npr--2020-01-09--Appeals Court Allows Trump To Divert $3.6 Billion In Military Funds For Border Wall

Appeals Court Allows Trump To Divert $ 3.6 Billion In Military Funds For Border Wall A federal appeals court has handed the Trump administration a victory by allowing the president to tap military construction funds to build a wall along the U.S.-Mexico border .
A divided 5th U.S .
Circuit Court of Appeals issued the decision late Wednesday , reversing a lower court order that stopped Trump from using $ 3.6 billion in U.S Defense Department money to construct the long-promised border wall .
The court noted that in July , the U.S. Supreme Court lifted a similar freeze on @ @ @ @ @ @ @ Trump would like to use to pay for border barriers .
`` The Government is entitled to the same relief here , '' wrote the three-judge panel in the opinion .
On Thursday , the White House welcomed the court 's action , calling the nationwide injunction put in place by the lower court `` illegitimate . ''
`` This is a victory for the rule of law .
We are committed to keeping our borders secure , and we will finish the wall , '' said White House press secretary Stephanie Grisham @ @ @ @ @ @ @ approved by Congress for other military projects in order to pay for border wall construction is an abuse of power .
Administration officials insist the maneuver became legal after Trump declared a national emergency along the southern border in February 2019 .
Under the declaration , Trump officials say , they have the right to reallocate military construction funding for more urgent projects , such as the 450 miles of border wall that Trump says he wants built by the end of the year .
When the president declared the national emergency over @ @ @ @ @ @ @ to find $ 6.7 billion in funding for other government projects to finance construction .
The declaration also created a path to another source of border wall funding : money collected in drug interdiction efforts .
In essence , Trump 's declaration enabled him to draw billions more dollars beyond the $ 1.3 billion that Congress specifically authorized for border wall funding .
Trump had previously requested $ 5.7 billion from lawmakers , but Democrats balked at the price tag .
In the 2020 spending package passed in December , Congress maintained border @ @ @ @ @ @ @ far below Trump 's request , which he had upped to $ 8.6 billion .
White House officials are hopeful that drawing funds from other projects appropriated by Congress will raise enough money to pay for the wall .
Critics highlight how then-candidate Trump often declared ahead of the 2016 presidential election that Mexico would pay for the border wall .
Building a wall along the border with Mexico was one of the central proposals of his immigration plan when running for president , and it is a policy the president still often @ @ @ @ @ @ @ .
Trump tapped his son-in-law and senior adviser , Jared Kushner , to help speed up completion of wall , but the project has been plagued by delay .
And protracted legal battles are not the only thing slowing down construction .
The government has found the process of seizing private land for the border wall to be vexing , leading critics to question whether Trump will get anywhere near those hoped-for 450 miles of new border barriers .
Lawyers for El Paso County and the Border Network for Human Rights , who @ @ @ @ @ @ @ , suggested that the legal fight is n't over .
`` We 're confident the district court 's ruling that the president ca n't usurp Congress 's power on this spending decision is correct , '' said Kristy Parker , a lawyer for the Protect Democracy Project , which is representing groups that sued the administration .
`` Even though border wall construction can move forward for now , we expect that in the end , the people of El Paso and the border community will prevail , '' Parker said .
On @ @ @ @ @ @ @ tweet following the appeal court 's order : '' The Fifth Circuit Court of Appeals just reversed a lower court decision & gave us the go ahead to build one of the largest sections of the desperately needed Southern Border Wall , Four Billion Dollars .
Entire Wall is under construction or getting ready to start ! ''

Appeals Court Allows Trump To Divert $3.6 Billion In Military Funds For Border Wall
Enlarge this image toggle caption Christian Chavez/AP Christian Chavez/AP
Updated at 5:51 p.m. ET
A federal appeals court has handed the Trump administration a victory by allowing the president to tap military construction funds to build a wall along the U.S.-Mexico border.
A divided 5th U.S. Circuit Court of Appeals issued the decision late Wednesday, reversing a lower court order that stopped Trump from using $3.6 billion in U.S Defense Department money to construct the long-promised border wall.
The court noted that in July, the U.S. Supreme Court lifted a similar freeze on a separate source of military funding that Trump would like to use to pay for border barriers.
"The Government is entitled to the same relief here," wrote the three-judge panel in the opinion.
On Thursday, the White House welcomed the court's action, calling the nationwide injunction put in place by the lower court "illegitimate."
"This is a victory for the rule of law. We are committed to keeping our borders secure, and we will finish the wall," said White House press secretary Stephanie Grisham.
Opponents say pulling money that was approved by Congress for other military projects in order to pay for border wall construction is an abuse of power.
Administration officials insist the maneuver became legal after Trump declared a national emergency along the southern border in February 2019. Under the declaration, Trump officials say, they have the right to reallocate military construction funding for more urgent projects, such as the 450 miles of border wall that Trump says he wants built by the end of the year.
When the president declared the national emergency over border security, he ordered federal agencies to find $6.7 billion in funding from other government projects to finance construction. The declaration also created a path to another source of border wall funding: money collected in drug interdiction efforts.
In essence, Trump's declaration enabled him to draw billions more dollars beyond the $1.3 billion that Congress specifically authorized for border wall funding. Trump had previously requested $5.7 billion from lawmakers, but Democrats balked at the price tag.
In the 2020 spending package passed in December, Congress maintained border wall funding at $1.3 billion, far below Trump's request, which he had upped to $8.6 billion.
White House officials are hopeful that drawing funds from other projects appropriated by Congress will raise enough money to pay for the wall.
Critics highlight how then-candidate Trump often declared ahead of the 2016 presidential election that Mexico would pay for the border wall.
Building a wall along the border with Mexico was one of the central proposals of his immigration plan when running for president, and it is a policy the president still often cites to fire up crowds at rallies.
Trump tapped his son-in-law and senior adviser, Jared Kushner, to help speed up completion of the wall, but the project has been plagued by delay.
And protracted legal battles are not the only thing slowing down construction. The government has found the process of seizing private land for the border wall to be vexing, leading critics to question whether Trump will get anywhere near those hoped-for 450 miles of new border barriers.
Lawyers for El Paso County and the Border Network for Human Rights, who originally sued over the controversial funding mechanism, suggested that the legal fight isn't over.
"We're confident the district court's ruling that the president can't usurp Congress's power on this spending decision is correct," said Kristy Parker, a lawyer for the Protect Democracy Project, which is representing groups that sued the administration.
"Even though border wall construction can move forward for now, we expect that in the end, the people of El Paso and the border community will prevail," Parker said.
On Thursday, Trump sent out a victorious tweet following the appeal court's order:
"The Fifth Circuit Court of Appeals just reversed a lower court decision & gave us the go ahead to build one of the largest sections of the desperately needed Southern Border Wall, Four Billion Dollars. Entire Wall is under construction or getting ready to start!"
NPR's John Burnett contributed to this report.


npr--2020-01-09--Teen Girls Don't Need Routine Pelvic Exams. Why Are Doctors Doing So Many?

Teen Girls Do n't Need Routine Pelvic Exams .
Why Are Doctors Doing So Many ?
An estimated 1.4 million adolescent girls and young women women in the U.S. might have received an unnecessary pelvic exam between 2011 and 2017 , according to a new study .
And an estimated 1.6 million might have received an unnecessary Pap test .
The authors of the study , which was published this week in the journal JAMA Internal Medicine , say the overuse of these procedures — which can cause false-positives and anxiety — led to an estimated $ 123 million annually @ @ @ @ @ @ @ The study was based on data from 3,410 respondents to the National Survey of Family Growth , between the ages of 15 and 20 .
The study authors assessed whether the Pap test or bimanual pelvic exam given to each respondent had been in accordance with current clinical guidelines .
They found that more than half of the pelvic exams administered , and nearly three quarters of the Pap tests , might have been unnecessary .
Bimanual pelvic exams and Pap tests used to be standard parts of annual gynecological checkups , but @ @ @ @ @ @ @ for most younger patients .
Dr. George Sawaya , a professor of obstetrics at the University of California , San Francisco , and the lead investigator on the study , says that the results indicate that health care providers are not paying close enough attention to current best practices .
`` Medical practice is very slow to change , '' Sawaya says .
`` For many years there 's been a very ingrained idea about what young women and girls should have as a part of gynecological care .
A lot of what @ @ @ @ @ @ @ doctors who are just not aware of the guidelines . ''
The Pap test is a screening for cervical cancer that involves inserting an instrument into the vagina and removing cervical cells to check for abnormalities .
It is no longer recommended that most women under 21 receive Pap tests by default .
Sawaya explains that the minimum age was raised from 18 to 21 because the incidence of cervical cancer in that age cohort is extremely low and did not justify the risks such as `` a high likelihood of false alarms @ @ @ @ @ @ @ , the physician places several fingers of one hand inside the patient 's vagina , and the other hand on the patient 's abdomen .
The pelvic exam was traditionally used to screen asymptomatic women for STDs , the study says , but that practice is now mostly `` outdated '' as urine-based tests have become widely available .
The pelvic exam is no longer a recommended routine procedure for women under the age of 21 .
That 's welcome news to many young patients , says Dr. Catherine Cansino , an associate @ @ @ @ @ @ @ the University of California , Davis , who was not involved in the study .
`` Young women , to a certain extent , are fearful of coming to the OB/GYN because they think they 're going to get a pelvic exam , '' she says .
If they avoid or delay appointments , she says , that can have an adverse effect on their overall health .
Cansino emphasizes that young women should still make annual wellness appointments with their health care provider — even if a Pap test and pelvic exam @ @ @ @ @ @ @ — to discuss things like pregnancy intentions , sexually transmitted infection and its prevention , vaccinations , and intimate partner violence .
According to Cansino , current guidelines from the American College of Obstetricians and Gynecologists would only recommend a pelvic exam for the age group in the study if a patient has persistent symptoms , like abnormal bleeding patterns .
Cansino says that physicians are now placing greater emphasis on clinicians and patients having conversations and arriving at treatment decisions jointly .
Especially for younger patients , who may not have been @ @ @ @ @ @ @ be first-time patients at a new clinic , Cansino says `` we really want to emphasize that there should be a conversation between physicians and their patients about why a pelvic exam is important , and when is it important , '' rather than treating a bimanual pelvic exam as a default part of the visit .
Dr. Melissa Simon , the vice chair of clinical research at the Department of Obstetrics and Gynecology at the Northwestern University Feinberg School of Medicine , says that the numbers in the study are high , @ @ @ @ @ @ @ really hard for health care providers to unlearn things that they 've been doing for years , let alone decades , '' she says .
Simon wrote an invited commentary on the study that was published in the same journal issue , and she was not involved in the study .
Simon explains that the guidelines for pelvic exams might be hard to keep up with , because different professional associations and governmental agencies have each changed their guidelines at different times in recent years , and with slight variations .
She says @ @ @ @ @ @ @ practitioner to keep track of the changing guidelines and know when it 's time to make a change in how they practice — a skill that medical training programs could be doing more to help students develop .
Sawaya says the high percentage of possibly unnecessary exams sends a message to physicians and educators that `` we have a lot of educating to do . ''
He hopes that the study will cause physicians to `` be a little shocked — and then be reflective about their own practice . ''

Teen Girls Don't Need Routine Pelvic Exams. Why Are Doctors Doing So Many?
Enlarge this image toggle caption Vladimir Nenov/EyeEm/Getty Images Vladimir Nenov/EyeEm/Getty Images
An estimated 1.4 million adolescent girls and young women in the U.S. might have received an unnecessary pelvic exam between 2011 and 2017, according to a new study. And an estimated 1.6 million might have received an unnecessary Pap test. The authors of the study, which was published this week in the journal JAMA Internal Medicine, say the overuse of these procedures — which can cause false-positives and anxiety — led to an estimated $123 million annually in needless expenses in 2014 alone.
The study was based on data from 3,410 respondents to the National Survey of Family Growth, between the ages of 15 and 20. The study authors assessed whether the Pap test or bimanual pelvic exam given to each respondent had been in accordance with current clinical guidelines. They found that more than half of the pelvic exams administered, and nearly three quarters of the Pap tests, might have been unnecessary.
Bimanual pelvic exams and Pap tests used to be standard parts of annual gynecological checkups, but leading professional associations no longer recommend them for most younger patients.
Dr. George Sawaya, a professor of obstetrics at the University of California, San Francisco, and the lead investigator on the study, says that the results indicate that health care providers are not paying close enough attention to current best practices.
"Medical practice is very slow to change," Sawaya says. "For many years there's been a very ingrained idea about what young women and girls should have as a part of gynecological care. A lot of what we're seeing is a holdover of doctors who are just not aware of the guidelines."
The Pap test is a screening for cervical cancer that involves inserting an instrument into the vagina and removing cervical cells to check for abnormalities. It is no longer recommended that most women under 21 receive Pap tests by default. Sawaya explains that the minimum age was raised from 18 to 21 because the incidence of cervical cancer in that age cohort is extremely low and did not justify the risks such as "a high likelihood of false alarms."
In a bimanual pelvic exam, the physician places several fingers of one hand inside the patient's vagina, and the other hand on the patient's abdomen. The pelvic exam was traditionally used to screen asymptomatic women for STDs, the study says, but that practice is now mostly "outdated" as urine-based tests have become widely available. The pelvic exam is no longer a recommended routine procedure for women under the age of 21.
That's welcome news to many young patients, says Dr. Catherine Cansino, an associate clinical professor of obstetrics and gynecology at the University of California, Davis, who was not involved in the study.
"Young women, to a certain extent, are fearful of coming to the OB/GYN because they think they're going to get a pelvic exam," she says. If they avoid or delay appointments, she says, that can have an adverse effect on their overall health.
Cansino emphasizes that young women should still make annual wellness appointments with their health care provider — even if a Pap test and pelvic exam aren't a part of the visit — to discuss things like pregnancy intentions, sexually transmitted infection and its prevention, vaccinations, and intimate partner violence.
According to Cansino, current guidelines from the American College of Obstetricians and Gynecologists would only recommend a pelvic exam for the age group in the study if a patient has persistent symptoms, like abnormal bleeding patterns. Cansino says that physicians are now placing greater emphasis on clinicians and patients having conversations and arriving at treatment decisions jointly.
Especially for younger patients, who may not have been to a gynecologist before, or may be first-time patients at a new clinic, Cansino says "we really want to emphasize that there should be a conversation between physicians and their patients about why a pelvic exam is important, and when is it important," rather than treating a bimanual pelvic exam as a default part of the visit.
Dr. Melissa Simon, the vice chair of clinical research at the Department of Obstetrics and Gynecology at the Northwestern University Feinberg School of Medicine, says that the numbers in the study are high, but not surprising.
"It's really hard for health care providers to unlearn things that they've been doing for years, let alone decades," she says. Simon wrote an invited commentary on the study that was published in the same journal issue, and she was not involved in the study.
Simon explains that the guidelines for pelvic exams might be hard to keep up with, because different professional associations and governmental agencies have each changed their guidelines at different times in recent years, and with slight variations. She says it's a skill for a medical practitioner to keep track of the changing guidelines and know when it's time to make a change in how they practice — a skill that medical training programs could be doing more to help students develop.
Sawaya says the high percentage of possibly unnecessary exams sends a message to physicians and educators that "we have a lot of educating to do." He hopes that the study will cause physicians to "be a little shocked — and then be reflective about their own practice."
Emily Vaughn is an intern on NPR's Science Desk.


npr--2020-01-09--Is There Hope For The American Dream? What Americans Think About Income Inequality

Is There Hope For The American Dream ?
What Americans Think About Income Inequality Income inequality in the U.S. is at an all-time high , according to the Census Bureau .
But do Americans care ?
A new poll from NPR , the Robert Wood Johnson Foundation and the Harvard T.H .
Chan School of Public Health shows that less than half of Americans , regardless of income , view it as very serious problem .
They hold these views even though a majority ( 57 % ) believes very wealthy Americans should pay more in taxes than they do @ @ @ @ @ @ @ ) of the top 1 % believe very wealthy Americans should pay more .
The poll , which surveyed 1,885 adults , is unique in that it was designed to reach a sample of at least 250 people in the upper 1 % of income — $ 500,000 or more of household income a year .
That opens a window on the views and experiences of this exclusive group that polls have not been able to capture .
Do n't see the graphic above ?
Click here .
A sizable minority of the @ @ @ @ @ @ @ reducing income inequality should be a priority for political leaders , though support for this idea was significantly higher among the poorest Americans ( 67 % ) .
There were a few surprises in the poll .
While the vast majority of the top 1 % say they 've achieved the American Dream , similar majorities of low- and middle-income people believe the American Dream is still within reach .
Do n't see the graphic above ?
Click here .
In addition , 70 % to 80 % of parents and grandparents across @ @ @ @ @ @ @ will achieve the American Dream .
( We did not provide a definition for American Dream in our questions – so the responses reflect whatever people think it is . )
What it takes to be successful There was remarkable agreement among the income groups that hard work is seen as very important in being economically successful in America today .
That 's despite research showing that factors such as family income , neighborhood and race/ethnicity are closely tied to economic achievement .
The top 1 % and middle- and lower-income adults did @ @ @ @ @ @ @ important to economic success .
Do n't see the graphic above ?
Click here .
Even though there 's a good deal of optimism about future generations ' ability to achieve economic success , about half of adults across income groups say it is harder for the average person to earn a middle-class income today , compared with when they were children .
Do n't see the graphic above ?
Click here .
A majority across all income groups says it is an important priority for government to make sure everyone living in @ @ @ @ @ @ @ Do n't see the graphic above ?
Click here .
When it comes to the biggest health problems facing their local communities , the income groups diverged .
The most cited health problems among the top 1 % of income adults are obesity and drug addiction/abuse .
For middle-income adults it 's drug addiction/abuse and health care access .
And among lower-income adults , the most-cited health problems are drug addiction/abuse , health care access , and cancer .
American health care is often touted as the best in the world , but @ @ @ @ @ @ @ can afford the best , quality is not guaranteed – 14 % of the top 1 % said they had had serious problems with health care quality .
And 31 % of the lowest income group said they had serious problems accessing health care when needed .
Do n't see the graphic above ?
Click here .
As might be expected , few of the wealthiest Americans reported having problems paying for the basics in life , though a surprising 1 in 10 say they 've had a serious problem paying for higher @ @ @ @ @ @ @ above ?
Click here .
When it comes to life satisfaction , most of the top 1 % highest income adults say they are very satisfied with their lives overall , their finances , their housing , their education , and their jobs .
Comparatively , middle- and lower-income adults report greater dissatisfaction than the top 1 % in all of these areas .
Adults in the top 1 % also report lower levels of anxiety about the future than middle- and lower-income adults .
The landline and cellphone poll was conducted in @ @ @ @ @ @ @ a sample size of 1,885 adults .
The margin of error for the full sample is plus or minus 3.2 percentage points .
Read the full results .

Is There Hope For The American Dream? What Americans Think About Income Inequality
Income inequality in the U.S. is at an all-time high, according to the Census Bureau. But do Americans care?
A new poll from NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health shows that less than half of Americans, regardless of income, view it as very serious problem.
They hold these views even though a majority (57%) believes very wealthy Americans should pay more in taxes than they do now. Nearly half (48%) of the top 1% believe very wealthy Americans should pay more.
The poll, which surveyed 1,885 adults, is unique in that it was designed to reach a sample of at least 250 people in the upper 1% of income — $500,000 or more of household income a year. That opens a window on the views and experiences of this exclusive group that polls have not been able to capture.
Loading...
Don't see the graphic above? Click here.
A sizable minority of the wealthiest Americans (45%) say reducing income inequality should be a priority for political leaders, though support for this idea was significantly higher among the poorest Americans (67%).
Achieving the American Dream
There were a few surprises in the poll. While the vast majority of the top 1% say they've achieved the American Dream, similar majorities of low- and middle-income people believe the American Dream is still within reach.
Loading...
Don't see the graphic above? Click here.
In addition, 70% to 80% of parents and grandparents across income groups believe their children or grandchildren will achieve the American Dream. (We did not provide a definition for American Dream in our questions – so the responses reflect whatever people think it is.)
What it takes to be successful
There was remarkable agreement among the income groups that hard work is seen as very important in being economically successful in America today. That's despite research showing that factors such as family income, neighborhood and race/ethnicity are closely tied to economic achievement.
The top 1% and middle- and lower-income adults did not see those factors as being very important to economic success.
Loading...
Don't see the graphic above? Click here.
Even though there's a good deal of optimism about future generations' ability to achieve economic success, about half of adults across income groups say it is harder for the average person to earn a middle-class income today, compared with when they were children.
Loading...
Don't see the graphic above? Click here.
Health and education
A majority across all income groups says it is an important priority for government to make sure everyone living in the U.S. has health insurance coverage.
Loading...
Don't see the graphic above? Click here.
When it comes to the biggest health problems facing their local communities, the income groups diverged. The most cited health problems among the top 1% of income adults are obesity and drug addiction/abuse. For middle-income adults it's drug addiction/abuse and health care access. And among lower-income adults, the most-cited health problems are drug addiction/abuse, health care access, and cancer.
American health care is often touted as the best in the world, but our poll suggests that even when you can afford the best, quality is not guaranteed – 14% of the top 1% said they had had serious problems with health care quality. And 31% of the lowest income group said they had serious problems accessing health care when needed.
Loading...
Don't see the graphic above? Click here.
As might be expected, few of the wealthiest Americans reported having problems paying for the basics in life, though a surprising 1 in 10 say they've had a serious problem paying for higher education.
Loading...
Don't see the graphic above? Click here.
Life satisfaction
When it comes to life satisfaction, most of the top 1% highest income adults say they are very satisfied with their lives overall, their finances, their housing, their education, and their jobs. Comparatively, middle- and lower-income adults report greater dissatisfaction than the top 1% in all of these areas. Adults in the top 1% also report lower levels of anxiety about the future than middle- and lower-income adults.
The landline and cellphone poll was conducted in July and August of 2019, with a sample size of 1,885 adults. The margin of error for the full sample is plus or minus 3.2 percentage points. Read the full results.