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      Arkansas and South Dakota pass bans targeting transgender minors

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      Arkansas lawmakers have approved a ban on gender-affirming healthcare for transgender children, sending the governor a bill that has been widely criticized by medical and child welfare groups.The Senate voted 28-7 on Monday in favor of the legislation. If the bill is enacted it would be the first prohibition of its kind in the country, opponents say. The bill would prohibit doctors from providing gender confirming hormone treatment or surgery to minors, or from referring them to other providers for the treatment. It also allows private insurers to refuse to cover gender-affirming care for trans people of any age.The legislation restricts treatments that have been endorsed by major medical associations and human rights groups. They say the care is well established and part of a gradual process that has been shown to dramatically improve the mental health of the most vulnerable kids.The state’s governor Asa Hutchinson a Republican, has not said whether he supports the measure, but has previously supported anti-trans bills. He has five days, not counting Sunday, after the bill reaches his desk to sign or veto the legislation before it becomes law without his signature.The measure is among dozens of bills targeting trans people that have advanced in Arkansas and other states this year. Arkansas, Mississippi and Tennessee have enacted measures prohibiting trans girls and women from competing in school sports teams consistent with their gender identity. On Monday, South Dakota’s governor also issued an executive order to prohibit trans girls from playing on girls’ sports teams.Conservative legislators have introduced more than 80 bills restricting trans rights in the US so far this year – most that would either block trans kids’ use of gender-affirming care or limit their access to certain sports teams. It is the highest number of anti-trans legislative proposals ever filed in a single year.Hutchinson on Friday signed a law that would allow doctors to refuse to treat someone because of religious or moral objections, a move that opponents say could be used to turn away LGBTQ+ patients.Opponents of the measure include the American Academy of Pediatrics. The American Civil Liberties Union said it plans legal action to block the treatments ban if it’s signed into law.If signed, the ban would take effect later this summer. More

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      in US Politics

      Why Medicare for All is a political headache: Politics Weekly Extra – podcast

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      The Guardian health reporter Jessica Glenza steps in for Jonathan Freedland this week. She speaks to Dr Abdul El-Sayed, co-author of a new book, Medicare for All: A Citizen’s Guide, about why the concept of providing healthcare coverage for all Americans is so politically vexing

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      No three words are likely to elicit a more divisive response in Washington than “Medicare for all”. From the outside looking in, some might wonder why any politician – Republican or Democrat – would hesitate to provide universal health coverage to all Americans. The answer goes to the core of American ideas about the role of government and the free market. This week Jessica Glenza speaks to Dr Abdul El-Sayed, a physician and epidemiologist and co-author of a new book, Medicare for All: A Citizen’s Guide. He also ran for governor of Michigan, where he advocated for universal healthcare. Send us your questions and feedback to podcasts@theguardian.com Help support the Guardian by going to gu.com/supportpodcasts More

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      The Ten Year War review: Obamacare, Trump and Biden's battles yet to come

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      Once upon a time, the Affordable Care Act (ACA) was unpopular, viewed by many as welfare redux. Barack Obama’s promise that “If you like your healthcare plan, you’ll be able to keep your healthcare plan”, didn’t exactly work out. By the middle of the 2010s, so-called Obamacare had cost the Democrats both houses of Congress.
      Yet one great recession and one raging pandemic later, the ACA is liked, if not necessarily loved, by a majority of Americans.
      The political process “doesn’t stop just because a bill becomes a law”, according to Jonathan Cohn.
      As if to prove Cohn’s point, the US awaits a ruling by the supreme court on another challenge to Obamacare, this one brought by the Trump administration and Republican state attorneys general. If they prevail, more than 20 million Americans may lose health coverage. Nearly a half-million have died from Covid. Markets don’t always deliver what is needed.
      The Ten Year War is a look back at the “crusade” for universal healthcare coverage, and a sequel to Cohen’s earlier book, Sick: The Untold Story of America’s Healthcare Crisis. Cohn is a senior correspondent at the Huffington Post. His take remains informed and nuanced, not breathless. The Ten Year War also captures acrid and tectonic shifts in US politics.
      Cohn persuasively argues that the combatants in the healthcare fight operated with less than perfect knowledge, and that preconceived convictions too often clouded their judgment. Cohn aims at both policy wonks and political junkies. Laced with interviews and quotes from both sides of the aisle, his book is definitely newsworthy.
      Obama and Tom Price, Donald Trump’s short-tenured health secretary, speak on the record. David Axelrod, Obama’s counselor, and Michael Carvin, a veteran conservative litigator who unsuccessfully argued against Obamacare’s constitutionality, also talk to the author. Years earlier, in the 2000 election, Carvin was on brief in George W Bush’s winning supreme court gambit.
      Obama admits his surprise over Republicans not moving on after the ACA passed, unlike Medicare in 1965 under Lyndon Johnson. “We got no take-up on any of that stuff,” he says. Left unsaid is that blue and red are more than just colors – they are tribes.
      By the same measure, Obama acknowledges “that there were those … who suggested that we shouldn’t do anything other than the economy”. That is an understatement.
      One of those “outsiders” was Chuck Schumer, now the Senate majority leader. Even then, Cohn writes, the New Yorker grasped the political consequences of going all-in on healthcare amid a meltdown in the jobs and housing markets.
      Indeed, after the Democrats lost the Senate in 2014, New York’s senior senator unloaded on Obama before the National Press Club: “After passing the stimulus, Democrats should have continued to propose middle-class-oriented programs.” Said differently, the ACA highlighted the inherent instability of the Democrats’ upstairs-downstairs coalition.
      Instead, in Schumer’s telling, “we took their mandate and put all of our focus on the wrong problem – healthcare reform.” Apparently, there are few things more gratifying in politics than telling a sitting president: “I told you so.”
      Of course, political myopia is not the sole province of any one party. Price admits that Republicans too operated in their own universe.
      “I think there was a lack of appreciation on the part of all of us in the administration about how difficult” repealing Obamacare would be, he says. Price is a physician as well as a former Georgia congressman.
      Price criticizes Trump for fashioning policy to comport with the last voice to whisper into his ear, and for a fundamental lack of understanding of healthcare and insurance.
      “We would make concrete decisions about what we were going to do,” he says, “get presidential sign-off, and then within 24 hours the decision would change.”
      For Price’s boss, pulling the rug out from under others was standard operating procedure. More

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      Biden's pandemic problem: Politics Weekly Extra podcast

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      Jonathan Freedland speaks to the Pulitzer prize-winning author and journalist Laurie Garrett about what Joe Biden needs to do to get a grip on the Covid crisis in the US

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      When Joe Biden entered the Oval Office as president, he got to work trying to figure out how to mitigate the coronavirus situation in the US, and what exactly he was up against. Jonathan speaks to the expert on how governments plan for pandemics, Pulitzer prize-winning author and journalist Laurie Garrett about how she knew a crisis like this was coming but why no one in government chose to act. They also discuss what the Biden administration needs to do next. Send us your questions and feedback to podcasts@theguardian.com Help support the Guardian by going to gu.com/supportpodcasts More

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      in Elections

      Biden announces 'wartime' boost in vaccine supply – video

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      The Biden administration is increasing vaccination efforts with a goal of protecting 300 million Americans by early fall, as the administration surges deliveries to states for the next three weeks following complaints of shortages and inconsistent supplies. ‘This is enough vaccine to vaccinate 300 million Americans by end of summer, early fall,’ Biden said. ‘This is a wartime effort,’ he added, saying more Americans had already died from the coronavirus than during all of the second world war
      Biden vows to vaccinate 300m in the US by end of summer or early fall – live
      Joe Biden appears to boost vaccination goal to 1.5m Americans per day More

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      in Elections

      'A liberating feeling': Fauci critiques Trump administration – video

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      Dr Anthony Fauci made not-so-veiled critiques of the Trump administration during a White House press briefing on Thursday. He said the new administration meant he did not need to ‘guess’ when he didn’t know the answer to questions.
      The health expert said the new administration felt ‘liberating’ and he did not take pleasure correcting the president and facing consequences for doing so.
      But Fauci pushed back against the characterization from some Biden officials that the new administration has to start ‘from scratch’ on coronavirus vaccine distribution
      US politics: latest updates More

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      How California went from a leader in the Covid fight to a state in despair

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      At the San Joaquin hospital in California’s Central Valley, nurses cover infectious Covid-19 patients with clear, tent-like barriers – or, when those aren’t available, white sheets – as they’re wheeled through the ICU.
      “It’s for everybody’s protection,” said Jessica Vasquez, an ICU nurse at the hospital – the sheets ensure that infection doesn’t spread to other patients and medical staff. But like so many of the protocols that the hospital has implemented since the coronavirus pandemic struck, it feels uncanny.
      It’s eerie, that these days, she barely talks to her patients – many of whom are too weak to speak. She remembers a man, who – not long before he died of the virus, suddenly grabbed her hand. “He just said, ‘Thank you, thank you.’” None of his loved ones could be there with him.
      “I’ve just felt so scared,” she said. “This virus can come, for any of us”
      When the virus first hit California, Vasquez was relieved to see the state implement a lockdown – it was the first American state to do so. Back in March, personal protective gear for medical staff was in short supply and hospitals were scrambling to understand the best practices to treat an illness they’d never encountered before, but at least, “people understood this was serious. They stayed inside, if they could – and California avoided the fate of New York and Louisiana.
      In that first phase of the pandemic, hospitals in the nation’s most populous state were strained, but they weren’t overwhelmed the way New York hospitals were. They didn’t have to acquire massive refrigerator trucks to serve as mobile morgues for the virus’ victims.
      Until now. Less than a fortnight before the Christmas holiday, California distributed 5,000 body bags to the hard-hit regions including Los Angeles, and readied 60 refrigerated trailers. As of Monday, the state has tallied more than 2.1m cases and counted more than 24,000 dead. The ICU capacity in southern California hit 0% by mid-December. Two people were dying of Covid-19 every hour in hard-hit Los Angeles county, where the public health director, Barbara Ferrer, fought back tears as she reported that thousands of “people who were beloved members of their families are not coming back”.
      Facing an increasingly dire situation, the state enacted a second lockdown, asking Californians to remain at home throughout the holidays to slow the spread of the virus. But nine months after the first shelter-in-place order, a pandemic-fatigued, frustrated public pushed back.
      They balked at leaders’ choice to allow retail shopping and entertainment production to remain open, while most schools were shuttered and families asked to keep away from loved ones. Rightwing protestors gathered outside the homes of public health officials, while progressives demanded that the government prioritize reopening schools over shopping malls. As politicians in Washington debated a second economic relief bill, restaurant owners fretted over whether their businesses could survive a second lockdown. Lines at coronavirus testing sites and food banks grew, as the pandemic devastated ranks of essential workers at farms, grocery stores, garment factories and warehouses. “After months and months, people are broken, and they’re tired,” said Monica Gandhi, an infectious disease specialist at UC San Francisco. “And they need support.”
      The year culminated in a deadly, damning indictment of California – its leaders inability to convincingly enact and enforce public health measures, its structural racism and inbuilt inequalities, its vicious political infighting and its inability to function as a “nation-state”, as governor Gavin Newsom likes to call it, in isolation of of a hostile federal government. More