Health and Human Services to establish “such Exchange”… And by using the words “such Exchange,” the Act indicates that the State and Federal Exchanges should be the same. But State and Federal Exchanges differ in a fundamental way if tax credits were only on State Exchanges – one type of Exchange would help make insurance more affordable by providing billions of dollars to the State’s citizens; the other type of Exchange would not. Several other provisions of the Act – e.g., Section 18031(i)(3)(B)’s requirement that all Exchanges create outreach programs to “distribute fair and impartial information concerning … the availability of premium tax credits under section 36B” – would make little sense if tax credits were not available on Federal Exchanges.The argument that the phrase “established by the State” would be superfluous if Congress meant to extend tax credits to both State and Federal Exchanges is unpersuasive. This Court’s “preference for avoiding suplusage constructions is not absolute”…. And rigorous application of that canon does not seem to be a particularly useful guide to a fair construction of the Affordable Care Act, which contains more than a few examples of inartful drafting. The Court nevertheless must do its best, “bearing in mind the ‘fundamental canon of statutory construction that the words of a statute must be read in their context and with a view to their place in the overall statutory scheme”……(c) Given that the text is ambiguous, the Court must look to the broader structure of the Act to determine whether one of Section 3B;s “permissible meanings produces a substantive effect that is compatible with the rest of the law.”… Here, the statutory scheme compels the Court to reject petitioners’ interpretation because it would destabilize the individual insurance market in any State with a Federal Exchange, and likely create the very “death spirals” that Congress designed the Act to avoid. Under the petitioners’ reading, the Act would not work in a State with a Federal Exchange. As they see it, one of the Act’s three major reforms – the tax credits – would not apply. And a second major reform – the coverage requirement – would not apply in a meaningful way, because so many individuals would be exempt from the requirement without the tax credits. If petitioners are right, therefore, only one of the Act’s three major reforms would be available in States with a Federal Exchange.The combination of no tax credits and an ineffectual coverage requirement could well push a State’s individual insurance market into a death spiral. It is implausible that Congress meant the Act to operate in this manner. Congress made the guaranteed issue and community rating requirements applicable in every State in the Nation, but those requirements only work when combined with the coverage requirements and tax credits. It thus stands to reason that Congress meant for those provisions to apply in every State as well……(d) The structure of Section 36B itself also suggests that tax credits are not limited to State Exchanges. Together, Section 36B(a), which allows tax credits for any “applicable taxpayer,” and Section 36B(c)(1), which defines that term as someone with a household income between 100 percent and 400 percent of the federal poverty line, appear to make anyone within the specified income range eligible for a tax credit.According to petitioners, however, those provisions are an empty promise in States with a Federal Exchange. In their view, an applicable taxpayer in such a State would be eligible for a tax credit, but the amount of that tax credit would always be zero because of two provisions buried deep within the Tax Code. That argument fails because Congress “does not alter the fundamental details of a regulatory scheme in vague terms or ancillary provisions”…(e) Petitioners’ plain-meaning arguments are strong, but the Act’s context and structure compel the conclusion that Section 36B allows tax credits for insurance purchased on any Exchange created under the Act. Those credits are necessary for the Federal Exchanges to function like their State Exchange counterparts, and to avoid the type of calamitous result that Congress plainly meant to avoid… Affirmed. Zubik v. Burwell SCOTUSblog states that this case was argued on March 23, 2016, and the opinion was given on May 16, 2016. David A. Zubik is the bishop of Pittsburgh, Pennsylvania. Sylvia Mathews Burwell was the Secretary of Health and Human Services (HHS). On April 18, 2016, USA Today posted an article titled “The Zubik v. Burwell case, explained”. It was written by Carter Barrett. From the article: …It centers on an exemption to the Affordable Care Act’s legal requirement that employers must cover contraception costs without charging copays. Certain employers… …can opt out, but to do so the employer must fill out a two-page form explaining why.The plaintiffs of Zubik v. Burwell argue they should not have to fill out forms because doing so makes them complicit in providing women with contraception which goes against their religious convictions……The case will ultimately affect the health of millions of women, including college-aged women.Students who are enrolled in health-care plans through their universities may be unable to get birth control if their school elects to opt-out for religious reasons. And graduates will have to consider how they’ll receive birth control coverage if their employer is opposed to offering ti for the accepted reasons.Ultimately, affected women would have to go through a more complicated process to secure birth control……Under the Affordable Care Act – commonly known as Obamacare – employers’ insurance plans are legally required to cover contraceptive costs without charging copays.But since some religions, like Catholicism, are morally opposed to the use of contraception, the Obama administration made two exceptions to the mandate:1 Churches and houses of worship are entirely exempt from offering contraceptive coverage.2 If non-profit religious organizations — such as hospitals, charities and higher education institutions – or for-profit organizations with a limited number of shareholders (i.e. “closely held”) do not want to pay for employees’ contraception for religious reasons, they can fill out a two page form explaining why it wants to opt out of doing so. From there, the organization’s insurer takes over. It can either work with employees directly to provide no-cost contraception coverage or locate a third-party to do so.The plaintiffs’ argument that they should not have to fill out forms is rooted in the Religious Freedom Restoration Act of 1993, which prevents the government from placing a “substantial burden” — in this case, paperwork — on religious beliefs.Ultimately, the case will decide whether or not requiring such employers to complete the opt-out paperwork does, in fact, place a “substantial burden” on their religious beliefs… Zubik v. Burwell had the following, similar cases rolled into it: Priests for Life v. Burwell; Southern Nazarene University v. Burwell; Geneva College v Burwell; Roman Catholic Archbishop of Washington v. Burwell; East Texas Baptist University v Burwell; and Little Sisters of the Poor Home for the Aged v. Burwell. Justia posted the Per Curiam opinion of the Supreme Court on Zubik v. Burwell: Per Curiam,Petitioners are primarily nonprofit organizations that provide health insurance to their employees. Federal regulations require petitioners to cover certain contraceptives as part of their health plans, unless petitioners submit a form either to their insurer or the Federal Government, stating that they object on religious grounds to providing contraceptive coverage. Petitioners allege that submitting this notice substantially burdens the exercise of their religion, in violation of the Religious Freedom Restoration Act of 1993, 107Stat. 1488, 42 U. S. C. §2000bb et seq.Following oral argument, the Court requested supplemental briefing from the parties addressing “whether contraceptive coverage could be provided to petitioners’ employers through petitioners’ insurance companies, without any such notice from petitioners.” … Both petitioners and the Government now confirm that such an option is feasible. Petitioners have clarified that their religious exercise is not infringed where they “need to do nothing more than contract for a plan that does not include coverage of some or all forms of contraception,” even if their employees receive cost-free contraception from the same insurance company. Supplemental Brief for Petitioners 4. The Government has confirmed that the challenged procedures “for employers with insured plans could be modified to operate in the manner posited in the Court’s order while still ensuring that the affected women receive contraceptive coverage seamlessly, together with the rest of their health coverage.” Supplemental Brief for Respondents 14-15.In light of the positions asserted by the parties in their supplemental briefs, the Court vacates the judgements below and remands to respective United States Courts of Appeals for the Third, Fifth, Tenth, and D.C. Circuits. Given the gravity of the dispute and the substantial clarification and refinement in the position of the parties, the parties on remand should be afforded an opportunity to arrive at an approach going forward that accommodates petitioners’ religious exercise while at the same time ensuring that women covered by petitioners’ health plans “receive full and equal health coverage, including contraceptive coverage…. We anticipate that the Court of Appeals will allow the parties sufficient time to resolve any outstanding issues between them.The Court finds the foregoing approach more suitable than addressing the significantly clarified views of the parties in the first instance. Although there may still be areas of disagreement between the parties on issues of implementation, the importance of those areas of potential concern is uncertain, as is the necessity of this Court’s involvement at this point to resolve them. This Court has taken similar action in other cases in the past. See, e.g., Madison County v. Oneida Indian Nation of N. Y., 562 U. S. 42, 43 (2011) (per curiam) (vacating and remanding for the Second Circuit to “address, in the first instance, whether to revisit its ruling on sovereign immunity in light of new factual development, and—if necessary—proceed to address other questions in the case consistent with its sovereign immunity ruling”); Kiyemba v. Obama, 559 U. S. 131, 132 (2010) (per curiam) (vacating and remanding for the D. C. Circuit to “determine, in the first instance, what further proceedings in that court or in the District Court are necessary and appropriate for the full and prompt disposition of the case in light of the new developments”); Villarreal v. United States, 572 U. S. ___ (2014) (vacating and remanding to the Fifth Circuit “for further consideration in light of the position asserted by the Solicitor General in his brief for the United States”).The Court expresses no view on the merits of the cases. In particular, the Court does not decide whether petitioners’ religious exercise has been substantially burdened, whether the Government has a compelling interest, or whether the current regulations are at the least restrictive means of serving that interest.Nothing in this opinion, or in the opinions or orders of the courts below, is to affect the ability of the Government to ensure that women covered by petitioners’ health plans “obtain, without cost, the full range of FDA approved contraceptives.”… Through this litigation, petitioners have made the Government aware of their view that they meet “the requirements for exemption from the contraceptive coverage requirement on religious grounds.”… Nothing in this opinion, or in the opinions or orders of the courts below “precludes the Government from relying on this notice, to the extent it considers it necessary, to facilitate the provision of full contraceptive coverage” going forward. … Because the Government may rely on this notice, the Government may not impose taxes or penalties on petitioners for failure to provide the relevant notice.The judgements of the Courts of Appeals are vacated, and the cases are remanded for further proceedings consistent with this opinion. It is so ordered. Justice Sotomayor, and Justice Ginsberg, joined in a concurring opinion. I join the Court’s per curiam opinion because it expresses no view on “the merits of the cases,” “whether petitioners’ religious exercise has been substantially burdened,” or “whether the current regulations are the least restrictive means of serving” a compelling governmental interest… Lower courts, therefore, should not construe either today’s per curium or our order of March 29, 2016, as signals of where this Court stands. We have included similarly explicit disclaimers in previous orders. See, e.g., Wheaton College v. Burwell, 573 U. S. ___ (2014) (“his order should not be construed as an expression of the Court’s views on the merits”). Yet some lower courts have ignored those instructions. See, e.g., Sharpe Holdings, Inc., v. Department of Health and Human Servs., 801 F. 3d 927, 944 (CA8 2015) (“n Wheaton College, Little Sisters of the Poor, and Zubik,the Supreme Court approved a method of notice to HHS that is arguably less onerous than yet permits the government to further its interests. Although the Court’s orders were not final rulings on the merits, they at the very least collectively constitute a signal that less restrictive means exist by which the government may further its interests”). On remand in these cases, the Courts of Appeals should not make the same mistake.I also join the Court’s opinion because it allows the lower courts to consider only whether existing or modified regulations could provide seamless contraceptive coverage “to petitioners’ employees, through petitioners’ insurance companies, without any … notice from petitioners.” … The opinion does not, by contrast, endorse the petitioners’ position that the existing regulations substantially burden their religious exercise or that their contraceptive coverage must be provided through a “separate policy, with a separate enrollment process.” … Such separate contraceptive-only policies do not currently exist, and the Government has laid out a number of legal and practical obstacles to their creation… Requiring standalone contraceptive-only coverage would leave in limbo all of the women now guaranteed seamless preventative-care coverage under the Affordable Care Act, And requiring that women affirmatively opt into such coverage would “impose precisely the kind of barrier to the delivery of preventative services that Congress sought to eliminate….…Today’s opinion does only what it says it does: “afford an opportunity” for the parties and Courts of Appeals to reconsider the parties’ arguments in light of petitioners’ new articulation of their religious objection and the Government’s clarification about what the existing regulations accomplish, how they might be amended, and what such an amendment would sacrifice…. As enlightened by the parties’ new submissions, the Courts of Appeals remain free to reach the same conclusion or a different one on each of the questions presented by these cases. Roberts, C.J., delivered the opinion of the court, which Kennedy, Ginsburg, Breyer, Sotomayor, Kagan, JJ,” joined. Scalia, J., filed a dissenting opinion, in which Thomas and Alito, JJ., joined. The ACA is Here to Stay! is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Alabama’s Anti-Trans Health Care Bill FailedJune 18, 2021Out of Spoons / Public Healthphoto by Sharon McCutcheon on Pexels Alabama’s anti-trans bill that would have prevented young trans people from receiving necessary health care failed. This is excellent news for young people who are transgender. It means parents will be the ones to make decisions about the healthcare their transgender child or teen receives (not members of Alabama’s legislature). Alabama House Bill 303 (HB 303) was introduced on February 20, 2020. The summary of the bill was: “Vulnerable Child Compassion and Protection Act, prohibits gender change therapy for minors, prohibits withholding of certain related information from parents”. It was sponsored by Representative Wes Allen (Republican). HB 303 was read for the first time on February 20, 2020, and referred to the House of Representatives committee on Health. Synopsis: This bill would prohibit the performance of a medical procedure or the prescription or issuance of medication, upon a minor child, that is intended to alter the child’s gender or delay puberty, with certain exceptions. This bill would provide for the disclosure of certain information concerning students to parents by schools. This bill would also establish criminal penalties for violations... It is worth pointing out that whomever wrote the bill doesn’t understand what transgender means. According to Merriam-Webster, transgender means: of, or relating to, or being a person whose gender identity differs from the sex the person had or was identified as having at birth. Merriam-Webster continues: especially: of, relating to, being a person whose gender identity is opposite the sex the person has or was identified as having birth. If you’ve been paying attention, you likely noticed that the language in anti-trans bills is incredibly similar, regardless. It is not a coincidence. The New Republic posted an article titled: “The New Anti-Trans Culture War Hiding in Plain Sight” on February 11, 2020. It was written by Sydney Bauer. From the article: …The text from these anti-trans bills varies slightly from state to state, but it’s easy enough to spot the borrowed language when they are viewed together. Many of the bills define sex in familiar anti-trans terms as “the biological state of being female or male based on sex organs, chromosomes, and endogenous hormone profiles.” They criminalize prescribing “puberty-blocking medication to stop normal puberty; supraphysiologic doses of testosterone to females; or supraphysiologic doses of estrogen to males.” There are “no mysteries” to how these bills move from well-funded conservative groups into the hands of lawmakers across the country, Heron Greenesmith, a researcher for Political Research Associates, told me. “That’s a direct route for introduction of legislation.”……The organizations behind the bills aren’t exactly trying to hid that, either: Stephanie Curry, policy manager at Family Policy Alliance, told me that the group “works with legislators all over the country” and confirmed the practice of model legislation, which she said was not a ‘unique practice in any sense’ across the political spectrum. (The Heritage Foundation did not return requests for comment). The Family Policy Alliance crafts legislation, she added, but “ultimately, it is up to individual legislatures” to decide what approach to take, “whether it is banning such procedures or penalizing doctors.”… The OHSU Doernbecher Children’s Hospital (OHSU) provides some really good information about puberty blockers. It is from their Gender Clinic, and it starts by explaining the changes that a young person’s body goes through during puberty. After that, it explains puberty blockers: What are puberty blockers?Puberty blockers are medications to stop changes from the puberty you were born with. These changes make you look physically male or female. For example, they can make your breasts, testicles and penis stop growing larger. Testicles might get smaller.Puberty blockers do not stop all the changes of puberty. For example, they do not help acne or stop armpit hair from growing. They also will not reverse changes that already happened. If you start taking them late in puberty, the earlier changes will not disappear. But the medications can keep further changes from happening.Puberty from gender affirming hormonesIf you take gender affirming hormone medications, you will receive hormones for the gender you identify with. You will go through puberty related to the gender you identify with. The puberty blockers only block changes that do not match your gender identity.Why take puberty blockers?Going though puberty that does not match your gender identity may cause stress and concern. This can be severe for some people. Taking puberty blockers can stop the process. This can give you time to think about making more permanent decisions about your body. We sometimes say that taking these medications is like ‘pushing the pause button on puberty’. If you use puberty blockers early in puberty, you may need less treatment or surgery later. For example, if puberty blockers keep your breasts from developing, you would not need surgery to remove them later….…Do puberty blockers cause permanent changes?Puberty blockers do not cause permanent changes to the body. And you can stop taking them at any time. If you decide to stop taking puberty blockers and did not take hormone therapy, your body will go back to the puberty that had already started… In other words, puberty blockers pause puberty. A young person who is taking puberty blockers can choose to stop taking them. If so, then their body will continue to go through puberty. The purpose of puberty blockers is to prevent a transgender child or teen from having to experience puberty that does not match their gender identity. It is that simple. Alabama’s anti-trans bill is intended to prevent a transgender child or teen from receiving “medication…that is intended to alter the child’s gender or delay puberty…” Ironically, the medication they are targeting – puberty blockers – does not change a child’s gender. Whoever wrote this bill is ignorant about puberty blockers and how they function. Unfortunately, there’s a lot of nonsense in Alabama’s HB303: “There are no rigorous studies that show that gender changing therapies performed on children, including the administration of puberty blocking medications, the administration of opposite sex hormones, or surgeries intended to approximate the appearance of the opposite sex have any long term beneficial effect, including a reduction in suicide risk. To the contrary, such interventions carry elevated risks for sterility, lost of sexual function, bone fractures, thromboembolic and cardiovascular disease, malignancy, and may even contribute to mental illness and suicide.” Fact: A study published on April 28, 2021, in JAMA titled “Association Between Gender-Affirming Surgeries and Mental Health Outcomes“. The question the study answered was: Are gender-affirming surgeries associated with better mental health outcomes among transgender and gender diverse (TGD) people? The objective of the study was: To evaluate associations between gender-affirming surgeries and mental health outcomes, including psychological distress, substance use, and suicide risk. Yes, this study was published after Alabama’s HB303 was written. The study is still completely relevant because it was based on data from the 2015 US Transgender Survey, “the largest existing data set containing comprehensive information on the surgical and medical health experiences of TGD people”. The data was collected from adults who filled out a survey from April 19, 2015 to September 21, 2015. The data existed long before HB303 was written. The data from the 2015 survey was analyzed by the authors of the 2021 study between November 1, 2020 and January 3, 2021. The Conclusion of the study stated: “This study demonstrates an association between gender-affirming surgery and improved mental health outcomes. These results contribute new evidence to support the provision of gender-affirming surgical for TGD people.” On May 1, 2021, NBC News posted an article titled: “Gender-affirming surgery linked to better mental health, study finds.” It was written by Dan Avery. From the article: Transgender people who have access to gender-affirming surgery report better mental health outcomes, according to a new study. The report, published Wednesday in JAMA Surgery, compared the psychological distress levels, suicide risk, and substance use in trans and gender-diverse people who had undergone gender-affirming surgery with those who wanted such procedures but had not yet had them.The researchers found that subjects who had not received the surgical interventions they desired were nearly twice as likely to report severe psychological distress and suicidal thoughts, and reported higher incidences of binge drinking and tobacco use, as well……The new report, however, represents the first large-scale controlled study of the relationship between gender-affirming surgery and psychological well being. It uses data from nearly 200,000 participants in the 2015 U.S. Transgender Survey conducted by the National Center for Transgender Equality… You may have noticed that the study regarding gender-affirming surgery only included adults. Alabama’s HB303 focuses on children and teens who are transgender. There is no data on children or young teens who have had gender-affirming surgery because that type of medical care is not provided to children or young teens. Politifact provided clarification in a fact-checking article that was posted in 2019. The fact-check was in relation to a situation in Texas where one parent of a transgender girl affirmed her gender, while the other parent did not. From the fact-check: …There are absolutely no medical interventions or surgical interventions on any prepubertal child,” said Colt Keo-Meier, a Texas-based psychologist and author who specializes in gender and sexual health. “That is not happening.” The widely accepted “Standards of Care” maintained by the World Professional Association for Transgender Health also emphasize this point.“Before any physical interventions are considered for adolescents, extensive exploration of psychological, family, and social issues should be undertaken,” the standards read. “The duration of this exploration may vary considerably depending on the complexity of the situation.”……The World Professional Association for Transgender Health outline minimum criteria that must be met before a child can receive puberty-suppressing medication, including that the child has demonstrated a “long-lasting and intense pattern of gender nonconformity or gender dysphoria” and that it “emerged or worsened with the onset of puberty.”Other interventions like hormone therapy (partially reversible) or surgery (irreversible) won’t be considered until a patent reaches adolescence.Even then, the Standards of Care stress that certain procedures should not be preformed until a patient is old enough to consent on their own (typically 16-18 years old) and others should occur only once a person has received other treatments for a specific time period… It is worth noting that Alabama’s HB303 claims that there is evidence that children and teens who receive gender-affirming surgery does not reduce the risk of suicide. That claim has been debunked by the 2021 JAMA study. Alabama’s HB303 also claims: To the contrary, such interventions carry elevated risks for sterility, lost of sexual function, bone fractures, thromboembolic and cardiovascular disease, malignancy, and may even contribute to mental illness and suicide.” It is impossible for the writers of Alabama’s HB303 to make this claim because there is no evidence that any child or young teen has been given gender-affirming surgery. More nonsense from Alabama’s HB303: “The continued performing of these therapies upon children constitutes a public health risk“. As I’ve already made clear in this blog post, puberty blockers are not a public health risk. Gender-affirming surgery is not a public health risk either, and is irrelevant within the context of HB 303 because no children or young teens receive gender-affirming surgery. More nonsense from Alabama’s HB303: SEX. The biological state of being male or female, based on the individual’s sex organs, chromosomes, and endogenous hormone profiles. The writers of Alabama’s HB303 are confused. They appear to believe that the word gender, and the word sex, are synonyms. That’s not so! Pediatrics, the Official Journal of the American Academy of Pediatrics, posted information titled: “Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents”. From the information: …Gender Identity is not synonymous with “sexual orientation,” which refers to a person’s identity in relation to the gender(s) to which they are sexually and romantically attracted. Gender identity and sexual orientation are distinct but interrelated constructs. Therefore, being transgender does not imply a sexual orientation, and people who identify as transgender still identify as straight, gay, bisexual, etc. on the basis of their attractions……Gonadotrophin-releasing hormones have been used to delay puberty since the 1980s for central precocious puberty. These reversible treatments can also be used in adolescents who experience gender dysphoria to prevent development of secondary sex characteristics and provide time up until 16 years of age for the individual and family to explore gender identity, access psychosocial supports, develop coping skills, and further define appropriate treatment goals. If pubertal suppression treatment is suspended, then endogenous puberty will resume… The next part of Alabama’s HB303 attacks doctors, for the purpose of preventing them from providing puberty blockers or gender-affirming care to patients. (NOTE: As I’ve already mentioned, children and young teens are not provided with gender-affirming surgeries.) Except as provided in subsection (b), no person shall engage in, counsel, or make a referral for any of the following practices upon a minor, and no person shall cause any of the practices in this subsection to be performed upon a minor if the practice is performed for the purpose of attempting to affirm the minor’s perception of his or her gender or sex, if that perception is inconsistent with the minor’s biological sex as defined in this act: 1 Prescribing, dispensing, administering, or otherwise supplying puberty blocking medication to stop or delay normal puberty. 2 Prescribing, dispensing, administrating, or otherwise supplying supraphysiologic doses of testosterone or other androgens to females. 3 Prescribing, dispensing, administering, or otherwise supplying supraphysiologic doses of estrogen to males. 4 Performing surgeries that sterilize, including castration, vasectomy, hysterectomy, oophorectomy, orichiectomy and penectomy. 5 Performing surgeries that artificially construct tissue with the appearance of genitalia that differs from the individual’s biological sex, including metoidoplasty, phalloplasty, and vaginoplasty. In short, the writers of Alabama’s HB303 want to prevent children and teens from receiving puberty blockers. The writers are also trying to prohibit older teens and young adults from receiving hormones. There’s also a whole lot of surgical procedures that are being prohibited – which don’t typically happen to children or young teens. 6 Removing any healthy or non-diseased body part or tissue. Surgeons don’t remove healthy (or non-diseased) body parts or tissue. They remove parts that are unhealthy, severely damaged, or diseased. I suspect the reason that part was put into Alabama’s HB303 is to further emphasize how badly they want to prevent children and young teens from having gender-affirming surgery. Again, no one is preforming gender-affirming surgery on minors, so there is no point to that part of the bill. That said, Alabama’s HB303 does allow certain kinds of surgeries for children or teens who are not transgender. This is discrimination. From HB 303: Subsection (a) does not apply to a procedure undertaken to treat a minor born with a medically verifiable disorder of sex development, including either of the following: 1 An individual born with external biological sex characteristics that are irresolvably ambiguous, including an individual born with 46 XX chromosomes with virilization, 46 XY chromosomes with under virilization, or having both ovarian and testicular tissue. 2 An individual whom a physician has otherwise diagnosed with a disorder of sexual development, in which the physician has determined through genetic or biochemical testing that the person does not have normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action for a male or female. A violation of this section is a Class C felony. The next part of Alabama’s HB303 attacks transgender children and teens by requiring school personnel to tell a parent of a transgender student that their child is transgender. Doing so could, in at least some cases, cause harm to that child or teen. This part of the bill could cause teachers and other school personnel to have to choose between losing their jobs or putting a transgender student into possible danger from family members. Section 5. (a) No nurse, counselor, teacher, principal, or other administrative official at a public or private school attended by a minor shall do either of the following: 1 Encourage or coerce a minor to withhold from the minor’s parent or legal guardian the fact that the minor’s perception of his or her gender or sex is inconsistent with the minor’s sex. 2 Withhold from a minor’s parent or legal guardian information that is relevant to the physical or mental health of the minor, including information related to a minor’s perception that his or her gender is inconsistent with his or her sex. A violation of this section is a Class A misdemeanor. The rest of Alabama’s HB303 bill puts in place disclaimer: “If any part, section, or subsection of this act or application thereof to any person or circumstances is held invalid, the invalidity shall not affect parts, sections, subsections, or applications of this at that can be given effect without the invalid part, section, subsection or application.” It also declares that this bill is excluded from further requirements from some other parts of Alabama law, and requires the bill to become effective 30 days following its passage and approval by the Governor, or its otherwise becoming law. On February 26, 2020, the Alabama House of Representatives Committee on Health amended HB 303. On page 7, lines 6 and 7, delete the following: “that is relevant to the physical or mental health of the minor, including information” On page 7, line 10 and 11, delete the following: “A violation of this section is a Class A misdemeanor.” The first amendment changes this part: 2 Withhold from a minor’s parent or legal guardian information that is relevant to the physical or mental health of the minor, including information related to a minor’s perception that his or her gender or sex is inconsistent with his or her sex. The result of the change would be: 2 Withhold from a minor’s parent or legal guarding information related to a minor’s perception that his or her gender or sex is inconsistent with his or her sex. The second amendment changes this part: A violation of this section is a Class A misdemeanor. It removes that part of the text entirely. On February 28, 2020, Alabama Political Reporter posted an article titled: “ACLU of Alabama condemns bill banning transgender treatment for minors”. It was written by Jessa Reid Bolling. From the article: The American Civil Liberties Union (ACLU) of Alabama has condemned a recently approved bill to prevent doctors from providing hormone replacement therapy or puberty suppressing drugs to people younger than 19 who identify as transgender……The Alabama House Health Committee and the Senate Health Committee approved the bill on Wednesday in separate hearings, both drawing overflow crowds. The committee approval moves the bill in line for consideration by the full House.The ACLU of Alabama said in a statement that the bill targets transgender youth and puts their academic success and health in danger.“Transgender girls are girls, and transgender boys are boys,” said Dillon Nettles, policy analyst at the ACLU of Alabama. “Alabama lawmakers are considering legislation that runs counter to medical science, prevailing standards for the treatment of transgender youth and basic human dignity.“The government shouldn’t threaten medical providers with jail for treating transgender kids and schools shouldn’t discriminate against them when it comes to participation in school sports. HB303 and HB35 are dangerous, discriminatory and put kids at risk.”Multiple women’s sports advocacy organizations, including The National Women’s Law Center, the Women’s Sports Foundation, and Women Leaders in College Sports, support trans-inclusive policies and oppose efforts to exclude transgender student from participating in sports… What happened to Alabama’s HB 303 bill? Ms Magazine provided information about that: …In 2020, Alabama legislators pre-filed their first house bill of the season – HB1 – which, if passed, would prohibit trans minors from receiving life-saving transition-related health care by making it a crime for doctors to provide it. The bill would also “provide for the disclosure of certain information concerning students to parents by schools” – essentially allowing schools to “out” young trans people to their parents… …The bill was previously introduced as HB303 in the 2020 regular session, where it died. The legislature is set to convene for its 2020 session in February. Alabama’s tireless lawmakers have also introduced a nearly identical bill in the state’s Senate – SB 10, also known as the “Vulnerable Child Compassion and Protection Act” – which, if passed, would essentially have the same effects as HB1, prohibiting health care and allowing for trans kids to be outed. SB 10 is what I like to call a “zombie bill”. It had a life as HB303, died, and returned from the dead as a zombie. Alabama’s SB10 was sponsored by Senator Shay Shellnutt (Republican). The bill was first read in the Alabama Senate on February 2, 2021. The title of SB10 is: “Vulnerable Child Compassion and Protection Act.” Here are some key points from SB10: …Relating to public health; to prohibit the performance of a medical procedure or the prescription or issuance of medication, upon or to a minor child, that is intended to alter the minor child’s gender or delay puberty; to provide for exceptions; to provide for disclosure of certain information concerning students to parents by schools; and to establish criminal penalties for violations… …Section 1. This act shall be known and may be cited as the Alabama Vulnerable Child Compassion and Protection Act Section 2. For the purpose of this act, the following terms shall have the following meanings: 1 MINOR. The same meaning as in Section 43-8-1, Code of Alabama 1975. 2 PERSON. Includes any of the following: a. Any individual. b. Any agent, employee, official, or contractor of any legal entity. c. Any agent, employee, official, or contractor of a school district or the state of any of its political subdivisions or agencies. 3 SEX. The biological state of being male or female, based on the individual’s sex organs, chromosomes, and endogenous hormone profiles... Section 3 is a “copy – paste” of the portions of HB 303 that prevent doctors from providing puberty blockers, hormones, or surgeries to transgender minors. It also includes the exceptions for minors who are not transgender (under certain circumstances). Again, this is discrimination. The part that reads: A violation of this section is a Class C felony remains in SB10. So does the part from HB 303 that requires school personnel to “out” a transgender child or teen to their parents. On March 2, 2021, the Alabama Senate held a roll call vote on SB10. The purpose of this vote was to read the bill a third time and pass adopted Roll Call 331. Here is how the Senators voted: Greg Albritton (R) – YEAGerald Allen (R) – YEAWill Barfoot (R) – YEAWilliam “Bill” M. Beasley (D) – NAYTom Butler (R) – P (either not voting or not present)Clyde Chambless (R) – YEADonnie Chesteen (R) – YEALinda Coleman-Madison (D) – P (either not voting or not present)Priscilla Dunn (D) – P (either not voting or not present)Chris Elliot (R) – YEAVivian Davis Figures (D) – NAYSam Givhan (R) – YEAGarlan Gudger (R) – YEAJimmy Holley (R) – YEADoug Jones (R) – YEASteve Livingston (R) – YEADel Marsh (R) – P (either not voting or not present)Jim McClendon (R) – YEATim Melson (R) – YEAArthur Orr (R) – YEARandy Price (R) – YEAGreg Reed (R) – YEADan Roberts (R) – YEAMalika Sanders-Fortier (D) – P (either not voting or not present)Clay Scofield (R) – YEADavid Sessions (R) – YEAShay Shelnutt (R) – YEABobby Singleton (D) – NAYRodger Smitherman (D) – NAYLarry Stutts (R) – YEAJ.T. Waggoner (R) – YEATom Whatley (R) – YEAJack Williams (R) – P (either not voting or not present) On March 2, 2021, the Associated Press posted an article titled: “Alabama Senate approves treatment ban for trans kids”. It was written by Kim Chandler. From the article: Transgender youth in Alabama would not be able to be treated with puberty-blockers, hormone treatment, or surgery under a bill approved Tuesday by the Alabama Senate, as parents and trans youth rallied outside the Statehouse in opposition.Senators voted 23-4 to approve the measure sponsored by Republican Sen. Shay Shelnutt of Trussville. The bill now moves to the Alabama House of Representatives where a committee has approved a nearly identical bill. The bills would make it a felony to use puberty-blocking drugs, hormonal therapy and surgery to treat transgender minors. Violators could face up to 10 years in prison……Dr. Monica Ladinsky, a pediatrician who has treated multiple transgender youths, told a Senate committee earlier that genital surgery is never performed on children, and puberty blockers and hormonal therapy are used only used after lengthy informed consent, mental health oversight and subspecialized medical care… Also on March 2, 2021, Montgomery Advertiser posted an article titled: “Alabama Senate approves bill banning transgender youth treatments amid protests at state Capitol”. It was written by Bryan Lyman. From the article: …”I currently am not comfortable in my own skin,” said Smith, a high school sophomore from Jacksonville who is a transgender teen. “But testosterone and hormone treatments and all of these gender-affirming surgeries, for some it means life or death.”It was a story repeated by about 40 protestors who traveled to Montgomery to protest two bills: one from Sen. Say Shelnutt, R-Trussville, that would ban transgender youth from receiving puberty blocking and hormone treatment, and a second from Rep. Scott Stadthagen, R-Hartselle, that would ban transgender youth from playing public school sports for the gender with which they identify.Shelnutt’s bill passed the Senate 23-4 Tuesday afternoon. The bill moves to the House. A similar measure was sponsored by Rep. Wes Allen, R-Troy, passed out of a House committee last week. The House adjourned on Tuesday evening before taking up Stadhagen’s bill……Parents of transgender children and doctors who work with transgender children say the treatments have positive psychological impacts. In testimony before several legislative committees, parents and doctor said genital surgery does not take place on minors…On March 2, 2021, Human Rights Campaign tweeted: “SB10 has passed the Alabama State Senate. The companion bill, HB1, has not yet passed the House. We need everyone to speak out before Alabama criminalizes gender-affirming care to trans kids. If you live in Alabama, please call your legislators and tell them to vote no on HB1”. On March 3, 2021, CBS News posted an article titled: “Alabama Senate votes to make hormone therapy and surgery for trans youth a felony”. It was written by Sophie Lewis. From the article: …The two bills would make it a felony for medical professionals to treat transgender minors under the age of 19 with gender-affirming care. Violators could face up to 10 years in prison or a $15,000 fine.The bill also requires school staff in the state to disclose to parents that “a minor’s perception that his or her gender is inconsistent with his or her sex.” Essentially, teachers would be required to “out” transgender students to their guardians – regardless of whether they are ready to do so……While similar measures have been considered across the country, Alabama would be the first state to pass such a bill. Parents, members of the transgender communities and medical experts opposed to the bills say it is dangerous, and that lawmakers do not understand the already difficult process to receive gender-affirming care… On May 18, 2021, Alabama Political Reporter posted an article titled: “Bill to ban treatments for transgender minors dies before coming to the House floor”. It was written by Eddie Burkhalter. From the article: A bill that would have banned gender-affirming care for transgender youth didn’t make it to the floor of the Alabama House on Monday, the last day of the session. The bill’s quiet death surely saved young lives, opponents of the bill say.The bill, sponsored by Republican Sen. Shay Shelnutt, passed the Alabama Senate 21-4 on March 3, but did not make it to the House floor on Monday. The bill was the last of eleven on a special order calendar brought up late Monday night, but House Democrats just before 11 p.m. Monday ran the clock out, ensuring an end to the bill… On May 26, 2021, the American Civil Liberties Union (ACLU) of Alabama posted information titled: “Our Summary of Alabama’s 2021 Legislative Session”. It was written by Dillion Nettles. From the information: …Meanwhile, we are always on the defensive when it comes to legislative attacks on our civil rights, whether abortion access, trans rights, voting restrictions, or free speech. This year was no different, with bills filed to ban healthcare access for trans youth, ban curbside voting, attack protester rights, and more.While the bills to ban cubside voting and to and to ban transgender youth from competing in student athletics both passed and were signed by Governor Ivey, we are relieved to report that HB 1/SB 10, the companion bills that would have criminalized healthcare for trans youth, died as the House adjourned before taking a vote. As we embarked on this session, we knew we would have to defend the rights of trans youth and their families, as we had already seen the “Vulnerable Child Compassion and Protection Act” filed in 2020, and you know that it will likely reappear next year, too… Alabama’s terrible bills that would have prevented transgender youth from receiving appropriate health care did not become law. This means parents, in consultation with doctors, will be the ones to determine what kind of health care their child or teen receives. Parents of transgender children or teens in Alabama now have the same rights over health care choices for them as do parents of cis-gender children. Alabama’s Anti-Trans Health Care Bill Failed is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Utah Governor Wouldn’t Sign Anti-Trans BillsMay 29, 2021Out of Spoons / Public HealthPhoto by Liviu C. on Unsplash There has been a whole lot of anti-transgender bills going through the legislature of various states. These types of bills all have one thing in common: their entire purpose is to harm people who are transgender. Utah Governor Spencer Cox (Republican) refused to sign an anti-transgender bill that, if passed, would have prevented girls who are transgender from participating in girls K-12 sports. This is good news for not only transgender girls, but also their families. The Governor also signaled he would veto a bill that would prevent young transgender people from accessing appropriate medical care. Utah House Bill 302 was sponsored by Representative Kera Birkeland (Republican). The floor sponsor for this bill was Senator Curtis S. Bramble (Republican). Cosponsors included: Cheryl K. Acton, Melisa G. Ballard, Jefferson S. Burton, Steve R. Christiansen, Michael L. Kohler, Karianne Lisonbee, Steven J. Lund, Phil Lyman, Michael J. Peterson, Candice B. Pierucci, Susan Pulsipher, Adam Robertson, Jeffery D. Stenquist, Mark A. Strong, Jordan D. Teuscher, Norman K. Thurston, Christine F. Watkins, and Ryan D. Wilcox. House Bill 302 was first read in the House on February 3, 2021. The bill was titled: “Preserving Sports for Female Students”. The general description of the bill said: This bill addresses participation in athletic activities reserved for female students in public education. Right away, its clear that this is an anti-trans bill. The sponsors and co-sponsors of this bill have made the incorrect assumption that girls who are transgender are actually boys. This is discrimination against some students specifically because of their gender. The Biden-Harris administration issued an executive order on January 20, 2021, titled: “Executive Order on Preventing and Combating Discrimination on the Basis of Gender or Sexual Orientation“. The purpose of the executive order is to ensure that people who are LGBTQA+ do not face discrimination based on who they are. The executive order gets its validity from two significant lawsuits. One is Bostock v. Clayton County, Georgia, in which Supreme Court Justice Neil Gorsuch ruled that an employer who fires an individual for being gay or transgender violates Title VII. In short, Title VII “makes it unlawful… for an employer to fail or refuse to hire or to discharge any individual, or otherwise discriminate against any individual… because of such individual’s race, color, religion, sex or national origin.” The executive order also gets its validity from Grimm v. Gloucester County School Board. In short, the School Board at first allowed Gavin Grimm, a transgender boy, to use the boy’s bathroom – but then changed their policy after facing intense backlash from parents. The case was heard in the United States Court of Appeals for the Fourth Circuit. The opinion of the court was written by Circuit Judge Floyd, who stated: “At the heart of this appeal is whether equal protection and Title IX can protect transgender students from school bathroom policies that prohibit them from affirming their gender. We join a growing consensus of courts holding that the answer is a resounding yes…” The outcome of this case confirmed that Title IX can protect transgender students from school bathroom policies. If Title IX can do that (which the court said it can) then Title IX can also prevent schools from prohibiting transgender students from playing on the sports team that matches their gender identity. Psychology Today provides a clear answer about gender in a post titled: “How Many Genders Are There?” A person’s gender refers to characteristics that relate to the categories male, female, or some combination thereof. The words “gender” and “sex” are sometimes confused, but a persons sex refers to biological characteristics determined at conception or in utero; a person’s gender is understood by many researchers to be influenced by a range of societal and environmental factors as well as biological factors. A person can be biologically female and experience gender dysphoria or gender incongruence, because they do not identify with their assigned sex.A person might identify as transgender has a gender identity that does not correspond to their biological sex. The term “cisgender” refers to a gender identity that corresponds to one’s biological sex. People whose gender identity feels neither masculine nor feminine, may identify as non-binary… All of this is to say that it is incorrect to presume that a person is a specific gender based on either the person’s genitals or the gender that they were assigned at birth. Employers who discriminate against people who are LGBTQA+ because of their gender are breaking Title VII. Schools who discriminate against students because of their gender are breaking Title IX. Both of those actions are entirely illegal, not only because of the court decisions, but also because of the executive order from President Biden. Merriam-Webster describes the Supremacy Clause this way: a clause in Article VI of the U.S. Constitution declares the constitution, laws, and treaties of the federal government to be supreme law of the land to which judges in every state are bound regardless of state law to the contrary. The Free Legal Dictionary says that preemption is a doctrine based on the Supremacy Clause of the U.S. Constitution that holds that certain matters are of such a national, as opposed to local, character that federal laws preempt or take precedence over state laws. As such, a state may not pass a law inconsistent with the federal laws. In summary, it is good that Utah’s discriminatory House Bill 302 did not get signed into state law. Doing so would have resulted in legal action against Utah and caused harm to transgender students. Here are some pieces of Utah’s House Bill 302 General Description: This bill addresses participation in athletic activities reserved for female students in public education. Highlighted Provisions: This bill: defines terms; requires schools and local education agencies to designate athletic activities by sex; prohibits a student of the male sex from participating in an athletic activity designated for female students; prohibits certain complaints or investigations based on a school or local education agency maintaining separate athletic activities for female students; provides severability clauses; I want to pause here for a moment to clarify that this part of the bill is illegal because it chooses to discriminate against transgender girls by prohibiting them from participating in a girl’s sports team. The bill has nothing to say about transgender boys playing on the boy’s sports team. This is discrimination against trans girls because of their gender. Therefore, it breaks Title IX. The “provides severability clauses” part is significant. This language is placed in bills that the writer, sponsor, and cosponsors know is not legal and/or that it will cause controversy. The severability clause is there in case the state has to defend the bad bill in court. The purpose of the severability clause is to remove a portion of the bill that a court told them to – without having to throw out the rest of the bill. Other parts of the bill also are discriminatory against transgender girls, but use more words to get there: A public school or LEA, or a private school that competes against a public school or LEA shall expressly designate school athletic activities as one of the following, based on sex: “male” or “boys”; “female” or “girls”, or “coed” or “mixed”. A student of the male sex may not participate, and a public school or LEA may not allow a student of the male sex to participate, in a school athletic activity designated as “female” or “girls”; and A government entity or licensing accrediting organization may not entertain a complaint, open an investigation, or take any other adverse action against a school or LEA described in Subsection (1) for maintaining separate school athletic activities for students of the female sex. To summarize, the bill is written in a way that presumes that gender and sex are synonyms. That’s incorrect. This part of the bill is discriminatory because it is prohibiting transgender girls from participating in a girl’s sports team, while allowing cisgender girls to participate on a girl’s sports team. It does not, however, prevent transgender boys from playing on a boy’s sports team. This is discrimination, because it breaks Title IX. The writers of this bill (and its sponsor and cosponsors) are incorrectly identifying transgender girls as boys. This is discrimination – and just plain mean. It is also illegal, because the Courts ruling on the Grimm v. Gloucester County School Board case sets a precedent that clearly states that Title IX allows transgender students to use the bathroom that matches their gender. As such, Title IX also protects transgender girls from being prohibited from playing on the girl’s sports team. In addition, the bill claims that “a government entity or licensing accrediting organization” can’t make a complaint, open an investigation, or otherwise hold a school that discriminates against transgender students accountable for their bad (and illegal) actions. This is the writers, sponsors, and cosponsors attempt to absolve themselves from having to face the consequences of their harmful words and actions. On February 17, 2021, House Bill 302 “Preserving Sports for Female Students” was voted on. The vote was 50 Yeas and 23 Nays (and two Representatives not voting). Here is who voted YEA: Nelson T. Abbott (R)Carl R. Albrecht (R)Cheryl K. Acton (R)Melissa G. Ballard (R)Stewart E. Barlow (R)Kera Birkeland (R)Brady Brammer (R)Walt Brooks (R)Jefferson S. Burton (R)Scott H. Chew (R)Steve R. Christiansen (R)Kay J. Christofferson (R)Joel Ferry (R)Francis D. Gibson (R)Matthew Gwynn (R)Stephen G. Handy (R)Timothy D. Hawkes (R)Dan N. Johnson (R)Marsha Judkins (R)Mike L. Kohler (R)Bradley G. Last (R)Karianne Lisonbee (R)Stephen J. Lund (R)Phil Lyman (R)A. Cory Maloy (R)Jefferson Moss (R)Calvin R. Musselman (R)Merrill F. Nelson (R)Michael J. Petersen (R)Val J. Petersen (R)Candice B. Pierucci (R)Susan Pulsipher (R)Paul Ray (R)Adam Robertson (R)Douglas V. Sagers (R)Mike Schultz (R)Travis M. Seegmiller (R)Rex P. Shipp (R)Casey Snider (R)Lowry V. Snow (R)Keven J. Stratton (R)Jeffrey D. Stenquist (R)Mark A. Strong (R)Jordan D. Teuscher (R)Norman K. Thurston (R)Christine F. Watkins (R)Steve Waldrip (R)Douglas R. Welton (R)Brad R. Wilson (R)Ryan D. Wilcox (R) Here is who voted NAY: Gay Lynn Bennion (D)Joel K. Briscoe (D)Clare Collard (D)Jennifer Dailey-Provost (D)James A. Dunnigan (R)Craig Hall (R)Susanne Harrison (D)Sandra Hollins (D)Brian S. King (D)Karen Kwan (D)Rosemary T. Lesser (D)Ashlee Matthews (D)Kelly B. Miles (R)Carol Spackman Moss (D)Doug Owens (D)Stephanie Pitcher (D)Angela Romero (D)Robert M Spendlove (R)Andrew Stoddard (D)Raymond P. Ward (R)Elizabeth Weight (D)Mark A. Wheatley (D)Mike Winder (R) Here is who did not vote: Steve Eliason (R)Jon Hawkins (R) Why did Utah Governor Spencer Cox refuse to sign HB 302 On February 19, 2021, Deseret News posted an article titled: “Gov. Spencer Cox says he won’t sign transgender sports bill as now written”. It was written by Katie McKellar. From the article: An at-times emotional Gov. Spencer Cox said Thursday he would not sign the current version of the bill making its way through the Utah Legislature to ban transgender girls from participating in girls K-12 sports.“I’m not in a place yet where I’m comfortable with the bill as it stands right now,” Cox told reporters during his monthly news conference with PBS Utah Thursday morning. “Those discussions are ongoing. We still have a lot of work to do.”Cox then paused and teared up.“These kids are… they’re just trying to stay alive,” Cox said. “There’s a reason none of them are playing sports… I just think there’s a better way. And I hope that there will be enough grace in our state to find a better solution.”……”I apologize for getting a little emotional,” Cox told reporters Thursday. “When you spend time with these kids, it changes your heart in important ways, and so I want to try and improve that message and see if we can’t find a better way to work together.”……Cox’s comments come the day after the House voted to approve Rep. Kera Birkeland’s bill following heated debate. It now goes to the Senate for consideration……HB302 is adamantly opposed by groups including Equality Utah and Democrats, who argue it’s “needlessly (targeting) youth who are already marginalized and vulnerable to mental anguish and suicide.”Cox also said he had “threatened to veto” another bill related to transgender issues: HB92 being sponsored by Rep. Rex Shipp R-Cedar City. Shipp’s bill would prohibit doctors from offering any gender reassignment treatment to minors. The original version of that bill, Cox said, had “many, many flaws.” But he said the latest iteration of Shipp’s bill “is closer to what medical standards are now.”……Cox’s comments mean if HB302 has a chance of becoming Utah law, it needs changes unless he decides to allow it to become law without signing it. However, it’s possible the bill might run into some trouble in the Senate, where legislative leaders have hinted it could be altered… According to KUER 90.1 (which appears to be part of the BBC), House Bill 302 – which would have banned transgender girls from competing on girls public school sports teams – passed the Utah house. A Senate committee killed the bill by declining to vote on the legislation. Governor Spencer Cox signaled he would veto the bill. What Did HB92 Say? HB0092 was introduced to on January 19, 2021. (It is also referred to as HB92). The summary of the bill was: “This bill prohibits a physician or surgeon from performing a transgender procedure on aminor “. This bill was absolutely terrible. It not only restricted people who are transgender from receiving the medical care they need, but also prohibited doctors from providing certain types of care to people who are transgender. The bill would make it unprofessional conduct to preform a medically unnecessary puberty inhibition procedure or a sex characteristic-altering procedure on a minor. I cannot help but be aware of the similarities between this discriminatory anti-trans bill and the bills that conservative Republicans create (over and over again) that are intended to prevent people who have a uterus from receiving an abortion. In some cases, those bills also prevent access to contraception. Those types of bills include unnecessary medical procedures and time limitations that a person must endure to get an abortion. HB92 is designed to prevent people who are transgender from accessing the medical care they need – care that conservative Republicans deem “unnecessary”. Put all that together, and it is abundantly clear that the real purpose of these types of bills is to exert control over marginalized people’s bodies and to take away their bodily autonomy. Both types of bills are also used to attack doctors by making them risk their licenses if they dare to provide appropriate medical care to patients. The majority of this bill is hurtful just to read. I’m going to summarize it here. Skip over this part if you need to. Definitions: “Ablative procedure” means a procedure that is expected to excise, vaporize, disintegrate, or remove living tissue, including the use of carbon dioxide lasers and erbium: YAG lasers, and excluding hair removal. In short, this part of the bill would prevent a transgender man from getting what is often referred to as “top surgery”. It would prevent transgender people from having surgery that would change their genitalia. I want to be clear about this – not all people who are transgender want to have those types of surgery. This part of the bill harms those who do want to have surgery. Also, to be clear, not all people who are transgender want to have these types of surgery – and that’s completely valid. The next part of the bill attacks physicians. “ACGME” means the Accreditation Council for Graduate Medical Education of the American Medical Association. “Administrative penalty” means a monetary fine or citation imposed by the division for acts or omissions determined to constitute unprofessional or unlawful conduct, in accordance with a fine schedule established by the division in collaboration with the board, as a result of an adjudication proceeding conducted in accordance with 63G, Chapter 4, Administrative Procedures Act. “Associate physician” means an individual licensed under 58-67-302.8. Put that together, and this part of the bill is telling licensed physicians that will lose their license, will be investigated, and could have to pay a fine or citation if they provide what in reality is appropriate and necessary medical care to a patient who is transgender. This is discrimination based on gender, and that means this law is illegal. The next parts of the bill are underlined, for some reason. “Attempted sex change” means an attempt or effort to change an individual’s body to present that individual as being of a sex or gender that is different from the individual’s biological sex at birth. “Biological sex at birth” means an individual’s sex, as being male or female, according to distinct reproductive roles as manifested by sex and reproductive organ anatomy, chromosomal makeup, and endogenous hormone profiles. This part makes it clear that the writer of the bill fails to understand that sex and gender are not synonyms. I’ve already pointed that out in this blog post by including the information from Psychology Today. There is another part of this bill that would prevent transgender people under the age of 18 from obtaining puberty blockers. “Medically unnecessary puberty inhibition procedure” means administering or supplying to an individual younger than 18 years old, alone or in combination with aromatase inhibitors: gonadotropin-releasing hormone agnostics, progestins, or androgen receptor inhibitors. “Medically unnecessary puberty inhibition procedure” does not include administering or supplying a treatment described in Subsection (17)(a) to an individual younger than 18 years old if the treatment is medically necessary as a treatment for: precocious puberty, idiopathic short stature, endometriosis, or a sex hormone-stimulated cancer. It is obvious that this part of the bill discriminates against transgender young people who seek to prevent having their body develop in ways that do not match the person’s gender. This is discriminatory, because it targets transgender people – while allowing the same medication to be administered to cisgender young people. That part about “precocious puberty” makes it clear that cisgender girls or boys who start puberty early are allowed to have puberty blockers. The bill denies that exact same type of medication to transgender girls or boys. This is discrimination. Pediatrics, the Official Journal of the American Academy of Pediatrics, posted information titled: “Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents”. From the information: …Gender Identity is not synonymous with “sexual orientation,” which refers to a person’s identity in relation to the gender(s) to which they are sexually and romantically attracted. Gender identity and sexual orientation are distinct but interrelated constructs. Therefore, being transgender does not imply a sexual orientation, and people who identify as transgender still identify as straight, gay, bisexual, etc. on the basis of their attractions……Gonadotrophin-releasing hormones have been used to delay puberty since the 1980s for central precocious puberty. These reversible treatments can also be used in adolescents who experience gender dysphoria to prevent development of secondary sex characteristics and provide time up until 16 years of age for the individual and family to explore gender identity, access psychosocial supports, develop coping skills, and further define appropriate treatment goals. If pubertal suppression treatment is suspended, then endogenous puberty will resume… A vote was held on HB0092 (also called HB92) on February 19, 2021. There were 10 YEAS and 3 NAYS. This means the bill was marked as “passed”. According to KUER 90.1 (which appears to be part of the BBC), the other anti-trans bill that would prevent transgender minors from accessing gender affirming health care (hormone therapy, puberty blockers, and surgery) failed. During its first committee hearing, lawmakers sent it back to the Rules Committee after some changes had been made on it. The Rules Committee decided not to give the legislation another public hearing. Governor Spencer Cox said he would veto this legislation. Utah Governor Wouldn’t Sign Anti-Trans Bills is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post, please consider supporting me on Ko-Fi... Biden’s COVID-19 Health Equity Task ForceMay 3, 2021Out of Spoons / Public HealthPhoto by Glen Carrie on Unsplash On January 21, 2021, President Biden issued an executive order titled: “Executive Order on Ensuring an Equitable Pandemic Response and Recovery.” The order called for an emphasis on ensuring the people who were disproportionately affected by COVID-19 would receive the help they needed. It also called for the creation of the COVID-19 Health Equity Task Force. The “Executive Order on Ensuring an Equitable Pandemic Response and Recovery” started with: “By the authority vested in me as President by the Constitution and the laws of the United States of American, and in order to address the disproportionate and severe impact of coronavirus disease 2019 (COVID-19) on communities of color and other underserved populations, it is hereby ordered as follows:” Section 1. Purpose This section starts by pointing out inequities on America’s health care system. “The COVID-19 pandemic has exposed and exacerbated severe and pervasive health and social inequities in America. For instance, people of color experience systemic structural racism in many facets of society and are more likely to become sick and die from COVID-19. The lack of complete data, disaggregated by race and ethnicity, on COVID-19 infection, hospitalization, and mortality rates, as well as underlying health and social vulnerabilities has further hampered efforts to ensure an equitable pandemic response…” The Mayo Clinic posted information on August 13, 2020, titled: “Why are people of color more at risk of coronavirus complications?” It was written by William F. Marshall, III M.D. From the information: Research increasingly shows that racial and ethnic minorities are disproportionately affected by coronavirus disease 2019 (COVID-19) in the United States.According to recent data from the Centers for Disease Control and Prevention (CDC), non-Hispanic American Indian or Alaska Native people had an age-adjusted COVID-19 hospitalization rate at about 5.3 times that of non-Hispanic white people. COVID-19 hospitalization rates among non-Hispanic Black people and Hispanic or Latino people were both about 4.7 times the rate of non-Hispanic white people.While there’s no evidence that people of color have genetic or other biological factors that make them more likely to be affected by COVID-19, they are more likely to have underlying health conditions. Having certain conditions, such as type 2 diabetes, increases your risk of severe illness with COVID-19. But experts also know that where people live and work affects their health. Over time, these factors lead to different health risks among racial and ethnic minority groups… Here are some factors mentioned in the Mayo Clinic information: Racial and ethnic minority members might be more likely to live in multi-generational homes, crowded conditions and densely populated areas such as New York City. This can make social distancing difficult. Many people of color have jobs that are considered essential or can’t be done remotely and involve interacting with the public. In the U.S., according to the CDC, nearly 25% of employed Hispanic and Black or African Americans work in the service industry, compared with 16% of non-Hispanic white workers. Black or African Americans also account for 30% of licensed practical and licensed vocational nurses. Many people of color also depend on public transportation to get to work. These factors can result in exposure to the virus. Members of racial and ethnic minority groups are more likely to encounter barriers to getting care, such as a lack of health insurance or not being paid when missing work to get care. In 2017, according to the CDC only about 6% of non-Hispanic white people were uninsured, while the rate was nearly 18% for Hispanics and 10% for non-Hispanic Black people. Racism also may play a role in health risks. The stress of dealing with racial discrimination can take a toll on your body, causing early aging. This has been linked to underlying conditions, which can increase the risk of severe illness with COVID-19. The executive order continues with: “…Other communities, often obscured in the data, are also disproportionately affected by COVID-19, including sexual and gender minority groups, those living with disabilities, and those living at the margins of our economy. Observed inequities in rural and Tribal communities, territories, and other geographically isolated communities require a place-based approach to data collection and the response. Despite increased State and local efforts to address these inequalities, COVID-19’s disparate impact on communities of color and other underserved populations remains unrelenting…” Kaiser Family Foundation (KFF) published the results of a poll on March 11, 2021. The poll was titled: “The Impact of the COVID-19 Pandemic on LGBT People”. From the findings: There has been little data on how the coronavirus pandemic has impacted the lives of lesbian, gay, bisexual and transgender individuals (LGBT) in the U.S. Drawing on previous research indicating that LGBT individuals are at greater risk of both COVID-19 health and economic outcomes, this analysis examines the reported experiences from self-identified LGBT individuals from two months of KFF COVID-19 Vaccine Monitor and finds that LGBT people have experienced the COVID-19 pandemic differently than non-LGBT people, including being harder hit in some areas: Economic: A larger share of LGBT adults compared to non-LGBT adults report that they or someone in their household has experienced COVID-era job loss (56% v 44%). Mental Health: Three-fourths of LGBT people (74%) say worry and stress from the pandemic has had a negative impact on their mental health, compared to 49% of those who are not LGBT, and are more likely to say that negative impact has been major (49% v 23%). Views: One-third (34%) of LGBT adults say the news has generally underestimated the seriousness of the pandemic (compared to 23% of non-LGBT adults). Three-fourths of LGBT adults (74%) are either “very worried” or “somewhat worried” that they or someone in their family will get sick from the coronavirus, similar to responses from non-LGBT adults (67%). A large share of LGBT adults report being willing to take CDC recommended steps to avoid acquisition/transmission of the virus. …Limited early data available on how LGBT people have experienced the COVID-19 pandemic in the United States (U.S.) has suggested that this group may be disproportionately impacted. The reasons are far-reaching and may include: LGBT individuals being at a greater risk of worse COVID-19 outcomes due to higher rates of comorbidities; working in highly affected industries such as health care and restaurants/food services; living on average on lower incomes than non-LGBT people; experiencing stigma and discrimination related to sexual orientation/gender identity, including in accessing health care and, for transgender individuals, being less likely to have health coverage… Johns Hopkins University posted a report on April 23, 2020, titled: “COVID-19 poses unique challenges for people with disabilities”. From the report: …For people with disabilities, all the general challenges that come with the pandemic certainly apply, but there are additional barriers. The first is communication – getting information can be more difficult for people with vision, hearing, and even cognitive disabilities, as popular news sources may not be accessible, especially when information is changing quickly… Keeping all of us informed is key to the COVID-19 public health response, but information is not accessible to the disability community……The second barrier involves adopting recommended public health strategies, such as social distancing and washing hands. For example, frequent hand-washing is not always feasible for people with certain types of physical disabilities… …public health policies often do not consider people with disabilities, leaving a gap in guidance. Those who have personal aides and caregivers also need to be considered, as they cannot participate in social distancing in the same way that others are……The third, equitable access to health care, is a long-standing barrier worsened by COVID-19. This ranges from getting a coronavirus test to being seen in an emergency room. For instance, drive-up testing may be impossible if you rely on state mobility services. There are also existing barriers in health care settings that are exacerbated as the industry aims to meet the surge of COVID-19 cases. For example, the use of personal protective equipment, including masks, can make communication more difficult for patients with hearing loss……There’s fear that medical resource allocation, including ventilators, may be discriminatory against patients with disabilities, and complaints have been filed in multiple states about these rationing policies… The Centers for Disease Control and Prevention (CDC) posted information on August 19, 2020, titled: “CDC data show disproportionate COVID-19 impact in American Indian/Alaska Native populations”. From the information: The Centers for Disease Control and Prevention (CDC) released a new study that specifically examines how COVID-19 is affecting American Indians and Alaska Natives (AI/AN) – one of the racial and ethnic minority groups at highest risk of the disease. CDC found that in 23 selected states, the cumulative incidence of laboratory-confirmed COVID-19 cases among AI/AN was 3.5 that of non-Hispanic whites.These data also showed that AI/AN who tested positive for SARS-CoV-2 tended to be younger than white non-Hispanic individuals with COVID-19 infection. Compared to whites, a higher percentage of cases among AI/AN individuals were in people under 18 years of age (12.9 percent AI/AN; 4.3 percent white), and a smaller percentage of cases were among AI/AN 65 years or older (12.6 percent AI/AN; 28.6 percent white). Limited data were available to quantify the disparity in COVID-19 incidence, COVID-19 disease severity, and outcomes among AI/AN persons compared with those among other racial/ethnic groups, reinforcing the need to prioritize improved data collection as a key strategy to understand and improve health outcomes.Recent CDC studies have shown that AI/AN are among the racial and ethnic minority groups at higher risk for severe COVID-19 outcomes. Persisting racial inequity and historical trauma have contributed to disparities in health and socioeconomic factors between AI/AN and white populations that have adversely affected tribal communities. The elevated incidence within this population might also reflect differences in reliance on shared transportation, limited access to running water, household size, and other factors that might facilitate community transmission… The last part of the Purpose section says: “Addressing this devastating toll is both a moral imperative and pragmatic policy. It is impossible to change the course of the pandemic without tackling it in the hardest-hit communities. In order to identify and eliminate health and social inequalities resulting in disproportionately higher rates of exposure, illness, and death, I am directing a Government-wide effort to address health equity. The Federal Government must take swift action to prevent and remedy differences in COVID-19 care and outcomes within communities of color and other underserved populations.” Section 2. COVID-19 Health Equity Task Force The second part of the executive order is about setting up a COVID-19 Health Equity Task Force. “There is established within the Department of Health and Human Services (HHS) a COVID-19 Health Equity Task Force (Task Force).” On January 30, 2020, CBS News posted an article titled: “Trump creates task force to lead U.S. coronavirus response”. From the article: President Trump has created a new task force to lead the government’s response to the fast-spreading coronavirus, the White House announced Wednesday.Led by Health and Human Services Secretary Alex Azar and coordinated through the National Security Council, the task force is made up of subject matter experts from across the federal government and has been meeting daily since Monday. Members of the 12-member group include National Security Adviser Robert O’Brian, Centers for Disease Control and Prevention Director Dr. Robert Redfield, and the National Institutes of Health’s Dr. Anthony Fauci.“The task force will lead the administration’s efforts to monitor, contain and mitigate the spread of the virus, while ensuring that the American people have the most accurate and up-to-date health and travel information,” the White House said… President Biden’s executive order describes who will be on his COVID-19 Health Equity Task Force, what the group will do, and other information. “The task force shall consist of the Secretary of HHS; an individual designated by the Secretary of HHS to Chair the Task Force (COVID-19 Health Equity Task Force Chair); the heads of such other executive departments, agencies, or offices (agencies) as the Chair may invite; and up to 20 members from sectors outside the Federal Government appointed by the President.” Xavier Becerra is the Secretary of Health and Human Services (HHS). According to The New York Times, he is the first Latino to serve as health secretary. On March 18, 2021, the Senate confirmed him with a vote of 50-49. Senator Susan Collins of Maine was the only Republican to support his confirmation. Previously, he was California’s Attorney General. The Secretary of Health and Human Services will select someone to be the COVID-19 Health Equity Task Force Chair. Federal members may designate, to perform the Task Force functions of the member, a senior-level official who is a part of the member’s agency and a full-time officer or employee of the Federal Government. Nonfederal members shall include individuals with expertise and lived experience relevant to groups suffering disproportionate rates of illness and death in the United States; individuals with expertise and lived experience relevant to equity in public health, health care, education, housing, and community-based services; and any other individuals with expertise the President deems relevant. Appointments shall be made without regard to political affiliation and shall reflect a diverse set of perspectives. Members of the Task Force shall serve without compensation for their work on the Task Force, but members shall be allowed travel expenses, including per diem in lieu of subsistence, as authorized by law for persons serving intermittently in Government service (5. U.S.C. 5701-5757). At the direction of the Chair, the Task Force may establish subgroups consisting exclusively of Task Force members or their designees under this section, as appropriate. Mission and Work of the COVID-19 Health Equity Task Force: “Consistent with applicable law and as soon as practicable, the Task Force shall provide specific recommendations to the President, through the Coordinator of the COVID-19 Response and Counselor to the President (COVID-19 Response Coordinator), for mitigating the health inequities caused or exacerbated by the COVID-19 pandemic and for preventing such inequities in the future. The recommendations shall include:” Recommendations for how agencies and State, local, Tribal, and territorial officials can best allocate COVID-19 infection, hospitalization, and mortality in certain communities and disparities in COVID-19 outcomes by race, ethnicity, and other factors, to the extent permitted by law; Recommendations for agencies with responsibility for disbursing COVID-19 relief funding regarding how to disburse funds in a manner that advances equity; Recommendations for agencies regarding effective, culturally aligned communication, messaging, and outreach to communities of color and other underserved populations. “The Task Force shall submit a final report to the COVID-19 Response Coordinator addressing any ongoing health inequalities faced by COVID-19 survivors that may merit a public health response, describing the factors that contributed to disparities in COVID-19 outcomes, and recommending actions to combat such disparities in future pandemic responses.” What the COVID-19 Health Equity Task Force will do regarding data collection: “…To address the data shortfalls identified in section 1 of this order, and consistent with applicable law, the Task Force shall:” Collaborate with the heads of relevant agencies, consistent with the Executive Order entitled “Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats,” to develop recommendations for expediting data collection for communities of color and other underserved populations and identifying data sources, proxies, or indices that would enable development of short-term targets for pandemic-related actions for such communities and populations; Develop, in collaboration with the heads of relevant agencies a set of longer-term recommendations to address these data shortfalls and other foundational data challenges, including those relating to data intersectionality, that must be tackled in order to better prepare and respond to future pandemics; and Submit the recommendations described in this subsection to the President through the COVID-19 Response Coordinator. The next few paragraphs set up more about what the Task Force can do. They may seek the views of health professionals; policy experts; State, local, Tribal and territorial health officials; faith-based leaders; businesses; health providers; community organizations; those with lived experience with homelessness, incarceration, discrimination, and other relevant issues; and other stakeholders. The Federal Advisory Committee Act may apply to the Task Force, and any functions of the President under the Act, (except section 6) shall be performed by the Secretary of Health and Human Services. HHS will provide funding and administrative support for the Task Force (as permitted by law and within existing appropriations). The Chair shall convene regular meetings of the Task Force, determine its agenda, and direct its work. The Chair shall designate an Executive Director of the Task Force, who shall coordinate the work of the Task Force and head any staff assigned to the Task Force. The COVID-19 Health Equity Task Force will terminate within 30 days of accomplishing the objectives set forth in this order, including the delivery of the report and recommendations specified in this section, or 2 years from the date of this order, whichever comes first. Section 3. Ensuring an Equitable Pandemic Response. “…The Secretary of Agriculture, the Secretary of Labor, the Secretary of HHS, the Secretary of Housing and Urban Development, the Secretary of Education, the Administrator of the Environmental Protection Agency, and the heads of all other agencies with authorities or responsibilities relating to the pandemic response and recovery shall, as appropriate and consistent with applicable law:” Consult with the Task Force to strengthen equity data collection, reporting, and use related to COVID-19; Assess pandemic response plans and policies to determine whether personal protective equipment, tests, vaccines, therapeutics, and other resources have been or will be allocated equitably, inducing by considering: The disproportionately high rates of COVID-19 infection, hospitalization, and mortality in certain communities; and Any barriers that have restricted access to preventative measures, treatment, and other health services for high-risk population; Any barriers that have restricted access to preventive measures, treatment, and other health services for high-risk populations; The effect of proposed policy changes on agencies’ abilities to collect, analyze, and report data necessary to monitor and evaluate the impact of pandemic response plans and policies on communities of color and other underserved populations Policy priorities expressed by communities that have suffered disproportionate rates of illness and death as a result of the pandemic; Strengthen enforcement of anti-discrimination requirements pertaining to availability of, and access to, COVID-19 care and treatment; and Partner with States, localities, Tribes, and territories to explore mechanisms to provide greater assistance to individuals and families experiencing disproportionate economic or health effects from COVID-19, such as by expanding access to food, housing, child care, or income support. The next part instructs the Secretary of HHS to provide recommendations to State, local, Tribal, and territorial leaders on how to facilitate the placement of contact tracers and other workers in communities that have been hardest hit by the pandemic, recruit such workers from those communities, and connect such workers to existing health workforce training programs and other career advancement programs. The Secretary of HHS must also conduct an outreach campaign to promote vaccine trust and uptake among communities of color and other underserved populations with higher levels of vaccine mistrust due to discriminatory medical treatment and research and engage with leaders within those communities. Members of the Biden-Harris Administration COVID-19 Health Equity Task Force On February 10, 2021, President Biden announced who would be on the COVID-19 Health Equity Task Force. The Task Force is chaired by Dr. Marcella Nunez-Smith. She is an associate professor of internal medicine, public health, and management at Yale, and is one of the nation’s foremost experts on disparities in healthcare access. According to information posted by Yale, Dr. Marcella Nunez-Smith had called attention to the unequal burden borne by communities of color. She is also associate dean for health equity research, director for the Center for Community Engagement and Health Equity, and the founding director of the Equity Research and Innovation Center (ERIC) at Yale School of Medicine. Dr. Marcella Nunez-Smith grew up in the U.S. Virgin Islands. In the press briefing about the Task Force, it states: “As Chair, Dr. Nunez-Smith will also ask six additional Federal agencies to be represented on the COVID-19 Health Equity Task Force as federal members. This includes the United States Department of Agriculture, Department of Education, Department of Health and Human Services, Department of Housing and Urban Development, Department of Justice and Department of Labor. The twelve Task Force members represent a diversity of backgrounds and expertise, a range of racial and ethnic groups, and a number of important populations, including: children and youth, educators and students; health care providers, immigrants; individuals; public health experts; rural communities; state, local, territorial, and Tribal governments, and unions. Mayra E. Alvarez, MPH is President of the Children’s Partnership, a California advocacy organization working to advance child health equity. Previously, she served in the U.S. Department of Health and Human Services during the Obama-Biden administration, including at the Centers for Medicare and Medicaid Service, the Office of Minority Health, and the Office of Health Reform. She also served as a Legislative Assistant in the US Senate and House of Representatives. She grew up in California, and graduated from the School of Public Health at University of North Carolina at Chapel Hill and the University of California at Berkeley. James Hildreth, PhD, MD is president and chief executive officer of Meharry Medical College, the nation’s largest private, independent historically black academic health sciences center. Dr.Hildreth served previously as the dean of the College of Biological Sciences at University of California, Davis and as a professor and associate dean at Johns Hopkins University School of Medicine. Dr. Hildreth is a member of the National Academy of Medicine an an internationally acclaimed immunologist whose work has focused on several human viruses including HIV. He currently serves on the advisory council for the NIH director and as a member of the FDA Vaccines and Related Biological Products Advisory Committee. Dr. Hildreth has led Meharry’s efforts to ensure that disadvantaged communities have access to COVID-19 testing and vaccines. He graduated from Harvard University as a Rhodes Scholar, from Oxford University with a PhD in immunology and obtained an MD from Johns Hopkins School of Medicine. Andrew Imparato, JD Andy Imparato is a disability rights lawyer and Executive Director of Disability Rights California, where he has spearheaded advocacy on crisis standards of care and vaccine prioritization in the last year. Imparato joined DRC after a 26-year career in Washington DC, where he served as the chief executive of the Association of University Centers on Disabilities and the American Association of People with Disabilities. From 2010-2013, Imparato served as Chairman Tom Harkin’s Disability Policy Director on the U.S. Senate Committee on Health, Education, Labor and Pensions. Imparato’s perspective is informed by his lived experience with bipolar disorder. Victor Joseph was elected by the 42 member tribes to the position of Tanana Chiefs Conference (TCC) Chief/Chairman in March of 2014 and served through October of 2020. As the Chief Chairman he was the principle executive officer for the corporation and presided over all corporate meetings of the member tribes. Prior to being elected TCC’s Chief Chairman Victor was employed as TCC’s Health Director from 2007 to 2014. He worked for TCC a total of 28 years in a variety of leadership positions. He has also served as Alaska Representative on the U.S. Department of Health and Human Services Secretary’s Tribal Advisory Committee and on the Indian Health Services Budget Formulation Committee. Joseph is a tribal member of the Native Village of Tanana. He has extensive experience building strong working relationships with tribal leaders, colleagues, staff, and funding agencies and corporate beneficiaries. Joneigh Khaldun, MD, MPH is the Chief Medical Executive for the State of Michigan and the Chief Deputy Director for Health in the Michigan Department of Health and Human Services (MDHHS). She is the lead strategist for Michigan’s COVID-19 response. Prior to her role in Michigan she was the Director of the Detroit Health Department, where she established a comprehensive reproductive health network and led Detroit’s response to the Hepatitis A outbreak. Dr. Khaldun has held former roles as the Baltimore City Health Department’s Chief Medical Officer and Fellow in the Obama-Biden Administration’s Office of Health Reform in the US Department of Health and Human Services. She obtained her BS from the University of Michigan, MD from the Perelman School of Medicine at the University of Pennsylvania, and MPH in health policy from George Washington University. She practices emergency medicine part-time at Henry Ford Hospital in Detroit. Octavio N. Martinez, Jr. MD, MBA, MPH is the Executive Director for the Hogg Foundation for Mental Health at The University of Texas at Austin. Additionally, Martinez is a Senior Associate Vice President within the university’s Division of Diversity and Community Engagement; clinical professor in the university’s School of Social Work; and professor at Dell Medical School’s Department of Psychiatry. He grew up in Texas, and has a MPH from Harvard University’s School of Public Health, an MD from Baylor College of Medicine, and an MBA and BBA in Finance from The University of Texas at Austin. Tim Putnam, DHA, EMS is President and CEO of Margaret Mary Health, a community hospital in Batesville, Indiana and has over 30 years of healthcare experience. He received his Doctorate in Health Administration from the Medical University of South Carolina where his dissertation was focused on acute stroke care in rural hospitals. He is a past president of the Indiana Rural Health Association and the National Rural Health Association. In 2015 he was appointed by the Governor to the newly created Indiana Board of Graduate Medical Education and has chaired the Board since its inception. Dr. Putnam is also a certified Emergency Medical Technician. Vincent C. Toranzo is an active student from Broward County, Florida. Mr. Toranzo has experience with the inner workings of municipality functions. He serves as the State Secretary of the Florida Association of Student Councils advocating for the inclusion of student voices in their community, such as assistance to foster children and the assurance of students’ safety amidst the COVID-19 pandemic. Mr. Toranzo was awarded the U.S. President’s Award for Educational Excellence and a Citizenship Award for School and Public Services from his local U.S. congresswoman. Mary Turner, RN is an ICU nurse at North Memorial Medical Center in Robbinsdale and in her sixth year as President of the Minnesota Nurses Association (MNA) union – the Minnesota affiliate of National Nurses United. She previously worked at Abbott Northwestern Hospital in Minneapolis for 10 years. Turner has been on the National Nurses United’s Joint Nursing Commission since 2011. She serves as the Chair of the Board for Isuroon, which provides empowerment, culturally sensitive health education, and advocacy for Somali women. Homer Venters, MD is a physician and epidemiologist working at the intersection of incarceration, health, and human rights. Dr. Venters is currently focused on addressing COVID-19 responses in jails, prisons, and immigration detention facilities. Dr. Venters is the former Chief Medical Officer of the NYC Correctional Health Services and author of Life and Death in Rikers Island. Dr. Venters has also worked in the nonprofit sector as the Director of Programs for Physicians for Human Rights and President of Community Oriented Correctional Health Service. Dr. Venters is a Clinical Associate Professor of the New York University College of Global Public Health. G. Robert (“Bobby”) Watts, MPH, MS is the CEO of the National Health Care for the Homeless Council, which supports 300 Health Care for the Homeless FQHC’s and 100 Medical Respite programs with training, research, and advocacy to end homelessness. Watts has 25 years’ experience in administration, direct service, and implementation of homeless health and shelter services. Watts served as Executive Director of Care for the Homeless in New York City for twelve years. He is a graduate of Cornell University and Columbia University’s Mailman School of Public Health from which he holds an MPH in health administration and an MS in epidemiology. Haeyoung Yoon, JD is Senior Policy Director at the National is Senior Policy at the National Domestic Workers Alliance. Over the course of her career, Yoon has worked on low-wage and immigrant workers rights issues. Prior to National Domestic Workers Alliance, Yoon was a Distinguished Taconic Fellow at Community Change. Yoon also has extensive litigation experience and taught at the New York University School of Law and Brooklyn Law School. She recently testified before the House Judiciary Committee’s Subcommittee on Immigration and Citizenship regarding Immigrants as Essential Workers during COVID-19. Yoon received her JD from CUNY School of Law, her MA from Harvard University, and her BA from Barnard College. Biden’s COVID-19 Health Equity Task Force is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... CockatielsPinky is DisappointedSeptember 26, 2021CockatielsOur flock of cockatiels let us know when they want to “go to sleep” for the night. Typically, they take a little nap, and then move around the cage. They eat more food, get a drink of water, and find a spot to sleep in. This photo is from February of 2021. Usually, I am able to properly cover the birdcage. But this new birdcage is tall, and I am short. I didn’t realize that I failed to cover up the cage all the way. After a while, I had the sense that I was being watched. I looked down the hall… and there was Pinky, looking back at me. The sight of him, patiently waiting for me to return and cover the entire cage this time made me giggle! This is what a cocktail looks like when he is “not angry… just disappointed”. Fortunately, cockatiels are generally happy little birds, and they forgive and forget easily. Photo by Jen Thorpe Pinky is Disappointed is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me Ko-fi. Thank you!... Brand New Cage!August 9, 2021CockatielsMarvin, Pepper, and Pinky are enjoying their brand new cage! It might look kind of cramped from the outside, but that’s an illusion. This new cage has plenty of space for the birds to spread out. These photos were taken in December of 2020. You can tell that all three birds are really happy and excited about the new cage because their eyes are “smiling” and their head crests are up. Pepper is sitting comfortably on the top perch. Pinky decided to sit on the toy (instead of play with it). Marvin is off to the side, looking rather nervous. He tends to take a little while to adjust to new things. Pinky has moved to one of the dishes that are on the top of the cage. Both of those dishes were empty, which is probably a good thing. Pinky likes to sit inside them. He looks really happy to be on the dish. Eventually, Marvin was placed on top of the big perch that is the highest point on top of the cage. He sits next to his best buddy, Pepper. Both of their crests are up, which means Marvin feels better sitting next to a friend. Pinky has moved to the ladder – but has decided not to climb it. Pinky has fluffed up his feathers – indicating that he will, in fact, attempt to nap on the edge of this bowl. All of the excitement over having a brand new cage to explore made the cockatiels sleepy. Pepper is becoming a “borb” – his feathers are so fluffy that he becomes a rounded shape. Pinky is delicately perched on the edge of the dish and taking a nap. Marvin is still not so sure about this new cage. His crest is up, indicating he’s not as nervous as he was before. He is also turning into a “borb” and on the way to having a nice nap. #Blaugust2021 Photos by Shawn Thorpe Brand New Cage! is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me Ko-fi. Thank you!... LadderApril 19, 2021CockatielsPepper is sitting on a ladder. He usually sits near Marvin, but has been having trouble climbing up the cage. Today, Pepper decided that the ladder was a nice place to sit. Pepper is an older bird, and has lived long past the typical lifespan of a cockatiel. He can climb the bars that are horizontal, but not the vertical ones. The ladder was added to help him get onto the top perch. Pinky decided that he needed some attention. Pinky is on his way to bother Marvin. As you can see, Marvin is getting ready to take a nap. Pinky can be absolutely adorable when he wants to! Pepper decided to take a nap near the food dish on a red perch that has texture on it. He is in the process of turning into a “borb”. Photos taken on November 1, 2020. Ladder is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me Ko-fi. Thank you!... Pepper and Marvin on CouchApril 5, 2021CockatielsPepper and Marvin spent some time on the couch having fun. They really like each other! They were turning into borbs (bird + round orb shape) when they noticed the camera. Marvin got all excited and started flapping his wings! He’s not a good flyer – but he tries. Pepper and Marvin decided to chill out and sort of snuggle together. Photos by Shawn Thorpe, taken on September 11, 2020. Pepper and Marvin on Couch is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Pinky on the Couch AgainJanuary 26, 2021CockatielsPinky cannot get on top of the couch by himself. He’s not very good at flying. If a human puts him on the couch, he is quite happy to sit there. Look at how tall his crest is! Photo by Shawn Thorpe on September 11, 2020. Pinky on the Couch is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... FriendshipNovember 12, 2020CockatielsPepper and Marvin have been good buddies for a long time. In September of 2020, they started preening each other. When birds do this, it is a sign of affection. Photo by Shawn Thorpe Friendship is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Orange SkyOctober 2, 2020CockatielsEvery morning, Pinky, Marvin, and Pepper wake up on the long perch that is in the back of the cage. They were ready for fresh food and water. There have been a lot of fires in California. None are near us, but the smoke from the fires had been drifting here. Our cockatiels did not know what to think of the strangely colored sky. Orange Sky is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Hot BirdSeptember 22, 2020CockatielsCalifornia had a heat wave. Cockatiels are tropical birds, so they usually enjoy that kind of weather. But, then it got a bit too hot for them. Marvin is doing what we call “hot bird”. He is sticking out his folded wings, in an effort to cool his body. Technically, he’s doing “warm bird”. Birds that get too hot become very skinny and they push their folded wings out a lot farther. They also pant. Don’t worry. Our birds always have access to plenty of nice, clean, cool water. Marvin (and Pepper and Pinky) were not in any danger. Photo by Shawn Thorpe. Hot Bird is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me Ko-fi. Thank you!... Pinky Climbed to the TopSeptember 18, 2020CockatielsAfter sharing the top of the cage with Marvin the other day, Pinky decided to climb up to the top of the cage all by himself. Marvin and Pepper were not yet ready to start the day. Pinky Climbed to the Top is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Two Birds On Top of CageSeptember 16, 2020CockatielsThe cockatiels decided to be active. Pinky climbed up to the top of the cage for the first time. Marvin climbed up there, too. Pepper is looking out the window. Pinky and Marvin were happy to share the top of the cage together. Their very tall head crests show how they feel. Meanwhile, Pepper is inside the cage and picking at the blanket that covers it. Cockatiels find joy in destroying things when they think the humans aren’t looking. It’s ok. He can’t do much harm to the blanket. Two Birds On Top of Cage is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Diablo ImmortalDiablo Immortal Closed Alpha: Elder Rifts, Jewels, and a SoulstoneJune 29, 2021Diablo Immortal / Diablo VideosIn this video, my Crusader started at Level 29. I tried out an Elder Rift for the first time. It is possible to do an Elder Rift solo. Players can buy crests to add to the Elder Rift with currency obtained in the Elder Rift. Or, you can pay money for them. New players get a crest from a merchant as part of a quest. Naturally, I used that crest in the next Elder Rift. The Elder Rifts are fun, with or without a crest. It appears that using a crest gives you more loot. Of course, I cannot be sure of that, having only done two Elder Rift. Next, my Crusader did a quest that led her to the Jeweler’s shop. The helpers in there can sell the players some stuff. I didn’t have the right items to buy things yet. However, I was able to get the Apprentice Jeweler to socket some gems into my gear. By the end of the video, my Crusader was at Level 30. She found Deckard Cain… who talked about Soulstones. If you enjoyed this video, please consider supporting me on Ko-Fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/Diablo_Immortal_Closed_Alpha_Elder_Rifts_Jewels_and_a_Soulstone.mp4Podcast: Play in new window | DownloadSubscribe: RSS... Diablo Immortal Closed Alpha: Beastiary and Dark WoodJune 29, 2021Diablo Immortal / Diablo VideosIn this video, my Crusader picks up where she left off in the previous video. I enjoyed the quests, and the scenery, in the Dark Wood area. Shortly after fighting some enemies, my Crusader got a notification about a Daily Reward. It turned out to be an item called Vicious Hero’s Companion of Fortitude. It was an upgrade to what my Crusader was currently using. Eventually, my Crusader got to meet Akara, someone who seems to be very important to the Sisters of the Sightless Eye. I also learned that the camp area gives the player the ability to access their stash. One of the interesting things in Diablo Immortal is that you can encounter other players who are working their way through the same quests that you are. It makes the game feel more populated than Diablo III does. The most interesting thing in the camp (other than the storyline) is the Horadric Beastiary. This was the first time I encountered it. To use it, a player must kill a certain kind of monster and pick up Monster Essence. Use the Monster Essence in the Beastiary to learn more about that type of monster. During the Closed Alpha, the Beastiary wasn’t entirely revealed to the player. Once this game is released, I intend to see how many of the beasts within in it I can unlock. My Crusader ended the video at Level 24. If you enjoyed this video, please consider supporting me on Ko-Fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/Diablo_Immortal_Closed_Alpha_Beastiary_and_Dark_Wood_Quests.mp4Podcast: Play in new window | DownloadSubscribe: RSS... Diablo Immortal Closed Alpha: Dark WoodJune 28, 2021Diablo Immortal / Diablo VideosIn this video, my Crusader started off at Level 22. She entered a Challenge Rift for the first time. I start off by explaining how I accidentally misgendered the Blacksmith. When I record these videos, I cannot hear the sounds in the game. I figured Charsi was either a woman – if so, that would make her the first Blacksmith that was a woman. Or, perhaps the Blacksmith was nonbinary, based on the image. The answer to my questions about Charsi’s gender was revealed not long after I started playing. She sent me on a quest in Dark Wood. I started out looking at the Codex and claiming a reward called Westmarch. I also earned some Salvage related achievements. I will need to remember to keep looking at that. You have to click on each achievement that you earn before you can obtain the loot. My Crusader completed a Challenge Rift Level 1. There is a leaderboard connected to the Challenge Rifts. A player can do the Challenge Rift solo, or bring in some other players to help. It took me a little while to understand how to navigate my way through the Challenge Rift. It was fun, and there was lots of loot. Upon leaving the Challenge Rift, my Crusader followed a set of glowing footprints that led me back to Charsi. She sent me on some quests that take place in the Dark Woods area. One of the things I like about these quests is that the entire quest chain is (almost) all women. That’s not something I’ve seen very often in a video game. If you enjoyed this video, please consider supporting me on Ko-Fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/Diablo_Immortal_Closed_Alpha_Dark_Wood.mp4Podcast: Play in new window | DownloadSubscribe: RSS... Diablo Immortal Closed Alpha: BlacksmithMay 11, 2021Diablo Immortal / Diablo VideosIn this video, my Crusader started off at Level 22. Part of this video is about figuring out where to find the Achievements and how to maneuver through the interface that shows Bounties, dungeons, and more. The main part of this video involves the Blacksmith. The first thing my Crusader did was talk to Xul. He sent her to go fight Lethes, who is in a location called Lord’s Rest. Upon entering, the screen said: “You have entered a solo Story Dungeon.” My initial impressions of Westmarch started forming while I played through this part of the game. I intend to wrote about that, but don’t want to squish it all into this post. Charsi is the Blacksmith of Westmarch. When I record these videos, I cannot hear the sound (due to the setup I have for recording my Diablo Immortal gameplay.) As such, I accidentally misgendered the Blacksmith. If I were able to hear Charsi speak, that would not have happened. I had the opportunity to start to figure out how to use the Blacksmith’s services. It is rather simple, once you understand how to move through the interface. I’m probably going to have to do that a lot before it will feel intuitive. This video also includes the most useful escort quest I’ve experienced in any of Blizzard’s games. If you enjoyed this video, please consider supporting me on Ko-Fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/Diablo_Immortal_Closed_Alpha_Blacksmith.mp4Podcast: Play in new window | DownloadSubscribe: RSS... Diablo Immortal Closed Alpha: Mad King’s BreachMay 10, 2021Diablo Immortal / Diablo VideosIn this video, my Crusader started off at Level 20. She made a second attempt at completing the Mad King’s Breach dungeon (after failing it on the first try). In this attempt, I learned that it is possible to complete this Dungeon solo, despite the game’s recommendation that you bring 9 other players with you. I also learned that King Leoric has a “tell” that makes it very clear where he is about to charge. This gives the player a chance to get out of the way. By the end of the video, my Crusader was at Level 22. If you enjoyed this video, please consider supporting me on Ko-fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/Diablo_Immortal_Closed_Alpha_Mad_King_s_Breach_Completed.mp4Podcast: Play in new window | DownloadSubscribe: RSS... Diablo Immortal Closed Alpha – Early QuestsMay 9, 2021Diablo Immortal / Diablo VideosThis is my first video of the Diablo Immortal Closed Alpha. I decided to play a Crusader that looked like the one featured on the Diablo social media accounts. In this video, my Crusader started out at Level 11. I was mostly learning how to play the game. I play a lot of app games, so that made things easier. My biggest problem was that I kept getting stuck in the scenery, and had not yet worked out how to maneuver effectively in order to not be stuck. This video includes The Festering Woods area and Ashwold Cemetery. It also features some quests that involve Xul and Lethes. It ends with my Crusader standing outside Mad King’s Breach. By then, she was at Level 18. I’m not intending to record every little bit of my game play in the Diablo Immortal Closed Alpha, in order to avoid accidentally exposing people to “spoilers”. If you enjoyed this video, please consider supporting me on Ko-Fi. Thank you! https://media.blubrry.com/bookofjen/p/ins.blubrry.com/bookofjen/Diablo_Immortal_Closed_Alpha_Early_Quests.mp4Podcast: Play in new window | DownloadSubscribe: RSS... World of WarcraftSprite Darter’s WingsNovember 21, 2020World of Warcraft / World of Warcraft otherThe Sprite Darter’s Wings transmog was given for free to players who have a six-month World of Warcraft subscription. That’s how I got it. Players who don’t have a six-month WoW subscription can buy it for $20.00 from the Blizzard Shop. Enchant your friends and beguile your foes with this eight-piece transmogrification set inspired by the fey dragons of Azeroth. This appearance features cosmetic wings and a mesmerizing mask that make you a sprite to behold and will take the breath away from friend, foe, and dragonkin alike. This colorful transmog set was perfect for Meipo, my Gnome Mage. She is based on one of my Dungeons & Dragons characters named Meepo. (WoW wouldn’t let me have that spelling). Meepo is a Kobold Sorcerer who loves bright colors and shiny things. Each piece of the Sprite Darter set can be found in your Appearances tab. Splitting it up means you have to search around each piece in order to do the entire transmogrification. The advantage of splitting up this transmogrification set into pieces means that a player can pick and choose which parts to transmog. For example, maybe you just want to use the wings – but not the rest of the set. If I remember correctly, it cost one gold for each piece I chose to transmog. Here is the entire Sprite Darter transmogrification set on my Gnome. I honestly love it! The colors and goofiness of the set is perfect for Meipo. This is what the back of the Sprite Darter wings look like. The Sprite Darter set transmog doesn’t match the Steamscale Incinerator. The set matches quite well with the Squeakers, The Trickster mount. It makes Miepo look like a tiny fairy dragon who is riding a mouse. Sprite Darter’s Wings is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Steamscale IncineratorOctober 30, 2020World of Warcraft / World of Warcraft Pets and MountsThe Steamscale Incinerator was offered to players who had six-month World of Warcraft subscriptions. To me, it looks like a steampunk dragon. The World of Warcraft Steamscale Incinerator was presented to players who had six-month World of Warcraft subscriptions on July 9, 2020. It would be waiting for me where the rest of my mounts were located – but it wouldn’t wait forever. “Thanks for purchasing a 6-Month Subscription to WoW! Please, enjoy this majestic mount on us. Claim by January 31, 2021. Not usable in WoW Classic.” A mad gnomish inventor had a dream to ride a dragon, so he created this metal monstrosity. He powered it with a trapped demon, in order to create “an authentic dragon soul,” and did not survive its activation. Here’s what this mount looks like when walking on the ground. (Stormwind City Guard for scale). The Steamscale Incinerator looks awesome when flying at night. The underside of the dragon glows a bright red that seems to pulse. There are two large cogs spinning where the wings attach to the body. I took this screenshot on a whim while flying around Stormwind. Just for fun, I took this screenshot of the Steamscale Incinerator in Ironforge while the 2020 Hallow’s Eve event was taking place. Steamscale Incinerator is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... WoW Classic: EcheyakeeJuly 21, 2020World of Warcraft / World of Warcraft ClassicAt the start of today’s adventure, Vaca was at Level 15. She was ready to take her newly acquired Stonewood Hammer and use it on whatever the quest givers wanted her to kill. She was certain Neverlast was equally ready to go. These screenshots were taken on September 25, 2019. Serga Darkthorn: How goes your hunt, Vaca? Have you found the prowlers? Vaca and Neverlast started their day by turning in the Prowlers of the Barrens quest. It took longer than expected because some of the prowlers lacked claws. The Taurens assumed there was some kind of plague affecting the local wildlife. Serga Darkthorn: Whitemist, Echeyakee in the Tauren tongue, is the king of the savannah cats. He hunts with such stealth, they say he’s like a thin, white mist on the earth. And he kills so fast his prey have no time for fear, or pain. The Tauren say he is both mercy and death. You will learn if that’s true, for I now set you on the path to hunt Echeyakee. His lair is northeast of the Crossroads, among the bones of giant Kodo Go. Blow this horn when you reach his lair. Blow the horn, and he will come. The Taruen decided to take this quest. Did Echeyakee exist? Vaca was certain this would be an exciting battle. All Serga Darkthorn wanted from the kill was Echeyakee’s hide and a report on what the fight was like. The hunt for Echeyakee required Vaca and Neverlast to leave The Crossroads. On the way, they found some very obviously plagued antelope. Neverlast used his fancy Druid skills to heal the plagued antelope. It became healthy again, and appeared to be glowing as it ran off. When the Tauren arrived at what they thought might be the right place, they blew the horns that Serga Darkthorn gave them. After waiting a little while, Echeyakee appeared. He was real! Vaca, being a warrior, rushed into battle to fight this beautiful, dangerous, creature. It was the only way to get the hide that Serga Darkthorn wanted. The battle was difficult, and Vaca may not have survived it if it wasn’t for Neverlast’s ability to heal her with Druid magic. The Tauren were victorious. Echeyakee disappeared right after the Tauren collected its hide. All that was left to do was return to The Crossroads and turn in the quest. On the way back, Neverlast stopped to heal more plagued antelope. They always ran away after he healed them. It was as though they felt better and regained the strength required to run across The Barrens. They came across a herd of antelope. A few that looked fully grown were surrounded by smaller young ones. The Tauren took a moment to stand still and take in the beauty of this world. Vaca hit Level 16 while fighting two Ornery Plainstriders. She survived thanks to Neverlast healing her. The Tauren reluctantly decided to begin working on a quest from Darsok Swiftdagger (who was also at The Crossroads). He wanted Vaca and Neverlast to kill some Harpies and collect 6 Harpy Lieutenant Rings. The rings are only held by Witchling Slayer Harpies. Vaca and Neverlast struggled through their previous battle with harpies. And now, they had to fight the ones that were even tougher! There was a dead Tauren off to the side of where the harpies lived. That’s never a good sign! Neverlast and Vaca started fighting Witchwing Slayer Harpies, each very glad they did not have to do this quest alone. Some of the Harpies dropped Harpy Lieutenant rings. But, not all of them did. Darsok Swiftdagger didn’t mention that before sending the Tauren out on this quest. Neverlast used a Druid spell to hit a harpy from a distance. The harpy immediately flew over to them, where Vaca could fight it without ending up in a mob of Harpies. Neverlast called this technique “fishing for harpies”. Eventually, the Tauren ran out of harpies that were within range. Vaca jumped into a mob, and noticed that the harpies she and Neverlast fought before – that seemed tough at the time – were much easier to kill. Vaca had grown stronger. Meanwhile, Neverlast had gotten into some trouble. Vaca had just finished killing harpies, when she noticed the “parade” that Neverlast was leading. Vaca intercepted the harpies and tried to fight them off. It did not go well for the Tauren. After making a “corpse run”, the Tauren moved away from the harpies and took the high ground. They needed a place to safely rest and recover. When they were ready, the Tauren walked back down the hill and began “fishing for harpies” again. They had not yet obtained enough of the rings they were asked to collect. The Druid spell that Neverlast used was super effective at getting the attention of harpies that had isolated themselves. This was so much more efficient than having to fight a mob of harpies! Eventually, the Tauren decided to return to The Crossroads. First, they handed Darsok Swiftdagger the Harpy Lieutenant Rings he wanted. They were rewarded with some silver. Next, they returned to Serga Darkthorn so they could give her Echeyakee’s Hide. Serga was very interested in hearing about how that battle went. Serga Darkthorn: You’ve beaten Echeyakee, and though his days of hunting are over … his spirit is with you. He will show you the strength found in subtlety, and the honor in mercy. Your path is still long, warrior. Let’s hope you stride it well. Serga Darkthorn had another quest for Neverlast and Vaca. Serga Darkthorn: Now, Vaca, the hunt deepens. Now you must defeat your prey, and then find your way to its lair. Hunt the sunscale raptors to the south. Slay them and remove the feathers they wear. Place the feathers on the scytheclaw nests southwest of the Stagnant Oasis. Show their brethren you do not fear them! By now, after a long day of fighting, Vaca and Neverlast were tired. They decided to spend the night in The Crossroads. The sunscale raptors would still be out there tomorrow. WoW Classic: Echeyakee is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... WoW Classic: HarpiesApril 29, 2020World of Warcraft / World of Warcraft ClassicNeverlast and Vaca had traveled together, fighting a wide variety of creatures and turning in quests. They had no idea how difficult it would be to fight a flock of skinny bird people. These screenshots were taken on September 22, 2019. Today started with Vaca and Neverlast fighting a Lost Barrens Kodo. Vaca, being a Warrior, jumped right in and started swinging. Neverlast, a Druid, healed his impulsive friend. The Tauren would soon learn that fighting Kodos was much easier than fighting Harpies. They needed to collect a few more Prowler claws in order to complete a quest. Strangely, it turned out that many of the Prowlers lacked claws. Vaca and Neverlast assumed that the Prowlers were suffering from the same plague that caused the Zhevra’s to lack hooves. Fortunately, this particular Prowler had some claws. The Tauren would be able to turn in this quest when next they visited The Crossroads. Overall, the day was going pretty well, until they encountered Harpies. The Tauren were asked to collect 8 Witchwing Talons. Little did they know that these winged, annoying, creature would be so difficult to kill. “A fine trophy your head will make, Tauren,” the Harpy threatened. Vaca won this battle, thanks to Neverlast’s help and healing. But, it was a much tougher battle than Vaca was expecting against skinny bird people. “My talons will shred your puny body, Tauren,” the next Harpy yelled. Vaca knew she was much stronger and heavier than this little bird person. She wondered what the Harpies thought the word “puny” meant. Neverlast used a spell and trapped the Harpy in place. It was a good idea. This particular Harpy was tougher than the other ones, and both of The Tauren were getting really tired. Eventually, the last Harpy was down. Neverlast and Vaca finally had gathered up the necessary amounts of Witchwing Talons, and could turn them in to Darsock Swiftdagger at The Crossroads. It was time for a moment of celebration! The next thing to do was to hoof it back to The Crossroads. There was time to enjoy the scenery along the way. Vaca wondered what these big skeletons were. She kept finding them scattered across the land. Maybe they were kodos? On their way through The Forgotten Pools, another Lost Barrens Kodo picked a fight with Vaca. There was no choice but to fight back. You can’t talk a Kodo out of a course of action once they have chosen it. When the battle was over, Neverlast was able to pick up some Thin Kodo Leather. Apparently “thin” is a relative term in this case. Back at The Crossroads, The Tauren climbed a tower and spoke with Darsok Swiftdagger. He was the one who gave them the quest to fight Harpies. It would be great to turn that in and forget all about the horrible bird people. Darsok Swiftdagger: Cut up enough of them yet? Keep slicing and taking trophies. I want 8 Witchwing talons. Neverlast and Vaca happily handed over the Witchwing Talons they collected. They each received some silver coins in return. Harpies are tough to fight, but the pay was worth it. Before The Tauren could start their way back down the tower, Darsok Swiftdagger had something else to say to them. Darsok Swiftdagger: Hahaha. Vaca, Back for more? Good, I like to hear that. This time I want you to assassinate some of the harpy lieutenants in the Dry Hills. Only Witchwing Slayers can be lieutenants, and you can tell them apart by the rings they carry. They are a nasty bunch, but they lead some of the underlings in that area. Taking out 6 of them will be a decisive strike against their matriarchy. Make sure they die painfully, Vaca. We want those harpy wenches to know the idiocy of picking fights with the Horde. Vaca wondered why this tough-talking Orc didn’t go out and fight the harpies himself. But then, she thought about the words Darsok was using. He clearly was afraid of the Harpies, whom he hated in part because they were female. Darsok wanted their matriarchy destroyed. Vaca guessed he saw it as a threat to the Orc’s patriarchal system. It took Vaca a moment to realize that Darsok thought she was a small, male Tauren. The first batch of Harpies were exhausting, and this new group was going to be even tougher. Vaca and Neverlast turned to each other, shrugged, and accepted the quest. Neither were looking forward to it. They decided to rest up before taking on more awful Harpies. Hopefully, the money would be worth the effort. #Blapril2020 WoW Classic: Harpies is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Ko-fi. Thank you!... Meipo the Mage – To Level 60!April 25, 2020Adventures of Meipo / World of WarcraftMeipo is the WoW version of one of my Dungeons & Dragon characters. I leveled her up to Level 50 in November of 2019, and eventually got her to Level 60 on February 17, 2020. My plan was to put together a blog about it shortly after that, but I wasn’t able to get around to it until now. Meipo hit Level 50 in Andorhal, so her adventure continues from there. She got in a fight with Darkmaster Gandling, and got pushed up into the air. Meipo was saved by Thassarian and Koltra Deathweaver. After that battle ended, Meipo was able to turn in the Scholomancer quest. Thassarian: Excellently done, Meipo. And now, with the leader of the Scourge forces eliminated from Andorhal, we bide our time. Gandling’s Gloves are a transmog item. Next, Meipo traveled to Chillwind Camp, to talk to Commander Ashlam Valorfist. An Achievement popped up when she arrived: The First Battle for Andorhal Commander Ashlam Valorfist: These farmers from the south wish to take these farms, but I can’t let them enter the plaguelands unprepared. Even with the Scourge gone, danger still looms in the form of the Forsaken. No, we must be ready to fight… and that includes our new visitors. Before doing anything else, however, I would recommend that you travel to Uther’s Tomb, to the east, and place this tribute before his statue to ask for his blessing. Speak with the priest that tends to the tomb when you are finished. She intended to do exactly that…. but got distracted by food instead. Now We’re Cookin’: Cook up one of every Pilgrim’s Bounty dish. Candied Sweet Potato, Cranberry Chutney, Pumpkin Pie, Slow-Roasted Turkey, Spice Bread Stuffing Pilgrim’s Progress: Complete each of the Pilgrim’s Bounty dailies. Can’t Get Enough Turkey, Don’t Forget The Stuffing, Easy As Pie, She Says Potato, We’re Out of Cranberry Chutney Again? Meipo put on all the Pilgrim’s clothing, and used this magic gun to turn some Rogues into turkeys. Short Order Cook: Learn 50 cooking recipes. Issac Allerton gave Meipo a Turkey Caller. It makes a noise like a turkey! It didn’t take long for Meipo to portal back to Stormwind, use the Turkey Caller, and catch all the turkeys she needed. She learned that some of her fire spells would not only stop a turkey from running, but also prepared it for cooking. Meipo also learned that the teleportation spell was extremely useful for getting things done during holiday festivals. Expert Cook: Obtain 225 skill points in the “Classic” category of cooking. Meipo learned the Candied Sweet Potato recipe. Meipo found herself surrounded by turkeys outside Ironforge. Meipo learned the Slow-Roasted Turkey recipe. Meipo hit Level 51 after turning in a cooking quest to Robby Flay. Getting back on track, Meipo flew past Aerie Peak. She noticed, for the first time, that there was a giant stone Gryphon standing on top of it. Meipo arrived at Uther’s Tomb and was greeted by High Priest Thel’danis. Uther the Lightbringer Here lies Uther the Lightbringer First Paladin – Founder of the Order of the Silver Hand Uther lived and died to defend the kingdom of Lordaeron. Though he was betrayed by his most beloved student, we believe that his spirit lives on. He continues to watch over us, even as the shadows close in around our ruined land. His light is the light of all humanity – and so long as we honor his example, it shall never fade. Anonymous Meipo received Uther’s Blessing. High Priest Thel’danis: You and the humans at Chillwind Camp wish to re-take Andorhal? I wish you luck. High Priest Thel’danis: If you truly intend to move forward in this battle for Andorhal… well, perhaps I can help. To the east lies a large crypt. The bottom level of the crypt was once used for storage of weapons and armor…until the Scourge came. Now that the undead have left, the weapons are free for the taking. Most of the weapons are probably rusted and rotten by now, but they will serve better than tunics and pitchforks. Meipo set out to find the Weapons Crate at the bottom of the Crypt in Western Plaguelands. She got temporarily distracted by this sculpture of Uther’s Hammer. Meipo found the Abandoned Crypt and a broken box of weapons. The Abandoned Crypt: Scattered all over the bottom level of the crypt, you find shattered crates that once held weapons and armor. It appears that somebody got here before you did. Meipo got ambushed by skeletons! She fought them with fire. After killing off the skeletons inside the Abandoned Crypt, Meipo gathered up the weapons she could find. Outside, there were more skeletons to fight. The Cryptkeeper’s Belt is a transmog item. Meipo took her collection of weapons, such as they were, to Thurman Grant. She remembered that he was leading a group of farmers who wanted to take back some farmland. But, he didn’t need the weapons. Thurman Grant: I told Commander Valorfist that we could hold our own, and we intend to. I had a little conversation with the death knight general, Thassarian, on my way over here. We farmers plan to help in our own way. We will take control of this farm, begin to cultivate the land… and then when the battle for Andorhal commences, we will attack the Forsaken from the rear. They’ll never expect it. First, we need to get rid of these Forsaken outsiders. Kill some. Then return to me. Meipo found that killing Forsaken with fire was pretty easy – especially if you had a group of farmers helping. The farmers worked surprisingly well as a team. Thurman Grant: In fact, you might still be able to help train some of my men. You probably noticed the abomination outside. We initially tried to fight him, but he didn’t fight back. He seems to want to help out on the farm. Take a group of four settlers and challenge this abomination to combat. He seems to be pretty tough, but with one of him and five of you, I think you’ll have a chance at beating him. Meipo gathered up four settlers and led them to the abomination. There was another group ahead of them, trying to fight the abomination. His name was Gory, and he wasn’t fighting back. Meipo decided to talk to Gory, and learned that he really does want to help out on the farm. He also enjoys standing in the warm sun. Meipo made a friend! She convinced the farmers to stop fighting Gory. Thurman Grant: We can handle things from here. I thank you for your help, Meipo. I assume that when we next meet, it will be in battle. Take care of yourself until then. We’ll get all the help we can get. Meipo earned the A Temporary Peace Achievement. Thurman Grant gave Training Leggings to Meipo. It is a transmog item. Meipo went to the Menders Stead and met Field Agent Kaartish. Field Agent Kaartish: Welcome, mage. As you can see, our camp is a joint expedition between Argent Crusade members and the Cenarion Circle druids, but we welcome all who wish to help heal the land. Miepo met Durnt Brightfalcon. She waved hello, but he didn’t wave back. Durnt Brightfalcon: Word is in from Andorhal, Meipo. The battle has resumed. It has become somewhat well-known among the Alliance forces that you’re a hero of the first battle of Andorhal. Thassarian has requested your presence immediately. Meipo was asked to report to Thassarian at Andorhal in Western Plaguelands. She started going there, but as usual, got a bit distracted on the way. She picked up a Plague Lurker Sample for…. someone. She forgot who. Meipo hit Level 52 while mining for shiny things. Meipo gave all the plague samples she found to Field Agent Kaartish. He was very happy to have them. Field Agent Kaartish: I will need some time to study these samples, Meipo. I will speak to you again when I have completed my analysis. Field Agent Kaartish: We are not the only Argent Crusaders here in the plaguelands. Our headquarters, Hearthglen, lies to the north. Even nearer to the north is a small lumber mill which we also control. Nathaniel Dumah is my main contact at the lumber mill. I encourage you to speak with him, should you find yourself in that part of the woods. Meipo intended to go to the Northridge Lumber Camp. But first… she decided to make more Spiced Bread Stuffing for Caitrin Ironkettle. In doing so, Meipo earned the 50 Daily Quests CompletedAchievement. Meipo made a friend! A Dun Morogh Chicken came up to sit by her campfire while Meipo was cooking. Got My Mind On My Money: Loot 100 Gold. Meipo watched a Dwarf fight a bunch of Goblin Brawlers at Booty Bay. Meipo stopped by the Ruins of Lordaeron to eat some Sweet Potatoes. The Forsaken didn’t seem to mind sharing with her. When Meipo finally made it to the Northridge Lumber Camp, she saw huge spiders everywhere! She decided to use teleport to “nope” on out of there. Meipo hit Level 53 while trying to reach the Pie Chair at Stillwater Pond. These elves were not as friendly as the Forsaken were! Meipo is wearing some combination of the holiday apparel. She also has on a Stormwind Tabard, gloves, and shoulders that are not part of the outfit. The Fine Pilgrim’s Hat is a transmog item. Meipo got lost and ended up in Thousand Needles, where she fought Needlespine Cobras. Meipo ended up in New Thalanaar fighting in a battle that she didn’t understand. These elves wanted help – so she threw fire at their enemies. Meipo fought Snarler in the Lower Wilds. She wasn’t intending to, but he jumped out and snarled at her. Snarler dropped a belt called Captain’s Waistguard of the Quickblade. It was not something Meipo could use. Archaeology involves digging – and that sounded like fun to Meipo. She went to the Ruins of Eldre’thar to see what she could find. Unfortunately, there were angry ghost elves there who tried to attack her. Meipo deployed an ice shield to protect herself. Eventually, she learned how to stay a safe distance away from them, and was able to dig up some interesting artifacts. Meipo learned that the Undead Ravagers in Desolace didn’t like fire! Professional Journeyman: Obtain 150 skill points in a “Classic” category of a profession. Meipo went to Shok’Thokar and fought some Doomguard Invaders. A fishing quest sent Meipo to go find Baby Octopus. They are as big as her! Meipo met Officer Jankie in Tehtris Aran. She stopped Meipo and directed her to Nijel’s Point. It wasn’t a choice. Officer Jankie: Halt! On behalf of the Nijel’s Point Guard, I am under orders to send all able-bodied allies to report directly to Corporal Melkins. I am not authorized to offer any other information. What I can offer is transportation. You are free to use my mount. It will deliver you directly. Dismissed. Shortly after arriving at Nijel’s Point, Meipo met Corporal Melkins. Corporal Melkins: Pentigast! Bring the new gnome up to speed, would you? Captain Pentigast: Yes, yes. Welcome to Desolace, gnome. Sorry we had to be so insistent, but we’re a small outpost, and there are big problems in this region – most of them quite urgent. Bottom line: We need all the help we can muster. To start with, our friend Vahlarriel over there has been getting pretty antsy, insisting that we send a contingent to visit the ruins in the east. Why don’t you go introduce yourself… Vahlarriel Demonslayer was nice to Meipo. “A pleasure to meet you, mage,” he said. Vahlarriel Demonslayer: Simply intolerable! Satyrs of all things, desecrating our sacred lands… Their days are numbered, gnome. I can assure you of that. As soon as we have the numbers, I shall lead a charge that will rid this land of the wicked creatures. For now, though, perhaps you could put my mind at ease? Travel just east of here to Sargeron and scour the ruins. Find the relics of Elune and ensure that they are in good condition. I’ll pay you well for the favor. Meipo hit Level 55 outside of Nijel’s Point. Meipo earned the Thistlefur Cap from finishing a quest. She tried it on, but couldn’t decide if it was better than what she was using before. So, she switched back and forth between them for a while. The Thistlefur Cap is a transmog item. The quests that Meipo was sent to do in Sargeron are a bit strange. First, she visited the Cup of Elune, which wants her to bring it 8 melons. The quest is called: “Nothing a Couple of Melons Won’t Fix.” The markings on the ruins here make one thing clear: There is something special about the old fountain in the Sanctuary of Elune. It would seem that one could expect special power from washing their face in the fountain. First, of course, there would need to be something in the ancient fountain with which to wash. Pondering this problem, you spot a melonfruit at the base of a nearby tree… After filling it with liquid from the melons, you proceed to wash your eyes from the ancient font. Upon opening your eyes, you are able to see the spirits of ancient elves, still faithfully carrying out rituals to their goddess. Spirits of ancient elves appeared. Three were close by the Cup of Elune, and more were wandering around the Sanctuary of Elune. There were spirits of ancient elves around Elune’s Brazier, too. What did the Brazier of Elune want Meipo to get for it? Ten pounds of flesh. Yes, really. According to ancient legend, this ancient brazier was placed her for the performing of sacrifices. From what little you remember of the history, a blessing is bestowed upon the being who places the flesh of Elune’s enemies on the brazier’s burning embers. Looking around, you determine that the satyrs who now possess this reagion would likely qualify. Meipo had no trouble finding Saytrs to fight. Gathering up a total of 10 pounds of Satyr Flesh was kind of icky. One of the Satyr’s dropped Hawkeye’s Cloak. It is a transmog item. Eventually, Meipo was able to gather up the Ten Pound of Flesh that Elune’s Brazier wanted. The divine brazier graciously endows you with a blessing. You feel a deep connection to the distant past having partaken of the ancient blessing granted by this relic. You determine to make as much as you can of this divine gift. Meipo found a statue of Elune’s Handmaiden. She had a quest called: To the Hilt! The handmaiden of Elune! It’s even more glorious than the stories tell. The legends surrounding this relic come to your mind as you draw near it. In ancient time, after battle, the enemies’ weapons were to be cast upon the basin in exchange for a divine gift of some sort. As you ponder this ritual, the glint of steel catches your eye from a nearby weapon rack… After collecting 20 Saytr Sabers from the weapon racks and various Satyrs in the region, Meipo brought them to the statue of Elune’s Handmaiden. With the ritual completed, you are awarded a divine gift. You can’t help but to feel a great sense of honor as you receive one of Elune’s boons. Sandals of Ritual are a transmog item. Meipo received Gloves of Nurture from Vahlarriel Demonslayer. The gloves are a transmog item. Meipo hit Level 56 at Firestone Point. Meipo earned the Pilgrim’s Peril Achievement at Thunder Bluff, will sitting in the Turkey Chair. Pilgrim’s Peril: While wearing either a Pilgrim’s Dress, Robe, or Attire, take a seat at each enemy capital’s Bountiful Table. Orgrimmar, Silvermoon City, Thunder Bluff, Undercity Meipo earned Pilgrim’s Paunch in Exodar while sitting in the Turkey Chair. Pilgrim’s Paunch: Acquire the Spirit of Sharing from a complete Bountiful Table feast at every Alliance capital. Darnassus, The Exodar, Ironforge, Stormwind Meipo earned the “FOOD FIGHT” Achievement outside of Stormwind. “FOOD FIGHT”: Bounce food off a fellow feaster’s head at a Bountiful Table. Meipo earned the Turkey Lurkey Achievement outside of Orgrimmar. There is a st
