npr--2020-01-30--Trump Administration Clears The Way For Medicaid Block Grants

Trump Administration Clears The Way For Medicaid Block Grants The Trump administration wants to dramatically alter the way the federal government gives money to states for Medicaid .
On Thursday , Seema Verma , the administrator of the Centers for Medicare and Medicaid Services , announced a new pathway for states to receive a capped amount of federal dollars for part of the program .
The new demonstration program , called Healthy Adult Opportunity , would not be mandatory for states and would not affect all Medicaid beneficiaries , only adults under age 65 who are not disabled .
But @ @ @ @ @ @ @ , it could profoundly reshape how Medicaid operates .
Medicaid covers health care for 71 million people across the country — most are low-income people , disabled people , and children .
It 's set up as a federal-state partnership — a state contributes money to cover its Medicaid population , and the federal government matches that contribution using a formula based on a state 's per capita income .
Therefore , low-income states get more from the federal government than high-income states do .
There is currently no limit to what the @ @ @ @ @ @ @ the country have a right to whatever care they need for however long they need it .
With the announcement , CMS is inviting states to design Medicaid plans that work with a new capped-funding approach ; they have flexibility in how they design these plans and could be exempted from certain Medicaid requirements .
For example , the plan would allow states to create a formulary to pick and choose which drugs are covered — normally Medicaid covers all drugs .
In her remarks , Verma anticipated critics who might consider this @ @ @ @ @ @ @ She spoke passionately about the purpose of Medicaid , calling it `` a lifeline for millions of Americans . ''
But she justified the new approach as a means to ensure financial sustainability for the program in the long term by letting states operate with a defined budget .
This has historically been called a `` block grant , '' but Verma was careful not to mention those words in her remarks .
`` The Healthy Adult Opportunity represents an innovative and historic approach to surmounting Medicaid 's structural challenges , '' she @ @ @ @ @ @ @ Trump administration is delivering on a longtime conservative ideal — block grants for Medicaid have been discussed for nearly as long as Medicaid has existed , going back to the Nixon administration .
Every time , either Congress or the White House has declined to take the plunge , and Medicaid has remained open-ended .
`` When enrollment goes up or during an economic downturn or the cost of prescription drugs go up , it costs the states more money to finance their programs , but the federal government matches those dollars to @ @ @ @ @ @ @ vice president of the Kaiser Family Foundation and co-director of the foundation 's program on Medicaid and the uninsured .
Whether Thursday 's announcement will upend that system depends on what states do with the new guidance .
States will have to ask CMS for a waiver and wait for approval .
It 's usually a lengthy process , although on Thursday , Verma indicated the agency would be attempting to streamline things by creating a template application .
Most likely , it will be months before this plan could go into effect @ @ @ @ @ @ @ a question about whether this would be legal .
Another major initiative from Verma to transform Medicaid was permission for states to get a waiver to make `` work requirements '' part of the program .
That effort has been blocked in the courts and is currently on appeal .
The only state that put into effect a work requirement — a requirement for some beneficiaries to report that they are working , going to school or doing community service — was Arkansas , and one analysis found thousands of people lost their @ @ @ @ @ @ @ has created the legal challenge for the government .
The legal argument against them , which has made headway in courts , is that work requirements fail to `` promote the objectives of the Medicaid program , which is primarily to provide affordable health coverage to low income people , '' said Rudowitz .
Oklahoma Gov .
Kevin Stitt joined Verma at Thursday 's announcement , calling the new approach to Medicaid `` a game-changer . ''
He said his state hopes to be among the first in the nation to apply for @ @ @ @ @ @ @ , is promoting his Medicaid plan as an alternative to a measure on the ballot in the upcoming election to expand Medicaid in his state , a move he said would be `` wrong and will be ineffective . ''
He said the waiver would allow the state to innovate , including finding new ways to contain costs and adding premiums and work requirements to the plan for adults .
He said his approach will create `` expectations for able-bodied individuals to see this as a true trampoline to their future . ''
@ @ @ @ @ @ @ like Stitt , said Jamila Michener , an assistant professor of government at Cornell University .
`` They ca n't outright support Medicaid expansion or support Obamacare , '' also known as the Affordable Care Act , she said .
`` Work requirements were a way for them to kind of help save face , to expand Medicaid , but still be able to make it appear as though they were remaining true to their conservative bona fides . ''
Now that work requirements are tied up in litigation , this presents another @ @ @ @ @ @ @ , she says .
Past efforts through the decades to institute block grants in Medicaid have come through Congress and would have changed Medicaid in all states at once — most recently in 2017 as part of the plan to repeal and replace Obamacare .
Since states will have to apply for the Healthy Adult Opportunity waiver , this wo n't change Medicaid in many states that do n't opt in .
( Washington Gov .
Jay Inslee , for one , tweeted , `` Hard pass . ''
) Critics responded quickly @ @ @ @ @ @ @ , health care policy advocate with the liberal advocacy group Public Citizen , called the program `` a Medicaid block grant by another name . ''
Edwin Park of the Georgetown University Center for Children and Families said this kind of arrangement is a bad deal for states .
`` [ They 're ] placing a fiscal straitjacket on themselves that will only lead to eventual cuts to their programs and harmful effects to their budgets , '' he said .
It 's a political risk for the Trump administration as well .
@ @ @ @ @ @ @ and that capping federal spending in the program is not .
`` Medicaid is more popular than it has ever been because people understand that if it 's not their immediate family , their kids , it 's their parents , it 's neighbors and others who rely on the program , '' Park adds .
Michener pointed out the wonkiness of this move might insulate it from the disapproval of voters in an election year .
`` If there 's a way to get at Medicaid , which is what this administration @ @ @ @ @ @ @ the entire time , then this is the way , '' she said .
And it helps , she adds , that the Trump administration can make this change on its own : `` You do n't have to fight Congress — like you did with repeal and replace — and lose in the end . ''

Trump Administration Clears The Way For Medicaid Block Grants
Enlarge this image toggle caption Mandel Ngan/AFP via Getty Images Mandel Ngan/AFP via Getty Images
The Trump administration wants to dramatically alter the way the federal government gives money to states for Medicaid.
On Thursday, Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, announced a new pathway for states to receive a capped amount of federal dollars for part of the program. The new demonstration program, called Healthy Adult Opportunity, would not be mandatory for states and would not affect all Medicaid beneficiaries, only adults under age 65 who are not disabled.
But for states that adopt the new approach, it could profoundly reshape how Medicaid operates.
Medicaid covers health care for 71 million people across the country — most are low-income people, disabled people, and children. It's set up as a federal-state partnership — a state contributes money to cover its Medicaid population, and the federal government matches that contribution using a formula based on a state's per capita income. Therefore, low-income states get more from the federal government than high-income states do.
There is currently no limit to what the federal government contributes — Medicaid beneficiaries across the country have a right to whatever care they need for however long they need it.
With the announcement, CMS is inviting states to design Medicaid plans that work with a new capped-funding approach; they have flexibility in how they design these plans and could be exempted from certain Medicaid requirements. For example, the plan would allow states to create a formulary to pick and choose which drugs are covered — normally Medicaid covers all drugs.
In her remarks, Verma anticipated critics who might consider this an attack on the safety net. She spoke passionately about the purpose of Medicaid, calling it "a lifeline for millions of Americans."
But she justified the new approach as a means to ensure financial sustainability for the program in the long term by letting states operate with a defined budget. This has historically been called a "block grant," but Verma was careful not to mention those words in her remarks.
"The Healthy Adult Opportunity represents an innovative and historic approach to surmounting Medicaid's structural challenges," she said.
With this announcement, the Trump administration is delivering on a longtime conservative ideal — block grants for Medicaid have been discussed for nearly as long as Medicaid has existed, going back to the Nixon administration. Every time, either Congress or the White House has declined to take the plunge, and Medicaid has remained open-ended.
"When enrollment goes up or during an economic downturn or the cost of prescription drugs go up, it costs the states more money to finance their programs, but the federal government matches those dollars to states," said Robin Rudowitz, vice president of the Kaiser Family Foundation and co-director of the foundation's program on Medicaid and the uninsured.
Whether Thursday's announcement will upend that system depends on what states do with the new guidance. States will have to ask CMS for a waiver and wait for approval. It's usually a lengthy process, although on Thursday, Verma indicated the agency would be attempting to streamline things by creating a template application. Most likely, it will be months before this plan could go into effect in a state.
There's also a question about whether this would be legal. Another major initiative from Verma to transform Medicaid was permission for states to get a waiver to make "work requirements" part of the program. That effort has been blocked in the courts and is currently on appeal.
One the few states that put into effect a work requirement — a requirement for some beneficiaries to report that they are working, going to school or doing community service — was Arkansas, and one analysis found thousands of people lost their health coverage as a result.
That has created the legal challenge for the government. The legal argument against them, which has made headway in courts, is that work requirements fail to "promote the objectives of the Medicaid program, which is primarily to provide affordable health coverage to low income people," said Rudowitz.
Oklahoma Gov. Kevin Stitt joined Verma at Thursday's announcement, calling the new approach to Medicaid "a game-changer." He said his state hopes to be among the first in the nation to apply for the waiver. Stitt, a Republican, is promoting his Medicaid plan as an alternative to a measure on the ballot in the upcoming election to expand Medicaid in his state, a move he said would be "wrong and will be ineffective."
He said the waiver would allow the state to innovate, including finding new ways to contain costs and adding premiums and work requirements to the plan for adults. He said his approach will create "expectations for able-bodied individuals to see this as a true trampoline to their future."
This move is geared toward red-state governors like Stitt, said Jamila Michener, an assistant professor of government at Cornell University. "They can't outright support Medicaid expansion or support Obamacare," also known as the Affordable Care Act, she said. "Work requirements were a way for them to kind of help save face, to expand Medicaid, but still be able to make it appear as though they were remaining true to their conservative bona fides." Now that work requirements are tied up in litigation, this presents another way to accomplish a similar political goal, she says.
Past efforts through the decades to institute block grants in Medicaid have come through Congress and would have changed Medicaid in all states at once — most recently in 2017 as part of the plan to repeal and replace Obamacare. Since states will have to apply for the Healthy Adult Opportunity waiver, this won't change Medicaid in many states that don't opt in. (Washington Gov. Jay Inslee, for one, tweeted, "Hard pass.")
Critics responded quickly to Thursday's announcement. Eagan Kemp, health care policy advocate with the liberal advocacy group Public Citizen, called the program "a Medicaid block grant by another name."
Edwin Park of the Georgetown University Center for Children and Families said this kind of arrangement is a bad deal for states. "[They're] placing a fiscal straitjacket on themselves that will only lead to eventual cuts to their programs and harmful effects to their budgets," he said.
It's a political risk for the Trump administration as well. Polling suggests that Medicaid is very popular and that capping federal spending in the program is not. "Medicaid is more popular than it has ever been because people understand that if it's not their immediate family, their kids, it's their parents, it's neighbors and others who rely on the program," Park adds.
Michener pointed out the wonkiness of this move might insulate it from the disapproval of voters in an election year.
"If there's a way to get at Medicaid, which is what this administration [has been] trying to do the entire time, then this is the way," she said. And it helps, she adds, that the Trump administration can make this change on its own: "You don't have to fight Congress — like you did with repeal and replace — and lose in the end."


npr--2020-01-30--1st Person-To-Person Spread Of Coronavirus Has Occurred In U.S., CDC Says

1st Person-To-Person Spread Of Coronavirus Has Occurred In U.S. , CDC Says The first human-to-human transmission of the deadly Wuhan coronavirus has occurred in the U.S. , the Centers for Disease Control and Prevention announced Thursday .
The respiratory virus was spread from a woman who had recently traveled in China to her husband when she returned to Chicago , CDC Director Dr. Robert Redfield said at a press briefing .
It 's the sixth confirmed case of the new coronavirus , or 2019-nCoV , in the U.S .
In addition to the Illinois cases , two have been confirmed @ @ @ @ @ @ @ one in Washington state .
Worldwide , the Wuhan coronavirus has spread to at least 20 countries since it was identified last month , the CDC says .
Illinois health officials are investigating 21 other possible cases in the state .
Overall , Redfield noted , `` the immediate risk to the American public is low . ''
The CDC says the relatively few people who have been identified as close contacts of people with confirmed coronavirus infections should follow the guidance of their doctors and health departments .
The agency is investigating @ @ @ @ @ @ @ .
An additional 68 were investigated and tested negative .
Ngozi Ezike , director of the Illinois Department of Public Health , explained that this person-to-person transmission was `` between two very close contacts , a wife and a husband . ''
She emphasized that the risk to the public in Illinois remains low .
`` The virus is not spreading widely across the community , '' she said .
She notes that Illinois public health officials `` are actively monitoring close contacts , including health care workers . ''
Globally , there @ @ @ @ @ @ @ infection with the virus .
Person-to-person spread had already been observed in other countries , said Nancy Messonnier , the director of the CDC 's National Center for Immunization and Respiratory Diseases .
`` This is a very serious public health situation , '' she said .
`` CDC and our state and local health partners are working to prevent community transmission from happening here . ''
`` Moving forward , we can expect to see more cases , and more cases means the potential for more person-to-person spread , '' she said @ @ @ @ @ @ @ a balance in our response right now .
We want to lean forward and to be aggressive but we want our actions to be evidence-based and appropriate to the current circumstance . ''
The CDC says members of the public do not need to wear masks out of concern for the coronavirus .
To reduce the chance of spreading any respiratory illness , the CDC recommends that people take simple steps such as washing hands with soap and water for at least 20 seconds and avoiding close contact with anyone who is sick @ @ @ @ @ @ @ areas of high-risk in China should be vigilant for signs of illness , including fever and cough , according to the CDC .
Those people should call their health care provider if symptoms do develop .

1st Person-To-Person Spread Of Coronavirus Has Occurred In U.S., CDC Says
Enlarge this image toggle caption Samuel Corum/Getty Images Samuel Corum/Getty Images
Updated at 2:10 p.m. ET
The first human-to-human transmission of the deadly Wuhan coronavirus has occurred in the U.S., the Centers for Disease Control and Prevention announced Thursday.
The respiratory virus was spread from a woman who had recently traveled in China to her husband when she returned to Chicago, CDC Director Dr. Robert Redfield said at a press briefing.
It's the sixth confirmed case of the new coronavirus, or 2019-nCoV, in the U.S.
In addition to the Illinois cases, two have been confirmed in California, one in Arizona and one in Washington state. Worldwide, the Wuhan coronavirus has spread to at least 20 countries since it was identified last month, the CDC says.
Illinois health officials are investigating 21 other possible cases in the state. Overall, Redfield noted, "the immediate risk to the American public is low."
The CDC says the relatively few people who have been identified as close contacts of people with confirmed coronavirus infections should follow the guidance of their doctors and health departments.
The agency is investigating 92 other possible cases across the country. An additional 68 were investigated and tested negative.
Ngozi Ezike, director of the Illinois Department of Public Health, explained that this person-to-person transmission was "between two very close contacts, a wife and a husband."
She emphasized that the risk to the public in Illinois remains low. "The virus is not spreading widely across the community," she said.
She notes that Illinois public health officials "are actively monitoring close contacts, including health care workers."
Globally, there are more than 7,800 confirmed cases of infection with the virus. Person-to-person spread had already been observed in other countries, said Nancy Messonnier, the director of the CDC's National Center for Immunization and Respiratory Diseases.
"This is a very serious public health situation," she said. "CDC and our state and local health partners are working to prevent community transmission from happening here."
"Moving forward, we can expect to see more cases, and more cases means the potential for more person-to-person spread," she said. "We're trying to strike a balance in our response right now. We want to lean forward and to be aggressive but we want our actions to be evidence-based and appropriate to the current circumstance."
The CDC says members of the public do not need to wear masks out of concern for the coronavirus.
To reduce the chance of spreading any respiratory illness, the CDC recommends that people take simple steps such as washing hands with soap and water for at least 20 seconds and avoiding close contact with anyone who is sick.
People returning from Wuhan and other areas of high-risk in China should be vigilant for signs of illness, including fever and cough, according to the CDC. Those people should call their health care provider if symptoms do develop.
Richard Harris contributed to this report.


npr--2020-01-30--Coronavirus Has Now Spread To All Regions Of Mainland China

Coronavirus Has Now Spread To All Regions Of Mainland China The deadly strain of coronavirus that emerged in Wuhan has now spread to every part of mainland China , from Shanghai to Tibet .
The rapid increase prompted Russia to close its long border with China on Thursday .
The coronavirus has now been found in at least 20 countries since the outbreak began last month , with the Philippines and India being the latest countries to report cases .
It 's expected to keep growing : Respiratory virus experts in Hong Kong say they believe the outbreak 's peak @ @ @ @ @ @ @ late spring .
`` Ben Cowling , a professor of infectious disease epidemiology at the University of Hong Kong , says that in the last few days the trajectory of this outbreak has grown much clearer , '' NPR 's Jason Beaubien reports from Hong Kong .
He adds , `` Cowling says the outbreak is just getting started , and he expects to see increased levels of transmission globally , including in the United States . ''
`` I think it 's quite likely that you will see human-to-human transmission in U.S. @ @ @ @ @ @ @ – but it only took a matter of hours for his prediction to come true , as the Centers for Disease Control and Prevention announced Thursday that the first human-to-human spread had occurred in Illinois .
A Chinese passenger who fell ill aboard a cruise ship in Italy was determined not to have the coronavirus Thursday – a finding that gave relief to more than 6,000 people aboard the Carnival Cruise Line-owned Costa Smeralda .
Italy 's health ministry says the tests it performed on samples from the woman and another passenger were @ @ @ @ @ @ @ its Italian home port of Civitavecchia Thursday morning , at the end of a seven-day cruise through tourism-heavy areas such as Marseille , Barcelona and Mallorca .
But instead of disembarking , the passengers were told to stay onboard until tests could determine whether the passenger , a 54-year-old woman from Macau , was carrying the virus .
The ship 's medical staff placed the woman and her traveling companion into isolation in the Costa Smeralda 's shipboard hospital Wednesday night after suspecting that she might have the coronavirus , Costa Cruises tells @ @ @ @ @ @ @ special task force to coordinate the U.S. response to the new coronavirus , or 2019-nCoV .
Led by Health and Human Services Secretary Alex Azar , the group includes CDC Director Robert Redfield as well as other health , security and transportation officials .
The World Health Organization says nations `` must be on alert '' to combat the coronavirus .
`` Person-to-person transmission has been seen in at least 3 countries outside China — Japan , Vietnam and Germany , '' WHO Director-General Tedros Adhanom Ghebreyesus said via Twitter on Thursday .
@ @ @ @ @ @ @ virus Thursday , its second such meeting in as many days as it weighs whether to designate the coronavirus outbreak a global health emergency .
The U.S. State Department is arranging further evacuation flights for Americans caught in Wuhan 's virtual lockdown , with the U.S. Embassy in Beijing saying additional flights are tentatively set for Monday .
About 200 Americans were brought to California on Wednesday , on a flight that included diplomats and their families .
The new flights will have `` capacity for private U.S. citizens on a reimbursable basis @ @ @ @ @ @ @ Nearly 82,000 people were under medical observation in China out of concern that they might have the virus , the Chinese Center for Disease Control and Prevention says .
There are now more than 7,700 confirmed cases of the coronavirus in China , where the illness has killed 170 people .
The majority of the cases are in Hubei province , where Wuhan is the capital .
But at least 13 other Chinese provinces have confirmed 100 or more cases of people who have the coronavirus .
Announcing Russia 's decision to close @ @ @ @ @ @ @ Minister Mikhail Mishustin said Thursday that the new restrictions will take effect Friday .
Saying the well-being of the Russian people is his top priority , Mishustin said the temporary closures are the result of special circumstances created by the deadly illness .
To reduce the chance of spreading any respiratory illness , the CDC recommends that people take simple steps such as washing hands with soap and water for at least 20 seconds and avoiding close contact with anyone who is sick .

Coronavirus Has Now Spread To All Regions Of Mainland China
Enlarge this image toggle caption Reuters Reuters
Updated at 9:40 p.m. ET
The deadly strain of coronavirus that emerged in Wuhan has now spread to every part of mainland China, from Shanghai to Tibet. The rapid increase caused the World Health Organization to declare a global health emergency and prompted Russia to close its long border with China.
Late Thursday, the U.S. State Department also issued a "do not travel" advisory for China.
The coronavirus has now been found in at least 20 countries since the outbreak began last month, with the Philippines and India being the latest countries to report cases. It's expected to keep growing: Respiratory virus experts in Hong Kong say they believe the outbreak's peak is still months away, likely in late spring.
"Ben Cowling, a professor of infectious disease epidemiology at the University of Hong Kong, says that in the last few days the trajectory of this outbreak has grown much clearer," NPR's Jason Beaubien reports from Hong Kong. He adds, "Cowling says the outbreak is just getting started, and he expects to see increased levels of transmission globally, including in the United States."
"I think it's quite likely that you will see human-to-human transmission in U.S. cities" within weeks, Cowling said – but it only took a matter of hours for his prediction to come true, as the Centers for Disease Control and Prevention announced Thursday that the first human-to-human spread had occurred in Illinois.
A Chinese passenger who fell ill aboard a cruise ship in Italy was determined not to have the coronavirus Thursday – a finding that gave relief to more than 6,000 people aboard the Carnival Cruise Line-owned Costa Smeralda. Italy's health ministry says the tests it performed on samples from the woman and another passenger were negative.
The ship had returned to its Italian home port of Civitavecchia Thursday morning, at the end of a seven-day cruise through tourism-heavy areas such as Marseille, Barcelona and Mallorca. But instead of disembarking, the passengers were told to stay onboard until tests could determine whether the passenger, a 54-year-old woman from Macau, was carrying the virus.
The ship's medical staff placed the woman and her traveling companion into isolation in the Costa Smeralda's shipboard hospital Wednesday night after suspecting that she might have the coronavirus, Costa Cruises tells NPR.
President Trump has created a special task force to coordinate the U.S. response to the new coronavirus, or 2019-nCoV. Led by Health and Human Services Secretary Alex Azar, the group includes CDC Director Robert Redfield as well as other health, security and transportation officials.
The World Health Organization issued a global health emergency on Thursday after holding its second meeting in as many days on the subject, with WHO Director-General Tedros Adhanom Ghebreyesus telling reporters in Geneva that the virus had "escalated into an unprecedented outbreak and which has been met by an unprecedented response."
Tedros said via Twitter on Thursday that "Person-to-person transmission has been seen in at least 3 countries outside China — Japan, Vietnam and Germany."
The U.S. State Department is arranging further evacuation flights for Americans caught in Wuhan's virtual lockdown, with the U.S. Embassy in Beijing saying additional flights are tentatively set for Monday.
"Those currently in China should consider departing using commercial means," it said in a travel advisory issued Thursday. "The Department of State has requested that all non-essential U.S. government personnel defer travel to China in light of the novel coronavirus."
About 200 Americans were brought to California on Wednesday, on a flight that included diplomats and their families. The new flights will have "capacity for private U.S. citizens on a reimbursable basis," the State Department says.
Nearly 82,000 people were under medical observation in China out of concern that they might have the virus, the Chinese Center for Disease Control and Prevention says.
There are now nearly 9,700 confirmed cases of the coronavirus in China, where the illness has killed 213 people. The majority of the cases are in Hubei province, where Wuhan is the capital. But at least 13 other Chinese provinces have confirmed 100 or more cases of people who have the coronavirus.
Announcing Russia's decision to close its land border with China, Prime Minister Mikhail Mishustin said Thursday that the new restrictions will take effect Friday. Saying the well-being of the Russian people is his top priority, Mishustin said the temporary closures are the result of special circumstances created by the deadly illness.
To reduce the chance of spreading any respiratory illness, the CDC recommends that people take simple steps such as washing hands with soap and water for at least 20 seconds and avoiding close contact with anyone who is sick.


npr--2020-01-30--Your Questions About Wuhan Coronavirus, Answered

Last week , we asked our audience to share questions they might have about Wuhan coronavirus , the new respiratory virus that was identified in China .
While there is a lot we do n't know about the virus — how the disease first emerged , for example — there are things that we do know .
Nearly 100 questions were submitted , on topics ranging from the name of the virus to whether it 's safe to touch goods shipped from China .
While there is a lot we do n't know about the virus — how the disease @ @ @ @ @ @ @ are questions that we can answer .
Although sometimes the answer is `` We need more information . ''
Here are some of the frequently asked questions , answered by NPR 's Richard Harris and Elena Renken .
What 's the latest on the spread of this disease ?
As of Thursday , the latest figures now show more than 7,800 confirmed cases of Wuhan coronavirus and at least 170 deaths .
The vast majority of these are in China .
Cases have been reported in nearly two dozen countries or locales around @ @ @ @ @ @ @ diagnosed in the U.S. — five of them among people who had recently been in the city of Wuhan , where the outbreak began in December 2019 .
What 's the risk that it will spread within the United States ?
Health officials say there are likely to be more cases , especially from people who traveled to China .
So far there 's no indication that any of the U.S. patients have passed it along to others .
The people at greatest risk would be health care workers who are caring for @ @ @ @ @ @ @ exposure .
But they are also on the highest alert and are taking precautions .
If the virus spreads , how dangerous is it ?
According to reports in the journal The Lancet that came out a few days ago , it appears that only 3 % of people who get sick actually die .
And it 's riskiest in older people in relatively poor health .
But that 3 % could well be revised to a higher number .
The disease is so new that it 's likely some people who have @ @ @ @ @ @ @ will change the mortality rate .
As a point of comparison , about 10 % of people who contracted a similar coronavirus , SARS ( severe acute respiratory syndrome ) , died as a result .
There have been news reports that people can spread the virus before they actually show symptoms themselves .
What 's the latest on that ?
Yes , that would be an important factor in the spread of this disease .
That kind of transmission happens with a lot of diseases , like measles and the flu , @ @ @ @ @ @ @ with the most similar coronavirus disease , SARS .
In a telephone news conference on Monday , Nancy Messonnier , director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention , got a question on this point : '' We at CDC do n't have any clear evidence of patients being infectious before symptom onset .
However we are being — with our state and local health department partners — very aggressive and very cautious in tracking of close contacts to determine if we are @ @ @ @ @ @ @ indeed are ill. '' Respiratory diseases often spread through a cough , and that is , in fact , a symptom of this infection , along with fever and shortness of breath .
How worried should we be about this coronavirus spreading in the U.S. ?
David Fisman , an epidemiologist at the University of Toronto , told NPR this week that it will be hardest by far to get the epidemic under control in China , because there already are so many cases — and each one has the potential to spread @ @ @ @ @ @ @ to contain the epidemic in China is like being an outfielder and being told to catch 100 fly balls all at once .
He says it 's much easier to control the virus in the U.S. `` We 're kind of getting knocked fly balls one at a time and the job is not to drop them .
But that 's much easier than playing catch-up when you 've allowed the epidemic to grow to a point where you have thousands of cases , and now you 're trying to track everyone down @ @ @ @ @ @ @ .
So at this point , the CDC 's message is that this is a serious condition but that we in the United States are currently at very low risk .
That is always subject to change , but as long as there are just a handful of cases , as is the case right now , health officials can stay on top of it .
The trick is to identify sick people , isolate them quickly , keep an eye on their contacts , and make sure the health care providers are @ @ @ @ @ @ @ .
Are health authorities in the U.S. reacting fast enough ?
The CDC very quickly devised a lab test to identify cases rapidly .
Right now health departments around the country send samples to the CDC in Atlanta for analysis , but the CDC hopes to make its test available to labs nationwide in a week or two .
That will make the response even faster .
Health officials also have stepped up screening of passengers returning from China — these are now being conducted at 20 U.S. airports .
And they are @ @ @ @ @ @ @ I recently received something in the mail that I ordered from China .
Could I catch the virus from it ?
There 's no evidence at the moment to suggest that goods imported from China could transmit the virus , according to the CDC .
The virus would n't make it through the trip from China to the United States on packing materials , says Ian Lipkin , director of the Center for Infection and Immunity at the Mailman School of Public Health .
And the same goes for an object you might @ @ @ @ @ @ @ .
`` Whether it 's a phone or a piece of furniture , it 's not going to survive . ''
The Wuhan virus , like others in the coronavirus family , `` does n't live for very long on surfaces , '' he says .
But that survival relies on certain qualities of the surroundings , says Amesh Adalja , a senior scholar with the Johns Hopkins University Center for Health Security who focuses on infectious diseases .
Some viruses last longer than others outside a body , and it depends on @ @ @ @ @ @ @ .
`` Shipping conditions of most products are going to be not conducive to the virus remaining viable , because of time , because of temperature changes , because of humidity , '' he adds .
`` I do n't think it 's a real risk . ''
Why are people in the U.S. so worried about the coronavirus and not the flu ?
Simply put , the Wuhan coronavirus is new , says Lipkin .
`` It 's something that has n't been seen before , and people are afraid of the @ @ @ @ @ @ @ the risk of contracting the novel coronavirus in the U.S. is low .
So far , there have been five confirmed cases of the disease in the U.S. And all five had traveled previously to Wuhan .
Meanwhile , the flu virus has been very active in the U.S. over the past few months .
Already this season , the CDC estimates that more than 15 million people in the U.S. have gotten sick with flu , more than 150,000 Americans have been hospitalized , and more than 8,000 people have died from @ @ @ @ @ @ @ flu outbreak here .
Why does n't the coronavirus have a less technical name yet , like Ebola or Zika ?
The virus 's temporary name , according to the World Health Organization , is 2019-nCoV .
It 's a combination of the year the virus first emerged and the abbreviation for `` novel coronavirus , '' a term indicating that the virus is a strain that has not been previously identified .
The virus is also referred to as `` Wuhan coronavirus , '' after the city where it first emerged .
@ @ @ @ @ @ @ soon .
`` This is a very new virus , and the virology community is trying to come up with a name for it , '' he says .
But naming a virus requires great care , because there can be negative repercussions , he adds .
In 2015 , the WHO published a set of best practices for naming new infectious diseases in humans , encouraging scientists , government officials and media to avoid names with unnecessary negative impact .
It advises against names that include locations , people 's names , @ @ @ @ @ @ @ unnecessary fear .
The WHO lists `` swine flu '' as an example to avoid .
Adalja says the name was stigmatizing to pig farmers and influenced many people to stop eating pork , even though eating properly handled pork did n't put anyone at risk of getting infected .
Whatever the name , a group called the International Committee on the Taxonomy of Viruses will eventually make the call , says Lipkin .
The ICTV decides names for categories of viruses that are agreed upon internationally .
Any virologist can submit proposals @ @ @ @ @ @ @ will discuss them at its next meeting in October , according to its website .
Do you have any questions about the Wuhan coronavirus outbreak ?
Email them to us with the subject line `` Wuhan coronavirus FAQ '' to goatsandsoda @ npr.org and we may answer them in a story for NPR next week .

Your Questions About Wuhan Coronavirus, Answered
Enlarge this image toggle caption Thomas Samson/AFP via Getty Images Thomas Samson/AFP via Getty Images
Updated at 5:01 p.m. ET
Last week, we asked our audience to share questions they might have about Wuhan coronavirus, the new respiratory virus that was identified in China.
While there is a lot we don't know about the virus — how the disease first emerged, for example — there are things that we do know.
Nearly 100 questions were submitted, on topics ranging from the name of the virus to whether it's safe to touch goods shipped from China. While there is a lot we don't know about the virus — how the disease first emerged, for example — there are questions that we can answer. Although sometimes the answer is "We need more information."
Here are some of the frequently asked questions, answered by NPR's Richard Harris and Elena Renken.
What's the latest on the spread of this disease?
As of Thursday, the latest figures now show more than 7,800 confirmed cases of Wuhan coronavirus and at least 170 deaths. The vast majority of these are in China. Cases have been reported in nearly two dozen countries or locales around the world. Six cases have been diagnosed in the U.S. — five of them among people who had recently been in the city of Wuhan, where the outbreak began in December 2019.
What's the risk that it will spread within the United States?
Health officials say there are likely to be more cases, especially from people who traveled to China. The people at greatest risk would be health-care workers who are caring for these patients — because of their continued exposure. But they are also on the highest alert and are taking precautions.
If the virus spreads, how dangerous is it?
According to reports in the journal The Lancet that came out a few days ago, it appears that only 3% of people who get sick actually die. And it's riskiest in older people in relatively poor health.
But that 3% could well be revised to a higher number. The disease is so new that it's likely some people who have been sick could still die and that will change the mortality rate. As a point of comparison, about 10% of people who contracted a similar coronavirus, SARS (severe acute respiratory syndrome), died as a result.
There have been news reports that people can spread the virus before they actually show symptoms themselves. What's the latest on that?
Yes, that would be an important factor in the spread of this disease. That kind of transmission happens with a lot of diseases, like measles and the flu, but it has not been the case with the most similar coronavirus disease, SARS. In a telephone news conference on Monday, Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention, got a question on this point:
"We at CDC don't have any clear evidence of patients being infectious before symptom onset. However we are being — with our state and local health department partners — very aggressive and very cautious in tracking of close contacts to determine if we are able to identify any close contacts who indeed are ill."
Respiratory diseases often spread through a cough, and that is, in fact, a symptom of this infection, along with fever and shortness of breath.
How worried should we be about this coronavirus spreading in the U.S.?
David Fisman, an epidemiologist at the University of Toronto, told NPR this week that it will be hardest by far to get the epidemic under control in China, because there already are so many cases — and each one has the potential to spread the disease farther. He said trying to contain the epidemic in China is like being an outfielder and being told to catch 100 fly balls all at once.
He says it's much easier to control the virus in the U.S. "We're kind of getting knocked fly balls one at a time and the job is not to drop them. But that's much easier than playing catch-up when you've allowed the epidemic to grow to a point where you have thousands of cases, and now you're trying to track everyone down and prevent transmission," says Fisman.
So at this point, the CDC's message is that this is a serious condition but that we in the United States are currently at very low risk. That is always subject to change, but as long as there are just a handful of cases, as is the case right now, health officials can stay on top of it. The trick is to identify sick people, isolate them quickly, keep an eye on their contacts, and make sure the health care providers are taking the right steps to protect themselves.
Are health authorities in the U.S. reacting fast enough?
The CDC very quickly devised a lab test to identify cases rapidly. Right now health departments around the country send samples to the CDC in Atlanta for analysis, but the CDC hopes to make its test available to labs nationwide in a week or two. That will make the response even faster. Health officials also have stepped up screening of passengers returning from China — these are now being conducted at 20 U.S. airports. And they are recommending against nonessential travel to China.
I recently received something in the mail that I ordered from China. Could I catch the virus from it?
There's no evidence at the moment to suggest that goods imported from China could transmit the virus, according to the CDC. The virus wouldn't make it through the trip from China to the United States on packing materials, says Ian Lipkin, director of the Center for Infection and Immunity at the Mailman School of Public Health.
And the same goes for an object you might get in the mail, he adds. "Whether it's a phone or a piece of furniture, it's not going to survive."
The Wuhan virus, like others in the coronavirus family, "doesn't live for very long on surfaces," he says.
But that survival relies on certain qualities of the surroundings, says Amesh Adalja, a senior scholar with the Johns Hopkins University Center for Health Security who focuses on infectious diseases. Some viruses last longer than others outside a body, and it depends on conditions, including surface material and temperature. "Shipping conditions of most products are going to be not conducive to the virus remaining viable, because of time, because of temperature changes, because of humidity," he adds. "I don't think it's a real risk."
Why are people in the U.S. so worried about the coronavirus and not the flu?
Simply put, the Wuhan coronavirus is new, says Lipkin. "It's something that hasn't been seen before, and people are afraid of the unknown."
The CDC says that the risk of contracting the novel coronavirus in the U.S. is low. So far, there have been five confirmed cases of the disease in the U.S. And all five had traveled previously to Wuhan.
Meanwhile, the flu virus has been very active in the U.S. over the past few months. Already this season, the CDC estimates that more than 15 million people in the U.S. have gotten sick with flu, more than 150,000 Americans have been hospitalized, and more than 8,000 people have died from flu.
Read more about the U.S. flu outbreak here.
Why doesn't the coronavirus have a less technical name yet, like Ebola or Zika?
The virus's temporary name, according to the World Health Organization, is 2019-nCoV. It's a combination of the year the virus first emerged and the abbreviation for "novel coronavirus," a term indicating that the virus is a strain that has not been previously identified.
The virus is also referred to as "Wuhan coronavirus," after the city where it first emerged.
Adalja anticipates that another name will emerge soon. "This is a very new virus, and the virology community is trying to come up with a name for it," he says. But naming a virus requires great care, because there can be negative repercussions, he adds.
In 2015, the WHO published a set of best practices for naming new infectious diseases in humans, encouraging scientists, government officials and media to avoid names with unnecessary negative impact. It advises against names that include locations, people's names, animals, foods and terms that create unnecessary fear.
The WHO lists "swine flu" as an example to avoid. Adalja says the name was stigmatizing to pig farmers and influenced many people to stop eating pork, even though eating properly handled pork didn't put anyone at risk of getting infected.
Whatever the name, a group called the International Committee on the Taxonomy of Viruses will eventually make the call, says Lipkin. The ICTV decides names for categories of viruses that are agreed upon internationally. Any virologist can submit proposals, and the ICTV's executive committee will discuss them at its next meeting in October, according to its website.
Elena Renken is the NPR Science Desk intern.
Do you have any questions about the Wuhan coronavirus outbreak? Email them to us with the subject line "Wuhan coronavirus FAQ" to goatsandsoda@npr.org and we may answer them in a story for NPR next week.


npr--2020-02-05--In Quarantined Wuhan, Hospital Beds For Coronavirus Patients Are Scarce

In Quarantined Wuhan , Hospital Beds For Coronavirus Patients Are Scarce First came Liu Xiaohong 's fever and a constant , throbbing ache .
Then six days later on Jan. 31 , her fever still raging , Liu desperately rushed by bike to the nearest hospital ; taxi services had been suspended days earlier as part of a citywide lock down .
Doctors did a CT scan of Liu 's lungs and concluded that day she likely had the new coronavirus .
Twelve days after falling ill , Liu is now waiting in a makeshift isolation ward for confirmation from @ @ @ @ @ @ @ finally be admitted to a hospital .
`` There is absolutely no medical care here .
They come and take your temperature each morning and night , '' Liu told NPR from her bed in the Chinese city of Wuhan .
Stomach pain and her worsening respiratory condition have left Liu struggling to breathe and talk .
`` All I am hoping for now is a bed in a hospital , '' she said .
`` But there are no hospital beds . ''
Scientists and public health authorities in China and around @ @ @ @ @ @ @ and treat a global outbreak of this new strain of the coronavirus .
But in Wuhan , which has fully a third of the more than 24,000 confirmed cases of the illness as of Wednesday , overwhelmed hospitals are struggling to screen all potential cases and to treat the ever-growing number of patients .
NPR spoke to more than a dozen families with confirmed or suspected cases of the coronavirus .
They recounted days of waiting in line to be screened with little more than an intravenous drip as treatment .
Hospitals are @ @ @ @ @ @ @ diagnosis , Wuhan residents say they can not get care , leaving those with potentially fatal cases of seasonal pneumonia and influenza untreated .
Many such cases are being sent to makeshift isolation wards in requisitioned hotels or clinics to keep them apart from family members while they wait to be screened .
Even those who test positive can wait days more for a hospital bed , increasing the risk of infection for others .
Overworked and under-supplied hospitals have been asking municipal community representatives to identify those most in need of coronavirus @ @ @ @ @ @ @ NPR community representatives are now starting to ignore calls or reroute them to other departments .
`` We are bitterly disappointed in the attitude of our public officials .
One after another they tell us they do not know who we should contact for help , '' said Wuhan resident Pan Yifei .
Pan 's grandmother suddenly died from a pneumonia-like illness on January 25 , early enough in the outbreak that health workers were unable to confirm whether she had the coronavirus .
But there was no time to mourn ; Pan @ @ @ @ @ @ @ now ill with similar symptoms .
Only her father , Pan Bing , has been officially diagnosed with the coronavirus and is waiting to be admitted to a hospital .
Desperate to get him admitted , Pan called her community representatives , who gave her the wrong number for the city 's health commission .
When she finally reached the health commission the next day , she says they hung up on her .
`` We listened to everything officials told us to do .
We were so obedient .
They said go @ @ @ @ @ @ @ my aunt and mother ] into isolation wards , '' Pan told NPR .
`` But let me tell you what these wards really are ; they are places where you send people to die by themselves . ''
Struggling to contain the virus On January 23 , authorities put Wuhan under quarantine with only hours of prior notice , preventing people from leaving , even halting public transit within the city .
Public health experts say that likely delayed the further spread of the virus .
`` It is safe to say @ @ @ @ @ @ @ [ the quarantine ] has reduced the peak of the epidemic , '' Dr Gauden Galea , the World Health Organization 's China representative , told China 's state broadcaster on Wednesday .
But the quarantine has also had the effect of bottling in thousands of sick , infectious people in a city with limited hospital beds , and made it more difficult for medical supplies to reach the sealed-off city .
Some doctors and nurses in Hubei province , of which Wuhan is the capital and where the epidemic has been the @ @ @ @ @ @ @ reduced to wearing rain jackets or sewing their own face masks while treating virus patients because of a lack of protective gear .
Donations of surgical gowns and masks must go through five state-authorized organizations , including the provincial chapter of the Red Cross , slowing distribution .
( Hubei 's government says it has punished three high-level staff of the Hubei Red Cross and fired the organization 's vice president . )
Wuhan is now close to finishing two new temporary treatment centers capable of holding 2,600 patients .
But like most @ @ @ @ @ @ @ for those who test positive for only the coronavirus .
`` I really hope my father gets diagnosed [ with the coronavirus ] , because if he is , then getting treatment may be easier .
But if he really does have the virus , then I am worried that he will not make it , '' Wan Jiuqiong , a Wuhan taxi driver , told NPR .
Wan 's mother tested positive for the virus and has been admitted to a hospital — but only after Wan pleaded her case on social @ @ @ @ @ @ @ 's lungs show dense tissue , a possible indicator of the coronavirus , but not strong enough of one to merit a hospital bed .
`` I was so heartbroken that I sat in my car and cried for half an hour when I found out that my mother tested positive but my father had not , '' said Wan .
Now , family members can only wait for the phone call that may deliver life-saving care .
Cheng Liang has been trying to find help for her 65-year old father-in-law since January @ @ @ @ @ @ @ a high fever .
A week later , this Wednesday , she was finally able to get him a coronavirus screening after CT scans showed his lung infection worsening .
They are still waiting for the results .
`` For elderly people , even waiting one more day can mean a heightened level of risk , '' said Cheng .
`` The results [ of the screening ] may take awhile to be confirmed .
Our hearts are sinking . ''
Others are risking infection themselves to care for loved ones , rather @ @ @ @ @ @ @ .
`` At this critical moment , we are family and I have to take care of them .
Nobody else will do it , '' said Pearl Tian , 23 .
Both her parents have been diagnosed with the coronavirus but neither has been able to get hospital care because of their relatively mild symptoms and a lack of hospital space .
The shutdown of public transit in Wuhan has made it difficult for the sick to reach the city 's hospitals .
Tian 's parents ride their scooters twenty minutes each @ @ @ @ @ @ @ Tian says they are paying for out of pocket until a hospital is willing to take her parents in .
`` I have never experienced anything like this before .
I have been forced to grow up , '' said Tian , who is also caring for her 13-year old brother .
`` I am scared .
Everyone is scared . ''

In Quarantined Wuhan, Hospital Beds For Coronavirus Patients Are Scarce
Enlarge this image toggle caption Xiao Yijiu/AP Xiao Yijiu/AP
Updated at 7:19 p.m. ET
First came Liu Xiaohong's fever and a constant, throbbing ache. Then six days later, on Jan. 31 and with her fever still raging, Liu desperately rushed by bike to the nearest hospital; taxi services had been suspended days earlier as part of a citywide lockdown.
Doctors did a CT scan of Liu's lungs and concluded that day that she likely had the new coronavirus. Twelve days after falling ill, Liu is now waiting in a makeshift isolation ward for confirmation from a virus screening test so she can finally be admitted to a hospital.
"There is absolutely no medical care here. They come and take your temperature each morning and night," Liu told NPR from her bed in the Chinese city of Wuhan. Stomach pain and her worsening respiratory condition have left Liu struggling to breathe and talk.
"All I am hoping for now is a bed in a hospital," she said. "But there are no hospital beds."
Scientists and public health authorities in China and around the world have mobilized quickly to identify and treat a global outbreak of this new strain of the coronavirus. But in Wuhan, which has fully a third of the more than 28,000 confirmed cases of the illness as of Wednesday, overwhelmed hospitals are struggling to screen all potential cases and to treat the ever-growing number of patients.
NPR spoke to more than a dozen families with confirmed or suspected cases of the coronavirus. They recounted days of waiting in line to be screened with little more than an intravenous drip as treatment.
Hospitals are so full that without an official coronavirus diagnosis, Wuhan residents say they cannot get care, leaving those with potentially fatal cases of seasonal pneumonia and influenza untreated.
Many such cases are being sent to makeshift isolation wards in requisitioned hotels or clinics to keep them apart from family members while they wait to be screened. Even those who test positive can wait days more for a hospital bed, increasing the risk of infection for others.
Overworked and undersupplied hospitals have been asking municipal community representatives to identify those most in need of coronavirus screening kits. But Wuhan residents told NPR that community representatives are now starting to ignore calls or reroute them to other departments.
"We are bitterly disappointed in the attitude of our public officials. One after another they tell us they do not know who we should contact for help," said Wuhan resident Pan Yifei.
Pan's grandmother died suddenly from a pneumonia-like illness on Jan. 25, early enough in the outbreak that health workers were unable to confirm whether she had the coronavirus. But there was no time to mourn; Pan's aunt, mother and father are now ill with similar symptoms. Only her father, Pan Bing, has been officially diagnosed with the coronavirus and is waiting to be admitted to a hospital.
Enlarge this image toggle caption Xiong Qi/AP Xiong Qi/AP
Desperate to get him admitted, Pan called her community representatives, who gave her the wrong number for the city's health commission. When she finally reached the health commission the next day, she says they hung up on her.
"We listened to everything officials told us to do. We were so obedient. They said go into isolation, so we sent [my aunt and mother] into isolation wards," Pan told NPR. "But let me tell you what these wards really are; they are places where you send people to die by themselves."
Struggling to contain the virus
On Jan. 23, authorities put Wuhan under quarantine with only hours of prior notice, preventing people from leaving, even halting public transit within the city. Public health experts say that likely delayed the further spread of the virus.
"It is safe to say to a high degree of probability that [the quarantine] has reduced the peak of the epidemic," Dr. Gauden Galea, the World Health Organization's China representative, told China's state broadcaster on Wednesday.
But the quarantine has also had the effect of bottling in thousands of sick, infectious people in a city with limited hospital beds and made it more difficult for medical supplies to reach the sealed-off city.
Some doctors and nurses in Hubei province, of which Wuhan is the capital and where the epidemic has been the most severe, say they have been reduced to wearing rain jackets or sewing their own face masks while treating virus patients because of a lack of protective gear.
Donations of surgical gowns and masks must go through five state-authorized organizations, including the provincial chapter of the Red Cross, slowing distribution. (Hubei's government says it has punished three high-level staff of the Hubei Red Cross and fired the organization's vice president.)
Wuhan is now close to finishing two new temporary treatment centers capable of holding 2,600 patients. But like most municipal hospitals now, they are reserved for those who test positive for only the coronavirus.
"I really hope my father gets diagnosed [with the coronavirus], because if he is, then getting treatment may be easier. But if he really does have the virus, then I am worried that he will not make it," Wan Jiuqiong, a Wuhan taxi driver, told NPR.
Wan's mother tested positive for the virus and has been admitted to a hospital — but only after Wan pleaded her case on social media. CT scans of his father's lungs show dense tissue, a possible indicator of the coronavirus, but not strong enough of one to merit a hospital bed. "I was so heartbroken that I sat in my car and cried for half an hour when I found out that my mother tested positive but my father had not," said Wan.
Waiting ... and waiting
Now, family members can only wait for the phone call that may deliver life-saving care.
Cheng Liang has been trying to find help for her 65-year-old father-in-law since Jan. 29, when he came down with a high fever. A week later, this Wednesday, she was finally able to get him a coronavirus screening after CT scans showed his lung infection worsening. They are still waiting for the results.
"For elderly people, even waiting one more day can mean a heightened level of risk," said Cheng. "The results [of the screening] may take awhile to be confirmed. Our hearts are sinking."
Others are risking infection themselves to care for loved ones rather than send them off to isolation wards. "At this critical moment, we are family and I have to take care of them. Nobody else will do it," said Pearl Tian, 23. Both her parents have been diagnosed with the coronavirus, but neither has been able to get hospital care because of their relatively mild symptoms and a lack of hospital space.
The shutdown of public transit in Wuhan has made it difficult for the sick to reach the city's hospitals. Tian's parents ride their scooters 20 minutes each day to the hospital for immunoglobulin injections Tian says they are paying for out of pocket until a hospital is willing to take her parents in.
"I have never experienced anything like this before. I have been forced to grow up," said Tian, who is also caring for her 13-year-old brother. "I am scared. Everyone is scared."


npr--2020-02-05--Michigan Gov. Whitmer Gives Democrats' Response To State Of The Union

Michigan Gov .
Whitmer Gives Democrats ' Response To State Of The Union NPR 's Noel King talks to Michigan @ @ @ @ @ who delivered the English-language , Democratic Party 's response to President Trump 's State of @ @ @ @ @ .

Michigan Gov. Whitmer Gives Democrats' Response To State Of The Union
NOEL KING, HOST:
With the impeachment trial almost behind him, President Trump gave his third State of the Union address last night. He was mostly optimistic. He talked about the low unemployment rate in this country and what he called, quote, "the great American comeback."
(SOUNDBITE OF ARCHIVED RECORDING)
PRESIDENT DONALD TRUMP: Our economy is the best it has ever been. Our military is completely rebuilt, with its power being unmatched anywhere in the world, and it's not even close. Our borders are secure. Our families are flourishing. Our values are renewed. Our pride is restored. And for all of these reasons, I say to the people of our great country and to the members of Congress, the state of our union is stronger than ever before.
(CHEERING)
KING: Governor Gretchen Whitmer of Michigan gave the Democratic Party's response. She's on the line now from Lansing. Good morning, Governor.
GRETCHEN WHITMER: Good morning.
KING: President Trump focused on the economy. Unemployment is low; wages are going up. Both those things are true. How do you rebut hard numbers?
WHITMER: Well, I think the fact of the matter is, what's happening in the stock market or the economy writ large doesn't mean a lot if you're working two jobs and still can't make your monthly bills when it comes to transportation and rent and groceries. There are a lot of people in our country that are struggling, who have issues, you know, in the workplace when the president issues a tweet and takes on trade policy and impacts autoworkers to farmers.
And so the stats that he used do not tell the story of what people are really confronting in our states across the country. And that's why I wanted to highlight what Democratic leaders are doing to deliver on affordable health care, to ensure that workers have minimum wage protections and overtime protections. This is how you raise people's standard of living. This is how you insure everyone has a path to a good life in this country.
KING: Let's talk about health care. You mentioned that, and the president talked about that quite a bit last night, including at one point where he delivered a kind of warning. Let me play that for you.
(SOUNDBITE OF ARCHIVED RECORDING)
TRUMP: To those watching at home tonight, I want you to know we will never let socialism destroy American health care.
(CHEERING)
KING: So leaving aside for a moment the fact that the term socialism is very loaded and that we expect to hear it a lot going into 2020, this is a very real concern for many voters, that the Democratic presidential nominee might take away their private sector health plans. What do you say to calm those people down?
WHITMER: Well, this is - part of my message last night was, you can listen to what people say, but watch what they do. That's where the truth is. Every candidate running for president has embraced the Affordable Care Act, and it wants to ensure that people with preexisting conditions have the kind of support that they need and coverage that they need.
This president talked about that, but we know he has filed lawsuit after lawsuit to gut the Affordable Care Act. He - that was - he ran on that. He's done it every day. And now he's pretending as though he cares about health care for the country. And it's baloney. And that's why I talked about the truth matters.
KING: Are you worried about losing swing voters, though, if the nominee is Sanders or Warren and they want these single-payer health care systems?
WHITMER: Well, I am a Democrat who is pragmatic, who's trying to solve problems and stay focused on the dinner-table issues, and there's no question access to affordable, quality health care is front and center for the vast majority of Americans. You know, every Democrat who's running has embraced creating greater coverage for people. And so whether it is, you know, one candidate or another, that is a shared goal, and that is one that is exactly counter to what this president has done in the three years that he's been in office.
KING: At one point, President Trump called for bipartisan legislation to lower prescription drug prices. Now, in the midst of this, the president last night would not shake Speaker Nancy Pelosi's hand. Later on in the evening, she ripped up his speech. As a governor, you need Congress and the president to work together. Do you think they are prepared to, based on what you saw last night?
WHITMER: Well, I think it was outrageous that the president went into the House of Representatives and wouldn't shake the speaker of the House's hand. She's the third most...
KING: Although to be fair, again, she ripped up the speech, right? Like, it did seem like there was a real back-and-forth of disrespect, if I can put it that way.
WHITMER: I can't speak to anyone's motives. But to start off the speech on that note, I thought, showed us that we were going to go into an incredibly divisive speech that - you know, I'm sure it kept the fact-checkers very busy because this is a man who started off by talking about inclusivity, when he's created space for bullies, and he tears down fellow Americans and has caged children who are trying to come to America for a better life.
It was one fiction after another, and I think probably that was the frustration that so many people, so many of us felt. Truth matters, and that's why it's so important to really watch what people do.
KING: Michigan Governor Gretchen Whitmer. Governor, thank you so much.
WHITMER: Thank you.
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NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.


npr--2020-02-05--Kobe Bryant Merchandise Increases In Value But Not Everyone Is Cashing In

Kobe Bryant Merchandise Increases In Value But Not Everyone Is Cashing In The death of basketball star Kobe Bryant is rippling through the memorabilia market , with buyers and sellers alike storming stores and online markets hoping to snag one last piece of his legacy .
The sneaker market spiked particularly quickly .
`` Pretty much the same day that he passed , everything we had available was just gone , '' said Candace Gray , a salesperson at Shoe Palace on Melrose Avenue in mid-city Los Angeles .
`` That following morning we got hit very hard with a @ @ @ @ @ @ @ they could as far as remembrance , '' she said .
But while some shoppers were in it for the sentiment , others were just looking to make a quick buck by flipping the shoes online .
On one website , shoes made famous by Bryant began selling for well over double what they were just hours before .
Not uncommon , says Robert Digisi at the Wharton School .
`` When a celebrity dies , whether it be sports , a musician , an actor , an actress , whatever that might @ @ @ @ @ @ @ of human sentiment involved and that will spike demand , '' he said .
`` And the market is n't necessarily ready for that . ''
That spike can lead to higher prices on a range of items , from jerseys to t-shirts , and posters to trading cards .
But Digisi says the spike is just that — prices level out over time .
That means both dealers and fans must choose whether to sell now or hold on .
At secondhand sneaker shop Cool Kicks , also in mid-city , co-owners @ @ @ @ @ @ @ hold onto them .
The store stocked several models , released over Bryant 's career .
Minutes after news of Bryant 's death , the two pulled them from the shelves .
`` We felt like all the resellers would hurry up and come to the store and take all of the items and try to make money off his name and we were opposed to that , '' Shams said .
Artis says they pulled the shoes just in time .
`` After we took everything off the shelf , everyone wants @ @ @ @ @ @ @ item or they wan na sell an item they have to profit off because [ they ] see a market that 's going increasingly crazy now too , '' he said .
Shams and Artis say they have more than 100 pairs of Kobe Bryant-associated shoes at the shop .
Bryant 's fanbase in China and Europe made him an international figure .
That translates to a world of collectors and fans hoping to get their hands on a dwindling number of relics — now priced out of reach for the average sneakerhead @ @ @ @ @ @ @ of Kobe 1 Protros .
`` We had it reselling at $ 750 , and now that I 'm looking at it , the closest shoe in this size is a 9-and-a-half going for $ 12,000 , '' he said .
But Shams and Artis do n't plan to sell anytime soon .
When they do , they say they 'll likely donate their profits to the Mamba on Three fund , which was founded in the wake of Bryant 's death by his wife , Vanessa .
The two are n't the @ @ @ @ @ @ @ Candace Gray , at Shoe Palace , does n't just sell Kobe gear : she collects it herself .
She does n't plan to sell her collection of shoes and jerseys either .
`` They are going to go into glass , '' she said .
`` I do n't want to have to worry about not having something that my kids can have tangible to be able to explain the magnitude of who Kobe Bryant was . ''

Kobe Bryant Merchandise Increases In Value But Not Everyone Is Cashing In
Enlarge this image toggle caption Austin Cross/KPCC Austin Cross/KPCC
The death of basketball star Kobe Bryant is rippling through the memorabilia market, with buyers and sellers alike storming stores and online markets hoping to snag one last piece of his legacy. The sneaker market spiked particularly quickly.
"Pretty much the same day that he passed, everything we had available was just gone," said Candace Gray, a salesperson at Shoe Palace on Melrose Avenue in mid-city Los Angeles.
"That following morning we got hit very hard with a lot of people hoping to grab what they could as far as remembrance," she said.
But while some shoppers were in it for the sentiment, others were just looking to make a quick buck by flipping the shoes online. On one website, shoes made famous by Bryant began selling for well over double what they were just hours before.
Not uncommon, says Robert Digisi at the Wharton School.
"When a celebrity dies, whether it be sports, a musician, an actor, an actress, whatever that might be, there is certainly a lot of human sentiment involved and that will spike demand," he said. "And the market isn't necessarily ready for that."
That spike can lead to higher prices on a range of items, from jerseys to t-shirts, and posters to trading cards.
But Digisi says the spike is just that — prices level out over time. That means both dealers and fans must choose whether to sell now or hold on.
Honoring Kobe's memory
At secondhand sneaker shop Cool Kicks, also in mid-city, co-owners Adeel Shams and Davon Artis chose to hold onto them. The store stocked several models, released over Bryant's career. Minutes after news of Bryant's death, the two pulled them from the shelves.
"We felt like all the resellers would hurry up and come to the store and take all of the items and try to make money off his name and we were opposed to that," Shams said.
Artis says they pulled the shoes just in time.
"After we took everything off the shelf, everyone wants to come in either looking for an item or they wanna sell an item they have to profit off because [they] see a market that's going increasingly crazy now too," he said.
Enlarge this image toggle caption Austin Cross/KPCC Austin Cross/KPCC
Shams and Artis say they have more than 100 pairs of Kobe Bryant-associated shoes at the shop.
Bryant's fanbase in China and Europe made him an international figure. That translates to a world of collectors and fans hoping to get their hands on a dwindling number of relics — now priced out of reach for the average sneakerhead. Shams points to a red pair of Kobe 1 Protros.
"We had it reselling at $750, and now that I'm looking at it, the closest shoe in this size is a 9-and-a-half going for $12,000," he said.
But Shams and Artis don't plan to sell anytime soon. When they do, they say they'll likely donate their profits to the Mamba on Three fund, which was founded in the wake of Bryant's death by his wife, Vanessa.
The two aren't the only ones putting passion over profit. Candace Gray, at Shoe Palace, doesn't just sell Kobe gear: she collects it herself. She doesn't plan to sell her collection of shoes and jerseys either.
"They are going to go into glass," she said. "I don't want to have to worry about not having something that my kids can have tangible to be able to explain the magnitude of who Kobe Bryant was."


npr--2020-02-05--Nigerians Shocked By Trump's New Immigration Restrictions

Akinbode Akinmutimi still remembers the first time he saw a U.S. dollar in Nigeria .
He was in the fourth grade , and was taken by the words , `` In God We Trust . ''
`` I really want to come to this country that trusted in God , '' Akinmutimi recalls .
He did just that , and moved to the U.S. 17 years ago .
Today , Akinmutimi says he 's living his American Dream with his wife and three kids .
But he worries about other Nigerians who are looking to do the same .
The @ @ @ @ @ @ @ , which stipulates who can enter the U.S. , to include six more countries — Nigeria , Eritrea , Sudan , Tanzania , Kyrgyzstan and Myanmar .
Unlike previous iterations , this travel proclamation does n't apply to refugees , students or tourists .
But it does prevent people from Nigeria from being able to immigrate to the U.S. permanently .
Government officials cited security concerns for the move , saying the countries on the travel ban are n't complying with U.S. security requirements for passports and information sharing .
Department of Homeland @ @ @ @ @ @ @ last week the restrictions `` are not blanket restrictions . ''
`` These tailored restrictions will make the U.S. safer and more secure .
And countries that make the necessary improvements will have their restrictions removed accordingly , '' Wolf said .
Akinmutimi , a cybersecurity analyst , understands the need to protect the security of America , but he does n't agree with how it 's being done .
`` They should make sure they vet people from coming to the United States .
But putting the entire ban on a country @ @ @ @ @ @ @ proper , '' he says .
Akinmutimi says members of the Nigerian diaspora contribute to not only American society , but the economy .
`` We have doctors , we have lawyers , we have so many people that are doing very well , '' he says .
A Migration Policy Institute study shows first- and second-generation Nigerians are typically more educated and more likely to hold professional jobs than the general U.S. population .
According to a New York Times report , experts say there could be wide-ranging economic impacts following the @ @ @ @ @ @ @ for its part , says it will address the security concerns outlined by the United States .
Kudirat Koletowo immigrated to America 50 years ago .
She 's a proud Muslim and believes the new travel ban targets certain African countries for a reason .
`` We know that Trump do n't like Muslims .
And he should take that out of his mind .
We contribute a lot to this country , '' Koletowo says .
`` Innocent people are caught in the middle of this . ''
Nigeria , Sudan , @ @ @ @ @ @ @ the latest travel ban — have large Muslim populations .
A Department of Homeland Security release following the latest announcement of the travel ban said , `` These restrictions do not reflect animus or bias against any particular country , region , ethnicity , race , or religion . ''
Other iterations of the travel ban have faced legal challenges and outcry from immigrant rights groups .
The Supreme Court upheld the travel ban in a 5-4 decision in 2018 , which found the ban was `` squarely within the scope '' of @ @ @ @ @ @ @ while her family members in Nigeria are n't looking to immigrate to the U.S. , she 's still concerned about what will happen if they do decide to leave .
Rafiu Aremu left Nigeria in 1999 and now lives in Maryland .
He thinks there 's more to the travel ban than protecting national security .
`` When you are making a targeted immigration restriction on certain countries , I think there 's an undertone to that , '' he says .
As Aremu speaks about the ban , he wonders : '' @ @ @ @ @ @ @ racial integration of African American [ s ] in the States ? ''
Many Nigerians have questions about how the travel ban might affect them .
The Nigerian American Lawyers Association plans to hold a community seminar to answer those questions this week , before the ban goes into effect in late February .

Nigerians Shocked By Trump's New Immigration Restrictions
Enlarge this image toggle caption Carmel Delshad/WAMU Carmel Delshad/WAMU
Akinbode Akinmutimi still remembers the first time he saw a U.S. dollar in Nigeria. He was in the fourth grade and was taken by the words "In God We Trust."
"I really want to come to this country that trusted in God," Akinmutimi recalls.
He did just that and moved to the U.S. 17 years ago.
Today, Akinmutimi says he's living his American dream with his wife and three kids. But he worries about other Nigerians who are looking to do the same.
The Trump administration recently widened its travel ban, which stipulates who can enter the U.S., to include six more countries — Nigeria, Eritrea, Sudan, Tanzania, Kyrgyzstan and Myanmar. Unlike previous iterations, this travel proclamation doesn't apply to refugees, students or tourists.
But it does prevent people from Nigeria from being able to immigrate to the U.S. permanently. Government officials cited security concerns for the move, saying the countries on the travel ban aren't complying with U.S. security requirements for passports and information sharing.
Department of Homeland Security Acting Secretary Chad F. Wolf said last week the restrictions "are not blanket restrictions."
"These tailored restrictions will make the U.S. safer and more secure. And countries that make the necessary improvements will have their restrictions removed accordingly," Wolf said.
Enlarge this image toggle caption Carmel Delshad/WAMU Carmel Delshad/WAMU
Akinmutimi, a cybersecurity analyst, understands the need to protect the security of America, but he doesn't agree with how it's being done.
"They should make sure they vet people from coming to the United States. But putting the entire ban on a country ... I don't think it's proper," he says.
Akinmutimi says members of the Nigerian diaspora contribute to not only American society, but the economy.
"We have doctors, we have lawyers, we have so many people that are doing very well," he says.
A Migration Policy Institute study shows first- and second-generation Nigerians are typically more educated and more likely to hold professional jobs than the general U.S. population. According to a New York Times report, experts say there could be wide-ranging economic effects following the travel ban.
Education Trump Travel Ban Expansion Could Affect HBCUs Trump Travel Ban Expansion Could Affect HBCUs Listen · 5:37 5:37
The Nigerian government, for its part, says it will address the security concerns outlined by the United States.
Kudirat Koletowo immigrated to America 50 years ago. She's a proud Muslim and believes the new travel ban targets certain African countries for a reason.
"We know that Trump don't like Muslims. And he should take that out of his mind. We contribute a lot to this country," Koletowo says. "Innocent people are caught in the middle of this."
Nigeria, Sudan, Tanzania and Eritrea — all part of the latest travel ban — have large Muslim populations.
A Department of Homeland Security release following the latest announcement of the travel ban said, "These restrictions do not reflect animus or bias against any particular country, region, ethnicity, race, or religion."
Other iterations of the travel ban have faced legal challenges and outcry from immigrant rights groups. The Supreme Court upheld the travel ban in a 5-4 decision in 2018, which found the ban was "squarely within the scope" of the president's powers.
Law Supreme Court Upholds Trump Travel Ban Supreme Court Upholds Trump Travel Ban Listen · 4:28 4:28
Koletowo says that while her family members in Nigeria aren't looking to immigrate to the U.S., she's still concerned about what will happen if they do decide to leave.
Rafiu Aremu left Nigeria in 1999 and now lives in Maryland. He thinks there's more to the travel ban than protecting national security.
"When you are making a targeted immigration restriction on certain countries, I think there's an undertone to that," he says.
As Aremu speaks about the ban, he wonders:
"Is the government trying to reduce the racial integration of African American[s] in the States?"
Many Nigerians have questions about how the travel ban might affect them. The Nigerian American Lawyers Association plans to hold a community seminar to answer those questions this week, before the ban goes into effect in late February.


npr--2020-02-05--Lessons Learned From The Iowa Caucuses, And Danger Signs Ahead

Lessons Learned From The Iowa Caucuses , And Danger Signs Ahead If the Iowa caucuses were a pop quiz on how well the nation is prepared for the 2020 elections , it looks like almost everyone failed .
Or at least that they need to do a lot more remedial work .
The meltdown was extensive .
A smartphone app purchased by the Iowa Democratic Party for precincts to use to report caucus votes did n't work as planned .
A backup hotline system also failed , leaving party officials scrambling on Tuesday to answer questions and produce results , @ @ @ @ @ @ @ figure out what was going on .
Some election watchers were not surprised .
Douglas Jones , a computer scientist at the University of Iowa , was one of many who have warned for weeks that maybe it was n't such a good idea to introduce a new technology at such a critical time — with the eyes of the nation on the first presidential voting of 2020 .
`` Caucus chairs in many cases apparently were attempting to download and install the app on their phones on caucus night .
That 's @ @ @ @ @ @ @ thing under pressure , '' says Jones .
`` Downloading an app at the last minute is crazy . ''
But that 's exactly what many caucus chairs tried to do .
Elesha Gayman , the Democratic Party Chair in Scott County , said their attempts were complicated by measures put in place to protect the reporting system against outside attacks .
`` We had a lot of our precinct captains and temporary chairs , and permanent chairs , that were trying to log into the system and quite frankly there were so @ @ @ @ @ @ @ get messed up . ''
she said .
Out of frustration , they resorted to calling a backup hotline , which was quickly overwhelmed with calls .
There were other worrisome things that occurred Monday night , which election experts see as warning signs of the kinds of problems that can emerge in the months ahead : Iowa Democratic Party officials were secretive about the details of the new smartphone app and whether it had been tested in advance for possible flaws .
When things began to go awry , the party was @ @ @ @ @ @ @ the delay , leaving the public and campaigns confused , frustrated and even suspicious .
The party had promised the new app would also mean quicker results , but instead the hours dragged on with nothing to report .
`` The media is ready to go and everyone 's ready to declare a winner and the candidates have their speeches and there 's this sense of anticipation , '' says Rick Hasen , an election law expert who 's just written a book — Election Meltdown : Dirty Tricks , Distrust , and @ @ @ @ @ @ @ all the things that could go wrong in 2020 .
`` If the Iowa Democratic Party had said , 'well , it 's going to be a day or two before we have results , ' people 's expectations would have been managed , '' Hasen said .
Election experts say that should be the message going forward and officials should n't be pressured into rushing out results that later prove to be wrong .
They warn that votes could take an especially long time to count this year , in what 's @ @ @ @ @ @ @ widespread use of mail-in ballots .
While Iowa 's caucuses are unique , others have also been considering the use of smartphone apps and Internet voting .
Monday 's meltdown has given them pause .
On Tuesday , Nevada 's Democratic Party announced that it will not be using an app like Iowa 's in its Feb. 22 caucuses despite having paid tens of thousands of dollars to the developer , a company called Shadow .
But Hasen notes that there are a number of states , like Pennsylvania , that will be @ @ @ @ @ @ @ and that could lead to breakdowns and confusion .
Some have already encountered problems .
A county in Pennsylvania had an election last November in which the machines showed only a handful of votes for a judicial candidate , while a recount showed that in fact he had won .
Officials and vendors are working together to make sure it does n't happen again .
They also breathed a sigh of relief that the problem emerged last year , while there was still time to fix it before this year 's election .
@ @ @ @ @ @ @ clear there was a problem in Iowa that the conspiracy theories began to fly .
`` Dems rigging it in Iowa ?
Such a peculiar vote delay .
They just ca n't let the People have their say ! ''
tweeted Kayleigh McEnany , press secretary for President Trump 's re-election campaign .
Donald Trump Jr. alleged , without evidence , that Iowa Democrats were `` fixing the results to get the candidate the Democrat Overlords in DC want . ''
Some Democrats also raised questions about the legitimacy of the vote , @ @ @ @ @ @ @ hacked , something quickly dismissed by security officials .
The spread of disinformation , especially on social media , is seen as one of the most serious threats to public confidence in this year 's elections .
`` We need to be on guard against that and really watch against disinformation and attempts to rile people up in an already very polarized environment , '' says Hasen .
Iowa caucuses are different from primaries and general elections because they 're conducted by party officials , not by people who run elections as a @ @ @ @ @ @ @ serious gap .
Iowa Secretary of State Paul Pate issued a release making clear that his office had `` 'no official role in the Iowa Caucuses . ''
Federal authorities were in contact throughout the evening with party officials , checking to make sure there were no signs of a cyber attack .
But they deferred to the Iowa Democratic Party to tell the public what was going on .
Department of Homeland Security officials also say they offered to test the new smartphone app for security flaws in advance of the caucuses @ @ @ @ @ @ @ declined .
`` Was it satisfying ?
No .
Was it frustrating ?
Yes , '' says Christopher Krebs , who runs the DHS cybersecurity agency that works on election security .
But Krebs called the Iowa meltdown a `` teachable moment , '' a stark reminder to those running elections that they need to be prepared for every contingency .
`` Do you have your plan ? ''
says Krebs .
`` If something goes wrong do you know who you 're going to call , what you 're going to say @ @ @ @ @ @ @ 're going to say to the press , what you are going to say to the voting public ? ''
Krebs says one good lesson learned from the Iowa incident is that having a paper record of votes — which the caucuses did — is key .
If something happens to the technology , he says , those paper ballots are available to count and audit , and to reassure the public that the results are accurate .

Lessons Learned From The Iowa Caucuses, And Danger Signs Ahead
Enlarge this image toggle caption Nati Harnik/AP Nati Harnik/AP
If the Iowa caucuses were a pop quiz on how well the nation is prepared for the 2020 elections, it looks like almost everyone failed. Or at least that they need to do a lot more remedial work.
The meltdown was extensive. A smartphone app purchased by the Iowa Democratic Party for precincts to use to report caucus votes didn't work as planned. A backup hotline system also failed, leaving party officials scrambling on Tuesday to answer questions and produce results, as candidates and the public tried to figure out what was going on.
Some election watchers were not surprised.
Douglas Jones, a computer scientist at the University of Iowa, was one of many who have warned for weeks that maybe it wasn't such a good idea to introduce a new technology at such a critical time — with the eyes of the nation on the first presidential voting of 2020.
"Caucus chairs in many cases apparently were attempting to download and install the app on their phones on caucus night. That's extraordinarily difficult, to do that kind of thing under pressure," says Jones. "Downloading an app at the last minute is crazy."
Elesha Gayman, the Democratic Party chair in Scott County, said their attempts were complicated by measures put in place to protect the reporting system against outside attacks.
"We had a lot of our precinct captains and temporary chairs, and permanent chairs, that were trying to log in to the system, and quite frankly there were so many layers of security, they would get messed up," she said. Out of frustration, they resorted to calling a backup hotline, which was quickly overwhelmed with calls.
There were other worrisome things that occurred Monday night, which election experts see as warning signs of the kinds of problems that can emerge in the months ahead.
Secrecy Fed Unrealistic Expectations Around Results Timing
Iowa Democratic Party officials were secretive about the details of the new smartphone app and whether it had been tested in advance for possible flaws.
When things began to go awry, the party was vague for hours about what was causing the delay, leaving the public and campaigns confused, frustrated and even suspicious. The party had promised the new app would also mean quicker results, but instead the hours dragged on with nothing to report.
"The media is ready to go and everyone's ready to declare a winner and the candidates have their speeches and there's this sense of anticipation," says Rick Hasen, an election law expert who has just written a book — Election Meltdown: Dirty Tricks, Distrust, and the Threat to American Democracy — about all the things that could go wrong in 2020.
"If the Iowa Democratic Party had said, 'Well, it's going to be a day or two before we have results,' people's expectations would have been managed," Hasen said.
Election experts say that should be the message going forward and officials shouldn't be pressured into rushing out results that later prove to be wrong. They warn that votes could take an especially long time to count this year, in what's expected to be a high-turnout election with widespread use of mail-in ballots.
New Voting Technologies Rolled Out Too Quickly
While Iowa's caucuses are unique, others have also been considering the use of smartphone apps and Internet voting.
Monday's meltdown has given them pause.
On Tuesday, Nevada's Democratic Party announced that it will not be using an app like Iowa's in its Feb. 22 caucuses despite having paid tens of thousands of dollars to the developer, a company called Shadow.
But Hasen notes that there are a number of states, such as Pennsylvania, that will be using all new voting equipment this year and that could lead to breakdowns and confusion.
Some have already encountered problems.
A county in Pennsylvania had an election last November in which the machines showed only a handful of votes for a judicial candidate, while a recount showed that in fact he had won. Officials and vendors are working together to make sure it doesn't happen again. They also breathed a sigh of relief that the problem emerged last year, while there was still time to fix it before this year's election.
Uncertainty Fed Conspiracy Theories
It wasn't long after it became clear there was a problem in Iowa that the conspiracy theories began to fly.
"Dems rigging it in Iowa? Such a peculiar vote delay. They just can't let the People have their say!" tweeted Kayleigh McEnany, press secretary for President Trump's reelection campaign. Donald Trump Jr. alleged, without evidence, that Iowa Democrats were "fixing the results to get the candidate the Democrat Overlords in DC want."
Some Democrats also raised questions about the legitimacy of the vote, even hinting that the system had been hacked, something quickly dismissed by security officials.
The spread of disinformation, especially on social media, is seen as one of the most serious threats to public confidence in this year's elections. "We need to be on guard against that and really watch against disinformation and attempts to rile people up in an already very polarized environment," says Hasen.
"Teachable Moment"
Iowa caucuses are different from primaries and general elections because they're conducted by party officials, not by people who run elections as a full-time job.
But that left a serious gap. Iowa Secretary of State Paul Pate issued a release making clear that his office had "'no official role in the Iowa Caucuses." Federal authorities were in contact throughout the evening with party officials, checking to make sure there were no signs of a cyberattack.
But they deferred to the Iowa Democratic Party to tell the public what was going on. Department of Homeland Security officials also say they offered to test the new smartphone app for security flaws in advance of the caucuses, but that the Iowa Democratic Party declined.
"Was it satisfying? No. Was it frustrating? Yes," says Christopher Krebs, who runs the DHS cybersecurity agency that works on election security. But Krebs called the Iowa meltdown a "teachable moment," a stark reminder to those running elections that they need to be prepared for every contingency.
"Do you have your plan?" asks Krebs. "If something goes wrong do you know who you're going to call, what you're going to say to the political parties, what you're going to say to the press, what you are going to say to the voting public?"
Krebs says one good lesson learned from the Iowa incident is that having a paper record of votes — which the caucuses did — is key. If something happens to the technology, he says, those paper ballots are available to count and audit and to reassure the public that the results are accurate.