This summer, a Kansas City man named Edwin got a call from immigration officials. They had picked up his nephew at the southern border and wanted to release the teen into his care. So Edwin went online and bought a bed.
Later that week, he was contacted again, this time by an Immigration and Customs Enforcement detective who knocked at his door. The agent gave Edwin a letter saying he needed to come to headquarters for an interview about three federal crimes: conspiracy, visa fraud and human smuggling.
Across the country, people like Edwin who have taken in young undocumented relatives are being swept up in what ICE calls a crackdown on guardians who pay human smugglers. More than 400 people were arrested over the course of two months this summer as part of the new approach. Others are still dodging ICE interviews, have agreed to go through deportation proceedings or have gone on the run. Some of those affected admit that they paid “coyotes” to reunite them with their young children. But many are collateral damage: People who just happened to be in the house when ICE showed up, or relatives who agreed to take in teens after they traveled to the U.S. on their own.
“The message is getting out: Don’t sponsor someone if you’re here illegally, or you’re going to get in trouble,” said Claude Arnold, a former ICE Homeland Security Investigations special agent who supports the new policy. “The idea is to have a deterrent effect, so when a teenager says, ‘Uncle, I can pay my own way, but can I stay with you?’ the uncle is going to say, ‘No way.’”
Edwin, who asked that his last name be withheld because of possible pending criminal charges, has been living in the U.S. for more than 15 years and says he never paid anyone to help his nephew cross the border. He points out that he has done everything by the book since emigrating from El Salvador to Missouri in 2001. He immediately got a job at a dry cleaning company and obtained Temporary Protected Status, which allows him to live and work in the U.S. so long as he keeps a clean criminal record. He doesn’t follow the news and didn’t know he was risking deportation by agreeing to take in his nephew. But he said it wouldn’t have mattered; he couldn’t have refused to welcome his sister’s son.
“My nephew is grown and he makes his own choices. Everyone pays their own way. But he’s my family and it’s my duty to take him in,” Edwin said.
Edwin’s nephew Wilbur lived in Kansas City with Temporary Protected Status himself as a child, but his parents decided to take him back to El Salvador when he was 6. He said he made up his mind to return to the U.S. after graduating high school this spring because he felt threatened by gangs. Wilbur took a bus across Guatemala, traveled through Mexico by pickup truck, then crossed into Texas in the back of a tractor trailer a month before his 18th birthday. He was picked up almost immediately by U.S. officials.
About 90 percent of minors detained at the southern border are eventually turned over to a family member. It’s a system intended to spare the state from having to take care of children, and allow young people to live in normal homes while their visa and asylum claims work through the courts.
Under President Barack Obama, ICE was instructed not to go after people who came forward to claim relatives, even if they were in the U.S. illegally. Guardians were told they had no reason to fear revealing themselves to authorities. Under President Donald Trump, that policy has been reversed.
Trump administration officials say it’s less of a policy change than a commonsensical return to the enforcement of existing immigration laws. In a February memo, then-Homeland Security Secretary John F. Kelly said that while all immigration laws should be enforced, it’s especially important to go after people “directly or indirectly” involved in smuggling, because the journey north can be so dangerous for children.
“Regardless of the desires for family reunification, or conditions in other countries, the smuggling or trafficking of alien children is intolerable,” he wrote.
Edwin said he felt bewildered when an immigration detective showed up at his door one morning in July, and was further confused by the letter instructing him to come to ICE headquarters the following week to talk about crimes related to smuggling.
Because Edwin has protected status, he was able to take the letter and go on with his day. For people in the country illegally, things have been playing out much differently.
A couple living in New Mexico fled the state after ICE agents turned up in August asking about a nephew they had recently taken in. They told their attorney that they hadn’t even known the high school junior was on his way up from Guatemala.
In Tennessee, two ICE agents came with pistols and flak jackets to arrest a mother who hid in her trailer home. The mother said she had no idea her 16-year-old daughter was coming from Honduras. The agents left once others in the trailer park started taking photos.
The Lutheran Immigration and Refugee Service, which has a contract from the U.S. government to help place unaccompanied minors with relatives, has seen cases in recent months of cousins and half-siblings swept up in the crackdown. In June, three members of a single Missouri family that had been working with the agency were put in deportation proceedings after ICE came around asking about smuggling.
In all, more than 400 people were arrested between late June and late August as part of what ICE describes as an enforcement surge to bolster the strategy of going after guardians. The great majority of those 400 were charged with immigration violations, not smuggling-related crimes.
A group of Democratic members of Congress asked ICE in July for specifics about the change in approach, including the protocol for deciding which sponsors would be targeted, but have yet to receive any answers.
For now, Edwin is ignoring his summons. He said that when he failed to appear at ICE headquarters, an agent responded by going to the dry cleaner where he works to review his employment verification papers. He is hoping the agent loses interest, but no longer feels like he knows what to expect.
“I’ve been here more than a decade and I’ve never had a single problem with the authorities. Now, it’s like the government is changing everything around,” he said. “Now, everything is dangerous.”
ProPublica would like to hear from people who have expertise in some facet of the health insurance industry. It’s one of the most important industries in the country and takes up a significant chunk of family budgets and taxpayer spending. Yet for those outside of it, the industry is difficult to understand. Will you help ProPublica reporter Marshall Allen learn about it? You could walk him through what you do in the industry and help him understand what works and what doesn’t. We hope you can help identify specific ways that ProPublica can spur improvement.
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ProPublica reporter Alec MacGillis will be the recipient of the 2017 Elijah Parish Lovejoy Award. Sponsored by Colby College, the honor recognizes a member of the news profession who has produced courageous journalism.
“The need for a free press and a commitment to truth in reporting has never been more important,” said Colby President David A. Greene. “We are honored to recognize Alec MacGillis for his courageous and unyielding efforts to reveal truths that have been carefully shielded from public scrutiny.”
Past winners of the Lovejoy Award, which has been presented annually since 1952, include Katherine Boo, David Halberstam and ProPublica reporter A.C. Thompson, who received the honor in 2013. MacGillis will be given the award, along with an honorary doctoral degree from Colby College, on Oct. 2. Read more about the award here.
by Kiah Collier, The Texas Tribune, and Neena Satija, The Texas Tribune and Reveal
HOUSTON — Houston Mayor Sylvester Turner on Tuesday gave his strongest endorsement to date for constructing a physical coastal barrier to protect the region from deadly storm surge during hurricanes.
Though such a barrier system would not have guarded against the unrelenting and unprecedented rain Hurricane Harvey dumped on the area, Turner — one of the region’s last leaders to endorse the so-called “coastal spine” concept — said at a Tuesday news conference that he believes it is crucial.
“We cannot talk about rebuilding” from Harvey “if we do not build the coastal spine,” he said.
With Harvey — which was downgraded to a tropical storm by the time it reached Houston — “we again dodged the bullet.”
Constructing such a system has been discussed since 2008, when Hurricane Ike shifted course at the last minute, narrowly sparing populated, low-lying coastal communities like Clear Lake and the Houston Ship Channel — home to the nation’s largest refining and petrochemical complex — from a massive storm surge. Scientists have modeled worst-case scenario storms that make clear the potential for devastation, which The Texas Tribune and ProPublica detailed extensively in a 2016 investigation. They also have urged local, state and federal elected officials to pursue infrastructure solutions.
Last year those scientists and officials told The Texas Tribune and ProPublica that a catastrophic storm likely would have to hit Houston before they could convince Congress to pay for such an endeavor — estimated to cost some $5.8 billion for the Houston area alone and at least $11 billion for the entire six-county coastal region.
Turner and other leaders are clearly hoping Harvey fits the bill.
They have suggested that the federal government could provide funding for the storm surge barrier and a variety of other storm protection measures as part of an overall Harvey relief package. Nicknamed the “Ike Dike,” the barrier proposal was first offered up by Texas A&M University at Galveston in 2009.
But the $15 billion Congress has approved for Texas so far can’t be spent on a coastal barrier; the money can only go toward rehabilitating flooded areas. That means local and state officials will either have to depend on Congress to fund something completely separate — a scenario many are doubtful of — or cobble together other funding.
U.S. Sen. John Cornyn, R-Texas, and Texas Land Commissioner George P. Bush have been leading an effort to secure federal funding for the coastal spine. In April, they and other officials, including Turner, wrote to President Donald Trump urging his support.
But the Ike Dike would only protect coastal areas from catastrophic storm surge. It would do nothing to prevent flooding damage from torrential rain, which is almost entirely responsible for the damage Houstonians suffered from Harvey.
“They thought [the coastal spine] would be the answer to a lot of these problems,” said Adrian Garcia, a former city councilman and Harris County sheriff. “And obviously it is not.”
Other flood protection ideas — either underfunded or long-abandoned — have received renewed attention since Harvey.
On Tuesday, Turner joined local officials in expressing support for a long-delayed reservoir project that experts say would’ve saved thousands of Houston homes from flooding during Harvey, along with three bayou-widening projects estimated to cost a combined $130 million.
Turner said the city shouldn’t have to choose one over the other as it seeks federal funding.
“I don’t think we need to pick one. ... We know we need another reservoir,” he said. “We just need to step up and do that. The same thing with the coastal spine.”
A spokeswoman for U.S. Rep. Michael McCaul said he has been working with FEMA, Gov. Greg Abbott and local officials to identify options for flood mitigation.
Turner’s advocacy for the coastal barrier concept is relatively new.
Early last year, amid the Texas Tribune/ProPublica investigation, Turner declined to discuss the need for such a barrier. Instead, the city sent statements dismissing the potential impacts — and not indicating whether Turner supported such a project, which dozens of area city councils had enthusiastically endorsed.
“Only a small portion of the city of Houston is in areas at risk for major storm surge,” the statement said. “Consequently, hurricane-force wind poses the major threat for the majority of the city.”
Reminded of a dire scenario that projected a 34-foot storm surge that put downtown Houston underwater, Turner’s office provided a follow-up statement acknowledging that the issue “continues to be a concern.” It also placed the onus on the federal government to take the lead on a coastal barrier project.
A few months later, in August 2016, Turner wrote to state leaders studying the coastal barrier concept and said he supported it.
On Tuesday, Turner spoke passionately about the impact Hurricane Ike could have had — and the impact Harvey did have — on the region’s industrial complex and the national economy.
“When Hurricane Ike hit in 2008 there were $30 billion in damages,” he said. If Ike’s direction hadn’t changed “we could have lost refineries, jet fuel and the entire Houston Ship Channel, not only destroying the jobs of many Houstonians, but there would have been an impact on the nation as a whole.”
During Harvey, Turner said, “the Houston port did close and business was shut down and the country as a whole was impacted.”
“That was a tropical storm,” he added. “Can you imagine if Hurricane Harvey had come closer, what the devastating effects would be?”
The World Association of Newspapers and News Publishers announced today that “Boomtown, Flood Town,” a collaboration between ProPublica and the Texas Tribune, is a finalist for the North American Digital Media Award in the Best Data Visualization category.
The multimedia project — by a team of local reporters and data journalists including ProPublica’s Al Shaw, along with The Texas Tribune’s Kiah Collier, and Neena Satija of the Texas Tribune and Reveal — presciently showed the risk to Houston of a major hurricane with the potential to devastate the region.
Published last year, the project served as an interactive, immersive call to action before such a storm hit, using excellent science journalism and cutting-edge technology to tell the story in a new way. It took a closer look at how the loss of undeveloped prairie and wetlands was making areas that had not flooded in decades more prone to inundation. The story also exposed the dangers of a bureaucratic nightmare in Houston: a process plagued by politicians passing the buck, and by the strange psychology of large disasters, which are often considered academic problems until it’s far too late.
With the recent catastrophic flooding in Houston from Hurricane Harvey, the reporting of “Boomtown, Flood Town” is increasingly urgent. This week, Houston Mayor Sylvester Turner gave his strongest endorsement to date for constructing a physical barrier to protect the region from deadly storm surges during hurricanes.
Winners for the North American Digital Media Awards will be announced in October. Read more about the award here.
The wonky words infrastructure and resilience have circulated widely of late, particularly since Hurricanes Harvey and Irma struck paralyzing, costly blows in two of America’s fastest-growing states.
Resilience is a property traditionally defined as the ability to bounce back that a host of engineers and urban planners have long warned is sorely lacking in America’s brittle infrastructure.
Many such experts say the disasters in the sprawling suburban and petro-industrial landscape around Houston and along the crowded coasts of Florida reinforce the urgent idea that resilient infrastructure is needed more than ever, particularly as human-driven climate change helps drive extreme weather.
The challenge in prompting change — broadening the classic definition of “infrastructure,” and investing in initiatives aimed at adapting to a turbulent planet — is heightened by partisan divisions over climate policy and development.
Of course, there’s also the question of money. The country’s infrastructure is ailing already. A national civil engineering group has surveyed the nation’s bridges, roads, dams, transit systems and more and awarded a string of D or D+ grades since 1998. The same group has estimated that the country will be several trillion dollars short of what’s needed to harden and rebuild and modernize our infrastructure over the next decade.
For fresh or underappreciated ideas, ProPublica reached out to a handful of engineers, economists and policy analysts focused on reducing risk on a fast-changing planet.
Alice Hill, who directed resilience policy for the National Security Council in the Obama administration, said the wider debate over cutting climate-warming emissions may have distracted people from promptly pursuing ways to reduce risks and economic and societal costs from natural disasters.
She and several other experts said a first step is getting past the old definition of resilience as bouncing back from a hit, which presumes a community needs simply to recover.
“I don’t think of resilience in the traditional sense, in cutting how long it takes to turn the lights back on,” said Brian Bledsoe, the director of the Institute for Resilient Infrastructure Systems at the University of Georgia. “Resilience is seizing an opportunity to move into a state of greater adaptability and preparedness — not just going back to the status quo.”
In thinking about improving the country’s infrastructure, and provoking real action, Bledsoe and others say, language matters.
Bledsoe, for instance, is exploring new ways to communicate flood risk in words and maps. His institute is testing replacements for the tired language of 1-in-100 or 1-in-500-year floods. A 100-year flood has a 1 in 4 chance of occurring in the 30-year span of a typical home mortgage, he said, adding that’s the kind of time scale that gets people’s attention.
Visual cues matter, too, he said. On conventional maps, simple lines marking a floodplain boundary often are interpreted as separating safe zones and those at risk, Bledsoe said. But existing models of water flows don’t provide the full range of possible outcomes: “A 50-year rain can produce a 100-year flood if it falls on a watershed that’s already soaked or on snowpack or if it coincides with a storm surge.”
“The bright line on a map is an illusion,” he said, particularly in flat places like Houston, where a slight change in flood waters can result in far more widespread inundation. Risk maps should reflect that uncertainty, and wider threat.
Nicholas Pinter, a University of California, Davis, geoscientist who studies flood risk and water management, said that Florida is well-situated to build more wisely after this disaster because it already has a statewide post-disaster redevelopment plan and requires coastal communities to have their own.
It’s more typical to have short-term recovery plans — for digging out and getting the lights back on, as 20,000 utility workers are scurrying to do right now.
The advantage of having an established protocol for redevelopment, he said, is it trims delays.
“Draw up plans when the skies are blue and pull them off the shelf,” he said of how having rebuilding protocols in place can limit repeating mistakes. “That fast response cuts down on the horrible lag time in which people typically rebuild in place.”
The rebuilt levee wall that was destroyed during Hurricane Katrina, in the Lower Ninth Ward of New Orleans, Louisiana
(Chris Graythen/Getty Images)
Many people point to the National Flood Insurance Program, which was created to boost financial resilience in flood zones, but has been criticized from just about every political and technical vantage point as too often working to subsidize, instead of mitigate, vulnerability.
How this debate plays out will have an important impact on infrastructure resilience, said Pinter of the University of California, Davis. If incentives remain skewed in favor of dangerous and sprawling development, he said, that just expands where roads, wires, pipelines and other connecting systems have to be built. “Public infrastructure is there in service of populations,” he said.
He also said the lack of federal guidance has led to deeply uneven enforcement of floodplain building at the state level, with enormous disparities around the country resulting in more resilient states, in essence, subsidizing disaster-prone development in others.
“Why should California, Wyoming or Utah be paying the price for Houston, Mississippi or Alabama failing to enforce the National Flood Insurance Program? ” he said.
Bledsoe, at the University of Georgia, said there’s no need to wait for big changes in the program to start making progress. He said the National Flood Insurance Program has a longstanding division, the Community Rating System, that could swiftly be expanded, cutting both flood risk and budget-breaking payouts. It’s a voluntary program that reduces flood insurance rates for communities that take additional efforts beyond minimum standards to reduce flood damage to insurable property.
Despite the clear benefits, he said, only one municipality, Roseville, California, has achieved the top level of nine rankings and gotten the biggest insurance savings — 45 percent. Tulsa, Oklahoma, Fort Collins, Colorado, King County, Washington, and Pierce County, Washington, are at the second ranking and get a 40 percent rate cut. Hundreds of other municipalities are at much lower levels of preparedness.
“Boosting participation is low-hanging fruit,” Bledsoe said.
Some see signs that the recent blitz of hurricanes is reshaping strategies in the Trump White House. President Donald Trump’s infrastructure agenda, unveiled on August 15, centered on rescinding Obama-era plans to require consideration of flood risk and climate change in any federal spending for infrastructure or housing and the like. The argument was built around limiting perceived red tape.
After the flooding of Houston less than two weeks later, Trump appointees, including Tom Bossert, the president’s homeland security adviser, said a new plan was being developed to insure federal money would not increase flood risks.
On Monday, as Irma weakened over Georgia, Bossert used a White House briefing to offer more hints of an emerging climate resilience policy, while notably avoiding accepting climate change science: “What President Trump is committed to is making sure that federal dollars aren’t used to rebuild things that will be in harm’s way later or that won’t be hardened against the future predictable floods that we see. And that has to do with engineering analysis and changing conditions along eroding shorelines but also in inland water and flood-control projects.”
Robert R.M. Verchick, a Loyola University law professor who worked on climate change adaptation policy at the Environmental Protection Agency under Obama, said federal leadership is essential.
If Federal Emergency Management Agency flood maps incorporated future climate conditions, that move would send a ripple effect into real estate and insurance markets, forcing people to pay attention, he said. If the federal government required projected climate conditions to be considered when spending on infrastructure in flood-prone areas, construction practices would change, he added, noting the same pressures would drive chemical plants or other industries to have a wider margin of safety.
“None of these things will change without some form of government intervention. That’s because those who make decisions on the front end (buying property, building bridges) do not bear all the costs when things go wrong on the back end,” he wrote in an email. “And on top of that, human beings tend to discount small but important risks when it seems advantageous in the short-run.”
After a terrible storm, he said, most Americans are willing to cheer a government that helps communities recuperate. But people should also embrace the side of government that establishes rules to avoid risk and make us safer. That’s harder, he said, because such edicts can be perceived by some as impinging on personal freedom.
“But viewed correctly, sensible safeguards are part of freedom, not a retreat from it,” he said. “Freedom is having a home you can return to after the storm. Freedom is having a bridge high enough to get you to the hospital across the river. Freedom is not having your house surrounded by contaminated mud because the berm at the neighboring chemical plant failed overnight.”
Thaddeus R. Miller, an Arizona State University scientist who helps lead a national research network focused on “Urban Resilience to Extreme Events,” said in an email that boosting the capacity of cities to stay safe and prosperous in a turbulent climate requires a culture shift as much as hardening physical systems:
“Fundamentally, we must abandon the idea that there is a specific standard to which we can control nature and instead understand that we are creating complex and increasingly difficult-to-control systems that are part social, part ecological and part technological. These mean not just redesigning the infrastructure, but redesigning institutions and their knowledge systems.”
After the destruction and disruption from Hurricane Sandy, New York City didn’t just upgrade its power substations and subway entrances, Miller said in a subsequent phone call. The city also rebooted its agencies’ protocols and even job descriptions. “Every time a maintenance crew opens a sewer cover, fixes or installs a pipe, whether new or retrofitting, you’re thinking how to enhance its resilience,” Miller said.
Miller said another key to progress, particularly when federal action is limited or stalled, is cooperation between cities or regions. Heat was not an issue in Oregon historically, Miller said, but it’s becoming one. The light rail system around Portland was designed to work with a few 90-degree days a year, he said. “The last couple of summers have seen 20-plus 90-degree days,” he said, causing copper wires carrying power for the trains to sag and steel rails to expand in ways that have disrupted train schedules. Similar rail systems in the Southwest deal with such heat routinely, said Miller, who has worked in both regions. The more crosstalk, the better the outcome, he said.
“At the broadest level, we need to think about risks and how infrastructure is built to withstand them at a landscape level,” Miller added. “We can longer commit to evaluating the impacts and risks of a single project in isolation against a retrospective, stationary understanding of risk (e.g., the 100-year flood we’ve been hearing so much about.)”
He said that an emerging alternative, “safe-to-fail” design, is more suited to situations where factors contributing to extreme floods or other storm impacts can’t be fully anticipated. “Safe-to-fail infrastructure might allow flooding, but in ways that are designed for,” he said.
Deborah Brosnan, an environmental and disaster risk consultant, said the challenge in making a shift to integrating changing risks into planning and investments is enormous, even when a community has a devastating shock such as a hurricane or flood or both:
“It requires a radical shift in how we incorporate variability in our planning and regulations,” she said. “This can and will be politically difficult. New regulations like California fire and earthquake codes and Florida’s building codes are typically enacted after an event, and from a reactive ‘make sure this doesn’t happen again’ perspective. The past event creates a ‘standard’ against which to regulate. Regulations and codes require a standard that can be upheld, otherwise decisions can be arbitrary and capricious. For climate change, non-stationarity would involve creating regulations that take account of many different factors and where variability has to be included. Variability (uncertainy) is the big challenge for these kinds of approaches.”
Stephane Hallegatte, the lead economist at the Word Bank’s Global Facility for Disaster Reduction and Recovery, has written or co-written a host of reports on strategies for limiting impacts of climate change and disasters, particularly on the poor. When asked in an email exchange what success would look like, he said the World Bank, in various recent reports, has stressed the importance of managing disaster risks along two tracks: both designing and investing to limit the most frequent hard knocks and then making sure the tools and services are available to help communities recover when a worst-case disaster strikes.
He added: “Facing a problem, people tend to do one thing to manage it, and then forget about it. (‘I face floods; I build a dike; I’m safe.’) We are trying to work against this, by having risk prevention and contingent planning done together.”
The Trump administration plans to stop accepting refugee applications from children with U.S.-based parents from three violence-riddled Central American countries — El Salvador, Honduras and Guatemala — according to the summary of a presentation the State Department made recently to refugee organizations.
The decision to end the Central American Minors program, which began in 2014 and is the only refugee program aimed at helping people from that region, could put hundreds of families split between two countries in a delicate situation.
The children will no longer be able to come legally to the U.S. Of course, they can still attempt to cross without authorization and then either request asylum or try to navigate the border region without being detained or injured — just the kind of dangerous illegal immigration that the CAM program was meant to discourage. (And if the children do cross the border, as ProPublica recently reported, they could expose their parents to an investigation for child smuggling.)
“Ending the program would force desperate children into the arms of smugglers and traffickers because they don’t have a safe and orderly way to get to the U.S.,” said Lisa Frydman, a vice president of Kids In Need Of Defense, an immigration advocacy group. “This administration is giving the unconscionable message that Central American children are not welcome here for protection.”
Refugee organizations were alerted to the impending demise of CAM two weeks ago by State Department officials, according to a memo summarizing the meeting that was obtained by ProPublica.
“We were told that [the State Department Bureau of Population, Refugees and Migration] will begin winding down the CAM program in its entirety,” according to the summary, which circulated at one resettlement agency. “Please note that this information was conveyed to us in person (verbally) with no documentation that we can share with you at this time … the CAM refugee program will be discontinued no later than December 31, 2017, perhaps sooner.”
A State Department spokesperson said that “all aspects of the FY2018 resettlement program are under review” but added that “no decisions have been made.” Asked about the meeting with the refugee agencies, the spokesperson responded, “The State Department works closely with its resettlement partners and shares information as part of an ongoing dialogue and partnership. No formal announcement has been made to partners regarding the CAM program.”
CAM admissions had already dwindled to a trickle. In August, 19 Central American refugees were admitted. By comparison, 160 were admitted last December, the single highest month. Over the history of the program, 1,627 refugees entered the U.S. through CAM, the overwhelming majority of them from El Salvador.
In August, the Trump administration terminated a program that served as a sort of back-up to CAM. The program allowed children who failed to qualify as refugees to be allowed into the U.S. temporarily if they could show there was a compelling humanitarian reason. (Obtaining refugee status requires demonstrating a “well-founded fear of persecution for reasons of race, religion, nationality, political opinion or membership in a particular social group.” The definition of “humanitarian” is much broader.) That program allowed 1,465 minors to travel to the U.S. before its cancellation.
An additional 2,500 who were approved for the humanitarian program but had yet to make it to the U.S. had those approvals rescinded. “No more individuals will travel into the United States under this … program,” according to a letter from the U.S. Citizenship and Immigration Services agency that announced the cancellation. “As such, USCIS is rescinding your condition approval.”
So far this year, Central American refugees accounted for just 1 percent of the 51,000 refugees who have been admitted to the United States. Latin America overall accounts for only 3 percent of the total.
“The CAM refugee program has been a small but an incredibly critical lifeline for Central American children,” Frydman said.
The cancellation of CAM is one of many moves the Trump administration has taken to discourage immigration from Latin America.
This month, the Trump administration announced the phaseout of DACA, a program for 800,000 young undocumented immigrants who are overwhelmingly from Mexico and Central America. Earlier this year, the Department of Homeland Security announced that it will soon end protections from deportation for 50,000 Haitians, and floated the possibility of doing the same with 200,000 Salvadorans, 60,000 Hondurans, and 3,000 Nicaraguans by next March.
The agency has endorsed slashing legal immigration by half. VICE reported this week that next year the U.S. will accept a historically low number of refugees from around the world.
The CAM program was launched in 2014 amid an exponential surge of Central American children who crossed the U.S.-Mexico border illegally, most of them claiming they had parents or other relatives in the U.S. To qualify for CAM, parents must be legally allowed to be in the U.S. and children must pass a DNA test proving they are the offspring of the person or people in question. (The tests cost the families close to $600.) The process takes an average of 13 months and about 75 percent of the refugee applications were denied.
It’s unclear how many applications are pending, but the number is likely to be in the thousands, based on figures from 2016. It’s also unclear what will happen to pending applications once the cancellation of the program takes effect.
“Usually, there is an attempt to have an orderly wind down and people who would be in the pipeline would be completed, their cases would be completed,” said Doris Meissner, a senior fellow at the Migration Policy Institute and a commissioner of the Immigration and Naturalization Service under Bill Clinton. “But we’ve certainly seen in others aspects of what the new administration has done, that they haven’t necessarily being so orderly.”
Want to market Nazi memorabilia, or recruit marchers for a far-right rally? Facebook’s self-service ad-buying platform had the right audience for you.
Until this week, when we asked Facebook about it, the world’s largest social network enabled advertisers to direct their pitches to the news feeds of almost 2,300 people who expressed interest in the topics of “Jew hater,” “How to burn jews,” or, “History of ‘why jews ruin the world.’”
To test if these ad categories were real, we paid $30 to target those groups with three “promoted posts” — in which a ProPublica article or post was displayed in their news feeds. Facebook approved all three ads within 15 minutes.
After we contacted Facebook, it removed the anti-Semitic categories — which were created by an algorithm rather than by people — and said it would explore ways to fix the problem, such as limiting the number of categories available or scrutinizing them before they are displayed to buyers.
“There are times where content is surfaced on our platform that violates our standards,” said Rob Leathern, product management director at Facebook. “In this case, we’ve removed the associated targeting fields in question. We know we have more work to do, so we’re also building new guardrails in our product and review processes to prevent other issues like this from happening in the future.”
Like many tech companies, Facebook has long taken a hands off approach to its advertising business. Unlike traditional media companies that select the audiences they offer advertisers, Facebook generates its ad categories automatically based both on what users explicitly share with Facebook and what they implicitly convey through their online activity.
Traditionally, tech companies have contended that it’s not their role to censor the Internet or to discourage legitimate political expression. In the wake of the violent protests in Charlottesville by right-wing groups that included self-described Nazis, Facebook and other tech companies vowed to strengthen their monitoring of hate speech.
Facebook CEO Mark Zuckerberg wrote at the time that “there is no place for hate in our community,” and pledged to keep a closer eye on hateful posts and threats of violence on Facebook. “It’s a disgrace that we still need to say that neo-Nazis and white supremacists are wrong — as if this is somehow not obvious,” he wrote.
But Facebook apparently did not intensify its scrutiny of its ad buying platform. In all likelihood, the ad categories that we spotted were automatically generated because people had listed those anti-Semitic themes on their Facebook profiles as an interest, an employer or a “field of study.” Facebook’s algorithm automatically transforms people’s declared interests into advertising categories.
Here is a screenshot of our ad buying process on the company’s advertising portal:
This is not the first controversy over Facebook’s ad categories. Last year, ProPublica was able to block an ad that we bought in Facebook’s housing categories from being shown to African-Americans, Hispanics and Asian-Americans, raising the question of whether such ad targeting violated laws against discrimination in housing advertising. After ProPublica’s article appeared, Facebook built a system that it said would prevent such ads from being approved.
Last year, ProPublica also collected a list of the advertising categories Facebook was providing to advertisers. We downloaded more than 29,000 ad categories from Facebook’s ad system — and found categories ranging from an interest in “Hungarian sausages” to “People in households that have an estimated household income of between $100K and $125K.”
At that time, we did not find any anti-Semitic categories, but we do not know if we captured all of Facebook’s possible ad categories, or if these categories were added later. A Facebook spokesman didn’t respond to a question about when the categories were introduced.
Last week, acting on a tip, we logged into Facebook’s automated ad system to see if “Jew hater” was really an ad category. We found it, but discovered that the category — with only 2,274 people in it — was too small for Facebook to allow us to buy an ad pegged only to Jew haters.
Facebook’s automated system suggested “Second Amendment” as an additional category that would boost our audience size to 119,000 people, presumably because its system had correlated gun enthusiasts with anti-Semites.
Instead, we chose additional categories that popped up when we typed in “jew h”: “How to burn Jews,” and “History of ‘why jews ruin the world.’” Then we added a category that Facebook suggested when we typed in “Hitler”: a category called “Hitler did nothing wrong.” All were described as “fields of study.”
Facebook’s automated system told us that we still didn’t have a large enough audience to make a purchase. So we added “German Schutzstaffel,” commonly known as the Nazi SS, and the “Nazi Party,” which were both described to advertisers as groups of “employers.” Their audiences were larger: 3,194 for the SS and 2,449 for Nazi Party.
Still, Facebook said we needed more — so we added people with an interest in the National Democratic Party of Germany, a far-right, ultranationalist political party, with its much larger viewership of 194,600.
Once we had our audience, we submitted our ad — which promoted an unrelated ProPublica news article. Within 15 minutes, Facebook approved our ad, with one change. In its approval screen, Facebook described the ad targeting category “Jew hater” as “Antysemityzm,” the Polish word for anti-Semitism. Just to make sure it was referring to the same category, we bought two additional ads using the term “Jew hater” in combination with otherterms. Bothtimes, Facebook changed the ad targeting category “Jew hater” to “Antisemityzm” in its approval.
Here is one of our approved ads from Facebook:
A few days later, Facebook sent us the results of our campaigns. Our three ads reached 5,897 people, generating 101 clicks, and 13 “engagements” — which could be a “like” a “share” or a comment on a post.
Facebook spokesman Joe Osborne said that they didn’t appear to have been widely used. “We have looked at the use of these audiences and campaigns and it’s not common or widespread,” he said.
We looked for analogous advertising categories for other religions, such as “Muslim haters.” Facebook didn’t have them.
In the wake of ProPublica’s report Thursday that Facebook advertisers could have directed pitches to almost 2,300 people interested in “Jew hater” and other anti-Semitic topics, the world’s largest social network said it would no longer allow advertisers to target groups identified by self-reported information.
“As people fill in their education or employer on their profile, we have found a small percentage of people who have entered offensive responses,” the company said in a statement. “…We are removing these self-reported targeting fields until we have the right processes in place to prevent this issue.”
Facebook had already removed the anti-Semitic categories — which also included “How to burn jews” and “History of ‘why jews ruin the world’” — after we asked the company about them earlier this week. Then, after our article was published, Slate reported that Facebook advertisers could target people interested in other topics such as “Kill Muslim Radicals” and “Ku-Klux-Klan.” Facebook’s algorithm automatically transforms people’s self-reported interests, employers and fields of study into advertising categories.
Because audiences in the hateful categories were “incredibly low,” the ad campaigns targeting them reached “an extremely small number of people,” Facebook said. Its statement didn’t identify the advertisers. Conceivably, those who might find it helpful to target anti-Semites could range from recruiters for far-right groups to marketers of Nazi memorabilia.
ProPublica documented that the anti-Semitic ad categories were real by paying $30 to target those groups with three “promoted posts” — in which a ProPublica article or post was displayed in their news feeds. Facebook approved all three ads within 15 minutes.
Facebook’s advertising has become a focus of national attention since it disclosed last week that it had discovered $100,000 worth of ads placed during the 2016 presidential election season by “inauthentic” accounts that appeared to be affiliated with Russia.
Like many tech companies, Facebook has long taken a hands-off approach to its advertising business. Unlike traditional media companies that select the audiences they offer advertisers, Facebook generates its ad categories automatically based both on what users explicitly share with Facebook and what they implicitly convey through their online activity.
Traditionally, tech companies have contended that it’s not their role to censor the internet or to discourage legitimate political expression. In the wake of the violent protests in Charlottesville by right-wing groups that included self-described Nazis, Facebook and other tech companies vowed to strengthen their monitoring of hate speech.
Facebook CEO Mark Zuckerberg wrote at the time that “there is no place for hate in our community,” and pledged to keep a closer eye on hateful posts and threats of violence on Facebook. “It’s a disgrace that we still need to say that neo-Nazis and white supremacists are wrong — as if this is somehow not obvious,” he wrote.
President Donald Trump’s voter fraud commission came under fire earlier this month when a lawsuit and media reports revealed that the commissioners were using private emails to conduct public business. Commission co-chair Kris Kobach confirmed this week that most of them continue to do so.
Experts say the commission’s email practices do not appear to comport with federal law. “The statute here is clear,” said Jason Baron, a lawyer at Drinker Biddle and former director of litigation at the National Archives and Records Administration.
Essentially, Baron said, the commissioners have three options: 1. They can use a government email address; 2. They can use a private email address but copy every message to a government account; or 3. They can use a private email address and forward each message to a government account within 20 days. According to Baron, those are the requirements of the Presidential Records Act of 1978, which the commission must comply with under its charter.
“All written communications between or among its members involving commission business are permanent records destined to be preserved at the National Archives,” said Baron. “Without specific guidance, commission members may not realize that their email communications about commission business constitute White House records.”
ProPublica reviewed dozens of emails to and from members of the commission as well as written directives on records retention. The commissioners appear to have been given no instructions to use government email or copy or forward messages to a government account.
Commissioner Matthew Dunlap, the secretary of state for Maine, confirmed that he’d received no such directives. “That’s news to me,” he said, when read the PRA provision governing emails. “I think it would be a little cleaner if I had a us.gov email account.”
Dunlap’s account is disputed by Andrew Kossack, the executive director of the commission. Kossack said attorneys from the Government Services Administration provided training on the PRA before the commission’s first meeting on July 19. Kossack provided a copy of the PowerPoint presentation. However, the word “email” appears in only a single slide — with no mention of anything relating to the use of government email.
Notably, the commission did not receive any training in records retention until the July 19 meeting, even though the commission was formed in May and had been actively engaged in commission business.
Indeed, the commission had kicked into high gear on June 28, when it sent a letter to all 50 secretaries of state requesting publicly available voter rolls. The response was swift and negative, and commissioners began receiving a wave of messages from election officials and the public.
Despite this, the commissioners were offered no instructions then on how to preserve communications. Baron said such messages would presumptively be considered presidential records, and “the obligation to preserve such records would have arisen on day one.”
In a statement, Kossack denied there is an obligation to provide commissioners with government email addresses. He maintained that the commission is required only to “preserve emails and other records related to work on commission matters, regardless of the forum on which the records are created or sent, which the commission and its members are doing.”
After the commission’s most recent meeting, on Tuesday, Kobach confirmed that he plans to continue to use his personal gmail account to conduct commission business. Using his Kansas secretary of state email address, he said, would be a “waste of state resources” as he’s acting as a private citizen on the commission and not in his role as secretary of state.
Dunlap has interpreted the requirements differently. He’s trying to ensure his state email account is used so that emails can be made available to constituents under Maine state law. Even this is a struggle, he said, asserting that commissioners continue to email him at his personal account despite multiple requests that they send email to his government account.
“I really don’t understand why they keep using my personal Gmail account instead of my official state email. But I’m saving everything!” Dunlap wrote to himself on August 7, when he forwarded a communication from the commission to his government address. He has, it appears, continued to immediately forward all emails sent to his personal address by the commission to his state address.
At ProPublica’s request, Dunlap shared every email he has received or sent relating to the commission. The majority went to personal email accounts.
At their recent meeting in New Hampshire, Kossack provided commissioners printed instructions on how to retain their own emails related to a lawsuit filed against the commission by the Lawyers Committee for Civil Rights Under Law.
Dunlap said these instructions are the only written set of instructions on records retention he recalls receiving. (The instructions leave records retention entirely to the discretion of each member of the commission, which Dunlap said concerns him.)
Past commissions with similar missions were not allowed such wide discretion. The Presidential Commission on Election Administration, formed by the Obama administration in March 2013, provided ethics and records retention training days after commissioners were nominated. Each commissioner was provided with a federal email address that automatically archived all messages. PCEA documents show extensive, specific instructions on records retention and compliance with FACA.
Richard Painter, who served as the George W. Bush administration’s chief ethics lawyer from 2005 to 2007, expressed shock that the current commission is being allowed to rely on personal email accounts (which are to be forwarded to Kossack at their discretion). “This is just sloppy,” he said, adding that waiting more than two months to offer ethics training was just another sign that the Trump administration “doesn’t take ethics training seriously.”
One footnote: Among the emails provided by Dunlap was a message from Carter Page, a former policy adviser to the Trump campaign who has reportedly attracted the attention of investigators probing the Russia imbroglio. Page sent an email on July 5 to three accounts associated with Kobach and cc’d Dunlap, New Hampshire Secretary of State Bill Gardner and Indiana Secretary of State Connie Lawson. In it, he implored the commission to investigate “the Obama administration’s misuse of federal resources of the Intelligence Community in their unjustified attacks on myself and other volunteers who peacefully supported [Trump’s] campaign as private citizens.”
“The work of your commission offers an essential opportunity to take further steps toward helping to further restore the integrity of the American democracy following their abuses of last year,” he wrote.
There is no evidence this email was forwarded to a federal email account. Page, Kossack and Kobach did not respond to requests for comment about the email.
This much is clear: The public is angry about the skyrocketing cost of prescription drugs. Surveys have shown that high drug prices rank near the top of consumers’ health care concerns.
What’s not as clear is exactly why prices have been rising, and who is to blame.
For the last four months, The New York Times and ProPublica, the nonprofit investigative journalism organization, have teamed up to answer these questions, and to shed light on the games that are being played to keep prices high, often without consumers’ knowledge or consent. Katie reports from the health desk at The Times, and Charles is a senior reporter at ProPublica.
Our reporting journey has turned up some counterintuitive stories, like how insurance companies sometimes require patients to take brand-name drugs — and refuse to cover generic alternatives — even when that means patients have to pay more out of pocket.
Along the way, we’ve asked readers to share their stories about their struggles with high drug costs. We’ve heard from nearly 1,000 people.
In recent weeks, a few stories caught our eye. A woman in Texas, for example, told us that the company that manages her drug benefits, OptumRx, was going to start asking her to pay more out of pocket for Butrans, a painkilling patch that contains the drug buprenorphine. As a “lower cost alternative,” OptumRx, which is owned by UnitedHealth Group, suggested she try painkillers like OxyContin, even though they carry a higher risk of dependence.
A letter sent by OptumRx, a pharmacy benefit manager, to a member in Texas, suggesting she consider switching from the Butrans painkilling skin patch to drugs that carry a higher risk of abuse and dependence.
(Letter obtained by ProPublica)
“The whole point of pain management is to take the least amount of medication possible to manage your pain, so that you always have somewhere to go when the pain increases or changes,” she wrote to us. “This is irresponsible and scary ‘cost management.’” She did not want to use her name, saying her employer prohibited her from identifying herself, but she allowed us to share OptumRx’s redacted letter.
Her pharmacy benefit manager, she wrote, is “effectively contributing to the ‘opioid crisis’ with its own policies.”
A spokesman for UnitedHealth, Matthew N. Wiggin, said it takes the crisis seriously and wants to ensure that people with chronic pain get the appropriate treatment.
But these stories — about patients who believed their insurers were placing roadblocks in the way of less risky painkillers — felt new to us.
We followed up with several of the readers, and searched social media to see if other patients were talking about this.
Then we asked for documents: billing statements from insurers, denial letters, call logs and doctors’ records. In the case of our lead example, a woman named Alisa Erkes, she also agreed to sign a privacy waiver allowing her insurer, UnitedHealthcare, to comment on her case.
Charles enlisted ProPublica’s deputy data editor, Ryann Grochowski Jones, to analyze data from Medicare prescription drug plans. The results showed that insurers were indeed placing more barriers to drugs like Butrans and lidocaine patches than to cheaper generic opioids.
Insurers say that they are doing their part by placing limits on new prescriptions for addictive painkillers, and that they are also doing more to monitor doctors’ prescribing patterns and to catch abuse by patients. Several insurers said they had seen declines in monthly opioid prescriptions, a sign of progress.
But their behavior has infuriated many patients, who say they want to avoid taking opioids if possible. They argue that insurers are too focused on a drug’s cost, since many of the painkillers with a lower risk of addiction are more expensive.
Our project examining high drug costs is not over. We are already digging into other corners of the prescription drug world, hoping to shed light on more of the hidden forces that are keeping drug costs high. Stay tuned, as well, for more stories that were inspired by our readers.
At a time when the United States is in the grip of an opioid epidemic, many insurers are limiting access to pain medications that carry a lower risk of addiction or dependence, even as they provide comparatively easy access to generic opioid medications.
The reason, experts say: Opioid drugs are generally cheap while safer alternatives are often more expensive.
Drugmakers, pharmaceutical distributors, pharmacies and doctors have come under intense scrutiny in recent years, but the role that insurers — and the pharmacy benefit managers that run their drug plans — have played in the opioid crisis has received less attention. That may be changing, however. The New York state attorney general’s office sent letters last week to the three largest pharmacy benefit managers — CVS Caremark, Express Scripts and OptumRx — asking how they were addressing the crisis.
ProPublica and The New York Times analyzed Medicare prescription drug plans covering 35.7 million people in the second quarter of this year. Only one-third of the people covered, for example, had any access to Butrans, a painkilling skin patch that contains a less-risky opioid, buprenorphine. And every drug plan that covered lidocaine patches, which are not addictive but cost more than other generic pain drugs, required that patients get prior approval for them.
In contrast, almost every plan covered common opioids and very few required any prior approval.
The insurers have also erected more hurdles to approving addiction treatments than for the addictive substances themselves, the analysis found.
Alisa Erkes lives with stabbing pain in her abdomen that, for more than two years, was made tolerable by Butrans. But in January, her insurer, UnitedHealthcare, stopped covering the drug, which had cost the company $342 for a four-week supply. After unsuccessfully appealing the denial, Erkes and her doctor scrambled to find a replacement that would quiet her excruciating stomach pains. They eventually settled on long-acting morphine, a cheaper opioid that UnitedHealthcare covered with no questions asked. It costs her and her insurer a total of $29 for a month’s supply.
Erkes, who is 28, is afraid of becoming addicted and has asked her husband to keep a close watch on her. “Because my Butrans was denied, I have had to jump into addictive drugs,” she said.
(Kevin D. Liles for The New York Times)
The Drug Enforcement Administration places morphine in a higher category than Butrans for risk of abuse and dependence. Addiction experts say that buprenorphine also carries a lower risk of overdose.
UnitedHealthcare, the nation’s largest health insurer, places morphine on its lowest-cost drug coverage tier with no prior permission required, while in many cases excluding Butrans. And it places Lyrica, a non-opioid, brand-name drug that treats nerve pain, on its most expensive tier, requiring patients to try other drugs first.
Erkes, who is 28 and lives in Smyrna, Georgia, is afraid of becoming addicted and has asked her husband to keep a close watch on her. “Because my Butrans was denied, I have had to jump into addictive drugs,” she said.
UnitedHealthcare said Erkes had not exhausted her appeals, including the right to ask a third party to review her case. It said in a statement, “We will work with her physician to find the best option for her current health status.”
Matthew N. Wiggin, a spokesman for UnitedHealthcare, said that the company was trying to reduce long-term use of opioids. “All opioids are addictive, which is why we work with care providers and members to promote non-opioid treatment options for people suffering from chronic pain,” he said.
Dr. Thomas R. Frieden, who led the Centers for Disease Control and Prevention under President Obama, said that insurance companies, with few exceptions, had “not done what they need to do to address” the opioid epidemic. Right now, he noted, it is easier for most patients to get opioids than treatment for addiction.
Leo Beletsky, an associate professor of law and health sciences at Northeastern University, went further, calling the insurance system “one of the major causes of the crisis” because doctors are given incentives to use less expensive treatments that provide fast relief.
The Department of Health and Human Services is studying whether insurance companies make opioids more accessible than other pain treatments. An early analysis suggests that they are placing fewer restrictions on opioids than on less addictive, non-opioid medications and non-drug treatments like physical therapy, said Christopher M. Jones, a senior policy official at the department.
Insurers say they have been addressing the issue on many fronts, including monitoring patients’ opioid prescriptions, as well as doctors’ prescribing patterns. “We have a very comprehensive approach toward identifying in advance who might be getting into trouble, and who may be on that trajectory toward becoming dependent on opioids,” said Dr. Mark Friedlander, the chief medical officer of Aetna Behavioral Health who participates on its opioid task force.
Aetna and other insurers say they have seen marked declines in monthly opioid prescriptions in the past year or so. At least two large pharmacy benefit managers announcedthis year that they would limit coverage of new prescriptions for pain pills to a seven- or 10-day supply. And bowing to public pressure — not to mention government investigations — several insurers have removed barriers that had made it difficult to get coverage for drugs that treat addiction, like Suboxone.
Experts in addiction note that the opioid epidemic has been changing and that the problem now appears to be rooted more in the illicit trade of heroin and fentanyl. But the potential for addiction to prescribed opioids is real: 20 percent of patients who receive an initial 10-day prescription for opioids will still be using the drugs after a year, according to a study by researchers at the University of Arkansas for Medical Sciences.
Several patients said in interviews that they were terrified of becoming dependent on opioid medications and were unwilling to take them, despite their pain.
In 2009, Amanda Jantzi weaned herself off opioids by switching to the more expensive Lyrica to treat the pain associated with interstitial cystitis, a chronic bladder condition.
But earlier this year, Jantzi, who is 33 and lives in Virginia, switched jobs and got a new insurer — Anthem — which said it would not cover Lyrica because there was not sufficient evidence to prove that it worked for interstitial cystitis. Jantzi’s appeal was denied. She cannot afford the roughly $520 monthly retail price of Lyrica, she said, so she takes generic gabapentin, a related, cheaper drug. She said it does not manage the pain as well as Lyrica, which she took for eight years. “It’s infuriating,” she said.
Jantzi said she wanted to avoid returning to opioids. However, “I could see other people, faced with a similar situation, saying, ‘I can’t live like this, I’m going to need to go back to painkillers,’” she said.
In a statement, Anthem said that its members have to meet certain requirements before it will pay for Lyrica. Members can apply for an exception, the insurer said. Jantzi said she did just that and was turned down.
Erkes, who is petting her dog, Kallie, once visited her pain doctor every two months. Since her insurer denied coverage of Butrans, she has gone back much more frequently, and once went to the emergency room because she could not control her pain.
(Kevin D. Liles for The New York Times)
With Butrans, the drug that Erkes was denied, several insurers either do not cover it, require a high out-of-pocket payment, or will pay for it only after a patient has tried other opioids and failed to get relief.
In one case, OptumRx, which is owned by UnitedHealth Group, suggested that a member taking Butrans consider switching to a “lower cost alternative,” such as OxyContin or extended-release morphine, according to a letter provided by the member.
Wiggin, the UnitedHealthcare spokesman, said the company’s rules and preferred drug list “are designed to ensure members have access to drugs they need for acute situations, such as post-surgical care or serious injury, or ongoing cancer treatment and end of life care,” as well as for long-term use after alternatives are tried.
Butrans is sold by Purdue Pharma, which has been accused offueling the opioid epidemic through its aggressive marketing of OxyContin. Butrans is meant for patients for whom other medications, like immediate-release opioids or anti-inflammatory pain drugs, have failed to work, and some scientific analyses say there is not enough evidence to show it works better than other drugs for pain.
Dr. Andrew Kolodny is a critic of widespread opioid prescribing and a co-director of opioid policy research at the Heller School for Social Policy and Management at Brandeis University. Kolodny said he was no fan of Butrans because he did not believe it was effective for chronic pain, but he objected to insurers suggesting that patients instead take a “cheaper, more dangerous opioid.”
“That’s stupid,” he said.
and I am now forced to be on stronger pain meds after dealing with out of control pain for weeks. How is this ok?
Erkes’s pain specialist, Dr. Jordan Tate, said her patient had been stable on the Butrans patch until January, when UnitedHealthcare stopped covering the product and denied Erkes’s appeal.
Without Butrans, Erkes, who once visited the doctor every two months, was now in Tate’s office much more frequently, and once went to the emergency room because she could not control her pain, thought to be related to an autoimmune disorder, Behcet’s disease.
Tate said she and Erkes reluctantly settled on extended-release morphine, a drug that UnitedHealthcare approved without any prior authorization, even though morphine is considered more addictive than the Butrans patch. She also takes hydrocodone when the pain spikes and Lyrica, which UnitedHealthcare approved after requiring a prior authorization.
Erkes acknowledged that she could have continued with further appeals, but said the process exhausted her and she eventually gave up.
While Tate said Erkes had not shown signs of abusing painkillers, her situation was far from ideal. “She’s in her 20s and she’s on extended-release morphine — it’s just not the pretty story that it was six months ago.”
Dr. Shawn Ryan, who runs an addiction treatment practice in Cincinnati, said too many insurance companies put onerous barriers on patients needing medications to treat their addictions.
(Andrew Spear for The New York Times)
Many experts who study opioid abuse say they also are concerned about insurers’ limits on addiction treatments. Some state Medicaid programs for the poor, which pay for a large share of addiction treatments, continue to require advance approval before Suboxone can be prescribed or they place time limits on its use, both of which interfere with treatment, said Lindsey Vuolo, associate director of health law and policy at the National Center on Addiction and Substance Abuse. Drugs like Suboxone, or its generic equivalent, are used to wean people off opioids but can also be misused.
The analysis by ProPublica and the Times found that restrictions remain prevalent in Medicare plans, as well. Drug plans covering 33.6 million people include Suboxone, but two-thirds require prior authorization. Even when such requirements do not exist, the out-of-pocket costs of the drugs are often unaffordable, a number of pharmacists and doctors said.
At Dr. Shawn Ryan’s addiction-treatment practice in Cincinnati, called BrightView, staff members often take patients to the pharmacy to fill their prescriptions for addiction medications and then watch them take their first dose. Research has shown that such oversight improves the odds of success. But when it takes hours to gain approval, some patients leave, said Ryan, who is also president of the Ohio Society of Addiction Medicine.
“The guy walks out, and you can’t blame him,” Ryan said. “He’s like, ‘Hey man, I’m here to get help. What’s the deal?’”
by Matt Drange, Forbes, Alan Huffman, special to ProPublica, and Derek Kravitz, ProPublica
Earlier this summer, the Trump Organization announced big plans to open a line of hotels across the country. The new brand, American IDEA, would be modestly priced and patriotically themed. “The product is very hometown and fits in every hometown in the United States,” Trump Hotels CEO Eric Danziger said during a presentation at Trump Tower in Manhattan, the same place where Donald Trump had announced his presidential campaign two years earlier.
American IDEA would be part of a wider rollout with another higher-end hotel line, Scion, that the Trumps had already unveiled. Progress on the hotels would be swift, Danziger said.
The Trump Organization had said it signed deals for Scion hotels in Nashville, Dallas, Cincinnati, Austin and New York. At various times, company officials have cited anywhere from 10 to 39 impending deals.
What we’ve found are false starts, fizzled-out partnerships and, for a number of cities that the Trumps said they had deals in, no evidence of deals at all.
Nashville faced petitions after the Trump Organization said it was coming to town. But development and tourism officials we spoke to said they were unaware of any Trump hotel being planned. Bobby Bowers, senior vice president of operations for Hendersonville, Tennessee-based hotel industry research firm STR, said his company has no information about a Trump hotel partnership in Nashville, even among its “unconfirmed” listings. A spokesperson for the city’s convention and visitors bureau said the same thing.
In Dallas, a developer who had been working with the Trumps had declared the deal dead two months before the Trump Organization identified the city as a hotel site. (He also had plans for a Trump hotel in downtown St. Louis before political pressure and protests derailed it.)
The developer, Mukemmel “Mike” Sarimsakci, did not respond to a request for comment. If the plan is back on with Sarimsakci or a different partner in Dallas, city officials don’t appear to know about it. Requests for correspondence between the city and representatives of the Trump Organization, as well as requests submitted to Dallas’ Office of Economic Development, turned up no records.
Officials and hotel developers in Cincinnati also said they had not heard of any deals involving Trump.
And in Austin, the deal “died before Trump was elected,” the head of a firm that had been working on the project told the Austin Business Journal. “It’s absolutely 100 percent dead.”
Danziger declined to comment for this story. Other representatives for the Trump Organization’s hotel business did not respond to requests for comment.
As we previously detailed, the Trumps are moving forward on four hotels in the Mississippi Delta. The deals are in partnership with a pair of Indian-American hoteliers, one of whom had met Donald Trump on the campaign trail and later gave money to his presidential campaign.
Suresh Chawla met Trump at a private fundraiser in August 2016 and donated $50,000, split between Trump’s campaign and the Republican National Committee. Months later, Chawla, along with his business partner and brother Dinesh, reached an agreement with the Trump Organization on a $20 million Scion hotel and three other franchise agreements to convert existing hotels to the American IDEA brand.
We also found a few other cities where the Trumps have had early conversations about partnering with local developers.
Jon Willis, a politically active developer in Mesa, Arizona, said he met Donald Trump Jr. through a mutual connection at Turning Point USA, a conservative PAC, and started working on the Trump campaign last year. When Willis spent time with Donald Jr. at a campaign event in Arizona last year, he said they discussed expansion plans that the Trump Organization had in Las Vegas, where it has a condo-hotel tower in partnership with billionaire Phil Ruffin. “That was the extent of what we talked about,” Willis said, adding that the two “mostly just talked about our kids.”
Willis added that while he wasn’t working with the Trumps on their new hotel line, he would be more than open to it: “I’d love to be involved.”
Three other established hoteliers and financiers in the South told us they’d also welcome working with the Trumps. The Trump Organization has said it is meeting with potential partners in Mississippi.
Len Blackwell, an attorney in Gulfport, Mississippi, said he had heard rumors of the Trumps “poking around” on the coast. (The Trump Organization has said it is meeting with potential partners in Mississippi.)
Blackwell has had experience working with the Trumps. He represented Trump in a planned $80 million casino and hotel project in Gulfport in the mid-1990s. Trump abandoned the deal before ground was broken.
One issue, according to Blackwell, was that Trump’s representatives were reticent about following through on a required $250,000 deposit they had negotiated with the city.
“My experience with the Trump Organization and its attempt to put a casino in Gulfport was: Its representatives, including Mr. Trump, came to town and had a lot of public relations activity, and did in fact work toward a project but, when it came down to it, chose not to go forward,” he said.
Attorneys general for 37 states sent a letter Monday to the health insurance industry’s main trade group, urging its members to reconsider coverage policies that may be fueling the opioid crisis.
The letter is part of an ongoing investigation by the state officials into the causes of the opioid epidemic and the parties that are most responsible. The group is also focusing on the marketing and sales practices of drug makers and the role of drug distributors.
On Sunday, ProPublica and The New York Times reported that many insurance companies limit access to pain medications that carry a lower risk of addiction or dependence, even as they provide comparatively easy access to generic opioid medications. The safer drugs are more expensive.
In their letter to America’s Health Insurance Plans, the trade group based in Washington, D.C., the attorneys general urged insurers to revise their rules “to encourage healthcare providers to prioritize non-opioid pain management options over opioid prescriptions for the treatment of chronic, non-cancer pain.”
“The status quo, in which there may be financial incentives to prescribe opioids for pain which they are ill-suited to treat, is unacceptable,” the letter said. “We ask that you quickly initiate additional efforts so that you can play an important role in stopping further deaths.”
The signatories include the attorneys general of California, Florida, New York, Pennsylvania and Michigan.
While opioids, such as hydrocodone and morphine, are often prescribed to relieve pain, they also have been linked to abuse and dependence. Drug overdoses are now the leading cause of death among Americans under 50, and more than 2 million Americans are estimated to misuse opioids. While the crisis has placed the practices of drug makers, pharmaceutical distributors, pharmacies and doctors under scrutiny, the role of insurers in enabling access to cheap, addictive opioids has received less attention.
The Department of Health and Human Services is now studying whether insurance companies make opioids more accessible than other pain treatments. An early analysis suggests that insurers are placing fewer restrictions on opioids than on less addictive, non-opioid medications and non-drug treatments like physical therapy, said Christopher M. Jones, a senior policy official at the department.
Last week, the New York state attorney general’s office sent letters to the three largest pharmacy benefit managers — CVS Caremark, Express Scripts and OptumRx — asking how they were addressing the crisis.
In a written statement to ProPublica, Cathryn Donaldson, a spokeswoman for America’s Health Insurance Plans, said that, “We share the state attorneys general’s commitment to eradicating the opioid epidemic in America.”
“Health plans cover comprehensive, effective approaches to pain management that include evidence-based treatments, more cautious opioid prescribing, and careful patient monitoring,” Donaldson wrote. “Recent research shows that non-opioid medications, even over-the-counter medication like ibuprofen, can provide just as much relief as opioids.”
Insurers say they have been addressing the issue on many fronts, including monitoring patients’ opioid prescriptions, as well as doctors’ prescribing patterns. A number of companies say they have seen marked declines in monthly opioid prescriptions in the past year or so. Moreover, at least two large pharmacy benefit managers, which run insurers’ drug plans, announcedthis year that they would limit coverage of new prescriptions for pain pills to a seven- or 10-day supply.
“Patients and their care providers should talk openly and honestly about pain and how to manage it — from lifestyle changes and exercise to over-the-counter options and clearly understanding the dangers of opioids,” Donaldson said.
Nonetheless, ProPublica and The New York Times found that companies are sometimes refusing to cover less risky drugs prescribed by doctors while putting no such restrictions on opioids.
We analyzed Medicare prescription drug plans covering 35.7 million people in the second quarter of this year. Only one-third of the people covered, for example, had any access to Butrans, a painkilling skin patch that contains a less-risky opioid, buprenorphine. And every drug plan that covered lidocaine patches, which are not addictive but cost more than other generic pain drugs, required that patients get prior approval from the insurer for them.
Moreover, we found that many plans make it easier to get opioids than medications to treat addiction, such as Suboxone. Drug plans covering 33.6 million people include Suboxone, but two-thirds require prior authorization. And even if they do approve coverage, some insurance companies have set a high out-of-pocket cost for Suboxone, rendering it unaffordable for many addicts, a number of pharmacists and doctors said.
“Everyone — including and especially insurance companies — have an obligation to address the opioid epidemic,” New York Attorney General Eric T. Schneiderman said in a press release today. “Insurers must take a hard look at the systemic problems in our healthcare system that result in the over-prescription of opioids and fuel the cycle of addiction.”
This past June, Florida’s top education agency delivered a failing grade to the Orange Park Performing Arts Academy in suburban Jacksonville for the second year in a row. It designated the charter school for kindergarten through fifth grade as the worst public school in Clay County, and one of the lowest performing in the state.
Two-thirds of the academy’s students failed the state exams last year, and only a third of them were making any academic progress at all. The school had had four principals in three years, and teacher turnover was high, too.
“My fourth grader was learning stuff that my second grader was learning — it shouldn't be that way,” said Tanya Bullard, who moved her three daughters from the arts academy this past summer to a traditional public school. “The school has completely failed me and my children.”
The district terminated the academy’s charter contract. Surprisingly, Orange Park didn’t shut down — and even found a way to stay on the public dime. It reopened last month as a private school charging $5,000 a year, below the $5,886 maximum that low-income students receive to attend the school of their choice under a state voucher program. Academy officials expect all of its students to pay tuition with the publicly backed coupons.
Reverend Alesia Ford-Burse, an African Methodist Episcopal pastor who founded the academy, told ProPublica that the school deserves a second chance, because families love its dance and art lessons, which they otherwise couldn’t afford. “Kids are saying, ‘F or not, we’re staying,’” she said.
While it’s widely known that private schools convert to charter status to take advantage of public dollars, more schools are now heading in the opposite direction. As voucher programs across the country proliferate, shuttered charter schools, like the Orange Park Performing Arts Academy, have begun to privatize in order to stay open with state assistance.
A ProPublica nationwide review found that at least 16 failing or struggling charter schools in five states — Florida, Wisconsin, Indiana, Ohio and Georgia — have gone private with the help of publicly funded voucher programs, including 13 since 2010. Four of them specialize in the arts, including Orange Park, and five serve students with special needs.
“The voucher just is a pass through in order to provide additional funding for private schools to thrive and to continue to work,” said Addison Davis, superintendent of schools in Clay County. Changing a school’s status “isn’t going to stop the process where we continue to see kids who are declining academically and not being able to demonstrate mastery and proficiency.”
The Orange Park Performing Arts Academy was the only charter school in Clay County, Florida, that focused on the arts.
(Charlotte Kesl for ProPublica)
Two key factors underlie these conversions. The number of voucher and voucher-like programs across the country has more than tripled over the past decade from 16 to 53. And charter schools, which became popular as a way to spur educational innovation with reduced regulation, have increasingly faced more stringent oversight. Jeanne Allen, founder and CEO of the Center for Education Reform and a longtime supporter of charter schools, lamented in a recent op-ed that increased government regulation is turning them into “bureaucratic, risk-averse organizations fixated on process over experimentation.”
“Why not just be a private school if the kids qualify for the scholarships?” said Christopher Norwood, a consultant for the Orange Park school, in an interview. “With 90 percent fewer regulations, schools can be independent and free, and just deal with the students.”
As private schools, the ex-charters are less accountable both to the government and the public. It can be nearly impossible to find out how well some of them are performing. About half of the voucher and voucher-like programs in the country require academic assessments of their students, but few states publish the complete test results, or use that data to hold schools accountable.
While most states have provisions for closing low-quality charter schools, few, if any, have the power to shut down low-performing voucher schools.
“Public money is being handed out without oversight,” said Diane Ravitch, a New York University education historian and public schools advocate, who served as assistant secretary of education under President George H.W. Bush. “The fundamental voucher idea is that parents are choosing the schools and they know better than the state. If they want to send their kids to a snake-charming school, then that’s their choice.”
The type of voucher program that rescues failed charter schools like Orange Park in Florida may soon be replicated nationwide. Visiting a religious school in Miami last April, Secretary of Education Betsy DeVos praised the state’s approach as a possible model for a federal initiative.
Typically, voucher programs are directly funded with taxpayer dollars. Florida’s largest program pursues a different strategy. Its “tax-credit scholarships” are backed by donations from corporations. They contribute to nonprofit organizations, which, in turn, distribute the money to the private schools. In exchange, the donors receive generous dollar-for-dollar tax credits from the state. This subsidy indirectly shifts hundreds of millions of dollars annually from the state’s coffers to private schools. More than 100,000 students whose families meet the income eligibility requirements have received the tax-credit coupons this year.
Of the nearly 2,900 private schools in Florida, over 1,730 participated in the tax-credit voucher program during 2016-17, according to the most recent state Department of Education data. On average, each school received about $300,000 last year.
While more than two-thirds of these schools are religious, the roundabout funding approach protects the vouchers against legal challenges that they violate the separation of church and state. Earlier this year, the state Supreme Court dismissed a lawsuit by the Florida Education Association, a teacher’s union, challenging the constitutionality of the voucher program.
In an education budget proposal from May, DeVos detailed her voucher plans, pitching a $250 million plan to study and expand individual state initiatives. She has since suggested that the administration may also create a federal tax-credit voucher scheme through an impending tax overhaul.
School choice advocates like DeVos have long contended that vouchers improve educational opportunities for low-income families. They reason that competition raises school quality, and that parents, given more options, will select the best school for their children.
A growing body of research, though, casts doubt on this argument. It shows voucher-backed students may not be performing better than their public school counterparts, and may do worse.
According to a February 2017 analysis by Martin Carnoy, a Stanford University education professor, most studies of voucher programs over the past quarter-century found little evidence that students who receive the coupons perform better than their public school peers.
The lack of evidence on the benefits of vouchers, Carnoy wrote, “suggests that an ideological preference for education markets over equity and public accountability is what is driving the push to expand voucher programs.”
Across the Florida panhandle from Orange Park, another troubled charter school for the arts has reinvented itself as a voucher-funded private school.
Founded in 2010, the A.A. Dixon Charter School of Excellence had the worst academic record in Escambia County, and the school board raised questions about its financial accounting.
“Every month they came before the board and there was a problem,” said Jeff Bergosh, a school board member at the time, adding that he supports school choice. “They tried to make it work, but they didn’t. There were serious issues that jeopardized student safety, like sanitation issues and not having supervision [for the students].”
After Dixon received two failing grades from the state — which triggers termination of a school’s charter under Florida rules — Reverend Lutimothy May, a Baptist pastor who chaired its board, appealed to state education authorities. They allowed the school to operate for at least one more year, but he began to seek other options.
Around the same time, a local beverage distributor, David Bear of the Lewis Bear Company, told May that he was considering contributing to the state tax-credit program. If the Dixon school privatized, Bear told May, donations could help save it. In 2013, May turned the charter, which had recently been renamed the Dixon School of the Arts, into a private Christian arts academy located inside his church. Nearly all current students at Dixon receive the tax-credit vouchers, bringing the school more than $500,000 a year, according to the most recent data from the state’s department of education.
“Our goal is still the same,” but the conversion has “untied some of the strings on education,” May said.
Dixon School of the Arts, a private arts academy in Pensacola, Florida. Dixon began as a public charter school, but after receiving two failing grades from the state, it converted to a private school with the help of tax-credit vouchers.
(Annie Waldman/ProPublica)
Some of the untied “strings” to which May referred were state educational requirements. By converting from a charter to private status, Dixon and other schools largely shield themselves from accountability.
For instance, while Florida requires all private schools to test students who receive vouchers, the schools face no consequences for weak academic performance. The University of Florida publishes an annual report analyzing the test scores of students that receive vouchers, but data from only a small fraction of the schools is made public. The report excludes many schools that don’t have test results for enough students in consecutive years.
The latest report released the academic performance of only 198 schools in 2014-15, out of the more than 1,500 schools that enrolled voucher-funded students that year. Most Florida families that receive vouchers do not have access to test data on their schools. The Dixon data was not published. Dixon’s principal, Donna Curry, maintained that the school has improved since its conversion from charter status, but declined to provide exam results to ProPublica, saying they were “for internal use.”
Curry added that state test results are not necessarily reflective of student success. “I will not accept the fact that our children are not learning because they are not normalized on the state test,” she said. Her staff “knows more than what the test evaluates.”
The state also has little control over how private, voucher-funded schools foster learning. There are no requirements on curriculum or teacher certification, other than the criminal background checks that are required for personnel at all private schools.
Because Dixon receives more than $250,000 in voucher money, it does have to file a financial accountability report. Only about 40 percent of all voucher-funded schools met this threshold to undergo such an audit in 2016. The reports, including Dixon’s, aren’t publicly posted.
Even an official at Step Up For Students, the largest nonprofit distributor of voucher money to Florida’s private schools, acknowledges the need for closer supervision of educational quality. “As the program matures and more students are enrolled and as inevitably we see some schools continue to have what most people would consider to be poor performance year-in and year-out, we will be having more and more discussions about whether there should be some kind of regulatory accountability mechanisms to respond to that,” said Ron Matus, the organization’s director of policy and public affairs.
Indiana’s largest voucher program, unlike Florida’s, is directly backed by taxpayer dollars and has stricter accountability requirements. A private school that accepts vouchers can be sanctioned if its performance dips low enough. Last year, 10 schools lost their access to new vouchers, according to Adam Baker, the spokesman for the Indiana Department of Education.
The tighter supervision, though, didn’t deter Padua Academy in Indianapolis. Originally a private Catholic school, Padua had become a “purely secular” charter in 2010, under an unusual arrangement between the local archdiocese and the mayor’s office. The school initially performed well, but soon sank from a solid A-rating to two consecutive F-ratings.
“These performance issues sounded alarm bells at the mayor's office,” said Brandon Brown, who led the mayor’s charter office at the time. Leadership issues with the school’s board and at the archdiocese, he added, caused the school to falter. After receiving $702,000 from a federal program that provided seed money for new charter schools, the school’s board relinquished its charter.
In the meantime, Indiana had established a voucher program. So, instead of shutting down, the school rebranded itself as St. Anthony Catholic School, nailing its crucifixes back onto the walls and bringing the Bible back into the curriculum. Last year, more than 80 percent of its students were on vouchers, from which the school garnered at least $1.2 million.
Its academic performance has improved, but still lags behind the state average. Only 25 percent of St. Anthony students passed both math and reading assessments this year, versus about half of all publicly funded students on average at both private and public schools, according to the state’s education data from 2017. Last year, the state gave St. Anthony a C grade.
Gina Fleming, superintendent of schools for the Archdiocese of Indianapolis, said through a spokesman that “significant staff turnover” at St. Anthony’s “made for a difficult start these past two years.” As a result, the archdiocese “has been studying ways in which we can recruit, retain and reward high-quality teachers and leaders.” It has also “made shifts in scheduling, resources, diagnostic analyses and personnel to better accommodate the learning needs of our students.”
In Fort Wayne, Indiana, two other charter schools went private. Both Imagine MASTer Academy and Imagine Schools on Broadway were associated with a national for-profit charter chain, Imagine Schools, which has been under scrutiny elsewhere. In 2012, the Missouri Board of Education shut down all six Imagine charter schools in St. Louis for financial and academic woes. In response to such setbacks, Imagine Schools has moved toward “an even deeper commitment to increasing the consistency of our network-wide performance,” said Rhonda Cagle, a spokeswoman for the chain.
The two Fort Wayne schools performed well initially, but by the time their charters were up for renewal, they had some of the worst test results in the area, said Robert Marra, executive director of the charter office at Ball State University, which was responsible for the schools’ oversight. Imagine MASTer received a D grade from the state in 2013 and Imagine Schools on Broadway, an F.
The data for the two schools “showed clear room for improvement but indicated consistent growth,” Cagle told ProPublica.
While some of Imagine’s students and staff have stayed on, Cagle said that Imagine has no involvement in the merged academy, other than owning the building.
“We could have allowed the buildings to just be empty, but we felt like if there was an interest by another entity for the purposes of education, that would be doing the right thing,” she said. Imagine “does not utilize vouchers for any of our schools,” she added.
Academically, Horizon Christian is far below average. Only 7 percent of its students passed both state exams this year, according to state data. One of its campuses received a D grade last year, and its other two failed. The academy did not respond to questions.
“Low-performing operators in Indiana and elsewhere have skirted accountability by converting their charter schools to private schools either right before or right after a charter revocation or nonrenewal,” said Brown, the former Indianapolis official. “I can say unequivocally that any attempt to keep a low-performing school open by evading rigorous accountability is not good for students, families, or the broader school choice movement.”
“Sometimes when you're knocked down the hardest, you come back the hardest,” said Kelly Kenney, who started as the new principal of the Orange Park Performing Arts Academy this year, after the district terminated its charter contract this summer.
(Charlotte Kesl for ProPublica)
As it awaits its first infusion of voucher funds later this month, the Orange Park Performing Arts Academy is strapped. The district has repossessed most of the former charter school’s instructional supplies, including 200 Chromebooks, 34 laptops, 27 iPads and hundreds of textbooks. The arts — the school’s core mission — have been cleaned out: ten easels, nine digital pianos, eight heartwood djembes and four conga drums, all gone. Once lined with silver bleachers, the walls of the cavernous gym are now bare.
Many children have left, too. While the school had about 170 students last year, only 94 enrolled this fall. At least one quarter are kindergarteners, who didn’t attend the charter school. Tanya Bullard, who pulled her three daughters out of Orange Park, predicted it would slide further as a private school, because there will be “no one to keep an eye on it and issues will be swept under the rug.”
The school’s new principal, Kelly Kenney, isn’t deterred. She said that she has already made significant strides to separate the school from its failed days as a charter. Most of the teachers and administrators are new hires, although half of the teachers are uncertified. Kenney plans to get the school accredited, and strengthen the board of directors. “It can’t be a board of friends,” she said. She has been working with each teacher individually to raise standards and improve curriculum.
“Most people would have been defeated,” Kenney said. “Sometimes when you're knocked down the hardest, you come back the hardest. And so for parents that have been skeptical, I'm like ‘This will be the best year of education your child will ever have. We're going to be looking at every detail of their progress, every detail of their learning gap to make sure that we're closing it.’”
Even though it’s not required, Kenney intends to publish her students’ performance data on the school’s website. “It’s important for us to show how we did compared to last year,” she said.
To recruit students this past summer, Kenney went door to door in nearby apartment complexes, hosting information sessions in laundry rooms. Believing that they couldn’t afford a private school, many families were reluctant to send their children to Orange Park — until Kenney told them about vouchers. For weeks, she and her staff have worked around the clock to sign up all the students in the voucher program, even helping them organize, fill out and fax in the necessary paperwork.
Bria Joyce is a loyalist. When her son started kindergarten at the local public school, she says he was “bumping heads” with classmates and she worried that he wasn’t receiving enough attention from teachers. She transferred him to the Orange Park charter school, where he took piano lessons and played Grandpa Joe in a production of “Charlie and the Chocolate Factory.”
When Joyce heard that the school was converting to a private school, she was nervous that she wouldn’t be able to afford the tuition. But the school reached out to her immediately and walked Joyce through the voucher process. Now Joyce’s son is starting fourth grade there.
“They were prepared and made it as easy as they could, considering everything,” she said. “I believe in what they’re trying to get done.”
California regulators said they have required Nationwide and USAA to adjust their auto insurance rates as a result of a report by ProPublica and Consumer Reports that many minority neighborhoods were paying more than white areas with the same risk.
The regulators said their review confirmed our finding that linked the pricing disparities to incorrect applications of a provision in California law. The statute allows insurers to cluster neighboring zip codes together into a single rating territory.
“The companies were making some subjective determinations,” as a basis for calculating rates in some zip codes, said Ken Allen, deputy commissioner of the rate regulation branch of the California Department of Insurance. Nationwide and USAA are two of the 10 largest auto insurance providers in the country by market share.
The department said that the adjustments would largely erase the racial disparities we found in the two companies’ pricing. According to our analysis, USAA charged 18 percent more on average, and Nationwide 14 percent more, in poor, minority neighborhoods than in whiter neighborhoods with similarly high accident costs. Allen said it’s not possible to quantify how these adjustments would affect customers’ premiums because the revisions are too complex. In addition, they’re taking effect at the same time as an overall rate increase.
Allen said the department is now requiring more justification from insurers for their measurements of risk in the poor, minority neighborhoods that California designates as “underserved” for auto coverage.
California’s action marks a rare regulatory rebuke of the insurance industry for its longtime practice of charging higher premiums to drivers living in predominantly minority-urban neighborhoods than to drivers with similar safety records living in majority-white neighborhoods. Insurers have traditionally defended their pricing by saying that the risk is greater in those neighborhoods, even for motorists who have never had an accident.
The department’s investigation was prompted by a ProPublica and Consumer Reports analysis published in April of car insurance premiums in California, Texas, Missouri and Illinois. ProPublica found that some major insurers were charging minority neighborhoods rates as much as 30 percent more than in other areas with similar accident costs.
The disparities were not as widespread in California, which is a highly regulated insurance market, as in the other states. Even so, within California, we found that units of Nationwide, USAA and Liberty Mutual were charging prices in risky minority neighborhoods that were more than 10 percent above similar risky zip codes where more residents were white.
California regulators said they approved rate increases from Nationwide and USAA last week that contained corrections to the disparities revealed by ProPublica. The regulators said they are still investigating the proposed rates of Liberty Mutual, which had the largest disparities in ProPublica’s analysis. Liberty Mutual spokesman Glenn Greenberg said the company is cooperating with the investigation.
The rate changes will only affect premiums charged from now on. The insurance commission chose not to look into whether, or the extent to which, drivers in California’s underserved neighborhoods may have been mischarged in the past.
Department spokeswoman Nancy Kincaid said there was no need to examine past rates. “After hundreds of hours of additional analysis, department actuaries and analysts did not find any indication the ProPublica analysis revealed valid legal issues,” she said.
Some consumer advocates disagreed with this approach. “We think the commissioner should go back and seek refunds for people who were covertly overcharged by the discriminatory practices that ProPublica uncovered,” said Harvey Rosenfield, founder of Consumer Watchdog. Consumers Union, the policy and action arm of Consumer Reports, has also sent a letter to the department, urging it to examine if any rates were calculated improperly in the past.
The insurance commissions in Missouri, Texas and Illinois did not respond to questions about whether they had taken any actions to address the disparities highlighted in ProPublica’s article. A spokesman for the Illinois Department of Insurance said in a statement that it urges consumers to shop around for the best price on automobile insurance.
ProPublica and Consumer reports analyzed more than 100,000 premiums charged for liability insurance — the combination of bodily injury and property damage that represents the minimum coverage drivers buy in each of the states. To equalize driver-related variables such as age and accident history, we limited our study to one type of customer: a 30-year-old woman with a safe driving record. We then compared those premiums, which were provided by Quadrant Information Services, to the average amounts paid out by insurers for liability claims in each zip code.
When ProPublica published its investigation, the California Department of Insurance criticized the article’s approach and findings, saying that “the study’s flawed methodology results in a flawed conclusion” that some insurers discriminate in rate-setting. Nevertheless, the department subsequently used ProPublica’s methodology as a basis for developing a new way to analyze rate filings. It used its new method to examine the recent Nationwide and USAA rate filings.
In California, when insurers set rates for sparsely populated rural zip codes, which tend to be relatively white, they are allowed to consider risk in contiguous zip codes of their own choosing. In some cases, these clusters led higher risk zip codes to be assigned a lower risk — and therefore, lower premium prices — than the state’s comprehensive analysis of accident costs warranted. The use of contiguous zip codes is also common in Missouri, Texas and Illinois but is less regulated there than in California.
In an interview, deputy insurance commissioner Allen said that Nationwide had made a “procedural error” in its use of the contiguous zip codes provision, and that the regulators required the company to rely more heavily on the state’s risk estimates in those areas.
Nationwide acknowledged that the state required a rate adjustment, but disputed the association with ProPublica’s reporting. “It is inaccurate and misleading for anyone to conclude or imply any connection between Nationwide’s recently approved rating plan and ProPublica’s unsubstantiated findings,” spokesman Eric Hardgrove said. He added that Nationwide is committed to nondiscriminatory rates and “disagrees with any assertion to the contrary.”
On page 2,025 of Nationwide’s most recent California insurance filing, the company disclosed that it provided premium quotes for the “ProPublica risk example” to the California insurance commission.
The improper use of the contiguous zip codes provision was also a factor in the USAA filing, Allen said in an interview. “USAA had failed to apply the updated industry wide factors where they had insufficient data,” he said.
USAA spokesman Roger Wildermuth acknowledged when the company filed its rate plan in August 2016, it did not use California’s most up-to-date risk numbers, which were published eight months earlier in December 2015. The reason, he said, was that the insurer had already “completed months of calculations prior to that update.”
He noted that the department approved that filing, including USAA’s decision to rely on its own data, and has now approved the company’s revised calculations using updated data.
“The department has consistently validated our approach to this rate filing,” he said.
California officials said they will more closely police the clustering algorithms, and their impact on poor and minority neighborhoods, as they review future rate filing applications.
“We will use this analysis going forward,” said Joel Laucher, chief deputy commissioner of the department. “We don’t need to change any rules to do that.”
In July, a sweltering tractor trailer ride in Texas became the latest harrowing example of the perils of crossing the U.S. border illegally. From the hospital, one survivor told authorities that he had paid smugglers to get him across the Rio Grande and then cram him on a northbound truck with what he guessed were nearly 100 people. The survivor managed to keep breathing in the pitch black trailer without food or water. But when the doors were opened in a San Antonio Walmart parking lot, eight migrants were dead, their bodies “lying on the floor like meat,” the truck’s driver subsequently said. Another two expired later.
Those 10 deaths are among the 255 known migrant fatalities recorded by the International Organization for Migration in the first eight months of 2017. That’s up from 240 in the same period last year. Experts aren’t certain what’s causing the recent increase; verifying numbers is inherently difficult when it comes to an endeavor whose very mission is to avoid detection by the authorities.
However, academics and the U.S. Border Patrol largely agree on the long-term trends, which reveal a clear pattern. Between 1998 and 2016, the number of unauthorized border-crossers who were captured — which is viewed as the best proxy for the rate of illegal crossings — has plunged 70 percent in the southwest U.S. border region, according to data from the Border Patrol. During that same period, yearly immigrant deaths have risen some 20 percent. (The increase in death rate, which was steady for many years, was interrupted for several years by a temporary surge in migrants from Central America, which we’ll explain, only to resume its upward march.)
The result is a significant increase in the chances of dying in an illegal border crossing over the past two decades. A key cause: efforts by the Border Patrol to push migrants away from easy-to-cross, hard-to-police urban corridors and into barren, isolated terrain. That’s the conclusion of “Why Border Enforcement Backfired,” a 2016 paper whose lead author, Douglas Massey, is a professor at Princeton’s Woodrow Wilson School of Public and International Affairs and the cofounder of the Mexican Migration Project. A spokesman for the Border Patrol echoed the view that the change in policy contributed to the increase in deaths (but disagreed that the policy backfired).
If somebody had been trying to slip across the border through Texas in the early ’90s, he might have just forded a narrow canal or hopped a chain-link fence from Juarez into El Paso. Back then, the vast majority of unauthorized crossings followed easy routes into big cities like El Paso or San Diego, where illegal immigrants could, to the frustration of authorities, quickly blend into the local population. Border deaths were relatively rare, said Daniel Martinez, an associate professor of sociology at the University of Arizona and a researcher on a project called the Migrant Border Crossing Study.
Things began to change when the Clinton administration, seeking to burnish its tough-on-illegal-immigrant credentials, swelled the Border Patrol’s ranks and adopted a strategy known as Prevention Through Deterrence. The initiative, adopted in 1994, clamped down on popular crossing routes through San Diego and El Paso.
The document laying out the strategy at the time predicted that “with traditional entry and smuggling routes disrupted, illegal traffic will be deterred, or forced over more hostile terrain, less suited for crossing and more suited for enforcement.” Migrant flow would shift to sectors in South Texas and Tucson, it anticipated, while acknowledging that “illegal entrants crossing through remote, uninhabited expanses of land and sea along the border can find themselves in mortal danger.”
That’s precisely what happened when the administration implemented Prevention Through Deterrence. Starting in the mid-’90s, the Border Patrol effectively sealed off the well-traveled crossing paths of the San Diego and El Paso Border Patrol sectors. From 1998 to 2008, deaths in these sectors — which had hovered between 20 and 40 annually — tailed off, eventually dropping to a handful in recent years.
Tens of thousands of migrants began shifting to lengthier, more dangerous, unpopulated routes, according to experts. The location of many fatalities shifted accordingly.
Memorial crosses decorate the border wall that separates Arizona from Nogales, Mexico.
(Susan Schulman/Barcroft Media)
Arizona became a hotbed for migrant crossings and deaths in the first years of the new millennium. In the Tucson sector, which stretches over 262 miles of border, much of it desert terrain, migrant fatalities jumped from 11 in 1998 to a peak of 251 in 2010.
But as the Border Patrol deployed more resources to the Tucson sector, migrants targeted other entry points and deaths began declining, to 84 last year. (As the sector became more heavily patrolled, the percentage of migrants whose cause of death was overheating and other environmental factors rose, according to University of Arizona researchers who examined autopsy data.)
“It’s like a balloon: If you cinch down on the left and the right, it’ll go elsewhere,” said Robert Daniels, a spokesman for the Border Patrol. “So after we cinched down on San Diego and El Paso, that led flow to Arizona. Then, as Arizona was cinched down, that led to flow further south in Texas.”
The latter change is visible in recent years in two Texas sectors. The relatively small Laredo area has seen deaths rise from 20 in 1998 to 68 last year. Meanwhile, in the Rio Grande Valley sector, which includes 320 miles of border and some formidable river crossing points, annual deaths rose from 26 in 1998, peaked at 156 in 2013 then tailed off to 130 last year. The Rio Grande is now the most common site of migrant deaths, according to Border Patrol data. Since January 2009, the remains of more than 550 migrants have been found in just one jurisdiction, Brooks County, where migrants attempting to bypass Border Patrol’s inland checkpoints hike for days through dry ranch land, often getting lost and dehydrated in the flat, arid brush.
When it implemented the Prevention Through Deterrence policy, the Border Patrol did not anticipate so many people would attempt to cross the deadly terrains left to them, said Doris Meissner, the head of the Immigration and Naturalization Service who signed off on the strategy in 1994. “Border Patrol believed the hostile conditions [in] the really new geographies that had not been typical crossing areas would create their own built-in deterrence, and that didn’t turn out to be true,” said Meissner, now a senior fellow at the Migration Policy Institute. “The shift to those areas happened more quickly than the Border Patrol realized that it would.”
The Border Patrol’s Daniels agreed that the extreme climates of migrants’ crossing paths were the primary cause of the increased deaths, but also blamed smugglers. “We saw the smugglers taking the aliens to more remote locations to cross with the thought that there would be no Border Patrol,” said Daniels, who began his career in Tucson in 1994. “I haven’t heard of any theories for this outside of the extreme weather.” Daniels noted that other possible factors, like shootings and general border violence, could not explain the deaths.
Once it became clear that environmental deterrence was not stopping migrants, however, authorities did not reverse their strategy. “That always has always been one of the major criticisms,” said Meissner. To make up for the increased risks, she said, the Border Patrol trained agents for emergency response operations and deployed agents, paramedics, helicopters and surveillance equipment to hazardous areas.
These rescue effort have saved lives, but they haven’t brought migrant crossing death rates backdownto levels seen in the 1990s. The Prevention Through Deterrence strategy “directly led to the exponential increase in deaths in Southern Arizona,” according to Martinez, the researcher on the Migrant Border Crossing Study. “The data speaks for itself: There’s a direct correlation between the border buildup and the deaths. It’s undeniable.”
As this shift took place, border crossings dropped regularly, and from 2012 to 2014, so did migrant death rates. But the latter figures were skewed by a surge of migrants from Central American countries at the same time that illegal entries by Mexicans dipped. Many of the Central Americans, fleeing violence in their countries, intentionally placed themselves in U.S. custody in an attempt to seek asylum. Since the migrant death rate is defined as fatalities as a percentage of apprehensions, the spike in apprehensions had the effect of lowering death rates.
Since 2014, however, those rates have been on the rise again. Some of the rise in deaths in 2017 may have to do with South Texas’ unique environmental factors, wrote Julia Black, project coordinator for the International Organization for Migration’s Missing Migrants Project, in an email to ProPublica. “It is not yet clear why the migrant death rate has increased this year,” she said. “Some part of this can be attributed to an increase in rainfall, which has led to more deaths in the Rio Grande, but it cannot explain the rise in deaths in e.g. the Arizona desert.”
Martinez argued that it is more important to look at the longer-term shifts than trying to identify one or two elements. People have been forced to take ever more demanding and precarious routes.
“We’re seeing more and more remains being recovered on trails at higher elevations than ever seen before,” said Martinez. “Rather than crossing for a couple hours, people cross for days, pushed farther away from the pick-up points, so they literally just can’t carry enough water anymore.”
For five days, ProPublica reporter Megan Rose hunkered down in a very small, very hot conference room in Las Vegas, surrounded by boxes brimming with legal records. She took notes and scanned documents one page at a time. The grind of investigative reporting, personified.
But in those pages lay a big payoff: a story of murder, misadventure and injustice.
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Rose had come searching for details about the remarkable case of Fred Steese, a drifter wrongfully convicted of killing a circus performer in 1992. It took nearly 20 years for Steese to get out of prison, even though prosecutors had evidence showing he wasn’t guilty, and that he was likely in another state when the murder happened.
In October 2012, a judge declared Steese innocent. But Steese wound up pleading guilty nonetheless through something called the Alford plea, an increasingly common, perplexing arrangement where a defendant maintains his innocence, but accepts the status of a convicted felon, and forfeits the right to sue.
Rose put it all together in “Kafka in Vegas,” which ran in the May 2017 issue of Vanity Fair.
“If you had been a TV writer, somebody — your producer, director — would be like, ‘This is too outlandish. You have to tone it down,’” Rose said, recalling the records from Steese’s original trial.
On today’s episode of The Breakthrough, she tells us all about it: how she first met Steese in the parking lot of a rundown Vegas apartment complex, how she persuaded veteran prosecutors to talk to her about a high-profile, highly sensitive case, and, of course, what it was like to be in that conference room.
“God, there was just so much,” Rose said. “It’s hard to express just how many pieces of paper that I was going through.”
Tune into The Breakthrough, the podcast from ProPublica where investigative reporters reveal how they nailed their biggest stories.
On Thursday, Facebook Chief Executive Mark Zuckerberg announced several steps to make political ads on the world’s largest social network more transparent. The changes follow Facebook’s acknowledgment earlier this month that $100,000 worth of political ads were placed during the 2016 election cycle by “inauthentic accounts” linked to Russia.
The changes also follow ProPublica’s launch of a crowdsourcing effort earlier this month to collect political advertising from Facebook. Our goal was to ensure that political ads on Facebook, which until now have largely avoided scrutiny, receive the same level of fact-checking by journalists, advocacy groups and political opponents as do print, broadcast and radio political ads. We hope to have some results to share soon.
In the meantime, here’s what we do and don’t know about how Facebook’s changes could play out.
How does Facebook plan to increase disclosure of funders of political ads?
In his statement, Zuckerberg said that Facebook will start requiring political advertisers to disclose “which page paid for an ad.”
This is a reversal for Facebook. In 2011, the company argued to the Federal Election Commission that it would be “inconvenient and impracticable” to include disclaimers in political ads because the ads are so small in size.
While the commission was too divided to make a decision on Facebook’s request for an advisory ruling, the deadlock effectively allowed the company to continue omitting disclosures. (The commission has just reopened discussion of whether to require disclosure for internet advertising).
Now Facebook appears to have dropped its objections to adding disclosures. However, the problem with Facebook’s plan of only revealing which page purchased the ad is that the source of the money behind the page is not always clear.
What is Facebook doing to make political ads more transparent to the public?
Zuckerberg also said that Facebook will start to require political advertisers to place on their pages all the ads they are “currently running to any audience on Facebook.”
This requirement could mean the end of the so-called “dark posts” on Facebook — political ads whose origins were not easily traced. Now, theoretically, each Facebook political ad would be associated with and published on a Facebook page — either for candidates, political action committees or interest groups.
However, the word “currently” suggests that such disclosure could be fleeting. After all, ads can run on Facebook for as little as a few minutes or a few hours. And since campaigns can run dozens, hundreds or even thousands of variations of a single ad — to test which one gets the best response — it will be interesting to see whether and how they manage to display all those ads on their pages simultaneously.
“It would require a lot of vigilance on the part of users and voters to be on those pages at the exact time” that campaigns posted all of their ads, said Brendan Fischer, a lawyer at the Campaign Legal Center, a campaign finance reform watchdog group.
How will Facebook decide which ads are political?
It’s not clear how Facebook will decide which ads are political and which aren’t. There are several existing definitions they could choose from.
The Federal Communications Commission defines political advertising as anything that “communicates a message relating to any political matter of national importance,” but those rules only apply to television and radio broadcasters. FCC rules require extensive disclosure, including the amount paid for the ads, the audiences targeted and how many times the ads run.
The Federal Election Commission has traditionally defined two major types of campaign ads. “Independent expenditures” are ads that expressly advocate the election or defeat of a “clearly identified candidate.” A slightly broader definition, “electioneering communications,” encompasses so-called “issue ads” that mention a candidate but may not directly advocate for his or her election or defeat.
The FEC only requires spending on electioneering ads to be disclosed in the 60 days leading up to a general election or the 30 days leading up to a primary election. And the electioneering communications rule does not apply to online advertising.
Of course, Facebook doesn’t have to choose of any of the existing definitions of political advertising. It could do what it did with hate speech — and make up its own rules.
How will Facebook catch future political ads secretly placed by foreigners?
Last week, when Facebook disclosed the Russian ad purchase, the company said it was increasing its technical efforts to identify fake and inauthentic pages and to prevent them from running ads.
Zuckerberg said the company would “strengthen our ad review process for political ads” but didn’t specify exactly how. (Separately, Facebook Chief Operating Officer Sheryl Sandberg said this week that the company is adding more human review to its ad-buying categories, after ProPublica revealed that it allowed advertisers to target ads toward “Jew haters.”)
Zuckerberg also said Facebook will work with other tech companies and governments to share information about online risks during elections.
Will ProPublica continue crowd-sourcing Facebook political ads?
Yes, we plan to keep using our tool to monitor political advertising. This month, we worked with news outlets in Germany — Spiegel Online, Süddeutsche Zeitung and Tagesschau — to collect more than 600 political ads during the parliamentary elections.
We believe there is value to creating a permanent database of political ads that can be inspected by the public, and we intend to track whether Facebook lives up to its promises.
If you want to help us, download our tool for Firefox or Chrome web browsers.
