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Denying Asylum to Domestic Violence Survivors Shocks the Conscience – posted 6/17/2018

June 17, 2018 Leave a comment

On June 11, Attorney General Jeff Sessions drastically restricted asylum claims of those fleeing domestic and gang violence. While I think the decision is wrong for both groups, I find the restriction placed on domestic violence victims particularly shocking and heartless. Sessions’ ruling reflects an outdated and misogynistic understanding of domestic violence as “private violence”.

Sessions minimized domestic violence as a crime. He harkens back to a time when domestic violence was seen as a private matter between spouses, something outside the jurisdiction of courts and governments.

It is not an exaggeration to say Sessions’ ruling will return countless women to grave danger and possible death at the hands of their abusers.

Karen Musalo, a lawyer who represents domestic violence victims who seek asylum in the United States, responded to Sessions’ ruling:

“What the decision does is yank us all back to the Dark Ages of human rights and women’s human rights and the conceptualization of it.”

Applicants for asylum to the United States must show they are persecuted because of characteristics such as their race, religion, political opinion or membership in a “particular social group”. Since 2014, the Board of Immigration Appeals had created legal precedent that allowed domestic violence victims to qualify for asylum as members of a “particular social group”.

The survivors of domestic violence could only qualify for asylum though if the violence rose to the level of “persecution” and if the government was unable or unwilling to protect them.

Sessions overturned this legal precedent when he personally intervened in the case of a Salvadoran woman known as Ms. A.-B. (her initials). Ms. A.-B. sought asylum in the United States after she had survived 15 years of physical, sexual and emotional abuse by her husband. During those 15 years, Ms. A.-B.’s husband beat her regularly, including when she was pregnant, and bashed her head against a wall.

Ms. A.-B. had moved to another Salvadoran town, had obtained restraining orders and had divorced her husband but the threats and violence continued. The ex-husband’s brother was a police officer and the government failed to protect her. She fled El Salvador in 2014 after her ex-husband threatened again to kill her and dump her body in a river.

When Ms. A.-B. initially went before an immigration judge who rarely grants asylum, she lost. However, she later won her case before the Board of Immigration Appeals. The Board ruled that the Salvadoran government had shown it was incapable of protecting Ms. A.-B. even after she moved to another town in El Salvador.

Before her asylum status was formally granted, Sessions intervened. He referred the case to himself for review and issued a new ruling. As Attorney General, Sessions has the power to intervene in cases to determine how immigration law is interpreted. He can issue decisions that serve as binding precedents for immigration judges.

In his Ms. A.-B. ruling, Sessions wrote that generally claims on domestic violence will no longer qualify for asylum and will not even reach the initial “credible fear” standard to allow an immigrant to have her claim heard by a judge.

Sessions is effectively closing the courtroom door and locking domestic violence victims out. As he would put it, victims of private criminal activity perpetrated by nongovernmental actors fail to meet the asylum standard.

His ruling could literally invalidate tens of thousands of pending asylum claims. Under immigration law, the rulings of the attorney general are binding on immigration judges unless they are reversed by a federal appellate court.

We must never forget that it was not too long ago that Americans did not view domestic violence as a problem worth talking about. If a man beat his wife, that was viewed as a private affair. Police and the public turned a blind eye. Abusers intimidated their victims into silence.

It has taken almost 50 years of feminist activism to change policies and attitudes about domestic violence. Through that long-term struggle, society came to see domestic violence as a public health and human rights concern – not a private issue. Sessions’ ruling is a dramatic step backwards. It misses the reality that the privacy of violence is exactly the shield abusers have used to escape the consequences of their acts.

Even before Sessions’ ruling, women who were victims of domestic violence were not guaranteed asylum. Their status as domestic violence victims only made them eligible to apply for asylum. In 2017, the national rate for the denial of asylum claims was 61%. What Sessions has done is make the process infinitely more difficult.

Whether Sessions’ ruling will withstand court challenge remains unclear. Even if a federal appellate court overruled Sessions’ Ms. A.-B. ruling, such a decision would only apply in the geographic area of that circuit court. Maybe a case will make it to the U.S. Supreme Court (and who knows what that outcome will be) but in the meantime, Sessions’ ruling will have a devastating effect.

You have to wonder what is next. Will Sessions attempt to roll back legal precedent for other victims of gender-based violence such as LGBT people, victims of female genital mutilation, and forced marriage who seek refuge in the United States?

We have come a long way from Emma Lazarus’s stirring words affixed to the pedestal of the Statue of Liberty:

“Give me your tired, your poor,
Your huddled masses
yearning to breathe free,
The wretched refuse of
your teeming shore.
Send these, the homeless.
tempest-tost to me,
I lift my lamp beside the golden door!”

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Categories: Uncategorized

Separating Immigrant Children From Their Parents is a Horror Show With Historical Precedent – posted 6/10/2018

June 10, 2018 Leave a comment

Occasionally in politics a story comes along that is so horrifying and morally reprehensible that it commands immediate attention. Such is the Trump Administration’s policy of indefinitely separating undocumented immigrant parents from their children as they cross the U.S. border.

On June 7, Lee Gelernt, the American Civil Liberties Union (ACLU) lawyer litigating the class action challenging the family separation practice, stated he thinks 1500 to 2000 children have been separated from their parents. This includes babies, toddlers and other small children torn from their mothers and fathers.

In the great majority of cases, the children have no idea where their parents are and when they will be able to see them again.

The Trump Administration is traumatizing a huge number of innocent children, putting them at high risk of suffering lifelong negative impacts. In response to the current situation, the American Academy of Pediatrics wrote a letter to Homeland Security Secretary Kirstjen Nielsen, urging the Trump Administration in the strongest possible terms to reject its family-separation policy:

“Separation from the very parents who would provide them with love, stability and reassurance only exacerbates children’s suffering… Fear and stress, particularly prolonged exposure to serious stress without the buffering protection afforded by stable, responsive relationships – known as toxic stress – can harm the developing brain and harm short- and long-term health.”

I am trying to visualize the situation of the detained immigrant children. They are being warehoused and held as prisoners in unsanitary and freezing conditions for months. Rows and rows of children sleep on thin mats behind chain-linked fences. The cells are like dog kennels or large cages. The children and the immigrants call the facilities hieleras or iceboxes. The ACLU just released a report about the level of abuse by Customs and Border Patrol and ICE of children in these hieleras. It is not a pretty picture.

NBC has reported that half of the detained children are under age 12.

When U.S. Senator Jeff Merkley tried to inspect the childrens’ detention conditions in a Brownsville Texas facility, prison operators locked him out and called the police. Sen. Merkley was not allowed to carry out an inspection. The detention center is a former Walmart with blacked-out windows. Not exactly a message of transparency.

Trump’s family-separation policy has no legal basis. Attorney General Jeff Sessions described this Kafkaesque policy as a “zero-tolerance” immigration measure. John Kelly, Trump’s chief of staff, has said the purpose of family separation is deterrence of illegal immigration.

Contrary to past policies in which families were kept together and only detained for a limited time, the Trump Administration has tried to work around time restrictions previously imposed by courts.

The Federal Court in San Diego has now preliminarily refused to dismiss the ACLU class action lawsuit, ruling that the “wrenching separation” of families may violate the Constitution’s guarantee of due process. Under U.S. Supreme Court precedent, family integrity is considered a fundamental due process right. In this case, the Trump Administration has failed to show any compelling government interest in separating parents and children. Nor have they used a least restrictive means to fulfill their interests required under due process law.

For those who may wonder, due process rights do apply to undocumented immigrants. The U.S. Supreme Court decided that in 2001 in the case of Zadvydas v Davis.
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The Trump Administration family-separation policy is premised on a racist dehumanization of those seeking to immigrate to the United States. To treat families in such a cruel fashion is not to accord them rights as fellow human beings. What happened to that old Republican favorite of “family values”?

Trump recently denounced unauthorized immigrants as “animals”. Sarah Huckabee Sanders later corrected her boss, stating, not reassuringly, that he only meant members of the MS-13 gang.

I wish I could say the current family separation policy is an aberration in American history. It is not. It is hard not to be reminded of both Native American and African American history.

In the last third of the 19th century, the government removed tens of thousands of Native Americans from their families and forced them into government-funded boarding schools. In these schools, the Native American children were forced to change their names, learn English, dress like Americans and convert to Christianity. Later in the 20th century, as many as 25 to 35% of native American children were taken from their families with the great majority placed in white households.

Slaveholders sold the children of African American slaves away from their families. Enslaved parents lived with the constant fear that they or their children might be sold away. The destruction of families was one of the most evil aspects of slavery.

The Trump Administration family-separation policy represents a profound devaluation of families of color and is in keeping with the most racist and inhumane traditions of U. S. history. The policy is a disgrace, immoral and likely unconstitutional, and we must do everything within our power to vigorously oppose it.

Categories: Uncategorized

Puerto Rico and the Vast Death Undercount – posted 6/3/2018

June 3, 2018 1 comment

A new study released by Harvard’s Chan School of Public Health estimated that 4,645 people died in Puerto Rico in the three month period after Hurricane Maria. The government of Puerto Rico is still quoting a death tally of 64 people.

The Harvard study is a figure 70 times higher than the official death count. It is more than double the number of people who died in Hurricane Katrina. The Harvard study ranks Hurricane Maria the deadliest natural disaster to hit the United States in the last 100 years. As the study says:

“Our results indicate that the official death count of 64 is a substantial underestimate of the true burden of mortality after Hurricane Maria.”

While no study like this can be absolutely accurate, the Harvard study is the most reliable accounting to date. The researchers from Harvard worked with graduate students at the Carlos Albizu University and Ponce Health Sciences University in Puerto Rico and others in Colorado and Boston to conduct a survey of 3,299 randomly selected households in Puerto Rico – about 9,522 people.

The researchers asked those surveyed about all deaths and their causes between September 20, 2017, the date of Hurricane Maria, and December 31, 2017. They tried to compare the normal death rate from the year prior to the late 2017 period. The researchers found a 62% increase in mortality in the three months after the hurricane.

How to explain the vast death undercount? The Harvard researchers present a persuasive explanation. What was deadly was not just the storm itself, it was the loss of electricity, power, and cellphone service in the aftermath of the storm which deprived thousands of medical care.

Health care disruption for the elderly and loss of basic utility service for the chronically ill had a devastating impact. Wendy Matos, a physician who supervises 468 doctors working at 29 sites across Puerto Rico has said her clinics saw increases in cardiac arrest and intracranial hemorrhage (bleeding inside the skull), more waterborne and infectious disease and more suicides after Maria.

Dr. Matos blamed lack of access to potable water. More patients presented with illnesses related to drinking water contamination. She also described acute mental health issues. She felt the elderly have suffered the most extreme anxiety and depression.

After the storm, heath care was effectively crippled on much of the island. Even by mid-December 2017, one-third of the island’s 68 hospitals lacked power. As late as March 2018, 11% of Puerto Rico’s community health centers had limited or no power. The researchers wrote:

“Interruption of medical care was the primary cause of sustained high mortality rates in the months after the hurricane.”

The government of Puerto Rico’s way of counting deaths led to a skewed picture of the real harm. The government was not using any guidelines for deciding what was counted as a hurricane-related death. It simply did not count deaths that could not be attributed to direct storm damage itself. Indirect deaths from the worsening of chronic conditions or from delayed medical treatments did not count. The picture presented minimized the damage done.

Puerto Rico was also the victim of a public relations sales job. When President Trump lobbed paper towels two weeks after Maria, he was anxious to brag about a successful relief effort. Trump said only 16 died and he said Puerto Rico had not experienced “a real catastrophe” like New Orleans with Katrina. In an interview on Fox and Friends, he graded himself an A-plus for effort and an A for achievement.

Aware of the disaster Katrina had been for President George W. Bush, Trump wanted to get ahead of the story. I would have to say his scam worked. He pre-empted the disaster by messaging that Maria was no Katrina. Then he and the mass media largely moved on and forgot Puerto Rico.

This is an instance where a false narrative of recovery governed and still governs popular perception. The storyline of recovery overshadows facts on the ground. The public stopped paying attention.

By almost any measure, the federal response has been a fiasco. Recovery has been conducted at a snail’s pace. On average, Puerto Ricans went 84 days without electricity, 68 days without water and 41 days without cellphone coverage after the storm. According to the Washington Post, 20,000 residents in remote areas of the island are still without power.

I think we can safely say that if such a performance had occurred on the U.S. mainland, it would have been deemed absolutely unacceptable. The federal government was underprepared for the storm. It failed to properly position supplies in advance and it failed to make provisions for military assets. Puerto Rico had a frail infrastructure even before the storm.

Considering the history of increasingly powerful storms to wrack the Caribbean and the Gulf areas, there was an anti-scientific dimwittedness behind the poor response. You have to wonder how many more monster storms will it take before climate change is even acknowledged.

There are deeper dimensions to this tragedy as well. Puerto Rico exists in a political twilight zone. Although it is called an unincorporated territorial possession, it is actually a colony of the United States. Even though the Puerto Rican people are U.S. citizens, they have no representatives in Congress or the Senate. Puerto Rico has no votes in the Electoral College and Puerto Ricans on the island cannot cast votes for President in the general election.

The political powerlessness of Puerto Rico makes it easier to ignore the crisis on the island. Politicians do not worry about blowback because the island can’t vote.

Adding to its invisibility, Puerto Rico’s military value has disappeared. Puerto Rico is less consequential now because the U.S. has no rival in the Southern hemisphere as it previously did with the Soviet Union and Cuba.

I think the racial dimension also deserves mention. Puerto Rico is 99% Latino. In an administration that panders to anti-immigrant sentiment and white supremacy, Puerto Rico remains a low priority. Neglect is the outcome.

June 1 marks the start of a new hurricane season which is a frightening prospect. The experience of Hurricane Maria and its ongoing legacy is beyond sobering. It is hard not to worry about history repeating itself.

Categories: Uncategorized

More Than Meets The Eye: Paid Patriotism and the NFL Players Protest – posted 5/27/2018

May 27, 2018 2 comments

The new policy outlined by Commissioner Roger Goodell which requires NFL players to stand during the national anthem did not come out of any collective bargaining agreement between the owners and the players. It was a unilateral assertion by management.

Up until now, there has been no NFL rule that prohibited players from demonstrating during the national anthem. I am at a loss to understand how the owners think they can enforce a unilateral declaration. The NFL players are represented by the NFL Players Association and they were not even talked to about the new policy.

To be legitimate, the new policy must be a subject of collective bargaining and that hasn’t occurred. This dispute is about the rights of labor and democracy in the workplace. We are way past a time when bosses can rule by fiat and simply dictate policy.

For the NFL owners, the matter of protest is fundamentally about the bottom line. With NFL viewership trending down and with President Trump whining, the owners caved in to conservative pressure. Apparently the owners believe sanitizing the game by disappearing protest will boost ratings and keep the money flowing.

Under the new rule, players who want to protest can do so privately in the locker room and will be allowed to join their teammates on the field after the anthem without incurring penalty. The price of protest is a new invisibility.

As with issues of domestic violence and concussions, the NFL owners are demonstrating cluelessness. The new anthem policy is a model of incoherence. What happens with the next clenched fist? Will fines vary in red states and blue states? Who knows? So much remains unclear.

Essentially, a handful of white Republican billionaires are trying to strong-arm and silence a league that is 70% African American. It is not disrespectful to want to challenge police brutality or to want to foster better educational and economic opportunities for poor people as players have demonstrated through peaceful protest.

Malcolm Jenkins of the Philadelphia Eagles has voiced the players’ perspective:

“What NFL owners did today was thwart the players’ constitutional rights to express themselves and use our platform to draw attention to social injustices like racial inequality in our society.”

Stephen A. Smith of ESPN has pointed out that until 2009, no NFL player stood for the national anthem because players stayed in the locker room until the anthem was over. The reason the players were moved to the field during the anthem was a marketing strategy to make the NFL look more patriotic and to enhance its bottom line.

The U.S. Department of Defense paid the NFL $5.4 million between 2011 and 2014 to stage on-field patriotic ceremonies as part of its military recruitment strategy. And it was not just the NFL. The Defense Department reported $53 million in spending on marketing and advertising contracts with sports teams between 2012 and 2015.

This paid tribute included on-field color guard, enlistment and reenlistment ceremonies, performances of the National Anthem and full-field flag details. The Defense Department paid teams for the opportunity to perform surprise welcome home promotion for troops returning from deployments and to recognize wounded warriors.

The sharpest comment I have seen about this paid patriotism comes from actor and activist, Jesse Williams:

“This is not actually part of football. This was invented in 2009 from the government paying the NFL to market military recruitment to get more people to go off and fight wars to die…They’re marketing.”

I do not believe the public has known how many of these displays were paid for at taxpayer expense and how many were a part of a sports marketing contract. The Department of Defense has maintained that all its spending on sports marketing and advertising with professional sports organizations is integral to its recruiting effort. However, disclosure has been lacking. Are military jet flyovers and anthem performances still contracted for NFL profit?

It would appear that the owners want the players to be silent, obedient props in their money making pageantry. Self-righteous posturing about paid patriotism is hardly appropriate. More is going on than simple respect for the flag and country. The game-time performances are about enlisting more troops for endless Middle Eastern wars. In this connection, President Trump must be mentioned. According to Trump:

“You have to stand proudly for the National Anthem or you shouldn’t be playing. You shouldn’t be there. Maybe you shouldn’t be in the country.”

To conservatives I have to ask: where is the free speech? Isn’t free speech for people who think differently? I have heard much berating of intolerant college students on campuses across the country who shout down their opponents. President Trump’s statements expose his opposition to free speech. He sets a new standard: not only can you not speak out, if you disagree with him, you need to leave the country.

Of Colin Kaepernick, Trump had previously said, “Maybe he should find a country that works better for him”.

The NFL players’ protest needs to be seen inside the long historical context of black athletes who have challenged American racism. I am reminded of Muhammed Ali who resisted the draft and refused to go to Vietnam in 1967. Among other penalties, Ali was banned from boxing for 3 years in the prime of his career. Ali told Sports Illustrated:

“Why should they ask me to put on a uniform and go ten thousand miles from home and drop bombs and bullets on brown people in Vietnam while so-called Negro people in Louisville are treated like dogs?”

in 1968, at the Mexico City Olympics, sprinters Tommie Smith and John Carlos staged their famous black power protest on the medal stand, raising clenched fists with black gloves as the national anthem played. The U.S. Olympic Committee, under pressure from the International Olympic Committee, subsequently suspended both Smith and Carlos from the Olympic team.

In his autobiography, I Never Had it Made, Jackie Robinson, who broke the color line in major league baseball, confessed, “I cannot stand and sing the national anthem.”. That was his silent protest.

The NFL players’ protest is the same struggle as that waged by earlier generations of black athletes. Instead of trying to silence the players, the NFL owners should listen, learn about and positively respond to their passionately-held concerns.

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The Democrats Cave on Torture – posted 5/20/2018

May 20, 2018 2 comments

I think Jeanne Shaheen has been a good senator. I have voted for her numerous times both when she ran for governor and as a senate candidate. In any long political career it is likely there will be troubling votes and Shaheen has made some. But, for me, her vote, along with five other Democratic senators, for Gina Haspel as CIA Director is the worst.

It was the votes of six Democratic senators that assured Haspel would become CIA Director. Three Republican senators – Rand Paul, Jeff Flake and John McCain – all opposed Haspel’s nomination. McCain was too ill to vote but was very much on record. Without the Democrats, Haspel’s nomination would have lost.

Why is the Haspel choice so disturbing? While there is much we do not know about her career as an intelligence operative because it remains classified, we do know that Haspel was in charge of a secret black site prison in Thailand known as Cat’s Eye from October to December 2002.

She oversaw the interrogation and three-time waterboarding of a Saudi detainee named Abd al-Rahim al-Nashiri. Nashiri is a suspect in the bombing of the USS Cole in October 2000 in which 17 U.S. sailors died. Captured in Dubai, he was handed over to the CIA. The CIA first rendered him to Afghanistan and then flew him to Thailand. He is currently detained in Guantanamo.

After her stint in Thailand, Haspel, a career CIA officer, returned to the agency’s Counterintelligence Center where she worked for two more years while the torture program was at its height. According to the 2014 Senate torture report, at least 119 men were tortured in this time period. In her CIA Director confirmation hearing, Haspel refused to specify her role in torture during these two years.

In a 2014 book, Company Man, John Rizzo, a longtime senior CIA lawyer, wrote that Haspel was in charge of the interrogation program and was responsible for the incommunicado detention and torture of potentially dozens of men. Rizzo recorded that Haspel ran the interrogation program. Supporting Haspel’s nomination, in early May this year Rizzo revised his view and said Haspel did not “run” the torture program. Rizzo would not say why he changed his mind.

In 2005, as chief of staff to the Director of National Clandestine Services, Haspel participated in the destruction of 92 videotapes documenting the torture and interrogations conducted against Nashiri and Abu Zubaydah. Sen. Tim Kaine pointed out that Haspel wrote a cable directing the CIA to destroy the interrogation videotapes, effectively destroying evidence.

There is important information in the public domain about Haspel’s actions. Jeremy Scahill, an investigative journalist for the Intercept, has reported on information provided by an American doctor and Naval Reserve Officer, Dr. Sandra Crosby. Dr. Crosby did extensive medical evaluation of almost 20 men who were tortured in U.S. custody, including Nashiri.

Dr. Crosby, who is now a professor of public health at Boston University, wrote Sen. Mark Warner, the vice chair of the Senate Intelligence Committee, to oppose Haspel’s nomination. Dr. Crosby wrote:

“I urge Senator Warner to oppose Ms. Haspel, who did not have the courage or leadership to oppose the Rendition, Detention and Interrogation program.”

While some of the techniques remain classified, Dr. Crosby listed a number of torture techniques that were used against Nashiri.

  • suffocated with water (waterboarding)
  • subjected to mock executions with a drill and gun while standing naked and hooded
  • anal rape through rectal feeding
  • threatened that his mother would be sexually assaulted
  • lifted off ground by arms while they were bound behind his back (after which a medical officer opined that shoulders might be dislocated)

On May 7, in a briefing to Senate Intelligence staffers, Dr. Crosby described the torture graphically:

“The terror of being kept naked in pitch-black, shackled to the ceiling while music blared, covered in urine and feces while insects crawled on their bodies, in dank cells that were freezing cold or unbearably hot. The horrific conditions in between interrogations were in some cases as bad as the interrogation. These torture methods were inflicted for hours and days, for weeks at a time, over the course of years. The men became disoriented with no sense of when the abuse would stop. Some of the men wished for death.”

Dr. Crosby is one of the only health professionals to have ever talked to Nashiri about his torture. She concluded:

“He is irreversibly damaged by torture that was unusually cruel and designed to break him. In my over 20 years of experience treating torture victims from around the world, including Syria, Iraq, and the Democratic Republic of Congo, Mr. al-Nashiri presents as one of the most severely traumatized individuals I have ever seen.”

Torture, such as the actions committed against Nashiri, violates the U.N. Convention against Torture and is clearly illegal under international law. Because the U.S. has signed and ratified the Convention, torture is always illegal under U.S. domestic law as well.

In her public testimony at her confirmation hearing, Haspel refused to renounce torture, her role in its use and she did not condemn the practice of waterboarding. When questioned by Sen. Kamala Harris, she explicitly refused to say that the “enhanced interrogation techniques” she oversaw at the black site in Thailand were immoral.

After her hearing, in a statement explaining why he would vote against Haspel, Sen. John McCain said:

“Her refusal to acknowledge torture’s immorality is disqualifying.”

By promoting someone so intimately engaged with torture, the Trump Administration is almost guaranteeing such crimes will be committed in the future because there has been no reckoning with the past abuses. It is likely the CIA will see Haspel’s elevation as vindication of both torture and its efforts to obscure history.

Considering Trump’s unmatched amorality, his support for Haspel is hardly surprising, but Democrats did not have to go along with the President in this appointment.

The failure of the six Democratic senators to oppose Haspel reflects a lack of values. There is no more fundamental moral issue than torture. Torture is a dividing line between modernity and medievalism and yet these Democratic senators voted the wrong way.

This vote speaks to a core identity problem for mainstream Democrats: their failure to .stand for anything. They believe being opposed to Trump is enough. Worse still, on this critical issue of human rights, they are not even against him.

A part of the problem goes back to the Obama Administration and their politics of impunity toward torture. Obama said he would not punish torturers because he was looking forward, not back. What this means is a willful decision not to punish wrongful acts and a total lack of accountability.

In fairness, it must be acknowledged that Americans have demonstrated a bi-partisan inability to tackle torture that goes back at least 50 years. The Phoenix Program in Vietnam, teaching torture to Latin American militaries, and the George W. Bush-era torture have all ultimately been swept under the carpet. The historian Alfred McCoy calls it “public forgetting”.

Torture is evil. The Haspel vote undermines respect for fundamental rights and the rule of law. The vote sends a horrible message about American values to the rest of the world.

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Medicaid Work Requirements Do More Harm Than Good – posted 5/14/2018

May 15, 2018 Leave a comment

It appears that for now the issue is settled: New Hampshire’s Medicaid program will have work requirements. In early May, the U.S. Center for Medicare and Medicaid Services approved the State’s plan to require most adult Medicaid recipients to work at least 25 hours per week. The plan could apply to as many as 53,200 recipients in the state although many are already working.

Medicaid beneficiaries, adults aged 19 to 64, will be required to participate 100 hours per month in “community engagement activities” such as work, education, job skills training or community service. That “engagement” will be a condition of their health care eligibility.

The new rules do offer important exemptions for the elderly, the medically frail and those people with children.

New Hampshire becomes the fourth state to introduce a Medicaid work requirement. The requirement has been instituted in Indiana, Arkansas and Kentucky and six other states have pending applications for approval. This is quite a departure for Medicaid which for over 50 years has never had any requirement like this.

While this plan sounds superficially good because it encourages work and personal responsibility, it is fraught with problems, and I expect it will do more harm than good. The idea that most people on Medicaid do not work is completely unfounded.

More than half of all adult Medicaid recipients already work and 78% live in a home where an adult works. The new rules are largely responding to stereotypes that see low income people as loafers and bums.

Considering how many people are already working, you have to ask if these new rules will do anything beyond knocking more people, who do not meet some new imposed requirement, off Medicaid.

Unfortunately, there are many ways that individuals can potentially have their Medicaid terminated that have nothing to do with a willful desire not to work.

People working lower-wage jobs are more likely to have irregular working hours or gaps in their employment. This is not because of the worker. Employers often schedule part-time hours for their own financial reasons. Workers who want to work may fall under the 100 hour a month marker because employers want them off their own health insurance coverage and they need to keep them under their own hourly threshold.

Lower-wage jobs typically offer fewer regular hours and are subject to seasonal changes. For example, food service, retail and construction jobs tend to be more volatile and less stable year-round. For instance, a holiday season may permit increased hours in retail whereas bad weather in winter can reduce hours for construction workers.

The work requirement rules assume low wage workers can find steady, regular full-time employment but the low wage job market is not like that. Many employers will not hire more than 24 hours a week because they want to avoid benefit costs. Even individuals who work substantial hours could lose coverage under the new work requirement.

Workers may not know in advance of the end of the month that they will fall under the 100 hour monthly threshold because employers may end up offering less hours. If workers fall under the threshold because of the wage-cutting actions of employers will that count against them?

How New Hampshire will interpret the failure of a worker to meet the 100 hour monthly threshold must be a matter of concern. Past experience in public benefits suggest many will be terminated from Medicaid due to a quite literal interpretation of rules and a bureaucratic approach.

Some workers will have difficulty verifying compliance with rules. For example, there are workers who may have difficulty producing pay stubs or timesheets even if they have worked.

The state will need to set up a new verification system. Red tape, backlogs and delays are a likely consequence. Many adult Medicaid beneficiaries lack internet access and will need to use snail mail or personal visits to prove compliance. It is not unusual for Medicaid beneficiaries to have transportation difficulties. The workers will still need to prove the work hours.

Homeless people will bring a unique set of issues. If you live in a shelter, you may have to choose between getting in line in the afternoon for a bed and working required hours. The lack of access to a shower or washing machines poses hygiene issues for workplaces. Also, not having a home mailing address or a working telephone can make employment success harder. Employment stability and just the ability to be in touch with an employer is compromised when there is no home.

Those with disabilities are at great risk. The term “medically frail” could mean many things and those claiming medical frailty will have to prove they qualify for an exemption. Obtaining necessary medical documents can be difficult especially if beneficiaries lack coverage. Low wage workers often may not have had any access to health care. It is much easier to get an exemption as a disabled person if you have a treating doctor.

Among those with disabilities, I would especially mention those with mental health issues. How will those with mental health issues fit under the definition of medical frailty? There are many who may not be in any disability program who have significant problems with concentration, clear thinking and social interaction. Those skills are often needed to meet documentation and reporting requirements.

The opioid crisis also must be noted. Will those with substance abuse disorders be seen as “medically frail”? How will work requirements impact recovery efforts? It is reasonable to assume that the burden of proving exemptions will cause people to lose coverage. Many people who suffer from substance abuse disorders have a hard time even acknowledging their condition.

Those who lose Medicaid or face an interruption in coverage can have very adverse health consequences. Those with chronic health conditions like diabetes or depression may require regular access to medications or other treatment. Disrupting access to care can impact the continuation of employability. Interruptions in coverage likely will mean increased emergency room visits and hospitalizations.

As a matter of public policy, I think it is a bad idea to make employment a precondition to Medicaid services. Work requirements actually block access to medically necessary services that individuals need to be able to work. The purpose of Medicaid has been to furnish medical assistance, rehabilitation, and other services that will help individuals attain and retain independence and self-care. Rather than making work a qualifying precondition, we need to see health care as a universal right.

Work requirements guarantee thousands more will be cut off health insurance. That is not the direction we as a society should be going.

According to the Center for Disease Control, over 28 million people in the U.S. under age 65 remain uninsured. That is a little over 12% of the population of those ages 18 to 64. Obamacare made some strides in reducing the number of the uninsured but not enough.

Universal coverage should remain the goal of health care advocates. Work requirements are rooted in uninformed, negative judgments about low income people. It is a safe bet these new requirements will do far more damage than good.

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A New National Monument – posted 4/29/2018

April 29, 2018 4 comments

On April 26, a new national monument came into existence. In Montgomery Alabama, the National Memorial for Peace and Justice opened. The memorial commemorates the victims of lynching in the United States.

The Equal Justice Institute, also known as EJI, a non-profit legal and civil rights group led by lawyer Bryan Stevenson, has been the moving force behind the memorial. EJI created the memorial on land where a slave warehouse once stood. The memorial is located on high ground about a mile from Alabama’s state capitol building.

The memorial, set on six acres of land, includes 805 coffin-shaped boxes of oxidized steel hanging from a square canopy. Each box is inscribed with the names of lynching victims and the county in which they were murdered. The design evokes bodies hanging from trees.

EJI has studied and documented 4,384 lynchings in the United States between 1877-1950 and they say that there were thousands more that have never been chronicled. They are still gathering information about previously unknown murders. EJI did six years of research and made numerous visits to southern states to record lynching data.

Murders of African-American people included being hanged, burned alive, shot, drowned and getting beaten to death by white mobs. The deaths were mostly lynchings but other horrible deaths are also reported.

A new accompanying Legacy Museum also created by EJI is located nearby in Montgomery. The Legacy Museum describes and exhibits our slavery history from early times to our present era of mass incarceration. It must not be forgotten that slavery lasted for centuries and caused vast, untold human suffering.

For any student of American history, the opening of this memorial must be recognized as long overdue. Our national monuments tell a story but a big part of the story has been left out. The lynching memorial is a necessary corrective.

Up until now, there has been no public acknowledgement of the wrong done. The sites of lynchings have been forgotten, ignored, and covered up. At the same time, hundreds of monuments in the South celebrate the Confederacy.

The problem here goes very deep into the way American history is taught and remembered. As a high school student at a good school, I remember my American history classes. There was a large void between the Civil War and World War I. Reconstruction was mentioned and there was that strange, close election in 1876 but my history classes passed over that era. I do not think that is uncommon in the teaching of American history.

The lynching memorial forces an honest accounting. And the truth is brutal. Lynchings were not isolated events carried out in the dark of night by renegade Klansmen. They were often public community events, attended by many thousands. People dressed in their Sunday finest and whole families went to watch the spectacle. Police, doctors, lawyers, clergy, teachers and working people – all the pillars of the community – attended.

Many photographed these events and made postcards of the images. The perpetrators sometimes distributed body parts as souvenirs.

Frequently, it was not enough to hang the victim. Mobs would torture, mutilate and set the bodies of lynching victims on fire. Then the perpetrators would sometimes drag what was left of the bodies through the streets. Women were lynched as well as men. About the lynchings, Stevenson has said,

“They actually lifted up the bodies because they wanted to terrorize. They wanted the entire community to see it.”

Those responsible were never punished and local police did not intervene to stop lynch mobs from taking the law into their own hands.

The reasons why people were lynched often bordered on the absurd. Failing to address a police officer as “mister”, drinking from a white man’s well, bumping into a white girl accidentally, attempting to vote, land ownership, an uppity look, or just being in the wrong place at the wrong time could lead to getting lynched.

If a black man so much as talked to a white woman, he could be accused of rape and could end up, lynched. Racist lynchers always claimed they were protecting white women.

Stevenson describes what he calls an advanced coping strategy of silence about lynching. To quote him:

“If I asked the question, “Name one African-American lynched between 1877 and 1950, most people can’t name one person. Thousands of black people were lynched. Can’t name one. Why?”

Lynching is a buried history, an untold story. There is a legacy of indifference to these crimes. The historian Sherrilyn Ifill, an expert on lynching, wrote that Southern whites of that era would typically lose all memory of the lynchings they attended. Afterward, they would claim they saw nothing. As Ifill has written, that silence about the lynchings and who carried them out was seen as an act of loyalty to the white community.

After the Civil War, for the Black community, expectations rose. Black men now had the right to vote. However, the white power structure wanted to send a message: for anyone who challenges white supremacy, we will kill you. And they did.

The late nineteenth century migration of Black people from the South to the northern states can, in part, be explained by the racial terrorism practiced by white communities in the South. To live in these circumstances was to live in fear. The threat of becoming the next lynch mob victim was omnipresent.

Bryan Stevenson describes the lynching memorial as “an act of ending silence and committing to truth and reconciliation”. He has said that the museum and memorial were directly inspired by the Apartheid Museum in South Africa and the Holocaust Museum in Germany.

Part of the virtue of the lynching memorial is that it entirely bypasses the bitter debate about the dismantling of Confederate statues. It is an affirmative statement that adds to historical understanding. At a time of resurgence of the alt-right and white supremacists, the memorial offers a powerful counter-narrative.

Without question, Bryan Stevenson is one of the most inspiring people in American public life. I plan a road trip to Montgomery to visit the lynching memorial and I would strongly encourage others to make the journey.

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