What If the Health-Care Collapse Saves Trump’s Presidency?

What If the Health-Care Collapse Saves Trump’s Presidency?

The Atlantic Opinion

Friday was the worst day of Donald Trump’s young presidency—an unprecedented defeat on his first legislative priority, which also happened to be his party’s signature promise for the last seven years and one of his own top campaign promises. What’s more, the collapse undercuts the central premise of Trump’s political identity, his supposedly formidable reputation as a dealmaker.

But what if, instead, Trump dodged a serious bullet on Friday, setting him up for a recovery? If that’s the case, Friday might even have perversely been the best day of Trump’s presidency so far—or at least the point where he hit rock-bottom, allowing him to turn things around.

This is not to argue, as Hugh Hewitt did, that last week was “a very good week for the conservative cause generally” and even less so, as Hewitt did, for “President Trump specifically.” Whatever progress was made on Neil Gorsuch’s Supreme Court nomination, Trump’s approval rating continues to plunge and his administration is under siege. Still, the coverage of the collapse has been so uniformly apocalyptic, and the press’s animosity toward Trump so manifest, that it may be useful to consider things from a fresh perspective.

With the failure of the repeal-and-replace effort, Trump—despite his own best efforts—unwittingly rescued himself from the passage of a hugely unpopular bill that would have hurt his own voters most. In a broader sense, Congress’s fractiousness saved Trump from having to follow through on an impossible campaign promise to repeal Obamacare, replace it with a conservative alternative, and expand coverage. Looking forward, post-health-care tension threatens to drive a wedge between Trump and Paul Ryan’s agenda, which is in many ways anathema to the Trump coalition.

Start with the bill in question. Trump had promised during the campaign to repeal and replace Obamacare “immediately” with something that would avoid mandates but maintain popular provisions that prohibit discrimination for preexisting conditions and allow people to stay on their parents’ insurance plans until 26. He also planned to make coverage available to anyone who wanted it, and to not touch Medicare and Medicaid. There is a plan that would do this: a single-payer universal health system. But since that wasn’t going to happen with a Republican president and Republican Congress, there was no obvious way for Trump to fulfill his promises.

Even by those standards, the American Health Care Act was politically toxic—which is, of course, one reason it failed in Congress. One poll found it had 17 percent approval. It would have cut federal funding for Medicaid, and it would have dramatically increased premiums for many voters, including Trump supporters. In the short term, the demise of the AHCA was a political disaster for the Trump administration, but in the long run, passing it might have been a greater disaster.

One side effect of the bill’s failure has been strain between Trump and House Speaker Paul Ryan. The two were always an odd pair; they disagreed on a range of fundamental issues, especially entitlements (Ryan wants to cut them; Trump promised to preserve them) and free-trade agreements (Ryan likes them; Trump hates them). They were temperamentally different; Ryan was obviously skeptical of Trump during the election, while the Trump-friendly site Breitbart had long sniped at Ryan.

Yet for a brief moment it seemed like there might be a productive truce between the two sides. Ex-Breitbart boss Steve Bannon, now Trump’s chief strategist, met with Ryan in January and managed to find some common ground. Trump allowed Ryan to direct the design of the health bill and the process for passing it. On Friday, Ezra Klein wrote that despite promising to change the way Washington and the Republican Party worked,

Trump has become a pitchman for Paul Ryan and his agenda. He’s spent the past week fighting for a health care bill he didn’t campaign on, didn’t draft, doesn’t understand, doesn’t like to talk about, and can’t defend. Rather than forcing the Republican establishment to come around to his principles, he’s come around to theirs — with disastrous results.

Immediately after Ryan and Trump agreed to pull the bill on Friday, Trump insisted he didn’t blame Ryan. But White House officials were already placing the blame at his feet in anonymous quotes to reporters. Trump also enigmatically encouraged his Twitter followers to tun in to Jeanine Pirro’s Fox News show on Saturday; she led off her show calling for Ryan to step down, which White House officials insisted was merely coincidental.

Although Ryan doesn’t seem to be going anywhere, a split with the speaker might be the best thing that could happen to Trump in political terms, freeing him up to pursue the deficit-bloating spending agenda he laid out during the campaign, rather than the far more austere and fiscally conservative one that Ryan desires. Say what you will about Trump losing the popular vote; his agenda still has more of a voter mandate than Ryan’s does. The tax reform that Ryan and Trump still say they will pursue is likely to be highly regressive, and if the failure of the AHCA makes it harder to push through a regressive tax plan, that too may be a case of Trump unwittingly dodging a bullet.

Rather than attack Ryan, Trump lashed out at the House Freedom Caucus on Twitter. The staunchly conservative faction has shown that it can withstand pressure from Ryan. Though it withstood Trump’s apparently clumsy last-minute charm offensive, a sustained attack from the White House might be one of the few things that could break it. (One member, Representative Ted Poe, has already left over the health-care failure.) And even if it doesn’t work, this gives Trump an excuse to reach out to Democratic lawmakers on future plans. He attacked them on Friday, but there’s already a growing sense that Republicans will have to reach across the aisle.

Trump enters the final third of his first 100 days with his political capital much depleted, a cratering approval rating, and his presidential campaign at the center of an FBI investigation. It’s an ample supply of lemons, but there are ingredients for lemonade, should Trump decide to make it. As I reported last week, Bill Clinton’s chaotic early presidency holds out an example of how a president can execute a successful turnaround.

If the past is precedent, Trump won’t do that. The AHCA debacle showed that Trump has little handle on the way Capitol Hill works, and minimal interest in learning. As a general rule, he lacks discipline. Moving to take advantage of the moment would also require a unified, concerted effort from a White House that has shown little ability to act in that way; and Chief of Staff Reince Priebus, who is perhaps best positioned to lead a turnaround, has come out of the health-care experience weakened internally. Still, if the failure of repeal and replace turns out to be an unmitigated disaster, that will only because Trump missed a golden opportunity.

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Breitbart’s Fight to Prove It’s a Legitimate News Outlet

The Atlantic Opinion

Breitbart News’s quest to obtain permanent congressional press credentials is forcing the secretive company to disclose more information about its operations, staff, and its links to White House chief strategist Steve Bannon.

The U.S. Senate Daily Press Gallery’s standing committee of correspondents is so far still refusing to grant a permanent press pass to the outlet, which was led by Bannon as executive chairman until he went on leave to join the Trump campaign in August. That’s been a sticking point for the committee, which has sought more information about Bannon’s involvement with the site. The committee is seeking clarification from Breitbart about issues related to its office space and the level of involvement of the Mercer family, the powerful Republican donors who have invested in Breitbart.

The committee met on Monday and considered a letter it had received that it had requested after a meeting last month attended by Breitbart CEO Larry Solov in which Solov had stated that Bannon had resigned from Breitbart in a phone call.

Solov’s letter to the committee, dated March 23, asserts that Bannon resigned from Breitbart News “on or about” November 13, 2016—five days after the election.

“Bannon has no editorial, executive, financial or other role or interest in BNN,” Solov writes in his letter.

At the last meeting in February, Solov disclosed Breitbart’s ownership structure publicly for the first time. “I want to disclose as little as possible about our financial structure,” Solov said, according to minutes of the meeting.

But he acknowledged then that the owners of Breitbart are himself, Andrew Breitbart’s widow Susie, and the Mercer family.

At the committee’s request, Solov also included the company’s masthead in his March 23 letter, which includes three names which are connected to Mercer-linked entities. Managing editor Wynton Hall and Senior Editor-at-Large Peter Schweizer are both tied to the Government Accountability Institute. Schweizer is its president, and the group reportedly paid Bannon $376,000 over the course of four years while he also ran Breitbart. The committee is also concerned about London editor Raheem Kassam having been involved with Glittering Steel LLC, a production company owned by the Mercers.

Press gallery rules bar reporters from being involved with any lobbying or paid advocacy for individuals, corporations, government entities or political organizations.

The committee also wants Breitbart to clarify its office situation in Washington. For years, the company has operated here out of the “Breitbart embassy,” a rowhouse on Capitol Hill owned by an Egyptian politician named Moustafa el-Gindy. USA Today reported last week that Breitbart is planning to move out of the embassy and into office space in downtown Washington; the embassy is not zoned to be an office.

Breitbart is being asked to clarify these issues to the committee by April 14, and the next committee meeting is scheduled for April 25. It has been given a two-month extension on its temporary congressional press pass, giving it until May 31.

Breitbart editor-in-chief Alex Marlow did not respond to a request for comment.

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The Ever-Deepening Mystery of Devin Nunes

The Ever-Deepening Mystery of Devin Nunes

The Atlantic Opinion

As House Intelligence Committee chairman, Representative Devin Nunes’s job is to oversee American spycraft. But Nunes’s own actions over the last few days suggest more the cloak-and-dagger actions of a would-be John Le Carré character than those of a sober government investigator.

Amid accusations from Democrats on the panel that Nunes is acting as a surrogate for the Trump administration, CNN revealed Monday that Nunes was seen on the White House grounds on Tuesday, the day before he announced he had new and important information about surveillance of Trump transition team figures by the intelligence community.

Nunes told CNN he was there “to confirm what I already knew” and that he needed a secure location to view intelligence information, and his spokesman gave a similar statement to NBC News. Nunes also said that no administration officials knew he was there. That claim, like many of Nunes’s statements so far, raises at least as many question as it answers.

CNN said Nunes had visited the National Security Council offices in the Eisenhower Executive Office Building adjacent to the White House, adding, “The official said Nunes arrived and left alone.”

Since Wednesday’s bombshell, the story has gotten only weirder. Nunes’s own claims, already difficult to pin down, have become only more enigmatic, while the focus has shifted to how exactly the California Republican obtained whatever documents he’s citing, and whether the White House was involved.

Nunes’s announcement was curious for several reasons, including the fact that by his own admission he did not yet have full information; his decision to take the partial information he possessed to the White House to brief President Trump, without informing other members of the committee first; and the fact that even as he railed against improper revealing of intelligence information, he was hastily releasing this.

The next few days saw an escalating war of words between Nunes and committee Democrats. On Thursday, Nunes apologized to Democrats for not informing them, but later said he had would have done things the same way again. That night he told Sean Hannity he had “a duty and obligation” to brief the president “because as you know he’s taking a lot of heat in the news media,” which is at odds with his supposed role as an independent investigator. On Friday, he precipitously canceled an open committee hearing scheduled for Tuesday, infuriating Democratic ranking member Adam Schiff, who called for an independent commission to look into the Trump administration’s ties to Russia, and said he thought Nunes was acting in response to pressure from the White House.

It’s the White House’s role, or lack thereof, that is now squarely in focus. The Daily Beast’s Tim Mak reported Friday evening that Nunes was in a car with a senior staffer on Tuesday when he suddenly hopped out and disappeared. Nunes staffers didn’t learn anything more before Nunes’s dramatic announcement on Wednesday. They had no idea what he planned to say until he said it. (He told reporters about his new information at the Capitol, then left for the White House, briefed the president, and then held a second presser there.)

Nunes is legally required to visit a secure facility to view classified information. The Washington Post reported Monday that “Congressional officials said that the director of National Intelligence, the FBI and National Security Agency had all indicated that they got no late-night visit from Nunes, a trip that probably would have been entered in security logs.”

CNN filled in some of the missing period: Nunes apparently got into an Uber and went to the White House complex.

But why did Nunes need to go to the White House to see the information? There are secure facilities at the Capitol. Nunes has refused to say whether his revelations came from White House officials, saying will not confirm or deny anything about his source. How does he know that no administration figures knew he was at the White House Tuesday? (Clearly, someone saw him and tipped off CNN. Who else did?) If Nunes entered and left alone, as CNN’s source said, who was there, if not an administration official? And if, as he told CNN, he was simply confirming what he already knew, where and when did he obtain that insight in the first place?

Even if Nunes’s reasons for viewing the information on the White House grounds are entirely innocent, they were politically foolhardy. With his late-night escapades and questionable explanation for his visit, he has fed speculation that he is working in concert with the White House and attempting to help the president. The groundwork for that idea had been laid by his hasty briefing for Trump, his comments to Hannity, and his confusing cancellation of the upcoming briefing, though, as the Post reports, Nunes has long been a close ally of the president’s and was on the transition team he now says was subject to surveillance. Although Nunes said the new information does not validate Trump’s accusation—offered with no evidence—that President Obama surveilled him, the administration has claimed it as vindication.

Some of Nunes’s allegations are already looking dubious. He has acknowledged that all of the information to which he has referred was legally collected, though he expressed concern that the names of Trump transition team members were not adequately redacted. But he has since said he cannot be sure that any transition team members were even directly caught up in surveillance, or whether they simply may have been mentioned.

Meanwhile, Nunes cannot or will not answer most of the questions about his information, citing classified-information rules. Like a spy-novel character in over his head, Nunes’s inability to answer pointed questions has placed him in an impossible situation.

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How Right-Wing Media Saved Obamacare

The Atlantic Opinion

As the Republican Party struggled and then failed to repeal and replace Obamacare, pulling a wildly unpopular bill from the House without even taking a vote, a flurry of insightful articles helped the public understand what exactly just happened. Robert Draper explained the roles that Stephen Bannon, Paul Ryan, and others played in deciding what agenda items President Trump would pursue in what order. Politico reported on how and why the House Freedom Caucus insisted that the health care bill repeal even relatively popular parts of Obamacare. Lest anyone pin blame for the GOP’s failure on that faction, Reihan Salam argued persuasively that responsibility rests with poor leadership by House Speaker Paul Ryan and a GOP coalition with “policy goals that simply can’t be achieved.”

But dogged, behind-the-scenes reporting and sharp analysis of fissures among policy elites do not capture another important contributor to last week’s failure—one Josh Barro came closest to unpacking in a column titled, “Republicans lied about healthcare for years, and they’re about to get the punishment they deserve.”

The article isn’t an attack on conservatives and libertarians.

Plenty of plausible alternatives to Obamacare have been set forth by people who are truthful about the tradeoffs involved. For instance, The Atlantic published a plan in 2009; Ezra Klein and Avik Roy usefully illuminated the disagreements between serious conservative and progressive health-care wonks; and Ross Douthat suggested reforms that borrow heavily from Singapore. Barro is aware of many smart right-leaning critiques of Obamacare and sympathetic to some.

What he points out in his column is that the GOP didn’t honestly acknowledge the hard tradeoffs inherent in health-care policy before making the case for a market-driven system.

Republicans tried to hide the fact of tradeoffs:

For years, Republicans promised lower premiums, lower deductibles, lower co-payments, lower taxes, lower government expenditure, more choice, the restoration of the $700 billion that President Barack Obama heartlessly cut out of Medicare because he hated old people, and (in the particular case of the Republican who recently became president) “insurance for everybody” that is “much less expensive and much better” than what they have today. They were lying. Over and over, Republicans lied to the American public about healthcare. It was impossible to do all of the things they were promising together, and they knew it.

That is basically correct. And it helps explain how Republicans could win a presidential election and lots of congressional elections on the promise of repealing and replacing Obamacare, only to produce bill so wildly unappealing to voters.

Once Republicans commenced governing, the tradeoffs couldn’t be elided any longer.

Still, even the insight that Republicans spent years willfully obscuring the tradeoffs involved in health-care policy doesn’t fully explain the last week. Focusing on GOP officials leaves out yet another important actor in this debacle: the right-wing media. By that, I do not mean every right-leaning writer or publication. Over the last eight years, lots of responsibly written critiques of Obamacare have been published in numerous publications, and folks reading the aforementioned wonks, or Peter Suderman at Reason, or Yuval Levin, or Megan McArdle at Bloomberg, stayed reasonably grounded in actual shortcomings of Obamacare.

In contrast, Fox News viewers who watched entertainers like Glenn Beck, talk-radio listeners who tuned into hosts like Rush Limbaugh, and consumers of web journalism who turned to sites like Breitbart weren’t merely misled about health-care tradeoffs.

They were told a bunch of crazy nonsense.

As I was drafting this article, Ted Koppel made headlines by telling Fox News entertainer Sean Hannity that he is bad for America. This upset some conservatives, who felt it was just another instance of the mainstream media attacking a fellow conservative. I don’t think that conservatives are typically bad for America. But I lament the fact that Hannity is still employed in my industry, in large part because his coverage of subjects like Obamacare is dishonest—and I say that as someone who has preferred a very different health-care policy since 2009.

Back then, my maternal grandmother was still alive, and I remember her listening to Hannity on Fox and getting very angry, upset, and afraid about what would happen next. I do not exaggerate when I say that the Obamacare debate lowered the quality of her last years. But not because she was so opposed to the actual tradeoffs that Obama and the Democrats were proposing that it made her anxious.

She was upset because Hannity said scary things like this:

So it sounds to me like they’re actually encouraging seniors in the end, “Well, you may just want to consider packing it all in here. This is—” What other way is there to describe this? So they don’t become a financial burden on the Obamacare system? I mean, that’s how they intend to cut costs, by cutting down on the amount of health care that we can give and get at the end of our lives and dramatically cutting it down for senior citizens? You know, welcome to the brave new world of Obamacare. We’re going to encourage, you know, inconvenient people to consider “alternatives to living.” Well, that just sounds terrific, which by the way is not uncommon and has been a source of deep concern in places like Great Britain. You know, the place where they have a government rationing body that denies women with advanced breast cancer their health care.

She mistook Hannity for a man with integrity, who would never go on national television or nationally syndicated radio and willfully or carelessly mislead millions.

That was a mistake. Had Hannity had been an outlier in this respect, perhaps people like me could have persuaded people like my grandma that whatever the demerits of Obamacare, the bill would not cause a bureaucrat to send Dr. Kevorkian to her bedside, or render her grandchildren servile subjects in a totalitarian dystopia.

Instead, Sarah Palin posted this to her Facebook page:

The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care.

Such a system is downright evil.

Chris Baker said this on Glenn Beck’s radio program:

Sir, you’re overweight. What? Yes, sir, you are overweight, we’re going to have to require you to lose weight. And if you don’t lose weight on your own, we’re going to send you to a fat camp and make you lose the weight. And if you still don’t lose the weight, then you know, we’re just going to have to do surg—we’re just going to have to put you in jail. And if you don’t lose the weight in jail, sir, I don’t know what else to do. Maybe some end-of-life counseling might be good. I mean, I remember a woman that got—that was greased by Dr. Kevorkian because she was fat.

Beck himself warned: “This is the end of prosperity in America forever if this bill passes. This is the end of America as you know it.”

Said Rush Limbaugh, “When this passes, they will have even more power, regulating every aspect of our lives, because they believe in their minds and hearts that we have no competence whatsoever to lead our own lives and make our own decisions.”

On another occasion Limbaugh added:

It’s not going to be a matter of whether you can or cannot pay. It won’t be a matter of whether you have coverage or don’t have coverage. What’ll matter is that all of us will be slaves; we’ll become slaves to the arbitrary and inhumane decisions of distant bureaucrats working in Washington where there’s no competition, nobody you can go to if you don’t like what you hear from the bureaucrats that you have to deal with.”

Said Jim Quinn:

Ladies and gentlemen, you have to understand that we are at a critical and pivotal moment in the history of the United States. If they pass health care, government health care, that is the end of the republic. That is the final nail in the coffin of the individual free human being. Once they own your body, they own everything. Once they can withhold health care from you, because you’re too old, because you’re too sick, or maybe ’cause they just don’t like you — did you ever think about that?

These aren’t just egregious, scare-mongering falsehoods that a few people uttered on a few occasions. They represent the tenor of coverage on right-wing TV and radio across scores of hours of broadcasting. This is the largely forgotten context that helps explain why my colleague David Frum could not have possibly succeeded in persuading elites on the right to work with Democrats to improve Obamacare (rather than guarantee that it would pass without any Republican input).

The coverage offered by right-wing media in those years also helps explain why elected Republicans never developed compelling arguments for why voters should prefer a different set of tradeoffs.

Right from the start, commentators who long ago traded their integrity for ratings spewed falsehoods so wild that anyone on the right could justify outright opposition to the legislation, without having to explain anything. “The Slaughterhouse Three, Obama, Pelosi and Reid, have authored the legislation that will make every American a POW, strip them of their Freedoms and Liberty and shove them in a meat cellar for cold storage,” a commentator at Breitbart declared in 2010. “So how is that Hope and Change working for you now?”

To take these people at their word was to assume merely repealing Obamacare would leave everyone better off. (Whose lot wouldn’t be improved by avoiding POW status?) Of course, Obamacare passed, and Americans were subject to neither cold storage nor death panels nor the end of individual freedom nor the abolition of all private insurance. Down syndrome kids were just fine. Millions gained coverage.

The right-wing entertainers never corrected bygone falsehoods or erroneous predictions when their fabricated catastrophes failed to unfold. They just shifted to new falsehoods. They are too numerous to detail, so let’s stick with a few more examples from Hannity. Here he is demagoguing a little girl’s lung transplant. Eric Stern re-reported a 2013 Hannity segment on specific Americans allegedly harmed by Obamacare to illustrate how egregiously the show misled viewers. The same year, Politifact explained why Hannity was wrong to make the outlandish claim that Obamacare would cause fully half of Americans to lose health insurance.

The point isn’t that Obamacare was without flaws, or that no one was pointing them out, but that many of the most-watched conservative entertainers were spreading wild falsehoods rather than cogently explaining the bill’s real costs and shortcomings. There were defensible reasons to oppose the law, but many who told pollsters they were against Obamacare had indefensible reasons, in that they were grounded in the wild falsehoods. What’s more, on a cable-news network that bills itself as “fair and balanced,” viewers were seldom given any information about Obamacare’s benefits or exposed to any stories of folks who were helped by it.

At more responsible right-leaning outlets, the right-wing audience still wouldn’t  encounter direct refutations of Hannity or Beck, because most right-leaning journalism outlets pull their punches when it comes to Fox News and its personalities. They want their writers to be invited on the network; journalists who write books want to publicize them there; and they certainly don’t want to anger their core readers by criticizing popular talk-radio hosts.

In the long run, mendacious right-wing health-care coverage had consequences. A significant faction of conservatives felt Obamacare was so dumb and malign that repeal alone would be a tremendous boon to all Americans, imposing significant costs on almost no one.

As Peter Suderman wrote:

Trump spent the last two weeks selling the House plan. He met with specific individuals and with various congressional factions opposed to the bill. He personally called the offices of more than 100 legislators. He has cajoled and threatened, telling those who refused to back the legislation that they would lose their seats. He threw the entire weight of his personality and the office of the president behind the vote, saying that he backed the bill “one-thousand percent.” But he never took the time to explain to either the public or congressional Republicans what the bill actually did.

He did not make a case for the bill’s policy merits, preferring instead to describe it using generic superlatives. Contrast that with President Obama, who traveled the country making the case for his health care overhaul, and made a major prime time address outlining its provisions. Trump, in contrast, was, by virtually all accounts, indifferent to the policy content of the bill so long as it passed and he could say that he had fulfilled his promise to repeal and replace Obamacare.

The Republican Party had previously benefited politically from its indifference to substance on health-care reform.

In the end, however, less than 20 percent of U.S. voters favored the passage of the Obamacare repeal bill, because even large swaths of the Republican base eventually discovered that, contrary to everything they’d been led to expect, repeal imposed huge tradeoffs!

There are many people bear responsibility for the GOP’s failure to improve upon Obamacare. But when apportioning blame, the right-wing media should not be forgotten.

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What it Means to Defund Planned Parenthood

The Atlantic Opinion

On March 6, House Republicans proposed legislation to repeal and replace the Affordable Care Act. It contained language that would defund Planned Parenthood—that is, end the provider’s reimbursements through Medicaid—for one year. The House abandoned that legislation on Friday. But this July, it’s possible that a small-scale version of that defunding will happen in Iowa, where Republicans are pushing for a repeal-and-replace of their own: They want to scrap the state’s family-planning program and redraft it to exclude Planned Parenthood from the list of eligible providers.

The argument for this in Iowa is the same as it was in Texas when the state passed similar legislation in 2013—and it’s the the same in most states where moves have been made to block the organization from funds: Lawmakers want to prevent state dollars from going to providers that facilitate abortions, and they say Planned Parenthood patients can instead receive family-planning care, like contraception and pelvic exams, at community-health clinics.

There are currently 12 Planned Parenthood clinics in Iowa, and the legislation stands to affect nearly 4,000 Planned Parenthood patients in the state who will have to go elsewhere for their family-planning needs. The question is: Can those patients get equal health-care elsewhere?

In Iowa, the answer—like the debate itself—is complicated. Some clinics simply aren’t capable of providing that care. The ones that can will require significant coordination and investment to serve these women. And despite their eagerness to defund Planned Parenthood, the lawmakers pushing the legislation seem to have made little effort to prepare for what would follow.

* * *

On February 2, Republicans in the Iowa Senate passed Senate File 2, a bill that would scrap the Iowa Family Planning Network waiver (IFPN) and replace it with a state family-planning program. The IFPN waiver currently allows people who don’t qualify for Medicaid to receive family-planning coverage, including contraception, pelvic exams, pap tests, and STD testing. The new state-run program would, according to Republicans, have the same requirements as the IFPN waiver, except funds wouldn’t go to any provider that performs or facilitates abortions. (No federal dollars are currently spent on abortions in keeping with the Hyde Amendment, but Republicans argue that funds actually free up money to be used for abortions.) The legislation is under deliberation in the House, but state Republicans have the votes—and Governor Terry Branstad is likely to sign it.

If it passes, beginning in July, patients receiving care under the IFPN waiver would no longer be able to get their family-planning services covered at Planned Parenthood and a handful of other providers in the state. According to the Iowa Legislative Services Agency, there were 12,219 people participating in the IFPN program in December 2016. Of those participants, 3,781 (30 percent) of them went to Planned Parenthood in 2016, for a total of 10,941 visits.

“This effort to block patients is really just a microcosm of what is happening at the federal level,” Planned Parenthood President Cecile Richards told me in a recent interview. “This is saying for many folks, you can no longer go to the health-care provider of your choice. At the federal level, it’s expanded, but it’s the exact same principle.”

Richards predicts that if legislation like this passes, it will trigger a statewide—and, eventually, a national—health-care disaster. “If women are denied the ability to go to Planned Parenthood, don’t think someone else is going to swoop in.” But that’s exactly what Iowa Republicans think will happen.

* * *

In recent months, Republicans have offered lists of alternative clinics where IFPN patients can receive family-planning care. An initial list released by Republicans included a dentist’s office, a school nurse, and a youth shelter. A more recent list, sent to me in February by Senate Majority Leader Bill Dix’s office, was more thorough: an Excel spreadsheet containing 47 federally qualified health centers and 170 rural health clinics. Many of the providers listed were duplicates, at least one clinic was permanently closed, and several told me they didn’t actually provide family-planning services. On the rural-clinic side, only a few would likely be used by patients as alternatives to Planned Parenthood, since most were at least an hour’s drive from the nearest Planned Parenthood clinic.

But several of the federally qualified health centers could feasibly serve as alternatives, so I called a few of them to ask if they could pick up those extra patients. The problem was, no one I spoke with could give me a definitive answer, because they were all very unclear about what the new state-run program would entail.

“We’ll respond, we just don’t have a clear plan or strategy in place other than trying to get clear information,” said Ron Kemp, the CEO of Community Health Centers of Southeast Iowa. The Planned Parenthood in Burlington, Iowa (population 26,000), serves 198 IFPN patients, and a nearby Planned Parenthood in Keokuk, Iowa (population 11,000), serves 96, according to figures from Planned Parenthood of the Heartland. Lawmakers had listed Kemp’s health centers as alternatives to those two Planned Parenthoods.

“We have some capacity,” he told me, cautiously. “We don’t know the funding volume, we don’t even know all the equipment, but we’re committed to do that.” Accepting an influx of new patients seeking pelvic and breast exams, as well as contraceptives like IUDs and implants, will require new equipment and an evaluation of provider capabilities and specialization, Kemp said. “We’ll figure out a way to adapt, and expand capacity if that’s what comes in the door… sometimes that takes longer than we would like it to.”

Ted Boesen, the CEO of the Iowa Primary Care Association, an non-profit organization comprised of clinics like Kemp’s across the state, was equally cautious: “They’re assuming we’re the alternative…but we’re waiting to see what kind of a scale it is.” Boesen said he can’t “buy in” until Republicans respond to his questions about the new state-run family-planning program. Kemp also characterized interactions with GOP lawmakers as “limited,” telling me, “If there had been more detailed discussions, we might be able to be more further along.”

That uncertainty is a key problem in the debate: Natoshia Askelson, an assistant professor in the College of Public Health at the University of Iowa, told me that providers are still in the dark about basic details on how program will be run, like what contraceptives will be provided or whether there will be enough providers for displaced patients. The new program is also supposed to be entirely state-funded, instead of relying mostly on federal funds, which the IFPN waiver currently does through a federal matching program.

Askelson is “very concerned” about that. “[Iowa is] not in a position right now where we can afford things the federal government would pick up the tab for otherwise.” She believes SF2 could very well be ruining a good thing.

***

Scrapping the IFPN waiver limits the choices of patients in two ways: First, it shortens the list of provider options. It tells patients they can no longer go to the local Planned Parenthood if they want their reproductive-health services to be covered. Boesen, the Iowa clinic spokesman, admitted that was one of his main concerns. “Those gals…for generations, that’s been a safe place for them to go,” he told me, “so everybody’s wondering how we can provide that.”

I asked state Senator Dennis Guth, a Republican representing Iowa’s 4th senate district and an SF2 proponent, if he sees that as a problem: If someone likes their doctor, shouldn’t they be able to keep her? Guth acknowledged that that might be an issue for some women, but in the end, his view was that visiting a general-health practice is more efficient.

“[You can] take care of your women’s-health needs and take care of your strep throat at the same time,” Guth told me. “It’s usually it’s better to do both of those at once, anyway.”

Askelson said that idea indicates “a general lack of understanding around women’s health and contraceptives.” In an ideal world, a single provider would be able to address all of a woman’s health-care needs, but there’s a reason people go to—and prefer—Planned Parenthood. “We’re talking about, for the most part, women of child bearing age [who] don’t need to be going to the doctor a lot,” Askelson said. “We’re talking about women going to a health-care provider for sexual and reproductive health. When you take that away, your average family practice doctor is just going to prescribe birth-control pills.”

The second way this bill could limit choice is by reducing access to long-acting contraception. The way government funding for family-planning services works is that providers front the money for contraception and exams, and then submit a request to the government for reimbursement. Rebecca Krietzer, an assistant professor of public policy at the University of North Carolina Chapel Hill, told me “It’s cheap to provide oral contraceptives and prophylactics,” but “it’s expensive to provide long-acting reversible contraceptives that we know to be the most effective.” That’s why IUDs and contraceptive implants (two kinds of long-acting reversible contraceptives) aren’t readily available at many general-health clinics, and staff isn’t always trained in inserting them. But Planned Parenthood is a big enough organization that they are able to front the money for those services, Krietzer said. And since their focus is on family-planning care, they usually have the staff and equipment on hand to provide those services quickly.

Calls to a few of the Iowa clinics listed as Planned Parenthood alternatives seemed to bear that out. Kemp’s Community Health Center in West Burlington doesn’t provide any form of contraception that has to be inserted, like implants or IUDs. The Keokuk clinic does, but their earliest opening for a contraception consultation—or a breast or pelvic exam—was in 11 days, while two nearby Planned Parenthood clinics both had same-day openings.

In Council Bluffs, the federally qualified All Care Health Center has one family-planning provider working only on Fridays. The local Planned Parenthood is open on Monday, Wednesday, and Friday. The earliest appointment at Eastern Iowa Health Center in Cedar Rapids was two weeks away, and at Siouxland Community Health Center in Sioux City, a new patient wanting an IUD might have to wait about a month. Both the Cedar Rapids and Sioux City Planned Parenthoods had same-day appointments for all of those services.

Would the Republicans’ new state-run program provide enough funding to enable clinics to have implants and IUDs at the ready? To hire enough women’s-health specialists? To provide same-day appointments? Clinics don’t know. Even if they will be able to provide all of those services, Askelson worries it won’t matter. If women aren’t already going to a general-health clinic for care in Council Bluffs, for example, are they going to start now?

“It’s hard enough to get people to use contraceptives every time,” Askelson said. “Now you change providers from someone they trust … I don’t know whether [clinics] will be seeing a lot of people.”

***

The Iowa Family Planning Network waiver was set up in February 2006 as a way to extend health services to low-income women who otherwise wouldn’t receive Medicaid coverage. In May 2016, the University of Iowa Public Policy Center conducted an evaluation and concluded that more than 80,000 women had accessed family-planning services through IFPN in those 10 years. There was a $345 million reduction in Medicaid costs for deliveries and births, and a net Medicaid savings of $265 million.

The abortion rate declined 23 percent in Iowa between 2011 and 2014, according to the Guttmacher Institute, something public-health experts attribute to wider access to publicly funded family-planning services. If access to those services becomes more limited, Askelson predicts that unintended pregnancy rates could increase, and with it, the number of abortions.

In 2011, the Texas state legislature reduced funding for family planning from $111 million to $38 million as part of an effort to defund Planned Parenthood. After the cuts, 82 clinics closed—two-thirds of which were not Planned Parenthood clinics. In 2013, the state prevented abortion providers from participating in the state’s family-planning program—just like what Iowa is trying to do now. After the cuts, nearly half of the organization’s clinics closed, and many patients were left without access to long-acting contraceptives.

A study published in the New England Journal of Medicine in February concluded that excluding Planned Parenthood from Texas’s family-planning program resulted in about 36 percent fewer requests for IUDs and implants, and the number of women who were regularly receiving contraceptive injections declined in counties where they could no longer go to Planned Parenthood. For the women relying on injectable contraceptives, the rate of childbirth covered by Medicaid increased by about 27 percent.

The study closed with a warning that the team’s findings indicate “the likely consequences of proposals to exclude Planned Parenthood affiliates from public funding in other states or at the national level.”

But at the national level, the House Republicans’ failed bill to repeal and replace the Affordable Care Act included a proposal to exclude Planned Parenthood from Medicaid reimbursements for one year. The much-awaited report from the Congressional Budget Office projected that a change like that would leave 15 percent of patients in low-income communities “without services that help women avert pregnancy.”

The CBO estimated that cutting Planned Parenthood would save $178 million under Medicaid, but that savings would be partially offset by “several thousand” more births—paid for under Medicaid.

***

Critics warn that excluding Planned Parenthood from state or federal funding—without ensuring that community-health clinics can serve as adequate alternatives in practicality—is a dangerous move. This is a “big deal for women,” Askelson said. “It concerns me that there’s a disregard for what the evidence says, that people aren’t crafting legislation based on data and evidence.”

It’s possible that Senate File 2 and similar legislation in Texas and other states, as well as the recent failed House Republican proposal, are all incremental moves leading to something much bigger.

One Iowa clinic representative told me he was concerned, above all, that SF2 would lead to the state barring Planned Parenthood from receiving Title X funds. That’s the federal-grant program enacted by President Richard Nixon in 1970 designed to help low-income Americans with family-planning coverage.  If that were to happen, he said he couldn’t fathom the impact it would have—and he didn’t think clinics would be able to pick up the slack.

Kreitzer suggests there is “not a small chance” that Americans might soon see proposals to cut or even abolish Title X. “It’s something that Republicans have floated around,” Kreitzer said. “And if that were to happen, that would affect millions of women.”

The continuing resolution to fund the federal government is set to expire on April 28, and the House Freedom Caucus, a congressional faction of strict fiscal conservatives, is expected to make defunding Planned Parenthood a non-negotiable condition in passing the bill.

In recent decades, contraception has “become intertwined ideologically with abortion,” Kreitzer said. “In this intermingling of contraception and abortion, women’s health care is really taking a hit.”

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The Legislators Working to Thwart the Will of Voters

The Legislators Working to Thwart the Will of Voters

The Atlantic Opinion

When Kris Steele joined the Oklahoma house of representatives in 2001, he noticed that whenever a matter of criminal justice came up, legislators felt it was necessary to appear “tough on crime.” As a result, the state kept enacting harsher sentences and making more crimes punishable by jail.

In 2016, after leaving government, he spearheaded two ballot measures to reverse that trend. Both passed. But 2017 has seen legislators in states around the countries moving to try to reverse ballot initiatives passed by voters in Novembers election, seeking to roll back minimum-wage increases, tax increases, and other matters. In other cases, legislators are seeking to make it harder to place such initiatives on the ballot in the first place. And so despite his victory at the polls, the fate of Steele’s two measures remains uncertain.

Steele is a self-described conservative Republican, but the longer he sat in the legislature, the more he questioned the logic of ever-more-aggressive laws. He noticed that even though the sentences got tougher and tougher, and incarceration rates in the Sooner State rose and rose, sitting at No. 2 in the nation, and jails got more and more overcrowded, the state wasn’t seeing markedly lower crime rates or safer neighborhoods. (Oklahoma was unusual in making simple drug and property offenses felonies punishable by jail time.) The taxpayer tab for imprisoning so many people kept growing, and ex-cons struggled to find gainful employment because of their records.

“I began to say, wait a minute, I’m not going to be part of this sort of paradigm that is based on shallow and often hollow rhetoric,” Steele recalls. “A lot of elected officials measure their political worth or value based on those kinds of policy decisions. The body tends to make decision in relation to corrections policy based on emotion, fear, and anecdote, rather than on data, research, and facts. When you base your policies on emotion and anecdotes and fear, you tend to have policies that may not produce the best outcomes.”

Meanwhile, Steele rose, eventually becoming speaker of the Oklahoma House. He helped shepherd through some laws intended to reform the system, but the legislature never funded them—in part, he thinks because of the “tough on crime” imperative. In 2013, Steele ran into term limits and left the legislature, but he remained interested in reform in his new job as executive director of a nonprofit called TEEM.

“We did some initial polling and we realized that there was a pretty significant disconnect between the people and our elected officials when it comes to corrections policy, and primarily when it comes to a desire to address issues of addiction and mental illness with treatment rather than with punishment,” Steele said. “The best way we felt to ultimately change the path that we have been on forever was to bypass the political gridlock.”

He set about assembling a coalition that ran from leftist groups that saw criminal-justice reform as a matter of social justice to religious ones that saw it as a vocation to conservative ones that saw it as simple fiscal common sense. They placed two measures on the ballot in 2016, one reclassifying some drug and property crimes as misdemeanors, and the second directing the savings from de-incarceration to rehabilitation programs. Voters approved, passing both by comfortable margins.

That might have been the end of the story. But some legislators had other ideas. When the legislative session began in Oklahoma City in February, several legislators introduced bills that would roll back the reforms.

“Am I surprised to see this kind of pushback? Unfortunately, no. Am I disheartened? Yes,” Steele told me. “I would hope that our elected officials would focus on protecting and implementing the will of the people rather than trying to undo or usurp the will of the voters.”

He blamed an ongoing perception gap between legislators who still feel the need to appear tough on crime, despite the November results. Still, Steele was unsparing in his verdict.

“It’s indefensible,” he said.

* * *

“This isn’t how democracy works,” said Justine Sarver, executive director of the Ballot Initiative Strategy Center, a nonprofit that works with progressive ballot campaigns. “You don’t get to pick and choose when you like a process and when you don’t.”

Sarver sees a trend of legislatures trying to restrict voters’ ability to make laws and amend state constitutions around the country. The popularity of initiatives has ebbed and flowed across the years, and the roles of defender and critic have been fluid. But there are a few factors that make the present moment especially ripe for such conflicts. First, Republicans dominate state legislatures around the country, thanks to favorable redistricting maps drawn after the 2010 Census, even in states with sizable Democratic-leaning voter bases that want more progressive policies. Second, while ballots sometimes function to deal with purely state-level concerns, policy fights are increasingly nationalized. Groups like BISC and the Fairness Project are working to coordinate state-level pushes around the country on liberal reforms like paid sick leave, minimum-wage hikes, or recreational marijuana. Their opponents are working at the national level too. In November, ProPublica and The New York Times reported on how major corporate lobbies, some convened under the auspices of the Koch brothers’ political network, have sought to push back on ballot measures.

In November, Mainers passed several contentious ballot measures. On one, they voted to legalize recreational marijuana for people older than 21. A second question asked voters to increase taxes on households making more than $200,000 annually to fund public education. Each of these passed by narrow margins. A third question sought to raise the minimum wage to $12 per hour by 2020, including specific language to raise the minimum wage for workers who receive tips, like waiters. That passed by an 11 percent margin.

Since then, lawmakers have taken up measures that would reverse or dampen ballot measures that passed in November. A law passed in January pushes back the timeline for some parts of marijuana legalization. Meanwhile, legislators are considering bills that would roll back part or all of the wage hikes. They’re cheered on by Governor Paul LePage, the Republican best known for racist claims and threats against lawmakers.

“The legislature doesn’t even have to enact it,” LePage said of the minimum-wage increase in December. “This is a recommendation to the legislature of what the people are feeling. You know, if you read the constitution, legislature can just ignore it, or they can modify, they can work with it.”

Unusually for LePage, this statement turns out to be basically true. An initiative that voters pass must be enacted, but the legislature can easily just pass another law that effectively erases it. It’s not hard to see why some opponents of these laws would oppose them; the Maine Restaurant Association, for example, has led the charge against the wage-increase for tipped workers, since it would force members to pay employees more.

Representative Stacy Guerin, a Republican from Glenburn, is sponsoring a bill that would reverse the higher minimum wage for tipped workers. Several Democrats have joined to co-sponsor the bill. Guerin’s family owns a restaurant-supply store, and she said she’s heard workers are actually making less now.

“We are already hearing reports of declining tips,” she said. “Servers are overhearing people saying, ‘Oh, they’re making minimum wage, you don’t have to tip them anymore.’ Nobody wants to make minimum wage,” but before the law, Guerin said, servers could make good money off tips.

Servers didn’t rally against the law ahead of the election, Guerin said, because they didn’t understand what the law would do, based on the short text on the ballot.

Working people are busy and they don’t have the time to investigate the backstory on these ballot initiatives that have been forced on Maine by an out-of-state lobby,” she said.

Guerin, like lawmakers around the country who challenge ballot measures, can claim political support for what she is doing, but the clearest gauge of voter sentiment is the election in November. Moving to reverse that is, depending on one’s view, either an act of political suicide or an act of selfless leadership.

“I think it does take some political courage, but I absolutely believe it is the right thing to do for Maine servers,” Guerin said. “I believe this referendum was brought by out-of-staters that did not really have the values of Maine … I think they played Maine, and not for the good of workers. I am working for the good of Maine.”

The backers of the ballot measures see this not as principled leadership, but blatant disregard for popular will.

“It really does call into question the whole direct democracy if the legislature doesn’t implement them as the voters intended,” said John Kozinski, who works in government relations at the Maine Education Association and helped run the campaign to increase taxes for school funding.

Guerin’s concern that ordinary citizens weren’t really able to disentangle what the November initiative did is a common critique of popular referenda. Critics say voters are not always well-prepared to adjudicate difficult issues, and may make decisions that, however well-intentioned, turn out poorly.

“Sometimes an idea on the face of it seems like a brilliant idea, when in fact most of us don’t have a professional staff at our disposal,” said Jennie Bowser, a freelance writer who was a longtime observer of ballot initiatives for the National Council of State Legislatures. “Most of us don’t have a bird’s eye view of the budget. How our idea might mesh with the related policies around it. Sometimes initiatives are just not as fully thought through as they should be.”

That doesn’t sit well with advocates of direct democracy. “I find that deeply patronizing and paternalistic,” said Jonathan Schleifer, executive director of the Fairness Project, which coordinated state-level ballot initiatives to raise the minimum wage in November, and is now pushing back against attempts to roll back the increases via courts and legislation. “I would argue that having worked on Capitol Hill that most legislators aren’t qualified to make these decision. If you can trust someone to chose who to vote for, then why aren’t they qualified to decide the particular issues that decide their lives?”

* * *

The quality of state legislatures around the country is, to understate things, mixed, and offering citizens the right to weigh in on key issues has a straightforward appeal. Yet the foundation of American governance is representative democracy, not direct democracy. Critics can find plenty of ballot measures that have had unintended consequences.

Some popularly supported measures end up being quickly struck down by courts as unconstitutional. Others don’t age well, like the spate of state bans on same-sex marriage passed in the mid-2000s, and later overturned by the U.S. Supreme Court; critics have argued for decades that civil rights cannot and must not be left to the whims of a voting majority.

The effects of a ballot measure are not always so immediately clear, or straightforwardly reversed. In California, the ballot is often cluttered with initiatives—17 of them in November 2016 alone—which has raised the familiar question of whether voters can possibly be expected to know the ins and outs of so many proposals. But set aside the process: What about the outcomes? The profusion of initiatives in California has handcuffed the state government, led to credit downgrades, and made the state by some measures “ungovernable.” (The Golden State’s credit rating has rebounded somewhat since its 2011 nadir.)

Colorado voters in 1992 amended the state constitution with a “Taxpayers Bill of Rights” (TABOR) that bars the state and local governments from raising taxes without voter approval and capped the amount the state could spend. The result was that even as the state’s economy boomed, spending on things like schools and infrastructure maintenance tumbled. Since TABOR was enacted, the state has moved to the left, and in 2005, frustrated voters approved a five-year suspension of some of TABOR’s caps. But despite the criticisms, TABOR remains in place.

Colorado’s situation is an extreme example, because TABOR is a constitutional amendment, which makes it especially difficult to reverse if voters have a change of heart. There are 24 states that give voters the right to put legislative issues to the ballot, but only 18 allow voters to pass constitutional changes.

The roots of the ballot-initiative process stretch back to the Progressive Era, when reformers sought a workaround to legislatures that were dominated by huge corporate interests. And advocates insist that despite their flaws, there remain cases where ballot initiatives are an essential tool.

“I’ve almost always lived in initiative states, and I have an absolute love-hate relationship with the process,” Bowser said. “It drives me crazy sometimes, but I wouldn’t want to live in a state that didn’t do it. There are some things the legislature just doesn’t want to do.”

It’s very hard to get legislators to pass measures, for example, that limit their own fundraising. In other cases, gerrymandered districts produce state legislatures that are to the left or—more likely in the current era of Republican dominance in state government—right of a state’s electorate. Such is the case in Washington state and Arizona, where voters passed minimum-wage increases by significant margins. In Washington, a GOP-led coalition controls the state senate and had shown no interest in passing an increase, but voters approved a hike to $13.50 per hour by 2020 and paid sick leave by a 15-point margin.

Unlike Washington, which is essentially a Democratic state despite a sizable Republican voter base, Arizona is a red state. Yet voters there approved a minimum-wage hike, to $12 by 2020, as well as paid sick leave and a cost-of-living adjustment, by an even wider margin that Washingtonians in November—nearly 17 points.

As in Maine, organizations representing businesses affected by the law were eager to stop it. But rather than fight the measure, which looked like a surefire winner at the polls, they tried to stop it after the fact in the courts, arguing that the proposition passed in November was unconstitutional because it would cost the state government money. The Arizona Supreme Court unanimously rejected the suit in a March 14 decision.

The battle over the wage increase may be settled—at least for now—but some legislators want to change the process to make it harder to place initiatives on the ballot and easier for the legislature to reverse voters’ decisions. This is a somewhat touchy subject in the Grand Canyon State. Ballot initiatives have been enshrined in Arizona’s constitution since statehood in 1912, and in 1998, voter passed a new constitutional amendment specifically designed to prevent legislative tampering with ballot measures passed by citizens.

There are five measures under consideration now; all of them have passed the state house and gone on to the state senate. Three of them would alter the 1998 “Voter Protection Act.” One would repeal the act altogether. The second would say that if voters overturned a law passed by the legislature, lawmakers could simply pass the law again, which is currently prohibited. Since they alter an existing constitutional amendment, both of these measures would have to be approved by voters in a ballot initiative to become law.

Another bill would require that the initiative language and any related pamphlets state that if passed, a proposition would be subject to the Voter Protection Act and difficult to overturn. The governor could sign this into law.

Other proposals would make it harder to get initiatives onto the ballot. One would change the formula for the number of signatures required for placement. Current law sets a minimum based on the total voter population, but the bill would set minimums in each legislative district. This would require voter approval, but another, which would prevent campaigners from paying workers to gather signatures, could become law with the governor’s signature.

Representative Michelle Ugenti-Rita, a Scottsdale Republican, is behind the first three proposals. She told me that while Proposition 206, the minimum-wage increase, is the hot issue at the moment, she has been trying to reform the process for years.

“This is not taking away the initiative process,” she said. “Half the states don’t have this process. They don’t even give this as an option. We are different in that regard, and we’re proud of that. That’s been something that’s been important to us.”

But Ugenti-Rita thinks that the Voter Protection Act takes an important safety valve and expands it into a massive breach. The 1998 amendment was passed in response to what she concedes was legislative overreach in reaction to a medical-marijuana initiative passed by voters, but said the unintended consequences have become a problem—as with initiatives overall.

“It’s been very difficult to manage our state priorities, budget priorities, when a decent amount of our statutes and our budget are voter-protected, or how I like to call it, legislatively restricted,” she said. “I don’t think that provides for good public policy, and [it] really hurts the voter.”

She said she just wants to bring Arizona’s ballot-initiative process closer more in line with those in most other states, which give legislators a little more leeway.

In Oklahoma, however, voters might be wishing they had some measure of voter protection.The state house passed a bill gutting the voter-approved criminal-justice reform in mid-March, and it’s been sent to the senate. Representative Scott Biggs, the bill’s sponsor, did not respond to a request for comment. (A separate tough-on-crime senate bill was withdrawn in February, and its sponsor has now been forced to resign after being charged with child prostitution.)

Steele said he was cautiously optimistic that the reforms would survive, and said he was sure that if they did, they’d soon come to feel like the new normal. They would also stand as a symbol of unity in a fractious age.

“I love the issue because it does transcend partisan politics,” Steele said. “It seems to be an issue that unites and gives us a chance to remember who we are at our best. When we work together we can solve problems.”

That may be true, but the debates in Oklahoma, Maine, and Arizona are a reminder that Democrat vs. Republican is not the only battle line in politics. Sometimes it’s voters vs. legislators.

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Trump Is Scaring Indian Americans Into Finding Their Political Voice

The Atlantic Opinion

Manik Suri is the archetypical overachiever from an Indian American family. The 34-year-old runs a start-up in Silicon Valley. He speaks four languages. He’s got two Ivy League degrees.

And yet, when the windows at an Indian restaurant near his house were shot out in late February, along with those of an Eritrean place nearby, he felt shaken. “We catered my wife’s sister’s wedding in that restaurant,” he said. “The whole conception of the Indian community as a model minority—we benefitted from that perception.” This is “the first time I’ve ever felt, ‘Wow, it doesn’t matter.’”

Many Indian Americans seem to be going through a period of disorientation during these first few months of the Trump administration. As more than one percent of the U.S. population, Indians are one of the country’s largest immigrant groups, and they’re also one of the most distinctive: They tend to be wealthier, more highly educated, and more geographically dispersed than other immigrants. While they do face discrimination, they’re often referred to as a “model minority,” as Suri noted: Middle- and upper-class Indians are more willing and able to assimilate to America’s majority culture because of their educational and economic status. The quickly growing minority has not always been that politically engaged, and their political identity isn’t necessarily connected to their ethnic or religious background: Mobilization around Indian or Hindu American identity is relatively rare compared to other minority groups, according to Sangay Mishra, a visiting assistant professor of political science at Drew University.

Especially with the recent violent attacks against a Sikh man in Washington, an Indian immigrant in South Carolina, and two Indian engineers in Kansas, Indian Americans have found themselves jolted out of this comfortable liminal space. For years, many middle- and upper-middle-class Indian Americans have largely escaped the kind of marginalization that other brown-skinned immigrants and religious minorities have faced.

While some Indian Americans are Muslim and Sikh, and were targeted as the subjects of hate crimes because of their religious identity after 9/11, others are Hindu, and are more likely to be caught in cases of “mistaken identity.” To take one example, the shooter in the recent Kansas attack apparently thought his two Indian American victims were Iranian. Now, Indian Americans’ sense of security is being shaken, which may give rise to a new political identity.

Despite the election-season hype about the Republican Hindu Coalition, which famously hosted a Bollywood-style Trump rally in October, only a small minority of Indian Americans voted for the president. New data from the National Asian American Survey shows that roughly 16 percent of this group chose Trump in November—the same share that voted for Romney in 2012. Among Hindus, 17 percent went for Trump—lower than other religious minority groups, including Jews and the unaffiliated. Indian Americans have been the most Democratic-leaning of any Asian American group, said Karthick Ramakrishnan, a professor in political science at the University of California, Riverside, who oversees the survey. “Discrimination plays a significant role in [their] political understanding.”

“There is definitely a greater sense of urgency. There is a greater sense of fear.”

In the same survey, roughly one-fifth of Indian Americans said they had been not hired for a job or denied a promotion for unfair reasons, or had been treated more poorly than others in a restaurant or store. Compared to answers from a similar survey in 2008, these results represented an uptick in perceptions of workplace discrimination. They were also gathered in December, right after the election. Especially following the shooting in Kansas last month, it’s likely that perceptions of other kinds of discrimination—including threats to personal safety—would be even higher. “For a few days, that was the leading news in television and newspapers and social media,” said Mishra. “There is definitely a greater sense of urgency. There is a greater sense of fear.”

Ro Khanna, a second-generation Indian American Congressman, said he’s gotten a few hundred calls, emails, and social-media messages from worried constituents—his Silicon Valley area is the only Asian American-majority district in the continental U.S., according to Mishra, and is home to many Indian immigrants. Like his constituents, Khanna said he feels a sense of urgency about discrimination toward ethnic minorities.

But Indian Americans’ worries about discrimination may also look different than those of other groups because of their distinctive identity. A majority of Indians currently living in the U.S. arrived after 2000, and they’re more likely than other immigrant group to have arrived recently. H1-B visas, which are given to foreigners in “specialty occupations” like tech, are also awarded to Indians more frequently than any other group. In early March, the Trump administration suspended expedited processing of these visas, inspiring angst from Silicon Valley to India itself, where families often receive cash from their immigrant relatives in the United States.

Because of their high levels of education and professional status, Indian Americans have often been able to assimilate into their broader communities. Khanna’s family offers a perfect example: When they moved into his childhood neighborhood in Pennsylvania in the 1980s, he said, his family faced some suspicion from neighbors. “The concern was: ‘What’s going to happen to the Christmas candles out on the streets?’” he said. “So my parents put out the Christmas candles, enthusiastically, and we had some of the best Christmas lights on the street.” This wasn’t a way of giving in: “That was in no way seen as not being proud of being Hindu,” he said. But “there was a respect for the kind of cultural traditions of the street and the country.”

Of course, blending in with America’s majority culture has always been more of an option for Indian Americans who are wealthy and educated. “For every engineer, doctor, and software professional in the community who most likely joins the middle or upper class, there are domestic workers, gas-station attendants, taxi drivers, and construction workers who negotiate the social and economic realities of the United States very differently,” wrote Mishra in his recent book, Desis Divided. Upper-class Indian Americans may not identify significantly with marginalized groups: As Suri put it, “connection to other Americans who have brown skin color … [has] not meant a lot to me personally.” Poorer Indians, on the other hand, are much more likely to identify across lines of religion and national origin, Mishra argues. For example: The California organization South Asian Histories for All explicitly identifies as interfaith and “inter-caste,” and South Asian Americans Leading Together, or SAALT, advocates on behalf of people who are poor or immigrants.

“It took a kind of boldness post 9/11 to be vocal. Now, I think you’re seeing everyday people getting more involved.”

Religious differences also make the Indian American experience distinctive. While there’s a lot of religious diversity among the group, which includes Muslims, Christians, Sikhs, Jains, and Parsis, most Indian Americans come from a Hindu background.

“There is one kind of approach within the Hindu American community which thinks that foregrounding Hindu identity or seeing themselves primarily as Hindu is the way to go” in the face of discrimination, said Mishra. “But there is an equally strong approach in the community that feels that they would not be safe.” That’s especially true now: Hindus increasingly “feel that they are also being targeted or seen as ‘the other,’ in many cases, as Muslims,” he said.

The Indian American community has a complicated relationship with Islam. The controlling political party in India, the BJP, promotes a strong national identity rooted in Hinduism and at times draws on anti-Muslim rhetoric. The party resonates with many Indians in America: Sunayana Dumala—the widow of Srinivas Kuchibhotla, the man who died in Kansas—posted a Facebook memorial for her husband praising India’s prime minister and the BJP’s leader, Narendra Modi.

Yet, Indian Americans have been widely unsympathetic toward Trump’s proposed immigration policies that would disproportionately affect Muslims. In a spring 2016 survey directed by Ramakrishnan, Indians were more likely than any other Asian group to say they wouldn’t vote for a political candidate with strongly anti-Muslim views. This hasn’t always translated into political action: Unlike Indian Sikhs, who have championed anti-discrimination campaigns in solidarity with Muslims, Hindus have not carved out a widespread activist identity as a group. Among some Indians, protesting and activism may also seem culturally alien: The head of a prominent university in India once told students they “should not get into politics,” an attitude that may be shared by some in the United States.

As Indian Americans experience increasing anxiety, this sense of political disengagement may shift. Their fear is certainly political: “It’s a hair-trigger thing” when violent attacks like the Olathe shootings happen in the U.S. now, said Devesh Kapur, the director of the Center for the Advanced Study of India at the University of Pennsylvania. “However heinous it is, every society has a suicide rate and a murder rate. The fact that this happened when Trump came in … poisoned the atmosphere.”

Now, said Ramakrishnan, Indian Americans of all backgrounds seem to be going through a political awakening. “It took a kind of boldness post 9/11 to be vocal,” he said. “Now, I think you’re seeing everyday people getting more involved.”

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