5 Americans Talk About How A Health Law Overhaul Would Affect Them

Charlene Yurgaitis gets health insurance through Medicaid in Pennsylvania. It covers the counseling and medication she and her doctors say she needs to recover from her opioid addiction.

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As the nation has debated the GOP proposals to repeal and replace the Affordable Care Act, NPR member station reporters have been talking to people around the country about how the proposed changes in the health law would affect them.

Here are five of those stories:

A young man with Parkinson’s Disease. Ford Inbody is already thinking about a time when he won’t be able to work. He is 33 and was diagnosed with early-onset Parkinson’s disease. While many of his Millennial friends are starting families, he and his wife have decided not to have children, and they’re carefully planning for the future where he will have to give up his job. Changes that make it harder to afford coverage for pre-existing conditions could affect him drastically. He’s hoping he would be able to buy insurance on the exchange once he’s no longer covered through work, and that eventually Medicaid would be there for him if and when the disease leaves him disabled. —- Reporting by Alex Smith, KCUR, Kansas City, Mo.

A farmer hopes stay insured until he’s old enough for Medicare. Darvin Bentlage says his health insurance plan used to be the same as all the other cattle farmers in Barton County, Mo.: Stay healthy until he turned 65, then get on Medicare. But when he turned 50, things did not go according to plan. He had some health problems, had to refinance his farm to pay those medical bills, and then went without insurance for a while. He says he signed up for insurance on the exchanges established under the Affordable Care Act as soon as he could. If he loses subsidies or gets charged more for his pre-existing conditions, “I just have to go back to plan A and hope I make it to 65,” he chuckles. — Reporting by Bram Sable-Smith, KBIA, Columbia, Mo.

A Man With Down’s Syndrome Gets By With A Little Help From Medicaid. Evan Nodvinhas a job at a fitness center, lives in an apartment and feels so passionately about keeping his independence, he went to Washington to lobby when he heard about potential cuts to Medicaid under GOP health care plans. “My life is very full,” he said. “I work, live and play in the community. My dream is to continue this healthy and useful life.” A few decades ago, states closed many institutions that took care of people with disabilities in hopes of that they would be integrated into the community. Many can, but with some support. Medicaid is often that support, with the majority of money going to help people with disabilities. — Reporting by Elly Yu, WABE, Atlanta.

A young woman breaking her addiction to opioids.Charlene Yurgaitis, 35, decided after a decade of using opioids, she was ready to tackle her addiction. And she is doing it full-on, with medication-assisted treatment combined with counseling. Medicaid is her insurance, for which she became eligible when Pennsylvania expanded the insurance program under the Affordable Care Act. “I would never be able to afford counseling,” she says. “I would never be able to afford psych meds. I would never be able to afford the Vivitrol shot.” She says she’d say to lawmakers who want to curtail federal spending on Medicaid, “Why are you trying to change something that’s working?” — Reporting by Ben Allen, WITF, Harrisburg, Pa.

A self-employed veteran in California. Air Force veteran Billy Ramos is a contractor in the heating and air conditioning business who is grateful to have Medicaid. He signed up when California expanded the health insurance program for low-income people under the ACA. About 1 in 10 veterans gets help from Medicaid; only about half of the 22 million veterans in the U.S. get care from the VA system. Ramos gets treatment for his hepatitis and feels relieved knowing he has emergency care if something goes awry on the job. —Reporting by Stephane O’Neill, freelance.

These stories are part of a reporting partnership with NPR, local member stations and Kaiser Health News.

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'Imminent' Dam Failure Threatens Thousands In Puerto Rico

A man wades on the water while pushing his bicycle through a flooded street in the aftermath of Hurricane Maria in Catano, Puerto Rico, Friday.

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Officials continued to urge tens of thousands of people living downstream from a precarious, slowly failing dam in northwestern Puerto Rico to evacuate Saturday. But the U.S. territory’s severely compromised communications infrastructure meant it was not immediately clear how successful the warnings would be.

The National Weather Service said in an alert Saturday that “dam operators continued to report the threat of a failure of the Guajataca Dam, potentially causing life-threatening flash flooding downstream.”

Aerial footage of the dam, inundated by days of heavy rain from Hurricane Maria’s passage over the island of Puerto Rico, revealed a torrential flow of water to the river below.

Dam fails in Puerto Rico, 70,000 told to evacuate #HurricaneMaria#guajatacadampic.twitter.com/s4t09qF0ra

— AFP news agency (@AFP) September 23, 2017

The National Weather Service Friday called the dam’s break “imminent,” and announced buses were evacuating locals and implored anyone in the area to get out of the “extremely dangerous situation.”

All Areas surrounding the Guajataca River should evacuate NOW. Their lives are in DANGER! Please SHARE! #prwx

— NWS San Juan (@NWSSanJuan) September 22, 2017

On Friday officials estimated 70,000 people living near the Guajataca dam, including in the towns of Quebradillas and Isabela, had been ordered to leave their homes, according to The Associated Press.

Anthony Reynes, a meteorologist with the National Weather Service in Miami, told NPR on Saturday that their evacuation goals had been scaled back considerably. Authorities were now, he said, focused just on reaching the 300 to 500 people along the banks of the river downstream.

Still, getting out the evacuation message was extremely difficult.

That’s because Hurricane Maria’s demolished the country’s power system, which the governor warned could take months to repair, and ruined telecommunications systems.

On Thursday the FCC estimated more than 95 percent of Puerto Rico’s cellular telephone sites were out of service. The commission added in its report that “large percentages of consumers are without either cable services or wireline services.”

“Basically there’s no cell communication. There’s no online communication,” Reynes said, describing the region near the Guajataca dam.

Calls were reportedly more difficult outside the U.S. territory’s capital, including municipalities like those threatened by the collapsing dam.

As the AP reports, the 345-yard, roughly 90-year-old Guajataca dam developed a crack during the storm, which engineers believe could be an indicator of an eventual complete failure.

Maria made landfall on the eastern coast of Puerto Rico early Wednesday as a Category 4 hurricane — the first since 1932 — with sustained winds of 155 mph. From there, it tore across the U.S. territory, downing buildings and power lines and drenching many spots on the island with about 20 inches of rain. One area near San Juan received 37.9 inches, as NPR’s Amity Kelly reported.

Michael Fernandez, the executive director of CARAS, a Puerto Rico-based nonprofit assisting in the recovery, told NPR’s Weekend Edition Saturday that the failing dam worried him, and he’s received no information from that region of the island.

He said that while he was encouraged by the work of the National Guard and the Army, the recovery ahead seemed daunting.

“This is a completely new life we have to start living,” he said.

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On The Eve Of A National Election, Germans Continue To Grapple With Identity

A political ad for the right-wing party Alternative für Deutschland (Alternative for Germany) reads: “New Germans? We can make them ourselves.”

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It is almost impossible to walk the streets of Berlin without running into history. It’s everywhere — the physical markers of conquest, division, horror, and reckoning. I was struck by it when I first came here in 2005 as NPR’s Berlin correspondent and I am no less moved by it today.

Since the Berlin Wall fell in 1989, Germans have been grappling with their collective identity. There is the cultural division between those who hail from what was West Germany versus those who lived life under Soviet communism in the East. But it’s the horrors perpetrated by Germany during WWII that have made German identity so complicated.

I remember being in Germany for the World Cup the summer of 2006 and what happened here was amazing. Something new was unleashed. There were German flags everywhere. Germans sang their national anthem before games. Fans walked around with the German national team jersey and German flags painted on their faces. Yes, it was about soccer and fandom, but it was bigger than that. It was the really the first time in post-war history that Germans displayed a sense of national pride, of patriotism, which until then had been basically off limits. There was too much shame associated with German history.

Fast forward more than a decade and the right wing party, the AfD or Alternative für Deutschland (Alternative for Germany) is trying to leverage the notion that Germans have paid the price for their past sins and it’s time to be proud of being German again. Time to be proud of their heritage. Time to “put German interests first,” as one AfD official put it to me.

Angela Merkel and her Christian Democratic Union party are expected to win a fourth term in Sunday’s elections. As Europe has become increasingly unstable — the global recession, the Brexit vote, the increased threat of terrorism — Merkel has been seen as the steady hand. And Germans like stability. But the refugee crisis of 2015 caused a political storm here. Merkel was heavily criticized by some for opening up the country’s borders and taking in more than a million refugees in two years. The AfD has capitalized on the immigration issue and it dovetails with the party’s nationalist bent. The basic message is — elect us and we will make sure immigrants, particularly Muslim immigrants stop pouring into Germany.

I spoke with the Berlin head of the AfD, Georg Pazderski, and he told me that refugees have put too much of a strain on the German economy. He says there aren’t enough resources to support them. And he says, too much immigration is a security risk.

“We want to know who is in our country, who is coming to our country and we want to do it like Australia or New Zealand, the U.S. or Canada,” Pazderski says. “We want to decide in advance who can come to our country and not afterwards.”

Pazderski also says there’s a deleterious effect on the culture. “Islam doesn’t belong to Germany because it’s not a part of history of German history,” he says. “But what we can see is that Islam is trying to get more and more influence in Germany…We have women running around in burqas and so on. So in certain areas of Germany, the picture of the cities is changing dramatically.”

He says that immigrants from Muslim countries don’t prioritize education. “They don’t go into the school. They are not successful,” Pazderski says. “They don’t learn German in the right way so that they can later be successful in professional life. This is a huge problem and we have this problem since 20, 30 years. There is no real integration in Germany.”

Mohammed Eh’tai may prove otherwise. I met Mohammed in 2015 when I was here covering the refugee crisis. He had been in Germany for just a few months back then and most of our conversation was about how he was determined to learn German and build a life for himself and his family. His family, who at the time was still in Syria.

I got a chance to meet Mohammed again this week. His wife Rawah and his daughter Rimas are with him now. They got their visas in early April and arrived in Berlin a few weeks after that. The three of them are living in an apartment in a Berlin suburb. He works at a grocery store full-time and just passed his citizenship test. Rawah is now studying to do the same thing and they are teaching their 4-year-old daughter German. They want to stay in Germany. They want their daughter to build her life here. But Mohammed knows she will face her own challenges.

Mohammed Eh’tai fled Syria a couple of years ago at the height of the migrant crisis. He’s now reunited with his wife Rawah and their daughter Rimas. Standing in front of their new apartment complex, the doll is one of the only items from their old life in Syria.

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“She will have to make up her own mind on things,” he says. “Maybe she will decide to cover her head maybe she won’t. Whatever she wants. She can be German but she will stay Syrian. She has this side and she must not lose it. [She] will be German but she will never forget where she comes from.”

Mohammed goes on to tell me that being German shouldn’t have to mean giving up his faith or his culture saying, “If I believe in God and I come to Germany and then say, ‘There is no God,’ how can I respect myself? How can my daughter respect me?”

Mohammed and his family represent yet another layer of German identity. Can it be more than a passport? Can it transcend a dark history? Can Germany be a multi-cultural society? Does it even want that? It was hard enough to integrate the East with the West after the wall came down. How will this country attempt to integrate more the a million foreigners with many more still trying to get here?

Voters will go to the polls tomorrow and most likely re-elect the same woman who has led them for the past 12 years. The question of German identity, however, will remain at the center of political debate here if the AfD gets into parliament and their message gets a much bigger platform.

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'Screaming Eagle Of Soul' Charles Bradley Dies At 68

Charles Bradley performing on July 16, 2017 in Louisville, Kentucky. Bradley passed away on Sept. 23, 2017 at the age of 68.

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Charles Bradley, the “Screaming Eagle of Soul,” whose late-blossoming career was built on fiery performances that evoked his idol, James Brown, died in Brooklyn on Saturday, Sept. 23, according to a statement by his publicist. In 2016, Bradley was diagnosed with stomach cancer, which spread to his liver. He was 68 yeas old.

Bradley, known for a powerful and pained rasp that he used to channel both his demons and deep gratitude, released his debut album No Time For Dreaming, at 62. Bradley, who openly shared his idolization of the legendary James Brown after first seeing Brown perform in 1962, became a totemic artist for the Daptone label, best known for its revivalist ’60s soul.

“Charles was truly grateful for all the love he’s received from his fans and we hope his message of love is remembered and carried on,” a statement from Daptone read. “Thank you for your thoughts and prayers during this difficult time.”

Born in Gainesville, Fla., Bradley grew up in Brooklyn but left home at the age of 14. “If I’m not wanted, I’m gone. And I left,” he said in a 2013 interview. He spent much of his life itinerant, performing at one point in Maine — where his band was disbanded due to the Vietnam draft, as he told the Chicago Tribunein 2011. From there he headed west, working odd jobs and seeking out chances to sing. In his 40s, he moved back to Brooklyn and began performing as James Brown impersonator under the name Black Velvet before being scouted by Gabriel Roth, a Daptone co-founder and recording engineer, though he continued to perform under the pseudonym while developing a career under his given name.

After the release of his debut album, Bradley began touring extensively, invariably closing his shows by descending the stage and thanking his audience, extending hugs to all.

“Charles was somehow one of the meekest and strongest people I’ve ever known. His pain was a cry for universal love and humanity. His soulful moans and screams will echo forever on records and in the ears and hearts of those who were fortunate enough to share time with him,” Gabriel Roth writes in a statement. “I find some solace knowing that he will continue to inspire love and music in this world for generations to come. I told him as much a few days ago. He smiled and told me, ‘I tried.’ It was probably the simplest and most inspiring thing he ever told me. I think he wanted to hug each person on this planet individually. I mean that literally, and anyone that ever saw him knows that he honestly tried.”

Bradley, at a listening party for his 2016 record Changes, told this reporter — in a conversation often punctuated by Bradley holding up a finger, smiling and singing along to his new record — he’d helped construct the studio in which he’d later record. The studio, within a nondescript house in Bushwick, Brooklyn that doubled as the Daptone office, was the same used for Amy Winehouse’s Back In Black.

Bradley and his mother reconciled after his move back to Brooklyn in the early ’90s — but his dedication to the his new life was abiding. The night she died, Bradley went forward with a sold-out show at Brooklyn’s Music Hall of Williamsburg in 2014.

“I’m gonna say it’s all right to dream, but work at it — make it come to reality,” Bradley told NPR around the time No Time For Dreaming was released. “It took 62 years for somebody to find me, but I thank God. Some people never get found.”

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Earthquake In North Korea Sets Off Alarm And Speculation

People watch a TV news program reporting North Korea’s earthquake, at Seoul Railway Station in Seoul, South Korea, Saturday, Sept. 23, 2017.

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Numerous scientific agencies on both sides of the Pacific detected an earthquake Saturday near the site where North Korea set off a hydrogen bomb earlier this month, at first prompting speculation of another weapons test, before a consensus appeared to emerge that the tremor was a natural occurrence.

Xinhau, China’s official news agency, said the country’s seismic service registered a 3.4 magnitude event that it originally viewed as “likely caused” by an “explosion.” Later, China’s Earthquake Administration revised its estimation, saying the quake was not a nuclear detonation, according to Reuters.

#CENC, China’s seismic service, says the quake is likely caused by explosion and happens in the same location where last H-bomb detonated https://t.co/CaKaRj0qIY

— China Xinhua News (@XHNews) September 23, 2017

South Korea’s presidential office said in a statement that a handful of its government agencies “still maintain [the quake] was natural and not from an explosion.” The president’s office did add that “analysis is still ongoing so we will keep you posted.”

The Comprehensive Nuclear-Test-Ban Treaty Organization, through its Executive Secretary, tweeted Saturday that the activity was “unlikely man-made.”

Two #Seismic Events! 0829UTC & much smaller @ 0443UTC unlikely Man-made! Similar to “collapse” event 8.5 mins after DPRK6! Analysis ongoing pic.twitter.com/DXaDn8TZOf

— Lassina Zerbo (@SinaZerbo) September 23, 2017

The United States Geological Survey was neutral in its assessment on the cause of the tremor, which it recorded as a 3.5 magnitude quake, saying in a statement that it could not “conclusively confirm at this time the nature (natural or human-made) of the event.”

For reference, the U.S. agency recorded a 6.3 magnitude quake following North Korea’s hydrogen bomb test on September 3, its sixth of a nuclear weapon.

Saturday’s seismic activity came on the same day China announced it would limit trade with the North, reducing its fuel exports to its neighbor and banning all textile imports. On Thursday, the U.S. unveiled its own set of economic sanctions targeting North Korea.

The quake also caps a week in which President Trump and North Korea’s leader Kim Jong Un exchanged increasing bellicose insults toward each other and follows a threat on Thursday by the North to carry out a significantly more dangerous nuclear test.

In comments to reporters in New York, North Korea’s foreign minister said his country’s leader is considering whether to demonstrate his ability to detonate a nuclear warhead aboard a missile sent above the Pacific Ocean.

So-called atmospheric tests of nuclear weapons were banned by the U.S., the then-Soviet Union and many of the world’s nations in a 1963 treaty, though China conducted the last such test known worldwide in 1980.

Atmospheric tests of nuclear-armed missiles, as NPR’s Geoff Brumfiel reported, are dangerous for a hosts for reasons, including the potential for sending nuclear fallout in unpredictable patterns, and possibly, if a test were to be administered by North Korea, in the direction of the U.S.

Until now, the North has not tested its missiles and nuclear weapons together, opting instead to fire them separately — the missiles above ground and the nuclear weapons below.

After a week in which, by way of tweets and a speech before the United Nations General Assembly, President Trump introduced the derogatory nickname “rocket man” for Kim Jong Un into international news coverage and left open his prerogative to “totally destroy” North Korea, the president gave no ground on Friday in his public standoff with his adversary’s leader.

During a campaign rally for Ala. Sen. Luther Strange Friday night, Trump lashed out against Kim, telling the crowd, “we can’t have mad men out there shooting rockets all over the place.”

“Rocket man should have been handled a long time ago,” he continued amid cheers from the audience. “He should have been handled a long time ago by Clinton — I won’t mention the Republicans, right — by Obama.”

The president assured those in attendance, without details, that he would defend the U.S. against any offensives launched by North Korea: “I can tell you one thing, you are protected, OK? You are protected. Nobody’s going to mess with our people.”

A day earlier, Kim reacted to Trump’s provocative speech at the U.N. by equating the U.S. president to “a frightened dog” and a “mentally deranged U.S. dotard,” employing an obscure insult for someone declining into senility.

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Mother And Daughter Who Opposed Bashar Assad Regime Brutally Killed In Turkey

The caskets of Orouba and Halla Barakat, the mother and daugher who were brutally murdered in Istanbul, Turkey.

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A brutal murder of two opponents of President Bashar Assad’s regime has left their family and wider relocated Syrian opposition community reeling in shock, and fearing for their lives.

Police discovered the bodies of Orouba Barakat, 60, and her daughter, Halla, 23, who is a U.S. citizen, in their Istanbul apartment, reportedly after friends and colleagues raised the alarm when they were unable to reach them for several days.

Orouba was a member of the Syrian National Coalition, the political opposition group that has participated in internationally brokered peace talks to bring an end to the Syrian war.

Her daughter, Hala, who spent her childhood in Raleigh, N.C., was a journalist who worked with opposition station Orient TV.

Even on her private Facebook page, the younger Barakat documented the unadulterated violence taking place in her country, with posts about children killed in airstrikes, and photos showing the victims of mass killings.

Turkish media outlets, citing police sources, reported the women had been repeatedly stabbed. There were also other, unconfirmed, reports that their throats had been slit.

The funeral procession for the mother and daughter Orouba and Halla Barakat who were murdered in Turkey. Halla is a U.S. citizen.

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Politically motivated killing

A police investigation is underway, and there are not yet any official statements regarding the circumstances of their deaths, or who the perpetrators might be.

But as the news spread, relatives and opposition activists immediately characterized this as a politically motivated killing.

Shaza Barakat, Orouba’s sister, said she suspected the Syrian government was to blame.

“Because Hafez al-Assad had been displacing us since the 1970s,” she told NPR, referring to the former Syrian president, and father to Bashar al-Assad. “We paid a high price – displacement, torture, suffering – we don’t have a country.”

“Orouba was always standing against all that, defending people’s rights and demanding justice. We are people, we have human rights and we deserve justice.”

In an earlier post on Facebook mourning her sister, Shaza wrote “the oppressor chases the good everywhere.”

Ghassan Aboud, the founder of Orient TV, where Halla worked, wrote in a post on Facebook: “No truce and no reconciliation with the monsters.”

Fear of retribution spreading

Thousands of Syrians have been tortured or killed in jails in Syria on account of opposing the country’s regime. In the course of the Syrian war, many opponents fled to Turkey and other neighboring countries, and sought to organize a political opposition that could force the Assad family from power.

But with the Syrian government, backed by Iran and Russia, now gaining the upper hand in the country’s civil war, fear of retribution is spreading among this community.

That’s why so many reacted to these killings by blaming the Syrian government, explained Rami Jarrah, a Syrian journalist who supports the opposition.

Shaza Barakat (seated in center on bench), sister of Orouba Barakat, who along with her daughter Halla were murdered in Turkey.

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“It’s too early a stage to determine whether the regime have begun a targeting campaign against Syrians dissidents abroad,” he said. “But the fact that so many activists believe it was the regime, is a sign of the genuine fear in this community now.”

The Committee to Protect Journalists cited a local journalist – who they said they would not name for the person’s safety – who said the Barakats had received death threats on social media and in emails from supporters of the Syrian government, but that they had not paid them much attention.

The CPJ has documented four other incidents of Syrian journalists being targeted in Turkey since 2015. In all these cases ISIS has claimed responsibility.

The Barakat women had been close friends of Kayla Mueller, the American aid worker who was kidnapped by ISIS in 2013, and who died whilst still being held hostage 18 months later.

How many more?

Carl and Marsha Mueller, Kayla’s parents said in a statement to ABC news that “Orouba and Halla were like a mother and sister to Kayla”. They said they had started a charity together to help Syrian refugee women find work.

The shock of their murders reached the United States, where the Barakat family has already suffered much.

Deah Barakat and his wife and sister – three members of the Orouba and Halla’s extended family – were shot dead in their home Chapel Hill, N.C. in 2015.

Their neighbor was indicted by a grand jury, and authorities suggested during a preliminary investigation the killings were not related to their politics or religion.

“How many more beloved family members will I lose to hatred and violence?” Suzanne Barakat, a relative in North Carolina wrote on Facebook. “We are not safe anywhere.”

NPR’s Peter Kenyon contributed to this report.

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