npr--2020-10-27--At Race's End, Trump's Rallies Recall Other Late Lunges In White House History

At Race 's End , Trump 's Rallies Recall Other Late Lunges In White House History What do you do when Election Day is a week away , you 're down in the polls and more than 60 million votes have already been cast ?
If you 're President Trump , you hit the road .
And you hit it big time , mounting rally stages and treating big raucous crowds to big servings of red meat .
No one doubts Trump can be compelling on camera for adoring crowds , a spectacle that plays to his strengths as a @ @ @ @ @ @ @ .
Here , as opposed to in debates and interviews , he can declare victory over the virus and promote any sort of conspiracy theory he likes .
So get ready for a full week of speeches that run 60 to 90 minutes with brash pronouncements about rigged elections , fake polls , corrupt opponents and news media prejudice .
Much of the president 's time will be devoted to recalling the glories of 2016 , when a flurry of such late rallies seemed to work wonders .
As the outsider challenging the @ @ @ @ @ @ @ the country at a frantic pace , holding by one count 26 rallies across 11 states in the final six days of the campaign — including 10 in eight states in the final 48 hours .
While he did not carry every state he hit on that frantic tour , Trump came remarkably close even in places where he lost , such as Nevada , New Hampshire and Minnesota .
All those states have been back on his itinerary this month , and he was in New Hampshire on Sunday .
Of course @ @ @ @ @ @ @ Trump did reap from his whirlwind tour , including the breathtakingly close ones : Florida , Pennsylvania , Michigan and Wisconsin .
The Florida margin was relatively fat at 1 % .
The other three prizes were taken by a combined total of about 77,000 votes .
Given the winner-take-all rules of the Electoral College , those razor-thin wins were enough to make him president — even though he lost the national popular vote by 2.8 million votes .
There have been voices , even within the Trump campaign , cautioning that these @ @ @ @ @ @ @ coronavirus infection .
There have already been cases traced to Trump rallies .
Moreover , some argue , the president should be seen at work in Washington , battling the pandemic , pushing a COVID-19-and-economy relief bill now hung up in Congress , or addressing other issues .
But those voices of dissent are being drowned out by the roar of the crowd .
Even Vice President Pence , a less dynamic stage performer , is traveling extensively and pitching to crowds .
Over the weekend , some Pence staffers , including his @ @ @ @ @ @ @ the coronavirus and went into quarantine .
But Pence is back out on the trail , providing his echo of the president and The Strategy .
Like other things in the Trump era that may seem unprecedented , these late forays into the country in search of votes actually have quite a history .
Torchlight parades on the eve of Election Day caught on in the burgeoning cities of the 1850s and were first seen as affecting the outcome in the 1860 election of Abraham Lincoln .
For a time , they were @ @ @ @ @ @ @ heat and generating voter turnout at the end of a long campaign year .
Perhaps the most famous late-inning rally on the road was Harry Truman 's legendary `` whistle-stop tour '' in 1948 .
Truman had become president when Franklin Roosevelt died in 1945 but utterly lacked the national stature of his predecessor .
There were few polls in that era , but the incumbent was trailing badly and widely expected to lose .
He refused to go quietly , however , launching a 30,000-mile odyssey that lasted weeks and took him @ @ @ @ @ @ @ gathered at every stop where the train blew its whistle , sometimes in modest numbers but also in notable crowds that spilled across the tracks .
Truman later estimated he had addressed 15 million people , and he wound up winning the popular vote along with a generous majority of the Electoral College .
Since then , incumbent presidents have more typically been well ahead at reelection time .
So they have largely relied on the `` Rose Garden strategy , '' fortified by the White House , projecting stability and confidence .
@ @ @ @ @ @ @ been associated more often with challengers to incumbents , usually in the face of near-certain defeat .
Republican Bob Dole tried the tactic in 1996 , jetting across 15 states in a final , 96-hour lunge for the brass ring .
Dole , then 73 ( now 97 ) , believed this show of indomitable determination would change minds and alter the outcome , but the longtime senator fell far short of dislodging President Bill Clinton , then the White House incumbent .
Even the star-crossed Democrat Walter Mondale pumped some life into @ @ @ @ @ @ @ in 1984 when he drew massive and supportive crowds to late rallies in Baltimore , Boston and New York .
On Nov. 1 , Mondale , the former vice president , and his running mate Geraldine Ferraro ( the first woman on either major party 's ticket ) drew an immense audience in the Garment District of New York City .
Police estimated the throng at 100,000 .
A day earlier , one wire service reporter had described the receptive crowd on Baltimore 's waterfront as `` so rousing it would have suggested @ @ @ @ @ @ @ did not show otherwise . ''
But the polls did show otherwise , and Reagan carried every state in the union but Minnesota , Mondale 's home .
On the night before Election Day , Reagan detoured Air Force One from a planned stop in Wisconsin to visit the Twin Cities instead , hoping a late rally there would capture that one last state .
It very nearly did .
Trump has also been holding rallies in Minnesota and in other states he nearly won in 2016 .
But unlike Reagan and most @ @ @ @ @ @ @ to avoid the big metro areas .
In something of an echo of Truman 's whistle-stopping , Trump heads for Bemidji , Minn. , in the vast northern reaches of the state .
In Pennsylvania , he goes to smaller airport cities between the metro centers and in Florida the targets are places such as Ocala and Pensacola .
The venues allow the campaign to hold rallies outdoor amid the pandemic , but this is also how the Trump team says to Middle America : We care about you .
And even if @ @ @ @ @ @ @ message truly resonates , his mere presence in these places makes a powerful impression — even for those who never thought of coming out for the rally .
In this age of social media and communications overload , does a late blitzkrieg still make a difference ?
One question is whether such rallies merely showcase the hardcore without reaching any new or persuadable voters .
After all , few of those visible at a Trump rally seem exactly undecided .
But a Trump campaign official told a reporter for Politico this month that @ @ @ @ @ @ @ , Ariz. , ( far from the metro areas of Phoenix and Tucson ) found nearly one-fourth of the attendees did not consider themselves Republicans .
Moreover , more than a third of them said they had not voted at all in 2016 .
If these individuals are as enthusiastic about Trump as most at the rally appeared to be , they are the new blood the president needs to win a second term .
Some Americans approach voting for president as a decision as momentous as choosing a college to attend or @ @ @ @ @ @ @ , the commitment is more akin to a car purchase or a vacation package .
Still others seem to make their choice much as they would settle on a movie or a restaurant , often at the last moment .
In any of these decision-making modes , there is both thought and emotion .
But the emotional element may well prevail most often in the third group — those who , deciding later , may not weigh the permanence of the consequences .
For this group , at least , the energy or @ @ @ @ @ @ @ events may well tip the balance .
Or , at at minimum , it 's easy to see why candidates can come to think so .

At Race's End, Trump's Rallies Recall Other Late Lunges In White House History
Enlarge this image toggle caption Mandel Ngan/AFP via Getty Images Mandel Ngan/AFP via Getty Images
What do you do when Election Day is a week away, you're down in the polls and more than 60 million votes have already been cast?
If you're President Trump, you hit the road. And you hit it big time, mounting rally stages and treating big raucous crowds to big servings of red meat.
No one doubts Trump can be compelling on camera for adoring crowds, a spectacle that plays to his strengths as a world class salesman and contemporary media master. Here, as opposed to in debates and interviews, he can declare victory over the virus and promote any sort of conspiracy theory he likes.
So get ready for a full week of speeches that run 60 to 90 minutes with brash pronouncements about rigged elections, fake polls, corrupt opponents and news media prejudice. Much of the president's time will be devoted to recalling the glories of 2016, when a flurry of such late rallies seemed to work wonders.
As the outsider challenging the establishment four years ago, Trump crisscrossed the country at a frantic pace, holding by one count 26 rallies across 11 states in the final six days of the campaign — including 10 in eight states in the final 48 hours.
While he did not carry every state he hit on that frantic tour, Trump came remarkably close even in places where he lost, such as Nevada, New Hampshire and Minnesota. All those states have been back on his itinerary this month, and he was in New Hampshire on Sunday.
Of course, the grand trophies were the states Trump did reap from his whirlwind tour, including the breathtakingly close ones: Florida, Pennsylvania, Michigan and Wisconsin. The Florida margin was relatively fat at 1%. The other three prizes were taken by a combined total of about 77,000 votes. Given the winner-take-all rules of the Electoral College, those razor-thin wins were enough to make him president — even though he lost the national popular vote by 2.8 million votes.
There have been voices, even within the Trump campaign, cautioning that these events could be "superspreaders" for coronavirus infection. There have already been cases traced to Trump rallies. Moreover, some argue, the president should be seen at work in Washington, battling the pandemic, pushing a COVID-19-and-economy relief bill now hung up in Congress, or addressing other issues.
But those voices of dissent are being drowned out by the roar of the crowd.
Even Vice President Pence, a less dynamic stage performer, is traveling extensively and pitching to crowds. Over the weekend, some Pence staffers, including his chief of staff, tested positive for the coronavirus and went into quarantine. But Pence is back out on the trail, providing his echo of the president and The Strategy.
Like other things in the Trump era that may seem unprecedented, these late forays into the country in search of votes actually have quite a history.
Before Twitter: torchlight and trains
Torchlight parades on the eve of Election Day caught on in the burgeoning cities of the 1850s and were first seen as affecting the outcome in the 1860 election of Abraham Lincoln. For a time, they were a standard way of turning up the heat and generating voter turnout at the end of a long campaign year.
Perhaps the most famous late-inning rally on the road was Harry Truman's legendary "whistle-stop tour" in 1948. Truman had become president when Franklin Roosevelt died in 1945 but utterly lacked the national stature of his predecessor. There were few polls in that era, but the incumbent was trailing badly and widely expected to lose.
Enlarge this image toggle caption AP AP
He refused to go quietly, however, launching a 30,000-mile odyssey that lasted weeks and took him literally from coast to coast. People gathered at every stop where the train blew its whistle, sometimes in modest numbers but also in notable crowds that spilled across the tracks. Truman later estimated he had addressed 15 million people, and he wound up winning the popular vote along with a generous majority of the Electoral College.
Since then, incumbent presidents have more typically been well ahead at reelection time. So they have largely relied on the "Rose Garden strategy," fortified by the White House, projecting stability and confidence.
The late, frantic campaign dash has been associated more often with challengers to incumbents, usually in the face of near-certain defeat.
Republican Bob Dole tried the tactic in 1996, jetting across 15 states in a final, 96-hour lunge for the brass ring. Dole, then 73 (now 97), believed this show of indomitable determination would change minds and alter the outcome, but the longtime senator fell far short of dislodging President Bill Clinton, then the White House incumbent.
Even the star-crossed Democrat Walter Mondale pumped some life into his longshot challenge to President Ronald Reagan in 1984 when he drew massive and supportive crowds to late rallies in Baltimore, Boston and New York. On Nov. 1, Mondale, the former vice president, and his running mate Geraldine Ferraro (the first woman on either major party's ticket) drew an immense audience in the Garment District of New York City. Police estimated the throng at 100,000. A day earlier, one wire service reporter had described the receptive crowd on Baltimore's waterfront as "so rousing it would have suggested he was the front-runner if the polls did not show otherwise."
Enlarge this image toggle caption Suzanne Vlamis/AP Suzanne Vlamis/AP
But the polls did show otherwise, and Reagan carried every state in the union but Minnesota, Mondale's home. On the night before Election Day, Reagan detoured Air Force One from a planned stop in Wisconsin to visit the Twin Cities instead, hoping a late rally there would capture that one last state. It very nearly did.
Target small cities and towns
Trump has also been holding rallies in Minnesota and in other states he nearly won in 2016. But unlike Reagan and most candidates since, Trump this year tends to avoid the big metro areas.
In something of an echo of Truman's whistle-stopping, Trump heads for Bemidji, Minn., in the vast northern reaches of the state. In Pennsylvania, he goes to smaller airport cities between the metro centers and in Florida the targets are places such as Ocala and Pensacola.
The venues allow the campaign to hold rallies outdoor amid the pandemic, but this is also how the Trump team says to Middle America: We care about you. And even if no other part of the president's message truly resonates, his mere presence in these places makes a powerful impression — even for those who never thought of coming out for the rally.
In this age of social media and communications overload, does a late blitzkrieg still make a difference? One question is whether such rallies merely showcase the hardcore without reaching any new or persuadable voters. After all, few of those visible at a Trump rally seem exactly undecided.
But a Trump campaign official told a reporter for Politico this month that a survey at one rally in Prescott, Ariz., (far from the metro areas of Phoenix and Tucson) found nearly one-fourth of the attendees did not consider themselves Republicans. Moreover, more than a third of them said they had not voted at all in 2016. If these individuals are as enthusiastic about Trump as most at the rally appeared to be, they are the new blood the president needs to win a second term.
Some Americans approach voting for president as a decision as momentous as choosing a college to attend or a place to live. For others, the commitment is more akin to a car purchase or a vacation package. Still others seem to make their choice much as they would settle on a movie or a restaurant, often at the last moment.
In any of these decision-making modes, there is both thought and emotion. But the emotional element may well prevail most often in the third group — those who, deciding later, may not weigh the permanence of the consequences.
For this group, at least, the energy or the media coverage generated by these 11th-hour events may well tip the balance. Or, at at minimum, it's easy to see why candidates can come to think so.


npr--2020-10-27--If The ACA Falls, Protecting Preexisting Conditions Could Be Harder Than It Sounds

If The ACA Falls , Protecting Preexisting Conditions Could Be Harder Than It Sounds President Trump has tried to get rid of the Affordable Care Act since the first day of his presidency , but there 's one part of Obamacare that he wants to preserve .
`` We will always protect patients with preexisting conditions — always , '' Trump told a campaign crowd on Sunday in Londonderry , N.H. — a message he 's shared repeatedly in the final days and weeks before the presidential election .
He said it again in an interview with CBS ' Lesley @ @ @ @ @ @ @ : `` We wo n't do anything — and no plan — unless we have preexisting conditions covered . ''
A `` preexisting condition '' refers to any health issue someone has before they sign up for a health insurance policy — from high blood pressure to pregnancy to allergies .
Before the Affordable Care Act , it was perfectly legal for health insurers to deny coverage to people with such conditions .
An estimate from the Kaiser Family Foundation suggests that around 54 million people have conditions that — without legal protections @ @ @ @ @ @ @ them policies .
Polls show this is one of the most popular provisions of the law , across the political spectrum .
Although Republicans failed to repeal the ACA in 2017 , Trump now has another chance to strike it down : his administration will argue that the law must `` fall '' at the Supreme Court on November 10 , just one week after the election .
The addition of Justice Amy Coney Barrett to the court could make this Supreme Court challenge more likely to succeed than two previous attempts .
@ @ @ @ @ @ @ and the administration would have to act fast to protect people with preexisting conditions .
But actually making a law that does that is harder than it sounds .
Here 's why it 's so tricky , and how Trump may look to address the problem if he 's elected for a second term .
To understand this problem , you have to time travel to pre-ACA times , says Sabrina Corlette , co-director of the Center on Health Insurance Reforms at Georgetown University .
Before the ACA , `` one of the @ @ @ @ @ @ @ was to discourage risky people from buying into their plans and get as [ many ] healthy people as they could , '' she explains .
That way , `` they could get the premium revenue and not have to pay out as much in medical claims . ''
When you applied for a private private health plan as an individual — as opposed to getting insurance through your job or a public plan like Medicare — insurers would usually require you to fill out a questionnaire and ask for permission to look @ @ @ @ @ @ @ found a health condition that concerned them , Corlette explains , there were three things they could do .
The first tool they could use was to `` simply deny you a policy and just say , ' I 'm sorry , we ca n't cover you . '
`` The second tool was to issue you a policy but to say , `` 'We wo n't cover any care related to your preexisting condition — we see that you have asthma , so we wo n't cover anything related to an upper @ @ @ @ @ @ @ third tool would be to simply say , 'We will cover you , but we 're going to essentially charge you a higher premium because we think you 're a riskier person — we normally charge people $ 100 a month , we 're going to charge you $ 150 a month , ' `` Corlette explains .
To stop insurance companies from doing this , the Affordable Care Act needed to come up with a way to keep enough healthy people in the market to balance out the cost of covering more @ @ @ @ @ @ @ fire insurance , says Larry Levitt , executive vice president for health policy at the Kaiser Family Foundation .
`` If you let people insure their house once it 's already on fire , everyone 's going to wait until their house is on fire to buy insurance .
It 's a similar problem in health care : If you tell people with preexisting conditions that they 're guaranteed access to insurance , people who are healthy will tend to wait to buy insurance until they get sick . ''
If the insurance @ @ @ @ @ @ @ who need lots of medical care , `` premiums skyrocket into what 's known as a death spiral , '' he says .
So , the people who crafted the Affordable Care Act came up with incentives to get more healthy people into the insurance pool .
`` The ACA had a carrot and stick , '' says Levitt .
`` The carrot was subsidies provided to low- and middle-income people that made insurance a good value , and the stick was the individual mandate . ''
In 2017 , Republicans in Congress @ @ @ @ @ @ @ $ 0 as part of the tax bill .
( The fact that the penalty is zero dollars is the basis for the legal challenge soon to be argued before the Supreme Court . )
Even without the threat of a fine for not having insurance , though , `` the carrot of the subsidies is still in place and has been very effective at keeping premiums stable , '' Levitt says .
As President Trump pointed out during Thursday 's debate , `` premiums are down , everything 's down . ''
@ @ @ @ @ @ @ the private market to keep premiums from skyrocketing , although critics still argue that high plan costs price people out of the market .
So without the ACA , how would President Trump and his allies prefer to approach the problem ?
`` We do n't know where the president is on this , '' says Douglas Holtz-Eakin , president of the American Action Forum , a conservative think tank .
Trump did sign an executive order related to preexisting conditions in September , but all it did , Holtz-Eakin says , `` @ @ @ @ @ @ @ [ health ] secretary is going to have to figure this out . ''
There are other ways to incentivize healthy people to pay for health insurance .
For Republicans , `` the leading alternative approach has been continuous coverage provisions , '' Holtz-Eakin says .
This idea has been part of Republican ACA replacement bills before — people could be charged a fee and potentially be locked out of the market if they have a break in coverage , thus presumably motivating the young and healthy to stay consistently insured .
Holtz-Eakin @ @ @ @ @ @ @ that `` an insurer has a stake in more than one year of your life — so there are now incentives to cover prevention more than there would be otherwise . ''
Critics have argued that could actually disincentivize healthy people who do n't have coverage from joining the market , and hurt low-income people who already have trouble finding and maintaining health insurance .
Another Republican idea is to go back to `` high risk pools , '' which were common before the ACA .
This divides the market into healthy people @ @ @ @ @ @ @ healthy people can pay lower premiums , but the pool for sick people gets expensive fast .
Monthly premiums — even if they 're very high — from the limited pool of sick people would not pay for all their care , meaning the government and insurance companies would have to step in to cover costs .
Of course , on the other side of the political spectrum , there 's the idea of Medicare-for-all , where everyone is covered in a government-funded plan .
That would ensure people with preexisting conditions can @ @ @ @ @ @ @ that 's an idea the Trump administration would never go for .
If the Affordable Care Act is fully struck down by the Supreme Court without a replacement , `` the preexisting condition protections go away , '' Corlette says , along with the insurance marketplaces , Medicaid expansion , premium subsidies , and more .
As a result , a recent Urban Institute analysis projected that 21.1 million could lose health coverage , a nearly 70 % increase in the number of uninsured .
Another concern : COVID-19 might be considered a @ @ @ @ @ @ @ could mean millions more people affected by changes to these rules because of the pandemic .
There are a lot of outstanding questions .
Would the Supreme Court justices give Congress a few months to come up with a fix to the ACA or pass a new law to prevent the coverage losses ?
Would the court make a narrow ruling that kept most of the law intact ?
Would it rule against the challengers , keeping the ACA as it is ?
Without the ACA or another federal law requiring insurance companies @ @ @ @ @ @ @ , they would almost certainly `` revert back to their business model of yore , '' says Corlette .
`` The incentives for them to start underwriting again and getting rid of high cost , high risk people are too strong . ''
As an example , if you 're an insurance company in a city with two competing insurers , `` and you 're the only one that is still taking sick people and enrolling them , you will quickly find yourself with the highest premiums , the fewest enrollees , and @ @ @ @ @ @ @ to your competitors , '' she says .
This is not what insurance companies want .
Insurance industry group America 's Health Insurance Plans submitted an amicus brief to the Supreme Court arguing that the ACA should not be struck down .

If The ACA Falls, Protecting Preexisting Conditions Could Be Harder Than It Sounds
Enlarge this image toggle caption Evan Vucci/AP Evan Vucci/AP
President Trump has tried to get rid of the Affordable Care Act since the first day of his presidency, but there's one part of Obamacare that he wants to preserve.
"We will always protect patients with preexisting conditions — always," Trump told a campaign crowd on Sunday in Londonderry, N.H. It's a message he has shared repeatedly in the final days and weeks before the presidential election.
He said it again in an interview with CBS' Lesley Stahl that aired Sunday on 60 minutes: "We won't do anything — and no plan — unless we have preexisting conditions covered."
A "preexisting condition" refers to any health issue someone has before they sign up for a health insurance policy — from high blood pressure to pregnancy to allergies. Before the Affordable Care Act, it was perfectly legal for health insurers to deny coverage to people with such conditions.
An estimate from the Kaiser Family Foundation suggests that about 54 million people have conditions that — without legal protections — could prompt health insurers to deny them policies. Polls show this is one of the most popular provisions of the law, across the political spectrum.
Although Republicans failed to repeal the ACA in 2017, Trump now has another chance to strike it down; his administration will argue that the law must "fall" at the Supreme Court on Nov. 10, just one week after the election. The addition of Justice Amy Coney Barrett to the court could make this Supreme Court challenge more likely to succeed than two previous attempts.
If the law does fall, Congress and the administration would have to act fast to protect people with preexisting conditions. But actually making a law that does that is harder than it sounds. Here's why it's so tricky and how Trump might look to address the problem if he's elected for a second term.
How things worked, pre-ACA
To understand this problem, you have to time travel to pre-ACA times, says Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University.
Before the ACA, "one of the essential business models for health insurance companies was to discourage risky people from buying into their plans and get as [many] healthy people as they could," she explains. That way, "they could get the premium revenue and not have to pay out as much in medical claims."
When you applied for a private health plan as an individual — as opposed to getting insurance through your job or a public plan like Medicare — insurers would usually require you to fill out a questionnaire and ask for permission to look through your medical records.
If they found a health condition that concerned them, Corlette explains, there were three things they could do.
The first tool they could use was to "simply deny you a policy and just say, 'I'm sorry, we can't cover you.' " The second tool was to issue you a policy but to say, "'We won't cover any care related to your preexisting condition — we see that you have asthma, so we won't cover anything related to an upper respiratory condition.' "
"A third tool would be to simply say, 'We will cover you, but we're going to essentially charge you a higher premium because we think you're a riskier person — we normally charge people $100 a month, we're going to charge you $150 a month,' " Corlette explains.
The ACA fix
To stop insurance companies from doing this, the Affordable Care Act needed to come up with a way to keep enough healthy people in the market to balance out the cost of covering more expensive, sick people.
Think about fire insurance, says Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation. "If you let people insure their house once it's already on fire, everyone's going to wait until their house is on fire to buy insurance. It's a similar problem in health care: If you tell people with preexisting conditions that they're guaranteed access to insurance, people who are healthy will tend to wait to buy insurance until they get sick."
If the insurance market is made up of sick people who need lots of medical care, "premiums skyrocket into what's known as a death spiral," he says.
So, the people who crafted the Affordable Care Act came up with incentives to get more healthy people into the insurance pool. "The ACA had a carrot and stick," says Levitt. "The carrot was subsidies provided to low- and middle-income people that made insurance a good value, and the stick was the individual mandate."
In 2017, Republicans in Congress changed the individual mandate's penalty to $0 as part of the tax bill. (The fact that the penalty is zero dollars is the basis for the legal challenge soon to be argued before the Supreme Court.)
Even without the threat of a fine for not having insurance, though, "the carrot of the subsidies is still in place and has been very effective at keeping premiums stable," Levitt says.
As Trump pointed out during Thursday's debate, "premiums are down, everything's down." Enough healthy people are buying plans in the private market to keep premiums from skyrocketing, although critics still argue that high plan costs price people out of the market.
The challenges of alternate solutions
So without the ACA, how would Trump and his allies prefer to approach the problem?
"We don't know where the president is on this," says Douglas Holtz-Eakin, president of the American Action Forum, a conservative think tank. Trump did sign an executive order related to preexisting conditions in September, but all it did, Holtz-Eakin says, "was to say very firmly that the [health] secretary is going to have to figure this out."
There are other ways to incentivize healthy people to pay for health insurance. For Republicans, "the leading alternative approach has been continuous coverage provisions," Holtz-Eakin says. This idea has been part of Republican ACA replacement bills before — people could be charged a fee and potentially be locked out of the market if they have a break in coverage, thus presumably motivating the young and healthy to stay consistently insured.
Holtz-Eakin says the promise of this model is that "an insurer has a stake in more than one year of your life — so there are now incentives to cover prevention more than there would be otherwise." Critics have argued that could actually disincentivize healthy people who don't have coverage from joining the market and hurt low-income people who already have trouble finding and maintaining health insurance.
Another Republican idea is to go back to "high risk pools," which were common before the ACA. This divides the market into healthy people and sick people. That way, healthy people can pay lower premiums, but the pool for sick people gets expensive fast. Monthly premiums — even if they're very high — from the limited pool of sick people would not pay for all their care, meaning the government and insurance companies would have to step in to cover costs.
Of course, on the other side of the political spectrum, there's the idea of "Medicare for All," where everyone is covered in a government-funded plan. That would ensure people with preexisting conditions can be covered, says Levitt, but that's an idea the Trump administration would never go for.
What could happen?
If the Affordable Care Act is fully struck down by the Supreme Court without a replacement, "the preexisting condition protections go away," Corlette says, along with the insurance marketplaces, Medicaid expansion, premium subsidies and more. As a result, a recent Urban Institute analysis projected that 21.1 million could lose health coverage, a nearly 70% increase in the number of uninsured.
Another concern: COVID-19 might be considered a preexisting condition by insurance companies. That could mean millions more people affected by changes to these rules because of the pandemic.
There are a lot of outstanding questions. Would the Supreme Court justices give Congress a few months to come up with a fix to the ACA or pass a new law to prevent the coverage losses? Would the court make a narrow ruling that kept most of the law intact? Would it rule against the challengers, keeping the ACA as it is?
Without the ACA or another federal law requiring insurance companies to cover everyone regardless of their health, they would almost certainly "revert back to their business model of yore," says Corlette. "The incentives for them to start underwriting again and getting rid of high cost, high risk people are too strong."
As an example, if you're an insurance company in a city with two competing insurers, "and you're the only one that is still taking sick people and enrolling them, you will quickly find yourself with the highest premiums, the fewest enrollees, and and you'll be losing money compared to your competitors," she says.
This is not what insurance companies want. Insurance industry group America's Health Insurance Plans submitted an amicus brief to the Supreme Court arguing that the ACA should not be struck down.


npr--2020-10-26--Eli Lilly Ends Antibody Trial In Hospitalized COVID-19 Patients, Other Trials Go On

Eli Lilly Ends Antibody Trial In Hospitalized COVID-19 Patients , Other Trials Go On Eli Lilly & Co. is ending a clinical trial of its antibody drug bamlanivimab in hospitalized COVID-19 patients after federal researchers concluded the therapy produced no marked improvement .
The study of the monoclonal antibody called bamlanivimab was initially paused by the company on Oct. 13 out of `` an abundance of caution , '' because of a potential safety concern .
For this particular study the therapy was being used in combination with remdesivir , an antiviral with emergency use authorization for the virus .
@ @ @ @ @ @ @ received after contracting the coronavirus .
On Monday , the National Institutes of Health , which sponsored the trial , found the antibody treatment posed no significant safety risks for patients .
However , researchers said , `` bamlanivimab is unlikely to help hospitalized COVID-19 patients recover from this advanced stage of their disease . ''
The decision to end this study does not put an end to Lilly 's investment in the experimental therapy .
Company officials said they `` remain confident ... that bamlanivimab monotherapy may prevent progression of disease for @ @ @ @ @ @ @ . ''
The company and the NIH are pursuing several additional trials involving the antibody , which is designed to stop the virus from infecting cells .
The trials target patients with less advanced stages of the disease .

Eli Lilly Ends Antibody Trial In Hospitalized COVID-19 Patients, Other Trials Go On
Enlarge this image toggle caption David Morrison/AP David Morrison/AP
Eli Lilly & Co. is ending a clinical trial of its antibody drug bamlanivimab in hospitalized COVID-19 patients after federal researchers concluded the therapy produced no marked improvement.
The study of the monoclonal antibody called bamlanivimab was initially paused by the company on Oct. 13 out of "an abundance of caution," because of a potential safety concern. For this particular study the therapy was being used in combination with remdesivir, an antiviral with emergency use authorization for the virus.
Remdesivir was among the medications President Trump received after contracting the coronavirus.
On Monday, the National Institutes of Health, which sponsored the trial, found the antibody treatment posed no significant safety risks for patients. However, researchers said, "bamlanivimab is unlikely to help hospitalized COVID-19 patients recover from this advanced stage of their disease."
The decision to end this study does not put an end to Lilly's investment in the experimental therapy. Company officials said they "remain confident ... that bamlanivimab monotherapy may prevent progression of disease for those earlier in the course of COVID-19."
The company and the NIH are pursuing several additional trials involving the antibody, which is designed to stop the virus from infecting cells. The trials target patients with less advanced stages of the disease.


npr--2020-10-27--Mask-Wearing Is Up In The U.S., But Young People Are Still Too Lax, CDC Survey Finds

Mask-Wearing Is Up In The U.S. , But Young People Are Still Too Lax , CDC Survey Finds More Americans may be wearing masks than early last spring , but other recommended behaviors to stop the pandemic 's spread have n't kept pace , according to a new federal survey .
And young people are the least likely to take needed steps to stop the virus , the data suggest .
The proportion of U.S. adults reporting wearing face masks increased from 78 % in April to 89 % in June , according to the nationally representative survey released by @ @ @ @ @ @ @ .
But the survey found either no change or a decline in other behaviors aimed at preventing the spread of the coronavirus , such as hand-washing , social distancing and avoiding public or crowded places .
`` Interesting data , '' Dr. Carlos Del Rio , a professor of global health and epidemiology at the Rollins School of Public Health at Emory University , wrote in an email to NPR .
Del Rio was not involved in conducting the survey , which appears in this week 's issue of Morbidity and Mortality Weekly @ @ @ @ @ @ @ '' he says , `` but I wish they were better — especially among younger people . ''
The survey , conducted by the CDC in April , May and June , questioned more than 2,000 U.S. adults ages 18 and older .
Young people were the least likely to engage in any of the recommended behaviors , which could help explain the increase in infections among this age group over that time period , the scientists say .
Although younger people are less likely to suffer the most serious complications of COVID-19 @ @ @ @ @ @ @ in some cases ; and even those with mild cases or who are asymptomatic can spread the virus to older people , who are most vulnerable .
`` These findings underscore the need to prioritize clear , targeted messaging and behavior modification interventions , especially for younger adults , to encourage uptake and support maintenance of recommended mitigation behaviors proven to slow the spread of COVID-19 , '' the researchers write in the MMWR report .
Overall , most adults reported engaging in most or all of the six recommended behaviors : hand-washing @ @ @ @ @ @ @ people , mask wearing and avoiding public or crowded places ; they 'd canceled or postponed social or recreational activities , they said , and avoided some or all restaurants .
But aside from the increase in mask-wearing , all other recommended behaviors decreased from April to June except for `` avoiding some or all restaurants , '' which did not change significantly .
People ages 60 and older were most likely to comply with recommendations , while those ages 18 to 29 were least likely .
For example , mask-wearing increased from @ @ @ @ @ @ @ in June among those ages 60 and older .
`` There 's more we must do to reduce infection , but that 's an astounding increase — from 0 % in less than eight months , '' Thomas Frieden , a former CDC director wrote of the increase in mask-wearing , in an email to NPR .
Still , among those ages 18 to 29 , mask-wearing only increased from 69.6 % in April to 86.1 % in June .
Respondents who said they wear masks were more likely to follow other recommendations @ @ @ @ @ @ @ report mask use , all other recommended behavior declined significantly from April to June , the survey found .
`` Older adults might be more concerned about COVID-19 , based on their higher risk for severe illness compared with that of younger adults , '' the researchers say .
Young adults might also be less likely to engage in mitigation behaviors because of `` social , developmental , and practical factors , '' they say .
`` Significant declines in self-reported mitigation behaviors among those not reporting mask use suggests that a minority @ @ @ @ @ @ @ COVID-19 mitigation behaviors , '' the scientists conclude , `` or unable to engage in mitigation behaviors because of the constraints introduced by their return to work , school or other settings . ''

Mask-Wearing Is Up In The U.S., But Young People Are Still Too Lax, CDC Survey Finds
Enlarge this image toggle caption Jeff Greenberg/Universal Images Group via Getty Images Jeff Greenberg/Universal Images Group via Getty Images
More Americans may be wearing masks than early last spring, but other recommended behaviors to stop the pandemic's spread haven't kept pace, according to a new federal survey. And young people are the least likely to take needed steps to stop the virus, the data suggest.
The proportion of U.S. adults reporting wearing face masks increased from 78% in April to 89% in June, according to the nationally representative survey released by Centers for Disease Control and Prevention Tuesday.
But the survey found either no change or a decline in other behaviors aimed at preventing the spread of the coronavirus, such as hand-washing, social distancing and avoiding public or crowded places.
"Interesting data," Dr. Carlos Del Rio, a professor of global health and epidemiology at the Rollins School of Public Health at Emory University, wrote in an email to NPR. Del Rio was not involved in conducting the survey, which appears in this week's issue of Morbidity and Mortality Weekly Report. "Results are encouraging," he says, "but I wish they were better — especially among younger people."
The survey, conducted by the CDC in April, May and June, questioned more than 2,000 U.S. adults ages 18 and older.
Young people were the least likely to engage in any of the recommended behaviors, which could help explain the increase in infections among this age group over that time period, the scientists say.
Although younger people are less likely to suffer the most serious complications of COVID-19, the infection can still be serious in some cases; and even those with mild cases or who are asymptomatic can spread the virus to older people, who are most vulnerable.
"These findings underscore the need to prioritize clear, targeted messaging and behavior modification interventions, especially for younger adults, to encourage uptake and support maintenance of recommended mitigation behaviors proven to slow the spread of COVID-19," the researchers write in the MMWR report.
Overall, most adults reported engaging in most or all of the six recommended behaviors: hand-washing, staying 6 feet away from other people, mask wearing and avoiding public or crowded places; they'd canceled or postponed social or recreational activities, they said, and avoided some or all restaurants.
But aside from the increase in mask-wearing, all other recommended behaviors decreased from April to June except for "avoiding some or all restaurants," which did not change significantly.
People ages 60 and older were most likely to comply with recommendations, while those ages 18 to 29 were least likely.
For example, mask-wearing increased from 83.7% in April to 92.4% in June among those ages 60 and older.
"There's more we must do to reduce infection, but that's an astounding increase — from 0% in less than eight months," Thomas Frieden, a former CDC director wrote of the increase in mask-wearing, in an email to NPR.
Still, among those ages 18 to 29, mask-wearing only increased from 69.6% in April to 86.1% in June.
Respondents who said they wear masks were more likely to follow other recommendations. And among those who did not report mask use, all other recommended behavior declined significantly from April to June, the survey found.
"Older adults might be more concerned about COVID-19, based on their higher risk for severe illness compared with that of younger adults," the researchers say.
Young adults might also be less likely to engage in mitigation behaviors because of "social, developmental, and practical factors," they say.
"Significant declines in self-reported mitigation behaviors among those not reporting mask use suggests that a minority of persons might be increasingly resistant to COVID-19 mitigation behaviors," the scientists conclude, "or unable to engage in mitigation behaviors because of the constraints introduced by their return to work, school or other settings."


npr--2020-10-27--As COVID-19 Cases Surge In Wisconsin, Health Workers Brace For More

As COVID-19 Cases Surge In Wisconsin , Health Workers Brace For More It took Wisconsin more than seven months to reach 100,000 coronavirus cases .
On Monday , just five weeks later , it reached 200,000 .
Wisconsin is now experiencing a massive upsurge in cases that rivals the numbers seen in much bigger states .
Hospital beds are at about 85 % capacity statewide .
The state just opened a field hospital near Milwaukee that can accommodate more than 500 patients .
`` Early on in the pandemic , we put a lot of plans in place and then @ @ @ @ @ @ @ to put those away for a while .
We had COVID cases , but they were n't overwhelming .
Things were going OK , '' says Dr. Jeffrey Pothof , an emergency room doctor in Madison .
`` And then everything changed .
And now we are the next hot spot .
And that 's been so challenging for all of our staff who have been at this for so long now . ''
Pothof , who is also chief of quality for the University of Wisconsin-Madison 's health system , tells NPR @ @ @ @ @ @ @ in OK shape .
The biggest concern is staffing .
`` It 's one of the things that we as a health system just ca n't create by investing more money or more time .
And , you know , we 're running short of critical care nurses , critical care physicians for patients that need them because they have COVID-19 and they 're in one of our ICUs , '' he says .
Hospitalizations have skyrocketed in the last month in Wisconsin , a state with a mix of rural and urban @ @ @ @ @ @ @ from rural hospitals that exceed their capacity to his hospital in Madison .
It 's those rural areas that are of particular concern as COVID-19 cases rise .
From the small city of Marshfield in central Wisconsin , nurse Theresa Weiler tells Morning Edition that `` it 's almost a rotating door here . ''
Weiler , who supervises the COVID-19 unit at Marshfield Medical Center , says they `` either send somebody home or they leave and then we get somebody else in a bed right away . ''
In nearby Wausau @ @ @ @ @ @ @ are very resource-intensive .
Andrews is the chief medical officer for Aspirus , a rural health system that covers 35,000 square miles .
`` Although we 've planned and are working through our plan , there is a finite amount that we can support , '' he says .
Many people already travel two to three hours to get to their facility .
`` And if we ca n't take care of them , if our capacity is reached , they 're going to have to travel another one to two to three @ @ @ @ @ @ @ very hard on patients and also very hard on their families and communities . ''
Andrews says the system has not reached capacity yet , but has asked surgical partners to postpone elective surgeries .
Both Marshfield and Wausau are dealing with an additional challenge : staffers getting COVID-19 themselves .
`` If we are putting ourselves at risk and we get sick , who covers for us ? ''
says Weiler in Marshfield .
She emphasizes the advice of health officials for everyone : Wear a mask .
Do n't gather in @ @ @ @ @ @ @ feet apart .
Wash your hands .
If you 're sick , stay home .
`` That little bit can kind of help us a long way . ''
Staff are tired , she says .
`` The exhausting part , '' says Weiler , is that `` we do n't know when it will end or when it will slow down . ''
Avery Keatley , Nina Kravinsky and Lilly Quiroz produced and Dalia Mortada edited the audio versions of this story .

As COVID-19 Cases Surge In Wisconsin, Health Workers Brace For More
Enlarge this image toggle caption Scott Olson/Getty Images Scott Olson/Getty Images
It took Wisconsin more than seven months to reach 100,000 coronavirus cases. On Monday, just five weeks later, it reached 200,000.
Wisconsin is now experiencing a massive upsurge in cases that rivals the numbers seen in much bigger states. Hospital beds are at about 85% capacity statewide. The state just opened a field hospital near Milwaukee that can accommodate more than 500 patients.
"Early on in the pandemic, we put a lot of plans in place and then we were fortunate enough to be able to put those away for a while. We had COVID cases, but they weren't overwhelming. Things were going OK," says Dr. Jeffrey Pothof, an emergency room doctor in Madison. "And then everything changed. And now we are the next hot spot. And that's been so challenging for all of our staff who have been at this for so long now."
Health COVID-19 Case Spike Stretches Medical Resources In Wisconsin COVID-19 Case Spike Stretches Medical Resources In Wisconsin Listen · 4:43 4:43
Pothof, who is also chief of quality for the University of Wisconsin-Madison's health system, tells NPR's Morning Edition that medical supplies are in OK shape. The biggest concern is staffing.
"It's one of the things that we as a health system just can't create by investing more money or more time. And, you know, we're running short of critical care nurses, critical care physicians for patients that need them because they have COVID-19 and they're in one of our ICUs," he says.
Hospitalizations have skyrocketed in the last month in Wisconsin, a state with a mix of rural and urban areas. Pothof says patients frequently come from rural hospitals that exceed their capacity to his hospital in Madison. It's those rural areas that are of particular concern as COVID-19 cases rise.
From the small city of Marshfield in central Wisconsin, nurse Theresa Weiler tells Morning Edition that "it's almost a rotating door here."
Weiler, who supervises the COVID-19 unit at Marshfield Medical Center, says they "either send somebody home or they leave and then we get somebody else in a bed right away."
In nearby Wausau, Dr. Ryan Andrews says coronavirus patients are very resource-intensive. Andrews is the chief medical officer for Aspirus, a rural health system that covers 35,000 square miles.
"Although we've planned and are working through our plan, there is a finite amount that we can support," he says. Many people already travel two to three hours to get to their facility. "And if we can't take care of them, if our capacity is reached, they're going to have to travel another one to two to three hours as well. And that's very hard on patients and also very hard on their families and communities."
Health Rural Wisconsin Is Hit The Hardest With Surge In COVID-19 Cases Rural Wisconsin Is Hit The Hardest With Surge In COVID-19 Cases Listen · 2:30 2:30
Andrews says the system has not reached capacity yet, but has asked surgical partners to postpone elective surgeries.
Both Marshfield and Wausau are dealing with an additional challenge: staffers getting COVID-19 themselves.
"If we are putting ourselves at risk and we get sick, who covers for us?" says Weiler in Marshfield.
She emphasizes the advice of health officials for everyone: Wear a mask. Don't gather in groups. Social distance. Stay 6 feet apart. Wash your hands. If you're sick, stay home. "That little bit can kind of help us a long way."
Staff are tired, she says. "The exhausting part," says Weiler, is that "we don't know when it will end or when it will slow down."
Avery Keatley, Nina Kravinsky and Lilly Quiroz produced and Dalia Mortada edited the audio versions of this story.


npr--2020-10-27--Judge Orders Richmond's Robert E. Lee Statue Can Be Removed

A Virginia judge has ruled that Richmond 's statue of Confederate Gen. Robert E. Lee can be removed under the governor 's order .
The statue , which stands 60 feet high , is the only Confederate statue still standing on the city 's Monument Avenue after others were toppled by protesters or removed by the city .
Judge W. Reilly Marchant 's ruling came Tuesday evening , following testimony in the case a week earlier .
The plaintiffs are expected to appeal the ruling .
The lawsuit was brought by a group of Richmond residents who live near the @ @ @ @ @ @ @ the statue removed in June .
The order has been mired in legal battles since , and injunctions have prevented its removal .
The judge wrote that the Commonwealth of Virginia has the legal authority to remove the monument after it successfully argued that the 19th-century convenants the plaintiffs used to try to block the removal `` would be in violation of the current public policy of the Commonwealth of Virginia . ''
`` We are one step closer to a more equitable and honest Virginia , '' Northam tweeted after the ruling @ @ @ @ @ @ @ the judge 's decision .
`` We WON the Lee statue case after a judge found that it was raised against a backdrop of white supremacy and that it is against public policy to keep it up , '' Herring tweeted .
`` The ruling is *stayed* pending appeal , but this is a HUGE win and we 're on the path to bringing down this relic '' .
As member station VPM 's Whittney Evans reported , the plaintiffs , who did not respond to VPM 's request for comment on Tuesday @ @ @ @ @ @ @ removal would `` degrade '' the district and lower their property values .
Witnesses for the plaintiffs included an archivist for the United Daughters of the Confederacy and the president the American Civil War Museum in Richmond .
In recent months , other statues on the city 's Monument Avenue have either been toppled by protestors or removed by the authorities .
The statue of Jefferson Davis was toppled in June , as was a statue of Christopher Columbus in another part of the city .
In July , Richmond Mayor Levar Stoney @ @ @ @ @ @ @ from the avenue .
Meanwhile , the Lee statue has taken on a new life as an icon of resistance and transformation .
The statue of Lee on horseback was erected in 1890 in the former capital of the Confederacy .
The statue itself is 21 feet high , on a pedestal almost twice as tall .
In June , Gov .
Northam explained why he was ordering the statue to be removed from the pedestal : '' Think about the message this sends to people coming from around the world to visit @ @ @ @ @ @ @ largest states in the country .
Or to young children .
What do you say when a six-year-old African American little girl looks you in the eye , and says : What does this big statue mean ?
Why is it here ?
`` When a young child looks up and sees something that big and prominent , she knows that it 's important .
And when it 's the biggest thing around , it sends a clear message : This is what we value the most .
But that 's just not @ @ @ @

Judge Orders Richmond's Robert E. Lee Statue Can Be Removed
Enlarge this image toggle caption Eze Amos/Getty Images Eze Amos/Getty Images
Updated at 7:29 p.m. ET
A Virginia judge has ruled that Richmond's statue of Confederate Gen. Robert E. Lee can be removed under the governor's order. The statue, which stands 60 feet high, is the only Confederate statue still standing on the city's Monument Avenue after others were toppled by protesters or removed by the city.
Judge W. Reilly Marchant's ruling came Tuesday evening, following testimony in the case a week earlier. The plaintiffs are expected to appeal the ruling.
The lawsuit was brought by a group of Richmond residents who live near the statue after Gov. Ralph Northam ordered the statue removed in June. The order has been mired in legal battles since, and injunctions have prevented its removal.
The judge wrote that the Commonwealth of Virginia has the legal authority to remove the monument after it successfully argued that the 19th-century convenants the plaintiffs used to try to block the removal "would be in violation of the current public policy of the Commonwealth of Virginia."
"We are one step closer to a more equitable and honest Virginia," Northam tweeted after the ruling.
Virginia Attorney General Mark Herring cheered the judge's decision. "We WON the Lee statue case after a judge found that it was raised against a backdrop of white supremacy and that it is against public policy to keep it up," Herring tweeted. "The ruling is *stayed* pending appeal, but this is a HUGE win and we're on the path to bringing down this relic".
As member station VPM's Whittney Evans reported, the plaintiffs, who did not respond to VPM's request for comment on Tuesday, have argued that the statue's removal would "degrade" the district and lower their property values.
Witnesses for the plaintiffs included an archivist for the United Daughters of the Confederacy and the president the American Civil War Museum in Richmond.
In recent months, other statues on the city's Monument Avenue have either been toppled by protestors or removed by the authorities. The statue of Jefferson Davis was toppled in June, as was a statue of Christopher Columbus in another part of the city. In July, Richmond Mayor Levar Stoney had the statue of Stonewall Jackson removed from the avenue.
Meanwhile, the Lee statue has taken on a new life as an icon of resistance and transformation.
The statue of Lee on horseback was erected in 1890 in the former capital of the Confederacy. The statue itself is 21 feet high, on a pedestal almost twice as tall.
In June, Gov. Northam explained why he was ordering the statue to be removed from the pedestal:


npr--2020-10-27--Study: Air Pollution Contributes To 500,000 Newborn Deaths A Year

As wildfires raged up and down the Pacific Coast last month , families across California and Oregon lived in – and breathed in — smoky , toxic air for weeks .
Many days , the region 's air quality ranked among the worst in the world .
Officials warned residents that the air pollution could exacerbate many health issues , such cardiovascular disease , asthma and other respiratory diseases .
And it could increase the risk catching COVID-19 .
But what about the youngest members of society ?
How does air pollution affect pregnant women and their newborn babies ?
@ @ @ @ @ @ @ a better understanding of that answer .
Air pollution , both inside and outside the home , contributed to the deaths of about 500,000 newborns in 2019 , the team reports in the State of Global Air 2020 .
`` The number is just staggering , '' says epidemiologist Rakesh Ghosh at the University of California , San Francisco , who led the study .
Each year about 2.42 million infants die within the first 27 days of life .
The new study suggests air pollutions contribute to about 20 % of those @ @ @ @ @ @ @ poor countries , with nearly half in sub-Saharan Africa .
And about two-thirds of the deaths were associated with air pollution inside of people 's homes , when they burn coal and wood to cook or stay warm .
But pediatrician Susan Niermeyer says the air pollution problem is , by no means , exclusive to low-income regions or where people cook with hard fuels .
`` I think you can easily dismiss this finding as something that only happens to people who live far away in thatched roof houses and not to @ @ @ @ @ @ @ professor at the University of Colorado Medicine .
`` But air pollution effects our babies , as well . ''
For example , families who live right near a highway can be exposed to large amounts of fine particulates , called PM 2.5 , and carbon monoxide , Niermeyer says .
And several studies have clearly linked air pollution exposure around airports to an increased risk of premature birth here in the U.S. Fine particulates , or PM 2.5 , are especially dangerous forms of pollution because the particles are small enough to @ @ @ @ @ @ @ and even absorb into the bloodstream , as well .
Once inside the bloodstream of a pregnant woman , PM 2.5 pollutants may behave like tobacco smoke .
They can trigger inflammation in the blood , which , in turn , can decrease the transfer of oxygen and nutrients across the placenta , Niermeyer says .
`` This inflammation can impact growth of the fetus .
And if it 's significant enough , inflammation can trigger preterm labor . ''
In the new research , Rakesh Ghosh and colleagues analyzed data from more @ @ @ @ @ @ @ to PM 2.5 during pregnancy to an increase risk of giving birth prematurely or to a low-weight baby ( that is , a baby weighing less than 5.5 pounds ) .
Both conditions reduce a child 's chance of surviving the first month of life .
For each 10 unit increase in PM 2.5 over the course of pregnancy , a woman 's risk of giving birth to a low-weight baby increases by about 6 % , Ghosh and his team report in the journal The Lancet .
`` This risk might appear @ @ @ @ @ @ @ but when you multiply that 6 % by the enormous amount of exposure that moms have in some countries , their risk multiples by orders of magnitude . ''
The findings raise awareness about an invisible killer of newborns , says epidemiologist Xueying Zhang at the Icahn School of Medicine at Mount Sinai .
`` Doctors will never say person died of air pollution , '' Zhang says .
`` They will say the cause of death is cancer , a stroke or respiratory disease .
But air pollution is an important cause @ @ @ @ @ @ @ . ''
And with this new report , policy makers and health officials can see that air pollution is also an important cause of premature and low-weight births .
`` Once people see how much air pollution threatens babies , they are more likely to look for ways to protect them . ''
And a first step could be as simple as teaching families that cooking over coal fires could be as harmful as tobacco smoke .
Then , says Zhang , perhaps they will be more likely to switch to cleaner fuels @ @ @ @ @ @

New Study Points To Invisible Killer Of Infants
Enlarge this image toggle caption David Paul Morris/Bloomberg via Getty Images David Paul Morris/Bloomberg via Getty Images
As wildfires raged up and down the Pacific Coast last month, families across California and Oregon lived in – and breathed in — smoky, toxic air for weeks. Many days, the region's air quality ranked among the worst in the world.
Officials warned residents that the air pollution could exacerbate many health issues, such cardiovascular disease, asthma and other respiratory diseases. And it could increase the risk catching COVID-19.
But what about the youngest members of society? How does air pollution affect pregnant women and their newborn babies?
Now an international team of researchers have a better understanding of that answer. Air pollution, both inside and outside the home, contributed to the deaths of about 500,000 newborns in 2019, the team reports in the State of Global Air 2020.
"The number is just staggering," says epidemiologist Rakesh Ghosh at the University of California, San Francisco, who led the study. Each year about 2.42 million infants die within the first 27 days of life. The new study suggests air pollutions contribute to about 20% of those deaths
Most of these deaths occurred in poor countries, with nearly half in sub-Saharan Africa. And about two-thirds of the deaths were associated with air pollution inside of people's homes, when they burn coal and wood to cook or stay warm. But pediatrician Susan Niermeyer says the air pollution problem is, by no means, exclusive to low-income regions or where people cook with hard fuels.
"I think you can easily dismiss this finding as something that only happens to people who live far away in thatched roof houses and not to us," says Niermeyer, a professor at the University of Colorado Medicine. "But air pollution effects our babies, as well."
For example, families who live right near a highway can be exposed to large amounts of fine particulates, called PM 2.5, and carbon monoxide, Niermeyer says. And several studies have clearly linked air pollution exposure around airports to an increased risk of premature birth here in the U.S.
Fine particulates, or PM 2.5, are especially dangerous forms of pollution because the particles are small enough to reach deep into a person's lungs and even absorb into the bloodstream, as well.
Once inside the bloodstream of a pregnant woman, PM 2.5 pollutants may behave like tobacco smoke. They can trigger inflammation in the blood, which, in turn, can decrease the transfer of oxygen and nutrients across the placenta, Niermeyer says. "This inflammation can impact growth of the fetus. And if it's significant enough, inflammation can trigger preterm labor."
In the new research, Rakesh Ghosh and colleagues analyzed data from more than 20 studies, which linked exposure to PM 2.5 during pregnancy to an increase risk of giving birth prematurely or to a low-weight baby (that is, a baby weighing less than 5.5 pounds). Both conditions reduce a child's chance of surviving the first month of life.
For each 10 unit increase in PM 2.5 over the course of pregnancy, a woman's risk of giving birth to a low-weight baby increases by about 6%, Ghosh and his team report in the journal The Lancet.
"This risk might appear small," Ghosh says, "but when you multiply that 6% by the enormous amount of exposure that moms have in some countries, their risk multiples by orders of magnitude."
The findings raise awareness about an invisible killer of newborns, says epidemiologist Xueying Zhang at the Icahn School of Medicine at Mount Sinai.
"Doctors will never say person died of air pollution," Zhang says. "They will say the cause of death is cancer, a stroke or respiratory disease. But air pollution is an important cause of cancer, strokes and respiratory syndromes."
And with this new report, policy makers and health officials can see that air pollution is also an important cause of premature and low-weight births. "Once people see how much air pollution threatens babies, they are more likely to look for ways to protect them."
And a first step could be as simple as teaching families that cooking over coal fires could be as harmful as tobacco smoke. Then, says Zhang, perhaps they will be more likely to switch to cleaner fuels or better ventilate their homes.


npr--2020-10-27--NXIVM Cult Leader Sentenced To 120 Years In Prison

`` I can still hear his voice in my head , '' the woman in her early 30s told the Brooklyn courtroom Tuesday , her voice shaking .
`` He robbed me of my youth , '' the woman , Camila , told the court , according to the New York Post .
`` He used my innocence to do whatever he wanted with me . ''
At the end of Tuesday 's sentencing hearing , in which victims of NXIVM cult leader Keith Raniere recounted their stories in sometimes painful detail , the 60-year-old Raniere was sentenced to 120 @ @ @ @ @ @ @ of 15 victims scheduled to testify against Raniere on Tuesday , part of an attempt by federal prosecutors to secure a life sentence for the defendant .
He has been in prison since jurors found him guilty last year of sex trafficking , forced labor conspiracy , human trafficking and multiple counts of racketeering .
Victims painted a picture of a charismatic self-help guru who lured followers with promises that he would help them take control of their lives .
But once ensconced in his orbit , many of the women were indoctrinated @ @ @ @ @ @ @ have sex with him , and even branded his initials on their skin with a cauterizing pen .
`` He screwed with my mind for so long , '' said Camila , the first of several victims to speak during the victim-impact section that preceded Raniere 's sentencing in federal court , the New York Post reported .
She was 15 years old and a virgin when Raniere raped her , she said , according to the Post .
Camila said her sexual relationship with Raniere lasted 12 years .
The abuse went @ @ @ @ @ @ @ cult leader , then in his mid-40s , manipulated her psychologically , to the point where she isolated herself from friends and family , so she could be his , alone .
The Daily Beast reported she told the court she decided to speak up as a way of getting her voice back and `` coming to terms with the trauma and the abuse . ''
Former NXIVM member India Oxenberg told the court Raniere was a sexual predator who forced her to lose so much weight that she stopped menstruating .
According @ @ @ @ @ @ @ she `` may have to spend the rest of my life with Keith Raniere 's initials seared into me . ''
Defense attorneys argued that Raniere is innocent and blamed his conviction on a `` media campaign '' that led to an unfair trial .
Multiple documentaries have been produced about NXIVM ( pronounced `` Nex-ee-um '' ) , which some have also likened to a pyramid scheme .
His attorneys had asked U.S. District Judge Nicholas Garaufis for a maximum sentence of 15 years in prison .
NXIVM was publicly advertised as @ @ @ @ @ @ @ attended by an estimated 18,000 people since the 1990s .
It offered intensive therapy courses lasting several days and claimed to help people overcome major trauma by `` integrating '' those experiences into their lives .
But the group also demanded loyalty to Raniere , who was known to followers as the guru named `` Vanguard , '' believed by some of them to be an `` evolved '' being .
Prosecutors said Raniere had created a secret group within NXIVM , called DOS — an acronym for `` Dominus Obsequious Sororium , @ @ @ @ @ @ @ Slave Women . ''
The women were expected to turn over incriminating photos that could be used against them if they ever tried to leave .
One of Raniere 's co-conspirators , 41-year-old heiress Clare Bronfman , was sentenced this month to nearly seven years in prison for fraud and forced labor as one of the executives of NXIVM .

NXIVM Cult Leader Sentenced To 120 Years In Prison
Enlarge this image toggle caption Elizabeth Williams/Via AP Elizabeth Williams/Via AP
Updated at 6:01 p.m. ET
"I can still hear his voice in my head," the woman in her early 30s told the Brooklyn courtroom Tuesday, her voice shaking.
"He robbed me of my youth,'' the woman, Camila, told the court, according to the New York Post. "He used my innocence to do whatever he wanted with me."
At the end of Tuesday's sentencing hearing, in which victims of NXIVM cult leader Keith Raniere recounted their stories in sometimes painful detail, the 60-year-old Raniere was sentenced to 120 years in prison.
Camila was one of 15 victims scheduled to testify against Raniere on Tuesday, part of an attempt by federal prosecutors to secure a life sentence for the defendant. He has been in prison since jurors found him guilty last year of sex trafficking, forced labor conspiracy, human trafficking and multiple counts of racketeering.
Victims painted a picture of a charismatic self-help guru who lured followers with promises that he would help them take control of their lives. But once ensconced in his orbit, many of the women were indoctrinated by Raniere, who pressured them to have sex with him, and even branded his initials on their skin with a cauterizing pen.
"He screwed with my mind for so long," said Camila, the first of several victims to speak during the victim-impact section that preceded Raniere's sentencing in federal court, the New York Post reported. She was 15 years old and a virgin when Raniere raped her, she said, according to the Post. Camila said her sexual relationship with Raniere lasted 12 years.
The abuse went beyond the physical. She said the cult leader, then in his mid-40s, manipulated her psychologically, to the point where she isolated herself from friends and family, so she could be his, alone. The Daily Beast reported she told the court she decided to speak up as a way of getting her voice back and "coming to terms with the trauma and the abuse."
Former NXIVM member India Oxenberg told the court Raniere was a sexual predator who forced her to lose so much weight that she stopped menstruating. According to The Independent, she lamented that she "may have to spend the rest of my life with Keith Raniere's initials seared into me."
Defense attorneys argued that Raniere is innocent and blamed his conviction on a "media campaign" that led to an unfair trial. Multiple documentaries have been produced about NXIVM (pronounced "Nex-ee-um"), which some have also likened to a pyramid scheme. His attorneys had asked U.S. District Judge Nicholas Garaufis for a maximum sentence of 15 years in prison.
NXIVM was publicly advertised as a professional development company that offered seminars attended by an estimated 18,000 people since the 1990s. It offered intensive therapy courses lasting several days and claimed to help people overcome major trauma by "integrating" those experiences into their lives.
But the group also demanded loyalty to Raniere, who was known to followers as the guru named "Vanguard," believed by some of them to be an "evolved" being.
Prosecutors said Raniere had created a secret group within NXIVM, called DOS — an acronym for "Dominus Obsequious Sororium," which translates to "Master Over Slave Women." The women were expected to turn over incriminating photos that could be used against them if they ever tried to leave.
One of Raniere's co-conspirators, 41-year-old heiress Clare Bronfman, was sentenced this month to nearly seven years in prison for fraud and forced labor as one of the executives of NXIVM.


npr--2020-10-27--'Dude, I'm Done': When Politics Tears Families And Friendships Apart

'Dude , I 'm Done ' : When Politics Tears Families And Friendships Apart If you find yourself fighting with a friend over politics , or frustrated and furious with your nearest and dearest over whom they 're supporting for president , you 're hardly alone .
A recent survey shows just how much the nation 's bitter political divide is causing social splintering and taking a toll on friendships .
Even decades-long relationships have been caving under the pressure , giving new meaning to `` social distancing . ''
`` I did straight up say , 'Dude , I @ @ @ @ @ @ @ ' `` said Shama Davis from Los Angeles , recalling when he `` unfriended '' a guy he 'd been friends with since high school 25 years ago .
`` I just hung up on my end and proceeded to just block him in every possible way , '' said Joni Jensen from New York , still fuming over the guy she felt compelled to dump .
And betraying just a tinge of regret about cutting off his cousins , Ricardo Deforest of Tampa , Fla. , conceded , `` I hate to @ @ @ @ @ @ @ '' before unabashedly proclaiming , `` I disowned them .
In my mind they 're not family anymore . ''
They are among the many Americans for whom political rifts have deepened .
It 's one thing to disagree about something such as tax policy , they said .
But they see their differences now as ones of basic morality , core values and character , and that can not be overlooked .
Davis , 42 , a consultant who is Black , said he simply could not abide his friend downplaying police @ @ @ @ @ @ @ looting and violence happening amid the mostly peaceful protests .
`` I told him , 'If this is your attitude , we ca n't be cool anymore , ' `` Davis said.
`` ' I do n't respect you now .
I do n't .
Because people are really dying . '
`` Jensen , a retired professor , also sees it as a moral absolute .
As a sexual assault survivor , she said , she could n't stand it when the guy she 'd been close to for 40 years was @ @ @ @ @ @ @ Trump 's then-Supreme Court nominee Brett Kavanaugh .
( Kavanaugh vehemently denied the sexual assault allegations . )
`` He was going off like , 'Oh , you drank the Kool-Aid , ' and 'Kavanaugh did n't do anything , ' `` she recalled .
`` It made me sick .
If this is his core ethics , I do n't want that kind of person in my life . ''
Conservatives can be just as quick to spurn the liberals in their lives who clash with their core values , such as @ @ @ @ @ @ @ biggie for Deforest .
`` They sold our country out , '' Deforest , a 61-year-old steelworker , said of those on the left of the political spectrum .
`` This election is about the soul of what America is .
You ca n't be a free country and be a socialist state at the same time . ''
He said the acrimony he 's feeling from what he calls `` hardcore Trump haters '' was as much a factor in his decision to cut them off as their differences that gave rise @ @ @ @ @ @ @ do is say , 'Trump is a racist .
Orange man bad !
Orange man racist !
They 're blowing spittle , and [ their ] veins popping out of their heads , '' he said .
`` Yo soy Latino .
But [ they assume ] I 'm some sort of horrible racist because I like Trump .
It 's ridiculous ! ''
Jocelyn Kiley , associate director of research at the Pew Research Center , said political polarization is more intense now than at any point in modern history .
Nearly @ @ @ @ @ @ @ just a few '' or no friends at all across the aisle , according to Pew .
And the animosity goes both ways .
`` Democrats are a little bit more likely to say they 'd end a friendship '' Kiley said .
`` But Republicans may be less likely to say they have friends on the other side .
So it may not be all that differential . ''
Another recent poll by the Public Religion Research Institute shows that 8 in 10 Republicans believe the Democratic Party has been taken over @ @ @ @ @ @ @ Democrats believe the Republican Party has been taken over by racists .
The report is aptly named titled `` Dueling Realities . ''
Tania Israel , a professor in the counseling , clinical and school psychology department at the University of California , Santa Barbara , said she 's seeing more of those kinds of distorted views in the workshops she runs on cross-the-aisle conversations .
The rancor is rising , she said , as both sides `` tend to view the other as being more extreme than they actually are . ''
@ @ @ @ @ @ @ common , she said , is that they all suffer from big blind spots when it comes to the morality of their own side .
They tend to view themselves as eminently fair and right , and the other side as irrational .
Case in point : Explaining his politics , Deforest noted , `` When I say all these things , I think I sound fairly reasonable , '' while declaiming the other side with , `` There 's something wrong with these people . ''
Jensen , meanwhile , is just @ @ @ @ @ @ @ was arguing with as `` brainwashed . ''
A little more listening to understand , a little less trying to convince , and a lot more intellectual humility would do everyone a world of good , said Israel , who 's also the author of Beyond Your Bubble : How to Connect Across the Political Divide , Skills and Strategies for Conversations That Work .
`` We 're flattening people out in terms of our view of them , '' she said , `` and we 're not really seeing the full complexity @ @ @ @ @ @ @ '' It 's exactly what Jon Langford , 28 , a Georgia truck driver , said he experienced when his brother , who is gay , wrongly assumed the worst about him .
`` He went off on me saying essentially I 'm a racist and a homophobe just because I 'm a Trump supporter .
No ifs , ands or buts .
And he completely cut me out of his life , '' Langford said .
They have n't spoken in years .
Now , Langford said , he 's determined not @ @ @ @ @ @ @ friends across the aisle , including his best friend , who supports former Vice President Joe Biden .
As Langford sees it , no one has a monopoly on morality .
`` I could assume that anybody that supports Biden is a firm believer that it 's OK to murder a baby , '' he said .
`` But I do n't . ''
Another conservative , Judith Margolis Friedman , may be one of the few who can claim that she 's managed not to lose any friends over politics .
But @ @ @ @ @ @ @ her political views secret for fear of `` social suicide . ''
`` I would politely nod and go along to avoid conflict [ ... ] with people whose relationships I valued , '' she said .
Instead , Friedman vented in a secret Facebook group that she said was a `` safe space '' where she could `` commiserate with other people who also feel shut out from their regular life because of their views . ''
But this month , Friedman could n't take it anymore and `` came out of @ @ @ @ @ @ @ people dumped her over her politics , `` they were n't real friends after all . ''
She 's hoping friends will give more weight to the person they 've known for years , than whom she chooses to vote for .
`` If someone expresses a more conservative worldview , they 're immediately called a Nazi and a racist and a misogynist and a homophobe and everything under the sun , '' Friedman said .
`` I 'm none of those things .
I 'm just a normal friggin ' person who @ @ @ @ @ @ @ '' At the other end of the political spectrum , Jeff Marinstein , a business and technology consultant from Connecticut , has also been trying to get past the ever-intensifying invective and insults from `` friends . ''
One , in particular , kept attacking him as a `` libtard , '' among other things .
Marinstein no longer talks to that guy .
But with another , he 's trying a new strategy to save the friendship , suggesting they keep talking , just not about politics .
So far , it @ @ @ @ @ @ @ thought .
`` I 'm still getting this nightly stream of New York Post articles and memes [ mocking ] Democrats , and I simply respond with a funny line that says , 'This post violates our agreement not to talk about politics , ' trying to creatively send the message that I just do n't want to engage , '' he said .
Whether the strategy ultimately works or not , Marinstein said , he wonders whether it may ultimately be doing as much harm as good .
`` It just feels @ @ @ @ @ @ @ do at the moment [ is ] to lower the temperature and to not continue these toxic conversations , '' he said .
`` But I suppose the risk is that I 'm just retreating into my own information bubble with people who think just like me . ''
Indeed , experts said it 's more conversation — not less — that 's needed , if the nation is to heal its blistering divide .
But it has to be healthy , productive conversation .
And Israel , who runs the workshops on @ @ @ @ @ @ @ must be to take it off social media and talk in person instead .
`` The only useful comment that you can make on somebody 's social media post is 'Can we find a time to talk about this ?
I 'm interested in hearing more , ' `` she said .

'Dude, I'm Done': When Politics Tears Families And Friendships Apart
Enlarge this image J.Stone/Imazins/Getty Images/ImaZinS RF J.Stone/Imazins/Getty Images/ImaZinS RF
If you find yourself fighting with a friend over politics, or frustrated and furious with your nearest and dearest over whom they're supporting for president, you're hardly alone. A recent survey shows just how much the nation's bitter political divide is causing social splintering and taking a toll on friendships. Even decades-long relationships have been caving under the pressure, giving new meaning to "social distancing."
"I did straight up say, 'Dude, I'm done. Lose my number,' " said Shama Davis from Los Angeles, recalling when he "unfriended" a guy he'd been friends with since high school 25 years ago.
"I just hung up on my end and proceeded to just block him in every possible way," said Joni Jensen from New York, still fuming over the guy she felt compelled to dump.
And betraying just a tinge of regret about cutting off his cousins, Ricardo Deforest of Tampa, Fla., conceded, "I hate to say it because family is everything," before unabashedly proclaiming, "I disowned them. In my mind they're not family anymore."
They are among the many Americans for whom political rifts have deepened. It's one thing to disagree about something such as tax policy, they said. But they see their differences now as ones of basic morality, core values and character, and that cannot be overlooked.
Davis, 42, a consultant who is Black, said he simply could not abide his friend downplaying police brutality, and harping instead on the looting and violence happening amid the mostly peaceful protests.
"I told him, 'If this is your attitude, we can't be cool anymore,' " Davis said. " 'I don't respect you now. I don't. Because people are really dying.' "
Jensen, a retired professor, also sees it as a moral absolute. As a sexual assault survivor, she said, she couldn't stand it when the guy she'd been close to for 40 years was being cavalier about the allegations against President Trump's then-Supreme Court nominee Brett Kavanaugh. (Kavanaugh vehemently denied the sexual assault allegations.)
"He was going off like, 'Oh, you drank the Kool-Aid,' and 'Kavanaugh didn't do anything,' " she recalled. "It made me sick. If this is his core ethics, I don't want that kind of person in my life."
Conservatives can be just as quick to spurn the liberals in their lives who clash with their core values, such as life and liberty — which is the biggie for Deforest.
"They sold our country out," Deforest, a 61-year-old steelworker, said of those on the left of the political spectrum. "This election is about the soul of what America is. You can't be a free country and be a socialist state at the same time."
He said the acrimony he's feeling from what he calls "hardcore Trump haters" was as much a factor in his decision to cut them off as their differences that gave rise to it.
"All they can do is say, 'Trump is a racist. Orange man bad! Orange man racist! They're blowing spittle, and [their] veins popping out of their heads," he said. "Yo soy Latino. But [they assume] I'm some sort of horrible racist because I like Trump. It's ridiculous!"
Jocelyn Kiley, associate director of research at the Pew Research Center, said political polarization is more intense now than at any point in modern history. Nearly 80% of Americans now have "just a few" or no friends at all across the aisle, according to Pew. And the animosity goes both ways.
"Democrats are a little bit more likely to say they'd end a friendship" Kiley said. "But Republicans may be less likely to say they have friends on the other side. So it may not be all that differential."
Another recent poll by the Public Religion Research Institute shows that 8 in 10 Republicans believe the Democratic Party has been taken over by socialists, while 8 in 10 Democrats believe the Republican Party has been taken over by racists. The report is aptly named titled "Dueling Realities."
Tania Israel, a professor in the counseling, clinical and school psychology department at the University of California, Santa Barbara, said she's seeing more of those kinds of distorted views in the workshops she runs on cross-the-aisle conversations. The rancor is rising, she said, as both sides "tend to view the other as being more extreme than they actually are."
Another thing conservatives and liberals have in common, she said, is that they all suffer from big blind spots when it comes to the morality of their own side. They tend to view themselves as eminently fair and right, and the other side as irrational.
Case in point: Explaining his politics, Deforest noted, "When I say all these things, I think I sound fairly reasonable," while declaiming the other side with, "There's something wrong with these people."
Jensen, meanwhile, is just as certain, upbraiding the guy she was arguing with as "brainwashed."
A little more listening to understand, a little less trying to convince, and a lot more intellectual humility would do everyone a world of good, said Israel, who's also the author of Beyond Your Bubble: How to Connect Across the Political Divide, Skills and Strategies for Conversations That Work.
"We're flattening people out in terms of our view of them," she said, "and we're not really seeing the full complexity of people on the other side."
It's exactly what Jon Langford, 28, a Georgia truck driver, said he experienced when his brother, who is gay, wrongly assumed the worst about him.
"He went off on me saying essentially I'm a racist and a homophobe just because I'm a Trump supporter. No ifs, ands or buts. And he completely cut me out of his life," Langford said. They haven't spoken in years.
Now, Langford said, he's determined not to do the same thing to his friends across the aisle, including his best friend, who supports former Vice President Joe Biden. As Langford sees it, no one has a monopoly on morality.
"I could assume that anybody that supports Biden is a firm believer that it's OK to murder a baby," he said. "But I don't."
Another conservative, Judith Margolis Friedman, may be one of the few who can claim that she's managed not to lose any friends over politics. But she said that's because she kept her political views secret for fear of "social suicide."
"I would politely nod and go along to avoid conflict [...] with people whose relationships I valued," she said.
Instead, Friedman vented in a secret Facebook group that she said was a "safe space" where she could "commiserate with other people who also feel shut out from their regular life because of their views."
But this month, Friedman couldn't take it anymore and "came out of the closet," deciding that if people dumped her over her politics, "they weren't real friends after all."
She's hoping friends will give more weight to the person they've known for years, than whom she chooses to vote for.
Politics When Dating In The Era Of Divisive Politics, Both Sides Stick To Themselves When Dating In The Era Of Divisive Politics, Both Sides Stick To Themselves Listen · 3:31 3:31
"If someone expresses a more conservative worldview, they're immediately called a Nazi and a racist and a misogynist and a homophobe and everything under the sun," Friedman said. "I'm none of those things. I'm just a normal friggin' person who has a different point of view."
At the other end of the political spectrum, Jeff Marinstein, a business and technology consultant from Connecticut, has also been trying to get past the ever-intensifying invective and insults from "friends."
One, in particular, kept attacking him as a "libtard," among other things. Marinstein no longer talks to that guy. But with another, he's trying a new strategy to save the friendship, suggesting they keep talking, just not about politics. So far, it's proving harder to enforce than he thought.
"I'm still getting this nightly stream of New York Post articles and memes [mocking] Democrats, and I simply respond with a funny line that says, 'This post violates our agreement not to talk about politics,' trying to creatively send the message that I just don't want to engage," he said.
Whether the strategy ultimately works or not, Marinstein said, he wonders whether it may ultimately be doing as much harm as good.
"It just feels like the healthiest thing for me to do at the moment [is] to lower the temperature and to not continue these toxic conversations," he said. "But I suppose the risk is that I'm just retreating into my own information bubble with people who think just like me."
Indeed, experts said it's more conversation — not less — that's needed, if the nation is to heal its blistering divide. But it has to be healthy, productive conversation. And Israel, who runs the workshops on civil discourse, said the first step must be to take it off social media and talk in person instead.
"The only useful comment that you can make on somebody's social media post is 'Can we find a time to talk about this? I'm interested in hearing more,' " she said.