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Column: Antiabortion agitators are trying to cripple a lifesaving federal healthcare law

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Column: Antiabortion agitators are trying to cripple a lifesaving federal healthcare law

Here’s how the legal departments of two hospitals, legislators in two states and even the Supreme Court turned a pregnancy emergency for Mylissa Farmer into a life-threatening nightmare.

Farmer, 41, was 18 weeks into her pregnancy when her water broke prematurely. Her doctor instructed her to go to her local hospital in Joplin, Mo.

There, the hospital’s labor and delivery doctors determined that she had no amniotic fluid left. Her baby had “‘zero’ chance of survival” and she risked infection, blood loss and even death. The doctors advised her that they could help her undergo an “inevitable miscarriage,” or she could wait, at risk to her life.

Obstetricians in Idaho live in constant fear…. Idaho’s doctors have been warned that they are being tracked and scrutinized and they should fear prosecution for providing an abortion under any circumstances — even when medically necessary.

— Idaho Coalition for Safe Healthcare

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She chose the former, and then the hospital’s legal department stepped in. Although Missouri’s antiabortion law has exceptions when continuing a pregnancy might cause the mother’s death or “irreversible physical impairment,” the lawyers determined she was not quite there yet.

The doctors advised Farmer to go out of state, but the only hospital capable of handling her condition was in Kansas, which was then in the thick of a political campaign over a proposed antiabortion constitutional amendment.

She arrived at University of Kansas Hospital on Aug. 2, 2022, the very day the vote was taking place. There the doctors offered either to induce labor or end her pregnancy surgically. Then that hospital’s lawyers stepped in. They forbade the doctors to provide any treatment at all, having ruled, according to a doctor, that it “was too risky in this political environment.” Three days later, she reached a clinic in Illinois that performed the necessary treatment.

Mylissa Farmer’s experience matches those of countless other women whose healthcare has been compromised by antiabortion state laws since 2022, when the Supreme Court in its so-called Dobbs decision overturned the guarantee of abortion rights established by Roe vs. Wade in 1973.

But there’s more to her case. The refusal by two major hospitals to treat her emergency condition violated federal law — the Emergency Medical Treatment and Labor Act of 1986, known as EMTALA.

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The law, which was drafted to stop hospitals from “dumping” emergency patients without insurance by denying them treatment, requires all hospitals receiving Medicare funds — pretty much all hospitals — to provide all emergency room patients with the treatment required to “stabilize” their conditions before transferring them or sending them home.

Investigations by Medicare inspectors last year concluded that the Joplin hospital and University of Kansas Hospital violated EMTALA when they released Farmer without providing the requisite treatment. The penalties run up to $50,000 per incident and the termination of the hospitals’ Medicare contracts, but no actions have been announced.

There’s no exception in EMTALA when the required emergency treatment is an abortion. And that has made EMTALA the newest target of antiabortion agitators and politicians. They claim that the Biden administration is using the federal law to promote or even mandate abortions in all cases, which is false.

The claim, however, has caught the eye of the Supreme Court, which has scheduled oral arguments April 24 in a case involving Idaho’s antiabortion law and its manifest conflict with EMTALA.

The court’s decision to take up the case alarmed abortion rights advocates when it was announced on Jan. 5. It looms even larger now: The court has signaled, though not guaranteed, that it will reject a right-wing challenge to the Food and Drug Administration’s approval of mifepristone, the key drug in medication abortions, but the Idaho case could give its conservative majority another crack at strengthening state antiabortion policies nationwide.

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“There was a lot of press around the mifepristone lawsuit,” says Michelle Banker of the National Women’s Law Center, which is providing Farmer with legal representation. “This is a bit of a sleeper case.”

The case is rooted in an advisory issued by Medicare authorities two weeks after the Dobbs decision overturned Roe vs. Wade. It emphasized to doctors and hospitals that when a pregnant woman arrived at an emergency room with a condition that required an emergency abortion, “the physician must provide that treatment.”

When a state law prohibited abortion and didn’t include an exemption when the life of the mother was threatened, the advisory said, “that state law is preempted ” by the federal law. (Boldfaced emphases in the original.)

Antiabortion advocates instantly took up arms against the advisory. They scurried to federal court in Lubbock, Texas, which has a single active judge, Trump appointee James Wesley Hendrix, who obligingly blocked it with a permanent injunction. The government’s appeal went to the notoriously right-wing U.S. 5th Circuit Court of Appeals, which upheld the injunction.

The Texas case hasn’t made it yet to the Supreme Court. It was outrun by the Idaho case, in which the federal government moved to block Idaho’s antiabortion law to the extent it conflicted with EMTALA.

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The conflict, as the government points out, is that the law requires doctors to perform an emergency abortion if necessary to prevent a patient’s condition from deteriorating or to protect her from potentially severe or permanent injury. Idaho law forbids an abortion unless it’s necessary to avert a patient’s death. Doctors caught in this vise are in effect being told that they must allow a pregnant woman’s condition to deteriorate until she is near death before they can act.

It wasn’t entirely surprising that Idaho would become the battleground for the issue. The state is doing very well in the race to enact the most goonishly malevolent antiabortion policies. Its abortion law criminalizes abortion at all stages of pregnancy, with narrow exceptions for cases in which continuing a pregnancy would threaten the mother’s life.

Idaho law also makes it a felony to help a minor leave the state for an abortion. (A federal judge has temporarily blocked the so-called abortion trafficking law while a lawsuit challenging its constitutionality proceeds.)

The state has claimed that its abortion law makes it a felony for a healthcare provider to refer a patient for an abortion out of state. (Also blocked, for now, by a federal judge.) Another state law exposes professors at Idaho public universities with jail terms of up to 14 years for teaching, discussing, or writing about abortion.

Put all that together, and a ruling that it can flout federal law to protect its antiabortion credentials would be right up Idaho’s alley.

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In making its case, Idaho asserts that after the Dobbs decision the Biden administration “reinterpreted” EMTALA “to create a nationwide abortion mandate” — a mandate the administration only “discovered” nearly 40 years after EMTALA’s enactment.

As the government points out, however, the mandate was always within EMTALA; it never had to be spelled out because the right to abortion became the law of the land via Roe vs. Wade 13 years before EMTALA was enacted. Until Dobbs, the role of abortion as an emergency treatment almost never came under question.

Antiabortionists maintain that Dobbs “caused a sea change in the law,” as 5th Circuit appellate judge Kurt D. Englehardt, another Trump appointee, wrote for the three-judge appeals panel upholding the Texas injunction.

That was a cute bit of legerdemain. EMTALA didn’t change as a result of Dobbs — it was healthcare laws in red states that changed to outlaw abortion. “It has always been the case that EMTALA has been understood to require abortion care when that’s necessary to stabilize a patient’s medical condition,” Banker told me. “The only thing that’s new is that Roe vs. Wade has been overturned.”

Indeed, according to a friend-of-the-court brief filed by six former Medicare administrators and former Health and Human Services Secretary Donna Shalala, who served under both President Bush as well as Presidents Clinton and Obama, Medicare repeatedly issued public guidance stressing that abortion should be considered appropriate emergency treatment when warranted, even before Dobbs.

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Idaho, like its apologists in the right-wing fever swamp, maintains that EMTALA “merely prohibits emergency rooms from turning away indigent patients with serious medical conditions” and doesn’t mandate “any specific type of medical treatment, let alone abortion.”

This is a crabbed and mendacious interpretation of the law. It’s a cynical attempt to conflate the problem that prompted Congress to act — hospitals were turning away emergency patients without insurance, a process known as “dumping” — with the much broader law Congress enacted.

EMTALA explicitly protects “any individual” who presents at an emergency room, regardless of their financial or insurance situation. Hospitals aren’t even allowed to inquire about the patient’s financial or insurance status if that would delay examination or treatment.

Idaho’s interpretation suggests that hospitals could simply keep indigent patients in their corridors, untreated, until they wasted away, without violating EMTALA. That’s not what the law says. It explicitly mandates that hospitals “provide either … such treatment as may be required to stabilize the medical condition” or transfer the patient to another facility that can provide the treatment — as long as the transfer itself won’t harm the patient.

What does “stabilize” mean? The law defines the term as meaning that “no material deterioration of the condition” would result from discharging or transferring the patient. It also defines an “emergency medical condition” as one that, without treatment, would jeopardize “the health of the individual,” or cause “serious impairment to bodily functions” or to any organ or body part.

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Far from ignoring pregnancy issues, EMTALA has always explicitly covered women presenting with a pregnancy emergency. In those cases, the law says, the hospitals are bound to provide treatment that protects “the health of the woman or her unborn child.”

The friend-of-the-court briefs piling up on the Supreme Court’s EMTALA docket include several outlining the horrific moral and legal trap facing doctors caught between EMTALA and antiabortion state laws.

“Obstetricians in Idaho live in constant fear,” states a brief filed by a coalition representing 678 Idaho doctors and other medical professionals. “Always at the back of their minds is the worry that a pregnant patient will arrive at their hospital needing emergency care that they will not be able to provide.”

Under Idaho law, doctors face prison terms of up to five years and the loss of their medical licenses for following medical protocols unless “the patient is face-to-face with death.” The federal and state laws are totally irreconcilable: Doctors confronted with an emergency pregnancy, the brief says, have the choice of complying with EMTALA and thus risking a stiff prison term and the end of their careers, or complying with state law and thus risking their patient’s health or even causing her death.

What’s worse, “the culture of fear surrounding Idaho’s abortion laws has only exacerbated the struggle,” the brief says. “Idaho’s doctors have been warned that they are being tracked and scrutinized and they should fear prosecution for providing an abortion under any circumstances — even when medically necessary.”

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Is there any mystery why OB/GYNS are leaving Idaho by the score? Half of the state’s 44 counties have no practicing obstetricians at all.

A solution, albeit a modest one, to the confusion over the responsibilities of obstetricians in antiabortion states would be for the Supreme Court to clarify that federal law prevails when it runs up against a more restrictive state law. Making that clear in Idaho would send a signal to Texas, Missouri and other states that a mother’s life and health can’t be legislated away.

The EMTALA case gives the Supreme Court an opportunity to uphold science and morality on women’s reproductive healthcare, as it appears to be preparing to do on mifepristone. But what if it follows that case by allowing states to sentence pregnant women to substandard emergency care?

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Commentary: Trump is demanding a 10% cap on credit card interest. Here’s why that’s a lousy idea

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Commentary: Trump is demanding a 10% cap on credit card interest. Here’s why that’s a lousy idea

A few days ago, President Trump staked a claim to the “affordability” issue by demanding that banks cap their credit card interest rates at 10% for one year.

Actually, Trump announced that in effect he had imposed the cap, a claim that some news organizations accepted as gospel.

So let’s dispose of that misconception right off: Trump has zero power to cap interest rates on credit cards. Only Congress can do so.

The idea of a 10% rate cap has all the seriousness of bread-and-circuses governance.

— Adam Levitin, Georgetown Law

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More to the point, his proposal, announced via a post on his TruthSocial platform, is a terrible idea. It’s half-baked at best, and harbors unintended consequences by the carload — so much, in fact, that the putative savings that ordinary households could see from the rate reduction might be diluted, or even reversed, by the drawbacks.

Still, the idea has so much consumerist appeal that it placed Trump in accord with some of his most obdurate critics, such as Sen. Elizabeth Warren (D-Mass.), who has been pressing to place limits on bank fees for years. Warren said she and Trump had a phone conversation in which they seemed to have talked companionably about the issue.

Trump’s announcement did have the salutary effect of placing the issue of financial services costs on the front burner, after its having languished for years. But it obscured the immense complexities of making any such change.

“Certainly this demonstrates a populist streak on both sides of the aisle,” says Adam Rust, director of financial services at the Consumer Federation of America. “But you can’t just write a tweet and upend a huge market.”

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The market for credit cards is indeed huge. As of 2024, credit card debt in the U.S. exceeded $1.21 trillion. This is the most profitable line of business for many banks, producing $120 billion in interest income and $162 billion in fees, chiefly those the card issuers impose on merchants.

“Almost 30% of that is pure profit,” reported Brian Shearer of Vanderbilt University, a former official at the Consumer Financial Protection Bureau, in a 2025 study.

So it should come as no surprise that the entire banking industry has circled the wagons against a cap on credit card interest rates, especially one as stringent as 10%. On Jan. 9, the very day of Trump’s announcement, five leading bank lobbying organizations issued a joint statement asserting that a 10% cap would be “devastating for millions of American families and small business owners who rely on and value their credit cards, the very consumers this proposal intends to help.”

Among its drawbacks, the statement said, “this cap would only drive consumers toward less regulated, more costly alternatives.”

It’s tempting to dismiss the statement as the normal grousing of a big industry about a government regulation. Banks have acquired a certain reputation for profiteering from customers, especially less well-heeled customers, and playing fast and loose with the facts about their costs and profits. But the truth is that on this topic, they have a point.

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Let’s take a look, starting with some basic facts — and misconceptions — about credit cards.

The credit card market is heterogeneous, segmented by income and more importantly by credit score. Those with the highest FICO scores typically get the lowest interest rates, but are also more inclined to pay off their balances every month without incurring any fees, even as their average balances are the highest.

About 40% of all users, including many with middling credit scores, pay off their balances monthly but use their cards for convenience, to access fraud protections provided by credit cards but not by other forms of credit, and to garner card rewards.

Interest fees aren’t the issuers’ sole source of revenue. Most revenue comes at the other end of the transaction, in interchange or “swipe” fees paid by merchants.

That’s why card issuers still cherish high-income transactors and shower them with rewards — the monthly balances of users in the 760-to-840 FICO score range vastly exceed those of other users, indicating that they’re generating correspondingly more in interchange fees from the merchants they patronize.

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The average interest rate on credit cards reached 25.2% last year, according to a December report by the Consumer Financial Protection Bureau. It has steadily increased since 2022, mostly because of an increase in the prime rate, the benchmark for card issuers.

How did it get so high? Blame the Supreme Court, which in 1978 undermined state usury laws by ruling that banks could charge customers the usury rate of their home state rather than the rate in the customer’s state. That’s why your credit card may be “issued” by a bank subsidiary in Utah, South Dakota or Delaware, which have lax usury limits. The solution would be enactment of a nationwide usury limit, but that falls entirely within congressional authority.

So what would happen if Congress did place a limit on the maximum credit card interest rate — if not 10%, then 15% or 18%, as has been proposed in the past? Shearer contends that banks make such fat profits from credit card users at every FICO level that they could still earn healthy returns even at a 15% cap. Shearer estimated that a cap of 15% would produce more than $48 billion in annual customer savings “coming almost entirely out of bank profits.”

Other analysts are not so sanguine. “There is no free lunch here,” argues Adam Levitin, a credit market expert at Georgetown law school. Levitin argues that while issuer profits are large, their margins are not so large. He calculates that a 10% cap would make the general credit card business unprofitable, because there wouldn’t be enough headroom over the benchmark prime rate (currently 6.75%) to cover administrative costs and other overhead.

Issuers don’t have many options to preserve their profitability. So they’re likely to respond by shutting the door on low-income and low-FICO customers and ratcheting back credit limits.

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“The effects will be devastating,” Levitin says. “Families that need the short-term float or the ability to pay back purchases over several months won’t have it. How will they pay for a new water heater when the old one goes out and they don’t have $3,000 sitting around?”

Many will be forced to resort to other short-term unsecured lenders — payday lenders, buy-now-pay-later firms and others that don’t offer the consumer protections of credit cards and would be exempt from the interest cap on credit cards.

“The idea of a 10% rate cap,” Levitin says, “has all the seriousness of bread-and-circuses governance.”

The availability of credit from alternative consumer lenders that don’t offer the statutory protections mandated for credit cards concerns consumer advocates.

A hard cap on interest rates “could create a sharp contraction in the kind of credit available in the marketplace,” says Delicia Hand of Consumer Reports. “It sounds good, but there could be unintended consequences, especially if you don’t think about what fills the gap,”

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Alternative products aren’t regulated as stringently as credit cards. “Direct-to-consumer products can layer subscription fees, expedited access fees, and ‘voluntary’ tips in combinations that produce effective annual percentage rates ranging from under 100% to well over 300% — and in some documented cases, exceeding 1,000% when annualized for frequent users,” Hand said in remarks prepared for delivery Tuesday to the House Committee on Financial Services.

If an interest rate cap is too tight, all but the highest-rated customers might face higher annual fees and stingier rewards. Issuers are likely to squeeze merchants too. Big businesses — think Costco and Amazon — might be able to negotiate swipe fees down and eat the remainder instead of passing them through to consumers. But small neighborhood merchants might refuse to accept credit cards for purchases below a certain amount, or add a swipe fee surcharge to customers’ bills.

Other complexities bedevil proposals like Trump’s, or for that matter bills introduced last year in the Senate by Bernie Sanders (I-Vt.) and Josh Hawley (R-Mo.) and in the House by Reps. Alexandria Ocasio-Cortez (D-N.Y.) and Anna Paulina Luna (R-Fla.), capping rates at 10% for five years. Those measures have the virtue of simplicity — they’re only three pages long — but the drawback, also, of simplicity.

Among the open questions, Levitin observes, are whether the 10% cap would apply to all balances or just to purchases. If the former, it remakes credit cards into tools for “low-cost leverage for cryptocurrency speculation and sports betting,” because in today’s interest rate environment it’s cheap money.

Trump’s announcement, in particular, displays all the drawbacks of insufficient cogitation characteristic of so many of his ventures. Published on Jan. 9, it called for the cap to be implemented on Jan. 20, the anniversary of his inauguration: a mere 11 days to implement a change in a $1.21-trillion market with potential ramifications on a dizzying scale.

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Since he doesn’t have the authority to mandate the cap by executive order, he’s in effect calling for the banks to make the change voluntarily. Given the impact on their profits, on the gonna-happen scale, that’s a “not.”

Adding to the sour ironies of this effort, Trump’s far-right budget director, Russell Vought, has been pursuing a vicious campaign to destroy the agency with statutory authority over the consumer lending industry, the CFPB — of which Trump appointed Vought acting director.

Vought also rescinded a Biden-era CFPB rule reducing credit card late fees to no more than $8 from as much as $41—further undermining Trump’s attempt to pose as a friend of the credit card customer.

Consumer advocates are pleased that the debate over card fees has placed financial services costs squarely in the “affordability” debate, where they belong.

There’s no question that capping card interest rates at some level could bring savings to consumers to maintain monthly balances — “revolvers,” in industry parlance. “It could be worth several bags of groceries a month, or a tank of gas,” Rust conjectures — “significant savings for millions of people.”

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The challenge is finding “where the right level is, balancing risk and availability,” he told me. “That’s not clear at the moment.”

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Disneyland Park attendance reaches 900 million over 70 years in business

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Disneyland Park attendance reaches 900 million over 70 years in business

Disneyland, the iconic tourist destination that transformed the entertainment landscape in Southern California, has reached a new milestone: 900 million people have visited the park since its opening in 1955.

The latest attendance figure was described in a new documentary called “Disneyland Handcrafted,” chronicling the creation of the theme park. The film, which includes footage from the Walt Disney Archives, will stream on Disney+.

In 2024 — the most recent year data was available — Disneyland’s attendance ticked up 0.5% to 17.3 million, according to a report from the Themed Entertainment Assn. Like many other theme parks, Disney does not release internal attendance figures.

Walt Disney Co.’s theme parks, cruise ships and vacation resorts have been a key economic driver for the Burbank media and entertainment company.

Last year, almost 57% of the company’s operating income was generated by the tourism and leisure segment, known as Disney’s “experiences” business. That sector reported revenue of $36.2 billion for fiscal year 2025, a 6% bump compared to the previous year. Operating income increased 8% to nearly $10 billion.

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Disney has said it will invest $60 billion into its experiences segment, underscoring the importance of that business to the company. At Disneyland Resort in Anaheim, that could mean at least $1.9 billion of development on projects including an expansion of the Avengers Campus and a “Coco”-themed boat ride at Disney California Adventure, as well as an “Avatar”-inspired area.

Over its 70 years, Disneyland has undergone many changes and expansions. Though some of its original attractions still exist, including Peter Pan’s Flight, Dumbo the Flying Elephant and the Mark Twain Riverboat, the park has evolved to align more with its Hollywood cinematic properties and expanded in 2019 to include a “Star Wars”-themed land.

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How bits of Apple history can be yours

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How bits of Apple history can be yours

In March 1976, Apple cofounders Steve Jobs and Steve Wozniak both signed a $500 check weeks before the official creation of a California company that would transform personal computing and become a global powerhouse.

Now that historic Wells Fargo check could be sold for $500,000 at an auction that ends on Jan. 29. The sale, run by RR Auction, includes some of Apple’s early items and childhood belongings of Jobs, Apple’s cofounder and chief executive, who died in 2011 at 56, after battling pancreatic cancer.

Since its founding, the Cupertino tech giant has attracted millions of fans who buy its laptops, smartphones, headphones and smart watches. The auction gives the adoring public a chance to own part of the company’s history ahead of Apple’s 50th anniversary in April.

Apple’s first check from March 1976 predates the company’s official founding in April 1976. It also includes the signatures of Steve Jobs and Steve Wozniak.

(RR Auction)

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“Without a doubt, check number one is the most important piece of paper in Apple’s history,” said Corey Cohen, a computer historian and Apple-1 expert, in a video about the item. At the time, Apple’s cofounders, he added, were “putting everything on the line.”

Cohen said he’s known of a governor, entrepreneurs, award-winning filmmakers and musicians who own rare Apple collectibles. Jobs is a “cult of personality,” and people collect items tied to the tech mogul.

“This is a very important collection that’s being sold because there are a lot of personal items, a lot of things that weren’t generally available to the public before, because these things are coming right out of Jobs’ home,” he said in an interview.

RR Auction said it couldn’t share the names of the consignors on the check and some of the other auction items.

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As of Monday, bids on the check surpassed $200,000. Jobs typically didn’t sign autographs, so owning a document bearing his signature is rare.

Other items up for auction include Apple’s March 1976 Wells Fargo account statement — the company’s first financial document — and an Apple-1 computer prototype board used to validate Apple’s first computer.

The auction features a variety of memorabilia, including vintage Apple posters, Apple rainbow glasses, letters, magazines, older Apple computers, and other historic items.

Apple didn’t respond to a request for comment.

Some of Jobs’ personal items came from his stepbrother, John Chovanec, who had preserved them for decades.

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The items provide “a rare view” into Jobs’ “private world and formative years outside Apple’s corporate narrative,” a news release about the auction said.

Jobs’ bedroom desk from his family’s Los Altos home, which housed a garage where Apple-1 computers were put together, is also up for sale.

Papers from Jobs’ years before Apple are inside the desk and the highest bid on that item has surpassed $44,000.

An auction celebrating Apple's upcoming 50th anniversary includes late Apple co-founder Steve Jobs' belongings.

A bedroom desk that belonged to late Apple cofounder Steve Jobs provides a glimpse into his early years before he created the tech company.

(RR Auction)

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Bids on an Apple business card on which Jobs writes “Hi, I’m back” in black ink to his father reached more than $22,200. The card features Apple’s colorful logo alongside Jobs’ title as chairman, a role he returned to in 2011, according to the auction site.

Other items include 8-track tapes that featured music from artists such as Bob Dylan. Bids on a 1977 vintage poster featuring a red Apple that hung in Jobs family’s living room top $16,600, the auction site shows.

While Jobs is known for donning a black turtleneck, he also wore bow ties during high school and at Apple’s early events.

An auction to celebrate Apple's upcoming 50th anniversary includes bow ties worn by late Apple cofounder Steve Jobs.

A collection of bow ties that belonged to late Apple co-founder Steve Jobs.

(RR Auction)

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Some of Jobs’ bow ties have sold for thousands of dollars at other auctions.

Last year, a pink-and-green striped bow tie he wore when introducing the Macintosh computer in 1984 sold for more than $35,000 at a Julien’s Auctions event that highlighted technology and history.

The items on RR Auction feature colorful clip-on bow ties from Jobs’ bedroom closet.

“This brief fashion phase contrasted sharply with the minimalist black turtleneck and jeans that would later define his public image,” a description of the item states. “The shift reflected Jobs’ evolution from an ambitious young innovator to a visionary with a distinct and enduring personal brand.”

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