SIOUX FALLS, S.D. (Dakota News Now) – A four-day motorcycle ride made its way through Sioux Falls Sunday benefitting South Dakota veterans, and more.

The South Dakota American Legion Ride 605 is a fundraiser for the American Legion Foundation.

The ride features 12 different posts presenting checks to the riders along their journey, and it got underway yesterday morning at Capital Lake in Pierre.

Donations go towards Veterans Affairs and rehabilitation– as well as youth programs.

The ride also includes stops at small-town veteran memorials– the legion riders set out with a goal of raising 5-thousand dollars.

Copyright 2024 Dakota News Now. All rights reserved.

Aiming to send a message, the Biden administration recently spotlighted its indictments and convictions in cases involving threats to election officials or workers.

But with no letup in reports of attacks, some elections professionals say federal law enforcement still isn’t doing enough to deter bad actors and ensure that those on the front lines of democracy are protected this fall.

“Election officials by and large have no confidence that if something were to happen to them, there would be any consequences,” said Amy Cohen, the executive director of the National Association of State Election Directors. “It is very clear that we are not seeing a deterrent effect.”

A U.S. Justice Department spokesman declined to comment for this story, instead directing States Newsroom to a webpage for the department’s Election Threats Task Force.

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Launched by the Justice Department in 2021 in response to the wave of harassment of election officials that followed the 2020 election, the Election Threats Task Force works closely with local law enforcement and U.S. attorney’s offices around the country to investigate threats.

In going after those who make threats against election workers, the Justice Department is honoring a foundational purpose: The department was created in 1870 in part to protect the voting rights of southern Blacks during Reconstruction.

Run by John Keller, a top official in the Justice Department’s Public Integrity Section, the task force also includes the Criminal Division’s Computer Crime and Intellectual Property Section, the Civil Rights Division, the National Security Division, and the FBI. It also works with several other government agencies, including the U.S. Postal Inspection Service and the Department of Homeland Security.

Since its launch, the task force has brought charges in 17 cases, according to the department’s tally. Eight cases have resulted in prison time, with sentencing scheduled in several more.

In one case, brought in Nevada, the defendant was acquitted.

In March, a Massachusetts man received a three-and-a-half-year sentence — the longest won by the task force to date — for sending an online message to an Arizona election official warning her a bomb would be detonated “in her personal space” unless she resigned.

A Texas man received the same sentence last August for posting threatening messages targeting two Maricopa County, Arizona officials and their families, and separately calling for a “mass shooting of poll workers” in precincts with “suspect results.”

‘Each of these cases should serve as a warning’

Attorney General Merrick Garland highlighted these convictions and others in a May 13 speech at a task force meeting.

“Each of these cases should serve as a warning,” declared Garland. “If you threaten to harm or kill an election worker, volunteer, or official, the Justice Department will find you. And we will hold you accountable.”

But those prosecutions amount to only a tiny share of what the Justice Department has said is over 2,000 reports of threats or harassment submitted by the election community to the FBI since the task force was launched in 2021. Around 100 of those were investigated, according to the Justice Department.

The small number of investigations and prosecutions is largely due to free speech concerns. Legal experts say that anything short of a direct and explicit threat to cause physical harm may well be protected speech under the First Amendment.

“A true threat is a serious expression of an intent to commit an act of unlawful violence,” Keller has said. “If they don’t cross that line into invoking violence, they are generally not going to constitute a criminally prosecutable threat.”

Still, as the 2024 vote approaches, there’s little evidence that the volume of attacks against the people who run elections has declined, or that election workers feel safer.

A recent Brennan Center survey found that more than half of local election officials said they were concerned about the safety of their colleagues or staff — around the same number as in 2022, the year of the last federal election. Around a quarter worry about being assaulted at home or at work.

“This is a widespread issue in the elections community,” said Tammy Patrick, the CEO for programs for the National Association of Election Officials, and a former election official in Maricopa County. “It’s happening all across the country. It’s not just a question of it being in swing states, or just being in the city or whatever. It’s happening in a way that is a concerted campaign to create and sow chaos.”

“There is some feeling that the task force is a political tool,” said another election expert, “that allows the administration to say they care and they’re doing something.”

Troubling episodes but little follow-up

In March 2022, anti-fraud activists, accompanied by the local GOP chair, showed up at the office of Michella Huff, the election director for Surry County, North Carolina.

Huff said the activists tried to pressure her to give them access to county voting machines, citing what they said were flawed voter rolls. The group repeatedly threatened to have Huff ousted from her job if she didn’t cooperate, and said they planned to return with the local sheriff, though they did not do so.

Huff declined to provide access to the machines, and reported the episode to the state election board’s investigations unit.

A spokesperson for the board did not respond to an inquiry about whether the report was forwarded to federal law enforcement.

Election security advocates have urged the FBI to do more to probe efforts by supporters of former President Donald Trump to gain access to voting machines in other states, warning that the breaches could have allowed for voting machine software to be compromised.

Huff said she never heard from law enforcement on any level, despite speaking publicly about the episode.

Though Huff wasn’t physically threatened, she said she’d still like to have seen federal authorities do more to respond.

“If it is truly a threat, I think every threat needs to be looked at serious(ly), and it needs to be considered as to what the intent was, if it was successful, and what the repercussions would be if it had been successful,” said Huff. “A threat is a threat.”

More overt efforts to physically intimidate election workers also have at times spurred little law enforcement followup.

The night before South Carolina’s 2022 primaries, a Republican candidate who has promoted lies about the 2020 election posted a message on the conservative social media site Telegram, to a group of anti-fraud activists.

“For all of you on the team tomorrow observing the polls, Good Hunting,” the message said. “We have the enemy on their back foot, press the attack. Forward.”

During the voting period, groups of activists showed up at multiple polling places to verbally harass, photograph, and film election workers as they did their jobs, recounted Aaron Cramer, the executive director of the Charleston County Board of Voter Registration and Elections.

The activists called the police to at least one polling site, falsely alleging evidence of fraud by election staff. The police came, but made no arrests — though the episode left the site’s lead poll manager shaken, Cramer said.

Cramer said his office provided detailed reports on both the Telegram message and the harassment at polling sites to the Department of Homeland Security, as well as to the state election commission.

“We took that threat pretty seriously,” he said, referring to the Telegram message.

He said he received a response from DHS saying the report was being looked into, but heard nothing after that.

“I don’t know what the conclusions were, or what occurred after submitting that information,” Cramer said.

But Cramer added that the experience produced a successful effort to increase collaboration with local, state, and federal authorities — with the result that the county is much better prepared to respond to, and anticipate, similar incidents this year.

“When you’re on the defense, you’re kind of reacting to everything, and I think that’s how the past was,” said Cramer.  “And now we’re being proactive.”

‘I dread November for you guys’

Patrick, of the National Association of Election Officials, said that while she understands the need to avoid running afoul of the First Amendment, authorities must balance legitimate free speech concerns with their urgent duty to protect those conducting elections.

And, she suggested, they may not always be getting that balance right.

“We need to be really careful that we’re not allowing people to yell fire in a crowded theater,” Patrick said.  “And that we’re not allowing people to use what they are potentially claiming as their freedom of speech as a way of creating chaos in a system, or to threaten individuals who are just trying to do their job.”

In addition, election professionals say they’ve complained for years that after they submit reports about threats and harassment to the FBI, there’s often a lack of follow-up beyond an acknowledgment of receipt.

Of course, law enforcement frequently can’t share details about their work, even with those who were targeted, in order not to compromise an investigation. But Patrick said even basic information could be helpful.

“Even letting them know that the report is being worked, so it doesn’t just go into the void, and a victim knows there’s going to be a knock-and-talk, gives the individual who made that report some sense of closure,” Patrick said, referring to when federal agents show up to speak with a suspect at their home.

The problem may be exacerbated by a lack of understanding among some in the elections world about what federal law enforcement can and can’t do. Many election officials, said Cohen, of the National Association of State Election Directors, want front-end help with steps like bolstering physical security to better prepare for incidents.

“Law enforcement, and especially federal law enforcement, is only coming at the back end,” said Cohen. “Their goal is not prevention or recovery, their goal is prosecution. And it has taken our community, I think, a long time to understand what we should be expecting from DoJ.”

Ultimately, said Cohen, the prosecutions brought by the Justice Department appear to have done little to reduce the number of threats election workers are subject to today.

“I’m really grateful that DOJ has secured convictions in Arizona,” said Cohen. “But I don’t think securing convictions in Arizona three years later has actually deterred anything in Arizona.”

Indeed, Arizona has been a hotbed for election misinformation, and its election officials continue to be targeted by a consistent stream of threats, according to multiple reports.

Huff, the county election director in North Carolina, said that with a major election approaching, members of the public often express sympathy for her and her staff — an acknowledgement that the vitriol they’ve been facing is only likely to get stronger.

“Out in public, I get that,” Huff said — ‘Boy, I dread November for you guys.’”

Several months ago, Forbes, a respected business and economics publication, released an analysis of the “The Most (And Least) Expensive States for Healthcare 2024.” A striking — and concerning — finding was that health care expenses in South Dakota were the second highest in the nation.

The multiplicity of payers and the differing demographics of populations in diverse geographic areas make measuring and comparing total health care costs across different regions a highly complex undertaking. Nonetheless, the findings in the Forbes article have been supported by other research.

An extensive and very interesting paper was published several years ago by the Health Care Pricing Project. This analysis looked at both Medicare costs and private insurance expenditures in 306 health care regions across the U.S. In that study, private insurance expenditures in the Sioux Falls region were the 14th highest in the nation but Medicare expenditures were near the bottom (275th out of 306). The huge difference can be explained by the fact that Medicare prices are set by the Medicare program, whereas each private payer has to negotiate prices with the individual providers.

In eastern South Dakota, there is intense competition between two large health care systems. One could reasonably expect that costs would be lower. The results show that just the opposite is true.

How can this be? The reality is that the economics of health care do not follow the principles that govern prices in standard consumer markets.

For a conventional consumer market to function efficiently, multiple suppliers need to compete based on price and the quality of products available. Consumers need to have full understanding of both product quality as well as  the price charged. They need to be free to switch suppliers if they find a “better deal.” They should have the freedom to “shop around.”

So how does all this apply to health care?

First, and probably most basic, health care providers rarely compete based on price. In fact, unless patients make an effort to ask, the price of a service may well not be known until the bill arrives. Since so much of health care is paid for by third-party payers, patients often have little incentive to ask. Additionally, there is little motivation to “shop” for the best price even if that is an option available to them, which it may not be.  

Furthermore, if patients do have prices to compare from competing providers, they sometimes have skepticism about low-priced services.  They may be concerned that providers have “cut corners” or that the service is less trustworthy. This follows directly from the fact that, unlike most consumer goods, patients usually do not have access to objective information about the quality of the actual service being considered. They usually rely on broad provider reputations or word-of-mouth evaluations. Such sources can provide helpful perspectives but are often lacking in specifics about particular procedures, individual providers, etc.

Treating health care as a commodity has not driven costs lower

Shopping around to get the best deal makes good sense if one is buying groceries or gasoline, but it presents major problems in health care.  Limitations imposed by insurance networks are real. More basically, moving from one provider to another hinders continuity of care and raises the risk of important past history being overlooked or serious risks going unnoticed. Additionally, multiple payers with multiple sets of reimbursement rules have led to administrative complexity and enormous administrative costs.

From the provider perspective, competition all too often leads to duplication of facilities and services. Rather than refer patients/customers to a competitor, each one sets up their own service. This can be a logical action from a business perspective, but in highly technical services such as organ transplantation, small volumes raise the risk of above average cost and poorer outcomes. Competition, instead of promoting lower cost and better service, actually does the opposite.

Paying for health care services is an exceedingly complex undertaking. In the U.S., health care expenditures are the highest in the world, even though we have significant portions of our population who are not getting care. Commitment to conventional market principles has served us well in much of our economy. It is clear, however, that it is not serving us well in the health care.