Business
Column: Healthcare — and not just reproductive care — was on the ballot, and it lost big
It was perhaps natural that campaign coverage of the presidential candidates’ healthcare policies began and ended with abortion rights; since June 2022, when the Supreme Court overturned Roe v. Wade, 20 states have banned abortions or enacted draconian restrictions on the procedure.
That landscape could turn even more dire with the reelection of Donald Trump. But many other healthcare issues were implicitly on the ballot Tuesday. Republicans may well feel empowered to continue their long campaign against the nation’s public health infrastructure, to step up their attacks on science, and to spread the anti-vaccine mantra of Robert F. Kennedy Jr., who has worked his way into Trump’s inner circle.
The Biden administration’s progress in making healthcare more accessible and affordable for all Americans, especially seniors on Medicare, is almost certain to be rolled back. RFK Jr. and other healthcare quacks, such as Florida Surgeon General Joseph Ladapo, may move into national policy-making. Religion-based policies may move to the fore, shouldering science-based policies aside. The plundering of healthcare institutions by private equity investors could pick up steam.
I will not give one penny to any school that has a vaccine mandate or a mask mandate.
— Donald Trump, threatening millions of children with measles, polio, COVID and other vaccine-preventable diseases
If any of these eventualities come to pass, America’s health profile will be in danger of declining, and sharply. The main victims would be women, seniors and low-income households.
Let’s examine the particulars. Some of these derive from the Heritage Foundation’s notorious Project 2025, a road map to a reactionary future that is sure to animate many Trump administration policies. But others reflect policy efforts already tried in red states or promoted during Trump’s first term.
ABORTION: Protections for abortion rights were on the ballot in 10 states, and passed in seven — not including Florida, where a measure rolling back the state’s draconian abortion ban garnered 57% of the vote but fell short of the 60% required to pass. (That threshold was enacted in 2006 after it was placed on the ballot by a Republican-controlled legislature; as it happens, the 60% rule passed even though it did not itself garner 60% of the vote.)
In only two other states is a supermajority required to pass a ballot measure: Colorado (55% required) and New Hampshire (two-thirds, or 66.7%).
The seven states in which voters protected abortion rights by enshrining them in the state constitution were Arizona, Colorado, Maryland, Missouri, Montana, New York and Nevada. Measures failed in South Dakota and Nebraska.
Republican and conservative hostility to abortion rights has persisted despite the ghastly deaths of pregnant women because doctors were unwilling to terminate their pregnancies because the treatment would break the law in their states, even in an emergency, and expose the doctors to consequences including criminal prosecution.
Trump has specifically said he would not support a national abortion ban “under any circumstances,” but that leaves open a multitude of ways he could achieve that goal by another name, whether by applying an ancient federal law to constrain the shipment of abortion pills, installing reproductive rights opponents at federal healthcare agencies as he did in his first term, or some other means. Plainly, abortion rights aren’t safe in a Trump presidency.
GENDER: Trump made gender-related medical treatments a target of his campaign, spinning a deranged fantasy about schools subjecting children to gender-changing surgery behind their parents’ backs; Project 2025 disdains what it calls “the new woke gender ideology, which has as a principal tenet ‘gender affirming care’ and ‘sex-change’ surgeries on minors.”
This parallels laws passed in several red states barring any gender-affirming care for minors. In fact, surgery is not part of the standard of care in gender-affirming cases involving children and adolescents. The authors of Project 2025 advocate barring transgender individuals from serving in the military.
AFFORDABLE CARE ACT: The repeal of Obamacare, as it’s familiarly known, has been a prime goal of Republicans since the law’s enactment in 2010. The law was saved from repeal in 2017, during the last Trump administration, by a single “no” vote from the late Sen. John McCain (R-Ariz.).
It’s still a target. House Speaker Mike Johnson (R-La.) vowed last month that there would be “No Obamacare” in another Trump term. The law is popular, however, favored by 62% of Americans according to a KFF opinion poll in May. Trump has repeatedly promised to offer an alternative program, but never has done so.
Project 2025 calls for giving more latitude to bare-bones health plans such as association health plans and short-term health plans. These don’t meet ACA standards because they often exclude essential healthcare services and can mislead consumers into thinking an illness or treatment is covered — learning the truth only when they try to obtain coverage.
The road map also calls for curtailing the ACA’s contraceptive mandate, which it says “has been the source of years of egregious attacks on many Americans’ religious and moral beliefs.” (Of course, the ACA doesn’t require that anyone actually use a contraceptive, only that they be covered without cost-sharing.)
It calls for removing the “morning-after pill” Ella from the contraceptive mandate. It also calls for turning the clock back on the Food and Drug Administration’s safety approval for the abortion pill mifepristone, which is currently the target of a lawsuit file by antiabortion activists.
MEDICAID and MEDICARE: These crucial federal healthcare programs — the first serving low-income Americans and the second serving seniors — are in the GOP’s gunsights. Project 2025 claims that they are “the principal drivers of our $31-trillion national debt. … In essence, our deficit problem is a Medicare and Medicaid problem.”
Never mind that the single biggest driver of federal deficits is the tax cut for corporations and the wealthy signed by Trump in 2017, which could add $5.2 trillion to deficits over the next 10 years.
By Project 2025’s reckoning, Medicare and Medicaid together cost $17.8 trillion from 1967 through 2020, a span of 53 years. This year, the two programs enroll more than 140 million Americans, or more than 41% of the population. (Medicare members also pay premiums for some of its parts.)
Although Trump has vowed not to cut Medicare benefits, conservative antagonism toward Medicaid, the state-federal healthcare program for low-income Americans, has never ebbed. In 2014, under former Speaker Paul Ryan (R-Wisc.), House Republicans proposed converting the program from one that covered a percentage of state spending on healthcare to enrollees into a block-grant structure, that lacked the flexibility needed to confront disease outbreaks as they occur. Ryan’s plan would have cut Medicaid funding by 26% over a decade.
Vaccines have eradicated smallpox and either eliminated or sharply reduced the incidence of measles, polio, rubella and whooping cough. So why are Trump and Robert F. Kennedy Jr. attacking them?
(Centers for Disease Control and Prevention)
It failed, but the idea was taken up by Trump in his first term, though it wasn’t enacted. Expect it to be considered again. Project 2025 advocates adding work requirements to Medicaid, an idea that has proved in the past to achieve nothing in terms of reducing joblessness or improving enrollees’ health, but did end up throwing thousands of people out of the program.
Permission that the last Trump administration granted some states to impose work requirements for Medicaid was overturned by a federal judge in 2019; the Biden White House consigned the idea to the dumpster.
Project 2025 asserts that the ACA “mandates that states must expand their Medicaid eligibility standards” to include everyone at or below 138% of the federal poverty level. This is a lie. Following a Supreme Court ruling, the ACA leaves it to individual states to cover childless low-income individuals; 10 states, all of which are under the control of GOP governors or legislatures, still haven’t done so. The project also calls for eliminating the 90% government match of the cost of that coverage and reducing it to a “fairer and more rational level,” presumably lower.
VACCINES: The rapid development of COVID-19 vaccines, which averted about 1.1 million U.S. deaths and more than 10.3 million hospitalizations within a year of their introduction in December 2020, was one of the few genuine achievements of the first Trump term. So it’s a mystery why he has turned against them, and against vaccines in general.
During his campaign he promised, “I will not give one penny to any school that has a vaccine mandate or a mask mandate.”
It’s possible that this reflects the sway that Robert F. Kennedy Jr. has exercised over Trump, who has promised to place RFK Jr. in a policymaking role over healthcare. The prospect should make all Americans queasy, for Kennedy is a one-stop shop for conspiracy theories ranging from anti-vaccine claims to outright antisemitism.
The truth is that vaccines are indisputably a triumph of medical science. They’ve eradicated smallpox from the face of the Earth and reduced diseases such as measles, polio and whooping cough to occasional outbreaks (among the unvaccinated). If Trump and RFK Jr. intend to make the world safe again for these diseases, they should come right out and say so.
To the authors of Project 2025, the COVID vaccines along with other anti-pandemic policies were nothing but infringements on individual rights (don’t think about the children and families whose rights to a healthy life would be jeopardized by the elimination of school vaccine mandates).
The project rails against the Centers for Disease Control and Prevention and the National Institutes of Health — the country’s premier public health agencies — for “the irrational, destructive, un-American mask and vaccine mandates that were imposed upon an ostensibly free people during the COVID-19 pandemic.” It also claims that “masks provide little to no benefit in preventing the spread of viruses and might even be counterproductive,” a statement that is unadulterated BS.
But that’s just one example of how the right wing, which will now occupy a favored perch in the White House, has elevated an amorphous concept of individual freedom over the undeniably real benefits, to millions of people, of robust pubic health imperatives based on communal responsibility.
How much worse will things have to get before the public wakes up to the consequences? Why in heaven’s name would anyone want to find out?
Business
Walmart’s EV chargers are coming to California with discounts for members
Walmart is rapidly expanding its network of electric vehicle chargers designed for customers to use while they shop.
The network could help fill gaps in EV infrastructure in states with greater need for chargers. Walmart, which has more than 5,000 locations in the U.S. and hundreds in California, says more than 90% of Americans live within 10 miles of one of its stores.
The chargers also offer an incentive for customers to choose Walmart — Walmart Plus members will receive a 10% discount off an average price of $0.46 per kilowatt-hour of energy at the company’s chargers.
Walmart chargers are already available at more than 75 locations in 17 states, with Texas boasting the most charging stations, followed by Florida and Arizona.
Matthew Nelson, Walmart’s director of energy policy, said last week on LinkedIn that the network will soon reach 29 states, including California.
“We are delivering on the promise of affordable, reliable and convenient charging,” Nelson said in his post.
According to Walmart’s website, six charging stations are coming to California soon, though the company did not offer a specific timeline.
The chargers will be installed at stores in Antelope, Brea, Fresno, Stockton, Suisun City and Vallejo.
Most charging sites in California will include eight to 16 fast-charging stalls, said Walmart spokesperson Kelsey Bohl.
The company first announced plans in April 2023 to install its own EV chargers at Walmart and Sam’s Club stores, with a goal of installing thousands of chargers by 2030. Partnering with ABB E-Mobility and Alpitronic, it added 25 new charging sites this past May and six more in June.
“Walmart is building a leading retail-integrated EV fast-charging network, focused on delivering an affordable, reliable and convenient charging experience where customers already shop,” Bohl said in an emailed statement. “Customers can charge while they shop, access stations through the Walmart app they already use, and benefit from affordable pricing.”
The charging stations already available include 612 individual charging stalls using 400-kilowatt chargers. Each stall has a dual charging cord with both Combined Charging System and North American Charging Standard connectors. The standard connectors, designed by Tesla, are smaller and lighter than the combined systems.
The primary way to pay for the chargers is through the Walmart app, but the company is also experimenting with built-in credit card readers to allow those without the app to use the stations.
Customers can check charger availability on the Walmart app. The company said the chargers will be available 24 hours a day.
Business
Waymo reports teen riders for bad behavior and delivers them to the police
Robotaxis could be turning into robocops.
A self-driving Waymo reported two teens to San Mateo, Calif., police on Monday after they were found drinking alcohol and shooting toy guns in the back of the vehicle.
According to a social media post from the San Mateo Police Department, officers detained two 15-year-olds after the Waymo they were riding in contacted the department and stopped in a parking lot until law enforcement arrived.
“Parents do you know where your teens are?” the San Mateo Police Department wrote on Facebook following the incident. “Waymo does!”
Officers removed both teens from the vehicle and determined they were using toy guns to shoot Orbeez out the windows. Orbeez are small, water-absorbing beads sold at toy stores.
“Toy guns, water guns, and BB guns all pose real dangers, especially to an untrained eye,” the Police Department said. “The simple handling of them can cause fear in [passersby].” “
A video posted on Facebook shows at least five officers and a police dog responding to the scene and approaching the Waymo with their weapons raised.
Waymo did not immediately respond to a request for comment.
Waymo vehicles have internal cameras and microphones that may be used in an emergency or to “promote safety and security,” according to Waymo’s online support page.
The cameras are also used to ensure the vehicles are clean and to help find lost items, according to the support page.
The company said it does not use facial recognition or other biometric identification technologies to identify individuals.
“In more urgent circumstances, support may access live video during a trip,” the Waymo page said.
The San Mateo Police Department’s Facebook post has garnered nearly 60 comments, with one user accusing Waymo of “snitching.”
“At least they got a designated driver?!” one user commented.
Business
Commentary: How right-wing anti-transgender attacks led to a Supreme Court ruling upholding sex discrimination
At the Supreme Court, the unfounded fear of boys masquerading as girls in youth sports rolled the clock back on gender equality.
On the surface, the Supreme Court’s June 30 opinion upholding state laws barring transgender girls from women’s and girl’s sports teams looks like a victory for women’s rights.
The 6-3 opinion by Justice Brett M. Kavanaugh certainly presents itself that way. “Females and males have inherent physical differences relevant to athletic performance,” Kavanaugh wrote. “Therefore, in contact sports, forcing female athletes to compete against males can create significant safety risks.” He also asserted that “forcing female athletes to compete against males can undermine competitive fairness.”
The ruling applied to prohibitions enacted in Idaho and West Virginia against “biological” males’ participation on women’s teams in public schools. Federal judges in both states overturned the bans. The Supreme Court majority restored them. The ruling essentially upholds similar bans enacted in 25 other states.
There was no record of any transgender person participating in school sports in the State, let alone any ‘problem’ with transgender students … creating unfair competition or unsafe conditions.
— Justice Sonia Sotomayor, demolishing the Supreme Court’s argument in favor of banning transgender girls from girl’s sports
Kavanaugh, like Donald Trump and others in the anti-transgender camp, maintained that one’s gender is an immutable fact of life, established even before birth.
Anything else, Trump stated in an executive order he issued on inauguration day 2025, could only be the product of “gender ideology extremism.” The U.S., his order stated, recognizes “two sexes, male and female. These sexes are not changeable and are grounded in fundamental and incontrovertible reality.” That’s a “biological truth,” he declared.
In his own version of this overconfident and factually insupportable conclusion, Kavanaugh wrote: “As all agree, females and males have inherent physical differences relevant to athletic performance.”
Science recognizes that some people are “born with sex traits that don’t fit into typical male or female patterns,” to cite a discussion on the Cleveland Clinic web page on the topic “intersex.” The condition “may involve chromosomes, hormones, reproductive organs or genitals.”
From a psychological standpoint, medical science recognizes “gender dysphoria” as a real condition often requiring counseling and medical intervention such as the use of puberty blockers and hormones to stave off the development of secondary sex characteristics until the condition can be resolved.
No one disputes that there are physical differences between the sexes. Few would dispute that on average or even at the median, males may be bigger and more powerful than females, or that in certain contact sports the difference may be telling and on occasion dangerous.
But that’s not the same as asserting that the physical differences between males and females invariably mean that men will invariably prevail over women in all competitions or that their participation will endanger women.
The International Olympic Committee — in a policy statement Kavanaugh cited incompletely — says that in “most running and swimming events,” males have a 10% to 12% advantage over women. That’s a range that would accommodate the full spectrum of outcomes — transgender females win, cisfemales win, they tie. (The “cis” prefix denotes those living consistent with their birth gender.)
West Virginia and Idaho addressed this ambiguity by banning transgender women from all girls’ teams. So under their rules transgender girls can’t play football or soccer with cisgirls. But what’s the argument in favor of banning them from the 100-yard dash, or cross-country track, or diving, or archery?
But something else is going on here. The Supreme Court’s ruling was almost preordained, given the years-long campaign by conservatives to demonize transgender individuals as if they’re members of an alien species.
It will be recalled that during his presidential campaign, Trump spun a despicable fantasy in which children were kidnapped in school and secretly subjected to sex-change operations.
Trump’s executive order wiped out policies aimed at protecting transgender adults from discrimination. He moved to outlaw gender-affirming medical therapies for anyone under 19 by cutting off federal funding for healthcare institutions that provide such care.
He banned transgender individuals from serving in the military and ordered federal prison officials to move transgender inmates into the general populations consistent with their birth genders, which exposes them to physical assault. (Federal Judge Royce Lamberth of Washington, D.C., has blocked the government from transferring three transgender women into the male prison population or terminating their hormone treatments.)
I wrote during Trump’s first term, when his anti-transgender policies were still gestating, that the goal was to show that “one can target any community, as long as it doesn’t have a strong political voice or political power. These are the actions of bullies and cowards, pretending to be strong.”
Last year, the Supreme Court struck its first blow against transgender rights by upholding a Tennessee law banning transgender care, including puberty blockers and hormone therapy, for minors. Similar laws have been enacted in 25 other states. The majority in that ruling by Chief Justice John G. Roberts Jr. was identical to the one in the June 30 ruling — Roberts, Kavanaugh, and Justices Clarence Thomas, Samuel A. Alito Jr., Neil M. Gorsuch and Amy Coney Barrett.
Who are the targets of this ideological campaign? They number only about 1.6 million U.S. adults, or one-half of 1% of the U.S. population. About 300,000 adolescents ages 13 to 17, or 1.4%, identify as transgender, according to a study by UCLA School of Law.
In West Virginia, as Justice Sonia Sotomayor observed in her dissenting opinion, “there was no record of any transgender person participating in school sports in the State, let along any ‘problem’ with transgender students … creating unfair competition or unsafe conditions.”
In endorsing the flat bans directed at transgender women in Idaho and West Virginia, Kavanaugh argued that any attempt to implement case-by-case judgments of students’ requests to join sports teams inconsistent with their biological gender would create “an enormous practical and administrability problem.”
Is that so? That wasn’t the case in Maine, where the annual K-12 population is more than 170,000. There, a committee was charged with determining whether a student’s participation in a sport consistent with their gender identity but inconsistent with their biological sex would “result in an unfair athletic advantage” or present a risk of injury to others. The committee held 56 hearings from 2013 through 2021, or an average of seven per year. During the entire time span, only four involved transgender girls. (The outcome of those hearings couldn’t be learned.)
It was Maine’s policy, one might recall, that provoked a confrontation between Trump and Maine Gov. Janet Mills at the White House last year, when Trump threatened to withhold federal funding from the state unless it barred transgender students from competing on women’s sports teams. “We’ll see you in court,” Mills snapped.
Whether the Idaho and West Virginia laws genuinely protect girls from unfair competition is questionable. (The Idaho law is styled the “Fairness in Women’s Sports Act.”) In practice, the laws may subject women in public schools to “invasive sex verification procedures,” as educational expert George Theoharis of Syracuse University wrote after the court ruling.
They’re also based on a retrograde view of women as fragile creatures needing men’s protection, Theoharis wrote — “the same logic that has historically been used to justify excluding women from making their own healthcare decisions and girls from rigorous math and science; that physically demanding work is simply beyond them.” (There don’t appear to be any state laws barring transgender women from competing in men’s sports.)
Becky Pepper-Jackson, the plaintiff in the West Virginia case, in which she is identified only as B.P.J., is the only transgender girl who sought to join girl’s teams — track and cross-country — in the state. That was in 2021, just after West Virginia passed its law and she was about to enter sixth grade. She didn’t appear to pose any competitive risk to others on the track and cross-country teams she applied to join — her lawyers told the Supreme Court that on those no-cut teams, she “came in near the back.”
Anyway, she had not gone through male puberty, which theoretically might have endowed her with a competitive advantage, because she had been taking puberty blockers and female hormones.
Thanks to the court’s ruling, Sotomayor observed in a dissent joined by Justices Elena Kagan and Ketanji Brown Jackson, West Virginia can deny Becky access to school sports “because it thinks they have an inherent athletic advantage, even if the facts show that they do not.”
B.P.J., Sotomayor wrote, “cannot practice on girls’ teams, even if she would not take anyone’s spot in an eventual competition, even if everyone who tries out for the team makes it, and even if having the chance to participate could aid immensely in treating B. P. J.’s gender dysphoria.”
So whose interest was really protected by the Supreme Court?
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