California’s Budget Proposal Would Expand Health Care To Some Undocumented Immigrants

California Gov. Gavin Newsom, pictured in January, must sign off on the latest state budget by June 15. The new $213 billion plan includes an expansion of the state’s Medicaid program for low-income adults under the age of 26, regardless of immigration status.

Rich Pedroncelli/AP


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Rich Pedroncelli/AP

California lawmakers are poised to offer low-income young adults living in the country illegally access to full health benefits, putting the state on track to become the first in the country to expand its insurance program to all working poor under the age of 26 regardless of immigration status.

The Democratic-controlled state legislature agreed on Sunday to allow 19 to 25-year-old undocumented residents to receive Medi-Cal, the state’s health insurance program partly funded by federal dollars.

Gov. Gavin Newsom applauded negotiation efforts by committee chairs Sen. Holly Mitchell and Assembly member Phil Ting in a statement, saying the budget — which includes a $21.5 billion surplus for the state — “is structurally balanced and invests in a California for All.”

State officials estimate the health care program would provide coverage for about 138,000 residents at a cost of $98 million in the first year. The vast majority — 75% — are already covered by the Medi-Cal system, and are either receiving restricted-scope benefits or services under SB 75, the Governor’s Budget Summary states.

Efforts by some Democrats to include undocumented seniors in the plan were rejected by Gov. Gavin Newsom and other legislators.

Cynthia Buiza, executive director of the California Immigrant Policy Center, called the move a “wise investment in legal representation for immigrants facing deportation in a cruel and callous system.”

But Buiza said lawmakers failed to achieve universal health care coverage, as they had pledged to do. “The exclusion of undocumented elders from the same health care their U.S. citizen neighbors are eligible for means beloved community members will suffer and die from treatable conditions.”

The agreement is part of a sweeping $213 billion budget plan that includes another national first: It would stretch eligibility for health insurance subsidies under Covered California to middle-class families earning up to 600% of the federal poverty level. That means a family of four can earn up to $154,500 per year and still qualify for a discount.

The programs would be partially funded by tax dollars collected from fines paid by Californians who forego health insurance coverage. It is similar to the federal penalty imposed by the Obama administration’s Affordable Care Act called the individual mandate, which was rolled back in 2017. Enrollment will begin in the fall and the plans will go into effect on Jan. 1.

Legislators cited a recent study favoring the expansion, saying that without state action “the uninsured rate will rise to 12.9 percent by 2023—a 24-percent increase from 2016.”

Republicans pushed back on the idea, arguing that Californians enrolled in the Medicaid program already face difficulties getting in to see a doctor, Capitol Public Radio’s Ben Adler told NPR.

“Reimbursement rates to doctors are so low that doctors aren’t willing to take Medicaid patients,” Adler said. Instead, Republicans lobbied for the governor to shore up the program as it exists now.

Immigrant children are already covered in California under Medi-Cal, as they are in six other states under their respective Medicaid programs, according to the Kaiser Family Foundation. California, the District of Columbia, Illinois, Massachusetts, New York, Oregon and Washington cover income-eligible children who are not otherwise eligible due to immigration status using state-only funds.

The full state Legislature is expected to vote and pass the budget later this week. California law sets a June 15 deadline to enact a budget, otherwise lawmakers face losing their pay.

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Opioid Crackdown Could Lead To More Drug Company Bankruptcies

Two years ago, the drug company Insys Therapeutics posted a quarter-billion dollars in annual sales. But the Arizona-based firm’s fortunes plummeted so far that on Monday its leaders declared bankruptcy. It was the latest fall-out from the nation’s prescription opioid epidemic, which has killed more than 200,000 Americans and triggered hundreds of lawsuits against Big Pharma.

Insys marketed an opioid pain medication called Subsys that included fentanyl. It generated tens of millions of dollar in annual sales. But like other prescription opioids marketed aggressively by the drug industry, it turned out to be highly addictive.

Many of the drug industry’s biggest companies are tangled up in a wave of opioid litigation, including name brand companies Johnson & Johnson and CVS. It’s unlikely large firms will follow Insys’ lead and seek Chapter 11 protection, but smaller firms including Purdue Pharma, the maker of OxyContin, have already floated the possibility.

Attorneys representing hundreds of communities that hoped to win compensation from Insys issued a statement Monday saying they’ll work to determine whether the company is actually insolvent. “We will actively pursue full financial disclosure for Insys and any other defendant that files for bankruptcy,” the plaintiff group said.

They added that their goal in targeting 21 other drug firms isn’t to put them out of business but to “abate the current opioid epidemic and seek long-term, sustainable solutions.” State and local officials hope to recoup some of the billions of dollars they’ve spent responding to the opioid crisis.

One major state opioid trial is underway now in Oklahoma against Johnson & Johnson, with a second consolidated trial against other firms set to begin in October in Ohio. Judge Dan Polster, who’s presiding over that federal case, has urged the parties to reach a settlement so communities receive some compensation without disrupting the pharmaceutical industry.

Sources tell NPR negotiations are underway but no deal has been reached.

In all, more than 1,800 state and local governments have filed opioid-related lawsuits. Penalties and settlements could run into the tens of billions of dollars, rivaling big tobacco payouts of the 1990s. The move by Insys came a week after the firm pleaded guilty to felony charges that it bribed doctors to prescribe its Subys fentanyl medication to patients who shouldn’t have been using it.

The company agreed to pay the federal government $225 million in penalties. Last month, company founder John Kapoor, once a towering figure in the drug-tech industry, was found guilty on federal racketeering charges along with four other Insys executives. The company still faced numerous other opioid-related lawsuits.

In his statement, Insys CEO Andrew Long, said in a statement those “legacy legal challenges” contributed to the firm’s decision to enter bankruptcy proceedings.

He said bankruptcy proceedings would allow the company to negotiate with creditors.

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Trump Administration Taps Hardliner Cuccinelli For Top Immigration Job

Ken Cuccinelli, seen here in 2016, was named on Monday as acting head of U.S. Citizenship and Immigration Services, which is charged with adjudicating requests for citizenship, green cards and visas.

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Molly Riley/AP

The Trump administration has named Ken Cuccinelli to serve as acting director of the agency in charge of legal immigration, raising concerns among immigrant rights advocates.

Cuccinelli has never worked at the agency that he’s now tasked with leading. U.S. Citizenship and Immigration Services, with more than 19,000 employees and contractors, is charged with adjudicating requests for citizenship, green cards and visas.

“Our nation has the most generous legal immigration system in the world and we must zealously safeguard its promise for those who lawfully come here,” Cuccinelli said in a written statement. “I look forward to working with the men and women of USCIS to ensure our legal immigration system operates effectively and efficiently while deterring fraud and protecting the American people.”

Cuccinelli is a frequent guest on cable news shows, where he’s known for taking hardline positions on asylum and other immigration issues. He served as attorney general of Virginia from 2010 to 2014, and ran unsuccessfully for governor of the state.

Immigration lawyers worry that Cuccinelli’s appointment signals more intense scrutiny and longer wait times for immigrants seeking citizenship, green cards and visas.

“Are they trying to break the system so that it doesn’t work?,” asked Ur Jaddou, a former chief counsel at USCIS who now directs the non-profit DHS Watch in Washington. “This is just another sign of what’s been happening over the last couple of years,” Jaddou said, as the backlog for immigration cases of all kinds has “exploded.”

Cuccinelli has advocated for denying citizenship to American-born children of parents living in the U.S. illegally. And he’s argued that states should invoke quote “war powers” to turn away what he calls an “invasion” of migrants from Central America seeking asylum in the U.S.

“You don’t have to keep ’em,” Cuccinelli said in an interview with Breitbart radio last year. “No catch and release, no nothing. You just point ’em back across the river, and let ’em swim for it.”

The Trump administration picked Cuccinelli to run USCIS despite opposition from Republicans in the Senate. Cuccinelli served as president of a conservative group that funded campaigns against Senate majority leader Mitch McConnell and others, and several Republican senators signaled they would oppose his nomination to lead the agency.

The White House has not formally nominated Cuccinelli to lead USCIS. Technically, his title will be “principal deputy director,” according to the agency.

Legal experts say that would allow Cuccinelli to serve as acting director under the Federal Vacancies Reform Act. But it would violate the spirit of the law, according to Anne Joseph O’Connell, an expert on administrative law at Stanford Law School.

“This does seem to be an end run,” said O’Connell. “Not just around the Senate confirmation process, where Senators have said they don’t want to confirm Mr. Cuccinelli. But it also seems like an end run around the Vacancies Act.”

Cuccinelli’s appointment means that there will be acting leaders at the helm of USCIS, U.S. Customs and Border Protection, U.S. Immigration and Customs Enforcement, and the Federal Emergency Management Agency, in addition to an acting Secretary of Homeland Security.

Cuccinelli’s predecessor at USCIS, former director L. Francis Cissna, had years of experience in immigration law, and was widely regarded as a policy wonk. Even some immigration hardliners wonder if Cuccinelli is ready for the job.

“Cuccinelli was an unusual choice, given his lack of immigration experience,” said Mark Krikorian, executive director of the Center for Immigration Studies, which favors lower levels of immigration. “But he does have law-enforcement and regulatory experience, so I’m cautiously optimistic, especially if he has White House backing in his interactions within his agency and with other agencies.”

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Vatican Issues Document During Pride Month Denying Gender Identity Is A Choice

A view of St. Peter’s Square during a Pentecost Mass celebrated by Pope Francis Sunday. A day later, the Vatican issued a document denying gender identity is a choice.

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The Vatican department charged with overseeing Catholic education released an extensive document Monday decrying what it calls a “crisis” on whether gender can be an individual choice rather than being set by God or biology.

The document describes a culture-wide “disorientation” that serves to “cancel out” the natural difference between man and woman, as well as “destabilise the family as an institution.”

The Congregation for Catholic Education says the goal of the 31-page guide is to “support those who work in the education of young people, so as to help them address in a methodical way (and in the light of the universal vocation to love of the human person) the most debated questions around human sexuality.”

The document entitled “Male and Female He Created Them” does not deviate from traditional Catholic teaching.

The timing of its release, however, during the heart of Pride Month, led some to wonder whether Vatican bureaucracy was making a point.

The text was dated Feb. 2, 2019, but was only made public more than four months later, around the time gay-rights supporters the world over gathered at rallies, parades and concerts honoring the LGBTQ community. The events are timed to coincide with the anniversary of the Stonewall Riots of 1969, widely considered to have launched the modern pride movement.

The document is co-signed by Cardinal Giuseppe Versaldi, the head of the education department, and Archbishop Angelo Vincenzo Zani, the secretary. Pope Francis did not sign it.

In the past, the pope has expressed sympathy for LGBTQ people, seeming to challenge Catholic teaching that men with “homosexual tendencies” are “objectively disordered.”

“If someone is gay and he searches for the Lord and has good will, who am I to judge?” Francis said in 2013. And later, he said the church should apologize to gays and other marginalized groups.

But that support has not extended to transgender individuals, whose gender identity does not match the sex they were identified as having at birth.

In the 2015 book This Economy Kills: Pope Francis on Capitalism and Social Justice, Francis is quoted comparing gender theory, which allows one’s identity to exist along a spectrum, to nuclear arms annihilation.

Breaking: Vatican document takes aim at “gender theory.” It rightly calls for “dialogue” and “listening,” but sets aside the real-life experiences of LGBT people. Sadly, it will be used as a cudgel against transgender people, and an excuse to argue that they shouldn’t even exist. https://t.co/UMAIKitD9w

— James Martin, SJ (@JamesMartinSJ) June 10, 2019

On Monday, the Rev. James Martin, a writer and Jesuit priest, tweeted that while the Vatican document rightly calls for listening and dialogue, it “sets aside the real-life experiences of LGBT people.”

“Sadly, it will be used as a cudgel against transgender people, and an excuse to argue that they shouldn’t even exist,” he wrote.

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A Musical Brain May Help Us Understand Language And Appreciate Tchaikovsky

An MRI scan of a person listening to music shows brain areas that respond. (This scan wasn’t part of the research comparing humans and monkeys.)



KUL BHATIA/Kul Bhatia/Science Source


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KUL BHATIA/Kul Bhatia/Science Source

What sounds like music to us may just be noise to a macaque monkey.

That’s because a monkey’s brain appears to lack critical circuits that are highly sensitive to a sound’s pitch, a team reported Monday in the journal Nature Neuroscience.

The finding suggests that humans may have developed brain areas that are sensitive to pitch and tone in order to process the sounds associated with speech and music.

“The macaque monkey doesn’t have the hardware,” says Bevil Conway, an investigator at the National Institutes of Health. “The question in my mind is, what are the monkeys hearing when they listen to Tchaikovsky’s Fifth Symphony?”

The study began with a bet between Conway and Sam Norman-Haignere, who was a graduate student at the time.

Norman-Haignere, who is now a postdoctoral researcher at Columbia University, was part of a team that found evidence that the human brain responds to a sound’s pitch.

“I was like, well if you see that and it’s a robust finding you see in humans, we’ll see it in monkeys,” Conway says.

But Norman-Haignere thought monkey brains might be different.

“Honestly, I wasn’t sure,” Norman-Haignere says. “I mean that’s usually a sign of a good experiment, you know, when you don’t know what the outcome is.”

So the two scientists and several colleagues used a special type of MRI to monitor the brains of six people and five macaque monkeys as they listened to a range of sounds through headphones.

Some of the sounds were more like music, where changes in pitch are obvious.

Other sounds were more like noise.

And Conway says it didn’t take long to realize he’d lost his bet.

“In humans you see this beautiful organization, pitch bias, and it’s clear as day,” Conway says. In monkeys, he says, “we see nothing.”

That surprised Conway because his own research had shown that the two species are nearly identical when it comes to processing visual information.

“When I look at something, I’m pretty sure that the monkey is seeing the same thing that I’m seeing,” he says. “But here in the auditory domain it seems fundamentally different.”

The study didn’t try to explain why sounds would be processed differently in a human brain. But one possibility involves our exposure to speech and music.

“Both speech and music are highly complex structured sounds,” Norman-Haignere says, “and it’s totally plausible that the brain has developed regions that are highly tuned to those structures.”

That tuning could be the result of “something in our genetic code that causes those regions to develop the way they are and to be located where they are,” Norman-Haignere says.

Or, he says, it could be that these brain regions develop as children listen to music and speech.

Regardless, subtle changes in pitch and tone seem to be critical when people want to convey emotion,” Conway says.

“You can know whether or not I’m angry or sad or questioning or confused, and you can get almost all of that meaning just from the tone,” he says.

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