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Podcasts

- Little Black Dress – Episode 050
  July 12, 2019Podcasts / Words of JenIn this episode, I read a piece of my writing that was inspired by something that was going around on Twitter. People were asked to share their worst first dates. Here’s mine! I read “Little Black Dress” on episode 050 of Words of Jen. If you enjoyed this episode please consider supporting me on PayPal.me. Thank you! https://media.blubrry.com/bookofjen/p/content.blubrry.com/bookofjen/woj050.mp3Podcast: Play in new window | DownloadSubscribe: Android | RSS...
- Little Black Dress
  July 12, 2019Podcasts / Words of JenMy inspiration to write this piece came from a writing prompt that was going around Twitter. People were asked to describe their worst first date. Here’s my story about that. I read “Little Black Dress” on Episode 050 of Words of Jen. I had absolutely no intention of going to my Senior Prom. My reasons for holding this unpopular opinion were valid (at least, to me). I wasn’t dating anyone at the time, and the financial cost of going to prom was way out of my reach. Most of the Senior boys, who I’d gone to school with since kindergarten, pretty much considered me to be “one of the guys.” I was entirely comfortable with that. It meant they weren’t going to hit on me, not even when I went drinking with them. They remembered me getting into fights with boys who harassed me in elementary school. There was a day where I beat up the school bully (who they were all afraid of). That year in high school, I nearly broke a boy’s fingers after he decided to shove his hand up my skirt. He ended up wearing a finger splint. It is the kind of story that high school gossip mongers love to spread around. The Senior boys were asking girls who were Sophomores to prom. One of them sought my permission for him to ask my younger sister to be his prom date. He was one of very few boys that was genuinely nice, so permission was granted. “Tell her I approve,” I told him. My sister did not go to prom with this boy. A close friend of mine, Beth (which is not her real name), felt bad for me because I wasn’t going to prom. She decided to set me up with a friend who did not go to his Senior prom last year – and regretted not going. Victor (not his real name) was someone I’d met before. The three of us were in a school theater group together. He and I barely knew each other. Beth told me that Victor had joined the National Guard after he graduated. We weren’t sure if he had been deployed oversees as part of Operation Desert Storm, which started in January of that year. It was the first time that the National Guard had been sent oversees that I knew of. Already, I felt very unprepared for this date. Victor was in the military – he was an actual adult. And here I was, an emotional wreck who had not yet begun to unpack all the baggage I was carrying due to trauma. There was a good chance I wouldn’t graduate high school – based on my very low attendance rate. I didn’t have a clue what I wanted to do with my life. I didn’t say any of this to Beth, though. Instead, I attempted to slightly change the subject – and maybe talk my way out of this impending date. “Wait, I thought Victor had gotten engaged to Melody?,” I said. (Melody is not her real name). “He did… but, they broke up. He’s single now,” Beth said, nodding her head emphatically. She explained that the two of them both joined the National Guard, and then broke up. “Victor told me he likes you. He just wants to take you to the mall,” Beth explained. I started breathing a little easier. The mall was always super busy. We would be surrounded by people and have no opportunity to be alone together. It was a place I knew well and felt somewhat comfortable in. After taking a moment to convince myself I could do this, I agreed to go out with Victor. Doing so would, at the very least, make Beth stop asking me to go out with him. On the evening of the date, Victor drove to my house to pick me up. I remember flying out the door and jumping into his car as fast as I could move. “I’m going to the mall,” I yelled over my shoulder at my parents. My father was racist, and so was my grandmother (who lived with us). They absolutely hated when I dated boys who weren’t white. Victor was Asian, maybe Vietnamese, I wasn’t sure. My goal was to avoid subjecting Victor to my mean-spirited family members. We made small talk as he drove to the mall. The weather was nice, and the parking lot was packed. I started to relax. Maybe this date would be fun after all. Victor and I walked around the mall, stopping in music stores to browse cassettes and CDs. There was a pet store in one wing of the mall, and a toy store somewhere else. Eventually, we went to the food court. It wasn’t overly crowded, and there were some empty tables to sit at. I remember that Victor insisted on paying for the food, but can’t recall what food he selected, because I didn’t eat. The reason was simple. I had been diagnosed with multiple food allergies, but not given clear enough information about what was safe for me to eat. The best way to avoid getting sick was to not eat anything. Victor bought me a Pepsi, the beverage I got the majority of my sustenance from back then. We talked some more while he ate and I picked at a few fries. Beth was right, Victor was nice. He was also funny. I could see us being friends, but wasn’t feeling like this date was going to turn into a boyfriend-girlfriend kind of thing. After eating, we wandered around the mall some more. “Let’s go in here,” Victor said. He pointed at a clothing store that was more expensive than I could afford. I hesitated, and gave him a questionable look. He smiled at me, and I figured that this big store was just another place to walk around in. Eventually, we ended up in the women’s section, where Victor pointed at a dress. “What do you think of this one?” he asked. I took a look at the price tag and winced. “It is too expensive.” This went on for a while as he kept suggesting other dresses. They were fancy dresses that one might wear to prom. Dresses that he asked me to try on, just to see if they fit. Strapless dresses that was I not wearing the right kind of bra for. Spaghetti strap dresses that were long, and made for women much taller than I was. I was getting more and more uncomfortable. Eventually, Victor suggested a little black dress. It had short sleeves, and a round edged collar that fit sort of like a t-shirt would. He held the dress up to me, and I could see that the skirt would go down almost to my knees. The entire dress was covered in a delicate black lace. “I don’t have the money for this,” I explained. “That’s ok. Just try it on and see if it fits. It doesn’t cost anything to try it on,” he responded. Seeing no other option, I took the dress into the changing room and tried it on. At the very least, doing so would stop the dress suggestions routine that I desperately wanted to end. The little black dress fit like it was made for me. I wasn’t sure what to do next, and hesitated before coming out of the changing room in the dress. Something felt very weird and wrong. Victor smiled when he saw me. He walked over and put his hands on my shoulders. “You look beautiful,” he said. I had very low self-esteem, and wasn’t at all used to receiving compliments. Anxiety surged through me. “…Thanks…” I said. Did I look as terrified as I felt? We stood there a moment, staring at each other. My heart was pounding, and I didn’t know what to do. “I want to buy you this dress,” Victor said. I took a look at the price tag, and shook my head. “Really, I want to,” he insisted. “You look so pretty in it.” It was then that I realized that the little black dress wasn’t the only thing that Victor wanted to buy tonight. Back to the changing room I went. Getting back into my regular clothes provided some comfort. I took some time to slow my breathing, to calm down, and to put a smile back on my face. Victor seemed nice – but I barely knew him. Some guys get mean when they feel rejected. There weren’t any other people in this store at the moment. Carrying the dress, I exited the changing room. Victor took the dress from me. “Just think about letting me buy it for you,” he said. I nodded. The dress went back on a rack, and we exited the store. I started trying to walk us back to more populated areas of the mall, as we made small talk. He was still very polite, and I started to feel less afraid. “VICTOR!!” a woman yelled across the mall. We stopped, and I turned around to see a woman rushing towards us. It was Melody, the woman Victor was reportedly not engaged to anymore. Melody glared at him, then at me, and then started yelling at Victor. Her friend, a girl I didn’t recognize, caught up and also started yelling. They all got very loud, and yelled over each other, and I did not need this. I slipped away and found a bench out of range of whatever was going to happen with them. No one noticed. Victor was my ride home, so I was stuck here until the screaming stopped. It ended when Melody’s friend started dragging her away, as Melody walked backwards and continued yelling insults at Victor. He stood there, looking drained and sad. I felt bad for him. The mall was starting to clear out, as it was near closing time. Victor looked around and eventually saw me on the bench. He came over to me, sat down, and was quiet. “We should go,” Victor said. I agreed. He didn’t explain what the very loud argument was about, and I didn’t want to ask. Clearly, whatever was happening between him and Melody wasn’t quite over yet. Victor found some nice music to listen to as he drove me home. We didn’t talk. What was there to say? It dawned on me that Victor never so much as mentioned prom before suggesting dresses. Tonight was exhausting, and confusing. He stopped the car in front of my house. When I turned to say goodbye, Victor leaned over and kissed me. I froze. The kiss was so unexpected that I simply didn’t know how to react to it. To his credit, Victor realized I wasn’t responding to his kiss. He moved away from me. “I guess you’re not that experienced….” he quietly said. “….Yeah…” I said, very softly. This was a lie. I frequently made out with the boys I was dating in the hallways at high school. Things never went beyond that, but I was far from being inexperienced at kissing. It seemed kinder to lie, though. We sort of said goodbye, and I think he mentioned seeing me again, but I was super unfocused by then. I got out of the car, and the worst first date I’d ever been on finally came to an end. Little Black Dress 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 PayPal.me. Thank you!...

Diablo III

- Season 17 (Season of Nightmares) Set Dungeon
  August 3, 2019Diablo III / Diablo SeasonsI am playing a Hardcore Barbarian in Season 17. For the most part, I am having fun. The one thing holding me back from making progress was the Season Journey requirement to complete a Set Dungeon. This proved to be a very difficult task for me. In this blog post, I share the strategy I used when I realized I was unable to complete the Set Dungeon that corresponded with Season 17’s “freebie set”. The “freebie set” for Barbarians in Season 17 was the Might of the Earth set. It was a set that I hadn’t used before because I’d never managed to collect up all the pieces. All I had to do to obtain this set was complete Chapters I – IV of the Season Journey. I’m moving slower than most people in the game because I’m playing Hardcore. One must make good choices if they want to avoid getting their main character killed. When I was able to equip the full set, I was pretty happy. It felt like I was making progress. After messing around with Skills for a while, and gathering up a few more Paragon Points, I felt like I understood how to use this set. The next thing to do was to locate the Might of the Earth Set Dungeon. In previous Seasons, my character was strongest when wearing a full set. It made sense to wear it to Leoric’s Mansion to find the clue about where the Set Dungeon was at. Season 17, however, had a unique buff that changed that. This Season, my character was strongest when she was wearing a lot of Ancient items. My strategy was to put the Might of the Earth Set into my Stash, put on a bunch of Ancient items, and fight my way to the clue while wearing those. If my Barbarian died on the way, she would lose all the Ancients she had been wearing. The new Barbarian I would have to make would have much fewer Ancients to work with, and that would slow down my progress. But, the new Barbarian would still have the Might of the Earth set in the Stash. I figured it would be easier to find more Ancients than to try and track down a second Might of the Earth set. The clue for the Might of the Earth Set Dungeon pointed me to Belial. I fought my way, through all the snake people to where I guessed this Set Dungeon would be located. Once there, I teleported back to town, swapped out my Ancients for the Might of the Earth set, and teleported back. After losing track of how many attempts I made to complete this Set Dungeon, I gave up. Maybe this one isn’t hard for other people. For me, it was very frustrating. All it takes is one mistake to complete fail the entire Set Dungeon. I learned how to hit and freeze the enemies I encountered, and the dungeon seemed rather forgiving about how many seconds passed by without out me killing and freezing one. (The timer appeared to reset whenever I froze and killed the next monster.) The problem was the gold monsters. I knew I had to hit three specific skills (Leap, Ground Stomp, and Earthquake) within just a few seconds, while standing very near the gold monsters. I could not get the timing right. The Slayer part of the Season Journey requires a player to complete a Set Dungeon. It doesn’t actually matter which one the player finishes. Unfortunately, I only had a few pieces of some (but not all) of the other Barbarian sets. My solution to this problem was to use Season Rebirth to get my Hardcore Demon Hunter into Season 17. The game required me to play through what I think of as “Story Mode”. I really didn’t mind because it gave me a way to start leveling up my Demon Hunter. I finished “Story Mode” somewhere around level 55 or so. Adventure Mode was now unlocked, and I did small things in it while leveling my Hardcore Demon Hunter to 70. This is when I realized a problem. My Demon Hunter didn’t have a set. He didn’t even have one piece of any Demon Hunter set. Back to the Barbarian! I had her run a lot of Bounties in the hopes that the Bounty Caches would include a set piece or two. Between that and a few Nephalem and Greater Rifts, I was starting to gather pieces from other Barbarian sets. Some of those pieces were duplicates, so I put them into Kanai’s Cube in the hopes that I could turn the extras into set pieces that I didn’t have yet. It’s kind of hit or miss. Eventually, I was successful. Upper Class: Complete two of the following Class Sets at level 70. I now had the Might of the Earth set and the Wrath of the Wastes set. Athena the Hardcore Barbarian was ready to find the Wrath of the Wastes Dungeon. My hope was that the corresponding Set Dungeon would be easier than the one I’d been trying (and failing) to complete. I followed the same strategy as before: put this set into the Stash, equipped my Ancient items, and went back to Leoric’s Mansion for the clue. After clearing away the enemies, I teleported back to town, and swapped the Ancients for the set gear. The Wrath of the Wastes Set Dungeon is located in the first level of the Pandemonium Fortress. The requirements for the Wrath of the Wastes Dungeon didn’t sound too difficult. But, I found myself struggling with it anyway. I kept running out of Wrath, and wasn’t very good at guessing how how many monsters were in a mob before I used Rend on them. I also kept running out of Fury. Rather than give up, I made a series of changes, hoping to find a combination that would give me the improvements I needed to complete this Set Dungeon. I had been using the Arcstone ring on both my Barbarian and the Templar. The rings cause a lightning pulse to shoot between all those who wear one of this type of ring. It might have been making it more difficult for me to Rend 10 different monsters at one time. So, I swapped those out for other rings (which probably weren’t as powerful). Using “trial and error”, I replaced skills and runes, hoping for the best. After many tries, I was starting to get a little better at this Set Dungeon. Not good enough to complete it, though. By this point, I had collected some pieces of each of the other two remaining Barbarian sets. I repeated the process of doing Bounties for the Bounty Cashes, running Greater Rifts in the hopes the right set gear would drop, and putting duplicate pieces into Kanai’s Cube. The Raekor’s set was the third Barbarian set I was able to collect in Season 17. The helm was an Ancient, which doesn’t give me any extra boost during Season 17 (because I am using it with set pieces and it is one of those pieces). That said, it will be useful after Season 17 ends. Once again, I removed the Raekor’s set pieces, put on a bunch of Ancients, and set out to find the clue about the location of the Raekor’s Set Dungeon. Next, I cleared out the enemies near the area the dungeon was located in, teleported back to town, put the Raekor’s set back on, and teleported back to it. The Raekor’s Set Dungeon is located in the Overgrown Ruins. Look for a square area that has two pillars on one side of it. The easiest way to reach it is by leaving the Act V town. It took some effort, but I was able to complete the Raekor’s Set Dungeon. This one was the easiest of the Set Dungeons that I tried in Season 17. If you are playing a Barbarian, and struggling with Set Dungeons, I recommend giving the Raekor’s one a try. I was overjoyed to have finally completed a Set Dungeon because it was the last thing I needed to do in order to complete the Slayer part of the Season Journey in Season 17. I’ve got some of the objectives for upcoming parts of the Season Journey done, but felt like the Set Dungeon was holding me back. There is more to do. The Champion part of the Season Journey requires players to Master a Set Dungeon. With a little more practice, I think I will be able to do that with the Raekor’s Set Dungeon. #Blaugust2019 Season 17 (Season of Nightmares) Set Dungeon 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 PayPal.me. Thank you!...
- Season 17 (Season of Nightmares) – Slayer
  July 21, 2019Diablo III / Diablo SeasonsSlayer was a bit difficult for me, especially since I was playing a Hardcore Barbarian. I had to be really careful about the choices I made, or she would be dead and I’d have to level up a new character. I had only completed two Slayer objectives by the time I started working on it. The Set Dungeon was frustratingly difficult. So, I skipped it and started working on objectives from upcoming parts of the Season Journey. UPDATE: I was eventually, after many attempts, able to complete the Raekor’s Set Dungeon. This was the last thing I needed to do to finish the Slayer part of the Season Journey. I completed two of the Slayer objectives already: No, You Can’t Have It Back: Obtain a Legendary item by spending Blood Shards with Kadala. Third Power Cubed: Equip Kanai’s Cube with armor, weapon and a ring of Legendary power. The Realm of Regret: Slay The King of the Dead and The Merciless Witch at level 70 on Torment I difficulty or higher. The Infernal Machine for the Realm of Regret drops from Odeg the Keywarden of Regret in the Fields of Misery. The Realm of Putridness: Slay The Vile Executioner and The Foul Desecrator at level 70 on Torment I difficulty or higher. The Internal Machine for the Realm of Putridness drops from Sokahr the Keywarden in the Dahlgur Oasis. I had all of the pieces of the Might of the Earth Set. It was time to go find the Set Dungeon. I had heard that this one is tough to complete, and wasn’t really looking forward to it. Season 17 had a special buff that gave players extra power for every Ancient they equipped. The result was a significant difference between what I could do with the Might of the Earth Set and what I could do with Ancients. The Ancients were way more powerful! So, I wore all the Ancients I had obtained so far and fought my way through Leoric’s Mansion to find the clue for the Might of the Earth Set. Tome of Set Dungeons, Page 14: … as that proved inaccessible, I was forced place it outside the court of the lying emperor. – Brother Althun. The “lying emperor” is Belial (Lord of Lies) in disguise. This clue was pointing me towards the area just outside the room where players fight Belial. To get there, I kept my Barbarian equipped in all the Ancient items I had, plus lesser items to fill out the rest. It wasn’t super difficult to fight my way through the “snake people” and get to the location I was aiming for. The problem was that I was carrying the Might of the Earth Set in my bag. This was not a smart idea. If my Barbarian died on the way to the Set Dungeon, I would have lost the entire Set and all my Ancient items. I recommend that Hardcore players fight their way to the Set Dungeon in as many Ancients as they have (during Season 17), and then portal back to town. Swap the Ancients for the Set pieces, and take the portal back. Of course, this strategy is only viable during Season 17, because of the buff. I tried the Might of the Earth Set Dungeon several times, but failed. This Set Dungeon is frustrating because all it takes is one mistake, seconds after the player enters it, to result in a fail. Eventually, I gave up in the hopes that I’d find some other Set Pieces and be able to do a different Set Dungeon. It doesn’t matter which one I do – they all count the same. After completely failing this Set Dungeon, several times, I decided to try something else. My goal was to do some Bounties in the hopes that I would get some different Set Pieces in the Bounty Cache. If not, then the completed Bounties would at least get me some materials so I could put more Legendaries into Kanai’s Cube. My Stash was filling up quickly and I didn’t want to drag all of that out of Season and struggle to find somewhere to put it! One of the Bounties was to kill Belial. The result was a plethora of “career” (or, non-seasonal) Achievements that I had not yet earned on hardcore. Good Eye: Kill Belial at level 70 without dying and without getting hit by his projectile or meteor attacks on Torment II difficulty or higher. The Snake Pit: Kill Belial at max level without crowd controlling enemies on Torment difficulty or higher in Hardcore mode. Out of the Shadows: Complete the Belial challenge achievements listed below. Master of Deceit: Kill the Belial at max level in under 2 minutes on Torment difficulty or higher in Hardcore mode. Lord of Losing: Kill Belial at level 70 on Torment II difficulty or higher. Conversion Incursion: Convert a set item with Kanai’s Cube. I got an Ancient Hexing Pants of Mr. Yan. The flavor text on this item says: These pants were part of an elaborate outfit worn by the infamous (and surprisingly stylish) enchanter Mr. Yan while adventuring in Westmarch. Lacking patience, and impulse control, Mr. Yan was always rushing headlong into danger- not a recipe for survival for a spell caster. Being a clever man, though, Mr. Yan designed this garment to turn his weakness into a strength. I started working on Greater Rifts in the hopes that I would be able to level up some Legendary gems. Alone Tonight: Reach Greater Rift level 15 Solo without any Set items equipped. 20/20 Vision: Reach Greater Rift Level 20 Solo without any Set items equipped. This Ancient Scourge was better than the Ancient weapon that I was currently using. The flavor text on this item says: A weapon of such evil visage is rarely seen outside the confines of the Burning Hells. Athena the Barbarian is wearing several Ancient items in this screenshot. The Optimist: Kill Rakanoth at max level in under 30 seconds on Torment difficulty or higher in Hardcore mode. This Ancient Bul-Kathos’s Wedding Band was better than one of the Set rings Athena was wearing. The flavor text on this item says: Forged in the city of Harrogath to commemorate a day sacred the barbarians. This Band of Might is the other Ancient ring that Athena was using. It is good for Barbarians because “after casting Furious Charge, Ground Stomo, or Leap take 65% reduced damage for 8 seconds.” The flavor text on this item says: “Seems designed to reduce damage, but I’m not sure how it works. Obviously, it failed its previous owner. Hopefully it will work better for you.” – Haedrig Feeling So Low: Reach Greater Rift Level 25 Solo. Quarter Rift Crisis: Reach Greater Rift Level 25 Solo without any Set items equipped. I completed Greater Rift 25 at 5:53.700. Gems In, Gems Out: Level on Legendary Gem to level 25. I completed Greater Rift 26 at 5.24.716 and hit Paragon 100. Burninating: Kill Urzael at max level in under 90 seconds on Torment difficulty or higher in Hardcore mode. Andariel’s Visage was the first Ancient Helm I’ve found in Season 17. The flavor text on this item says: Some long-forgotten artisan crafted this helmet in the hideous likeness of the Maiden of Anguish. For what purpose, none can say. The King and I: Kill the Skeleton King at max level in under 1 minute on Torment difficulty or higher in Hardcore mode. The first Ancient Shoulders I got in Season 17 were Pauldrons of the Skeleton King. The flavor text on this item says: “No matter its value, it would be wise to let the raiment of the Black King remain buried with its fallen owner. No good can come of disturbing Leoric’s rest.” – Deckard Cain The Sum Of All Hells: Kill Azmodan at max level in under 1 minute on Torment difficulty or higher in Hardcore mode. Sin-Cerely Sorry: Kill Azmodon at level 70 on Torment III difficulty or higher. Be Cool: Kill Azmodon at level 70 without getting hit by a fireball or walking over the bloody demonic ground on Torment III difficulty or higher. Sinfest: Kill Azmodan at max level without crowd controlling enemies on Torment difficulty or higher in Hardcore mode. Azmodone: Complete the Azmodon challenge achievements listed below. I completed Greater Rift Level 27 at 6.48.600. It is the highest Greater Rift that I have done in Season 17 (so far). Then, I took a little break from Diablo III for a while, mostly because I had a sinus infection. Playing while really sick is never a good idea, especially if you have a Hardcore character. When I returned, I started working on the rest of Slayer. Rifticulous: Finish a level 70 Nephalem Rift on Torment V difficulty or higher. Under My Skin: Reach Greater Rift Level 30 Solo without any Set items equipped. Solipsist: Reach Greater Rift Level 30 Solo. I completed Greater Rift Level 30 at 7.23.766. Adventure Club: Kill Rakanoth at level 70 on Torment VII difficulty or higher. What the Hex?: Kill Adria at max level in under 1 minute on Torment difficulty or higher in Hardcore mode. Witch, Please!: Complete the Adria challenge achievements listed below. Players who complete this group of achievements get a Banner Pattern. Whatever: Kill Adria at level 70 on Torment VII difficulty or higher. I am struggling with the Might of the Earth Set Dungeon. While I understand what I need to do in order to finish it, I cannot seem to do it properly. Eventually, I gave up and tried to get around having to do this particular Set Dungeon. The result is that I have not yet completed Slayer. I will update this blog post after I manage to complete a Set Dungeon – any Set Dungeon. UPDATE: After many attempts, I was able to successfully complete the Raekeor’s Set Dungeon. Set Me Free: Complete any Set Dungeon. While wearing the 6-piece bonus of a Class Set, visit the Tome of Set Dungeons in Leoric’s Manor for a clue that will lead you to the entrance to your Class Set’s Dungeon. Legacy Of The Roid: Complete 1 Primary Objective and kill the initial amount of enemies in the Legacy of Raekor Set Dungeon. Players who earn that Achievement get a Banner Sigil Reward. SEASON JOURNEY (SLAYER) COMPLETE! Players who complete Slayer get a Portrait Frame as a reward. Greyhollow – Slayer: You slayed ’em. Season 17 (Season of Nightmares) – Slayer 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 PayPal.me. Thank you!...

Book Reviews

- Nocturne – by Syrie James
  January 1, 2019Book Reviews / romanceNocturne is “a haunting story of forbidden love”. It says so right on the cover. The entire story takes place in just a few days, which is more than enough time for the main characters to fall madly in love with each other. Michael is a vampire (and Nicole is not). Michael’s secret is revealed to the reader early on in the story. Nicole misses every clue until something bloody obvious finally opens her eyes. Can a relationship between a human, and a vampire, work out? This is the question that Nicole and Michael must find an answer to. I tend to find books that include vampire characters to be intriguing. It takes what could be a rather ordinary story and opens it up to possibilities that are unlikely to happen if all the characters are regular humans. Nicole was driving home from a “ski-wedding”, hoping to get to the airport before the blizzard arrives. Unfortunately, the storm hit earlier than expected. She had a car accident, slid off the road, and passed out. She probably would had frozen to death if it wasn’t for Michael. He watched the accident happen from his truck, which he was using as a snow plow to clear the road that led to his chalet. Michael rescues Nicole and takes her home with him. This immediately causes problems. Michael, who has been alone for a very long time, is struggling to cope with the smell of Nicole’s blood. He managed to treat her wounds, and put her on the couch under a blanket. When she wakes up, Michael appears very standoffish and unwelcoming. The two quickly become attracted to each other. It turns out that they have some things in common. Both enjoy classical music and love playing the piano. Both are big readers, and Nicole learns that Michael’s bookshelves include several books by her favorite author. Unfortunately, Nicole learns that Michael has some… quirks… that she finds frustrating and confusing. He runs hot and cold. One moment, he would be engaging her in conversation. The next, he would become angry and shut himself in another room behind a locked door. Nicole found that the kitchen had almost no food, except for something that Michael said his housekeeper made for him. They were snowed in, so she made do with the apples, carrots, and oats that were in the kitchen. Michael never joined her for meals, and she found this strange. Almost instantly, Michael and Nicole become deeply attracted to each other. He starts to open up to her, and tells her a few of his secrets. There is an intense moment when Michael is teaching Nicole how to make a part of a music box – a hobby of his. The two smolder, and embrace… and then Michael stops it. The entire story takes place within just a few days. Without giving away any “spoilers”, Nicole eventually figures out that Michael is a vampire. It takes a little while for them both to adjust to this revelation. The two become closer after that secret is out. In general, I would be skeptical about a story where two strangers, who are essentially snowed in for a few days, fall madly in love. Is that really enough time for that to happen? Syrie James made the evolution of Nicole and Michael’s relationship seem natural and uncontrived. There is a strong chemistry between Michael and Nicole, and this leads to some passionate sex scenes that give the reader just enough details without becoming too graphic. By the end, Michael and Nicole have to decide what to do. The blizzard has passed by, the roads are clear, and Nicole can go home. Neither of them want to separate, but there are some good reasons to do so. I’ll leave the reader to discover what they decided to do. Overall, I found Nocturne to be entertaining. It is a quick read that takes place in a cold and snowy environment. This is a very sweet story with a few scary moments here and there. What makes this story work so well is that Nicole and Michael are well matched for each other (despite him being a vampire.) Book Review – Nocturne by Syrie James 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 PayPal.me. Thank you!...
- Spook – by Mary Roach
  December 26, 2018Book Reviews / non fictionMary Roach is the author of Stiff – the Curious Lives of Human Cadavers. After writing about what happens to the human body after the person dies, it seems appropriate to write a book about what happens to the human soul after the body dies. Spook – Science Tackles the Afterlife was written in 2005. In my opinion, the best way to read Spook is to set aside whatever religious ideas you may have about the afterlife. Go into this book with an open mind and you will definitely learn something about human nature. This is not the book for people who have strong religious beliefs about the afterlife and who are looking for something that confirms what their religion tells them. It is the book for people who wonder what science can tell us about the soul, where it lives, and where it might go. In Spook, Mary Roach asks plenty of interesting questions, and follows up by finding out what science had to say regarding the afterlife. She does not provide the reader with a definitive answer about what, exactly, one should expect from the afterlife. Readers are free to take in whatever they find to be thought-provoking. The very first chapter delves into reincarnation. Mary Roach traveled through India with Dr. Kurti S, Rawat, director of the International Centre for Survival. He seeks out children who claim to have been reincarnated and gathers up as much information as he can from the child and the child’s family. Mary Roach appears to have experienced culture shock while in India, and I found her observations to be fascinating. There are parts of India where people believe in reincarnation. As such, when a very young child starts talking about people that the child’s parents do not know – the assumption is that reincarnation has occurred. The parents will ask the child questions, in an effort to learn more about who they were in a past life. In the United States, claims of reincarnation are very rare. The process Dr. Rawat uses goes like this: he learns of a child who claims to have been reincarnated. He travels to where that child lives and interviews the child and their family members. Dr. Rawat writes down all the details and studies it later. The best data comes from parents who immediately started writing down what the child told them about his or her former self, the names of that person’s loved ones, and the manner in which the person died. For some reason, people who have been reincarnated tend to have died a quick, unexpected, and very violent death. In short, the best outcome is when the child’s family, and the living relatives of the person who has been reincarnated into the child, meet and become like extended family. The worst outcome is when a scammer picks a target (usually someone rich), learns about their deceased relative, and coaches the child to pretend to be that person. Part of Spook includes details about a variety of ideas regarding where in the human body the soul “lives”. The specific part of the body that was believed to house the soul changed over time. Potential parts have included: sperm, ova, the pineal gland, the nerves (and/or the nervous system), a bone on the end of the spine called the luz, the coccyx, and one of the four chambers of the brain. A controversial study (which had many ethical issues) was done in an effort to find out how much the soul weighs. It was done in 1854 at a Consumptives Home, a charity that cared for people who were slowly dying of tuberculosis. A surgeon and physician named Duncan Macdougall placed a bed on a large, industrial, scale. A person who appeared to be about to die of consumption was placed on the bed. Macdougall, and other doctors, watched and waited for the person to die. At that moment, they checked the scale to see if the total weight had changed. The scale often showed that the person (and the bed they were lying on) weighed a tiny bit less immediately after the person died. The study was controversial for many reasons, the biggest of which was the question of whether a person who was about to die of consumption could truly give consent to being in the study. Despite this, other doctors attempted to replicate the study (using animals instead of people). The animals were not dying of consumption. They were euthanized after being placed on the industrial scale. The results of these studies contradicted each other and were inconclusive. From here, things move away from the realm of science (wonky and questionable as it was) and into the realm of seances (which were run by women who intended to scam people). I found this part of the book to be extremely entertaining, and I’ll leave you to read it for yourself. In short, seances became a popular thing for people to experience. Many people came to the seance already believing that they would encounter a spirit. They were easy marks. Another interesting thing I learned from Spook is that people have been using whatever the most modern technology was at the time to attempt to record the voices of spirits (or ghosts). Some of the earliest recordings were of mediums who claimed to be channeling a spirit – who had a lot of things to say. Sometimes, people heard crackles over the radio and interpreted them to be voices from the beyond. It often turned out to be the person’s imagination – with the exception of a situation where the people lived really close to where the radio waves were being transmitted. Those people were actually hearing radio transmissions from local stations that were somehow picked up by things like – for example – their oven. More recently, people began using tape recorders to capture the voices of the spirits. I presume people have started using there smartphones for this purpose. The common theme here is that people have a tendency to want to believe that the newest, hottest, piece of technology that can record something is definitely going to pick up the voices of spirits. Spook is a truly bizarre book that mixes scientific study (such as it was) with religion and the cultural beliefs of a population in a specific location at different points in history. When it comes to the afterlife, these concepts blend together and influence not only what a person believes about the human soul, but also what the afterlife is like. Spook – by Mary Roach 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 PayPal.me. Thank you!...

World of Warcraft

- Darkmoon Faire Achievements
  May 15, 2019Holiday Events / World of WarcraftThe Darkmoon Faire is fun, but I rarely have found time to play in it. So, I made an effort to bring Meipo, my little Gnome Mage, to the Faire. In this blog post, I have screenshots of all the Darkmoon Faire Achievements that she was able to earn. (Some will be added later as Meipo levels up and gains opportunity to earn more of them.) Come One, Come All!: Attend the Darkmoon Faire. I had to crop the Achievement Toast screenshot because another player, on a huge, flying mount, appeared and entirely blocked Meipo out of the screenshot. Quick Shot: Score a Quick Shot at the Shooting Gallery. Blast Off!: Complete The Real Race with the Rocketeer within 25 tolls. Rocketeer: Bronze: Complete The Real Race with the Rocketeer within 20 tolls. I Was Promised a Pony: Ride a Darkmoon Pony. Meipo got to ride a pony! Blastenheimer Bullseye: Score a bullseye when launched from the Darkmoon Cannon. Step Right Up: Play five different Darkmoon games: Cannon Blast, Shooting Gallery, Ring Toss, Tonk Battle, Whack-A-Gnoll Darkmoon Racer Novice: Complete The Real Race with the Racing Strider within 25 tolls. Darkmoon Racer Jockey: Complete The Real Race with the Racing Strider within 20 tolls. Darkmoon Racer Leadfoot: Complete The Real Race with the Racing Strider within 15 tolls. There are many more Darkmoon Faire Achievements. This blog is about the ones that Meipo the Mage got the first time she went to the Darkmoon Faire. I will update this blog post if and when Meipo returns to the Darkmoon Faire and completes more Achievements. Darkmoon Faire Achievements 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 PayPal.me. Thank you!...
- My Thoughts About World of Warcraft Classic
  December 23, 2018World of Warcraft / World of Warcraft ClassicI was fortunate enough to attend Blizzcon 2018. One of the (many) demo games that was available for people to try was World of Warcraft Classic. I wanted to share my thoughts about it before I forgot what I intended to say. The screenshots you see in this blog were obviously NOT taken while I was at BlizzCon. I had time to play the World of Warcraft Classic demo after returning home from BlizzCon. These screenshots were taken on my computer after BlizzCon 2018 was over. I decided to get in line for the World of Warcraft Classic demo at BlizzCon to kill some time. My husband needed to go all over the conference in order to do some shopping for someone who was unable to attend BlizzCon. It was the second day of BlizzCon, and I was exhausted. I have several chronic illnesses, including rheumatoid arthritis and fibromyalgia. There was no way I was going to summon the energy that shopping trip required. Instead, I took the opportunity to try some game demos. There were two guys ahead of me in the long and winding line. It turned out all three of us played Vanilla WoW back in the day, and all as Alliance characters. We reminisced about how long it took to run around without a mount, and wondered about how much of that old world would remain the same in WoW Classic. My first character was a Night Elf Hunter, and I shared my story about running out of arrows and not having any idea of how or where to get more. We laughed about Hunter pets that had moods that the player had to manage. Failure meant the Hunter pet would run away, leaving the Hunter to try and tame another one. Actually sitting down at a computer at BlizzCon to play WoW Classic was exciting. There is something about hands-on video game experience that makes the things that had been announced seem real. I rolled a Night Elf Hunter, and received a boar as a pet. So did all the other Hunters. Blizzard planned ahead and gave all Hunters plenty of ammo to start with. I didn’t have to worry about running out. I found it amusing that my pet started to get unhappy if I was standing around for too long – but quickly became super happy again when I sent it into battle. I had forgotten that Hunters needed to feed their pet to keep it happy. When I tried to give my boar some food, I was reminded that it was a picky eater. If I remember correctly, text popped up that said something like “Your pet doesn’t like that food.” It made me laugh! Those who tried the WoW Classic demo at BlizzCon found themselves in a server filled with other, very excited, players. Someone invited me into a group right away, and I accepted the invitation. There was a brief moment when four Night Elf Hunters were running around together, trying to slay bandits that were a higher level than we were. Speaking of levels, Blizzard made a very good decision and started players off at Level 15. This happened in both the demo at BlizzCon and the one people could try at home. It made things move a lot faster than if we all had to start at Level 1 and grind our way upward. Starting at Level 15 allowed players to actually survive some of their encounters with enemies! A group of players on the BlizzCon server had a fun idea. They urged everyone to go to Deadmines, in as large a group as possible, and kill Elites together. This was manageable because all Alliance players started in Westfall. It was so much fun slaying Elite enemies in the hallway that leads to Deadmines! We outnumbered them, and the quick respawns weren’t a match for the sheer number of overexcited players who were having a great time. It turned out we couldn’t access the actual Deadmines dungeon, so we stayed in the hallway, battled to our death, and made multiple corpse runs right back in. It was announced at BlizzCon that World of Warcraft Classic would not require a separate subscription. It will come with a regular World of Warcraft subscription. Personally, I think this was another great decision by Blizzard. It enables people who want to play WoW Classic to be able to afford it. Those who were not initially interested in WoW Classic, but who have a “regular” WoW subscription, will have the opportunity to try Classic at any time without having to pay extra money to do so. Maybe the nostalgia of it will bring in some hesitant players. Or, it could bring in players who were too young to have played in Vanilla WoW, and who are curious about what it was like. The “Con Crud” caught up to me shortly after I returned home from BlizzCon. I expected this – my immune system sucks and I get sick all the time. Later, I learned that plenty of typically healthy people who went to BlizzCon were also afflicted with bad “Con Crud”. As such, I was at home playing WoW Classic on my computer while exhausted. The hyped-up energy of BlizzCon had disappeared; there was no crowd of players to interact with in person; and the server I was on felt very empty. It probably didn’t help that I was playing at weird hours when most other people were probably sleeping. The first thing I did was roll another Night Elf Hunter – who started at Level 15 with a boar pet and more ammo than I was likely to use up before the demo ended. The whole atmosphere had changed. I was fighting enemies by myself, dying more than I did at BlizzCon, and making really dumb decisions because I was playing while sick. This slowed-down experience was not actually a disappointment. It reminded me very much of what it was like when I played Vanilla WoW. Long story short, I didn’t have anyone to play with back then, and did not join a guild until after The Burning Crusade had launched. It was quiet, with long stretches of calm as I slowly walked around Westfall. I enjoyed the challenge of figuring out where I was supposed to go to complete the quests that I had accepted. In “live” WoW, my Death Knight has an easy time killing all who cross her path. In WoW Classic, I had to return to using strategy, thinking hard before sending my pet to attack an enemy, and running away when I accidentally pulled the whole mob at once. Overall, I’m looking forward to playing WoW Classic. I want the opportunity to level up a brand new character (with the old skills and talent tree) and exploring an Azeroth that has changed so much between then and now. I want to visit the less traveled areas of Azeroth once again. My Thoughts About World of Warcraft Classic 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 PayPal.me. Thank you!...

Out of Spoons (Chronic Illness)

- Migrants are Dying From Lack of Health Care
  July 22, 2019Out of Spoons / Public HealthPhoto by Min An from Pexels How many migrants have died while in ICE custody? I wanted to find out, so I started doing research. This blog includes details about the children, women, and men who have died while in the custody of Immigration and Customs Enforcement (ICE) or in private detention centers. It also includes people who died shortly after being released from the custody of ICE or of other detention centers. There is a pattern. A migrant who is sick is – reportedly – given a brief amount of medical care. It is only after the person becomes desperately and dangerously ill that ICE and Border Patrol take that person to a hospital. After that, many are sent back into custody after a doctor at the hospital takes a quick look at the person. Some are misdiagnosed. The person gets sicker, and is quickly taken to another emergency room or hospital for treatment. There have been at least two cases where a toddler was very sick, and the parent was released from Border Patrol (or ICE) custody right before the child died. It is clear that the migrants who are in custody are not receiving the medical care that they need until after it is too late. There is another disturbing pattern. ICE places adults in solitary confinement, without access to medical care, until the person dies or commits suicide. The people sent to solitary confinement often are people who have mental illnesses or people who are transgender. Jose de Jesus Deniz-Sahagun June 15, 2015: Arizona Central posted an article titled: “Detention death ruled a suicide; protestors disagree”. It was written by Megan Jula and Daniel González. From the article: Jose de Jesus Deniz-Sahagun ran into the pedestrian lane at the Douglas port of entry in mid-May trying to enter the U.S.The Mexican national had been deported before – twice within the last four years, including an expedited removal in April 2013.Customs and Border Protection arrested the 31-year-old on May 15 and transferred him to Immigration and Customs Enforcement custody.Two days later, he was dead.Last week, immigrant rights advocates called the death suspicious, alleging that he was beaten by guards and thrown into solitary confinement.But as about 25 protestors gathered outside the ICE Phoenix headquarters Monday demanding an independent investigation, the Pima County medical examiner revealed to The Arizona Republic that Deniz-Sahagun committed suicide.Pima County Chief Medical Examiner Gregory Hess said Deniz-Sahagun died on May 20 of asphyxia due to choking after he swallowed a sock. Deniz-Sahagun was held at the Eloy Detention Center while waiting for an immigration hearing… June 17, 2015: Arizona Central posted an article titled: “Autopsy raises questions about Eloy detainee’s suicide”. It was written by Megan Jula. From the article: Activists contend that immigrant detainee Jose de Jesus Deniz-Sahagun was beaten before he died, even though an autopsy report by the Pima County Medical Examiner’s Office ruled the death a suicide.The report, obtained by The Arizona Republic, does raise questions about the circumstances surrounding the death at the Eloy Detention Center.Did detention-center personnel realize Deniz-Sahagun may have already attempted suicide while in custody?Was the suicidal inmate adequately monitored?Deniz-Sahagun, a 31-year-old Mexican national, killed himself May 20 by lodging a sock in his throat, the report said…On May 19, he was evaluated for “delusional thoughts and behaviors for which he had to be restrained,” according to the autopsy. He was placed on constant watch due to concerns of suicidal intentions.A day later, however, Deniz-Sahagun was taken off constant watch. He was placed in a single-person cell with video monitoring and security checks every 15 minutes……Deniz-Sahagun was last seen in video surveillance at his cell door at 4:57 p.m. May 20, according to the autopsy.Pima County Chief Medical Examiner Dr. Gregory Hess, who conducted the autopsy, said in the video someone knocked on a window at about 5:15 p.m. and appeared to say something.“That indicates he was either alive at the time or it appeared that he was fine,” Hess said.About 15 minutes later, a guard stopped at Deniz-Sahagun’s cell and apparently noticed something was wrong, Hess said.Emergency medical personnel entered his cell at 5:33 p.m……The autopsy showed no sign of Deniz-Sahagun being beaten, Hess said.Hess reported that Deniz-Sahagun’s head had a subscalp and subperiosteal hemorrhage – in lay terms, “basically, he had a bump on is head.”… August 21, 2015: Phoenix New Times posted an article titled: “Amid Faux Coffins, Protesters Demand Justice for Immigrant’s Death in ICE Detention”. It was written by Elizabeth Stuart. From the article: …Jose De Jesus Deniz-Sahagun, who choked on a sock May 20, is one of more than 150 people who have died in ICE custody over the past 12 years – a fact that demonstrators said they find reprehensible……A Pinal County coroner ruled Deniz-Sahagun’s death a suicide. But demonstrators weren’t ready to let ICE off the hook. Interviews with other detainees at Eloy Detention Center, they said, suggest he may have died after a brutal beating from the guards.Deniz-Sahagun presented himself to border agents May 15, begging for asylum, after the men he hired to smuggle him over the border threatened to kill him, Porchas said. Family members reported he was in good spirits when he was transferred to Eloy Detention Center May 18……Examiners found no evidence of physical abuse aside from a bump on Deniz-Sahagun’s head. However, the autopsy report does raise questions about the quality of mental healthcare Deniz-Sahagun received.On May 19, according to the report, a mental-health provider evaluated Deniz-Sahagun for “delusional thoughts and behaviors for which he had to be restrained by corrections staff” and ordered he be placed on suicide watch.There was a broken off toothbrush handle in Deniz-Sahagun’s stomach, which suggested he may have previously attempted to kill himself.The next day, however, Deniz-Sahagun was transferred to a single-person cell, where officers checked on him only every 15 minutes… Raquel Calderon de Hildago November 28, 2016: Arizona Central posted an article titled: “Another death at Eloy migrant-detention center”. It was written by Daniel Gonzalez. From the article: Another detainee from the deadliest immigration detention center in the nation died this week.The detainee, a 36-year-old woman from Guatemala, died Sunday at Banner Casa Grande Medical Center, according to Immigration and Customs Enforcement officials. She was being held at the Eloy Detention Center, which an investigation by The Arizona Republic found to have the highest number of deaths in the U.S.Raquel Calderon de Hildago , was sent to the hospital after medical staff at the Eloy Detention Center called paramedics following a series of seizures, ICE officials said in a news release. The woman continued to experience seizures in the ambulance on the way to the hospital, ICE officials said.Calderon is the third person in ICE custody to die since the start of fiscal year 2017 on Oct. 1 and the 15th tied to the Eloy Detention Center since 2003.The 15 deaths represent 9 percent of the 165 immigration detainees who have died in ICE custody since 2003, according to ICE statistics.A 2015 analysis of ICE data by The Republic found that there have been more deaths tied to the Eloy Detention Center than any other detention facility in the nation… January 2, 2017: Arizona Central posted an article titled: “Autopsy: Eloy immigration detainee died of blood clots in her lung”. It was written by Daniel Gonzalez. From the article: A Guatemalan detainee, whose death in November was the 15th tied to the Eloy Detention Center, died of blood clots in her lung, an autopsy has concluded.The autopsy found blood clots “throughout all the lobes of the right lung” as a result of a leg injury.The woman, Raquel Calderon de Hildago, had difficulty walking at the time she was apprehended by the Border Patrol, according to the autopsy concluded by the Pima County Medical Examiner’s Office. She was taken to a hospital for evaluation, the autopsy said. Calderon was later transferred to the custody of Immigration and Customs Enforcement. She was being held at the Eloy Detention Center awaiting deportation to Guatemala when she was taken to Banner Casa Grande Hospital after experiencing a series of seizures at the detention center. The seizures continued on the way to the hospital, where she died Nov. 27, Immigration and Customs Enforcement officials said earlier.The blood clots, which traveled from her leg to her lung, would have triggered the seizures, Dr. Gregory Hess, Pima County’s chief medical examiner, said in an interview… June 20, 2018: Tuscon.com posted an article titled: “Human Rights group concerned about immigrant deaths while held in ICE custody”. It was written by Anita Snow. From the article: …For its report, Human Rights Watch had physicians with expertise in correctional health examine the official Ice death reviews of 15 detainees who died between December 2015 and April 2017. The doctors raised questions in eight cases about ICE’s ability to address serious medical-care deficiencies.Dr. Marcus Stern, former health services director for Washington State’s Department of Corrections analyzed ICE’s formal reviews for all 15 of those detainees who died. He has investigated medical care in ICE facilities for the Department of Homeland Security in the past.Other medical experts consulted include Dr. Robert Cohen, past director of health services on Rikers Island, and Dr. Palav Babaria, chief administrative officer of Ambulatory Services at Alameda Health System in Oakland, California……The report also mentioned Raquel Calderon de Hildago, who died 18 months ago after falling ill at the Eloy Detention Center. CoreCivic, which operates the facility, said it “does not provide medical or mental health services or staffing at the Eloy Detention Center” and said the federal government is “solely responsible for providing, contracting, staffing and oversight of any medical and mental health services at Eloy.”Calderon was awaiting deportation to Guatemala in November 2016 when she suffered seizures and was taken to a local hospital, where she died. An autopsy found she died from a blood clot from a leg injury suffered while crossing the desert into the United States.Babaria noted delays in Calderon’s care, saying if she were seen earlier a “different outcome might have happened.” Roger Rayson March 22, 2017: ThinkProgress posted an article titled: “The first immigrant detainee to die under President Trump had a treatable disease”. It was written by Esther Yu His Lee. From the article: Roger Rayson, a 47-year-old Jamaican immigrant, died last week at a Louisiana-area hospital while in the custody of the U.S. Immigration and Customs Enforcement (ICE) agency. He was the first detainee to die under the Trump administration, which is seeking to rapidly expand the use of detention centers to detain more immigrants.Rayson died of apparent cardiac arrest at the Lafayette General Hospital in Lafayette on March 13, an ICE press release said. The statement said that Rayson was transferred from the LaSalle Detention Facility, an immigration detention center in Louisiana, to a nearby hospital on February 11 for nausea, vomiting, and increased pain. Doctors diagnosed him with Burkitt Lymphoma (non-Hodgkin’s Lymphoma), a fast-growing lymphoma that is curable by treatment. He died within nine days of being transferred to Lafayette General Hospital.Prior to being transferred over to immigration detention, Rayson had been serving a 30-month prison sentence for importation of cocaine. Rayson was the fourth detainee to die in ICE custody in the 2017 fiscal year, according to the ICE statement. In total, 166 people have died in ICE custody between 2003 and late November 2016.The circumstances leading up to Rayson’s death are unclear. But Rayson wasn’t the first immigrant detainee to die at the LaSalle Detention Facility, which is owned and operated by the controversial private-prison operator GEO Group… Osmar Epifanio Gonzalez-Gadba March 28, 2017: LAist posted an article titled: “ICE Detainee Dies 6 Days After Attempting Suicide At Adelanto Facility”. It was written by Julia Wick. From the article: A 32-year-old Nicaraguan man died early Tuesday morning in Victorville, six days after attempting suicide at an immigration detention facility in the high desert.Personnel conducting routine rounds found Omar Epifanio Gonzalez-Gadba hanging in his cell at the Adelanto Detention Facility on March 22. Medical staff at Adelanto called 911 and began efforts to resuscitate him, according to an ICE statement. Gonzalez-Gadba was transferred to the intensive care unit at Victor Valley Global Medical Center in Victorville, where he was placed on life support. He never regained consciousness. The preliminary cause of death is thought to be heart failure caused by the cerebral edema which resulted from asphyxiation, according to ICE.The privately-owned Adelanto Detention Facility is run, like many other immigrant detention facilities, by GEO Group, the nation’s second largest for-profit prison operator. ICE contracts with the city of Adelanto for the space, and the city of Adelanto contracts with GEO Group to run it, according to KPCC. Adelanto is the largest immigrant detention center in California, with a population approaching 2000 people……Gonzalez-Gadba is the second immigrant detainee to die in ICE custody since President Trump took office on January 20…. October 2, 2018: Los Angeles Times posted an article titled: “Nooses in cells, rotting teeth – report details harsh conditions at Adelanto immigration facility”. It was written by Paloma Esquivel and Britnny Mejia. From the article: A Nicaraguan man who was detained at the Adelanto ICE Processing Center died in March 2017 after he was found hanging in his cell from his bedsheets. Not long after, two other detainees also used sheets in an attempt to hang themselves.When federal officials arrived in May of this year for a surprise inspection of the privately run immigration detention facility, they found nooses made from bedsheets in 15 of 20 cells……The nooses are just one of many problems posing “significant health and safety risks” identified by federal inspectors at Adelanto, which can house nearly 2,000 detainees as they await the outcome of their immigration cases.Detainees reported waiting “weeks and months” to see a doctor, and inspectors met with a dentist who dismissed the necessity of fillings, and suggested that detainees use string from their socks to floss, the report said.Inspectors also said they found that detainees were commonly subjected to disciplinary segregation before being found guilty of violating rules……The Times reported in August 2017 that there had been at least five attempted suicides at the facility in less than one year, according to a review of 911 calls……According to the report, in the months after Osmar Epifanio Gonzalez-Gadba, 32, of Nicaragua was found hanging from bedsheets in his cell and later died, ICE compliance reports documented at least three suicide attempts by hanging at Adelanto, two of which specifically used bedsheets.Still, when inspectors visited the facility, they found braided sheets that both staff and detainees referred to as nooses hanging from the vents in 15 of the approximately 20 male detainee cells that they visited in four housing units……The report also notes that some detainees reported waiting “weeks and months” to see a doctor and said that appointments were canceled without explanation, with detainees placed back on the waiting list.From November 2017 to April 2018, detainees filed 80 medical grievances with the facility for not receiving urgent care, not being seen for months for persistent health conditions and not receiving prescribed medication, according to the report.Inspectors also highlighted serious problems with dental care at the facility, saying detainees are placed on wait lists for months and, sometimes, years to receive basic care, “resulting in tooth loss and unnecessary extractions in some cases.”No detainees have received fillings in the last four years, according to the report. One detainee reported multiple teeth falling out while waiting more than two years for cavities to be filled… Sergio Alonso Lopez April 14, 2017: ABC News 7 posted an article titled: “Mexican detainee dies while in ICE custody at Victorville medical center”. From the article: A Mexican national died of internal bleeding while in the custody of ICE at the Victor Valley Global Medical Center in Victorville Thursday.Sergio Alonso Lopez, 55, had been transferred from a hospital at the Adelanto Detention Facility on April 1 after throwing up blood, according to ICE. Department officials said he had a history of medical issues that included cirrhosis, hypertension, alcohol abuse and opioid dependence with withdrawal symptoms.ICE said the preliminary cause of death for Lopez was determined to be internal bleeding.The agency notified state health and local law enforcement agencies of Lopez’s death as well as the Department of Homeland Security’s Office of the Inspector General and the ICE Office Professional Responsibility. ICE notified Mexican consular representatives who will contact Lopez’s next of kin.The department said Lopez had been in custody since Feb. 7 after he was arrested in Los Angeles by an ICE operations team. His deportation case had been pending in court at the time of his death… January 6, 2019: NBC News posted an article titled: “22 immigrants died in ICE detention centers during the past 2 years”. It was written by Lisa Riordan Seville, Hannah Rappeleye and Andrew W. Lehren. From the article: …When Sergio Alonso Lopez, 55, entered Adelanto in February 2017, he had been undergoing methadone treatment for 17 years.A doctor at Adelanto ordered him to taper off methadone over 12 days, and ICE review shows. Staff failed to administer several doses of methadone. A nurse told investigators there was little direction about prioritizing patients and too few staff.On April 1, Lopez was rushed to the hospital. Officers cuffed his swollen leg to a hospital bed. Doctors treated him for cirrhosis, sepsis and serious internal bleeding. On the afternoon of April 13, he began vomiting blood. One officer with the Geo Group, a private prison company, guarding him tipped Lopez’s head so he would not chicken, while another ran into the hall to yell “Code Blue,” according to the report. Lopez died three hours later of massive internal bleeding, cirrhosis, and substance abuse… Jeancarlo Alfonso Jimenez-Joseph May 16, 2017: NBC News posted an article titled: “Death of Panamanian Detainee Held in Solitary Confinement Initially Ruled Suicide”. It was written by Annie Rose Ramos. From the article: Federal authorities are investigating the death of a Panamanian immigrant who was being held in solitary confinement at an immigration center in southern Georgia, officials said this week.Jean Jimenez-Joseph, 27, was found unresponsive with a sheet around his neck in his cell at Stewart Detention Center in Lumpkin, Georgia, officials with U.S. Immigration and Customs Enforcement (ICE) said Monday……On the day Jimenez died, he had served 19 of his 23 days of isolation.However, this was not the first time Jimenez was in isolation. “He was placed in disciplinary segregation once before for fighting with another detainee,” said Brian Cox. That period of isolation spanned April 13-18, he said.Per a recommendation by United Nations special rapporteur, detained immigrants should not be placed in segregation for more than 15 days……According to a year-long investigation released just this month on behalf of Penn State Law and Project South, a Southern-based social justice organization, even though health care staff exists at Stewart, they primarily handle suicide risks, which are reportedly health with by placing the at-risk individual in segregation. The investigation says immigrants do not approach the mental health care staff because they are too afraid of being placed in segregation…Jimenez’s autopsy will take place no later than Thursday, according to GBI, and ICE have advised Panamanian consular representatives who have notified his next of kin. August 26, 2018: KDRV.com posted an article titled: “The Jump That Landed Him In Solitary”. From the article: …The night he died in May 2017, Jimenez was more than two dozen people in solitary at the Stewart Detention Center, a hulking complex just outside Lumpkin, Georgia, that can house nearly 2,000 immigrants.He was the fourth detainee to die in Immigration and Customs Enforcement custody in 2017 and the 170th since the agency began in 2003……Special agents from the Georgia Bureau of Investigation spent months interviewing witnesses, combing over documents, sifting through surveillance footage and listening to audio recordings after Jimenez’s death.The conclusion they reached: Suicide. There was no foul play.But even though their case is closed, the records GBI investigators unearthed could provide crucial information as a federal inquiry continues, Jimenez’s family pushes for answers and authorities investigate another apparent suicide in solitary at Stewart.The photos, files and recordings from the state investigation into Jimenez’s death offer a rare public window into life behind bars in the largest immigrant detention center in the Southeast. They reveal key details about events preceding Jimenez’s death. And they raise larger questions about the quality of medical and mental health care the tens of thousands of people in ICE custody receive, at a time when the administration has vowed to increase the number of undocumented immigrants it detains and deports.Jimenez’s family alleges that the staff at Stewart knew he needed better mental health care but punished him instead of treating him… October 28, 2018: The Intercept posted an article titled: “Immigrant Detainee Called Ice Help Line Before Killing Himself In Isolation Cell”. It was written by Spencer Woodman and José Olivares. From the article: The young Panamanian man used to tell his fellow immigration detainees that he was the reincarnation of Julius Caesar. Sometimes he hallucinated voices instructing him to kill himself. Things got so bad that Jeancarlo Alfonso Jimenez-Joseph, a 27-year-old ICE detainee, called a federal hotline on April 4, 2017, asking for help.Documents reviewed by The Intercept show that Jimenez-Joseph repeatedly brought his suicidal thoughts to the attention of officials at the rural Stewart Detention Center in Georgia, a private Immigration and Customs Enforcement detention center run by CoreCivic.Just six weeks after his call to ICE’s help line, Jimenez-Joseph killed himself in a tiny solitary confinement cell where he had been held for 19 days……In 2013, ICE adopted a policy that put new restrictions on placing detainees with a history of mental illness in solitary confinement. The policy requires that such detainees be removed from isolation if their mental state appears to be deteriorating……It is unclear exactly what he conveyed in his complaint to the help line a few weeks later, on April 4. But the existence of the call shows that Ice officials far beyond Stewart Detention Center, or even the agency broader region, had been warned of Jimenez-Joseph’s deteriorating psychological condition. Additionally, the log suggests that Jimenez-Joseph felt his situation had become serious enough to elevate his concerns above management at the CoreCivic-run facility….…ICE’s central office took at least some note of the call: It prompted ICE authorities to contact ICE regional headquarters in Atlanta to check on how Jimenez-Joseph was being treated, according to the call log. Within 24 hours, ICE’s central office received a response from Atlanta: The privately run facility said it knew of Jimenez-Joseph’s condition, and officials insisted that he was “being treated with medication and therapy.”… Kamyar Samimi December 4, 2017: The Denver Channel posted an article titled: “Man, 64, dies while in ICE custody in Colorado”. It was written by Blair Miller. From the article: A 64-year-old man in custody of U.S. Immigration and Customs Enforcement died Saturday at an Aurora hospital, the agency said Monday.Kamyar Samimi, 64, originally of Iran, was arrested by Ice agents in Denver on Nov. 17 – more than 12 years after he was convicted of cocaine possession in Arapahoe County.According to ICE, Samimi first entered the U.S. in New York in April 1976 as a student, and became a permanent resident in May of 1979. But in January 1987, ICE says, his application for full citizenship was denied because he didn’t submit the correct documents.Samimi was off the radar of law enforcement after that until the 2005 arrest for possession of cocaine. He received a two-year deferred sentence and 64 hours of community service upon his conviction.But ICE says that since he was convicted of a felony, he was eligible for removal from the U.S. Agents arrested him at his home Nov. 17, and Samimi was served a notice to appear before an immigration judge.Samimi had been in custody at the Aurora Contract Detention Facility since his arrest until he “fell ill,” according to ICE, on Saturday morning.Emergency responders came to the jail, started performing CPR, and transported Samimi to the University of Colorado Medical Center of Saturday. Staffers there pronounced Samimi dead just after noon Saturday.ICE said his preliminary cause of death was cardiac arrest… January 6, 2019: NBC News posted an article titled: “22 immigrants died in ICE detention centers during the past 2 years”. It was written by Lisa Riordan Seville, Hannah Rappleye and Andrew W. Lehern. From the article: …Seven months later, at a facility 1,000 miles away in Denver, the Geo Group would receive another detainee with a history of methadone use, an Iranian-born father of two named Kamyar Samimi.In November 2017, ICE agents arrested the 64-year old outside his suburban Denver home. He had lived in the U.S. since 1976.Twelve years earlier, Samimi was convicted of a possession of a gram or less of cocaine, a low-level felony that stripped him of his green card. Soon after his arrest, he was taken to the Aurora Detention Facility, which has a history of substandard medical care……Samimi had been taken off methadone upon arriving in detention, according to records review by NBC News. His autopsy stated that Samimi “had been ‘clean’ for two weeks in the ICE facility and was being watched for withdrawal, dehydration, nausea and vomiting.” He was also on suicide watch.On the morning of Dec. 2, he began spitting up blood, according to the autopsy. He was taken to a nearby hospital, where he was pronounced dead. While rare, “methadone withdrawal cannot be ruled out as the cause of his death,” the coroner noted in his report.Soon after his death, the ACLU of Colorado began looking into what happened to Samimi… April 6, 2019: American Civil Liberties Union (ACLU) of Colorado posted a press release titled: “ACLU Of Colorado Sues ICE For Information About Death Of Iranian Man At Detention Facility”. From the press release: The ACLU of Colorado filed a lawsuit this morning seeking previously requested records related to the arrest, detention, and subsequent death of Kamyar Samimi, an Iranian man who died on December 2, 2017 while in U.S. Immigration and Customs Enforcement (ICE) custody at the Aurora Contract Detention Facility, a for-profit detention center operated by GEO Group, Inc.Mr. Samimi came to the United States as a student in 1976 and became a Legal Permanent Resident in 1978. ICE agents arrested him at his home on November 17, 2017, and kept him in ICE detention, where he died 15 days later. ICE still has not provided a thorough explanation as to what caused Mr. Samimi’s death. Meanwhile, multiple recent reports and complaints have highlighted concerns about medical care in ICE detention.“It has now been sixteen months since Mr. Samimi died, and ICE continues to keep the community in the dark about this tragedy,” said ACLU of Colorado Staff Attorney Arash Jahanan. “All we know is that ICE arrested a man who lived in the U.S. for over four decades, and 15 days later he died in ICE’s care. The public deserves to know more and this lawsuit seeks that information.”The ACLU of Colorado filed its first Freedom of Information Act (FOIA) request on December 20, 2017. In response, ICE produced only five pages, which had nothing to do with Mr. Samimi’s death. The ACLU of Colorado appealed and ICE responded on July 3, 2018, stating that its investigation of Mr. Samimi’s death had been completed and more documents would be forthcoming. But ICE has not produced any additional documents, nor has it indicated when it might be doing so.“Immigration detention facilities, like the one operated by GEO Group in Aurora, are all too often cloaked in secrecy, offering little to no transparency into the way detainees are treated within their walls,” said ACLU of Colorado Legal Director Mark Silverstein. “We are filing suit to further the public’s right to know what goes on in these secretive taxpayer-funded institutions.” July 17, 2019: The American Civil Liberties Union (ACLU) of Colorado posted a press release titled: “Nightmares and Tragedies in Immigration Detention”. From the press release: Kamyar Samimi died in the custody of U.S. Immigration and Customs Enforcement on December 2, 2017, 15 days after ICE agents arrested him. Mr. Samimi held a green card and had lived in the U.S. for more than four decades. Within days of his death, ACLU of Colorado sent ICE a request under the Freedom of Information Act for records related to his arrest, detention, and subsequent death.It took 17 months and a federal lawsuit for ICE to produce its report about Mr. Samimi’s death. The report confirmed our worst fears about why ICE kept the public in the dark about this tragedy for so long. It paints a gruesome picture of the conditions inside the Aurora detention facility operated by GEO Group, Inc., a for-profit prison corporation; and a gruesome picture of how our government treats immigrant detainees.Medical staff at GEO were ignorant about how to treat Mr. Samimi’s opioid addiction and apathetic about his overall care. The physician’s decision to cut Mr. Samimi off methadone was medically unjustifiable. To make matters worse, nurses failed to provide him with the correct doses of medication designed to treat the subsequent brutal withdrawal symptoms and to monitor his condition appropriately. They ignored his desperate pleas for medical attention because they thought he was faking it. Mr. Samimi became suicidal. As his deteriorating condition drew him closer to death, the nurses didn’t follow suicide-watch protocols or contact the physician, who apparently ignored calls when he wasn’t at the facility……Ultimately, Mr. Samimi didn’t take his own life. It was snuffed out by a broken system. After vomiting blood and collapsing, Mr. Samimi stopped breathing. He was finally taken to a hospital and pronounced dead. Later, the corner’s autopsy would cite gastrointestinal bleeding as contributing factors in his death. The forensic pathologist wrote that methadone withdrawal could not be ruled out as the cause of death… Yulio Castro-Garrido February 1, 2018: NBC News posted an article titled: “Cuban detainee, 33, dies in custody of U.S. immigration authorities”. It was written by Daniella Silva. From the article: A Cuban national died in the custody of U.S. Immigration and Customs Enforcement (ICE) at a clinic in Florida, the agency said Wednesday, becoming the second detainee to die in custody in as many months. Yulio Castro-Garrido, 33, died Tuesday night at a Mayo Clinic in Jacksonville, Florida, ICE said in a statement Wednesday evening.Earlier this month, Castro had been diagnosed with pneumonia by ICE medical personnel at the Stewart Detention Center in Lumpkin, Georgia, according to the statement. He was transported to Southwest Regional Medical Center in Cuthbert, Georgia, on Jan. 7 after the diagnosis, according to the statement.“After diagnosis, Mr. Castro initially resisted medical treatment which caused his condition to worsen,” ICE said. “On Jan. 9, IHSC [ICE Health Service Corps] staff coordinated the transfer of Castro to the Phoebe Putney Memorial Hospital in Albany, Ga. where he was placed on a ventilator to stabilize him.”That hospital transported Castro to the Mayo Clinic for additional treatment on Jan. 17, according to the statement.“Mr. Castro slipped into a coma Jan. 22 and never regained consciousness,” the statement read……Castro was placed in ICE custody on Nov. 24 after being transferred from the D. Ray James Federal Correctional Institute in Folkston, Georgia, the agency said. He had been convicted on Dec. 8, 2016, of “conspiracy to transport and move an undocumented alien within the United States by means of transportation,” according to the statement.Castro was sentenced to a year and a day of confinement and three years of supervised probation… June 10, 2019: WYNC Studios posted an article titled: “ICE Records: III Migrant Continued Working in ICE Custody Until he was Hospitalized. Three Weeks Later, He Died.” It was written by José Olivares. From the article: Thirty-three-year-old Yulio Castro-Garrido, an Immigration and Custom Enforcement detainee from Cuba, had no health problems when he first entered ICE custody at the Stewart Detention Center, a sprawling immigrant jail in rural Georgia run by private prison company CoreCivic. But Castro-Garrido died two months later of pneumonia, a lung infection and viral influenza, according to the ICE Detainee Death Review of his case.On January 30, 2018, Castro-Garrido died in a hospital after spending six weeks at the Stewart Detention Center. The review notes three “areas of concern” regarding the migrant’s care while in ICE custody. These include: staff neglecting to monitor Castro-Garrido’s blood pressure after showing signs of stage-two hypertension, and staff not immediately calling for an ambulance on the day he was taken to a hospital, causing a delay in his access to emergency care.The third concern detailed in the review involves labor practices at the facility. After reporting his illness to staff, Castro-Garrido worked in the detention facility kitchen for food service duties under CoreCivic supervision, potentially transmitting his illness to others. He even worked in the kitchen on the day he was taken from the facility in an ambulance, the ICE review notes. In the past the facility has fallen under criticism for allegedly threatening migrants who refuse to take part in labor at the facility… Here is a summary of what happened to Yulio Castro-Garrido: He was booked into the Stewart Detention Center on November 24, 2017, while waiting his immigration hearing before a judge. Stewart healthcare staff noted he had no health problems aside from a “slightly elevated blood pressure”.Days later, he had a physical exam with a different nurse. It was documented that he had high blood pressure. According to the review, his blood pressure readings “met the American Heart Association criteria for stage two hypertension.” Nurses did not initiate blood pressure monitoring or refer him to a provider.December 7, 2017 – He began working in the detention center kitchen, even though records show he was not medically cleared for labor at the facility.Late December and early January, he began reporting his illness to Stewart Detention. Center staff.January 6, 2018, he reported to the detention center’s medical unit with a fever, an “abnormally rapid heart rate”, and an elevated blood pressure. He was given cold medicine, Benadryl and acetaminophen. The nurse did not remove his medical clearance to work in the kitchen.January 7, 2018, he worked at the facility kitchen for food service.Later that night, he told his cellmate about his worsening health. The cellmate notified a shift supervisor at the facility. The cellmate had to help carry Castro-Garrido to the medical unit.6:40 p.m., January 7, 2018: Castro-Garrido was having difficult speaking due to shortness of breath, a temperature of 100 degrees, an “exceptionally fast heart rate” and very low oxygen saturation.6:56 p.m. January 7, 2018: Staff were told to call for an ambulance for him to be taken to the hospital. A staff member “did not authorize an EMS call until 16 minutes later, causing a delay in Castro’s access to emergency care.”7:43 p.m., January 7, 2018: ambulance arrivesUpon arrival at Southwest Georgia Regional Medical Center, his temperature was 104.2 degrees. He was diagnosed with multifocal pneumonia and influenza A. January 8, 2018: He was sent to Phoebe Putney Memorial Hospital where he could get a higher level of care.January 12, 2018: Hospital staff had to ask a Stewart Detention Center supervisor to remove Castro-Garrido’s restraints. A short while later, his right lung collapsed and he went into respiratory failure. Stuart Detention supervisor finally approves his family for visitation later that day.January 16, 2018: His respiratory functions shut down, due to the infection in his lungs. He had abnormally high carbon dioxide levels in his blood. Hospital staff medically paralyzed him, and decided he should be taken to Mayo Clinic in Jacksonville, Florida.January 17, 2018: Staff at Mayo Clinic were unable to pump his blood via ECMO therapy because of brain injury and gas-filled lesions in his lungs.Six days later, Castro-Garrido went into cardiac arrest and was in a coma on critical conditionJanuary 30, 2018, Castro-Garrido died. Luis Ramirez-Marcano February 22, 2018: New York Daily News posted an article titled: “Man awaiting deportation dies in custody, the third ICE detainee death this year”. It was written by Brian Lisi. From the article: A 59-year-old man died Monday after being in the custody of U.S. Immigration and Customs Enforcement for over a month.Luis Ramirez-Marcano had been awaiting deportation to Cuba since his arrest Jan. 12, but on Feb. 17 he was transferred from the Krone Detention Center fo Miami’s Kendall Regional Medical Center after he complained of abdominal pain, the Hill reports.“On Feb. 18, medical staff at KRMC informed ICE staff that Ramirez-Marcano was transferred to the intense care unit where his condition continued to decline,” the agency said in a statement.“Despite round-the-clock care, Ramirez-Marcano passed away the afternoon of February 19.”His official cause of death remains unknown… Roxsana Hernández May 31, 2018: The Guardian posted an article titled: “Transgender Honduran woman’s death in US ‘ice box’ detention prompts outcry”. It was written by Carla Green. From the article: A transgender Honduran woman died in Ice custody last Friday after coming to the US as part of a caravan of Central American migrants, including several dozen other transgender women fleeing persecution in their respective countries.Roxsana Hernández reportedly died from HIV-related complications following an alleged five-day detention in what’s known by immigrant rights groups as the “ice box” – Ice detention facilities notorious for their freezing temperatures…A statement from Ice said that Hernández arrived in the US on 9 May at the San Ysidro port of entry, was transferred to the transgender unit of Cibola County Correctional Center in New Mexico, and was hospitalize the next day for dehydration, pneumonia and other HIV-related complications. She died eight days later.According to Ice, Hernández was the sixth immigrant to die in its custody since October of last year… November 26, 2018: Rewire News posted an article titled: “Legal Advocates Seeking #JusticeForRoxsana Announce Lawsuit”. It was written by Tina Vasquez. From the article: …At a press conference Monday in San Diego, the Transgender Law Center (TLC), the Black LGBTQ+ Migrant Project (BLMP), Familia: Trans Queer Liberation Movement, and the law office of R. Andrew Free announced that they filed a Notice of Wrongful Death Tort Claim in New Mexico on behalf of Roxsana Hernández. The claim essentially puts government entitles on notice that advocates will soon file a wrongful death lawsuit against the state of Mexico, the first step in what will likely be a years-long process “to get justice for Roxsana and her family,” said Anna Castro, a media consultant with the Transgender Law Center……According to Immigration and Customs Enforcement (ICE), which used Hernández’s former name when publishing the details of her death, the Honduran asylum seeker was admitted to Cibola General Hospital on May 17 “with symptoms of pneumonia, dehydration and complications associated with HIV.” Later that day, she was transferred via air ambulance to Lovelace Medical Center (LMC) in Albuquerque, New Mexico, where she remained in the intensive care unit until she died on May 25. According to ICE, the 33-year-old’s preliminary cause of death was cardiac arrest.At Monday’s press conference, advocates revealed previously unknown details surrounding Hernández’s death.“According to an independent autopsy report, Ms. Hernández endured physical assault and abuse while in custody,” according to the wrongful death tort claim. “Specifically, forensic evidence indicates she was handcuffed so tightly as to cause deep tissue brushing and struck repeatedly on the back and rib cage by an asp or similar instrument while her hands were restrained behind her back.”Lynly Egyes, TLC’s director of litigation, said in a statement that the autopsy report by an independent board-certified forensic pathologist suggests that Hernández was “shackled for a very long time and very tightly, enough to cause deep bruising on her wrists.”“In the final days of her life, she was transferred from California to Washington to New Mexico, shackled for days on end. If she was lucky, she was given a bottle of water to drink,” Egyes said. “Her cause of death was dehydration and complications related to HIV. Her death was entirely preventable.”… Manuel Antonio Cano Pacheco June 9, 2018: Des Moines Register posted an article titled: “Des Moines DREAMER dies within weeks after being sent back to Mexico’s violence”. It was written by Rekha Basu. From the article: Manuel Antonio Cano Pacheco should have graduated from high school in Des Moines last month. The oldest of four siblings should have walked across a stage in a cap and gown to become a proud symbol to his sister and brothers of the rewards of hard work and education.Instead, Manuel died a brutal death alone in a foreign land, a symbol of gang supremacy in a country plagued by violent drug cartels. It happened three weeks after U.S. Immigration and Customs Enforcement returned him to Mexico, a country he had left at age 3 when his parents brought him here without a visa.The fact that America was the only home he has known made Manuel eligible to apply for and be granted DACA status under the Deferred Action for Childhood Arrivals program initiated by former President Barack Obama. It exempted from deportation certain young people, referred to as DREAMERS, who were brought to the U.S. without papers as children.But that status didn’t protect Manuel when he came to immigration authorities’ attention after being stopped for speeding last fall and charged with driving under the influence. An ICE spokesperson said in a statement that ICE officers arrested him in Polk County Jail, and a federal immigration judge terminated his DACA status because of two misdemeanor convictions.The statement from Shawn Neudauer, ICE public affairs officer, also said Manuel wasn’t technically deported, but he was escorted to Mexico by ICE deportation officers at the Laredo, Texas, border this past April 24. He called it a voluntary departure process that doesn’t carry the penalties of a formal deportation. But the impact was the same: Manuel had no choice but to go back, either as a deportee or in a “voluntary departure.” He chose the “voluntary” route… June 11, 2019: Democrats.org reported: …In May, three weeks after arriving in Mexico, Cano-Pacheco was killed in the north-central state of Zacatecas. His throat was slit while getting food with an acquaintance of his cousin’s, his family and friends told Des Moines Register.” June 12, 2018: ABC News posted an article titled: “19-year-old Iowa man killed weeks after being deported to Mexico”. It was written by Kaelyn Forde. …Manuel Antonio Cano Pacheco, 19, was kidnapped and killed on May 18 in Zacatecas, Mexico, his mother said. Just weeks before, on April 24, he had been escorted by officers from U.S. Immigration and Customs Enforcement (ICE) to the border at Laredo, Texas, after living in Iowa for nearly his entire life……Pacheco had been in Mexico only three weeks when his mother said he was kidnapped and killed. He grew up in Des Moines with his mother and siblings, and had been granted permission to stay in the United States under the Deferred Action for Childhood Arrivals program (DACA), in May 2015, according to ICE.An Obama-era program, DACA allows some undocumented immigrants who were brought to the United States as children — also known as Dreamers — to live and work. The program is in jeopardy as the courts decide whether President Trump’s plans to end it are illegal.In a statement, ICE said Pacheco’s DACA status had been terminated after hew as convicted of three misdemeanors. Court records show he was convicted on marijuana and drug paraphernalia possession charges as well as traffic violations……Pacheco was detained on Sept. 27, 2017, his mother said, and time in the detention center was hard on him, a sentiment echoed by Alfaro-Santiz, the pastor……When Trump announced that he planned to end DACA, his mother said, Pacheco was worried, as was she. Her family had told her how Zacatecas in north-central Mexico had grown to be one of the most violent places in the country… Marco Antonio Muñoz June 10, 2018: The Guardian posted an article titled: “Honduran border crosser separated from family kills himself in Texas jail”. From the article: A Honduran man who entered the US illegally killed himself in a Texas jail despite guards checking on him every half-hour and the presence of a camera in his padded-cell, a sheriff’s report showed.The Star county sheriff’s office said in a report on the incident, which happened in May, that Marco Antonio Muñoz, 39, became combative during the booking process and was restrained and placed in a padded cell overnight.Like a Customs and Border Protection (CBP) news release on the case on Saturday, the sheriff’s report made no mention of why Muñoz might have become enraged and then despondent. It said he did not show any mental health problems of say anything about that might have suggested he was thinking about killing himself.But the Washington Post cited unnamed border agents with detailed knowledge of what occurred when it reported that Muñoz entered the country with his wife and their three-year-old son.He became enraged and had to be restrained when agents said the family would be separated, the paper said.Under a “zero tolerance” Trump administration policy announced by the attorney general, Jeff Sessions in May, families suspected of crossing the border illegally are separated. The policy has promoted widespread criticism and opposition.The Starr County sheriff’s report said officers checked on Muñoz every 30 minutes and at least once more during the morning shift before he was found unresponsive on the morning of 13 May, a day after border patrol agents brought him to jail.It said video footage showed Muñoz used a sweater to strangle himself.The report did not say what time that occurred. Muñoz was declared dead around 10am, the report said… June 10, 2018: NBC News posted an article titled: “Immigrant dies by suicide in Texas jail after being apprehended at border, U.S. authorities say”. It was written by Daniella Silva. From the article: …Marco Antonio Muñoz was found dead of an apparent suicide at a jail in Starr County, Texas, on May 13, according to a statement from a U.S. Customs and Border Protection spokesperson on Sunday.He was apprehended on May 11, by agents with the Welasco, Texas Border Patrol Station and allegedly became “disruptive and combative” while at a processing center for people in the country illegally, according to CBP. He was transferred to the jail as a result, the statement said.Muñoz’s death was attributed to suicide caused by self-strangulation, according to an incident report filed to the Texas attorney general’s office by the Starr County Sheriff’s Office. He died despite being checked on by officers every half hour and the presence of a cell camera, according to the report, which was obtained by The Associated Press Sunday.The Washington Post, which first reported the death, said that Muñoz, 39, was a Honduran father who suffered a breakdown after he was separated from his wife and 3-year-old son. The Post cited Border Patrol Agents with knowledge of the incident.An agent told the newspaper that Muñoz had “lost it” after Border Patrol told the family they would be separated and that, “They had to use physical force to take the child out of his hands.”Neither the incident report nor the CBP statement mention if Muñoz was separated with his family, but both describe his behavior after his detention as combative… June 11, 2018: USAttorneys.com posted information titled: “Honduran Man Takes his Life in Texas Jail Cell After Being Separated from his Wife and 3-Year-Old Son”. From the information: …The Washington Post, which was the first source to disclose the details of this unexpected death, stated that Muñoz, who is a Honduran father, “crossed the Rio Grande with his wife and 3-year-old son on May 12th near the tiny town of Granjeno, Texas.” The area is known to be a “popular crossing point for Central American families and teenagers who turn themselves in to apply for asylum in the United States.”Shortly after Muñoz and the family were taken into custody, they arrived at a processing station nearby to McAllen and told officials they wanted to apply for asylum. Border Patron agents informed the family that they would be separated. Naturally, like any father, Muñoz “lost it,” according to one agent. He was later booked into the Starr County jail and officials stated that he remained combative. They decided to place him in a padded isolation cell, without any information regarding the whereabouts of his family was or when he would be released.On May 13th, just two days after crossing the border, a guard passed by Muñoz cell at 9:50 a.m. and that is when he noticed Muñoz “lying in the center of the floor unresponsive and without a pulse.” The source stated that the guard “noticed a small pool of blood by his nose” and “a piece of clothing twisted around his neck which was tied to the drainage location in the center of the cell.” This information was taken from an incident report filed by the sheriff’s department that morning.After Muñoz took his own life, his wife and son were released from Border Patrol custody. Apparently, Muñoz had suffered a breakdown after being separated from his wife and child after crossing the border and may not have been able to handle the stress and worry he felt not knowing what was going to happen or how long he would be kept away from his family.The strange thing about this case is that the death of Muñoz was not publicly disclosed by the Department of Homeland Security nor did it appear in any local news reports when it first happened back in May. While news sources were able to get their hands on the incident report nearly a month later, the source highlighted that Starr County authorities have “refused to provide a copy of Muñoz’s autopsy report” and have not yet responded to requests for more information about the cause of death… Huy Chi Tran June 16, 2018: Arizona Central posted an article titled: “Officials” Vietnamese man in Arizona dies in ICE custody”, It was written by Bayan Wang. From the article: A Vietnamese man awaiting deportation died Tuesday while in U.S. Immigration and Customs Enforcement custody in Arizona, according to ICE officials.Huy Chi Tran, 47, obtained legal permanent residency into the U.S. in 1984. But a judge ordered his removal in 2004 from the U.S. based on a criminal conviction “stemming from charges related to aggravated assault,” ICE officials said in a statement Saturday.Tran is the seventh detainee to die in ICE custody in fiscal year 2018, which began Oct. 1, 2017, according to ICE.Following his release from an Arizona prison in May, Tran was transferred to the Eloy Detention Center on May 28, where he awaited deportation to Vietnam.On June 5, Tran “was found unresponsive in his residential unit,” officials said.He was transported to the Banner Casa Grande Medical enter where he was pronounced dead on Tuesday.ICE policy requires officials to notify the local Vietnam consulate of Tran’s death.An autopsy is pending to determine the official cause of death, officials said. January 6, 2019: NBC News posted an article titled: “22 immigrants died in ICE detention centers during the past 2 years”. It was written by Lisa Riordan Seville, Hannah Rappleye and Andrew W. Lehren. From the article: …Huy Chi Tran, 47, arrived from Vietnam in 1984 and became a legal permanent resident. ICE records show Tran also suffered from schizophrenia. After being convicted of assault, he was stripped of his green card and ordered deported in the mid-2000’s.Vietnamese immigrants like Tran who arrived before 1993 have been considered protected from deportation since 2008, when the U.S. and Vietnam signed a repatriation agreement. Over the last year, the Trump administration has moved to reverse those protections, detaining Vietnamese regardless of when they arrived amid a wider effort to deport immigrants whose countries would not previously take them back.ICE picked Tran up in May 2018 from an Arizona prison where he was serving time for disorderly conduct. He was slated to be deported before he died of a heart attack in June… Zeresenay Ermias Testfatsion July 9, 2018: U.S. News and World Report posted an article titled: “Eritrean US Detainee Kills Himself at Egyptian Airport” From the article: An Eritrean national who was denied asylum in the United States and was being sent back to his homeland has died in an apparent suicide in a holding area at Cairo International Airport, airport officials said in Saturday.Zeresenay Ermias Testfatsion was a detainee of U.S. Immigration and Customs Enforcement and was being held by Egyptian authorities at the airport, awaiting his return to Asmara, Eritrea, ICE said.Testfatsion, 34, was found dead on Wednesday in a shower area and his remains were taken to a hospital, ICE said……His remains will be transported to Eritrea, ICE said in a statement, adding that the U.S. Department of Homeland Security’s Office of Inspector General and the ICE Office Professional Responsibility were notified……Court records show Testfatsion went to the U.S. seeking asylum “for fear of returning to his country.”Testfatsion was ordered deported on October 2017, and after he wasn’t deported within 90 days he petitioned to be released, arguing he should not be forced to stay in detention indefinitely because the Eritrean Consulate hadn’t taken action in his case.His petition, dated Jan. 30, said ICE was working on travel documents but had not been able to remove him because the Eritrean government views those who leave the country as traitors, making it virtually impossible for him to get necessary travel documents……During Testfatsion’s 16-month detention in the United States, he spent time at centers in Pampano Beach, Florida, and Youngstown, Ohio, court records show…. Efraín Romero de la Rosa July 13, 2018: Albany Herald post an article titled: “Third Stewart detention facility detainee passes away”. It was written by Tessa Green. From the article: According to a news release from U.S. Immigrations and Customs Enforcement, Efrain De La Rosa, a Mexican national being held in the Stewart Detention Facility in Lumpkin, passed away this week. De la Rosa’s death marked the third death of a detainee at the Stewart detention facility and the second death this year.Authorities said De La Rosa was found unresponsive in his cell at 10:38 p.m., Tuesday, and medical personnel immediately began to perform CPR and contacted Stewart County Emergency Medical Services. He arrived at the facility at 10:48 p.m. and was pronounced dead at Southwest Georgia Regional Medical Center in Cuthbert at 11:29 p.m……De La Rosa was 40 at the time of his death, and the preliminary cause of death appears to be self-inflicted strangulation… July 27, 2018: The Intercept posted an article titled: “ICE Detainee Diagnosed with Schizophrenia Spent 21 Days In Solitary Confinement, Then Took His Own Life”. It was written by José Olivares. From the article: Isaí Romero had no idea how to break the news to his parents that their son – his brother – had died. The elderly couple, nearly 2,000 miles away in Puebla, Mexico, had been anxiously waiting for their 40-year-old son, Efraín Romero de la Rosa, to be deported back home. Efraín was also looking forward to it.“His big hope was that – going to Mexico,” Isaí Romero, who lives in North Carolina, told The Intercept by phone. The deportation would be a relief compared to the limbo of immigration detention, where Efraín had landed after being placed in immigration removal proceedings by U.S. Immigration and Customs Enforcement. But Efraín never made it out of the ICE facility……Efraín Romero’s suicide came at the end of 21 days in solitary confinement, according to investigators.Romero had been previously diagnosed with schizophrenia and bipolar disorder, according to documents from the Virginia Department of Corrections. His death parallels a case from May 2017, when 27-year-old Jean Jimenez-Joseph, another Steward detainee with a mental health diagnosis, killed himself at the facility after 19 days of solitary confinement. The United Nations has previously said that such confinements could constitute torture and ICE itself has issued strict directives about isolating detainees, including specifically on segregating people with mental health conditions for extended periods……Efraín Romero entered ICE custody in March, after being arrested for larceny. He had been staying with his brother Isaí in North Carolina……The Stewart Detention Facility is managed by the private detention corporation CoreCivic under a contract from ICE. The facility is located on the remote outskirts of Lumpkin, Georgia, making visits from family, advocates, and lawyers a challenge. It has fallen under continued scrutiny for its internal operations, by both advocacy organizations and the U.S. government itself…According to a December 2017 report released by the Department of Homeland Security’s Office of Inspector General, Steward violated some of the standards, including when it came to the use of “segregation” – also known as solitary confinement. According to the report, staff did not always tell detainees why they were being placed in solitary confinement. Sometimes, the report notes, detainees were places in solitary “for violations of minor rules” without required written notification for reasons of lockdown. As The Intercept previously reported, detainees at Stewart have been punished with solitary confinement for refusing to perform voluntary labor……Why Efraín Romero was placed in solitary confinement during his time at Stewart remains unclear……ICE did not answer questions regarding Romero’s mental health, including whether the agency received his mental health diagnosis from the Virginia Department of Corrections. The Virginia Department of Corrections did not respond to requests for comment… Mariee Juárez August 29, 2018: NBC News posted an article titled: “Guatemalan mom says inadequate medical care in ICE custody led to toddler’s death”. It was written by Daniella Silva. From the article: A toddler who came across the border with her mother seeking asylum died after receiving inadequate medical care in ICE custody, according to lawyers for the woman.Yazmin Juárez came to the United States in March with her 18-month-old daughter Mariee. In May, the little girl died. The Guatemalan mother and her lawyers now plan to file several lawsuits alleging that negligence and inadequate medical care when they were held in detention led to the toddler’s death.Juárez, 20, filed a notice of claim Tuesday against the city of Eloy, Arizona, which is the primary contractor of the facility 900 miles away in Dilley, Texas, under an unusual arrangement between Immigration and Customs Enforcement, Eloy and CoreCivic, the private company that runs the facility……Juárez and Mariee were transferred to an Immigration and Customs Enforcement facility in Dilley on March 5, a few days after they crossed the border and requested asylum, according to a statement from the law firm. Mariee had no health problems at the time, according to the statement……At the detention facility, Mariee became sick with a severe respiratory infection that went “woefully under-treated for nearly a month,” according to the law firm. Juárez continually sought attention from medical staff but she was prescribed medications that did not improve the child’s condition and Mariee continued to get worse, according to a timeline provided by the law firm……Juárez took Mariee to see medical staff on March 11 and the little girl was diagnosed with an acute upper respiratory infection, according to the timeline. Over the next two weeks, Juarez brought Mariee back for treatment multiple times, with the little girl losing weight and suffering from high fevers, coughing, congestion, diarrhea and vomiting, according to the timeline……Juárez and her daughter passed the first step in their asylum claim and were released from ICE detention on March 25 and put in a plane to Juárez’s mother’s house, according to the timeline. Juárez took Mariee to the hospital the next day and the little girl remained hospitalized at different locations for six weeks before dying on May 10……[Benard] Dreyer,[a pediatrician and past president of the American Academy of Pediatrics] said Mariee’s records showed that when she hospitalized she had multilobar pneumonia, meaning the infection had spread to more than one lobe in her lungs.“That did not happen in 24 hours,” he said… November 27, 2018: NBC News posted an article titled: “Feds hit with $60 million claim over migrant infant who died after leaving detention center”. From the article: The mother of a toddler who died weeks after being released from the nation’s largest family detention center filed a legal claim seeking $60 million from the U.S. government for the child’s death.Attorneys for Yazmin Juárez submitted the claim against multiple agencies Tuesday. Juárez’s 1-year-old daughter, Mariee, died in May.Juárez’s lawyers said Mariee developed a respiratory illness while she an her mother were detained at the South Texas Family Residential Center in Dilley, Texas. They accused U.S. Immigration and Customs Enforcement of releasing the pair while Mariee was still sick.The girl died six weeks later in Philadelphia.Washington-based law firm Arnold & Porter said it will file a lawsuit if the government doesn’t settle its claim. R. Stanton Jones, a lawyer at the firm, said the government has six months to respond before his firm can file suit… July 31, 2019: PBS posted an article titled: “Private prison company sued in death of 1 year old migrant child”. From the article: A woman whose 1-year-old daughter died weeks after they were released from an immigration detention center in Texas filed a lawsuit Wednesday against the private prison company that operates the facility.Lawyers for Yazmin Juárez are demanding $40 million from CoreCivic in the complaint filed in federal court in San Antonio. It’s the third claim they have filed related to the death of Yazmin’s daughter, Mariee, in May last year.The deaths of children detained by border agents have drawn national attention as have the conditions in border facilities where in some cases dozens of children have been held together at a time. Yazmin Juárez testified on July 10 before a U.S. House panel as photos of Mariee were displayed on television screens. Some lawmakers wiped away tears as she spoke.CoreCivic operates the U.S. Immigration and Customs Enforcement family detention center at Dilley, Texas, the largest facility of its kind. Juárez’s lawyers say CoreCivic allowed poor conditions to fester at the 2,400-bed facility……Mariee died in May 2018 after suffering a hemorrhage that led to irreversible brain and organ damage, six weeks after she and her mother were released from Dilley. Juárez contends that when they left Dilley, Mariee was dangerously sick and admitted to an emergency room one day later.According to Juárez’s lawyers, Mariee started to have symptoms of a respiratory illness several days after they were taken to Dilley. As her condition worsened – with a fever that hit 104.2 degrees Fahrenheit (40.1 degrees Celsius), then coughing and vomiting – her lawyers allege Dilley medical staff didn’t properly treat her, then wrongly cleared her to travel……Juárez’s lawyers have already filed a claim against ICE and other U.S. government agencies demanding $60 million as a precursor to a lawsuit. They have also filed a $40 million lawsuit against Eloy, Arizona, the city that previously had an agreement with ICE to serve as a “pass-through” for funding to Core Civic. Mergensana Amar October 10, 2018: Crosscut posted an article titled: “Asylum seeker at Tacoma jail goes 50 days without food.” It was written by Lilly Fowler. From the article: …One such individual currently sits at the Northwest Detention Center in Tacoma – without food now for 50 days.He is a man in his 30s from Buryatia, a Russian republic located in Siberia, just north of Mongolia, and known for its mountain ranges and punishing winters.He arrived in the United States to seek asylum last December. He turned himself in at San Isidro, a border crossing that sits between Tijuana and San Diego, only to land in the Tacoma detention center a few weeks later. He is refusing to eat in protest of his detention and possible deportation. If forced to return home, he fears he would lose his life.Sitting behind glass in a gray sweatshirt underneath a dark blue prison shirt on Sunday, the detainee looked gaunt and pale. He asked to remain anonymous for fear of persecution and retaliation from the Russian government though his act of defiance demands attention. He has been participating in a hunger strike for what was then 47 days – one of the longest anger strikes in the recent history of the Tacoma detention center.…”The Court finds that there is sufficient cause to believe the without the requested medical testing and treatment” he is “in danger of irreparable injury, and possible death,” according to the court order.The order specifies that medical staff at the detention center have permission to administer fluids intravenously and to perform certain laboratory tests that check for vital signs……According to inmates and Grace Meng, a senior researcher with Human Rights Watch, GEO guards have taken liberties with the forced hydration order and even retaliated against the Buryatia native, as well as others who were recently on a hunger strike to protest conditions at the detention center……When he refused laboratory tests, such as urinalysis, “heavily armored people, with helmets and shields, came and surrounded him, and told him if he doesn’t resume eating voluntarily, they will force-feed him through a tube.” Meng said they then pointed to the court order as if it provided them with the authority to do so, despite the fact that the court order does not allow for force-feeding.Attempting to determine whether the detainee had become suicidal, Meng asked, “Do you want to die?”“It won’t be intentional, but that’s the whole point, it’s my protest,” she recalled him saying in response. “My goal is to deteriorate, to lose more weight, to get sick.”“I will never go back,” the detainee told Meng. “What is waiting for me is jail. They already have accused me of treason. It’s punishable by firing squad… I would prefer to die on this soil than go back to Russia.”… December 29, 2018: The Guardian posted an article titled: “The immigrants who have died in US custody in 2018”. It was written by Erin Durkin. From the article: Mergensana Amar, a 40-year-old Russian national, died in November when he was removed from life support 11 days after trying to kill himself in his cell at the Northwest Detention Center. Amar tried to hang himself after being removed from a brief suicide watch that began when guards found a rope under his bed, according to the Washington Post. Amar had participated in a hunger strike; he died win the same month he was scheduled to be deported. “I would prefer to die on this soil rather than go back to Russia,” he told a Human Rights Watch researcher, according to a report on the news site Crosscut. I put the piece of The Guardian article in here to show that the anonymous man in the Crosscut article is Mergensana Amar. November 29, 2018: Seattle Times posted an article titled: “Medical examiner says Russian detainee in Tacoma died after suicide attempt, not from hunger strike”. It was written by Paul Roberts. From the article: Mergensana Amar had been in ICE custody for almost a year, during which his asylum claim was denied by a court. He was scheduled for deportation this month.The Pierce County Medical Examiner’s Office confirmed the death of a Russian detainee Saturday was the result of an earlier suicide attempt, and wasn’t related to an extended hunger strike as claimed by an immigrant-rights group.The cause of 40-year-old Mergensana Amar’s death was “anoxic encephalopathy,” or lack of oxygen to the brain, due to hanging, investigator Ryann Sale said Monday.The medical examiner’s investigation results back up an account offered earlier Monday by U.S. Immigration and Customs Enforcement (ICE)……Amar was taken to the hospital Nov. 15 after being found unconscious in his cell at the Northwest Detention Center in Tacoma, ICE said. The agency’s medical staff had tried to resuscitate him again after calling 911. He was admitted to the intensive-care uint, where he remained on life support until Saturday, six days after his brain activity stopped.Amar was pronounced dead at 6:05 p.m., Saturday, according to the medical examiner……Before Nov. 15, Amar was in “good physical health” and had been monitored daily by ICE medical staff, the agency said… Jakelin Caal Maquin December 14, 2018: The Guardian posted an article titled: “Guatemalan migrant girl, seven, dies in US border patrol custody”. It was written by Amanda Holpuch. From the article: A seven-year-old girl who crossed a remote part of the US-Mexico border with her father last week died less than two days after being apprehended by the US border patrol in New Mexico, immigration officials have said.The girl vomited and stopped breathing in the custody of US Customs and Border Protection (CBP) before being transferred to a hospital, where she suffered brain swelling and cardiac arrest, according to CBP.The CBP commissioner, Kevin McAleen, identified the girl as Jakelin Caal Maquin……The girl and her father, both from Guatemala, were traveling in a group of 163 people, including 50 children who were traveling without a parent, when they were apprehended around 9:15pm on 6 December……They were held in a small facility near the border before being transferred by bus to a border patrol station 95 miles away. At that facility, officials said, people had access to food, water and restrooms.On the bus, just before 5am, the father told agents his child was sick and vomiting, then personnel at their destination were notified about the medical situation, officials said. Once they arrived, about an hour later, the father told agents that his child was not breathing. Emergency medical technicians revived her twice before she was taken by air ambulance to a children’s hospital in Texas.Officials said later that morning Jakelin went into cardiac arrest, showed signs of brain swelling in a scan, was breathing by machine and had liver failure.She died at 12:35am on Saturday with her father on the scene, officials said… March 30, 2019: NPR posted an article titled: Autopsy for 7-Year-Old Migrant Who Died in U.S. Custody Shows She Died of Sepsis”. It was written by Shannon Van Sant. From the article: An autopsy report has revealed that a 7-year-old girl who migrated to the United States from Guatemala died from a bacterial infection known as streptococcal sepsis while in custody of the U.S. Customs and Border Protection.Jakelin Caal Maquin had traveled to the U.S. with her father 2,000 miles from northern Guatemala. She died in December, two days after they were detained by border officials. By the time Jakelin was transported to a children’s hospital in El Paso, Texas, she was vomiting, having seizures and had difficulty breathing.The medical examiner’s office in El Paso released its autopsy report on Friday showing that streptococcus bacteria was found in the girl’s lungs, adrenal gland, liver and spleen. The report says the infection led to the failure of multiple organs……According to The New York Times, several physicians who reviewed the autopsy report said Jakelin “would have been visibly sick for many hours.” Felipe Alonzo Gomez December 26, 2018: CBS News posted an article titled: “Timeline shows final days of Felipe Alonzo Gomez, the migrant boy who died in U.S. custody”. It was written by Camilo Montoya-Galvez. From the article: For a second time in a month, a migrant child died in U.S. custody after being detained near the southern border by immigration authorities. Felipe Alonzo Gomez, an 8-year-old boy from Guatemala, died in a New Mexico hospital late on Christmas Eve……CBP released a timeline of the events it says ensued after Felipe and his father, Augstin Gomez, were detained near El Paso on Dec. 18. Before dying on Monday night, Felipe spent a week in America… I’m going to summarize the timeline posted by CBS News. Between December 18, 2018, and December 23, 2018, Felipe and his father were transferred from El Paso to the Paso del Norte point of entry, then (two days later) to a Border Patrol station in El Paso. On December 22, late at night, they were transferred to the Border Patrol station at Alamogordo, New Mexico. Felipe and his father arrived at that station early on December 23, 2018. On December 24, 2018, early in the morning, CPB filed a placement request for Felipe and his father to ICE’s family planning inbox. Here’s what happened next: Later in the morning at 9:00 a.m., a CBP agent noticed Felipe was coughing and appeared to have “glossy eyes.” Thirty minutes later, the Guatemalan boy was transferred to Gerald Champion Regional Medical Center in Alamogordo, alongside his father. Hospital staff conducted several strep throat tests on Felipe, but diagnosed him with a common cold and gave him Tylenol to treat pain and fever, CBP said.Felipe remained in the hospital for further observation after he was found to have a 103 degree fever. he was released, however, late in the afternoon and prescribed antibiotics. CBP transported the 8-year-old and his father to a Border Patrol checkpoint on Highway 70, where agents gave them a hot meal and provided Felipe a dose of the prescribed medication.During the evening, Felipe experienced nausea and vomiting. CBP said Felipe’s father declined further medical attention because his son was feeling better. Late at night, around 10:00 p.m., CBP said Felipe again appeared nauseous and “lethargic.” Because there was no EMT present, agents decided to transport Felipe and his father to the same hospital in Alamogordo.On the ride to the hospital, Felipe vomited and lost consciousness. Felipe, his father, and a CBP agent arrived at the hospital a little after 11 p.m. CBP said hospital staff were unable to revive Felipe, who was pronounced dead at 11:48. p.m. December 27, 2018: NBC News posted an article titled: “Guatemalan boy who died in U.S. custody had the flu, medical investigator says”. It was written by Daniella Silva. From the article: The New Mexico Office of the Medical Investigator said Thursday that an 8-year-old boy who died in U.S. custody on Christmas Eve tested positive for influenza B.The medical investigator’s office cautioned in a statement that the cause of death for Felipe Gómez Alonzo, who died minutes before midnight on Dec. 24, was still under investigation, but it was determined that he had been suffering from the flu.“Results of nasals and lung swabs have tested positive for influenza B,” the office said. “While this result indicates that the child had influenza, determining an accurate cause of death requires further evaluation of other laboratory specimens and interpreting the findings in the context of the symptoms and autopsy findings.”The announcement came as pediatricians were raising questions about the medical care given to Felipe, who was apprehended at the border Dec. 18 with his father… April 4, 2019: ABC News posted an article titled: “Autopsies show deaths of children at border were caused by bacterial infections”. It was written by Anne Flaherty. From the article: Bacterial infections were to blame for the deaths of two migrant children in U.S. custody last December, according to newly released autopsy reports……The New Mexico Office of the Medical Investigator said Felipe died of complications from the influenza B infection which damaged his lungs, “allowing a generalized infection.”…[Julie] Linton [of the American Academy of Pediatrics], who has not reviewed the his autopsy report, said the signed of sepsis in a child can be easily missed by someone not trained to treat children. The dangers of bacterial infections and the flu in young children also underscores why AAP recommended two years ago that migrant children are kept in a child-friendly setting with an attentive caregiver and rapid access to medical treatment.Linton said a concrete floor in a border facility wouldn’t count..“Every hour of delayed treatment dramatically increases the chances of death of sepsis,” she said… Mexican Man – Name Unreleased February 18, 2019: CNN posted an article titled: Man dies in Border Patrol custody”. It was written by Geneva Sands. From the article: A 45-year-old Mexican man who was taken into custody by border patrol agents in the Rio Grande Valley of Texas earlier this month died Monday, the U.S. Customs and Border Protection said.CBP says the man was detained on February 2, after crossing the border illegally. He initially asked for medical attention from the Roma Police Department. He was transported to the regional medical center and then cleared to travel to the Rio Grande City Border Patrol Station.The next day, he again sought medical attention and was transferred to McAllen Medical Center in McAllen, Texas, where he died earlier today.The man was initially diagnosed with cirrhosis of the liver and congestive heart failure, though the official cause of death is not known, according to CBP. He remained at McAllen Medical Center until his death.CBP did not provide additional details such as the man’s name… February 19, 2019: NBC News posted an article titled: “Detained Mexican migrant dies in Texas hospital”. From the article: A Mexican man detained by Border Patrol for illegal re-entry died Monday at a hospital in Texas.The 45-year-old man, who was not immediately identified, was initially apprehended Feb. 2 by police in the Texas border community of Roma and requested medical attention, U.S. Customs and Border Protection spokesman Andrew Meehan said in a statement. He was taken to a medical center in McAllen and later cleared to return to the Rio Grande City Border Patrol Station.The next day, he requested medical attention again and was taken to the hospital where he stayed until he died Monday.Meehan said the official cause of death is not yet known, but the medical center diagnosed him with cirrhosis of the liver and congestive heart failure when he was admitted. The death is under investigation… Honduran Woman in custody has stillborn baby February 25, 2019: NBC News posted an article titled: “Honduran woman in immigration custody gives birth to premature, stillborn baby”. It was written by Daniella Silva. From the article: A Honduran woman delivered a stillborn baby boy at an immigration detention center in Texas after going into premature labor last week, authorities said.The woman, 24, was about six months pregnant when she was apprehended by Border Patrol early Feb. 18 near Hidalgo, Texas, according to a joint statement by Immigration and Customs Enforcement and Customs and Border Protection. Both agencies are a part of the Department of Homeland Security……On Tuesday, members of the Congressional Hispanic Caucus called for an investigation into the incident……While the woman was in Border Patrol Custody, she was taken to a hospital and cleared for release on Thursday after receiving two medical screenings, according to the statement. She was then transferred to ICE custody at the Port Isabel Detention Center on Friday afternoon to be processed for release, the statement said.That night, the woman “began complaining of abdominal discomfort” and was examined by ICE’s Health Service Corps, according to the statement. A clinical director was called and ordered that the woman be sent to a hospital and Emergency Medical Services wee called, according to the statement.“At that time, she conveyed that the baby was coming,” the statement said. “She went into premature labor, at 27 weeks pregnant, and delivered an unresponsive male infant.”They were taken to a local hospital where the baby was pronounced dead, the statement said. The woman remains in ICE custody pending medical clearance, according to the statement. Rene Pablo Perez Gordillo March 30, 2019: HuffPost posted an article titled: Migrant Dies In Border Patrol Custody, The Fourth Death In 4 Months”. It was written by Nina Golgowski. From the article: Authorities said a 40-year-old Mexican man died in U.S. Border Patrol custody at a Texas hospital on Monday, making it the fourth death in as many months. The man was treated at the Las Palmas Medical Center in El Paso after medical staff diagnosed him with flu-like symptoms, liver failure, and renal failure. He died later that day, the U.S. Customs and Border Protection said.Telemundo has identified the man as Rene Pablo Perez Gordillo of Maltrata, Veracruz, citing the Consulate General of Mexico.According to the CBP, the migrant had twice crossed the border illegally just 24 hours earlier. During his second detainment, medical professional at the Border Patrol’s processing facility evaluated him near El Paso’s Paso Del Norte Point of Entry and then transported him to the medical center… NOTE: This man is not the 45-year-old Mexican migrant in Border Patrol custody who died at another Texas hospital after staff diagnosed him with cirrhosis of the liver and congestive health failure. Abel Reyes-Clemente April 5, 2019: Arizona Central posted an article titled: “Fourth person in six months dies in ICE immigration detention center.” It was written by Rebekah L. Sanders. From the article: A 54-year-old Mexican man held in a detention center by U.S. Immigration and Customs Enforcement died Wednesday after showing signs of the flu, the federal agency said.Abel Reyes-Clemente is the fourth person to die in ICE custody since Oct. 1, officials said. Two children held by the Border Patrol began vomiting and died in December. Lawsuits have alleged poor hygiene and medical care at detention centers……Reyes-Clemente was detained at a Florence immigration center on Feb. 26 after serving time at a Maricopa County jail for a misdemeanor conviction of driving under the influence, officials said. He had been deported five times before, most recently in 2008, the agency said. Reyes-Clemente became sick and was “placed into medical observation” on April 1, ICE said. Two days later, facility personnel found him around 6 a.m., unresponsive and not breathing.Medical staffers at the detention center and local paramedics who responded failed to revive Reyes-Clemente, the agency said. Doctors at Mountain Vista Medical Center declared him dead at 6:33 a.m……An autopsy to determine the cause of death is pending. June 9, 2019: NBC News posted an article titled: “24 immigrants have died in ICE custody during the Trump administration”. It was written by Hannah Rappleye and Lisa Riordan Seville. From the article: …When 54-year-old Abel Reyes-Clemente died in a cell in Arizona in early April, an ICE press release pointed to complications from the flu. But the Pinal County Medical Examiner found he died from complications from cirrhosis, diabetes, and heart disease, also noting he had tested positive for bacterial pneumonia… Juan de Léon Gutiérrez May 1, 2019: BuzzFeed News posted an article titled: “A 16-Year-Old Unaccompanied Immigrant Boy Has Died In US Government Custody”. It was written by Hamed Aleaziz and Adolfo Flores. The article was updated on May 3, 2019. From the article: A 16-year-old unaccompanied Guatemalan boy died in government custody in Texas on Tuesday, officials said.Juan de Léon Gutiérrez is the third child to die in government custody since December, when a 7-year-old girl died hours after being taken into Border Patrol custody……The government contracts with private and nonprofit shelters to hold unaccompanied migrant children until a family member can pick them up. In this case, on April 20, Immigration and Customs Enforcement (ICE) officials brought Gutiérrez to the ORR shelter in Brownsville, Texas, Southwest Key Casa Padre. The migrant youth shelter, run out of a former Walmart, houses about 1,200 boys and girls.US Customs and Border Protection clinicians did not notice any health concerns and Gutiérrez did not mention any when brought to the shelter, said Evelyn Stauffer, a Health and Human Services spokesperson. The next morning, however, Guitérrez became “noticeably ill,” including having a fever, chills and a headache, she added.Workers at Southwest Key Casa Padre brought Gutiérrez to a hospital that morning on April 21, where he was treated and released that day and brought back to the shelter, Stauffer said.“The minor’s health did not improve after being transferred back to the shelter so on the morning of April 22, 2019, the minor was taken to another hospital emergency department via ambulance,” she said. “Later that day, the minor was transferred to a children’s hospital in Texas and was treated for several days in the hospital’s intensive care unit. Following several days of intensive care, the minor passed away at the hospital on April 30, 2019.”The cause of death has yet to be determined as the ORR investigates the case. A person with knowledge of the 16-year-old’s case said Guitérrez made the journey, at least in part, because he wanted to seek medical treatment related to headaches. The unaccompanied minor was sent to the hospital after going through an initial screening at Casa Padre.The Guatemalan consulate said Guitérrez was admitted with a severe infection in his frontal lobe at a children’s hospital in Corpus Christi, Texas. After a surgery to stabilize the pressure in his head, the minor was put in intensive care before he died April 30… May 9, 2019: Yahoo! News posted an article titled: “US won’t answer new questions about migrant teen’s death”. It was written by Nomaan Merchant and Sonia Pérez D. From the article: Juan De Léon Gutiérrez told his mother he was calling from warehouse in Mexico, hidden by a human smuggler who had been paid to take the teenager to the United States.“He told me he had something of a headache, perhaps because he was hungry and had not been able to sleep,” said his mother, Tránsito Guitérrez de Léon.The 16-year-old died on April 30 after officials at a Texas rough detention facility noticed he was sick, becoming the third Guatemalan child to die in U.S. custody since December……Almost a week after the teenagers’s death, the U.S. Department of Health and Human Services has not said why he was first taken to the hospital and released, only to return one day later. Evelyn Stauffer, an HHS spokeswoman, declined to provide more information Wednesday.Juan had a rare condition known as Pott’s puffy tumor, according to the Nueces County medical examiner in Corpus Christi, citing information from a children’s hospital in Corpus Christi, where he was in intensive care for several days before his death.Despite the name, the condition is not the same as a cancerous tumor. The name refers to the swelling that occurs on a patient’s forehead caused by an infection in the frontal bone. The condition is rare, and while usually treatable with antibiotics, it can require surgery……Dr. Mobeen Rathore, a pediatrician based in Jacksonville, Florida, and spokesperson for the American Academy of Pediatrics, said Juan’s death was further evidence that detaining immigrant children was a health risk under any circumstances.“If a child was in a home and not in a detention center with 1,400 kids… there would be more attention paid to this, whether by a parent of a guardian or whoever,” Rathore said… July 24, 2019: Texas Monthly posted an article titled: “Autopsy Offers Jarring New Details About the Death of a 16-Year-Old Guatemalan Boy”. It was written by Robert Moore. From the article: …Juan DeLeon Gutierrez, 16, died April 30 in Corpus Christi. He crossed the border in the El Paso area April 19 without parents or guardian. He fell ill at an Office of Refugee Resettlement shelter in Brownsville and was treated for several days at a Corpus Christi hospital before he died. The Nieces County medical examiner said no autopsy was preformed because Guiterrez was not in custody at the time of his death and died of natural causes… Simratpal Singh May 6, 2019: Tucson Sentinel posted an article titled: “Indian national dies in ICE custody after posting bond with La Paz County Sheriff”. It was written by Paul Ingram. From the article: An Indian man being held in the custody of U.S. Immigration and Customs Enforcement at a county jail, died at a hospital in Parker, Ariz., on Friday morning.Simratpal Singh, 21, was found “unresponsive and not breathing,” by personnel with the La Paz County Sherriff’s Office in Parker, Ariz., about 230 miles northwest of Tuscon.Singh had been charged with assault and sexual assault, and he had posted bond, however, rather than being released, he was transferred to ICE custody, officials said. While waiting for a transfer to an immigration facility on Thursday, Singh was found by jail staff, who called local paramedics……An autopsy is pending to determine the cause of death, officials said……The Indian consulate has been advised of Singh’s death, ICE said. May 7, 2019: Voice Of America posted an article titled: “Indian Man Dies in US Immigration Custody”. It was written by Victoria Macchi. From the article: An Indian man in U.S. immigration custody died in an Arizona jail last week, federal officials announced late Monday.Simratpal Singh, 21, was found unresponsive on May 2, at La Paz (Arizona) County Jail, where he was awaiting transfer to a U.S. Immigration and Customs Enforcement facility, the agency said in a statement.Medics transported him by ambulance to a local hospital, then by helicopter to a second facility, where personnel declared him dead shortly before 2 a.m. on May 3……An autopsy is pending to determine the official cause of death, according to ICE.Singh is the fifth detainee to die in ICE custody in fiscal year 2019. The agency sees about 10 deaths in its custody every year……The medical treatment of people held by ICE and U.S. Customs and Border Protection is under heightened scrutiny as the Trump administration continues a series of policy decisions designed to limit immigration while responding to an increased number of families arriving at the southwest border.Immigrant advocates question the speed and quality of care that those in custody are receiving… May 10, 2019: Arizona Central posted an article titled: “Medical examiner: Indian national died by suicide in Arizona jail while in ICE custody”. It was written by Daniel Gonzalez. From the article: The Indian national who died in an Arizona jail while in the custody of Immigration and Customs Enforcement died by suicide by hanging himself, according to the Maricopa County medical examiner……The Maricopa County Office of the Medical Examiner listed suicide as the manner of death and hanging as the primary cause of death on its website. Autopsy results have not yet been released… Wilmer Josué Ramírez Vásquez May 16, 2019: HuffPost posted an article titled: “Guatemalan Toddler Apprehended At U.S. Border Dies in Hospital”. It was written by Nina Golgowski. From the article: A Guatemalan toddler apprehended at the U.S.-Mexico border has died after several weeks in a Texas hospital – the fourth death of a migrant child since December.The 2 1/2-year-old boy died on Tuesday night in El Paso, Texas, The Washington Post first reported.The Guatemalan Consulate in Houston later confirmed the boy’s death in a release, stating that he is believed to have died from complications from pneumonia.The boy, whose identity wasn’t revealed by authorities, was apprehended with his mother on April 3, near the Paso Del Norte Bridge, a U.S. Customs and Border Protection official told HuffPost in an email. That bridge spans the Rio Grande, connecting El Paso with the Mexican city of Ciudad Juarez.The day after their capture, the boy’s mother reported him as sick, authorities said. He was transported to a hospital in Horizon City, and later to a children’s hospital in El Paso. His mother was released from custody on April 8, CBP said.“At that point, the family was no longer in [Border Patrol] custody,” CBP said……The boy is at least the sixth migrant to die after crossing the border since December. Four of those deaths were children, all from Guatemala, which is gripped by a hunger crisis… May 21, 2019: BuzzFeed News posted an article titled: “A 2-Year-Old Boy Detained At The Border Had Died After Weeks In The Hospital”. It was written by Adolfo Flores. From the article: A 2-year-old boy from Guatemala who was detained by US agents at the border died Tuesday night after being hospitalized for weeks in Texas, Guatemalan Consulate officials said.Wilmer Josué Ramírez Vásquez is the fourth Guatemalan child to die after being apprehended at the US-Mexico border since December. The death, first reported by the Washington Post, comes amid a growing number of migrants, many of them Central American parents with children, who are presenting themselves at the border to request asylum……Guatemalan General Consul Tekandi Paniagua told BuzzFeed News that Ramírez was hospitalized for about a month and appeared to have pneumonia. US Customs and Border Protection officials did not immediately respond to BuzzFeed News’ request for comment.A Customs and Border Protection (CBP) official familiar with the case told BuzzFeed News that the mother and child were apprehended by Border Patrol agents April 3 near the Paso del Norte International Bridge that links Cuidad Juarez, Mexico, and El Paso Texas.On April 6, the mother told agents that Ramírez was sick and was taken to the Providence at Horizon hospital, in Horizon City, Texas. The next day, he was transferred via ambulance to Providence Children’s Hospital in El Paso, Texas.The family was given a notice to appear in immigration court on April 8 and released on their own reconnaissance at the El Paso hospital. At that point, the family was no longer in Border Patrol custody, the official said…… The bridge was the site of a temporary detention facility in March where Border Patrol detained migrants outdoors behind a chain-link fence topped with razor wire. Families held there said they experienced cold and windy nights sleeping on gravel. Other makeshift sites operated by Border Patrol have continued to spring up to contend with the surge of migrants at the border… July 24, 2019: Texas Monthly posted an article titled: “Autopsy Offers Jarring New Details About the Death of a 16-Year-Old Guatemalan Boy”. It was written by Robert Moore. From the article: …Wilmer Josue Ramierz Vasquez, 2 1/2, died May 14 after several weeks in an El Paso hospital. He crossed with his mother in El Paso on April 3. Wilmer died of “multiple intestinal and respiratory infectious diseases,” including influenza A, according to an autopsy report. Carlos Gregorio Hernandez Vasquez May 20, 2019: The Texas Tribune posted an article titled: “Guatemalan migrant dies after being apprehended at the Texas-Mexico border”. It was written by Julián Aguliar. From the article: A Central American migrant has died while in the custody of the U.S. Border Patrol in the Rio Grande Valley, the agency said in an news release Monday.The Guatemalan teenager, who hasn’t been identified, was processed by agents May 13 and was set to be transferred to the federal Office of Refugee Resettlement, which oversees the treatment of immigrant minors in federal custody. He was found unresponsive Monday morning at the Border Patrol station in Weslaco……A cause of death is unknown, CBP added. The agency said its inspector general, members of Congress and the Guatemalan government have been notified of the teenager’s death… May 20, 2019: NBC News posted an article titled: “16-year-old migrant boy dies in U.S. custody, 5th child to die since December”. It was written by Daniella Silva. From the article: A 16-year-old Guatemalan boy who died Monday in immigration custody in south Texas was diagnosed with the flu a day before, a Customs and Border Protection official said. The teenager is the fifth migrant child to die in U.S. custody since December.Carlos Gregorio Hernandez Vasquez was found unresponsive Monday morning during a welfare check at Weslaco Border Patrol Station, a CBP official familiar with the case said in a Monday afternoon teleconference.He had been transferred to the station Sunday from the Rio Grande Valley Sector’s Central Processing Center, the official said. Early Sunday, Carlos told staff at the processing center that he was not feeling well and a nurse practitioner assessed him and determined he had influenza A, the official said. Carlos was prescribed the medicine Tamiflu for treatment, which Border Patrol agents picked up from a local pharmacy, the official said.The official said Carlos continued to receive care at the processing through the day and was transferred midday to the Weslaco station, where he was to be segregated from much of the other migrant population due to his illness. At the station, he was again medically assessed and his medications was turned over to the medical professionals there, the official said.The next morning, Carlos was found unresponsive in one of the station’s short-term holding rooms about an hour after his previous welfare check, the official said. Medical staff were unable to treat him or save his life, the official said. He had been in the border patrol station for about 17-18 hours at the time.When asked why the boy was not taken to a hospital for treatment, the official said such a decision was up to the medical care providers at their facilities. The official added that he while they did not have the individual specifics on the symptoms, Carlos was exhibiting at the time, the official suspected it was one of the matters that would be reviewed in the investigation… May 22, 2019: Houston Chronicle posted an article titled: “Texas migrant detention center quarantined amid flu outbreak after 16-year-old dies.” It was written by Meagan Flynn. From the article: U.S. Customs and Border Protection has stopped taking detainees at its main processing center in McAllen, Texas, after identifying “a large number” of migrants suffering from flu like symptoms, the agency announced late Tuesday. The move comes one day after a teenage migrant who had been held at the facility died after being diagnosed with the flu……Medical staff as the center identified migrants in custody with high fevers and exhibiting “signs of a flu-related illness,” and they are now receiving medical treatment, CBP said.A spokesman in the Rio Grande Valley Sector did not say how many migrants were affected by the illness. The McAllen processing center, a crowded warehouselike building where detainees are being held behind fencing and sleep on mats, is among the busiest facilities along the southern border… July 24, 2019: Texas Monthly posted an article titled: “Autopsy Offers Jarring New Details About the Death of a 16-Year-Old Guatemalan Boy”. It was written by Robert Moore. From the article: After a 16-year-old Guatemalan boy died in Border Patrol custody in May, officials gave a basic account of what happened. Carlos Gregorio Hernandez Vasquez crossed the border alone near Weslaco on May 13, and was then held at a processing center for unaccompanied minors in nearby McAllen for six days until falling ill on May 19. That day, a nurse practitioner found that he had a 103-degree fever, and he tested positive for the flu. He was prescribed Tamiflu and transferred to the Border Patrol station at Weslaco. Hernandez died the next morning.Now an autopsy report obtained by Texas Monthly provides new details about the death of Hernandez, the fifth Guatemalan child to die since December after being taken into Border Patrol custody. Conducted by Dr. Norma Jean Farley, a contract forensic pathologist for Hidalgo County, the autopsy concludes that Hernandez succumbed to the flu, complicated by pneumonia and sepsis, on or near the toilet of his South Texas Border Patrol cell.He was fed a 2 a.m., May 20, and agents reportedly checked on him every hour, according to the autopsy. But some time later, in a video that Farley apparently reviewed, Hernandez “is seen lying on the floor, vomiting on the floor, and walks over to the commode, where he sits and later lies back and expires.”The exact time of Hernandez’s collapse isn’t known because, as the report notes without explanation, “the time on the video is incorrect.” Regardless, the boy was found at 6 a.m. that same morning, and declared dead twelve minutes later.The circumstances of Hernandez’s death strengthen the criticism of Border Patrol’s handling of sick children. The agency is required to transfer unaccompanied children to the Office of Refugee Resettlement within 72 hours, but officials have acknowledged repeatedly failing to meet that requirement this year, including in Hernandez’s case. Hernandez was also never taken to a hospital despite the apparent seriousness of his illness and the fact that the flu has claimed the lives of two other Guatemalan children in Border Patrol custody in the last six months… Darlyn Cristabel Cordova-Valle May 24, 2019: Refinery 29 posted an article titled: “The 10-Year-Old Migrant Girl Who Died in U.S. Custody Has Been Identified”. It was written by Andrea González-Ramriez. From the article: The 10-year-old migrant girl from El Salvador who died in federal custody last September has been identified as Daryln Valle. According to CBS News, Darlyn planned to make the journey from El Salvador to Omaha, NE, to reunite with her mother. But she was apprehended by Border Patrol halfway through, in Texas, in March 2018.Darlyn, who had a history of congenital heart defects, was placed in an Office of Refugee Resettlement (ORR) facility in Texas. She underwent a surgical procedure and complications left her in a coma, according to the U.S. Department of Health and Human Services (HHS) spokesperson Mark Weber. (HHS oversees ORR). Daryln was only brought to Omaha three days before her death, so she could spend her final moments with her mother. She passed due to fever and respiratory distress.Her death was only disclosed to the public this week. Darlyn is one of six migrant children, all from Central America, who have died after being detained by the U.S. government over the past eight months. Before this period, no migrant child had died while in federal custody since 2010… May 26, 2019:FOX 43 posted an article titled: “Mother of 10-year-old who died in US custody says her daughter was born with a heart murmur.” From the article …The girl’s mother, who asked not to reveal her identity, said her daughter was born with a heart murmur. Doctors told her the girl would need surgery later……Darlyn died in September of last year, but her death was not announced until Thursday. Hers is one of six recent deaths of migrant children while in custody of federal authorities after journeying to the US……The girl traveled with acquaintances by car for four days from El Salvador to the border, her mother said.According to a CBP official, Daryln was encountered by Border Patrol on March 1, 2018, about nine miles west of Hidalgo, Texas. The next morning, Darlyn received a welfare check and a meal. When she complained about chest pains she was sent to the hospital. She was transferred to HHS custody on March 4. According to HHS spokesperson Mark Weber, Darlyn was in a medically fragile state and was transported to various facilities for treatment, including in San Antonio, Texas, and Phoenix, Arizona. He said the child had surgery complications that had left her in a comatose state. She was transported to a nursing facility in Phoenix and later transported to Children’s Hospital in Omaha, Nebraska, where she died due to fever and respiratory distress on September 29, according to Weber… Johana Medina León June 3, 2019: NBC News posted an article titled: “Transgender asylum-seeker dies after six weeks in ICE custody”. It was written by Ben Kesslen. From the article: A transgender woman from El Salvador seeking asylum in the United States died Saturday in a Texas hospital four days after being released from custody, officials and advocates said.Johana Medina Leon, 25, complained of chest pains and was brought to Del Sol Medical Center in El Paso, Texas, on Tuesday, Immigration and Customs Enforcement said. That same day, ICE said she was processed for release on parole. Leon died on the first day of pride month……Leon, who was known to friends as Joe, had been detained in the U.S. since mid-April. On May 18, she received a positive credible fear finding, ICE said. Advocates told NBC News that she was seeking asylum in the U.S. as a transgender woman.Leon was being held at Otero County Processing Center, a private detention center in New Mexico where the ACLU and the Santa Fe Dreamer Project recently alleged poor treatment and of “unconscionable conditions” for LGBTQ immigrants. In a letter sent to Ice, the groups said “ICE practices at Otero have created an unsafe environment” for the LGBTQ detainees there.Leon fell ill while in ICE custody, when she also tested positive for HIV… June 9, 2019: NBC News posted an article titled: “24 immigrants have died in ICE custody during the Trump administration”. It was written by Hannah Rappleye and Lisi Riordan Seville. From the article: …The cause of death for Medina Leon, the asylum seeker who died on June 1, remains unclear. Like Roxsana Hernandez, a transgender woman who died in ICE custody last summer, Medina Leon was diagnosed with HIV while she was detained……ICE sent Medina Leon to the hospital. The same day she went to the hospital, ICE paroled her, meaning released her from custody. As a result, the agency is not required to issue a press release about her death, nor conduct a death review. The El Paso Medical Examiner told NBC News that it will not conduct an autopsy, which is required for all in-custody deaths. June 12, 2019: The Guardian posted an article titled: “Trans woman who died after illness in US Custody had asked to be deported, family says”. It was written by Sam Levin. From the article: A transgender woman who died after becoming sick in Immigration and Customs Enforcement (Ice) custody asked to be deported after she was repeatedly denied medical care, attorneys said on Wednesday.The family of Johana Medina León, a 25-year-old asylum seeker from El Salvador who died this month, filed a civil rights claim against the US government this week, alleging that officials ignored her numerous requests for treatment as her health “rapidly deteriorated”.Medina León, who worked as a nurse in El Salvador, recognized that she needed IV fluids, but was denied. When she asked for water, sugar and salt so she could make her own IV, Ice also refused, the claim said. The treatment in Ice custody was so bad that Medina León, who was fleeing violence in her home country, requested to be deported so she could get medical attention, lawyers said. That request was also denied……Christopher Dolan, an attorney who filed the claim, added: “She was desperate, because the government would not provider her with assistance of any kind for her medical needs.”The death of Medina León, who was detained for more than a month despite following official procedures for seeking asylum and passing her first interview, comes at a time of escalating concerns about human rights violations in US immigration facilities. Queer and trans migrants are particularly vulnerable, suffering disproportionate rates of physical and sexual abuse behind bars and often being forced into solitary confinement……Medina León was threatened with physical violence because she is a trans woman and fled El Salvador in December 2018, lawyers said. She was granted a humanitarian visa in Mexico and then presented herself to US authorities to request asylum……She was subsequently detained in El Paso, Texas, in April and transferred to the Otero county processing center in New Mexico. Like other trans women at the privately run detention center, she was housed with men.On 18 May, authorities determined she had “credible fear” of persecution if forced to return o El Salvador, but Ice continued to detain her. She eventually became unconscious and was taken to a Texas hospital, her attorneys said. That same day, she was released on parole.Dolan, a San Francisco-based lawyer, accused Ice of finally releasing her when she became seriously ill in an effort to “absolve themselves of responsibility”…On 1 June, [her family] learned she had died of pneumonia… Óscar Alberto Martínez and his daughter Valeria June 26, 2019: NBC News posted an article titled: “Family of Salvadoran migrant dad, child who drowned say he ‘loved his daughter so much’. It was written by Daniella Silva. From the article: The mother of a Salvadoran migrant who drowned alongside his 23-month-old daughter while trying to cross into the United States said the man “loved his daughter so much” and was seeking a better life for his family.Óscar Alberto Martínez and his daughter Valeria died while trying to cross the Rio Grande on Sunday, their deaths captured by a horrific and haunting image that sparked outrage.The father and daughter lie face down on the water on the bank of the Rio Grande in Matamoros, Mexico, Valeria tucked inside her father’s short with her tiny arm wrapped around his neck……Estela Avalos, Tania’s mother, said her daughter also almost drowned but a friend was able to rescue her……The family had become frustrated and desperate after waiting two months in Mexico, unable to present themselves to U.S. authorities to request asylum, according to reporting by Julia Le Duc, who photographed the death of the father and daughter, for Mexican newspaper La Jornada……Immigration lawyers and rights advocates say asylum-seekers have been increasingly trying to cross the border illegally because of policies by the Trump administration, such as “metering,” or restricting the number of migrants who can be processed at a legal port of entry. The administration has also been ramping up its policy of forcing asylum-seekers to wait in Mexico as their cases play out after presenting themselves at a port of entry to seek asylum… I put this article into this blog even though this family was not being held by Border Patrol or ICE. Instead, they were stuck in Mexico for an indeterminate amount of time, until the Trump Administration would deal with their asylum claim. This father and daughter did not die due to lack of medical care. They died from neglect and a harmful, indeterminate, waiting period imposed on people who have a legal asylum claim. Yimi Alexis Balderramos-Torres June 1, 2019: BuzzFeed News posted an article titled: “A 30-Year-Old Father Died After Being Detained For Weeks By ICE”. It was written by Hamed Aleaziz. From the article: A 30-year-old Honduran man who had previously been forced wait in Mexico while his asylum case was processed in the US died Sunday, weeks after being taken into federal immigration custody, officials said.The death of Yimi Alexis Balderramos-Torres, first reported by BuzzFeed News on Monday morning, is the sixth in Immigration and Customs Enforcement custody since October. Hours after the report, congressional staffers were informed by ICE officials of the man’s death. Six hours after the initial BuzzFeed News report, ICE officials confirmed the death in a press release.Baldeáramos-Torres had previously been apprehended by immigration officials in El Paso, Texas, on May 17, according to a statement released by ICE. The man was accompanied by his son when he was encountered by Border Patrol on May 17, according to a source with knowledge of the matter.Baldeáramos-Torres had been sent back to Mexico under a Trump administration program that requires Central American immigrants to wait outside the US as their asylum cases make their way through the immigration courts. More than 15,000 individuals have been sent back to Mexico through the program, according to statistics released by the Mexican government……On May 27, Balderramos-Torres again crossed the border without authorization and was picked up by local police in the US during a traffic stop. He was placed in ICE custody on June 6, according to the authorities. Because he had previously been arrested by Border Patrol and deported in 2013, ICE officials “reinstated” his previous deportation order and kept him in custody pending his future removal to Honduras, they said.Nearly two weeks later, on June 18, he was transferred to the Houston Contract Detention Facility in Houston.On June 30, Balderramos-Torres was found “unresponsive,” and medical officials at the facility were unable to revive him. He was taken to a local hospital where he was pronounced dead Sunday morning. A cause of death is pending as officials conduct an autopsy… Unnamed El Salvadoran Man June 3, 2019: KVEO.com posted an article titled: “Salvadorian Man Dies in Border Patrol Custody”. It was written by Marlane Rodriguez. From the article: U.S Customs and Border Protection released the following statement:According to initial reports, U.S. Border Patrol agents from Rio Grande Valley Sector apprehended a man near the border in Roma, Texas, at 12:10 p.m., CDT. Shortly after taking him into custody, agents called Emergency Medical Services after they observed signs that the man was suffering from an apparent seizure at 12:22 p.m. An EMT-certified Border Patrol Agent quickly initiated medical care until EMS arrived at 12:29 p.m. EMS continued emergency care and transported him to a local hospital at 12:45 p.m. Despite all efforts to save the 33-year-old man’s life, hospital authorities pronounced him deceased. At this time, CBP is not releasing the identity of the individual until confirmation that the man’s loved ones have been notified….…The Department of Homeland Security’s Office of the Inspector General and the Government of El Salvador have been notified… Guatemalan Teen Mother and Prematurely Born Baby These two did not die while in Border Patrol custody, but likely would have if human rights attorneys had not visited the facility. June 13, 2019: (and updated June 20, 2019): HuffPost posted an article titled: “Teen Mom and Prematurely Born Baby Neglected At Border Patrol Facility for 7 Days”. It was written by Angelina Chapin. From the article: A prematurely born infant and her 17-year-old mother spent seven days being almost entirely neglected in Border Patrol custody, according to lawyers who visited an immigrant processing station in McAllen, Texas, on Tuesday and Wednesday.The baby, barely a month old, was wrapped in a dirty towel, wore a soiled onesie and looked listless, said one of the lawyers, Hope Frye. The mother was in a wheelchair due to complications from her emergency C-section and had barely slept – the pain made it too uncomfortable for her to lie down and she was afraid of dropping her baby, the immigration and human rights attorney said……The mother, according to Frye, said she had been taken to the hospital at least once to receive pain medication, but the baby had received no medical attention since being in Border Control custody. The child was born in Mexico just after her teenage mother left Guatemala for the U.S. when she was eight months pregnant……Frye said one of her colleagues, an immigrant rights advocate, told her on Wednesday that the baby had not cried for five hours and had become “weak and listless.” The advocate, according to Frye, said that since the infant was wrapped only in a towel she was concerned her body temperature was dropping, which can be fatal……Frye said that she and her team worked Tuesday and Wednesday to try to get the new mother and her child released from Border Patrol custody. After alerting government officials and medical officers, they also called 911 and the local Child Protective Services office, both of which said they didn’t have jurisdiction over the federal facility, according to Frye……The lawyers later on Thursday confirmed to HuffPost that the family had been transferred to a resettlement facility… Four Severely Ill Toddlers Hospitalized Four toddlers in a Border Patrol facility were found to be extremely ill, and likely would have died if a group of lawyers had not visited the facility. June 21, 2019 (updated June 22, 2019): HuffPost posted an article titled: “4 Severely Ill Migrant Toddlers Hospitalized After Lawyers Visit Border Patrol Facility”. It was written by Angelina Chapin. From the article: Four toddlers were so severely ill and neglected at a U.S. Border Patrol facility in McAllen, Texas, that lawyers forced the government to hospitalize them last week. The children, all under age 3 with teenage mothers or guardians, were feverish, coughing, vomiting, and had diarrhea, immigration attorneys told HuffPost on Friday. Some fo the toddlers and infants were refusing to eat or drink. One 2-year-old’s eyes were rolled back in her head, and she was “completely unresponsive” and limp, according to Toby Gialluca, a Florida-based attorney……Another mother at the same facility had a premature baby who was “listless” and wrapped in a dirty towel, as HuffPost previously reported.The lawyers feared that if they had not shown up at the facility, the sick kids would have received zero medical attention and potentially died. The Trump administration has come under fire for its treatment – and its alleged neglect – of migrants who have been crossing the southern border in record numbers. The result is overcrowded facilities, slow medical care and in some instances, deaths.…Children and their parents told lawyers that in some cases they didn’t have any access to medical treatment in Border Patrol facilities despite being visibly ill. Gialluca spoke with one 16-year-old mother whose toddler had the flu, but was told by a a guard the child “wasn’t sick enough to see a doctor.” She said others also reported being denied medical attention despite having critically sick babies……Gialluca met one 16-year-old mother whose 8-month old baby was sick with the flu and forced to sleep outside for four days at the McAllen Border Patrol station. The mother said the guards took the clothing off the baby’s back, leaving her in a diaper, and forced them to sleep on concrete without a blanket.A sick 2-year-old girl was shivering in a T-shirt and had shallow breathing, according to Mike Fassio, a Seattle-based immigration attorney who visited Ursula. [Ursula is a Border Patrol processing center in McAllen, Texas.)…Some children were so exhausted they fell asleep during the interviews, said Clara Long, a senior researcher at Human Rights Watch who spoke with kids at a facility in Clint, Texas. Long met a 3-year-okd boy who was dirty with matted hair and was being taken care of by his 11-year-old brother. She said that more than 10 sick children were being quarantined in cells.While the group of roughly eight lawyers and interpreters at Ursula were supposed to be interviewing children about conditions in the facilities, they also ended up asking guards and government officials to bring kids to the hospital because they were so worried about their state… June 24, 2019: The New York Times posted an article titled: “Hundreds of Migrant Children are Moved Out of an Overcrowded Border Station”. It was written by Caitlin Dickerson. From the article: …Hundreds of migrant children have been transferred out of a filthy Border Patrol station in Texas where they had been detained for weeks without access to soap, clean clothes or adequate food, the authorities confirmed on Monday, suggesting that worsening conditions and overcrowding inside federal border facilities may have reached a breaking point.The move came days after a group of lawyers was given access to the station in Cling, Tex., about 20 miles southeast of El Paso, and said they saw children as young as 8 caring for infants, toddlers with no diapers, and children who said they were waking up at night because they were hungry…The visit by lawyers to the Clint facility on June 17 was allowed as a result of a judge’s orders in a long-running court case concerning the conditions under which migrant children are held in government facilities. After they arrived and observed what was happening, the lawyers, including representatives of some of the nation’s most prominent law schools, immediately began lobbying for the children to be released.Some 249 of the children were transferred into a shelter system maintained by the Office of Refugee Resettlement, according to Ms. Stauffer; an unknown number of others were sent to a temporary tent facility in El Paso, according to Elizabeth Lopez-Sandoval, a spokeswoman for Congresswoman Veronica Escobar, Democrat of Texas, who began looking into the overcrowded facility in Clint last week after reports about the conditions there……The Border Patrol was routing children to Clint because the agency had been facing an unusually large influx of border crossers. The infants there had either been separated from adult family members with whom they had crossed the border or were the children of teenage mothers who had also been detained there. Some of the minors had been held there for nearly a month……Ms. Lopez-Sandoval said that only 30 children remain in Clint. The Border Patrol station there was meant to be temporary; children are supposed to be transferred out after 72 hours. But many had been languishing there because the Department of Health and Human Service’s shelters were full… Unnamed El Salvadoran man with daughter June 30, 2019: CBS News posted an article titled: “El Salvador man dies in U.S. border custody”. From the article: A 43-year-old El Salvadoran man who crossed into the U.S. with his daughter collapsed at a border station and later died at a hospital, officials said Saturday. The man had been held about a week at the Rio Grande Valley Central processing center in McAllen, Texas, according to a law enforcement official.The official said the man, who had health issues, had been medically checked.The daughter was still in U.S. Border Patrol custody, but officials requested an expedited transfer to a shelter run by the agency that manages children who cross the border alone, an official told The Associated Press. The official did not know the daughter’s age.The child will be in a shelter until she is released to a sponsor, but that process could take weeks.U.S. Customs and Border Protection issued a statement to CBS News acknowledging the man’s death, saying the agency was “saddened by the unfortunate death of a 43-year-old man from El Salvador who was rushed to the hospital after falling into medical distress.”……The facility where the man was being held, like most other Border Patrol stations along the U.S.-Mexico border, is overcrowded. Border station are generally at capacity with about 4,000 people and more than 15,000 are in custody. Advocates and attorneys have decried fetid, filthy conditions inside the stations that were not meant as more than a temporary holding station… Unknown Migrant Woman with Two Infants and a Toddler June 24, 2019: The New York Times posted an article titled: “Three Children and a Woman Are Found Dead Along the Border in Texas”. It was written by Mitchell Ferman and Manny Fernandez. From the article: The bodies of what appeared to be a migrant woman in her 20s and three children – two infants and a toddler – were found Sunday night near the edge of the Rio Grande outside the South Texas city of McAllen, the authorities said.Migrant deaths happen with grim regularity along parts of America’s southwestern border, largely when adults and unaccompanied teenagers succumb to harsh desert conditions or a lack of water, and die of hypothermia. The discovery on Sunday was unusual – it is rare for officials to discover dead migrant children on the American side of the border, and rarer still for the bodies of three children to be found together……Officials said there were as yet no signs of foul play, and that the four may have died from dehydration and heat exposure. The bodies appeared to be those of undocumented immigrants, but neither their identities nor their country of origin had been determined on Monday……The four bodies were found by Border Patrol agents across the river from Reynosa, Mexico, in an area of the United States side of the border that is heavily traveled by Central American families. They were in a brush-covered region southeast of Anzalduas Park on federal property managed by the United States Fish and Wildlife Services, near the state-run Las Palomas Wildlife Management Area, officials said. The Federal Bureau of Investigation was leading the investigation because the bodies were found on federal land……It was unclear what went wrong from the woman and children whose bodies were found: whether they had gotten lost in the brush in the heat, whether they were already ill when they crossed the river, whether they were abandoned by smugglers or other migrants. Sheriff Guerra said they were found in a makeshift staging area, a clearing near the river where groups of migrants often gather after they cross the river. From there, they typically walk deeper into the countryside to look for federal agents.South Texas is always hot in June, but the heat has been extreme in recent days… August 15, 2019: The Guardian posted an article titled: “Detained migrant children must have access to soap and other basic needs, court rules”. From the article: Migrant children detained by the US government must have access to soap, toothpaste, and other basic hygiene products, as well as edible food, clean water and places to sleep, a panel of judges has ruled.The administration had contended that detained immigrant children, who are required to be provided with “safe and sanitary” conditions, didn’t need basic hygiene products.The ninth circuit court of appeals in San Francisco tossed out the government’s challenge to a lower court’s findings that authorities had failed to provide safe and sanitary conditions for the children in line with a 1997 agreement widely known ad the Flores settlement.The government argued that authorities weren’t required to provide specific accommodations under the settlement, such as soap, and asked the panel to weigh in.A Trump administration lawyer tried to argue the point in June, saying the agreement was vague and might not require that a toothbrush and soap be provided to children during brief stays in custody.The appellate judged disagreed, writing: “Assuring that children eat enough edible food, drink clean water, are housed in hygienic facilities with sanitary bathrooms, have soap and toothpaste, and are not sleep deprived are without double essential to the children’s safety.”……The Flores settlement between advocates for young immigrants and the US government says children should be held in facilities that meet certain standards and released as soon as is reasonably possible, which has been considered to be about 20 days. August 15, 2019: The Hill posted an article titled: “Appeals court rules Trump administration must provide hygiene products at migrant facilities”. It was written by Zack Budryk. From the article: A federal appeals court on Thursday upheld a previous court order mandating the Trump administration to provide basic personal hygiene items to children in detention facilities in the Rio Grande Valley in Texas. The ruling by the U.S. 9th Circuit Court of Appeals in San Francisco hands a loss to the Trump administration, which had challenged a lower court decision two years ago ordering U.S. officials to provide basic personal hygiene items as well as adequate sleeping conditions, temperatures, and food and water to children in detention facilities in the Rio Grande Valley.The appeal’s court ruling essentially backs the two-decade old Flores agreement, which mandates key aspects of how immigrant children can be held by authorities, including that they be kept under the “least restrictive conditions” possible.“Assuring that children eat edible food, drink clean water, are housed in hygienic facilities with sanitary bathrooms, have soap and toothpaste, and are not sleep-deprived are without doubt essential to the children’s safety,” the appeals court panel ruled.“The district court properly construed the agreement as requiring such conditions rather than allowing the government to decide whether to provide them,” they added… THIS BLOG WILL BE UPDATED WHEN MORE INFORMATION IS FOUND. Migrants are Dying From Lack of Health Care 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 PayPal.me. Thank you!...
- A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Three – Continued
  July 3, 2019health insurance / Out of SpoonsThis blog post is a continuation of everything significant that happened with Obamacare, Medicare, Medicaid, and access to reproductive health care in the United States in 2019. Part Three left off at the end of June of 2019. This blog picks up in July of 2019. You may want to go back and take a look at the efforts that the Trump administration and the GOP made to destroy people’s access to health care in 2017 and in 2018. The purpose of this series of blog posts is to make it incredibly easy find information about what happened to health care access during the Trump administration. July 1, 2019: The Hill posted an article titled: “Overnight Health Care: Panel of judges set for ObamaCare case | Trump officials delay ‘ conscience protection’ rule | Theranos founder to go on trial for fraud next summer”. It was written by Peter Sullivan. From the article: Panel of judges set for big ObamaCare court case next weekThe three-judge panel on the Fifth Circuit Court of Appeals that will hear the lawsuit seeking to overturn the Affordable Care Act was revealed on Monday.The judges for the July 9 arguments are Carolyn King, Jennifer Elrod and Kurt Englehardt. King was appointed by President Jimmy Carter, while Elrod and Englehardt were appointed by President George W. Bush. That means there are two Republican-appointed judges to one Democratic-appointed judge.Most legal experts in both parties view the lawsuit’s legal argument challenging the health care law as extremely weak and think that eventually ObamaCare will be upheld. But there are still a lot of question marks around the case, especially after the court last week asked whether the blue states arguing to uphold the health law even have the legal standing to be involved……Trump administration delays implementation of ‘conscience protection’ ruleThe Department of Health and Human Services (HHS) is delaying the implementation of its “conscience protection” rule until November to give the administration more time to deal with a lawsuit over the policy.HHS announced in a court filing Saturday that the rule, which was originally scheduled to take effect July 22, would not be implemented until Nov. 22 at the earliest.A coalition of Democratic-led states filed a lawsuit against the administration in May saying the policy, which would allow health care providers to refuse to provide services on the basis of their religious beliefs, is unconstitutional……Background: President Trump announced the policy in May, which proponents say would protect health care workers and institutions from having to violate their religious or moral beliefs by participating in abortions, providing contraception sterilization, or performing other procedures… July 1, 2019: NPR posted an article titled: “Court Order Delay Of Trump Administration’s Health Care ‘Conscience Rights’ Rule”. It was written by Selena Simmons-Duffin. From the article: The federal government’s rule designed to support health workers who opt out of providing care that violates their moral or religious beliefs will not go into effect in July as scheduled. The effective date has been delayed by four months, according to court orders.The “Protecting Statutory Conscience Rights in Health Care” rule was originally issued in May by the Department of Health and Human Services’ Office for Civil Rights. It aligns with that office’s religious freedom priorities and would put new emphasis on existing laws that give health care workers the ability to file a complaint with that office if they are forced to participate in medical care that violates their conscience – such as abortion, gender confirmation surgery, and assisted suicide.As NPR reported, the rule also expands the type of workers who are able to file this kind of complaint to billing staff and receptionists and anyone else who in any way “assist[s] in the performance” of a procedure……Several groups sued the federal government over the rule immediately after it was issued. New York state led a coalition of 23 cities and states in one suit, and three jurisdictions in California also sued, including California state and San Francisco. Yet another plaintiff, Santa Clara County in California’s Bay Area, made the case that the rule put patient safety at risk, since it gave health workers the right to opt out of providing care without prior notice – potentially even in an emergency……Santa Clara and several other plaintiffs had filed for a preliminary injunction to prevent the rule from going into effect while the legal process played out……The new effective date is Nov. 22 – the federal judge in the California cases make that official over the weekend, and in the New York case, the federal judge certified the change on Monday… July 1, 2019: CNBC posted an article titled: “Nancy Pelosi’s latest Medicare proposal would pass drug discounts to all consumers”. It was written by Berkeley Lovelace, Jr. From the article: House Speaker Nancy Pelosi’s latest draft of legislation allowing Medicare to negotiate lower drug prices would also apply those discounts to private health plans across the U.S., according to a senior Democratic aide.The Department of Health and Human Services is currently prohibited from negotiating drug prices on behalf of Medicare – the federal government’s health insurance plan for the elderly. Pelosi has been working for months on a plan that would give HHS that power, which private health insurers already have. The most recent draft of the legislation proposes to extend those cost savings to private insurance plans, the aide said, asking not to be identified because the legislation is still being drafted and could change.Kaiser Health News first reported the news……It’s unknown if Pelosi’s plan would apply to all drugs. But according to Kaiser, it would authorize HHS to negotiate the prices of the 250 most expensive drugs. July 1, 2019: The American Medical Association (AMA) posted news titled: “Supreme Court to Medicare: Seek feedback before changing rules”. It was written by Contributing News Writer American Medical Association Tanya Albert Henry. From the news: A recent U.S. Supreme Court ruling ensures that Centers for Medicare & Medicaid (CMS) officials must tell the public about proposed changes to Medicare benefits – even if they seem minor – and give physicians and other stakeholders a chance to comment on modifications’ potential impact.Physicians are cheering the ruling, as the outcome is one the Litigation Center of the American Medical Association and State Medical Societies advocated for in a friend of the court brief filed in the case before the high court on behalf of the AMA and the Medical Society of the District of Columbia. Physicians told justices that “even ‘seemingly minor’ modifications in reimbursement determinations give rise to extreme financial consequences for providers and ultimately their patients.”The majority opinion, written by Justice Neil Gorsuch, opens by saying that in “one way or another, Medicare touches the lives of nearly all Americans,” noting that it provides health insurance for nearly one-fifth of the nation’s population. In explaining its reasoning for requiring the Department of Health and Human Services (HHS) to seek input, the court echoes arguments that the Litigation Center brief made about the importance of a notice-and-comment period for physicians, patients, and other stakeholders… July 1, 2019: University of Wisconsin-Madison News posted an article titled: “Wisconsin Medicaid expansion lowered antidiabetic drug costs 70%”. It was written by Katie Gerhards. From the article: …A new study by a team of University of Wisconsin-Madison researchers shows that Wisconsin Medicaid’s 2004 coverage expansion had a tremendous impact on making antidiabetic drugs more affordable for one of the state’s populations that needs them the most: childless adults with low income.Although Wisconsin did not participate in the Affordable Care Act Medicaid expansion, legislators approved a limited expansion through a Section 1115 Medicaid Demonstration Waiver. Effective 2014, this waiver expands coverage for childless adults earning up to 100% of the federal poverty level.Previously, this group had been covered by the BadgerCare Plus Core Plan, with covered fewer medications and had higher copays for generic and brand-name drugs. Transitioning from the Core Plan to the more comprehensive Standard Plan dropped out-of-pocket costs for antidiabetic medication by an average of 70 percent per childless adult, or $36.59 per year.The expanded coverage also correlated with a 4 percent increase in childless adults using antidiabetic medications, such as insulin and oral medications like metformin. That increase is largely driven by a growing number of people using medication, suggesting affordability might have been an obstacle before the coverage expansion… July 1, 2019: IndyStar posted an article titled: “State calls new rules ‘Gateway to Work.’ Activists call them a ‘poverty trap.'” It was written by Shari Rudavsky. From the article: …The requirements began Monday. People covered under the Healthy Indiana Plan are expected to work at least 20 hours per month. That number will slowly climb until July 2020, when Medicaid recipients will need to show that they have worked, volunteered, studied, or acted as a caregiver for 80 hours each month.State officials have said the Gateway to Work program will encourage low-income Hoosiers to find employment and improve lives. They said the program will support Hoosiers as they transition to employment at the same time it requires them to have “some skin in the game.”Those who oppose the work requirements point to Arkansas, where an estimated 17,000 people have lost health insurance since work requirements went int effect in June 2018.But officials for the Family and Social Services Administration have said the road map for Indiana looks nothing like the one overseen in Little Rock. They have estimated that about 20 percent of those currently on the Healthy Indiana Plan, or about 85,000 people, will be affected by the work requirement.At the start, FSSA officials have said they will operate under “an economy of trust” and allow HIP recipients to log their work hours without requiring outside documentation.Still, activists say they fear the new requirements will lead those in need to lose precious coverage, coverage that many value……Even if the system works as well as it can be expected, some recipients could still find it challenging to meet the requirement that they log on monthly to prove their eligibility, said Donna Neidnagel, a Brown County resident who spoke Monday.Only about a third of people who are full-time residents in Brown County have access to the internet. Many people live in areas where cellphones have no reception… July 1, 2019: Crain’s Chicago Business posted an article titled: “Illinois hiring hundreds to reduce Medicaid backlogs”. It was written by Stephanie Goldberg. From the article: Illinois is hiring hundreds of frontline workers to resolve major delays of its Medicaid application and renewal process.The Illinois Department of Healthcare and Family Services, which oversee Medicaid, and the Illinois Department of Human Services are working together to fill the vacancies, the departments said in a statement today. The first positions are expected to be filled this week.The Medicaid redetermination process, which reviews eligibility for the state’s nearly 3 million Medicaid beneficiaries, can lead to lapses in coverage. Such gaps are hard on patients, especially those managing chronic conditions, and health systems that don’t get reimbursed for medical services when claims are denied by health plans.Backlogs, which have increased in recent years, are considered delays of 45 days or more for initial applications and 60 days or more for renewals, the statement says……A recently passed a bipartisan Medicaid reform package also aims to reduce the backlogs. July 1, 2019: The Independent posted an article titled: “Iowa sued for blocking Medicaid from funding reassignment surgery”. It was written by Lily Puckett. From the article: The ACLU of Iowa has filed a lawsuit challenging a new state law that prohibits the use of Medicaid funding for gender reassignment surgery.Governor Kim Reynolds signed a bill on 3 May that included language amending the Iowa’s Civil Rights Act so that the state is not required to pay for gender reassignment surgery. On Friday, The ACLU sued Mr Reynolds, the state and the Iowa Department of Human Services on behalf of One Iowa, a group that advocates for transgender rights, and two transgender Iowans who qualify for Medicaid and whose doctors say they need the surgery to treat gender dysphoria.The lawsuit filed in the state court asks a judge to declare the measure invalid because it’s unconstitutional and order the state to halt enforcement. It claims the law violates inalienable rights to liberty, safety and happiness and equal protection sections of article 1 of the Iowa Constitution……In March, the Supreme Court ruled that the Iowa Department of Human Services cannot block Medicaid from paying for gender reassignment surgery for two transgender women whose doctors recommended the procedure.Republicans in the Iowa Legislature passed the law being challenged as part of a last minute addition to a human services budget bill responding to that ruling… July 2, 2019: Politico posted an article titled: “GOP states seek delay in Obamacare case”. It was written by Dan Diamond. From the article: REPUBLICAN STATES REQUEST OBAMACARE TRIAL DELAYThe GOP-led states seeking to overturn Obamacare requested on Monday that they get an additional 20 days to file a supplemental brief and that the opening argument set for next week to be delayed to “a date of the Court’s choosing” after the filing.In a letter to the clerk of the 5th U.S. Circuit of Appeals, attorney Kyle Hawkins said these “important” questions “merit a thorough response” that represents the views of all the states. “As of today, it appears unlikely that any such response will be completed by the Court’s July 3 deadline.”……ORAL ARGUMENTS SET IN CONSCIENCE-RULE LAWSUITPlaintiffs suing to stop HHS’s rule to strengthen conscience rights will have their day in court on Oct. 30, a federal judge in California ordered on Monday.The Trump administration’s rule, which would expand protections for religious-workers to deny health services, was to take effect on July 22, but U.S. District Court Judge William Alsup this weekend postponed the rule’s effect until Nov. 22. HHS was sued by San Francisco city attorney Dennis Herrera, California Attorney General Xavier Becerra and the Democratic-led states……REPRODUCTIVE RIGHTS GROUPS PUSH BACK ON FDAA coalition of 75 reproductive rights organizations and physicians sent an open letter to FDA calling for the agency and other government officials to remove barriers for patients to access abortion pills. The pills are supplied by a Dutch pharmacist through the website AidAccess.Org, but in March the FDA ordered the site in a warning letter to stop selling unapproved versions of two drugs – mifepristone and misoprostol – to U.S. consumers.The groups, including Planned Parenthood and National Organization for Women, argued that the medicines have been proven safe and effective and if laws and regulations “were based on science – not politics” they would be readily available… July 2, 2019: Aid Access.org posted “Open Letter – Medication Abortion Access Should Be Based on Science Not Politics”. From the open letter: In October of 2018, the international group AidAccess.org, led by Dr. Rebecca Gomperts, began offering mifepristone and misoprostol, commonly known as medication abortion pills, by mail, to patients in the United States. After an online medical consultation with a patient, Dr. Gomperts writes a prescription and a pharmacy fills the prescription and ships pills to the patient. According to analysis conducted by a research team at the University of Texas at Austin, in its first year of operation, AidAccess.org received over 21,000 requests for abortion pills, without any advertising or outreach.The two-medication combination that AidAccess.org is providing has been demonstrated to be safe and effective in extensive research and is the same combination approved for use in the United States by the Food and Drug Administration (FDA). Yet, despite the strong safety record of medication abortion, in March 2019 the FDA sent warning letters to AidAccess.org and Dr. Rebecca Gomperts, stating that they are violating the Federal Food, Drug, and Cosmetic Act by offering mifepristone and misoprostol directly to U.S. consumers seeking to end a pregnancy. The agency demanded that AidAccess.org immediately cease offering these medications to people in the United States.If the laws and regulations that determine the terms of abortion access in the United States were based on science – not politics – medication abortion would be widely available in the United States without medically unnecessary restrictions on distribution. Abortion with quality pills delivered by mail directly to one’s home with instructions for use in multiple languages and access to medical counseling and back-up, if needed, should be one of an array of abortion options available, ensuring everyone who needs to end a pregnancy has the freedom and control to do so in a way that best fits their lives. However, due to the politics of abortion, medication abortion has been over-regulated by the FDA, and pushed further out of reach for many by state restrictions.The high demand for medication abortion by mail should come as no surprise. Access to abortion is under direct threat today, with near-total bans on abortion care recently signed into law in Alabama, Georgia, Kentucky, Mississippi, and Ohio. This is happening in a context in which abortion is already inaccessible for many: 90% of U.S. counties have no abortion clinic. In addition to having to travel a long distance to the nearest abortion clinic, many people have to endure legally-mandated waiting periods. These medically unnecessary waiting periods create further challenges for people who have to take time away from work or school or arrange for childcare. These hurdles may increase the cost of an abortion, which averages $500 in the first trimester and only becomes more expensive as pregnancy progresses. In 35 states and the District of Columbia, Medicaid does not cover abortion care except in rare cases, making abortion financially inaccessible for low-income people. These restrictions are about control and limiting options, not safety or health……The risk for a person self-managing an abortion with pills in the United States today is not medical but legal. Since the year 2000, there have been at least 21 known arrests in the United States of people for ending their own pregnancy or helping someone who has made the decision to do so. Some have gone to jail, but even those who have not have had their lives turned upside down by investigations and in some cases have suffered economic and social harm caused by negative media exposure. The threat of investigation, arrest, or punishment is particularly of concern for those who live under heightened government surveillance, including many in immigrant communities. Five states currently have laws on the books that criminalizes self-managed abortion. The fact that these laws are generally outdated and likely unconstitutional does not mean they are inert: they have been used in the last decade to arrest, investigate, and prosecute people who ended or who were suspected of ending their own pregnancies. And in states without such laws, prosecutors who wish to punish people for abortion have used laws that were never intended to apply to self-managed abortion to target people who have ended, or are suspected of ending, their own pregnancies.The anti-abortion politicians and activists who propose restrictions are attempting to legislate legal abortion out of existence. They are well aware that the FDA’s restrictions and actions are a key element in the success of their own efforts to make abortion inaccessible… The letter included a list of organizations who signed on to the letter, as well as a list of individual medical professionals. Here are the organizations: Abortion Access FrontAbortion Care NetworkACCESS Women’s Health JusticeAdvocates for YouthAll-OptionsCarolina Abortion FundCatholics for ChoiceChicago Abortion FundCivil Liberties and Public Policy ProgramClarinda Regional Health CenterFeminist Women’s Health CenterForward TogetherGateway Women’s Access FundIf/When/How: Lawyering for Reproductive JusticeIn Our Own Voice: National Black Women’s Reproductive Justice AgendaIpasLegal VoiceMaine Family PlanningMariposa FundMedical Students for ChoiceMidwest Access CoalitionNARAL Pro-Choice ArizonaNARAL Pro-Choice ColoradoNational Abortion FederationNational Asian Pacific American Women’s Forum (NAPAWF)National Latina Institute for Reproductive HealthNational Institute for Reproductive HealthNew Voices for Reproductive JusticeNurses for Sexual and Reproductive HealthPendergrast ConsultingPhysicians for Reproductive HealthPlan CPlanned Parenthood Federation of AmericaProgress FloridaPublic Leadership InstituteReligious Coalition for Reproductive ChoiceSisterLove, Inc.SisterReachSurge Reproductive JusticeURGE: Unite for Reproductive & Gender EqualityWest Virginia FreeWhole Woman’s Health / Whole Woman’s Health AllianceWomen on Web July 1, 2019: CBS News posted an article titled: “American Medical Association sues North Dakota over abortion laws”. It was written by Emily Tillett. From the article: The American Medical Association (AMA), which often shies away from weighing in on overtly political matters, is suing the state of North Dakota over medical practices, which the AMA says directly “contradict reality and science”. In a lawsuit filed last week, the AMA is challenging the constitutionality of two laws in particular that direct doctors and medical care teams to provide patients with “false, misleading, and non-medical” information about reproductive health. The AMA, in a joint filing with the Center for Reproductive Rights (CRR), argues that the laws violate the First Amendment rights of physicians by forcing them to convey false information and non-medical statements with which they disagree……The state laws represent some father most restrictive abortion laws in the country. One law, H.B. 1336, which is set to take effect Aug. 1, compels doctors to tell their patients that medication-induced abortions can be reverse. Under this law, doctors must also give patients government-scripted information on where to find a medical professional who will provide an experimental and unethical treatment to “reverse” an abortion.The measure targets drug-induced abortions that require two drugs to be taken separately to complete the abortion. Abortion providers are supposed to tell women undergoing this kind of procedure that they might be able to stop the abortion if they’ve only taken the first drug.The AMA said that medical advice was “patently false”……The AMA is also challenging an existing North Dakota law that forces to tell patients that abortion terminates “the life of a whole, separate, unique, living human being.” The medical group argues that the law requires physicians to impart “ideological, government-mandated messages that are false or misleading” to their patients……The lawsuit argus that just last term, the U.S. Supreme Court held in National Institute of Family & Life Advocates v. Xavier Becerra that the government cannot regulate the speech of medical professionals to advance controversial ideas or to discriminate based on the content and/or viewpoint of the speaker… July 2, 2019: Statesman posted an article titled: “Court denies Texas bid to delay Affordable Care Act arguments”. It was written by Chuck Lindell. From the article: Keeping a legal challenge to the Affordable Care Act on a fast track, a federal appeals court Tuesday rejected a request to delay next week’s oral arguments made by Texas and 19 the states seeking to overturn the law.The Republican attorneys general, including Ken Paxton of Texas, said they needed more time to research and respond to questions – recently posed by the 5th U.S. Circuit Court of Appeals’ three-judge panel – that could end the appeal and provide a victory for opponents of the law.With that response due Wednesday, Texas Solicitor General Kyle Hawkins, the top appellate lawyer in Paxton’s agency, asked for 20 additional days to submit the brief, with oral arguments to be reset for sometime afterward.The appeals court rejected the request but pushed the deadline back two days, giving all sides until 5 p.m. Friday to submit the requested briefs.The delay was opposed by Democratic-led states and the U.S. House, which are fighting to preserve the Affordable Care Act after a federal judge in Texas – based on a lawsuit filed by Paxton – ruled in 2018 that the law was unconstitutional……The law, sometimes known as Obamacare, remains in effect during the appeal… July 2, 2019: WITF posted an article titled: “Pennsylvania’s own insurance exchange coming next year”. It was written by Marc Levy. From the article: Pennsylvania is moving to replace the federally operated Healthcare.gov with its own website to sell Affordable Care Act-compliant policies in a bid to get more people into it and lower their costs.Gov. Tom Wolf signed legislation Tuesday after it passed the Legislature unanimously last week. The administration unveiled the legislation in June after lining up support from a wide range of business and consumer advocacy groups, as well as leadership in the Republican-controlled Legislature.Pennsylvania let the federal government know of its intent and is preparing to submit its plans, called a “blueprint,” in the coming weeks.Wolf’s administration expects to take over some of the marketing and outreach efforts for Healthcare.gov next year before it unveils its new website next year for enrollment in the 2021 insurance year.It says it expects it can lower premiums by 5% to 10% for the 400,000 people who buy policies in the marketplace. Wolf’s insurance commissioner, Jessica Altman, said the savings can especially help the roughly 80,000 people who buy policies through Healthcare.gov, but whose incomes are too high to qualify for a federal tax subsidy… July 2, 2019: KTVA The Voice of Alaska posted an article titled: “Alaskans lose Medicaid dental benefits after Dunleavy budget cuts”. It was written by Lauren Maxwell. From the article: After Gov. Mike Dunleavy vetoed $50 million from the state’s Medicaid budget last week, some Alaskans are already starting to feel the effects.A large chunk of those cuts – $27 million – eliminates dental benefits for adults on Medicaid that in 2018 included approximately 30,000 Alaskans.On Monday, Anchorage Dental Group began calling its Medicaid patients to tell them their dental benefits were gone. Office Manager Candace Fleming said that included some patients whose treatment wasn’t finished yet……The cuts eliminate all services including preventive care like cleanings and fillings – the kind of things that Dr. James Hyer said can keep small problems from getting worse……The State said services to children on Medicaid are not impacted by the budget cuts and that adults who need emergency care for immediate relief of pain or acute infection will still be covered. July 2, 2019: Planned Parenthood posted a press release titled: “Ninth Circus Provides Emergency Relief for Millions of Title X Patients”. From the press release: The U.S. Court of Appeals for the Ninth Circuit has blocked the Trump-Pence administration’s dangerous Title X gag rule. The court’s order provides much-needed emergency relief to millions of people who access birth control and other reproductive health services through the program.Title X is the nation’s program for affordable birth control and reproductive health care, which serves four million people each year. Trump’s gag rule makes it illegal for health care providers in the Title X program to refer patients for abortion, and also blocks access to care at Planned Parenthood by imposing cost-prohibitive and unnecessary “physical separation” requirements. Title X helps millions of people struggling to make ends meet – the majority of whom are people of color, Hispanic, or Latino – access birth control, cancer screenings, STI testing, and other essential reproductive health care. Providers who serve nearly half of the patients who get care through Title X have made it clear that the rule would force them out of the program – the administration is putting health care at risk for patients across the country by pushing this rule to go into effect… July 2, 2019: Center for Reproductive Rights posted a press release titled: “Trump Administration Postpones Denial of Care Rule”. From the press release: In response to the Trump administration’s announcement that the Denial of Care Rule will no longer go into effect on July 22, the Center for Reproductive Rights, Lambda Legal, Americans United for Separation of Church and State, and the County of Santa Clara issued the following statement:“As we know from the firsthand accounts of our plaintiffs – health care providers who are on the front lines every day caring for patients – discrimination in health care is dangerous and lives are truly at stake. Confronted with these facts and the flurry of lawsuits showing how the Denial of Care Rule would irreparably harm health care providers and patients across the country, the Trump administration agreed to delay implementation. The Rule invites health care workers to discriminate based on religious or moral objections, targeting LGBTQ people and women seeking reproductive health care. The Rule is unconstitutional and we are ready to take on the Trump administration in this fight.”On Saturday, June 29, the U.S. Department of Health and Human Services (HHS) stipulated that it will delay the implementation of Denial of Care Rule. A court order put the delay of the rule into effect yesterday. The rule will no longer take effect on July 22 as originally planned; instead the rule will be delayed at least until November 22……The new regulation, issued in May by HHS, invites anyone employed by a health care provider – including doctors, nurses, EMTs, administrators, janitors, and clerical staff – to deny medical treatment and services to patients because of personal religious or moral beliefs. Health care facilities that do not comply risk losing federal funding. If allowed to go into effect, the Rule will cause mass confusion among health care providers and is completely infeasible to implement. As a result, some health care facilities – most of which receive federal funding through HHS – may do away with reproductive and LGBTQ services altogether, leaving millions without access to health care.In the lawsuit, the civil rights organizations argue that the rule is unconstitutional because it advances specific beliefs in violation of the First Amendment; violates patients’ rights to privacy, liberty, and equal dignity as guaranteed by the Fifth Amendment; and chills patients’ speech and expression in violation of the First Amendment, all to the detriment of patients’ health and well-being. The lawsuit also asserts that HHS violated the federal Administrative Procedure Act in creating the rule by arbitrarily and capriciously failing to consider the impact on patients and the health care system. July 3, 2019: The Hill posted an article titled: “Judge blocks Ohio’s ‘heartbeat’ abortion law”. It was written by Jessie Hellmann. From the article: A federal judge on Wednesday temporarily blocked an Ohio law that would have banned abortions after six weeks of pregnancy.The law, which bans abortions after a fetal heartbeat is detected, was signed earlier this year by Gov. Mike DeWine (R) and challenged by the American Civil Liberties Union (ACLU) and Planned Parenthood.It was slated to take effect this month, but U.S. District Judge Michael Barrett issued a preliminary injunction, blocking the law from taking effect while it is challenged in court……Barrett wrote in his ruling that the law places an “undue burden” on a woman’s right to obtain an abortion before the fetus is viable, violating Supreme Court precedent.The law would have been one of the strictest in the nation with no exemptions for cases of rape or incest… The case is called Preterm-Cleveland, et. al. vs. David Yost, et. al. It is available online. Here are some parts of U.S. District Judge Michael Barrett’s ruling: …In a nutshell, S.B. 23 bans abortion care at and after approximately six weeks in pregnancy. And, in so doing, according to Plaintiffs – a collection of reproductive clinics and physicians providing abortion care – violates women’s right to privacy as guaranteed by the Fourteenth Amendment……At six weeks LMP, many women are unaware that they are pregnant… Typically the menstrual cycle is approximately four weeks long, but varies based on the individual. Assuming a woman has consistently regular periods, she would be considered four weeks pregnant as measured from her LMP when her missed period occurs. Those who have irregular periods – caused by common medical conditions, contraceptive use, age or breastfeeding – or those who experience bleeding during early pregnancy that could be mistaken for a period may not realize that they missed a period…. But assuming a patient does know she is pregnant, there are certain logistical obstacles to obtaining abortion care before six weeks in pregnancy… She will need to schedule an appointment, make sure of payment, arrange for transportation, time off of work and possibly childcare during appointments… A minor patient, unless emancipated, also must obtain written parental consent or a court order… And all patients, regardless of age, must make two in-person trips – at least 24 hours apart – to the clinic before they can obtain an abortion… These reasons explain why the majority of abortions in Ohio – approximately 90% – take place at or after six weeks LMP. … S.B. 23, therefore, will prohibit almost all abortion care in Ohio……The Court concludes, based on current United States Supreme Court precedent, that Plaintiffs are certain to succeed on the merits of their claim that S.B. 23 is unconstitutional on its face……Plaintiffs argue that their patients will suffer serious and irreparable harm in the absence of a preliminary injunction, because allowing the Act to take effect will prevent Ohio women from exercising their constitutional right to reproductive freedom as protected by the Fourteenth Amendment… Inasmuch as this Court has determined that S.B. 23 places an “undue burden” on a woman’s right to choose a pre-viability abortion, and thus violates her right to privacy guaranteed by the Fourteenth Amendment, we further determine that its enforcement would, per se, inflect irreparable harm……[Planned Parenthood of Southeastern Pa. v] Casey acknowledged the State’s “legitimate interest from the outset of the pregnancy in protecting the … life of the fetus that may become a child.”… But that acknowledgement was preceded with the recognition that “[b]efore viability, the State’s interests are not strong enough to support a prohibition of abortion or the imposition of a substantial obstacle to the woman’s effective right to elect the procedure”…. An injunction will preserve the status quo that has been in place for more than 40 years since Roe was decided, and some 25 years since Casey followed… CONCLUSIONFor the foregoing reasons, Plaintiffs’ Motion for Preliminary Injunction … is GRANTED. Specifically, all Defendants, their officers, agents, servants, employees, and attorneys, and those persons in active concert or participation with them who receive actual notice of this Order, are preliminarily enjoined from enforcing or complying with S.B. 23 pending further Order of this Court… July 3, 2019: The American Civil Liberties Union (ACLU) posted a press release titled: “Judge Blocks Ohio’s Near Total Abortion Ban in ACLU Case”. From the press release: A federal judge temporarily blocked an Ohio law that would have banned abortion as early as six weeks into pregnancy, before most women know they are pregnant. The American Civil Liberties Union (ACLU), the ACLU of Ohio, and Planned Parenthood brought the lawsuit on behalf of Preterm-Cleveland and other abortion clinics in the state. Senate Bill 23 was signed by Governor DeWine and was scheduled take effect this month.Ohio is one of more than seven states that have considered similar legislation so far this year. In addition to Ohio, the ACLU has challenged similar abortion bans in Kentucky and Georgia, a near total ban in Alabama, and an 18-week ban in Arkansas, among other litigation. Courts have already blocked identical measures in Kentucky and Mississippi. None of the bans are in effect, and abortion remains legal in all 50 states… July 3, 2019: Politico posted an article titled: “Appeals court takes up fresh challenge to Trump abortion ‘gag rule'”. It was written by Rachel Roubein and Renuka Rayasam. From the article: The full 9th U.S. Circuit Court of Appeals on Wednesday said it would take up a fresh challenge to the Trump administration’s overhaul of the federal family planning program just weeks after three of its Republican-appointed judges said the policy change can take effect nationwide while several legal challenges play out.The appeals court froze the administration’s rule revamping the Title X program while it hears the case, according to Brigitte Amiri, deputy director at the ACLU’s Reproductive Freedom Project.The court’s order marks the latest turn in a battle over the administration’s changes to the program, which seek to steer federal dollars away from providers such as Planned Parenthood that offer abortions and abortion referrals. Critics have dubbed the Trump policy a “gag rule”.The order covers several challenges to the rules, but it’s unclear whether they will be heard together or separately… July 3, 2019: The American Civil Liberties Union posted a press release titled: “Court Blocks Trump Administration’s Attempt to Gut Family Planning Program in Response to ACLU Lawsuit”. From the press release: The Ninth Circuit Court of Appeals restored a preliminary injunction today in the ACLU’s case against the Trump Administration’s efforts to roll back Title X, the nation’s family planning program. The decision blocks the implementation of the rule, which would have undermined the health care needs of four million low-income people each year, while the cases argued… July 3, 2019: Center for Reproductive Rights posted a press release titled: “Judge refuses to block Title X Rule in Maine, jeopardizing healthcare access for thousands of Mainers”. From the press release: U.S. District Court Judge Lance Walker today denied the Center for Reproductive Rights’ request to block the Trump Administration’s Domestic Gag Rule from going into effect in the state of Maine, jeopardizing the future of Maine Family Planning’s clinics across the state.In June 2019, on behalf of Maine Family Planning (MFP), the Center for Reproductive Rights made an emergency request to re-block the rule after a federal appeals court overrode lower court decisions that had previously blocked the rule from going into effect nationwide.Maine Family Planning is the state’s sole Title X grantee and the largest reproductive health care organization in Maine. With this ruling, 85% of abortion clinics in the state of Maine are in jeopardy…The Domestic Gag Rule Will:Force healthcare providers that receive federal funding like MFP to stop performing abortions, even though no federal funds are used to finance abortion.Prohibit doctors at these facilities from making referrals to abortion providers, even when the patient has already decided to have an abortion and directly asks for a referral.Force doctors to give all pregnant patients prenatal referrals, even when the patient doesn’t want one.Give Title X funding to non-medical organizations known as “crisis pregnancy centers,” which are designed to look like medical clinics but aim to deter women from getting abortions… July 3, 2019: The U.S. Court of Appeals for the Ninth Circuit posted its order on the case called State of California v. Alex M. Azar. It was written by Chief Justice Sidney R. Thomas. Upon the vote of a majority of nonrecused active judges, it is ordered that these cases be reheard en banc pursuant to Federal Rule of Appellate Procedure 35 (a) and Circuit Rule 35-3. The three-judge panel Order on Motions for Stay Pending Appeal in these cases shall not be cited as precedent by or to any court of the Ninth Circuit. Judges Graber, Christen, and Owens did not participate in the deliberations or vote in these cases. July 3, 2019: Delaware Online posted an article titled: “For the first time, Highmark looks to lower its Obamacare marketplace rates”. It was written by Meredith Newman. From the article: For the first time, Highmark BlueCross Blue Shield of Delaware is asking the state to decrease its Obamacare marketplace rates.Highmark, the only insurer on the Delaware Affordable Care Act marketplace, has proposed decreasing rates by 5.8 percent in 2020, officials said. This is expected affect about 20,000 residents.Previously, the insurer has increased rates in the double digits. Last year, rates increased by 3 percent, This decrease would only apply to Delawareans who are enrolled on the ACA marketplace, not those who have Medicaid, Medicare and private insurance… July 3, 2019: Oklahoma’s News 4 posted an article titled: “Oklahoma Medicaid Office: Update address or lose benefits”. From the article: Oklahoma’s Medicaid agency is warning its SoonerCare members to keep their current address on file with the agency or risk losing their health care benefits.The Oklahoma Health Care Authority sent out a public reminder Wednesday of the new rule that was signed by Gov. Kevin Stitt last week. The agency says it intends to launch outreach efforts through social media and through outbound phone calls to SoonerCare recipients after hours and on weekends.Agency officials say the rule is needed to comply with federal guidelines. But advocates for the poor have criticized the policy, saying low-income people move more frequently and that many members will be wrongfully cut from the programs… July 3, 2019: RappNews posted an article titled: “Free Clinic changes business model to accommodate expanded Medicaid program”. From the article: As of January 1, an additional 400,000 Virginians gained access to quality, low-cost health insurance through the state’s expanded Medicaid program.The enduring mission of the Fauquier Free Clinic (FFC) is to provide eligible residents of Fauqier and Rappahannock counties with access to comprehensive medical, dental and mental health care. This year, the clinic’s business model underwent extensive changes to accommodate new and existing patients when Medicaid expanded its services for low-income adults throughout Virginia……In Fauquier County alone, 1,700 to 1,800 people have become eligible for Medicaid insurance benefits. In Rappahannock County, 300 to 400 people are now eligible. Throughout the state of Virginia, eligibility has been granted to around 400,000 people.“Medicaid expansion was a great opportunity for the Commonwealth and Fauquier County to provide health insurance coverage for those most in need,” said FFC board member Gregory Bengston. “Changing our business model to ensure that clinic patients who were now Medicaid-eligible had continued access to health care services was a huge accomplishment”… July 3, 2019: The Middletown Press posted an article titled: “Appeals court puts Trump abortion restrictions on hold again”. It was written by Gene Johnson. From the article: Trump administration rules that impose additional hurdles for low-income women seeking abortions are on hold once again.The 9th Circuit Court of Appeals in San Francisco on Wednesday vacated a unanimous ruling from a three-judge panel and said a slate of 11 judges will reconsider lawsuits brought by more than 20 states and several civil rights and health organizations challenging the rules.Critics say the rules would force many clinics to find new locations, undergo expensive remodels or shut down……With [the three-judge panel’s decision] vacated, the injunction issued by the lower court judges are once again in effect. It’s not clear when new court arguments will be held.“We are profoundly grateful the preliminary injunction is back in place,” said Clare Coleman, president of the National Family Planning and Reproductive Health Association, which is involved in the cases… July 3, 2019: Senator Dick Durbin (Democrat – Illinois) posted a press release on his official website titled: “Durbin Calls On Congress To Protect And Strengthen The ACA, Not Undermine It”. From the press release: With health care advocates once again under attack, U.S. Senator Dick Durbin (D-IL) today stood with advocates and individuals who have been helped by the Affordable Care Act (ACA) to address the Trump Administration’s latest lawsuit seeking to dismantle the health law and call on Congress to strengthen the ACA, not undermine it. Next week, oral arguments will be head on Texas v United States – a lawsuit over the constitutionality of the entire ACA. If the Trump Administration and 20 Republican state Attorneys General (AGs) succeed, the ACA could be struck down, leaving tens of millions of Americans without health care or protections for pre-existing conditions.“Thanks to the Affordable Care Act, 20 million Americans gained health insurance, including more than one million people in Illinois,” said Durbin. “All of its important and life-saving protections will be gone if President Trump gets his way starting next week in court. I stand ready to work with my colleagues in Congress to protect and strengthen the Affordable Care Act.”After President Trump’s failed attempt to repeal the ACA two years ago, he turned to the courts to sabotage the health law. Last February, 20 Republican AGs filed a lawsuit over the constitutionality of the ACA – arguing that because the individual mandate penalty was zeroed out in the 2017 Republican tax law, the rest of the ACA should also be struck down.In December, a District Court judge in Texas sided with the Republican plaintiffs, and the case will go to the 5th U.S. Circuit Court of Appeals in New Orleans next week. If the Trump Administration and Republican AGs succeed, the entirety of the ACA could be struck down, meaning: Protections for people with pre-existing conditions would be eliminatedMillions would be kicked off MedicaidIndividual insurance markets and premium assistance would be eliminatedSeniors on Medicare would face increased prescription drug costsWomen could be charged more than men for health careYoung people would no longer have access to their parents’ insurance plan up to age 26Annual and lifetime caps on benefits could returnThere would no longer be guaranteed coverage for preventative screening and contraception services without deductibles or copaymentsThere would no longer be guaranteed coverage for mental health or addiction treatment services Since the ACA was signed into law in 2010, the uninsured rate in Illinois has fallen by 49 percent. More than one million uninsured Illinoisans now have health insurance thanks to Medicaid expansion and tax credits to purchase Exchange plans, and 90,000 young adults have health insurance by staying on their parents’ plans until age 26. Further, the approximately 5 million Illinois residents with pre-existing conditions now have protections against discrimination from insurance companies, and Illinois seniors have saved an average of more than $1,000 on their prescription drugs due to the ACA’s closing of the Medicare “donut hole” coverage gap.Last month the House of Representatives passed bi-partisan legislation, Protecting Americans with Pre-Existing Conditions Act, to prevent President Trump from allowing health insurance companies to discriminate against people with pre-existing conditions, yet Senate Majority Leader Mitch McConnell (R-KY) has refused to call up this legislation for a vote. The House has also advanced legislation to crack down on junk health plans and restore funding for insurance sign-ups and outreach. July 3, 2019: Kaiser Family Foundation posted information titled: “Explaining Texas v. U.S: A Guide to the 5th Circuit Appeal in the Case Challenging the ACA”. It was written by MaryBeth Musumeci. I highly recommend you read it want to understand more about that case. In this blog post, I will include only the “Looking Ahead” portion of the information. Oral argument is scheduled for 1:00 p.m. on July 9th, with 45 minutes to be shard among the state intervener-defendants and the House, and 45 minutes to be shared among the state plaintiffs, individual plaintiffs, and federal government. The case will be heard by a panel of three judges, including Judge Carolyn Dineen King (appointed by President Carter), Judge Jennifer Walker Elrod (appointed by President George W. Bush), and Judge Kurt D. Engelhardt (appointed by President Trump). There is no deadline by which the court must issue a decision, but it could come as early as fall 2019.If the court finds that the individual mandate is unconstitutional and invalidates only that provision, the practical result will be essential the same as the ACA exists today, as amended by the TCJA, without an enforceable mandate. If the court adopts the position that the federal government took during the trial court proceedings and invalidates the individual mandate as well as the protections for people with pre-existing conditions, then the federal funding for premium subsidies and the Medicaid expansion would stand, and it would be up to the states whether to reinstate the insurance programs.The most far-reaching consequences, affecting nearly every American in some way, will occur if the court decides that the entire ACA must be overturned. The number of non-elderly individuals who are uninsured decreased by 19.1 million from 2010 to 2017, as the ACA went into effect. The ACA made significant changes to the individual market, including requiring protections for people with pre-existing conditions, creating insurance marketplaces, and authorizing premium subsidies for people with low and modest incomes. The ACA also made other sweeping changes throughout the health care system including expanding Medicaid eligibility for low-income adults; requiring private insurance, Medicare, and Medicaid expansion coverage of preventative services with no cost sharing; phasing out the Medicare prescription drug “doughnut hole” coverage gap’ reducing the growth of Medicare payments to health care providers and insurers; establishing new national initiatives to promote public health, care quality, and delivery system reforms; and authorizing a variety of tax increases to finance these changes. All of these provisions could be overturned if the trial court’s decision is upheld, and it would be enormously complex to disentangle them from the overall health care system… July 5, 2019: The Jamestown Sun posted an article titled: “Number of abortions continues to slide in North Dakota”. It was written by John Hageman. From the article: The number of induced abortions performed in North Dakota slid for the fourth straight year in 2018, marking the lowest figure since recordkeeping began almost four decades ago, according to new state data.There were 1,141 induced abortions recorded in North Dakota last year, down slightly from 1,155 in 2017, according to state Department of Health reports. The agency began tracking abortion statistics in 1981.The state hit a record number of abortions in 1982 with 3,076.Tammi Kromenaker, the director of the state’s sole abortion clinic, the Red River Women’s Clinic in Fargo, cited Medicaid expansion and the Affordable Care Act’s contraceptive mandate, which the Trump administration has tried to roll back.“The (ACA) continuing to cover birth control, with no deductible and no co-pay, that is huge for so many families,” Kromenaker said Friday, July 5, noting that North Dakota is following a national trend in seeing abortion decline……The Red River Women’s Clinic recently joined the American Medical Association in filing a federal lawsuit against two North Dakota abortion laws they say will force doctors to misinform their patients and violate their medical ethics. That includes requiring physicians to inform patients it may be possible to revers a drug-induced abortion… July 5, 2019: San Francisco Chronicle posted an article titled: “California offers doctors student-loan help to treat underserved patients”. It was written by Elizabeth Aguilera. From the article: It’s a trade aimed at getting more doctors to treat poorer patients: California says it will help repay the student loans of 247 selected doctors in exchange for their promise that at least 30% of their caseload will be people enrolled in Medi-Cal.The $60 million student loan repayment, CalHealthCares, is funded by the state tobacco tax that voters increased three years ago.It’s all a part of California’s effort to increase the number of doctors who accept Medi-Cal, the state’s Medicaid health insurer of low-income residents, which has been plagued by shortages – due both to the state’s paltry rates for doctors in its provider network and to the substantial increase in the number of residents on Medi-Cal. California has one of the lowest Medicaid reimbursement rates in the country, and patients wait months, or longer, to see specialists.More than 1,300 doctors and medical residents applied for the benefit which provides up to $300,000 over five years, and those selected were chosen based on their commitment to treat the underserved, their geographic location and their specialities……Research indicates that debt is a major concern for physicians nationwide: a 2017 server by an affiliate of the American Medical Association found that half owed $200,000 or more in medical school loans……This is the first doctor group to receive funding from the $340 million fund created by Prop. 56 tobacco tax revenue. The state expects there will be at least five more rounds of awards.Later this summer, the state will announce awards for dentists who applied to participate in the loan repayment program for serving Denti-Cal patients. Information about that lawsuit can be found on the American Medical Association website. July 5, 2019: Idaho Press posted an article titled: Idaho seeks public comment on 2nd Medicaid waiver, for same purpose as 1st. It was written by Betsy Z. Russell. From the article: The Idaho Department of Health and Welfare is taking public comment on a new Medicaid expansion waiver, less than a week after the comment period on a related waiver closed.Both applications deal with people who earn between 100 percent and 138 percent of the federal poverty level. The intent is to give them the option to buy subsidized private health insurance through the state exchange, rather than shift to Medicaid. The agency announced the new waiver Wednesday, saying the move stems from conversations with the federal Centers for Medicare and Medicaid Services……The move stems from actions taken by the Idaho Legislature during the 2019 session. Rather than implement straight Medicaid expansion, as approved by voters, Republican lawmakers adopted a series of conditions and restrictions on the program. One of the conditions was that people in the 100 percent to 138 percent income category be given the choice to remain in the state exchange.Under current federal rules, people who qualify for Medicaid aren’t eligible for the tax credits that will help lower the cost of private insurance through the state exchange. Consequently, Idaho will need federal approval to enact the Legislature’s will… July 5, 2019: The Philadelphia Inquirer posted an article titled: “Medicaid enrollment growth driven by families working for large employers, CHOP study finds.” It was written by Sarah Gantz. From the article: Enrollment in Medicaid and CHIP, the Children’s Health Insurance Program, among children whose parents work full time and earn more than 100 percent of the federal poverty level grew significantly between 2008 and 2016, according to a new study by researchers at the Children’s Hospital of Philadelphia published this month in Health Affairs.Researchers found the growth was largely driven by families working for large private employers, where health insurance is a standard benefit – but an increasingly unaffordable one.Employer-sponsored health insurance is still the most common type of health plan for adults under 65 and their children. But employees are spending more and more out of pocket as their wages remain stagnant.As companies are strained by rising health-care costs, they are shifting more of the burden to their employees. Across the country, employees’ average share of a premium for family coverage increased 57 percent between 2008 and 2016, to $5,277, according to the Kaiser Family Foundation. Deductibles rose from $1,344 to $2,147 for a family during that period.A study by the Commonwealth Fund found that nearly 24 million people with employer health plans spend at least 10 percent of their income on premiums, out-of-pocket costs, or both.Meanwhile, Medicaid offers low-cost coverage and possibly more comprehensive benefits for eligible families who are finding that they can’t afford their employer health coverage, said David Rubin, director of PolicyLab at Children’s Hospital of Philadelphia and a co-author of the Health Affairs study… July 8, 2019: The Texas Tribune posted an article titled: “Texas is going to court to end Obamacare. It hasn’t produced a plan to replace it.” It was written by Emma Platoff and Edgar Walters. From the article: Last year, after a federal judge in Texas declared the entirety of the Affordable Care Act unconstitutional, throwing into question millions of Americans’ health coverage, the state’s Republican leaders promised they would come up with a plan to replace it.But on Tuesday, a legislative session that seemed to have no room for issues other than property tax reform and school finance, Texas will ask a federal appeals court in New Orleans to end the law in its entirety – without offering a replacement plan.The conservative crusade against portions of the act, known as Obamacare, has spanned a decade. But Texas’ latest lawsuit, filed in February 2018, became an existential threat to the law after U.S. District Judge Reed O’Connor ruled in December that it is unconstitutional in its entirety. At stake: subsidized health coverage of roughly 1 million Texans, sweeping protections for patients with preexisting conditions, young adults staying on their parents’ insurance plans until age 26, and a host of low-cost benefits available to all people with health insurance, including those covered through their employers. Texas already has the highest uninsured rate in the nation……Attorneys for the state of Texas argue the health law cannot stand since the Republican-led Congress in 2017 zeroed out Obamacare’s individual mandate – a penalty imposed on people who choose to remain uninsured. Democrats had favored the penalty as a way to induce more people to purchase health insurance, with the goal of reaching near-universal coverage. Without it, Texas argues, the whole law must fall.But the state’s Republican leaders have offered few ideas about what should replace Obamacare, a law that touches practically every aspect of health care regulations and includes several popular protections for patients. Gov. Greg Abbott – a vocal critic of the law – pledged in December that if the law remained struck down on appeal, “Texas will be ready with replacement health care insurance that includes coverage for pre-existing conditions.”Since then, he’s been quiet on the issue, including during this year’s 140-day Texas legislative session… July 8, 2019: Planned Parenthood posted a press release titled: “Congress Blocks D.C. Abortion Ban in Spending Bill”. From the press release: The House of Representatives voted 224-196 to pass a spending bill that survived Republican efforts to include a provision to block District of Columbia residents with low incomes from accessing safe, legal abortion. The provision has been included in previous spending bills and in current law, and the fact that the House FY 2020 Financial Services and General Government Appropriations bill expands access to safe, legal abortion is in part due to the historic number of reproductive health champions in Congress. Unfortunately, the bill retains language in current law that prohibits federal employees and their dependents from purchasing insurance plans that cover abortion… July 8, 2019: Center for Reproductive Rights posted a press release titled: “Statement on Commission of Unalienable Rights”. From the press release: On Monday, July 8, Secretary Pompeo announced the creation of a Commission on Unalienable Rights, chaired by Professor Mary Ann Glendon, to advice on “human rights grounded in our nation’s founding principles” based on documents like the Declaration of Independence and the 1948 Universal Declaration of Human Rights (UDHR), for a term of two years.The following is a statement by Stephanie Schmid, U.S. Foreign Policy Council at the Center for Reproductive Rights, about the Commission:“The Commission is nothing less than a subterfuge for undermining reproductive rights and the rights of marginalized communities including LGBTQ persons.“Contrary to its asserted purpose, there is no need to redefine or develop foundational principles on human rights. There is a clear and unequivocal consensus by U.N. human rights treaty bodies and independent experts that reproductive rights are human rights, grounded in the right to life, health, equality, non-discrimination and freedom from cruel, inhuman, and degrading treatment, among other rights.“This new Commission is part of a comprehensive effort by this Administration to erase sexual and reproductive health and rights from global discourse. The State Department has deleted reporting on reproductive rights from its annual Country Reports on Human Rights Practices and the Center for Reproductive Rights currently has two lawsuits pending in the United States District Court for the District of Columbia challenging these cuts. In addition, this Administration has insisted on the elimination of sexual and reproductive health and rights protections from U.N. resolutions, sending a clear message that the United States does not care about the plight of women and girls, nor established international law.“We are also alarmed by reports that the State Department has not engaged in Congressional consultation in advance of creating this Commission and similar reports that there was no consultation or input from career human rights experts working in the State Department’s Bureau of Democracy, Human Rights, and Labor (DRL). Indeed, this Commission appears to be an attempt to circumvent the State Department’s foreign policy and human rights experts in an effort to pick and choose which rights the United States will respect and promote. This redundant and duplicative Commission is a waste of tax-payer resources, which the House of Representatives recognized when it passed H.R. 2740 which included a provision explicitly prohibiting funds being allocated to this Commission.“This unnecessary Commission will further compound the Administration’s disengagement, deprioritization, and rollback of human rights and further cede the United States’ leadership in advancing the full spectrum of human rights protections within the United States and globally.” July 8, 2019: Planned Parenthood posted a press release titled: “State Department Attempts to Redefine Human Rights In Order to Violate Them”. From the press release: Today, the U.S. Department of State rolled out the Commission on Unalienable Rights, with the stated objective of “promotion of individual liberty, human equality, and democracy through foreign policy.” As outlined by Secretary Pompeo, the intent of the commission is to redefine human rights according to what he calls “America’s founding principles.” The commission is stacked with advisors who have long records arguing against reproductive rights – including access to safe, legal abortion – and against rights for LGBTQ communities, including Chair Mary Ann Glendon, a prominent anti-abortion activist.Statement from Dr. Leana Wen, President, Planned Parenthood Global:“The Trump-Pence administration’s new sham commission should be seen for what it really is: an attempt to narrowly redefine human rights in order to violate them. At at time when this administration is attacking reproductive rights, rolling back LGBTQ rights, and detaining children and families under horrific conditions, this commission is nothing more than a thinly veiled attempt to unconscionably exclude specific groups from legal protections. The U.S. should be leading the charge to protect and defend human rights, not undermining them for political gain.” July 8, 2019: Xavier Becerra tweeted: “The entire #ACA is at risk. In less than 24 hours, my team will be in court defending healthcare for millions of Americans just like Anna and her family. #ProtectOurCare”. The tweet includes a thread of tweets by Anna. July 9, 2019: New York Attorney General Letitia James tweeted: “!! Today we’re in court to defend the #ACA & #ProtectOurCare because the health & safety of millions of Americans is at risk. Access to quality & affordable healthcare is a basic right. Rolling back the clock is dangerous & irresponsible. We’re ready to fight.” July 9, 2019: CNBC posted an article titled: “Health-care stocks fall ahead of court arguments over constitutionality of Obamacare”. It was written by Berkeley Lovelace Jr. From the article: Health-care stocks fell Tuesday ahead of a legal showdown between the Trump administration, a group of Republican-led states and more than a dozen Democratic state attorneys generals over the constitutionality of the Affordable Care Act before the U.S. 5th Circuit Court of Appeals in New Orleans……Shares of insurers UnitedHealth, Cigna and Humana were down more than 1% in early afternoon trading. Shares of HCA Healthcare, the largest for-profit U.S. hospital operator, and Tenet Healthcare were down 2% and 3%, respectively. Community Health Systems was falling by more than 7%… July 9, 2019: Planned Parenthood posted a press release titled: Court Hears Challenge to Affordable Care Act, Risking Health Care for Millions”. From the press release: The U.S. Court of Appeals for the 5th Circuit will hear oral arguments in Texas v. U.S., a case that seeks to strike the Affordable Care Act (ACA) in its entirety, putting access to health care for millions at risk. Under the ACA, 20 million people gained health care coverage and more than 62 million women have gained coverage for preventable services with no out-of-pocket costs, including birth control, STI screenings, breast cancer screenings, and Pap tests……Gutting the ACA would threaten the health and financial security of millions of people:More than 62 million women now have access to no-copay preventative services, including birth control, STI screenings, and life-saving preventative services such as breast cancer screenings and Pap tests.Under the ACA, women of color are able to access better preventative care, a step forward in leveling the playing field for communities the have faced years of discriminatory policies that result in poor health outcomes.Financial assistance to purchase health insurance could be eliminated, threatening millions’ access to private insurance coverage, and coverage for the 12 million people who receive coverage under the ACA’s expansion of Medicaid is also threatened.Prior to the ACA, routine women’s health conditions were considered pre-existing conditions, including pregnancy.The Affordable Care Act eliminate “gender rating,” ensuring women do not pay an estimated $1 billion more annually than men for the same health care. July 9, 2019: Representative Joe Kennedy III tweeted: “This is what the Trump Admin is arguing in court today: – Health care is a privilege – Preexisting conditions can be disqualifying – Low-income patients can’t be treated – Addiction treatment can’t be covered – This nation is too weak to care for all its citizens #ProtectOurCare.” July 9, 2019: CBS News posted an article titled: “Judges have tough questions for Obamacare backers”. From the article: The fate of former President Obama’s signature health care law, and its coverage and insurance protections for millions of Americans, was again being argued before a panel of judges – this time a federal appeals court in New Orleans.Attorneys for states hoping to save President Obama’s health care law were hit with some intense and occasionally skeptical questioning from appellate judges in a New Orleans federal court.The main issue in Tuesday’s hearing was whether Congress rendered the entire Affordable Care Act unconstitutional when it zeroed out the tax imposed people who don’t buy health insurance.The law’s supporters say Congress clearly didn’t want “Obamacare” dismantled when it eliminated the tax in 2017. And they said the tax elimination doesn’t destroy the whole law.But appellate judges Kurt Engelhardt and Jennifer Walker Elrod both noted the law still says people must buy insurance. They questioned whether that command now violates the Constitution. Engelhardt also suggested Congress, not the courts, should choose which parts of the law should be salvaged… July 9, 2019: Senator Patty Murray tweeted: “ICYMI: Here’s what is at risk today because of the lawsuit being brought by Representatives to undermine families’ health care:” The tweet includes a link to a Seattle Times opinion piece from June of 2019. July 9, 2019: Politico posted an article titled: “Appeals court skeptical Obamacare can survive”. It was written by Paul Demko. From the article: A panel of federal appeals judges aggressively questioned whether Obamacare can survive during Tuesday afternoon oral arguments in a case that could upend the 2010 health care law.Two Republican appointees on the three-judge panel frequently interrupted attorneys to question whether the Affordable Care Act’s individual mandate is unconstitutional and if not whether the entire law could stand without it. The ACA’s future appeared murky after two hours of oral arguments at the 5th Circuit Court of Appeals, but it’s not clear if the judges were ready to uphold a federal judge’s earlier decision invalidating the law……Appellate Judge Jennifer Elrod, a George W. Bush appointee, on Tuesday posited that lawmakers – who failed to agree on an Obamacare replacement plan two years ago – deliberately eliminated the mandate penalty because they knew the rest of the law would have to fall. She said perhaps lawmakers thought, “Aha, this is the silver bullet that’s going to undo Obamacare.”Attorneys for the 20 Democratic-led states that are defending the law, as well as the Democratic-controlled House, countered that Congress clearly intended for the rest of the law to survive when it eliminated the mandate penalty.“All the court has to do is lookout the text,” said Samuel Siegel, the attorney representing the Democratic-led states.The three-judge appellate panel is expected to rule in the coming months. They could back the lower court ruling invalidating all of Obamacare or overturn it entirely. The judges may also determine that the elimination of the individual mandate penalty only renders certain parts of the ACA unconstitutional, such as its protections for individuals with preexisting medical conditions. That was the Trump administration’s original stance on the lawsuit before recently embracing the lower court ruling against the entire ACA… June 9, 2019: California Governor Gavin Newsom tweeted: “The Trump administration is going to court today to try and overturn the ENTIRE Affordable Care Act. – 133 MILLION with pre-existing conditions could lose coverage. – 23 MILLION could lose their health insurance – 12 MILLION could lose Medicaid coverage” The tweet included a link to The New York Times from March of 2019. June 9, 2019: Former Vice-President Joe Biden tweeted: “Today, the Affordable Care Act is back in the courts – putting the health care of millions of Americans at risk. It’s clear some will stop at nothing to sabotage Obamacare and roll back the progress we’ve made.” The tweet included a link to The New York Times. July 9, 2019: The New York Times posted an article titled: “Appeals Court Seems Skeptical About Constitutionality of Obamacare Mandate”. It was written by Abby Goodnough. From the article: …In 90 minutes of oral arguments on whether a federal district judge in Texas was correct in striking down the Affordable Care Act in December, two appellate judges appointed by Republican presidents peppered lawyers with blunt questions while the third judge, appointed by President Jimmy Carter, remained silent.The two Republican appointees, Jennifer Walker Elrod, appointed by President George W. Bush in 2007, and Kurt Engelhardt, appointed by President Trump in 2018, seemed particularly skeptical of the Democratic defendants’ argument that Congress had fully intended to keep the rest of the law when it eliminated the penalty for going without insurance as part of its 2017 tax overhaul……The case, which could make its way to the Supreme Court ahead of those elections, threatens insurance protections for people with pre-existing medical conditions and many other sweeping changes the 2010 law has made throughout the health care system……The arguments did reveal some tensions between the Republican states that brought the case, led by Texas, and Mr. Trump’s Justice Department. For example, a lawyer for Texas took issue with a puzzling new Justice Department position – revealed in a May brief – that the ruling should apply to only the 18 plaintiff states, not nationwide. The Republican states would need to evaluate if they had “been the victims of a bait and switch,” said the Texas lawyer, Kyle D. Hawkins.In another wrinkle, August E. Flentje, a lawyer for the Justice Department, appeared reluctant to answer questions from Judge Elrod about how applying the ruling only to the plaintiff states would work. He was also vague about another new and surprising position the administration mentioned almost in passing in its May brief: that some pieces of the health law, though not its insurance provisions, should be preserved….…Over all, though, the panel spent the most time on the question of whether the rest of the law should fail if Judge O’Connor was correct in scrapping the insurance mandate – and Judge Elrod and Judge Engelhardt, based on their questioning, seemed to firmly believe he was. Judge Engelhardt asked Mr. Letter, the House lawyer, why Congress could not remedy the situation by writing a new health law or set of laws.“The could do this tomorrow, ” Judge Engelhardt said, leading Mr. Letter to dryly point out that Mr. Trump would need to sign off on new laws, too.“And obviously the president would sign this, right?” he asked sardonically. “No, obviously not.”..…Judge Engelhardt twice asked Mr. Letter why, if Congress fully intended to keep the rest of the health law when it eliminated the penalty for going without insurance in 2017, the Senate, which is controlled by Republicans, had not also sent a lawyer to make that case.“Why would the Senate not be here to say, ‘Oh, this is what we meant when we wrote this?” he asked. “They’re sort of the 800-pound gorilla that’s not in the room.”..…The appeals panel also spent a good chunk of the allotted 90 minutes asking questions on a third topic: whether the Democratic states and House of Representatives even have standing to appeal Judge O’Connor’s ruling……If the appeals court ultimately decides that neither the House nor the intervening Democratic states have standing, it could either let Judge O’Connor’s ruling stand or vacate it. In any event, the losing party will almost certainly appeal to the Supreme Court… July 9, 2019: Julián Castro tweeted: “The Trump administration is actively working to undermine our health care system and jeopardize the coverage of 130 million Americans with pre-existing conditions. We must #ProtectOurCare and work to expand, not restrict, access to quality health care.” The tweet included a link to The New York Times article above. July 9, 2019: Beto O’Rourke tweeted: “We will defend the ACA. We will protect the care of those whose lives depend on it. And we will fight for universal, guaranteed, high-quality health care so every person can see a doctor, afford their prescriptions, and to live to their full potential.” The tweet included a link to The New York Times article above. July 9, 2019: Governor Jay Inslee tweeted: “800,000 people who have healthcare coverage in WA state are at risk if the Affordable Care Act is struck down. The #ACA has saved lives, strengthened consumer and patient protections for everyone, and is keeping costs from growing unabated. #ProtectOurCare”. The tweet included a link to The New York Times article above. July 9, 2019: Pete Buttigieg tweeted: “Republicans are putting health care for over 20 million Americans in jeopardy with their latest attack on the Affordable Care Act. Instead of restricting access, we should be expanding health care with Medicare for All Who Want It.” The tweet includes a link to an NPR article. July 9, 2019: Elizabeth Warren tweeted: “The Trump administration is in court today in their never-ending crusade to destroy health care for millions of Americans. If they succeed, families like Chantel’s would go bankrupt. People would die. #ProtectOurCare.” The tweet includes a video featuring Chantel and her family. July 9, 2019: Nancy Pelosi tweeted: “Under the ACA, the 130 million Americans w/ pre-existing conditions cannot be discriminated against y their insurer. Their health care costs could skyrocket if the GOP’s Texas v. US lawsuit succeeds in throwing out years of progress on health care. #ProtectOurCare”. July 9, 2019: Speaker of the House Nancy Pelosi posted remarks on the official Speaker of the House website titled: “Pelosi Remarks at Press Conference on Day of Oral Arguments in GOP’s Texas v. U.S. Lawsuit to Destroy Health Care”. From the remarks: …Today, the Trump Administration is demanding that the court strike down every last provision of the ACA. Protecting protections for the over 130 million Americans with pre-existing conditions and their families, bans on lifetime and annual limits, as the Leader mentioned, that can have a very devastating impact financially, as well as health-wise, for a family. The Medicaid expansion in the ACA, very important to people born with a pre-existing condition, babies born with a pre-existing condition and families otherwise, savings for seniors on prescription drug cost, the premium assistance that makes health coverage affordable for millions of American families.As you all know, the Affordable Care Act extended benefits to 20 million people who did not have health care before and that was very important – a major achievement in itself, but that was not the full extent of the bill.130 million Americans have pre-existing conditions and they are affected by this law case. And, what’s interesting about it is during the campaign, across the country, Republicans were saying, “We’re for preserving the pre-existing medical conditions [protections]” and yet they vote over and over again to prevent it and now they’re taking it to court.And, the reason they think they have a chance in court is because of what they did on the horrible GOP Tax Scam bill, where they undermined the Affordable Care Act there. Every chance they get, they try to undermine the health and financial security of America’s working families.The ACA is a pillar of health and economic security, standing alongside Medicare, Medicaid, and Social Security. But the GOP is showing that they want to destroy the Affordable Care Act for America’s families……But more than 190 Republicans that day voted to be fully complicit in the Administration’s attempt to tear away health care protections. Families across the nation have called on Congress to ‘Protect Our Care’ and House Democrats are fighting for them……Democrats will continue to fight For The People to lower health care costs and the cost of prescription drugs and to protect people with pre-existing conditions… July 9, 2019: Representative Jerry Nadler tweeted: “Today the Trump Admin is arguing to strike down the entire ACA, turning their back on millions with preexisting conditions. @HouseJudiciary is committed to fighting this GOP assault, and will hold a hearing on the DOJ’s refusal to defend the ACA this month #ProtectOurCare”. The tweet included a link to an NPR tweet. July 9, 2019: Covered California posted a news release titled: “California’s Initiatives Will Lead to Hundreds of Thousands Gaining Health Care Coverage With Lower Premiums and New Financial Help”. From the news release: California’s individual market will see a preliminary rate change of 0.8 percent in 2020, which is the lowest change since Covered California’s launch, due to new state affordability initiatives designed to lower costs and encourage enrollment.An estimate 922,000 people – including many middle-income Californians – will be eligible from a first-in-the-nation expansion of financial help that builds on the Affordable Care Act and lowers the costs of their health care coverage.Covered California projects that lowering health care costs and reinstating the penalty on individuals who can afford coverage, yet choose to go without insurance, will result in 229,000 people becoming newly covered.All 11 health insurance companies return to the market in 2020, and a major national plan, Anthem Blue Cross, with expand – giving nearly all Californians a choice of two carriers, and 87 percent able to choose from three carriers or more.A Covered California analysis projects that an estimated 922,000 will be eligible for the new state subsidy program that will help lower the cost of their coverage in 2020. The consumers who are projected to benefit from the new state subsidies are:An estimated 235,000 middle-income Californians who previously did not qualify for financial help because they exceeded federal income requirements. They will be eligible to receive an average of $172 per household per month, which will help them save an average of 23 percent off their current premiums. Many of these consumers, particularly those who live in high-cost regions, will see significant savings and annual reductions in their health care premiums in the hundreds or even thousands of dollars.An estimated 663,000 Covered California enrollees who currently receive federal financial help. They will be eligible to receive an average of an additional $15 per household per month which will help them save an average of 5 percent on their current premiums.An estimated 23,000 Covered California enrollees whose annual household income falls below 138 percent of the federal poverty level (FPL), which is less than $17,237 for an individual and $35,535 for a family of four. They will see their premiums for the benchmark plan lowered to $1 per member, per month. July 9, 2019: Los Angeles Times posted an article titled: “With Obamacare in peril, California reins in rising health insurance premiums”. It was written by Barbara Feder Ostrov and Ana B. Ibarra. From the article: Premiums on California’s health insurance exchange will rise by an average of 0.8% next year, the lowest increase in the agency’s history, state officials announced Tuesday.Covered California Executive Director Peter Lee credited two new statewide initiatives for keeping the proposed rate hikes low: Next year, California will be the first state in the country to offer state-funded tax credits to middle-class enrollees, which will be paid for in part by a new tax penalty on Californians who don’t have health insurance……Covered California estimates that the state-based tax credits, in conjunction with the new state tax penalty, will result in 229,000 newly insured Californians.The average rate hike for 2020 is far lower than this year’s average increase of nearly 9% and the five-year average increase of 8.4%. Covered California began offering health plans in 2014 to individuals and families who purchase their own insurance as part of the state’s implementation of the Affordable Care Act, a.k.a. Obamacare……The new individual mandate for Californians starts in 2020. The penalty for not having insurance will mirror the one under the Affordable Care Act, which as $695 per adult (and $347.50 per child under 18) or 2.5% of annual household income, whichever is greater. That can amount to thousands of dollars a year.The revenue from the penalty, plus other state funds, will help pay for state-based tax credits for roughly 922,000 people who purchase insurance through Covered California. As part of the 2019-20 state budget signed by Gov. Gavin Newsom last month, the state will pledge $1.45 billion over the next three years for this effort.Under the deal, California will become the first state to offer financial aid to middle-income enrollees who make between 400% and 600% of the federal poverty level – many of whom have been struggling to pay their premiums. That’s between about $50,000 and $75,000 a year for an individual and between about $103,000 and $154,500 for a family of four.Under the Affordable Care Act, people who purchase plans through Covered California and other health insurance exchanges are eligible for federal tax credits only if they make between 138% and 400% of the federal poverty level. People who earn more than 400% of the federal poverty level get no federal aid… July 9, 2019: Concord Monitor posted an article titled: “Sununu to sign Democrat-backed safeguards to Obamacare provisions”. It was written by Ethan DeWitt. From the article: Gov. Chris Sununu is poised to sign a Democratic bill that would protect certain portions of the Affordable Care Act by codifying them into state law, his office said.On Tuesday, Democratic legislative leaders in Concord sent a bill to Sununu that would add a range of provisions into state statute, including a requirement that health insurance plans cover those with pre-existing conditions.The move comes as a New Orleans federal court takes up oral arguments over the constitutionality of the Affordable Care Act – a high stakes case that threatens funding as well as regulations within the law……Senate Bill 4 would add to state law a mandate that insurance plans also cover a range of “essential health benefits” such as coverage for emergency services, maternity care, and rehabilitative services. And it would prevent the re-emergence of lifetime caps on age or expenses for those on certain insurance plans.Those protections were introduced into federal law by the ACA in 2010 – also known as “Obamacare” – which has faced opposition and legal challenges by several Republican attorneys general and supported by the U.S. Department of Justice……For Sununu, support for the bill puts him odds with some in his party. While SB 4 passed the Senate nearly unanimously, it left the House on party lines, after House Republicans argued it would tie the state’s hands in the event the ACA did fall and big decisions needed to be made… July 9, 2019: The Catholic Health Association of the United States (CHA) posted a news release titled: “CHA Strongly Urges Upholding The ACA In Texas v. United States”. From the news release: CHA Strongly Urges Upholding the ACA in Texas v. United StatesStatement by Sr. Mary Haddad, RSM, President and Chief Executive Officer, Catholic Health Association of the United StatesAs the U.S. Court of Appeals for the Fifth Circuit considers the constitutionality of the Affordable Care Act (ACA), the Catholic Health Association of the United States (CHA) stands firmly with those defending the law. CHA joined with four hospital organizations earlier this year in filing a brief as amici curiae in support of the Intervenor-Defendants-Appellants in Texas v. United States.“We believe health care is a basic human right and the effort to eliminate access to affordable health care coverage for millions of Americans is unconscionable,” stated Sr. Mary Haddad. The consequence of being uninsured are significant. Since uninsured patients are often forced to delay receiving necessary care, they are up to four times more likely than insured patients to require affordable hospitalization and emergency care. In addition to being harmful to patients’ health, the lack of coverage adds unnecessary expense to our nation’s health care system and deprives patients with an equitable opportunity for a healthy, productive life.Under the ACA, we as a nation have taken significant steps toward expanding health care access and coverage, as well as improving our nation’s health care delivery system. Nearly 20 million Americans have gained affordable insurance coverage, including 12 million low-income individuals who have gained coverage through state Medicaid program expansions under the ACA. The law also provides protections for 130 million people with pre-existing health conditions – including 17 million children – all of whom no longer need to worry that they will be denied insurance coverage.CHA believes that a decision by the Fifth Circuit to strike down the ACA as unconstitutional, if upheld, would reverse the progress we have made, adversely impacting the health of millions of Americans. We believe, as a matter of human dignity, everyone is entitled to health care. Like any basic element of life, health care sustains us and should always be accessible and affordable for everyone – where they need it, when they need it, no exceptions and no interruptions. CHA will continue to work with policy makers to advance the goal of ensuring everyone has access to affordable health coverage and high-quality health care. July 9, 2019: Daily Memphian posted an article titled: “Pastors urge Lee to request Tennessee drop from Affordable Care Act lawsuit”. It was written by Sam Stockard. From the article: With arguments set Tuesday in a lawsuit to dismantle the Affordable Care Act, a network of pastors is urging Gov. Bill Lee to request Tennessee drop out of the federal case.The Southern Christian Coalition made a public appeal for the governor to call on Attorney General Herbert Slatery to remove the state from Texas v. United States. The case is to be argued in the U.S. Fifth Circuit Court of Appeals in New Orleans, and its next stop would be the U.S. Supreme Court.“I appeal to Gov Lee, as a man of faith and a man of Christian values, to then live up to his values, to care for the least of these, to be compassionate… and to ask Slatery to remove the state of Tennessee from this lawsuit,” said Kelli X, minister of Village Church in Madison.She argued dismantling the Affordable Care Act would take health care coverage from more than a million Tennesseans, decreasing the number of people able to seek mental health care, possibly causing them to wind up in prison and limiting access to health care for babies born with health problems such as asthma……The group points out no plan is in place to provide health care for Tennesseans with preexisting conditions if the law is overturned… July 9, 2019: Roll Call posted an article titled: “States grapple with Medicaid work requirements”. It was written by Sandhya Raman. From the article: State action to implement work requirements into their Medicaid programs is heating up, as some states roll out their programs while others are fighting in court to keep them alive.New Hampshire announced Monday it would delay suspending any Medicaid coverage until September because of consumers’ noncompliance with the work requirements. Meanwhile, Indiana on July 1 began the first steps of implementing its work requirements. Court action in three other states is expected in the coming months,The path to implementing requirements for work or other forms of community service through Medicaid, the health program that covers some of the nation’s poorest individuals, has been tricky and controversial.MaryBeth Musumeci, associate director at the program on Medicaid and the uninsured at the nonpartisan Kaiser Family Foundation, said the overarching issue is whether requiring work is a permissible objective of Medicaid coverage……A June study published in the New England Journal of Medicine found that work requirements are not increasing employment and private insurance coverage……Arkansas was the first state to incorporate 80 hour per month work requirements in 2018 for some enrollees, but these are no longer in effect due to a circuit court ruling this year.New Hampshire became the second state to start phasing in slightly stricter requirements but recently changes them. Starting in June, individuals were supposed to work 100 hours per month, and enrollees would have had until July 7 to report their June hours or risk suspension later this year. Pregnant women and people who are medically frail or have a disability were exempted.But in late June, New Hampshire’s Democratic-controlled legislature passed a compromise scaling back the work requirements and expanding the exemptions. The legislation allowed the New Hampshire Department of Health and Human Services to delay implementation……Indiana rolled out its 20 hours per month requirements on July 1, with stricter requirements being phased in over time. Unlike in Arkansas, compliance is evaluated yearly rather than monthly.Last year, Arkansas terminated consumers’ coverage after three months of noncompliance, resulting in almost 17,000 individuals being dropped from the program……Wisconsin and Michigan are the next states slated to roll out work requirements in late October and January, respectively. Both states also have New Democratic governors.Maine, which also has a New Democratic governor this year, will not implement its work requirements, but it may not be as simple for Wisconsin and Michigan to reverse course……The next legal action expected is for New Hampshire’s program, which will be heard in the U.S. District Court for the District of Columbia.U.S. District Judge James Boasberg, an Obama appointee who previously ruled that both Arkansas and Kentucky’s programs were invalid, is scheduled for the case……Both the Kentucky and Arkansas cases are set to be heard by the U.S. Court of Appeals for the District of Columbia Circuit. The states’ briefings end Aug. 1, and oral arguments are expected by October… July 9, 2019: Des Moines Register posted an article titled: “ACLU says judge should block Iowa law that could limit Medicaid coverage for transition-related care”. It was written by Anna Spoerre. From the article: A judge is expected to rule within the next week on a bid to temporarily block an Iowa law that denies mandatory Medicaid coverage to transgender Iowans for transition-related care. Polk County District Judge David Porter heard arguments Tuesday from the American Civil Liberties Union of Iowa that the law is both discriminatory against and betrays an animus toward transgender individuals……The ACLU of Iowa in May sued to block legislation passed in April that allows government entities to opt out of using public insurance money, including Medicaid, to pay for transition-related surgeries. It was filed on behalf of two transgender Iowans – Mika Covington of Central Iowa and Aiden Vasquez of southeast Iowa – and the LGBTQ advocacy group One Iowa.Added to the health budget bill, the provision allows any state or local government unit or tax-supported district to decline to use public funds for “sex reassignment surgery” or “any other cosmetic reconstructive or plastic surgery procedure related to transsexualism, hermaphroditism, gender identity disorder or body dysmorphic disorder.”The law was passed after the Iowa Supreme Court in March ruled that a different ban on using Medicaid funds for transition-related care violated the Iowa Civil Rights Act. The new legislation, in turn, amended the Civil Rights Act.The lawsuit in question now says the new Medicaid provision runs afoul of the Iowa Constitution. The state Supreme Court did not address that question in its March ruling… July 9, 2019: Deseret News posted an article titled: “Utah leaders react to the uncertain fate of the Affordable Care Act”. It was written by Kim Bojouquez. From the article: Utahs are watching closely as the future of the Affordable Care Act is considered by three judges on the other side of the country.A three-judge panel, two Republican-appointed and one Democrat-appointed, from the U.S. Court of Appeals for the 5th Circuit in New Orleans, heard oral arguments on the constitutionality of the Affordable Care Act, also known as Obamacare, on Tuesday.In February 2018, Utah Attorney General Sean Reyes joined a 20-state coalition lawsuit against the federal government challenging the lawfulness of the health care law and calling it unconstitutional, after Congress repealed a provision that people without health insurance had to pay a fine……Lauren Simpson, policy director for Alliance for a Better Utah, a government advocacy and watchdog organization, said it’s too soon to tell where the judges will lean.“This is something that’s going to have really serious consequences for Utah. It directly contradicts what we know Utahs want,” Simpson said.Last November, Utahns voted in support of Proposition 3 to expand Medicaid coverage in the state. But in February, Gov. Gary Herbert signed a replacement to limit Medicaid expansion… July 10, 2019: Des Moines Iowa Register posted an article titled: “Iowa agrees to give Medicaid management companies 8.6% raises”. It was written by Tony Leys and Stephen Gruber-Miller. From the article: Iowa’s controversial use of private insurers to run its Medicaid program just got $386 million more expensive.That’s how much more state and federal money Iowa officials have agreed to pay through this fiscal year for two national companies to manage the giant health care program.The 8.6% raises will go to Amerigroup and Iowa Total Care, which Iowa hired to insure about 575,000 poor or disabled Iowans whose health care is covered by Medicaid……The Medicaid program is jointly financed by federal and state tax dollars, with rates set in closed-door negotiations between the companies and the Iowa Department of Human Services. The increased costs announced Wednesday include a 6.5% boost in state financing, which translates to $115 million, according to a summary posted by Iowa DHS.The new terms come a year after DHS officials agreed to give Amerigroup and UnitedHealthcare, then the state’s Medicaid managers, a raise of 8.4% in state and federal money for fiscal year 2019. That year’s raise amounted to $344 million, including $103 million more in state money. As a result, legislators had to come up with more money last spring, in the middle of the budget year… July 10, 2019: The Salt Lake Tribune posted an article titled: “Utah health care panel objects to state’s partial Medicaid expansion plan”. It was written by Benjamin Wood. From the article: Most members of Utah’s Medical Care Advisory Committee oppose the state’s plan to partially expand Medicaid through the imposition of service reductions, spending and enrollment caps, and patient work requirements.Ten of the advisory committee’s 19 members – who are appointed by Utah health care entities – signed on to a June 30 letter addressed to the state Department of Health asking local and national administrators to reject proposed changes to Utah’s Medicaid program, which “could risk the health and security of many Utah beneficiaries.”……The advisory committee’s objections were made as part of the public comment for a waiver that Utah is seeking from the federal government to implement a scaled-back version of Medicaid expansion approved by lawmakers earlier this year. The Legislature’s plan, SB96, replaced Proposition 3, a full Medicaid expansion initiative approved by voters last year that would have extended Medicaid services to tens of thousands of additional low-income Utahns.In its letter, the advisory committee highlights four areas of concern with Utah’s waiver request: a per-capita funding scheme that could leave the state liable for increased health care costs without matching federal funds; enrollment caps that could exclude otherwise eligible patients from Medicaid if funding runs dry; a requirement that patients prove they are working, looking for work or engaged in other qualifying activities to participate in Medicaid; and the elimination of some Medicaid benefits for 19- and 20-year-old patients……Last month, the Utah Health Policy Project released a report suggesting that per-capita funding could cause Utah’s Medicaid program to face a $39 million budget shortfall by 2024. Budget constraints were among the primary motivations cited by lawmakers in repealing and replacing Proposition 3 with the scaled-back expansion of SB96 intended to control costs……Utah’s Medicaid program currently is operating under a temporary waiver, often referred to as the “bridge” plan, which includes a limited expansion population and approval for work requirements, but those work requirements have not yet been implemented… July 11, 2019: Planned Parenthood posted a press release titled: “Ninth Circuit Denies Emergency Relief From Domestic Gag Rule”. From the press release: An en banc panel of the U.S. Court of Appeals for the 9th Circuit refused to block the Trump-Pence administration from enforcing the dangerous Title X gage rule. Title X is the nation’s program for affordable birth control and reproductive health care, which serves 4 million people each year. Trump’s gag rule makes it illegal for health care providers in the Title X program to refer patients for abortion, and also blocks access to care through the program at Planned Parenthood by imposing cost-prohibitive and unnecessary “physical separation” requirements. Planned Parenthood will continue its effort to restore the nationwide preliminary injunction and fight to protect health care for millions across the country.Providers that serve nearly half of the patients who get care through Title X have made it clear that the rule would force them out of the program – the administration is putting health care at risk for millions of patients across the country. Title X helps millions of patients struggling to make ends meet – the majority of whom are people of color, Hispanic, or Latino – access birth control, cancer screenings, STI testing, and other essential reproductive health care……Four district court judges had previously blocked the rule, with two judges blocking it nationwide. On June 20, 2019, the 9th Circuit granted the request from the Trump-Pence administration to stay the preliminary injunctions in California, Oregon, and Washington, which allowed the gag rule to be enforced. The 9th Circuit agreed to re-hear the administration’s request for a stay on July 3, 2019. Today’s order makes it clear that while the court is rehearing the request for the stay, the stay remains in place, jeopardizing the care of millions of people who access birth control and other reproductive health services through Title X.In June, the House of Representatives passed a spending package including strong language blocking the Trump-Pence administration’s Title X gag rule from being implemented. Now, the Senate must push for a spending bill that includes protective language to make sure millions of people can continue to access health care through Title X… July 11, 2019: Rewire News posted an article titled: “Republicans Get Another Win in Their Fight to Gut Title X”. It was written by Jessica Mason Pieklo. From the article: The Ninth Circuit Court of Appeals on Thursday ruled the Trump administration’s domestic “gag rule” which bans family planning dollars from going to health-care providers who perform abortions or refer patients for abortion services, can take effect everywhere but the state of Maryland.The ruling jeopardizes comprehensive reproductive health-care for nearly 4 million people……The Trump administration’s changes to the Title X program also mandate a new “physical and financial separation” between a Title X-funded program and a facility that engages in “abortion activities.” This separation must include separate waiting, consulting, examination, and treatment rooms, as well as office entrances and exists. Title X grantees would have to provide different phone numbers and email addresses for those staff members and facilities involved in abortion services. These separation requirements apply to all Title-X funded projects that give referrals to patients who wish to obtain an abortion, as well as any that engage in separately funded advocacy or public education activities that “promote” abortion as determined by the Trump administration.To obtain Title X funding, providers would have to open and operate an entirely independent facility to merely provide a referral for abortion care……First proposed in May of 2018, the administration’s changes had been blocked by the courts from taking effect while lawsuits challenging them proceed. Thursday’s order, however, allows those changes to take effect immediately, except for the separation requirements: Title X grantees will have until March 4, 2020, to comply with those requirements… July 11, 2019: Los Angeles Times posted an article titled: “Trump’s vaunted kidney initiative depends on Obamacare, which he’s trying to kill”. It was written by Michael Hiltzik. From the article: President Trump was showered with praise Wednesday when he unveiled an initiative to fix the country’s wretched and ridiculously expensive system for dealing with kidney disease.Only one problem. Trump’s plan depends on the Affordable Care Act, which he is trying to kill……He has eviscerated effective programs at the Department of Health and Human Services and replaced professional policy officials with ideology-driven hacks. His appointees at HHS have routinely approved state-level changes to Medicaid, the nation’s most important healthcare program for low-income Americans, that deprive enrollees of coverage by thousands at a time……There’s no question that the nation’s existing method of dealing with end-stage kidney disease is a mess. The most common treatment, dialysis, is so expensive – running an average of $90,000 per year per patient – that Congress in 1973 allowed advanced renal patients to enroll in Medicare at any age. The act effectively made end-stage renal disease the only condition subject to a single-payer program.That helped turn dialysis into a hugely profitable business. About 10,000 patients were covered in 1973; today more than 750,000 are. Federal spending through Medicare has soared to more than $34 billion a year from $1.1 billion (in current dollars) in 1973……Two remedies for this situation have long been obvious. One is to increase the rate of kidney transplants, which sharply reduce the cost of treating kidney disease. But kidneys are hard to come by. More than 100,000 patients in the U.S. are on the waiting list, with only about 21,000 donor organs available per year. Kidney transplants cost an average of about $32,000 and annual post-surgical care only about $25,000.The other remedy is to preform more dialysis at home, where it’s cheaper than at the dialysis centers operated by DaVita, Fresenius, and other companies, and certainly more convenient for patients. But only about 12% of U.S. patients receive dialysis at home, far less than in most other developed countries.Trump’s proposal, embodied in an executive order signed Wednesday, aims to increase transplants by covering more of the costs for donors, including lost work time and child care expenses. The White House says that, along with other changes in the transplant system, would double the number of kidneys available for transplant by 2030.The plan aims to increase the share of patients reviving dialysis at home to 80%. This would be done in part by changing the incentives for providers so they steer more patients to home dialysis (assuming that’s the right choice for them).The rub is that such changes would require congressional authorization – if it wasn’t for the Affordable Care Act. The act established the Centers for Medicare and Medicaid Innovation, which allow the changes to be made administratively… July 11, 2019: Planned Parenthood posted a press release titled: “New Multi-State Study Shows Telemedicine Abortion Is as Safe and Effective as In-Person Care”. From the press release: A new study published in Obstetrics & Gynecology shows that medication abortion via telemedicine is just as safe and effective as when the health care provider is in the same health center as the patient. The study was conducted by Planned Parenthood Federation of America – with researchers from Ibis Reproductive Health and University of California San Francisco (UCSF) Advancing New Standers in Reproductive Health (ANSIRH) – and supports existing evidence that outcomes for medication abortion via telemedicine are comparable with medication abortion provided in person.The study is the nation’s largest multi-state study of medication abortion via telemedicine to date, with researchers analyzing records from nearly 6,000 patients receiving medication abortion either through telemedicine or in person at 26 Planned Parenthood health centers in Alaska, Idaho, Nevada, and Washington…Medication abortion has been safe and legal in the U.S. since the FDA approved of its use nearly 20 years ago. It helped ensure that patients are able to make their own private medical decisions, and it has expanded access to reproductive health care.In a health-center-to-health center model of providing abortion via telemedicine, a patient has an ultrasound scan, laboratory testing, and counseling with health center staff. Telemedicine patients then meet with a provider in another health center through a secure videoconferencing platform, while standard medication abortion patients meet with a provider in person. During the study period, researchers compared rates of ongoing pregnancy, the need for a subsequent in-clinic abortion, and any significant adverse effects between the two groups. Researchers concluded that medication abortion provided remotely offers patients the same effective, high-quality care that they would receive if they were in the same room with the same trained providers. The study also found that complications are very rare for medication abortion via telemedicine, which is consistent with findings from previously published research.Restrictions and political attacks on access to abortion have left entire swaths of the country without access to safe, legal abortion, disproportionately affecting people with low incomes, people of color, and people living in rural communities. Right now, anti-abortion politicians are pushing burdensome and medically unnecessary bans that effectively prohibit access to medication abortion via telemedicine. Leading medical associations, such as the American College of Obstetricians and Gynecologists (ACOG), agree that these bans are not based in evidence… July 11, 2019: The Tennessean posted an article titled: “Blue Cross plans to return to Obamacare marketplace in Nashville, Memphis”. It was written by Brett Kelman. From the article: …The state’s largest insurance company, BlueCross BlueShield of Tennessee, plans to reenter the Affordable Care Act marketplace in Nashville, Memphis and surrounding counties next year, providing another option for residents on Obamacare in these cities. Cigna and Oscar Health, are planning to significantly reduce the cost of their coverage plans.Although the proposals are not final, it appears Tennesseans will have more options and competitive prices in the coming year, said Kevin Walters, a spokesman for the Department of Commerce and Insurance…Five insurance companies that currently offer Obamacare coverage plan to continue to do so next year, according to the department. The companies have submitted the following proposals to state regulators for approval:.. Those companies are BlueCross BlueShield of Tennessee, Bright Health, Celtic/Ambetter Insurance, Cigna, and Oscar Health. July 11, 2019: West Dakota FOX posted an article titled: “North Dakota argues Affordable Care Act’s validity”. From the article: …North Dakota’s Democratic Party says if the Affordable Care Act is overturned, there would no longer be penalties.“The penalty for those who don’t carry health insurance, they just reduced that penalty to zero, which essentially means there is no longer a tax,” said Kylie Oversen, Chairwoman of the Dem NPL.House Dem-NPL legislators proposed an amendment to the insurance commissioner’s budget this past session, in case the ACA would be found unconstitutional. It would require health insurance companies in North Dakota to cover people with pre-existing conditions……Insurance Commissioner Jon Godfread says the language on the amendment was unworkable… July 11, 2019: Military Times posted an article titled: “Yearlong birth control supply for female vets could cut costs and unplanned pregnancies”. It was written by Ariana Puzzo. From the article: The Department of Veterans Affairs could save about $2 million a year in prenatal, birth and newborn care costs by offering female veterans a year’s supply of birth control pills, researchers say.The VA does not currently offer an upfront 12-month supply option. Approximately 24,000 women receive oral contraceptives and a policy change could prevent an estimated 583 unintended pregnancies, found Colleen Judge-Golden, an MD, Ph.D. student the University of Pittsburg School of Medicine…Judge-Golden, the lead author of the paper published Monday in the Journal of the American Medical Association, analyzed the expense of the proposed program with senior author Sonya Borrero, M.D., M.S., the associate director of the VA’s Center for Health Equity Research and Promotion. Research found that money saved on health care costs would exceed the cost of providing larger upfront quantities of birth control pills to women.Forty-three percent of women receiving three-month increments of birth control will encounter at least one refill gap over a 12-month period that increases the risk of unintended pregnancies, VA data showed. Women outside of the VA who receive one year’s worth of birth control pills were alternatively found to experience fewer refill gaps and less pregnancies… July 11, 2019: Reuters posted an article titled: “U.S. lawmakers advance bill to boost Puerto Rico Medicaid funding”. From the article: A bill that would substantially boost federal Medicaid funding for Puerto Rico advanced out of a U.S. House subcommittee on Thursday after lawmakers agreed to work on stricter safeguards in the wake of a government corruption scandal in the territory.The Health Subcommittee sent the legislation, which would give the bankrupt U.S. commonwealth an additional $12 billion over four years, to the full House Committee on Energy and Commerce.On Wednesday, U.S. law enforcement officials announced a 32-count indictment and arrests of six people, including two former high-ranking Puerto Rico government officials, who were charged with conspiracy and other crimes in connection with millions of dollars in federal Medicaid and education funds……Federal funding to the five U.S. territories to support the healthcare program for low-income residents is capped, often leading to shortfalls during economic downturns or natural disasters like the devastating hurricanes that hit Puerto Rico in 2017 just months after it filed a form of bankruptcy in U.S. District Court… July 11, 2019: NPR posted an article titled: “Young Undocumented Californians Cheer Promise of Health Benefits”. It was written by Sammy Caiola. From the article: …California’s governor signed a law Tuesday that approved $98 million to expand Medi-Cal to income-eligible undocumented adults from age 19 until they turn 26, making it the first state in the United States to cover this group. California estimates 138,000 young adults will become insured under the new policy.While the state has expanded options for children and young adults, most undocumented people in California still have limited access to health care. They can sign up for “restricted” MediCal, but it only covers emergencies and pregnancy-related care. Many people on this plan end ip putting off treatment or turning to county clinics for help.Supporters who want to further expand Medi-Cal to all residents say that move would boost public health and bring down emergency room costs. California Gov. Gavin Newsom has vowed to make everyone eligible……But after months of debate at the California State Capitol, proposals to offer Medi-Cal to all undocumented adults, as well as a push to cover undocumented seniors, were deemed too costly……President Donald Trump has also criticized California for offering health insurance to undocumented people… July 11. 2019: The Hill posted an article titled: “Nearly half of voters less likely to support lawmakers who back ObamaCare repeal.” From the article: Almost half of Americans say they are less likely to support lawmakers who are in favor of repealing Obamacare, according to a new Hill-HarrisX poll.The survey, released on Thursday, found that 47 percent of registered voters said they were less likely to cast a ballot for members of Congress who backed a lawsuit that aims to eliminate ObamaCare, compared to 28 percent of respondents who were more likely to support those lawmakers.Twenty-six percent of voters said it doesn’t matter either way.Older Americans and minorities were least likely to support lawmakers who favored the ObamaCare lawsuit. The poll found that 58 percent of respondents age 65 and older and 68 percent of African Americans were less inclined to back lawmakers who are opposed to ObamaCare……The survey of 1,001 voters was conducted online July 5-6. The margin of error is plus or minus 3.2 percentage points. July 12, 2019: Planned Parenthood posted a press release titled: “Congress Expands Birth Control Access for Service Members”. From the press release: The House of Representatives approved two amendments to the Fiscal year 2020 National Defense Authorization Act (NDAA) that would expand contraception and reproductive health care access for service members. Most service members receive health insurance coverage through TRICARE, which currently does not offer comprehensive contraception coverage and reproductive health care resources for service members and their families……The amendments were offered by Reps. Jackie Speier (CA-14), Veronica Escobar (TX-16), Katie Hill (CA-25), Deb Haaland (NM-01), Ayanna Pressley (MA-07), Judy Chu (CA-27), and Barbara Lee (CA-13). One amendment adopted into the underlying bill clarifies that all FDA-approved contraceptive methods are covered by TRICARE without a copay, and brings TRICARE in line with the ACA’s birth control benefits. The second amendment passed by a vote of 231-199 establishes a standard family planning education program across all branches of the military, increasing services members’ ability to make the best decisions for themselves and their families. July 12, 2019: Fauquier Times posted an article titled: “Fauquier Free Clinic changes business model to include additional Medicaid patients”. From the article: This year the Fauquier Free Clinic, which has a mission to provide eligible residents of Fauquier and Rappahannock counties with access to comprehensive medical, dental, and mental health care, underwent “extensive changes” to accommodate new and existing patients when Medicaid expanded its services for low-income adults throughout Virginia, the clinic said in a news release.“In the past, our medical patients were not eligible for services if they had any type of medical insurance,” John McMahon, FFC board secretary said in the news release, “Now, approximately 60 percent are Medicaid eligible.”In Fauquier County, between 1,700 and 1,800 more people are now eligible for Medicaid, according to the clinic news release. In Rappahannock County, 300 to 400 people are now eligible. Throughout the state of Virginia, eligibility has been granted to around additional 400,000 people… July 12, 2019: Planned Parenthood posted a press release titled: “Planned Parenthood’s Clergy Advocacy Board Condemns the Trump-Pence Administration’s Gage Rule”. From the press release: An en banc panel of the U.S. Court of Appeals for the 9th Circuit refused to block the Trump-Pence administration from enforcing the dangerous Title X gag rule. Title X is the nation’s program for affordable birth control and reproductive health care, which serves 4 million people each year. The Clergy Advocacy Board of Planned Parenthood Federation of America condemns the Trump-Pence Administration’s dangerous Title X gag rule that makes it illegal for doctors, nurses, hospitals, community health centers, and any other provider in the Title X program to tell patients how they can safely and legally access abortion.The gag rule also makes it impossible for millions of patients to access birth control at Planned Parenthood health centers across the country.“We, the Clergy Advocacy Board condemn this gag rule. It brings politicians into the exam room, impairing access to accurate and complete medical information, undermining the patient’s moral agency, harming the poor and those in need, and for blocking access to preventative health care, including contraception.“We are called as clergy and faith leaders to provide pastoral care to people facing medical decisions. Day in and out, we witness the importance of how our congressional members get or don’t get the help they need, the medical information they need, the benefit of the doctor-patient relationship, and access to the care that arises from these personal, private deliberations.“Our faiths and pastoral experience also bear witness to the urgency and moral good in available access to all forms of contraception, and in keeping abortion safe and legal.” July 12, 2019: Center for Reproductive Rights posted a press release titled: “Oklahoma Court Goes Rogue, Upholds Abortion Ban”. Today, the Oklahoma district court became the first court in the country to uphold a ban on the standard method of ending a pregnancy after approximately 14 weeks. Judge Cindy Truong ruled from the bench, denying the Center for Reproductive Rights’ request to strike down the law, which has been enjoined since 2015……Every other court that has reviewed similar bans has blocked them from taking effect, including in Alabama, Arkansas, Kansas, Kentucky, and Texas. Just last month, the Supreme Court let stand a lower court’s decision, which found an identical ban in Alabama unconstitutional. Major medical organizations, including the American Congress and Obstetricians and Gynecologists (ACOG) oppose these types of bans, writing, “these restrictions represent legislative interference at its worst: doctors will be forced, by ill-advised, unscientifically motivated policy to provide lesser care to patients. This is unacceptable.”……Only four health centers provide abortion services in the entire state of Oklahoma. In addition to the 72-hour mandatory delay. Oklahoma has passed many other laws restricting abortion access, including: a parental consent requirement for minors; a ban on the use of telemedicine to prescribe pills for medication abortion; and restrictions on when private, public, and state health insurance plans can cover abortion services. These laws disproportionately affect populations that already experience barriers to health care, including people fo color, immigrants, and people with low incomes. July 13, 2019: Reuters posted an article titled: “Democrats take aim as Trump abandons drug pricing plan”. It was written by Ginger Gibson. From the article: …Trump talked regularly about drug prices during his 2016 campaign, but has failed so far to deliver the changes he promised.On Thursday, his administration scrapped one of its most ambitious proposals for lowering prescription medicine prices, backing down from a policy aimed at health insurers and raising the possibility of new measures focused on drugmakers.The abandoned proposal would have required health insurers to pass billions of dollars in rebates from drugmakers to Medicare patients……[Robert] Blendon [a political scientist at Harvard University] said Trump, having failed to broker any deals in Congress, made his drug price plan to complicated, and voters are unlikely to see him as having made any strides. That is an opportunity for Democrats to offer their own effort at messaging……On Thursday, U.S. Senators Kirsten Gillibrand unveiled a plan to lower drug prices. On Friday, Democrat Amy Klobuchar announced a plan to help lower the cost of pharmaceuticals purchased by seniors. Warren also has a Medicare pricing plan.Sanders is heading to Canada later this month for an event to highlight the difference in the price of insulin……Klobuchar’s proposal, which includes investing in research for a cure for Alzheimer’s disease and improving the stability of Social Security, would allow the government to negotiate Medicare Part D costs, which cover prescriptions for seniors.Klobuchar, a U.S. senator from Minnesota, would also let people order prescription drugs from countries like Canada, a proposal proponents say would Lowe drug costs… July 12, 2019: The Rolla Daily News posted an article titled: “Governor Parson signs “Nathan’s Law,” fixes glitch in Affordable Care Act”. It was written by Ron Reports. From the article: Governor Mike Parson signed House Bill 397 and Senate Bill 514 on Thursday. Both bills fixed an oversight in the Affordable Care Act related to youth formerly in foster care. One of the most popular provisions of the Affordable Care Act is the ability for children to stay on their parents’ health insurance until they turn 26…The ACA allows children that aged out of the foster care system at 18 to remain on Medicaid until they are 26 years old. However, the language passed in the ACA only required a state to provide Medicaid to that individual if they aged out of that specific foster system. Currently, if a youth aged out of Illinois’s foster system, but moved to Missouri to work, they are not allowed to maintain their public insurance in Missouri……Research has shown that access to health care for youth previously in foster care is important because they are more likely to have health complications. Ensuring these youth remain insured helps the broader community by keeping them out of crisis that could lead to emergency room visits or hospitalizations……In the fall of 2018, Congress passed and President Trump signed into law a federal fix to this provision within the ACA, but it will not take effect until Jan. 1, 2023. These former foster youth in Missouri will be able to access Medicaid beginning August 28, 2019, when the bill takes effect, according to the nonprofit Kids Win Missouri, whose mission it is to further child well-being… July 15, 2019: Former Vice President Joe Biden (who is running for President) revealed information about his Health Care Plan. Here is some of the key parts of Joe Biden’s Health Care Plan: Giving Americans a new choice, a public health insurance option like Medicare. If your insurance company isn’t doing right by you, you should have another, better choice. Whether you’re covered through your employer, buying you insurance on your own, or going without coverage altogether, the Biden Plan will give you the choice to purchase a public health insurance option like Medicare. As in Medicare, the Biden public option will reduce costs for patients by negotiating lower prices from hospitals and other health care providers. It also will better coordinate among all of a patient’s doctors to improve the efficacy and quality of their care, and cover primary care without any co-payments. And it will bring relief to small businesses struggling to afford coverage for their employees. Increasing the value of tax credits to lower premiums and extend coverage to more working Americans. …The Biden Plan will help middle class families by eliminating the 400% income cap on tax credit eligibility and lowering the limit on the cost of coverage from 9.86% of income to 8.5%. This means that no family buying insurance on the individual marketplace, regardless of income, will have to spend more than 8.5% of their income on health insurance. Additionally, the Biden Plan will increase the size of tax credits by calculating them based on the cost of a more generous gold plan, rather than a silver plan. This will give more families the ability to afford more generous coverage, with lower deductibles and out-of-pocket costs…. Expanding coverage to low-income Americans. …The Biden Plan will ensure these individuals get covered by offering premium-free access to the public option for those 4.9 million individuals who would be eligible for Medicaid but for their state’s inaction, and making sure their public option covers the full scope of Medicaid benefits. States that have already expanded Medicaid will have the choice of moving the expansion population to the premium-free public option as long as the states continue to pay their current share of the cost of covering those individuals. Additional, Biden will ensure people making below 138% of the federal poverty level get covered. He’ll do this by automatically enrolling these individuals when they interact with certain institutions (such as public schools) or other programs for low-income populations (such as SNAP)…. …The Biden Plan has several additional proposals aimed directly at cutting the cost of health care and making the health care system less complex to navigate. The Biden Plan will: Stop “surprise billing”… The Biden Plan will bar health care providers from charging patients out-of-network rates when the patient doesn’t have control over which provider the patient sees (for example, during a hospitalization). Tackle market concentration across our health care system… The Biden Administration will aggressively use its existing antitrust laws to address this problem… Lower costs and improve health outcomes by partnering with the health care workforce. The Biden Administration will partner with health care workers and accelerate the testing and deployment of innovative solutions that improve quality of care and increase wages for low-wage health car workers, like home care workers… Repealing the outrageous exception allowing drug corporations to avoid negotiating with Medicare over drug prices… The Biden Plan will repeal the existing law explicitly barring Medicare from negotiating lower prices with drug corporations. Limiting launch prices for drugs that face no competition and are being abusively priced by manufacturers… For these cases where new speciality drugs without competition are being launched, under the Biden Plan the Secretary of Health and Human Services will establish an independent review board to assess their value. The board will recommend a reasonable price, based the average price in the countries (a process called external reference pricing) or, if the drug is entering the U.S. market first, based on an evaluation by independent board members. This reasonable price will be the rate Medicare and the public option will pay. In addition, the Biden Plan will allow private plans participating in the individual marketplace to access a similar rate. Limiting price increases for all brand, biotech, and abusively priced generic drugs to inflation… The Biden Plan will also impose a tax penalty on drug manufacturers that increase the costs of their brand, biotech, or abusively priced generic over the general inflation rate. Allowing consumer to buy prescription drugs from other countries… The Biden Plan will allow consumers to import prescription drugs from other countries, as long as the U.S. Department of Health and Human Services has certified that those drugs are safe. Terminating pharmaceutical corporations’ tax break for advertisement spending. … As president, Joe Biden will end this tax deduction for all prescription drug ads, as proposed by Senator Jeanne Shaheen. Improving the quality of generics… The Biden Plan supports numerous proposals to accelerate the development of safe generics, such as Senator Patrick Leahy’s proposal too make sure generic manufacturers have access to a sample. Ensure Health Care Is A Right For All, Not A Privilege For Just A Few Expanding access to contraception and protect the constitutional right to an abortion… The Biden Plan supports repealing the Hyde Amendment because health care is a right that should not be dependent on one’s zip code or income. And the public option will cover contraception and a woman’s constitutional right to choose. In addition, the Biden Plan will: Restore federal funding for Planned Parenthood… As president, Biden will reissue guidance specifying that states cannot refuse Medicaid funding for Planned Parenthood and other providers the refer for abortions or provide related information and reverse the Trump administration’s rule preventing Planned Parenthood and certain other family planning programs from obtaining Title X funds. …President Biden will rescind the Mexico City Policy (also referred to as the global gag rule) that President Trump reinstated and expanded… Reducing our unacceptably high maternal mortally rate, which especially impacts people of color…California came up with a strategy that halved the state’s maternal death rate. As president, Biden will take this strategy nationwide… Defending health care protections for all, regardless of gender, gender identity, or sexual orientation… President Biden will defend the rights of all people – regardless of gender, sexual orientation, gender identity – to have access to quality, affordable health care free from discrimination. Doubling America’s investment in community health centers… The Biden Plan will double the federal investment in these centers, expanding access to high quality health care for the populations that need it most… Achieving mental health parity and expanding access to mental health care. As Vice President, Biden was a champion for efforts to implement the federal mental health parity law, improve access to mental health care, and eliminate the stigma around mental health. As President, he will redouble these efforts to ensure enforcement of mental health parity laws and expand funding for mental health services… July 15, 2019: Planned Parenthood posted a press release titled: “Nearly 80 Reproductive Health, Rights, and Justice Organization Unveil Proactive Blueprint for Sexual and Reproductive Health, Rights, and Justice”. From the press release: Today, a broad and diverse coalition of nearly 80 organizations released a proactive policy agenda for a fully supportive Congress and Administration to advance sexual and reproductive health in the U.S. and around the world. The Blueprint is significant and unprecedented because it is the first time the wide range of reproductive health, justice, and rights organizations have come together to develop a detailed and intersectional policy agenda.The Blueprint for Sexual and Reproductive Health, Rights, and Justice is centered on five principles:Ensure sexual and reproductive health care is accessible to all people.Ensure discriminatory barriers in health care are eliminated.Ensure research and innovation advance sexual and reproductive health, rights, and justice now and in the future.Ensure health, rights, justice and wellness for all communities.Ensure judges and executive officials advance sexual and reproductive health, rights and justice.The Blueprint is a vision for the future that includes forward thinking ideas to transform sexual and reproductive health, rights, and justice policy domestically and globally, as well as basic and fundamental measures to correct the backtracking that has taken place in recent years.Guided by the five key principles, the Blueprint lays out many critical policy goals, including:Coverage of and access to comprehensive sexual and reproductive health care services and qualified providers at no or low cost and without exception for all people, including immigrants, incarcerated individuals, and young people under the age of 18.Full access to abortion that is best for an individual and their circumstances and comprehensive insurance coverage for care.Comprehensive pregnancy and material health care strategies that prioritize the health care needs of pregnant and birthing individuals.Strong non-discrimination protections for patients, including protections that ensure providers’ religious or personal beliefs do not dictate patient care.Health care system transformation that prioritizes sexual and reproductive health care, including research and development in the field of reproductive health and scientific integrity and transparency in sexual and reproductive health care.Foreign policy that prioritizes sexual and reproductive health and rightsRobust response to the global HIV/AIDS crisis.Economic opportunity, freedom from violence, and healthy and safe environments for all individuals, families, and communities.Selection and conformation of administrative and judicial nominees who will advance sexual and reproductive health, rights, and justice… The nearly 80 organizations who have endorsed the Blueprint are: Abortion Care NetworkAdvocates for YouthAIDS Alliance for Women, Infants, Children,Youth & FamiliesAll-OptionsAll* Above AllAmerican AtheistsAmerican Jewish World ServiceAmerican Medical Student AssociationAmerican Sexual Health AssociationAVACBlack Mamas Matter AllianceBlack Women for WellnessBlack Women’s Health ImperativeCatholics for ChoiceCenter for Health and Gender Equity (CHANGE)Center for Reproductive RightsCivil Liberties & Public Policy ProgramEquity ForwardGender JusticeGlobal Justice CenterGuttmacher InstituteHarambee Village DoulasHealthy Teen NetworkIbis Reproductive HealthIf/When/How: Lawyering for Reproductive JusticeIn Our Own Voice: National Black Women’s Reproductive Justice AgendaInternational Women’s Health Coalition IpasJacobs Institute of Women’s HealthJewish Women InternationalMaroon CalabashNARAL Pro-Choice AmericaNational Abortion FederationNational Asian Pacific American Women’s Forum (NAPAWF)National Black Women’s HIV/AIDS Network National Center for Lesbian RightsNational Council of Jewish WomenNational Family Planning & Reproductive Health AssociationNational Health Law ProgramNational Institute for Reproductive HealthNational Latina Institute for Reproductive HealthNational LGBTQ Task ForceNational Network of Abortion FundsNational Organization for WomenNational Partnership for Women & FamiliesNational Women’s Health NetworkNational Women’s Law CenterNew Voices for Reproductive JusticeNot Without Black WomenPAIPeople For the American WayPhysicians for Reproductive HealthPlanned Parenthood Federation of AmericaPopulation Connection Action FundPopulation CouncilPopulation InstitutePositive Women’s Network-USAPower to DecideReproductive Health Access ProjectSecular Coalition for AmericaSexuality Information and Education Council of the United States (SIECUS)Sierra ClubSisterLove, Inc.SisterReachSocial Workers for Reproductive Justice SPARK Reproductive Justice Now!, Inc. Surge Reproductive JusticeThe Afiya CenterThe American Civil Liberties UnionThe Center for Sexual Pleasure and Health UltraVioletURGE: Unite for Reproductive & Gender Equity#VOTEPROCHOICE Wisconsin Alliance for Women’s Health Women with a VisionWoodhull Freedom Foundation July 17, 2019: Anchorage Daily News posted an article titled: “ACLU sues Dunleavy for veto to Alaska court system over abortion rulings”. It was written by Tegan Hanlon. From the article: The American Civil Liberties Union of Alaska is suing Gov. Mike Dunleavy over his decision to cut funding to the state court system because of its rulings on abortion.The ACLU says Dunleavy is retaliating against the courts and seeking to punish them for the decisions he doesn’t agree with in violation of the Alaska Constitution and the separation of powers doctrine……The lawsuit was filed Wednesday in Superior Court in Anchorage against Dunleavy and the state of Alaska. It comes as Alaska’s divided legislature wrestles with the governor’s $444 million in vetoes to the state operating budget.The ACLU targets one of Dunleavy’s vetos: a $344,700 cut to the court system budget. That amount, Dunleavy has said, is equal to the amount the state spent on “elective abortions” last year.His veto followed years of attempts by Alaska conservatives to bar the state’s Medicaid program from paying for abortions outside of cases of rape, incest, and when the mother’s life is in danger. Each time, they’ve been blocked by the Alaska Supreme Court. Most recently, in February, the court declared two such laws unconstitutional.A document from the Dunleavy administration explaining the veto says: “The Legislative and Executive Branch are opposed to State funded elective abortions; the only branch of the government that insists on State funded elective abortions is the Supreme Court. The annual cost of abortions is reflected by this reduction.”That violates the state constitution, says ACLU’s complaint in the lawsuit……The ACLU is asking the court to rule that Dunleavy has violated the state constitution by breaching the separation of powers when he issued his veto and by illegally reallocating funding. It also wants the court to order that Dunleavy and the state must restore the $344,700 in funding to the court system… July 17, 2019: The American Civil Liberties Union (ACLU) of Alaska posted a press release titled: “ACLU Of Alaska Sues To Reverse Governor Dunleavy’s Retaliatory Veto Of Court System Funding.” From the press release: Today, the ACLU of Alaska filed suit against Governor Dunleavy to block his administration’s attempt to punish the Alaska Court System by vetoing $334,700 in its 2020 budget because the Alaska Supreme Court ruled in a manner at odd with his political views.The veto is an impermissible exercise of executive authority that attacks Alaskans’ deep commitment to an independent judiciary, violates Alaska’s constitutional separation of powers, and illegally attempts to reallocate budget appropriations.“Governor Dunleavy admitted outright that his veto was direct retaliation against the Alaska Court System for a court decision at odds with his political views. That isn’t just petty and vindictive; it is a clear assault on the constitutional power of the judiciary and a grossly inappropriate attempt to use money to coerce judges to a political end,” said ACLU of Alaska Executive Director Joshua A. Decker. He continued, “Alaskans don’t want judges making decisions with one eye on how much money politicians will give them if they rule one way or another. That isn’t how we get justice.” July 17, 2019: Detroit Free Press posted an article titled: “After huge spikes, Obamacare rates in Michigan now falling”. It was written by JC Reindl. From the article: Sticker prices for many Affordable Care Act-compliant individual health insurance plans will drop next year, a reversal from the huge price hikes sought in past years by insurance companies.Insurers’ new proposed rates, which would take effect in 2020 if approved, were announced Wednesday by the Michigan Department of Insurance and Financial Services……The Blue Care Network of Michigan, an HMO that insures the most people in Michigan’s individual market at about 157,400 people, is seeking to lower its individual plan rates by an average of 1.7% in 2020. And the market’s second-most popular Insurer, Priority Health, is looking to shave it’s rates by 0.1%.Blue Cross Blue Shield of Michigan, the third most popular choice with 50,600 people, wants to drop its prices by 7.7%……About 5% of Michiganders, or 333,000 people, currently get health insurance through these individual plans, which are sold on the website Healthcare.gov. The lower rates will not directly benefit many of those policyholders because more than 80% of those in Michigan who buy individual plans do not pay full sticker price since they receive the ACA’s tax credit subsidies……The poorest individuals in Michigan qualify for Medicaid health insurance… July 18, 2019: The American College of Obstetricians and Gynecologists (ACOG) posted a statement titled: “ACOG Statement on Federal Surprise Billing Legislation”. From the statement: Ted L. Anderson, MD, PhD, president of the American College of Obstetricians and Gynecologists (ACOG) issued the following statement about federal legislation to address surprise medical bills:“ACOG believes that patients should be protected from unanticipated medical bills for care provided by an out-of-network physician. This problem can extend beyond patients who receive unexpected care in the emergency setting, also impacting patients who have received expected care, such as childbirth or surgery, from a care team that includes an out-of-network provider. We understand that patients are not always able to choose an in-network provider. For example, in situations where care is provided by an out-of-network provider in an in-network setting, patients should not be punished financially for circumstances beyond their control. After all, women who recently had a child should be able to focus on their growing family and their own health and well-being, rather than the burdensome out-of-pocket costs.“Surprise billing can interfere with the patient-physician relationship. We believe that in order to protect the patient-physician relationship, patients should be absolved from any payment that disputes that arise between physicians and insurers related to out-of-network care. However, we also must ensure that physicians receive fair compensation for the quality of care they provide, and that patients do not face network inadequacy or limitations in access to care. To that end, we support an independent dispute resolution process, such as the proven model in place in New York State. This model enables a neutral third party to evaluate the many variables associated with each case to reach a fair agreement between physicians and insurers that reflects the complexity of the case, the experience of the physician, and insurers that reflects the complexity of the case, the expertise of the physician, and the reasonable rate charged in that geographic area.“We thank Members of Congress, particularly the physicians in Congress, for their attention to this complex situation and look forward to the refinement and enactment of legislation that both protects patients and ensures the financial sustainability of physician practices.” July 18, 2019: CBS News posted an article titled: “House votes overwhelmingly to repeal Obamacare “Cadillac” tax”. From the article: The Democratic-led House of Representatives has overwhelmingly voted to repeal a tax on high-cost health insurance plans under Obamacare known as the “Cadillac tax”.The 419-6 vote is a signal of bipartisan unity against a key provision of the Affordable Care Act. The 40% tax on high-cost plans is meant to help subsidize other plans under the Affordable Care Act, but it’s become unpopular even among many Democrats……Based on Congressional Budget Office estimates, repeal would add $193 billion to the federal deficit from 2022-2029, by removing revenues off the government’s books. The nonpartisan Kaiser Family Foundation expects that about 1 in 5 employers offering health insurance would have at least one insurance plan subject to the tax in 2022, and the share would grow quickly over time.Before the passage of the ACA, employers used to benefit from offering the expensive plans because they were not taxed on employee health care benefits, while they are taxed on the salaries they pay their employees. Labor unions, in particular, disliked the tax because they’re known for their generous health benefits, and they have argued that the 40% tax would affect their members……The president has pledged to introduce a new GOP health care plan, but that has yet to come to fruition. July 18, 2019: News Observer posted an article titled: “Senate Republicans unite agains Cooper, say budget is ‘hostage’ to Medicaid expansion”. It was written by Dawn Baumgartner Vaughan. From the article: North Carolina Senate Republicans didn’t like what Democratic Gov. Roy Cooper said about their leaders Wednesday. They responded in a letter signed by all 29 Republican members the state Senate, saying that Cooper is holding the budget hostage over Medicaid expansion.Talking to reporters after hosting a Medicaid expansion roundtable on Wednesday, Cooper said it was Republican leadership, not rank-and-file legislators, who are holding up budget negotiations……It is almost three weeks into the new fiscal year that started July 1, but there’s still no state budget.The House presented its budget in April, followed by the Senate in May; then they submitted what’s called the conference budget to the governor in June. Both chambers are led by Republicans. Cooper vetoed the budget on June 28, and negotiations have been at a standstill since then. A potential override vote on the veto has been on the House’s calendar for several days, but House Speaker Tim Moore, a Kings Mountain Republican, has yet to call for the vote. At least seven House Democrats and all Republicans would be needed pass a veto override.The House override vote is tied to a Medicaid expansion compromise bill called NC Health Care for Working Families that would expand Medicaid but include work requirements and premiums. It made it through committee with bipartisan support. However, the Senate has not proposed any sort of compromise on Medicaid… July 18, 2019: The Neighbor posted an article titled: “Idaho submits Medicaid waiver request.” It was written by Nathan Brown. From the article: Idaho has submitted its waiver request to let some people who would be covered by Medicaid expansion stay on private insurance.The “Section 1332 Coverage Choice Waiver” was submitted Monday and, if approved by the Centers for Medicare and Medicaid Services, would give people making between 100 percent and 138 percent of the poverty level the option of getting federal tax credits to buy insurance on the Your Health Idaho state exchanges instead of going on Medicaid when the expansion kicks in on Jan. 1, 2020. An estimated 18,000 Idahoans who have exchange insurance now will qualify for expanded Medicaid coverage and would, without a waiver, have to give up their current policies for Medicaid.The state has already taken public comment on the proposed waiver, and also took public comment on a “Section 1115” Medicaid waiver that is related to the proposal to let some people stay on the exchange. However, CMS had some additional questions on that waiver request, said Department of Health and Welfare spokeswoman Niki Forbing-Orr, and it isn’t clear if the state needs to submit two waiver requests or just the 1132 waiver. Forbing-Orr said the state is in talks with CMS to see what is required……Reclaim Idaho, the group that spearheaded last years Medicaid expansion push and lobbied against putting any restrictions on it during the 2019 legislative session, has come out against the proposal to insure some people on the exchange, saying it could cost Idaho taxpayers more than straight expansion……Idaho’s request to spend some Medicaid money on mental health treatment is similar to a waiver that has been allowed in many other states and is expected to be approved. Work requirements, which are the most controversial of the proposed waivers, have been approved in numerous states and the Trump administration supports the idea. The final fate of the concept could be decided by courts through – opponents have sued to block work requirements elsewhere and in March a federal judge sided with them and blocked them in Kentucky and Arkansas. July 18, 2019: WABE posted an article titled: “Georgia’s Medicaid Waiver Application Process Reaches Next Step”. It was written by Emil Moffatt. From the article: An effort to expand Georgia’s Medicaid rolls is moving into its next phase……The consulting group Deloitte, which got a nearly $2 million contract to prepare Medicaid waivers for the state, painted a deficient picture of Georgia’s health insurance system.Its number show 14.8 percent of Georgians are uninsured (compared to a national average of 10.5 percent) and the state ranks third in the nation when it comes to the number of rural hospitals at risk of closing.The data was compiled using numbers from the Department of Insurance plus community and public health data, something Ryan Like with the governor’s office says is unprecedented……And now the at the numbers are in, says Like, the 47-member advisory board group made up of lawmakers, medical professionals, health groups and health insurance companies can weigh in……In the end, it will be Gov. Brian Kemp who’ll decide what exactly goes into the waiver applications.The goal is to bring more federal health care dollars to the state without fully expanding Medicaid under the Affordable Care Act. July 19, 2019: The Hill posted an article titled: “Federal judge upholds Trump’s expansion of non-ObamaCare plans”. It was written by Jessie Hellmann. From the article: A federal judge on Friday upheld the Trump administration’s expansion of health insurance plans that don’t meet ObamaCare’s coverage requirements.U.S. District Judge Richard Leon in Washington ruled against the insurance companies that sued the administration in an attempt to block the rules……The plans aim to “minimize the harm and expense” for individuals who might otherwise decide not to purchase insurance because of high premiums, Leon added.The Trump administration issued a regulation last year allowing short-term health care plans to last up to 12 months instead of three. These plans were originally intended as an option for individuals who need to bridge a gap in health insurance coverage.But the administration extended the length of time they can be sold to provide customers with more affordable options.The plans generally cost less because they don’t have to comply with coverage requirements set by the Affordable Care Act (ACA), such as maternity care and prescription drugs.The short-term plans can also deny coverage to sick people, which ObamaCare insurers are prohibited from doing……The Association for Community Affiliated Plans (ACAP) the plaintiff in the case, said in a statement that it would appeal the decision……The Trump administration has been looking for ways to dismantle ObamaCare through regulation after Congress failed to repeal it in 2017… July 19, 2019: Iowa Public Radio posted an article titled: “Judge Dismisses Lawsuit On Medicaid Funding for Transgender-Related Surgeries”. It was written by Natalie Krebs. From the article: A Polk County judge has dismissed a lawsuit to overturn a law that would allow organizations using public insurance dollars – like Medicaid – to opt out of covering gender-affirming surgery.The lawsuit was filed by the ACLU on behalf of Mika Covington and Aiden Vasquez, two transgender plaintiffs on Medicaid who are seeking the procedure. It asks for the law to be ruled unconstitutional under the state’s Civil Rights Act.The legislature passed the provision as part of a health budget bill in April and it was signed into law by Gov. Kim Reynolds in May.It came just weeks after a state Supreme Court decision struck down a decades-old ban on using Medicaid dollars for transition-related surgery.Polk County Judge David Porter wrote in his ruling released this week that the injunction sought by the ACLU is not “ripe for judicial consideration” because Covington and Vasquez have not yet exhausted the administrative appeals process through the Department of Human Services, which oversees Medicaid.At a hearing last week, Assistant Attorney General Thomas Odgen told the judge the language of the law does not actually ban funding……But it does allow the government insurance program to refuse to provide the surgery… July 19, 2019: Forbes posted an article titled: “Don’t Slash Medicare in Last-Minute Budget Agreement”. It was written by Sally Pipes, who covers health policy as President of the Pacific Research Institute. From the article: …White House officials are feverishly negotiating with congressional leaders to raise the debt ceiling and reach a two-year budget deal that averts more than $126 billion in automatic spending cuts.Democrats want the deal to dramatically raise domestic spending levels. Republicans want to offset those increases with cuts elsewhere. So on Thursday evening, the president sent House Speaker Nancy Pelosi a list detailing $574 billion of possible spending cuts and reforms. One of those proposed offsets would fundamentally transform Medicare’s “Part D” prescription drug benefit.I’ve long advocated systemic reforms to Medicare. And the White House is right to call for offsets. But it’d be a mistake to target Part D, a successful, comparatively free-market program that helps nearly 45 million Americans afford their prescriptions. The proposal would hurt vulnerable seniors and stifle medical innovation…….The program’s success stems from its market-based structure. Private insurers sponsor plans and sell them to seniors. The government subsidizes and regulates these plans, but otherwise, it doesn’t interfere. This forces insurers to compete with each other fir beneficiaries’ business.This market competition helps keep beneficiaries’ premiums down. The average Part D premium totaled just over $39 a month in 2019, a decrease of 4% from the previous year……Medicare Part D is one of the government’s only successful entitlement programs precisely because it relies on private-sector competition. Adjusting the program could lead to higher premiums for beneficiaries and fewer new therapies. Let’s hope the White House and Congress find a smarter way to offset the cost of any budget deal. July 24, 2019: National Organization for Women (NOW) posted a press release titled: “NOW Applauds Arkansas Decision to Protect Abortion Rights”. From the press release: Judge Kristine Baker ruled today to temporarily block three anti-abortion laws the would have left Arkansas residents with only one clinic providing abortion care. Currently, Arkansas has two such clinics, and only one of them performs abortions after 10 weeks into a pregnancy. That clinic would not have been able to meet new burdensome requirements under one of the blocked bills.The National Organization for Women applauds Judge Baker for ruling against these bills and temporarily preventing Arkansas from becoming the seventh state with only one abortion clinic, a dangerous situation that puts the who do not have the resource to travel out of state in danger.We know that these bills were not passed to protect women’s health – because women are safest when they have access to affordable, accessible abortion care, not when clinics have their hands tied or are forced to close. This ruling stands as a strong refusal to value the ideological extremism of a few over the health, safety, and constitutional rights of Arkansas women. July 24, 2019: Mother Jones posted an article titled: “A New Study Found that 15,000 People Died Because Their State Didn’t Expand Medicaid”. It was written by Abigail Weinberg. From the article: Approximately 15,600 people died between 2014 and 2017 as a result of their states refusing to expand Medicaid coverage under the Affordable Care Act, according to a new working paper by the National Bureau of Economic Research.The ACA promise to expand Medicaid coverage to individuals whose income was at or below 138 percent of the federal poverty level, but a 2012 Supreme Court ruling left it up to states to decide whether to expand coverage. Today, 14 states have not yet adopted Medicaid expansion, and three others have adopted it but not yet implemented it.The paper studied mortality rates in expansion states and in non-expansion states before and after the increased Medicaid coverage was implemented. It found that, in states that had expanded Medicaid, 4,800 fewer Medicaid-eligible individuals between the ages of 55 and 64 died per year than in non-expansion states……Harold Pollack, a health policy expert at the University of Chicago, said that NBER’s finding seemed plausible and that the number of people affected could actually be greater……Several Republican governors have refused to expand Medicaid in their stats, even though the federal government finances most of the costs of expansion, likely because the legislation is associated with Barack Obama’s presidency. Still, Medicaid expansion polls well even in red states, and has been favored by voters in states with Republican governors, such as Utah. July 25, 2019: The Guardian posted an article titled: “Doctor claiming to ‘reverse’ abortion was told to stop using medical school’s name”. It was written by Jessica Glenza. From the article: A doctor who has said he invented a procedure to “reverse” abortion has for years falsely claimed an affiliation to a prestigious US medical school, the Guardian can reveal.A medication abortion or “self-managed” abortion, is an FDA approved procedure and is administered through two doses of medicine over 48 hours. Medication abortions now represent nearly one-third of all abortions nationally, according to the Guttmacher Institute. There is no reversal procedure.But Dr George Delgado, the medical director of Culture of Life Family Services in San Diego, claims to have invented a “reversal”, in which women are given a large dose of progesterone following the first dose of a medicated abortion.Delgado’s assertions about the “reversal” procedure have been denounced as “unproven and unethical” in a statement from America’s largest association of women’s doctors, the American College of Obstetricians and Gynecologists. His work has been described as an “unmonitored research experiment” in an article in the New England Journal of Medicine.Despite condemnation from the medical community, Delgado’s claims have been adopted by some Republican state legislators as part of a wider campaign to undermine women’s reproductive rights. North Dakota legislators recently passed a law forcing doctors to tell patients medication abortions are reversible, the fifth state to do so in 2019……Delgado had been listing an affiliation with the University of California San Diego (USD), even after the university asked him to stop last year.Delgado worked in UCSD’s department of family medicine as a voluntary clinical associate professor beginning in 2005, but left in June 2011, according to the school. The school could not describe the scope of Delgado’s duties, but said his position was unpaid, and may have been “as little as teaching a class once a year”, according to the university spokesperson Scott LaFee.”.. July 29, 2019: Senator Kamala Harris released her Medicare For All plan. It is a plan intended to be a transition from what we have now to Medicare for All. This plan would go into effect if she becomes President of the United States. Here are some key points of that plan: Who will be covered under Medicare for All and what benefits will be offered?Medicare for All will provide every individual in America with access to comprehensive health care. It will cover all medically necessary services, including emergency room visits, doctor visits, hearing aids, vision, dental, mental health and substance use disorder treatment, and comprehensive health care services. These benefits will be covered – no deductibles, and no copays for high-quality care. The plan will also have strong caps on out-of-pocket costs. It will also empower the Secretary of Health to negotiate for lower drug prescription drug prices. My health plan will give more Americans more options to gain access to the health care they need.Under my Medicare for All plan, we will also expand the program to include other benefits Americans desperately need that will save money in the long run – for instance, an expanded mental health program including Telehealth and easier access to early diagnosis and treatment, and innovative patient navigator programs to help people identify the right doctor and understand how to navigate the health system. It will provide a serious auditing of prescription drug costs to ensure Americans aren’t paying more for their prescription drugs than other comparable countries; a comprehensive maternal & child health program to dramatically reduce deaths, particularly among women and infants of color; and meaningful rural health care reforms, such as increasing residency slots for rural areas with workforce shortages and expanding loan forgiveness for rural health care professionals, to promote high-quality access to people regardless of their zip code.Will I be able to keep my doctor under Medicare for All?Yes. 91% of eligible doctors participate in the Medicare program today. Envision a program where you can walk into a doctor’s office knowing that they are in-network and you can walk out without worrying about your out-of-pocket costs or a surprise medical bill. My plan recognizes that doctors, nurses, and your entire health care team who provide high-quality care will have a voice in their workplace and be paid at appropriate rates under my plan.How does this plan work and how will we transition to Medicare for All?Under my Medicare for All plan, we will immediately allow people to buy into a Medicare Transition Plan through an extended 10-year phase-in period.We will automatically enroll newborns (with an opt-out provision for families with employer-sponsored insurance) and the uninsured into a Medicare Transition Plan, and provide a commonsense path for employers, employees, the underinsured, children, and others on federally-designated programs, such as Medicaid or the Affordable Care Act exchanges, to transition into the Medicare Transition Plan. The Medicare Transition Plan will provide enhanced benefits with limited cost-sharing requirements and financial assistance for those who qualify based on income. During the transition, seniors will be able to keep their Medicare with immediate coverage of additional benefits such as dental, vision and hearing aids.Second, after the 10-year transition period, we will have a new Medicare framework where most Americans will be in an expanded and improved public Medicare plan. In my Medicare for All system, similar to Medicare Advantage today, private insurance plans can contact through Medicare and compete with the public Medicare plan. However, these private Medicare plans will be subject to stricter consumer protection requirements than under current law, such as getting reimbursed by Medicare for less than the cost of the public Medicare plan to ensure taxpayers aren’t subsidizing insurance company profits. Americans can then choose whether to stay in the public Medicare plan or opt-out into a private Medicare plan.What about employer-based plans?During the transition period, employees can continue to provide private health coverage to employees. However, employers will also have the opportunity to provide health care for employees through the Medicare Transition Plan, with a shared responsibility payment. Employees will also have the option on their own to buy into the Medicare Transition Plan during the transition period.Following the transition period, under my Medicare for All system, employers will have the option to provide a private Medicare plan for their employees that will be certified by the Medicare program, similar to how employers can offer Medicare Advantage today. Employees could choose to be in that employer Medicare plan, a different private Medicare plan, or the public Medicare plan……How does your plan affect people with disabilities?People with disabilities will also transition to the Medicare system and have access to comprehensive long-term services and supports, as well as necessary equipment and assistance devices. Under my Medicare for All plan, long-term services and supports will be consumer-directed and provided in home- and community-based settings, unless the individual chooses otherwise……How does your plan affect Medicaid?Medicaid will transition to the Medicare for All system, which will ensure that all current Medicaid benefits for low-income individuals will be covered. States will be required to make maintenance effort payments to the Medicare program equal to the amounts they currently spend on Medicaid and CHIP, which will grow with inflation.Does your plan eliminate all private insurance?No. Under my Medicare for All system, the power of big insurance companies will be greatly diminished. After the transition period, private insurance will only exist in two ways1…Under my plan, private health insurers can compete with the new public Medicare plan, as long as the plans they offer adhere to strict requirement like those laid out below. This would function similarly to how Medicare Advantage operates within the Medicare system today….In my Medicare for All system, Medicare will continue to set the rules of the road for these plans, including price and quality, and private insurance companies will play by those rules, not the other way around. But unlike the current program, these private Medicare plans will be held to stricter consumer protection standards than they are today, such as getting reimbursed less than what the public Medicare plan will cost to operate…2. People will be able to purchase supplemental insurance covering services not included under Medicare for All, such as medical insurance for traveling abroad and cosmetic surgery. Employers will still be able to offer their employees retiree supplemental coverage through a private insurance plan… July 30, 2019: Planned Parenthood posted a press release titled: “Breaking: Planned Parenthood takes Missouri to court over one of nation’s most restrictive abortion bans”. From the press release: Today, Planned Parenthood, along with partners at the ACLU and law firm Paul, Weiss, Rifkind, Wharton & Garrison LLP took the state of Missouri to court to stop an unprecedented number of abortion bans from taking effect in the state. If the bans are allowed to go into effect, abortion would be outlawed at nearly every stage of pregnancy. Missouri is one of 12 states to ban abortion just in the first half of this year. State politicians, emboldened by the Trump-Pence administration, have passed a total of 26 abortion bans nationwide in 2019 alone.In May, Missouri Gov. Mike Parson signed House Bill 126, one of the nation’s most restrictive abortion laws, despite massive public outcry. The law also imposes a long list of medically unnecessary restriction designed to shame people who choose to end their pregnancy. This isn’t a coincidence – with Kavanaugh on the Supreme Court, anti-abortion politicians are racing to overturn Roe v. Wade… July 30, 2019: The American Civil Liberties Union (ACLU) posted a press release titled: “Planned Parenthood and ACLU Take Missouri To Court Over Abortion Bans”. From the press release: Planned Parenthood, the ACLU, and the ACLU of Missouri, along with law firm Paul, Weiss, Riftkind, Wharton & Garrison, LLP, took the state of Missouri to court today to stop an unprecedented number of abortion bans from taking effect in the state. If the bans are allowed to go into effect, abortion would be outlawed at nearly every stage of pregnancy……”Unless they are blocked by the court, these extreme laws would outright ban the vast majority of abortions in Missouri,” said Andrew Beck, senior staff attorney at the ACLU Reproductive Freedom Project. “The impact would be devastating for Missourian seeking abortion care and would be felt mostly by low-income patients and people of color. Politicians have no business dictating personal medical decisions, and we will not stand for it: the ACLU, along with our partners, is in this fight until these laws are blocked once and for all, and everyone who needs an abortion in Missouri can get one.”In May, Missouri Gov. Mike Parson signed House Bill 126, one of the nations’ most restrictive abortion laws. The law also imposes a long list of medically unnecessary restrictions designed to shame people who choose to end their pregnancy. Missouri is one of 12 states to ban abortion just in the first half of this year……Political attacks and targeted restrictions have left Reproductive Health Services of Planned Parenthood of the St. Louis Region as the last remaining health center that still provides abortion in the state. These restrictions – which blocked the only other health center in Missouri from providing abortions – include requiring doctors to perform invasive and medically unnecessary pelvic exams; a 72-hour mandatory delay for patients accessing abortion, which forces patients to make two trips to the health center; and demanding abortion providers hold local hospital and admitting privileges. August 1, 2019: WBTV 3 posted an article titled: “Blue Cross NC is seeking approval to lower Obamacare rates for its customers again”. From the article: People who are Affordable Care Act participants in North Carolina could see a decrease in their insurance bills come January.Blue Cross and Blue Shield of North Carolina, the only insurance company to provide Affordable Care Act coverage in all 100 N.C. counties, has requested an average ACA rate decrease of 5.2% for individuals.The ACA rates have to be approved by the N.C. Department of Insurance, which Blue Cross N.C. expects to happen in late August. The insurance company also requested a average rate decrease of 3.3% for small business ACA plans.Open enrollment in ACA plans, also called Obamacare, begins on Nov. 1 and ends Dec. 15……The company isn’t releasing detailed information on regional pricing right now, but will release more information after getting approval from the Department of Insurance……The insurance company said the rate decreases were made possible by reducing internal operating expenses, and shifting care to value-based provider reimbursement – paying for the value of services provided to the patients, not the quantity……The company said the rate decrease request was also possible because the state legislature didn’t add regulatory burdens on the company. August 1, 2019: Center for Reproductive Rights posted a press release titled: “Record Support in Congress for Bill to Protect Abortion Access”. From the press release: The Center for Reproductive Rights applauds the more than 200 Members of Congress who have signed on to cosponsor the Women’s Health Protection Act of 2019, a bill to preserve equal access to abortion everywhere. As of today, the Women’s Health protection Act has 203 cosponsors in the House of Representatives.The Women’s Health Protection Act was introduced in the House by U.S. Representatives Judy Chu (D-CA), Lois Frankel (D-FL), and Marcia Fudge (D-OH) on May 23, 2019, with 173 original cosponsors. The bill was referred to the House Committee on Energy and Commerce. Senators Richard Blumenthal (D-CT) and Tammy Baldwin (D-WI) introduced an identical bill in the Senate with 42 original cosponsors.The Women’s Health Protection Act establishes a statutory right for health care providers to provide, and their patients to receive, abortion services free from medically unnecessary restrictions and bans…..The surge in support comes as state legislatures continue to pass restrictive abortion laws designed to dismantle the constitutional protections recognized by the Supreme Court in Roe v. Wade, and repeatedly upheld by the Court since then. Despite these legal guarantees, 18 states have enacted 46 new laws this year that prohibit or restrict abortion, including nine unconstitutional pre-viability bans on abortion.The Women’s Heath Protection Act would prohibit bans and medically unnecessary restrictions that single out abortion and impede access to care. These include six-week, eight-week, and 15-week bans, requirements that providers give patients medically inaccurate and false information, and state-mandated medical procedure including unnecessary ultrasounds… August 3, 2019: Arizona Central posted an article titled: “Florida senator wants to block abortion votes unless legislature is at least half women”. It was written by James Call. From the article: A Florida state senator wants voters to decide whether a male-dominated state legislature should be allowed to limit a woman’s access to abortion.State Sen. Lauren Book filed a bill tax calls for a constitutional amendment that would prohibit the Florida House of Representatives and Senate from voting on a bill the would affect access to abortions unless at least half of the members of the chamber are women……A supermajority of the Florida legislature in both chambers are men. They make up 70-percent of the House (84 of 120 members). And it’s the same in the Senate where 12 women senators (30-percent) are among the 40-member chamber.SB 60 would create a constitutional amendment for voters to decide whether to block a legislative vote on proposals that would limit access to an abortion unless 50% of the chamber is female.Book, a Democrat, said the measure is in response to recent attempts to restrict abortion services with measures like the so-called fetal heartbeat bill approved in six states earlier this year. Those bills prohibit abortion in the first trimester when a heartbeat is detected……More than a dozen abortion bills were filed last session by Florida lawmakers – none made it to a floor vote. But state Rep. Mike Hill earlier told the Tallahassee Democrat he intends to file a heartbeat bill again in 2020.Last session, his proposal failed to gain a committee hearing. It is likely that Book’s bill may face the same fate in the Republican-controlled Senate… August 4, 2019: Reuters posted an article titled: “Trump administration considers September unveiling of healthcare plan: WSJ”. It was written by Katanga Johnson. From the article: U.S. President Donald Trump’s administration is considering unveiling, as early as September, his healthcare plan as part of his presidential re-election campaign strategy, the Wall Street Journal reported on Saturday.The plan would lay out an alternative to former President Barack Obama’s Affordable Care Act, which has been challenged by Republicans in court, and could include coverage for people with pre-existing conditions and a variety of insurance options, the Wall Street Journal said, citing unnamed sources.Trump has not signed off on the tentative plan, the newspaper said, describing ongoing debate about the plan and the timing for the roll-out. Polling shows that healthcare is a top concern for voters leading up to the election.The White House did not immediately respond to a request for comment on the timing… August 5, 2019: Wisconsin State Journal posted an article titled: “Wisconsin Democrats try again for Medicaid expansion”. It was written by David Wahlberg. From the article: Democratic state lawmakers said Monday they will try again to expand Medicaid as allowed under federal health law, a move the Republican-controlled Legislature has repeatedly opposed.Sen. Jon Erpenbach, D-West Point, and Rep. Daniel Riemer, D-Milwaukee, said they would introduce a standalone bill to expand Medicaid eligibility to 133% of the federal poverty level and accept additional federal funding under the Affordable Care Act. Republicans this year cut Medicaid expansion from Democratic Gov. Tony Evers’ budget, and most legislative Republicans have opposed the move since it became possible in a statement,Under the plan, eligibility for the state-federal health program would increase from 100% of the poverty level to 133%. The federal government would pay at least 90% of the cost, up from its regular 60% share for most people on Medicaid.Taking Medicaid expansion in 2014 would have saved the state $1.1 billion through 2019, according to the nonpartisan Legislative Fiscal Bureau……Assembly Speaker Robin Vox, R-Rochester, has called the proposal a “massive welfare expansion.” His spokesman didn’t immediately respond to a request for comment.Wisconsin is among 14 states that have not expanded Medicaid as allowed under the ACA, also known as Obamacare.It is the only one of those states that has no gap in coverage for people with low incomes. Wisconsin’s Medicaid program covers people up to the poverty level, unlike those in the other states, and the subsidized private insurance on the Obamacare exchange is available for people who make more. August 6, 2019: The American Civil Liberties Union (ACLU) posted a press release titled: “Federal Court Blocks Arkansas Abortion Bans and Restrictions”. From the press release: A federal district court judge in Arkansas has issued a preliminary injunction blocking a set of abortion bans and restrictions from taking effect while a lawsuit challenging the laws proceeds. Last month, the court issued a 14-day temporary restraining order, which was set to expire today.The laws included a ban on abortion starting at 18 weeks of pregnancy, a ban on abortion based on the patient’s reason for seeking care, and a law prohibiting qualified physicians from providing abortions. The lawsuit was filed by the ACLU, the ACLU of Arkansas, Planned Parenthood Federation of America, and the law firm of O’Melveny & Myers, LLP on behalf of Little Rock Family Planning Services, Planned Parenthood of Great Plains (PPGP), and two physician providers, challenged three laws…. The ACLU has embedded the preliminary injunction from the United States District Court Eastern District of Arkansas Western Division on the ACLU’s website. …Had the challenged laws been permitted to take effect, people in the state would be left with a single health center which could provide only limited medication abortion care. August 7, 2019: Vox posted an article titled: “Why this law could be a bigger threat to Roe v. Wade than near-total abortion bans”. It was written by Anna North. From the article: …But an Arkansas law requiring physician certification could have nearly the same effect without banning the procedure outright – and it might have a better shot at surviving a court challenge.The law imposes new certification requirements on doctors who provide abortions, which abortion rights advocates say are medically unnecessary. It would also cause Little Rock Family Planning, the only clinic in the state that provides surgical abortions, to shut down. The state’s one other clinic provides only medication abortions, which are only available in the first 10 weeks of pregnancy, leaving the Arkansas law to essentially function like a 10-week ban……For now, the law is on hold – one of three Arkansas abortion laws a federal judge temporarily blocked on Tuesday from going into effect. But Arkansas Attorney General Leslie Rutledge has already filled an appeal, and some experts think that laws like the one in Arkansas have a better chance of getting a Supreme Court hearing than more extreme, and unpopular, near-total bans. If Roe v. Wade does fall, the law that topples it may look more like Arkansas’s than Alabama’s.Passed by the state legislature last session, the law would have required that doctors who provide abortions in the state be board-certified or board-eligible in obstetrics and gynecology. Doctors who are not OB-GYNs – for example, family medical physicians or internal medicine physicians – routinely provide abortions in Arkansas and elsewhere. But under the new law, they wouldn’t be able to……The Arkansas law was scheduled to go into effect last month, but Judge Kristine Baker issued an eleventh-hour temporary restraining order blocking the law along with two other restrictions: a ban on all abortions after 18 weeks’ gestation, and a ban on abortions because of fetal Down syndrome diagnosis. Because the order was set to expire Tuesday, she issued a longer-term injunction blocking enforcement of the laws while the ACLU pursues its case… August 7, 2019: Mother Jones posted an article titled: “Trump’s Anti-Obamacare Insurance Plans Are Ripping People Off”. It was written by Abigail Weinberg. From the article: The so-called “junk insurance” plans the Trump administration promotes may be helping insurance companies more than patients.Short-term, limited-duration health insurance plans – Obamacare workarounds that do not have to copy to the Affordable Care Act – spend less than ACA-compliant plans on medical care, according to a data published last week in the National Association of Insurance Commissioner’s 2018 Accident and Health Policy Report, as Modern Healthcare reported.For every dollar paid in premiums on UnitedHealthcare’s short-term health plans, 37 cents are spend on medical claims. At Cambia Health Solutions, just 9 percent of premium costs go to medical care. The rest of the money goes to administrative expenses or is kept as profit. On average, the report found that among the five health insuraers the earn the most in short-term insurance premiums, 39.2 percent of premiums were going to pay for patients’ medical care……ACA-compliant plans are required to spend 80 percent of premiums on medical care. Essentially, Obamacare set a cap on the percentage of profit health insurance companies can make off premiums, forcing them to spend the majority of their funds on actual medical services. If an insurance company ends up charging higher premiums than that 80 percent rate, the insurers have to send out rebates… August 8, 2019: Roll Call posted an article titled: “Senate GOP plans to divert health, education funds to border wall”. It was written by Paul M. Krawzak. From the article: Senate Republicans are looking to pay for President Donald Trump’s border wall in part by putting about $5 billion less into the largest domestic spending bill, several people with knowledge of the process said.That move signals a likely fight over wall funding, as well as over Trump’s ability to reprogram or transfer funds to the border, when the fiscal 2020 appropriations process resumes after Congress returns in September.According to several people familiar with the process, Senate Appropriations Chairman Richard C. Shelby, an Alabama Republican, wrote an allocation for the fiscal year 2020 Labor-HHS-Education spending bill, that is about $5 billion lower than it would have been to provide funding for the wall……Shelby’s provision for wall funding is not surprising. At the very least, it sets the table for a negotiation with the Democrat-led House, which did not include any wall funds in its Homeland Security bill, and sought to tie the administration’s hands in transferring military and other funds to the border project.In the Senate, it takes 60 votes to end debate to pass appropriations bills. While many Senate Democrats are expected to oppose the $5 billion in wall funds, one former GOP aide said the Labor-HHS-Education bill may be “generous” enough to attract Democrats’ support despite their objections……Senate Democrats will also have the chance to argue for changes more to their liking in a conference over House and Senate bills… August 8, 2019: The Hill posted an article titled: “Graham promises ObamaCare repeal if Trump, Republicans win in 2020”. It was written by Jessie Hellmann. From the article: Sen. Lindsey Graham (R-S.C.) said this week that Republicans would push to repeal ObamaCare if they win back the House and President Trump is reelected in 2020.“If we can get the House back and keep our majority in the Senate, and President Trump wins reelection, I can promise you that not only are we going to repeal ObamaCare, we’re going to do it in a smart way where South Carolina will be the biggest winner,” Graham said in an interview with a South Carolina radio station.“We’ve got to remind people the we’re not for ObamaCare.”Graham’s repeal bill, introduced in 2017, would eliminate major sections of ObamaCare, including subsidies that help people buy insurance and the Medicaid expansion the covers low-income adults in 36 states and Washington D.C.The bill would essentially shift money from states like California that expanded Medicaid to states that didn’t, like South Carolina. Such a move could force some states to cut health care services and reduce eligibility……Graham on Tuesday touted his bill, which would allow states to opt out of consumer protections, like those that prevent insurers from charging people with pre-existing conditions more for coverage… August 9, 2019: Pueblo Chieftain posted an article titled: “Health advocacy group backs Affordable Care Act in Pueblo”. It was written but Zach Hillstrom. From the article: Stage 4 cancer survivor and Denver resident Laura Packard rolled up to the Pueblo office of Republican Sen. Cory Gardner on Friday in a large van resembling an ambulance to deliver a petition asking Gardner to support a resolution protecting the Affordable Care Act.Packard and Hillary Glasgow, the president of the Southern Colorado Labor Council, made the stop at Gardner’s Office as part of the Health Care Emergency Tour – a 22-city tour highlighting Republican efforts to overturn the ACA hosted by the health care advocacy organization Protect Our Care.“We’re here going to Sen. Gardner’s office in Pueblo to drop off a petition asking him to sign on to Sen. (Jeanne) Shaheen’s resolution to protect the Affordable Care Act and stop the court case that threatens protection for everyone,” Packard said……The resolution sponsored by Shaheen that Packard referenced seeks to sway the Department of Justice to reverse its decision supporting a December ruling of a Texas court, which found the ACA o be unconstitutional…Packard, who was diagnosed with stage 4 cancer in April 2016, underwent six months of chemotherapy treatment and one month of radiation and was finally declared in remission at the beginning of 2018.She was insured both before and after the ACA was passed, and said one of the primary reasons she is taking part in the Health Care Emergency Bus Tour is to protect others like her, who have preexisting conditions that could disqualify them from receiving insurance if the ACA is repealed… August 9, 2019: IndyStar posted an article titled: “Here’s how Pete Buttigeig would improve rural health care”. It was written by Chris Sikich. From the article: Democratic presidential hopeful Pete Buttigeig released a second major policy proposal this week, delving into how he would reform health care for rural Americans.The South Bend mayor points to the widening gap between rural and urban life and how each needs different approaches.Some of the ideas are familiar pitches from stump speeches, such as expanding access to Medicare, while others sound new, including increasing the available of doctors through a variety of means.Buttigeig released the 10-page proposal in an email to supporters Friday. It calls for significant taxpayer investment in programs like Medicare, Medicaid, the Affordable Care Act, and numerous grants, though it is unclear precisely how much it would cost or how he would pay for it. His campaign did not immediately return a phone call… August 9, 2019: South Bend Mayor Pete Buttigeig, who is running for president, released a 10-page plan called Securing a Health Future for Rural America. Here are some key points from his plan: Guarantee an affordable health insurance option through Medicare for All Who Want It: Implement Medicare for All Who Want It. This approach makes a Medicare-type insurance plan available for all people. This plan will make coverage more affordable by creating incentives that encourage corporate insurers to compete with the cheaper Medicare-type plan. It will also give people more choice in health care options, which is critical in rural areas the frequently face a shortage of coverage options. If corporate insurers don’t lower costs to deliver something dramatically better than what is available today, competition will lead us toward Medicare for All.Increase and expand access to federal subsidies for marketplace coverage. Pete will increase subsidies for low-income Americans and expand the subsidies to middle-income Americans. The subsidies from the ACA have made affordable for many low-income Americans, and we know that more generous subsidies would help improve both affordability and coverage. Dramatically reduce care shortages in rural areas by increasing the number of physicians and other health providers, with an emphasis on primary care, maternal care, mental health, and addition providers. Expand the Public Service Loan Forgiveness Program (PSLF) and the National Health Service Corps. We will expand PSLF program beyond government-, and not-for-profit- based employment to include employment in rural private hospitals and practice groups. We will also restructure the program so that rather than relieving all the debt at the end of a 10-year period, the PSLF will forgive a portion of loan debt annually.Increase Medicare reimbursement rates – and encourage states to increase Medicaid reimbursement rates – for providers working in medically underserved areas. Increasing rural providers’ reimbursement rates will help make it more sustainable for them to treat patients in rural settings and help avoid hospital closures.Expand funding for training models that incentivize medical students and residents to work in rural communities. This includes development and expansion of graduate medical education (GME) and rural residency training track (RTT) programs and supports other initiatives to rebalance GME training funds from urban settings – where 99% of the funding goes – to rural ones. This can include decoupling GME funding from hospitals and instead tying it to Federally Qualified Health Centers (FQHCs) Rural Health Clinics (RHCs) and community-based programs. Assure universal access to prevention and treatment for mental illness and addiction, and invest in making communities livable, resilient, and healthy. … To address this crisis, we will begin by prioritizing ensuring universal access to effective treatment, such as therapy and medication to treat opioid addiction, and enforcing mental health parity. We will also train communities to address sigma and better support each other through a pillar of our National Service Plan, the Community Health Corps. These policies, and more, will be fully articulated in a forthcoming mental health and addiction policy plan. Reduce maternal morality rates by expanding access to high quality care and support before, during, and after pregnancy. Ensure coverage for and access to the full range of reproductive health care and family planning services in rural areas, including through increased funding for Title X family planning, and protection of Medicaid expansion and the ACA’s Essential Health Benefits that provide preventive reproductive care for women with no cost sharing.Support the Rural MOMS Act. The Act will improve data collection of maternal mortality and morbidity in rural areas, develop grants to establish regional networks of care, support telehealth initiatives and infrastructure specific to maternal health, and train family medicine physicians, nurse practitioners, doulas, and other professionals to provide maternal care services in rural settings.Support the MOMMA Act, Maternal CARE Act, MOMS Act, and MOMMIES Act. These Acts require training to address implicit bias and racism in hospitals and other health care settings, expand Medicaid coverage for one year postpartum, expand evidence-based programs shown to reduce disparities in pregnancy outcomes, such as the maternal safety bundles developed by the Alliance for Innovation on Maternal Health, and establish pregnancy medical home demonstrations to improve continuity of care. Make it easier for patients to be treated at or near their home by investing in telehealth. Massively expand coverage of high-speed broadband Internet across the country by the end of the first term. This policy will be fleshed out in a forthcoming policy plan for rural communities and small towns.Help health providers purchase and implement the technology necessary to provide telehealth services by doubling the funding for the Federal Communication Commissions (FCC) Rural Health Care Program to $1 billion annually. This includes support for the FCC’s Connected Care pilot program, which will develop telehealth programs for rural veterans and low-income people.Expand the types of care settings that can receive reimbursement for telehealth services. This expansion will include outpatient rehabilitation centers and other locations outside traditional health care settings.Allow health professionals to get compensated for virtually treating patients at home, including for annual wellness visits, chronic care management, acute visits, and remote patient monitoring. August 12, 2019: ABC WKBW Buffalo posted an article titled: “Health insurance premiums to drop under Affordable Care Act”. From the article: Health insurance premiums are set to drop next year under the Affordable Care Act.The Department of Financial Services (DFS) announced Premium Rates for 2020 on Monday. According to a news release issued by the department, “rates for individuals are more than 55% lower than prior to the establishment of the NY State of Health in 2014, adjusting for inflation but not counting federal financial assistance that the ACA makes available to many consumers purchasing insurance. Approximately 326,000 New Yorkers are currently enrolled in individual commercial plans.”The DFS, “reduced overall Insurers’ Requested Rate for Individual Coverage from 9.2% to 6.8%, saving consumer over $50million.”… August 12, 2019: Politico posted an article titled: “Trump to deny green cards to immigrants receiving public benefits”. It was written by Ted Hesson. From the article: The Trump administration issued a final rule Monday that allows for federal officials to deny green cards to legal immigrants who have received certain public benefits or are deemed likely to do so in the future.The “public charge” regulation – pushed by White House senior advisor Stephen Miller and other hard-line officials – is the latest part of President Donald Trump’s vast immigration crackdown. While Trump has railed against migrants arriving at the U.S.-Mexico border, the new regulation represents his most ambitious effort yet to restrict legal immigration has he gears up for his 2020 reelection campaign……Still, the contentious policy is already triggering legal challenges, with one pro-immigrant group, the Los Angeles-based National Immigration Law Center, announcing this morning that it will file suit……A collection of public health associations, educators, and pro-migrant activists have argues the public charge rule will force patients to forgo essential services for their children. Both House and Senate Democrats criticized the measure after a draft version published in October.The benefits covered under the regulation include food stamps, welfare, Medicaid, and housing assistance. Even before the administration issued a proposed rule last year, agencies across the country reported decreased enrollment in a federal nutrition program aimed and pregnant women and children.The overall thrust of the regulation, which will be effective October 15, is unchanged from the proposed version, but there are some notable differences outlined by USCIS in a related summary released Monday.The regulation will not consider enrollment in Children’s Health Insurance Program toward a public charge determination. The draft published this fall asked whether CHIP – which provides low-cost coverage to families that earn too much to qualify for Medicaid – should be included in the list of benefits.In addition, the use of Medicaid by children, pregnant women, and new mothers during a 60-day period after going birth will not lead to being labeled a public charge. The final also dropped a prescription drug subsidy program, known as Medicare Part D, from a list of restricted benefits.The final regulation specifically noted that the use of the WIC program, a supplemental food benefit for low to moderate-income pregnant women, infants, and children, would not contribute to a public charge determination.While the Homeland Security Department acknowledged it was “plausible” the regulation could have a chilling effect driving families away from the nutrition program, the department stopped short of qualifying the phenomenon… August 12, 2019: The Hill posted an article titled: “Data shows drop in coverage among people ineligible for ObamaCare subsidies”. It was written by Peter Sullivan. From the article: Health insurance enrollment decline among people who do not qualify for financial help under ObamaCare as premiums rose to make coverage less affordable, new federal data shows.The data release by the Centers for Medicare and Medicaid Services (CMS) on Monday shows that enrollment declined by 1.2 million people, or 24 percent, between 2017 and 2018 among people with incomes too high to qualify for ObamaCare subsidies.In contrast, in the same period, enrollment ticked up by 300,000 people among those with lower incomes who did qualify for financial help under ObamaCare.The data illustrates that while ObamaCare remains stable given the subsidies available to lower-income people, premium increases helped drive away people with higher incomes, experts said……Cynthia Cox, another Kaiser Family Foundation expert, pointed out that the individual market for health insurance, including both those who receive and do not receive ObamaCare subsidies, is still larger than it was before the Affordable Care Act (ACA).“There were about 10.6 million people signed up ON the exchange markets in early 2019,” she wrote on Twitter. “Plus, there are a few more million people signed up OFF-exchange”.“Pre-ACA, the entire individual market was about 10.5 million people,” she added. August 12, 2019: The Sacramento Bee posted an article titled: “Charity case spending by California hospitals has plunged in wake of Affordable Care Act”. It was written by Harriet Blair Rowan. From the article: California hospitals are providing significantly less free and discounted credit to low-income patients since the Affordable Care Act took effect.As a proportion of their operating expenses, the state’s general acute-care hospitals spent less than half on these patients in 2017 than they did in 2013, according to data the hospitals reported to California’s Office of Statewide Health Planning and Development.The biggest decline in charity care spending occurred from 2013 to 2015, when it dropped from just over 2 percent to under 1 percent. The spending has continued to decline, though less dramatically, since then.The decline was true of for-profit hospitals, so-called nonprofit hospitals and those designated as city, county, district or state hospitals.Health experts attribute the drop in charity care spending largely to the implementation of the federal Affordable Care Act, popularly known as Obamacare. The law expanded insurance coverage to millions of Californians, starting in 2014, and hospitals are now treating far fewer uninsured patients who cannot pay for the care they receive……The data on charity care comes from most of the state’s general acute-care hospitals but does not include Kaiser Permanente hospitals, which are not required by the state to report their charity care totals……Nonprofit “hospitals get tax-exempt status, but they don’t get it for free,” said Ge Bai, associate professor of accounting and health policy at Johns Hopkins University. Charity care “is part of the implicit contract between hospital and taxpayers.”Bai sees the reduced spending on charity care as part of a trend of nonprofit hospitals acting more like their for-profit counterparts.Many nonprofit hospitals “no longer consider charity care their primary mission,” she said. “They are making more and more money but they are dropping their charity care.”… August 12, 2019: Kaiser Family Foundation posted information titled: “Changes to “Public Charge” Inadmissibility Rule: Implications for Health and Health Coverage”. Here are the key takeaways from the information: In August 2019, the Trump Administration announced a final rule that changes the public charge policies used to determine whether an individual applying for admission or adjustment of status is inadmissible to the U.S. Under longstanding policy, the federal government can deny an individual entry into the U.S. or adjustment to legal permanent resident (LPR) status (i.e. a green card) if he or she is determined likely to become a public charge. Under the rule, officials will newly consider use of certain previously excluded programs, including non-emergency Medicaid for non-pregnant adults, the Supplemental Nutrition Assistance Program (SNAP) and several housing programs, in public charge determinations.The changes will create new barriers to getting a green card or immigrating to the U.S. and likely lead to decreases in participation in Medicaid and other programs among immigrant families and their primarily U.S.-born children beyond those directly affected by the new policy. Nationwide, over 13.5 million Medicaid and CHIP enrollees, including 7.6 million children, live in a household with at least one noncitizen or are noncitizen themselves and may be at risk for decreased enrollment a result of the rule.Decreased participation in these programs will contribute to more uninsured individuals and negatively affect the health and financial stability of families and the growth and healthy development of their children. August 12, 2019: Planned Parenthood posted a press release titled: “Planned Parenthood Responds to Trump Administration’s “Public Charge” Rule”. From the press release: Today, the Trump-Pence administration’s Department of Homeland Security released its final public charge rule, a harmful rule designed to keep families separated and to dissuade immigrants from accessing health care and meeting other basic needs. Under this new rule, people could be denied visas, green cards, and entry into the U.S. simply because they have received any one of a broad range of public benefits they are legally allowed to access, including health care, nutrition assistance, and housing assistance. The rule will likely take effect on or around October 15, 2019.Statement from Alexis McGill Johnson, Acting President, Planned Parenthood Federation of America:“This is a racist and cruel attack against immigrants, on the heels of massive raids that have torn apart families, and racist and hateful rhetoric from the president himself. These relentless attacks on immigrants by the Trump-Pence administration have contributed to a culture of fear in immigrant communities, and keep far too many from seeking the health care they need.No one’s health or safety should be at risk because of their immigration status. If this harmful rule goes into effect, it would have a devastating impact on millions of people including our patients. Planned Parenthood is committed to standing with all immigrants. Living in a safe and healthy environment alongside their family is part of living a healthy, complete life.This administration is punishing people simply for taking care of their health, for feeding their families, or for putting a roof over their heads. This is inhumane. No person should be punished for meeting their basic needs, or for caring for their families. August 12, 2019: CBS News posted an article titled: “Tennessee to push for total abortion ban with sights on Supreme Court”. It was written by Kate Smith. From the article: After struggling to pass a six-week abortion ban earlier this year, Tennessee lawmakers are now considering one of the most restrictive abortion laws in the country: a total ban on the procedure.On Monday and Tuesday, the state’s judiciary committee will hear testimony from more than 20 witnesses and debate an 11-page amendment to its stalled “fetal heartbeat” bill. If the changes are adopted, the legislation will ban abortion once a woman knows she’s pregnant.The committee, which has seven Republicans and two Democrats, is expected to accept the changes. The amended bill would be put up for a vote in January 2020, when the legislature reconvenes.This week’s summer study comes as states have raced to pass legislation restricting abortion, hoping to challenge Roe v. Wade, the 1973 Supreme Court decision that protects access to the procedure. This year six states — Arkansas, Georgia, Kentucky, Louisiana, Mississippi and Ohio — passed so-called “heartbeat” bills, legislation that bans abortion after cardiac activity can be detected in a fetus. Missouri passed an eight-week ban in May, and Alabama went a step further passing an near-total abortion ban.Tennessee nearly joined those conservative states with House Bill 77, a “fetal heartbeat” bill that doesn’t provide exceptions for victims of rape or incest.It passed the state’s House in March but stalled in the Senate when conservative leaders questioned the efficacy of the bill, said state Senator Kerry Roberts, who serves on the state’s judiciary committee, in a telephone interview with CBS News……Rather than cutting off access to abortion after cardiac activity is detected, the amendment redefines fetal viability. Federal standards, based on past Supreme Court decisions, consider viability to mean when a fetus can survive on its own outside the womb. In Tennessee, policy makers have proposed that viability is when a pregnancy can be detected… August 13, 2019: The American College of Obstetricians and Gynecologists (ACOG) posted a press release titled: “Joint Statement of America’s Frontline Physicians Opposing Public Charge Final Rule”. From the press release: The Department of Homeland Security issued a final regulation that changes long-standing rules governing how and whether immigrants can be determined to be a “public charge;” widens the scope of programs considered by the government in making such a determination; and serves as a barrier to accessing health care for legal immigrants, as doing so can now serve as a basis for denying individuals green cards or U.S. visas.In response, the Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American Osteopathic Association, American College of Physicians, and American Psychiatric Association, collectively representing more than 597,000 of America’s frontline physicians, issued this statement:Our organization, which represent more than 597,000 physicians and medical students, are united in expressing our deep concern and opposition to the final public charge regulation issued by the Department of Homeland Security (DHS). The regulation upends decades of settled policy with regard to public charge and makes it much more likely that the lawfully present immigrants may not seek health care, whether preventative services or treatment, when faced with illness, since doing so could be used to deny green cards or U.S. visas, or even lead to deportations.Rather than face that threat, impacted patients currently served by our members almost certainly will avoid needed care from their trusted physicians, jeopardizing their own health and that of their communities. Many of our members have already witnessed this chilling effect among their own patient populations, with patients avoiding health services and programs out of fear. The public charge final rule not only threatens our patients’ health, but as this deferred care leads to more complex medical and public health challenges, it will also significantly increase costs to the health care system and U.S. taxpayers. Most important, the order puts a governmental barrier between physicians and patients and stands in stark contrast to the mission our organizations share: ensuring meaningful access to health care for patients in need.We urge DHS to rescind the public charge final rule and work with us to ensure broader access, improved quality, and more affordable care for our patients. August 13, 2019: WHYY posted an article titled: “Pa. N.J. health experts warn new Trump immigration rule will increase uninsured”. It was written by Nina Feldman. From the article: The Trump administration is making it more difficult for some immigrants who are in the United States legally and receiving certain public benefits to be granted permanent legal status here.As it stands, if people are considered likely to become a “public charge” to the state, that will be counted against them in their applications for green cards. The new rule, which was announced Monday and will be published the Federal Register Wednesday, will expand the definition of “public charge” to include those on public benefits such as Medicaid, food stamps, and housing vouchers.In New Jersey, the Department of Human Services estimated that as many as 200,000 eligible women and children enrolled in Medicaid and CHIP could be affected y the chilling effect of the proposed rule……Although the new rule does not include enrollment in CHIP, the Children’s Health Insurance Program, as a cause for public charge designation, researchers and advocates are worried that parents will confuse that insurance program with Medicaid, causing their kids – many of whom are U.S.-born citizens – to lose health insurance……The new rule expands the number of factors to be considered in public charge designations. On top of receiving public benefits like Medicaid, Medicare Part D, and subsidized public housing, the adjusted rule also considers a person’s income and part-time student status… August 13, 2019: The American Civil Liberties Union (ACLU) posted a press release titled: “ACLU Of Arkansas Tells Trump Admin: Don’t Roll Back Health Care Rights”. From the press release: The ACLU of Arkansas urged the United States Department of Health and Human Services not to roll back critical nondiscrimination protections for vulnerable people and communities. In comments submitted yesterday objecting to proposed changes to the Health Care Rights Law, Section 1557 of the Affordable Care Act, the ACLU of Arkansas stressed the devastating health consequences for transgender people, those seeking reproductive health care including abortion, as well as people of color, people who are disabled, those with limited English proficiency, and others.“No one should be blocked from care for being themselves. But two years after attempting to eliminate protections for pre-existing conditions, the Trump administration is once again putting the health of Arkansans at risk by proposing to roll back critical nondiscrimination protections for our most vulnerable communities,” said Jayme Womack, policy director for the ACLU of Arkansas. “Health care discrimination causes lasting and life-threatening harm to people’s health and well-being, and transgender and non-binary people are especially vulnerable to being denied care.”……Since taking office, the Trump administration has attempted to roll back protections for transgender people in education, the military, prisons, and homeless shelters, in addition to health care. It has also supported allowing insurance companies to discriminate and deny care to people with pre-existing conditions like cancer and diabetes.On October 8, the Supreme Court will hear arguments in a case involving Aimee Stephens, who was fired because she is transgender. While a federal appeals court and the federal agency in charge of workplace discrimination complaints have said that transgender people are protected from discrimination, the Department of Justice reversed positions under the Trump administration. However, in both health care and employment, the Trump administration cannot erase decades of court decisions saying trans people are protected under laws prohibiting sex discrimination… August 14, 2019: Planned Parenthood posted a press release titled: “New Filing: Unless Ninth Circuit Intervenes by August 19, Planned Parenthood, Which Serves 40 Percent of the 4 Million Title X Patients, Will be Forced Out of The Title X Program”. From the press release: Facing an HHS-imposed deadline of Aug. 19, Planned Parenthood today informed the 9th Circuit Court of Appeals that unless it intervenes, Planned Parenthood entities who are Title X grantees will be forced out of the Title X program by August 19 – putting access to affordable birth control at risk for people across the country. Planned Parenthood health center serve 40 percent of the 4 million Title X patients, and have been a part of the Title X program since its inception.Title X is the nation’s only dedicated program for affordable birth control and reproductive health care. The gag rule makes it illegal for any provider in the Title X program to tell patients how or where to access abortion, and imposes cost-prohibitive and unnecessary “physical separation” restrictions on health centers that provide abortion – moves that are clearly meant to push Planned Parenthood health centers and other reproductive health care providers out of Title X. HHS – which has asked all direct grantees to submit a plan for complying with the unethical gag rule by August 19 – even awarded $1.7 million in Title X funding this year to the Obria Group in California, an anti-abortion group that has made clear they “do not provide contraceptives.”……Congress is also looking to take long-term action to protect Title X. In June, the House of Representatives passed a spending package including strong language blocking the Trump-Pence administration’s Title X gag rule from being implemented. Now, the Senate must push for a spending bill that includes protective language to make sure millions of people can continue to access health care through Title X……Planned Parenthood is not the only direct grantee who will be forced out under the Trump Administration’s unethical gag rule – in total, the gag rule would force providers that serve nearly half of all Title X patients out of the program. So far, five governors (HI, IL, NY, OR, WA) have made clear that the could not participate in the Title X program if the gag rule was implemented, two state legislatures (MA and MD) have passed laws to that effect, and the only Title X direct grantee that serves the state of Maine has made clear they would not participate in Title X under the gag rule. In total, these eight states and Planned Parenthood health centers collectively serve 47 percent of the Title X patients in the Unites States… August 16, 2019: California Attorney General Xavier Becerra posted a press release on his official website titled: “Attorney General Becerra Leads Coalition of Five Attorneys General, Files Suit Challenging Trump Administration Public Charge Rule”. From, the press release: California Attorney General Xavier Becerra today led a multistage coalition in challenging in court the Trump Administration’s Inadmissibility on Public Charge Grounds Final Rule, known as the “Department of Homeland Security (DHS) Public Charge Rule.” The lawsuit, filed in the U.S. District Court for the Northern District of California, claims the Rule targets working immigrants and their families by creating unnecessary new barriers to lawful admission to the United States. The Rule discourages hardworking eligible families from accessing critical health, nutrition, and housing programs that supplement their modest wages and help them make ends meet. The Rule creates such a strict standard that, if it were applied to citizens across the country, a substantial portion would be considered likely to be a ‘public charge’……Public benefit programs are designed to help working families make ends meet and ensure strong, healthy families in California. Current guidance by the federal government defines a public charge as a person who is primarily dependent on either public as assistance for income maintenance or institutional long-term care at the government’s expense. The Rule declares that use of additional government programs, including nutrition and food support through CalFresh (California’s Supplemental Nutrition Assistance Program), healthcare through MediCal (California’s Medicaid program), and housing families through Section 8 housing assistance, now constitute grounds for a public charge determination. These changes would discourage many immigrants and mixed immigration-status families, who are not otherwise subject to the rule, from accessing benefits for which they are eligible and entitled. It will also make it harder for hard-working, low and moderate-income immigrants to be admitted into the United States or get green cards. In the lawsuit, the Attorneys Generals argue that the rule: Violates the Equal Protection Guarantee of the Fifth Amendment: The Rule will disproportionately block admission of non-white, non-European immigrants from Asia, Latin America, and Africa. It will also prevent higher numbers of immigrants of color from extending their visas or becoming lawful permanent residents, and ultimately create more obstacles in the path to U.S. citizenship.Arbitrary and Capricious: The Rule punishes immigrants for participating in widely used public benefits programs that are designed to mitigate economic inequality and bolster self-sufficiency, particularly among low wage workers. The Rule also fails to adequately assess the costs that increasing the poverty of families and U.S. citizen children will have on the Nation, its states, and communities.Contrary to Law: The Rule is contrary to law, interfere with the states’ rights to protect their residents, and exceeds the Administration’s authority under federal immigration law by circumventing congressional intent… …Joining Attorney General Becerra in filing the lawsuit are the Attorneys General of Maine, Oregon, Pennsylvania, and the District of Columbia. A copy of the complaint is available to view online on the California Office Of Attorney General website. August 16, 2019: The Hill posted an article titled: “Appeals court again allows Trump family planning rules to go into effect”. It was written by Tal Axelrod. From the article: A U.S. appeals court Friday again declined to block new rules from the Trump administration that prohibit clinics that receive federal funds from referring patients for abortions.The 9th U.S. Circuit Court of Appeals rejected a lawsuit from over 20 states, Planned Parenthood and the American Medical Association to suspend the rules while their case against them is litigated, according to The Associated Press.A three-judge panel and an 11-judge panel had already ruled that the rules can go into effect while the administration appeals district court rulings against them. Oral arguments are slated to commence next month.Planned Parenthood, the nation’s chief abortion provider, said this week it would leave the federal Title X program Monday unless the administration’s rules are blocked. The group stopped using Title X family planning funds last month after the restrictions were announced but told the Department of Health and Human Services (HHS) it would stay in the program while it sues over the changes.Planned Parenthood has been a staple in the program for decades, serving about 40 percent of all Title X patients and receiving millions of dollars in federal funds… THIS BLOG WILL BE UPDATED WHENEVER ADDITIONAL RELEVANT, CREDIBLE INFORMATION IS FOUND. A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Three – Continued 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 PayPal.me. Thank you!...

Other Video Games

- Dragon Mania Legends: Seedling Dragons Collection
  August 19, 2019Dragon Mania Legends / Other Video GamesThere are plenty of dragons for players to collect in Dragon Mania Legends. Gather up specific types of dragons to complete a collection. Players who complete the Seedling Dragons collection are rewarded with a prize of 15,000 food. The only way to level up a dragon is by feeding it more food. So, this is a very useful prize. This is what a Plant Dragon egg looks like. The Dragon Mania Legends Wiki says that the Plant Dragon can be obtained by breeding a Normally-Breedable Dragon and one of the Base Dragons. There are no further details, and each list has several dragons to choose from. I don’t remember what dragons I bred to get the Plant Dragon egg. Here is what a Plant Dragon hatchling looks like. It only has the Plant Element, so it must go into a Plant Habitat. The Plant Dragon is Common. This is what a baby Plant Dragon looks like. It is in a Plant Habitat. Here is what an adult Plant Dragon looks like. One thing about this dragon that I think is cool is that the end of its tail resembles the egg that it hatched from. This is what a Leaf Dragon egg looks like. It has little green leaves growing on the top of it. The Dragon Mania Legends Wiki says that the Leaf Dragon can be obtained by breeding two dragons that have the Plant Element and the Wind Element together. One could have the Plant Element, and the other the Wind Element. Here is what a Leaf Dragon hatchling looks like. It has the Plant Element and the Wind Element. It can be placed in either a Plant Habitat or a Wind Habitat. The Leaf Dragon is Uncommon. Here is what a baby Leaf Dragon looks like. The leaves that were growing on its egg are now growing on its head, body, and the end of its tail. This is what an adult Leaf Dragon looks like. The Dragon Mania Legends Wiki pointed out that it has a little, white, heart in its eye (instead of a typical round white reflection). This is what a Candy Dragon egg looks like. It reminds me of the Dots candy, the one with little, colored, dots stuck to a piece of paper that you had to separate from the paper with your teeth. It also looks like some kind of jawbreaker, but in an egg shape. It seems out of place in the Seedling Dragon collection, but it wouldn’t have questioned it if this egg was in Candy Crush. The Dragon Mania Legends Wiki says that the Candy Dragon can be obtained by breeding two dragons that together have the Plant Element and the Water Element. There is no guaranteed way to obtain a Candy Dragon. Pick two dragons to breed together (who have the right Elements) and wait. The egg that they create will be a surprise… sort of like the prize inside a Kinder Egg. Here is a Candy Dragon hatchling. It has the Plant Element and the Water Element. It can be placed in either a Plant Habitat or a Water Habitat. The Candy Dragon is Uncommon. This is what a baby Candy Dragon looks like. I put it in a Water Habitat because it has a body shape that is similar to some other dragon that I think look like fish. Here is an adult Candy Dragon. The colorful bumps that were on top of the egg are now part of the dragon’s back. This is what a Seed Dragon egg looks like. I had difficultly obtaining this one. It seemed like no matter what combinations of dragons I selected – they just didn’t want to produce a Seed Dragon egg. The Dragon Mania Legends Wiki says that players can obtain a Seed Dragon by breeding together a dragon that has the Wind Element and a dragon that has the Plant element. There is no combination that is guaranteed to result in a Seed Dragon, so players will likely have to make several attempts to get one. The Dragon Mania Legends Wiki also says that players must be at least Level 11 before they can breed a Seed Dragon. I wish I knew that when I was trying to obtain one! Here is a Seed Dragon hatchling. It has the Wind Element and the Plant Element. A Seed Dragon is Common. This is what a baby Seed Dragon looks like. I put it into a Plant Habitat because it felt like the right place for a Seed Dragon to go. This is what an adult Seed Dragon looks like. The spiky top of its egg is reflected in its spiky tail and the larger spikes that grow on top of its head. Players who complete the Seedling Dragons collection are rewarded with a prize of 15,000 food. #Blaugust2019 Dragon Mania Legends: Seedling Dragons 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 PayPal.me. Thank you!...
- Dragon Mania Legends: Watered Dragons Collection
  August 18, 2019Dragon Mania Legends / Other Video GamesDragon Mania Legends is an app game where players collect dragons. Complete a collection of dragons, and you get a prize. Those who complete the Watered Dragons collection receive a Submarine dragon. There are quests in the game that encourage players to breed their dragons. Eventually, this will allow players to complete a collection of dragons. This is what a Boiling Dragon egg looks like. The Dragon Mania Legends Wiki says that a Boiling Dragon can be obtained by breeding two Dragons that each have the Fire and Water elements. It recommends you breed a Fire Dragon with a Water Dragon. I’m pretty sure that’s what I did. Here is a Boiling Dragon Hatchling. It has the Fire Element and the Water Element. So, it can be placed into either a Fire Habitat or a Water Habitat. Boiling Dragons are Common dragons. I put my baby Boiling Dragon into a Fire Habitat because it seemed like a better fit than a Water Habitat. All of the dragons in Dragon Mania Legend are automatically given a random name that has four letters in it. I would not have selected to name a dragon “Mold”, because I have a mold allergy. There is probably a way to change the name, but I haven’t bothered to learn how. This is what the Boiling Dragon looks like after it reaches Level 4 and becomes an adult. This is what an Ice Dragon egg looks like. The Dragon Mania Legends Wiki says that players can obtain an Ice Dragon by breeding two dragons together that have the Wind and Water Elements. I don’t remember which dragons I bred in order to get the Ice Dragon. Here is what a hatchling Ice Dragon looks like. It has the Wind Element and the Water Element, so it can be placed in either a Wind Habitat or a Water Habitat. An Ice Dragon is a Common dragon. Here is a baby Ice Dragon. I put it into a Water Habitat, in part because I had room there. My Wind Habitat was full. This is what an adult Ice Dragon looks like. This is what a Mud Dragon egg looks like. The Dragon Mania Legends Wiki says that a player can obtain a Mud Dragon by breeding dragons that have the Earth Element and the Water Element. In other words, you need one dragon that has the Earth Element and another dragon that has the Water Element. Here is a Mud Dragon hatchling. It has the Earth Element and the Water Element, so it can go into either an Earth Habitat or a Water Habitat. Mud Dragons are Uncommon Dragons. Here is a baby Mud Dragon. I put it into a Water Habitat. This is what an Adult Mud Dragon looks like. This is what a Clownfish Dragon egg looks like. The Dragon Mania Legend Wiki says that the Clownfish Dragon can be obtained by breeding two dragons that together have the Water Element, Earth Element and Fire Element. It recommend that you choose from the following: Cloud Dragon, Ice Dragon, or Peacock Dragon. Or, if you don’t have those, you can try breeding the Wind Dragon with either the Mud Dragon or the Snow Dragon. This is what a Clownfish Dragon hatchling looks like. It is a Rare dragon. The Clownfish dragon has the Water Element, Earth Element, and Wind Element. That means it can be placed into a Water Habitat, Earth Habitat, or Wind Habitat. I put my baby Clownfish Dragon into a Wind Habitat, because that was the only option that had room for another dragon at the time. Here is what an adult Clownfish Dragon looks like. I had to place it in a Wind Habitat because I didn’t have enough room at the time in a Water Habitat. Sometime later, I purchased another Water Habitat and leveled it up so I could fit the Clownfish Dragon in it. This is what a Submarine Dragon egg looks like. The Dragon Mania Legends Wiki says that the Submarine Dragon is a Rewards-Exclusive dragon which is awarded only once time if the Player has completed the Watered Dragons collection. Here is what a Submarine Dragon hatchling looks like. It has the Water Element and the Shadow Element. It can be placed in either a Water Habitat or a Shadow Habitat. This is what a baby Submarine Dragon looks like. I ended up placing it into a Legendary Habitat. There wasn’t any room left in my Water Habitats at that time, and I didn’t have a Shadow Habitat. A Legendary Habitat can house all types of dragons. Later, I leveled up one of my Water Habitats so that it could hold 3 dragons. I think the Submarine Dragon looks better in a Water Habitat than in a Legendary Habitat. #Blaugust2019 Dragon Mania Legends: Watered 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 PayPal.me. Thank you!...

TV & Movie Reviews

- Things from Mad Men that are Different from Today – Season Seven
  April 8, 2017TV and Movie ReviewsSeason Seven was the final season of Mad Men. I was kind of sad to have reached the end of the story, but I liked how it ended. I can always re-watch it if I want to. My husband and I watched the entire series of Mad Men on Netflix. I took notes on the things in Mad Men that are different from today. Before you read this post, you might want to read what I wrote about previous Seasons: Mad Men Season One Mad Men Season Two Mad Men Season Three Mad Men Season Four Mad Men Season Five Mad Men Season Six Warning: There are spoilers. Episode 1: Don flies to California where his wife, Megan, is living. She has a tiny black and white television. He buys her a huge console television. The thing is so heavy that it requires two big men to carry it inside. It looks like a cabinet with the television embedded in it, and I think it had built in speakers on either side of the TV. This was a top-of-the-line, expensive, color television…. that Megan didn’t want. Episode 2: * Don wakes up to a buzzing noise. It is coming from his alarm clock, which can be described as an analog electric alarm clock. The numbers flip over. * Don and his daughter, Sally, are at a diner. She wants to call her friends. Don put two quarters on the table. Sally takes the quarters, gets up, walks across the diner, and puts the quarters into the payphone that is on the wall. Today, Sally would have picked up her smartphone and made the call (or would have borrowed her dad’s smartphone to make the call). Episode 3: * Harry finally tells one of the other partners that he’s been lying – for a long time – about there being a computer that he uses to figure out the best ad placement for television ads. He’s been lying to the customers about it, too. There is no computer. This revelation sparks a conversation about the company needing to invest in a computer. Today, its hard to imagine an entire office without computers. * Betty goes on a field trip with her son, Bobby. She is a chaperone. Betty and Bobby ride on the school bus with his classmates, teacher, and a few other moms. Betty smokes a cigarette on the way, and ashes out the window. Episode 4: * The creative’s lounge is taken away from them because the office is going to put a computer there. It takes up that entire space. The only thing this computer could do was “crunch numbers” – literally computing. * The computer is an IBM 360. It is a mainframe computer that was accessed by remote terminals. It had 8,000,000 characters in bulk core storage. Monthly rentals ranged from $27,000 for a basic configuration to $115,000 for a typical large multi system configuration. * The “System/360″ became available for delivery in 1965. The office in Mad Men is getting it installed in 1969. Today, most offices do not invest in computers that are four years old. * Harry asks the IBM guy who is overseeing the computer installation to tell him where to find a keypunch service. The IBM 360 ran on punch cards. A keypunch service had people (often women) whose job it was to put a deck of blank cards into a hopper. The worker would type an operator command, and the hopper machine would feed one card at a time into a punch station. A series of dies punched holes into an individual card. Harry needed a service to make those cards for the office’s computer. * In order to operate the mainframe, a person needed to – by hand – put the stack of punchcards, in a specific order, into the mainframe one by one. * I have personally done that a few times when I was a little kid (because my dad sometimes took me to work with him.). Dropping the punch cards on the floor was a complete disaster. It meant you had to stop entering the cards, stop the computer, take the time to put the cards back in order, and start putting them into the computer again. If you accidentally put one card into the computer in the wrong order – the computer wouldn’t work. Once all the punchcards were correctly entered, you had to wait around for the mainframe to process them before you could start working from a terminal. * Don uses a typewriter at his desk to get some work done. He has a piece of white paper, then a sheet of carbon, then another piece of white paper sandwiched together. The purpose of this was so Don could make two copies of what he was typing at the same time. Episode 5: * There is now a secretary who sits at the terminal inside the room the giant computer is in. She appears to be typing something into the terminal. Behind her is a computer with a magnetic reel tape drive. * The giant mainframe computer makes a constant humming noise. The computer room always has the doors closed because it needs to be in an air conditioned room. Episode 6: * Peggy is working on an ad campaign for Burger Chef. She and Don decide to come up with a new idea rather than what they originally planned. Peggy mentions something about the ad including a mother who is picking up Burger Chef for her family on the way home from work. Don says “Mothers who work is too sad for an ad.” Peggy points out that he is surrounded by mothers who work. This doesn’t change Don’s mind. They end up going with a completely different idea. Episode 7: * This episode focuses on the Moon Landing. Everyone watches the rocket lifting off on television. Then, they watched the first space walk on television. * Peggy is in Indiana with Don, Pete, and Harry because they are pitching to Burger Chef the next day. Peggy went out to get alcohol, but Indiana was dry on Sundays – meaning stores could not sell alcohol. She ends up having to buy two cans of beer from the hotel clerk. Indiana was dry on Sundays until July 1, 2016. The laws changed on that date to allow distilleries, breweries, and wineries to sell alcohol on Sundays. The laws still did not allow people to buy alcohol and bring it home with them on a Sunday. Episode 8: * Don has an answering service. He calls and a female worker answers and tells him who called him and when. The service is not work related – it is taking calls from women in Don’s social life. * Joan and Peggy are talking to their client, Topaz pantyhose, about a problem. L’Eggs pantyhose – a competitor – is a lower price and is selling more than Topaz. L’Eggs pantyhose came in a plastic egg shaped container. Episode 9: * I didn’t see anything new in this episode, that you don’t see today (that hadn’t already been mentioned in this post or in posts about previous seasons.) Episode 10: * Sally’s friend Glenn comes to visit. He is now 18 years old. Glenn, and a female friend he brought with, ask Sally to go to Playland with them. Glenn reveals that he has joined the military and will be going to Vietnam. Sally gets very upset about this and rushes to her room. Later, Glenn returns, knowing that Sally is not there. (She was on a class trip.). Glenn came to see Betty. Betty gives Glenn a beer. The legal drinking age in New York was 18 until 1982 – when it went up to 19. On December 1, 1985, the legal drinking age in New York moved up to age 21. * Don was running late for work, so he shaves at his desk in his office while his secretary fills him in about what is scheduled for the day. He uses a battery powered electric razor. Those types of razors increased in popularity in the 1960s. * The office has a darkroom which Stan (one of the creatives) uses to develop film – usually for ad campaigns. People have to knock on the door before coming in because opening the door lets light into the room. Doing that at the wrong time can completely destroy film. Episode 11: * Peggy and Stan are working with children for an ad campaign. There is a table of toys in front of the kids. One of the toys is a metal slinky. Episode 12: * The office gets absorbed by McCann. They lose the computer that took over the creative’s lounge. Harry says that McCann has a team of people who do statistics – so they don’t need the computer. * McCann has an informal “ladies club”. The women who work there get together to complain about work (and drink). * Peggy’s last remaining creative guy chooses not to go to McCann. He is still at the old office. He says he is still being paid, so he thought he’d “make some long distance calls”. Long distance calls were very expensive at the time. Episode 13: * Don has gone on an impromptu road trip. He doesn’t carry luggage. Instead, he has a large paper bag with a change of clothes in it. The bag says Sears. Today, a lot of Sears stores are closing. Episode 14: * Don’s road trip continues. This time he is carrying a bag from Penney’s. The bag probably came from JC Penney’s (which, today, is also closing a lot of stores.) Things from Mad Men that are Different from Today – Season Seven 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 Patreon or at PayPal.me. Thank you!...
- Things from Mad Men that are Different from Today – Season Six
  April 7, 2017TV and Movie ReviewsAs my husband and I watched our way through Mad Men, I took notes about things that are in the show that are different from today. This post is about Mad Men Season Six. We watched the entire series on Netflix. Before you read this, you might want to read what I wrote about previous Seasons: Mad Men Season One Mad Men Season Two Mad Men Season Three Mad Men Season Four Mad Men Season Five Warning: There are spoilers. Episode 1: * Megan uses a Kodak Instamatic camera to take a photo of Don while they are on a work/vacation in Hawaii. The Kodak Instamatic was launched in 1963. It used a 126 film cartridge. The Kodak Instamatic 104 was released in 1968. It had a holder for a single flashbulb on the top of the camera. Take a photo with the flashcube, and cock the camera for the next exposure (meaning – roll the film for the next photo). The flashcube would turn 90 degrees to bring the next flashbulb into position automatically. * The maid was vacuuming while Don was watching TV. The television had two squiggly lines of interference across it – one near the top of the screen and one near the bottom. It was not a common problem, and the TV went back to normal when after the vacuum was shut off. Episode 2: I did not see anything in this episode that was different from today (and that wasn’t already mentioned in this list or the lists about previous seasons.) Episode 3: * The news in the background on televisions in various scenes discuss the Vietnam War. It has been said that Vietnam was the first “television war”, or the first “living-room war” (the room people watched television in.) Being able to sit in your home, in front of your TV, and watch what was happening in a war far away had an effect on people. At first, TV stations were trying to be upbeat – providing wire reports or a battlefield roundup. Later, things got darker and some “horror of war” was televised. The ability to watch the war on TV had an effect on people’s opinion about the war. In 1968, the Tet Offensive happened. It appears that this is what the television news is talking about in this episode of Mad Men. Episode 4: * Joan and her friend Kate go to a restaurant where there is a telephone at every table. The name of the restaurant is “Ma Bells”. The name is a play on The Bell Telephone Company. Ma Bells was the creation of Restaurant Associates. The restaurant actually existed. Every table had a telephone on it. People called their order into the kitchen. The telephones could also be used to call someone who was sitting at another table. * Megan and Don go out to dinner with Megan’s coworker and boss (who are a married couple.). During the dinner, it is revealed that the couple are “Swingers” who are interested in swinging with Megan and Don. Swingers were people who had open relationships. Some were heterosexual, and some were bisexual. Being a swinger became popular in the late 1960s, when the “free love” movement was taking place and casual sex was becoming an accepted thing among some people. Swingers felt it was natural to have sexual desires outside of your relationship, and to act on those desires (if the desired person was consenting.) Episode 5: * This episode focused on when Martin Luther King Jr. was shot and killed. * Someone (I forgot who) turns on a black and white television. A bright dot appears in the center of the screen, which becomes a horizontal line, that eventually spread out over the screen. This was how televisions at the time warmed up if they had not been turned on in a while. * Don takes Bobby to watch a movie. They see “The Planet of the Apes.” At the end of the movie, it’s clear that Bobby liked it. Don asked “Do you want to see it again?” Bobby does, so they stay in their seats and watch the movie again. This wasn’t unusual and was allowed at the time. Episode 6: * I didn’t see anything in this episode that hasn’t already been mentioned in this list (or the lists I put together about previous episode) Episode 7: * Pete’s mother comes to his apartment. The handyman calls Pete to let him know she is there. Pete tells the handyman to fix his mother a drink. The ice cube tray is made out of aluminum. It has a quick release handle on it that you pull up to crack the ice cubes. Today, ice cube trays are plastic and you twist them to crack the ice. Episode 8: * The office is visited by a “doctor” (brought in by one of the partners of the company that Don’s company merged with). The man is not really a doctor. He was brought to “fix everyone up.” Don agrees to see the “doctor” because he is suffering from a bad cough. The “doctor” injects several of the men in the office with an unknown concoction. Based on the actions of the men who took this injection – it appears that at least some of it is amphetamine. The “doctor” appears to be somewhat based on a real person named Max Jacobson who was known as “Dr. Feelgood”. Jacobson did have a background as a doctor – but was known for mixing up unknown ingredients (along with amphetamine) and injecting that into the (often famous) people who came to him for help. Jacobson “treated” JFK, Marylin Monroe, Eddie Fisher, and others. Episode 9: * Don stops at a gas station and tries to get the gas station attendant’s attention. It was a full service gas station (which was standard at the time). People did not pump their own gas – the attendant did it for them. The gas station attendant would fill the tank, check the tire pressure, check the oil, and wash the cars windows. People paid for the gas, but the other services were provided for free. Gas stations used to hand out trinkets as well – for travelers to collect. (drinking glasses, key chains, calendars, road maps, etc). There are some places in the United States today where people are required by law to allow a gas station attendant to pump their gas for them. It is no longer a common practice – and does not come with the extra services. Episode 10: * Joan tells a potential client that Harry works on figuring out where to place television ads “with a computer as big as this room”. The first personal computer wasn’t introduced until 1975 – and they were kits that people had to put together themselves. * This episode focused on the 1968 Democratic National Convention that took place in Chicago. * Megan watches the violence that took place outside the DNC. She calls Don, who is watching it, too, (while away on business). Megan says she can’t vote – but still cares about what’s going on. Megan is Canadian. She was from Quebec. * There is a lava lamp on the desk in the Creatives Office. The lava lamp was created by Edward Craven Walker (who was a British accountant). He sold the U.S. manufacturing rights in 1965 to a company named Lava Lite. In 1968, lava lamps were marketed to executives. Episode 11: * The office, which is in New York, receives fresh oranges from California from Sunkist (who is a client). In a previous episode, Roger’s daughter told him that her husband had this great idea about investing in refrigerated trucks that ship produce. This indicates that it was not easy to obtain fresh oranges from California if you lived in New York. Those oranges were a big deal. * Sylvia and Arnold (Don’s neighbors) have a son, Mitchell, who is 18. He returned his draft card as a form of protest of the Vietnam War. After Mitchell dropped out of school, the military re-classified him 1-A. This designation meant that it was extremely likely that Mitchell would be drafted and sent to Vietnam. Mitchell tells his problem to Megan (who relays the problem to Don). Megan said that Mitchell was “going to run”. This meant that Mitchell was going to leave the United States and go to Canada in order to avoid being drafted. Megan considers helping Mitchell because she has family in Canada. Much of this episode is about how to solve Mitchell’s problem. Episode 12: * I didn’t notice anything new in this episode (that wasn’t already mentioned in this post or in posts from previous seasons.) Episode 13: * Sally get suspended from boarding school because she used a fake ID with her mother’s name on it and bought alcohol for herself and the other girls. Betty calls Don, all upset. Betty tells Don that the reason why “nothing is working” and “the bad is beating the good” is because Sally is “from a broken home.” That’s not a phrase people use today in regards to a child from a family where the parents got divorced and remarried. Things from Mad Men that are Different from Today – Season Six 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 Patreon or at PayPal.me. Thank you!...

Cockatiels

- Throwback Thursday: Nap
  June 9, 2016CockatielsThrowback Thursday: Max loved to take naps on me (2011) Throwback Thursday: Nap is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. The photo in this post is not allowed to be posted on other websites. If you enjoyed this blog post please consider supporting me at PayPal.me. Thank you!...
- Throwback Thursday: Reading
  June 9, 2016CockatielsThrowback Thursday: Max was attempting to read over Shawn’s shoulder. Meanwhile, Gordo was simply getting comfy on the couch. (2011) Throwback Thursday: Reading is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. The photo in this post is not allowed to be posted on other websites. If you enjoyed this blog post please consider supporting me at PayPal.me. Thank you!...

Coloring Pages

- Johanna Basford 2019 Coloring Calendar – March
  April 17, 2019ColoringI’m working my way through the 2019 Johanna Basford coloring calendar. A friend gave it to me as a Christmas gift. My goal is to try not to fall too far behind. Coloring is a good for my health. It reduces stress (which is bad for my fibromyalgia). I also color to keep my hands active, which is good for my rheumatoid arthritis. March 1 March 2 and 3 March 4 March 5 March 6 March 7 March 8 March 9 and 10 March 11 March 12 March 13 March 14 March 15 March 16 and 17 March 18 March 19 March 20 March 21 March 22 March 23 and 24 March 25 March 26 March 27 March 28 March 29 March 30 and 31 Johanna Basford 2019 Coloring Calendar – March 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 PayPal.me. Thank you!...
- Johanna Basford 2019 Coloring Calendar – February
  March 1, 2019ColoringColoring is relaxing. A friend gave me the Johanna Basford 2019 coloring calendar as a Christmas present. I am really enjoying it! I have rheumatoid arthritis in my hands (among other places). I’ve heard it is good to keep my hands and fingers active. Coloring is a good way to do that. February 1 February 2 and 3 February 4 February 5 February 6 February 7 February 8 February 9 and 10 February 11 February 12 February 13 February 14 February 15 February 16 and 17 February 18 February 19 February 20 February 21 February 22 February 23 and 24 February 25 February 26 February 27 February 28 Johanna Basford 2019 Coloring Calendar – February 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 PayPal.me. Thank you!...