ProPublica

by Lizzie Presser

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Maylia Sotelo arrived in a black Cadillac. It pulled down an alley by the Fox River, which cuts through the city of Green Bay, Wisconsin. On that Tuesday evening in November 2022, she stepped out of a rear door and into another car. Maylia was 15 years old and slight, with a soft, girlish face and large, upturned eyes. For $50, she sold a man five “blues,” round pills stamped with “M30” that passed for Percocet. Narcotics investigators from the Brown County Drug Task Force were listening over a wire and, within minutes, their informant turned over his buy. Like every fake Percocet the task force seized that year, the pills were actually fentanyl. The officers, though, decided to let Maylia leave.

Maylia was comfortable around the business of drugs. Her childhood home had been a hangout for users and dealers; hollowed-out pens littered the floors, and strange men let themselves in at all hours. She had grown up with three older sisters, who had all been kicked out or left because of their mother’s violence. It fell to Maylia to protect Maliasyn, two years younger, from their mom’s unpredictable delusions. She would lose herself in uppers and opioids, start yelling out of nowhere or cry uncontrollably. Sometimes, she locked the girls in the house for days.

Before Maylia sold blues, she sold weed. She had been smoking since fifth grade. The first time she tried weed, she found herself laughing at nothing. “Why would I sit here being sad and sober when I can be high and happy?” she thought. She hated staying home, so after class, she took Maliasyn to a trap house where teens smoked blunts on the first floor and adults met in the bedrooms upstairs. The guys there, a couple of years older, were dropping out of school to sell weed. When Maylia was 13, she started dealing, too, because everyone was doing it.

By the start of her sophomore year at West High School, blues had overtaken bud in popularity. Across the city, boys blared songs about popping percs (“Yeah, just popped a 30, yeah, a 30 / It could change your life or it could ruin it, that’s the dirty”), and blue circle emojis with an “M” dominated Snapchat and Facebook. Maylia didn’t use percs. Like everyone at West, she knew they were fake, but nobody talked about what that meant. Instead of the oxycodone in Percocet, the pills contained filler and fentanyl, an opioid 50 times stronger than heroin.

Two days after the drug task force confirmed that Maylia was selling fentanyl, she arranged through a friend to buy a bulk order of blues from a man she’d never met. The city was facing a dry spell, so instead of her typical hundred-pill order from her usual source, she asked the man for a thousand. When her friend delivered the percs, she poured them onto a tray in her lap and pushed each chalky pill with a key, counting them one by one. She texted her customers: “Back in motion.” The next day, she caught a ride to an apartment complex and sold a pill to a teenager named Jack McDonough.

Early the following week, Maylia told Maliasyn that she’d be home soon, put on her “Sesame Street” slides and settled into the passenger seat of a friend’s Audi Q5. He drove her to Culver’s for a strawberry milkshake and then to Taco Bell for a sale. When they parked, lights flashed in the rearview mirror. Drug task force agents in unmarked cars rushed in and Maylia was handcuffed. “I don’t think you can do that,” she said quietly, as an officer went to pat her down. “I’m a minor.”

Agents took Maylia to a juvenile detention center in Fond du Lac, an hour south of Green Bay, and booked her on drug charges. Since she had no criminal history, the prosecutor and a county caseworker began negotiating with Maylia’s attorney. They presented a consent decree, the juvenile justice equivalent of a deferred prosecution agreement, which proposed that Maylia could be released to her father, whom she barely knew, placed on an ankle monitor, and required to satisfy certain conditions, like attending therapy or substance abuse counseling. If Maylia complied for six months, her charges could be dropped. After Christmas, while her dad was preparing his home, the county moved her into the less restrictive setting of shelter care, a coed house for kids.

In early January, a month after the arrest, a police officer arrived looking for Maylia. She was in the shower, getting ready for a hearing where she expected to be let out. Instead of taking her to court, the officer drove her to jail. There, he told her that she was under arrest for first-degree reckless homicide. Jack McDonough had died of an overdose.

Maylia would be the first juvenile in Wisconsin charged with homicide for providing the fentanyl that led to a death. In a country flooded with the drug, at a time when teens were dying from opioids at record rates, far outpacing plans to help them, she would be treated as an adult by a justice system that has no clear guidelines for how to handle the kids who are selling.

Jack McDonough first tried blues a year earlier, at the age of 17. With his girlfriend, he learned to crush the pill on a swatch of tinfoil, run a lighter underneath it and inhale the smoke through a straw. Calm blanketed them, muting their anxiety. Sometimes, it triggered a surge of confidence, a feeling that anything was doable. More often, it let them drift into nothingness, a fuzzy space between wakefulness and sleep. “We thought we were doing Percocets,” his girlfriend told me. “I didn’t even really know what a perc was.” At first, they smoked the pills a few times each week, sitting in Jack’s car between classes at Southwest High. Within a couple months, they needed one a day or they’d be sick — vomiting, legs shaking, unable to sleep. “I told Jack that I’m pretty sure it’s not even real percs, I’m pretty sure it’s fentanyl, and he was like, ‘What? No. I’m not doing fentanyl.’”

Until recently, opioids almost exclusively claimed the lives of adults. Since COVID-19 began, though, the rate of overdose deaths among teenagers has rocketed, more than doubling in three years. It’s not that more teens are using drugs, but that fentanyl has made the supply deadlier than ever. Many know or discover that the pills on the street are tainted but don’t want to stop — until they can’t. In a matter of weeks or a couple of months, they’ve become addicted. Today, over 300,000 kids under 18 are estimated to have an opioid-use disorder.

As fentanyl has rapidly entered the world of adolescents, the major institutions that touch teens’ lives have been unprepared to manage the fallout. Few doctors are offering the recommended medication, most schools are ill-equipped to help, and the justice system is treating children as criminals. Parents don’t know what to look for: the straws, the ash marks, the weight loss, the nausea of withdrawals. Teens are on their own. With nowhere to turn, each week, 22 high-school-aged kids — a classroom’s worth — are dying from overdose.

Jack’s parents had separated when he was an infant, and he’d grown up with his mom, Carrie, who owned a small house in De Pere, a suburb of Green Bay, and worked in sales at a truck maintenance supply company. He saw his father on weekends and holidays and in the summer. Carrie is warm and effusive, a self-labeled “helicopter parent,” with a deadpan sense of humor. Jack preferred body comedy, jump-scaring anyone he could. If he wanted to learn karate, Carrie booked him classes; if he wanted to swim with friends, she drove them to the water park. Together, the two worked out, volunteered to walk rescue dogs, went shopping, talked through plays he could run on his basketball team. After Carrie remarried when Jack was 11, he continued to confide in her about his insecurities and offered updates on his various crushes.

By high school, Jack was a gangly 6 foot 3, and he preferred duck hunting to sitting in class. At Southwest, 4 miles from Maylia’s school, he kept falling behind. He had trouble believing in himself: He told his mom he thought he was too slow. She would stay up late helping him with homework or she’d do it for him when he gave up. With his friend Mason, he liked to break down old cars just to fix them back up. The two clicked “like Buzz and Woody,” Mason told me. They would wrestle in public, but “behind closed doors, he was like a teddy bear.”

Left photo: Jack and Carrie, when he was 13. Right photo: Jack celebrates Christmas in 2017. (Collage by Han Cao for ProPublica. Source images: Courtesy of Carrie Harrison.)

The winter he started smoking percs, Jack cut out most of his friends. In early 2022, he began buying from a young dealer who went by Speakers, and soon he was introduced to other teens who were selling. Within a couple months, he dropped 15 pounds. Carrie worried he was bulimic. She would press her ear against the bathroom door, listening for hints of purging. He’d always been sweet and respectful, but that semester, he started disobeying her, becoming hostile out of nowhere. On weekends, he racked up speeding tickets and broke curfew; Carrie and her husband, Ryan, clamped a wheel lock on his car. On weekdays, he retreated to his room after school and went to bed at sundown. Carrie had no idea, but he often video-chatted with his girlfriend so the two could smoke percs at the same time.

Carrie booked him a therapy appointment, but the first slot she could get was a few months out. She told his school counselor that she thought he was using drugs but says she was brushed off. Carrie couldn’t prove anything — the drug tests she randomly gave Jack kept coming back negative. Others, though, knew what was going on. A classmate texted saying that he had lost two friends and didn’t want to see Jack die, too. “1 perk can’t kill you lmao, you’d have to smoke like 10 perks to even think abt overdosing,” Jack replied. “It just gets you high, for like an hour.” Mason also worried, and he sometimes probed Jack, who swung from denial to regret. “He knew he was addicted,” Mason said. “He knew it was hurting the people around him. He also knew he couldn’t stop on his own.”

In April of 2022, Carrie got a call from Tracy Liska, a police officer assigned to Southwest. Jack had been caught going door to door, pretending to fundraise for St. John’s Homeless Shelter — a place Maylia’s mom sometimes stayed. Liska had heard rumors that kids at school were using fake Percocet, which she knew was probably fentanyl, but she couldn’t search them unless she had reason to believe they had pills on them. Jack was “attached at the hip” to his girlfriend, “so in love,” Liska told me, and kids said she was using. When Carrie arrived at her office, stammering that something wasn’t right with Jack, Liska told her that a classmate was calling him a “perkhead.” Back home, Carrie took Jack’s phone and started scrolling. She found streams of texts setting up deals to buy “erks” and photos and videos of Jack smoking them.

Carrie didn’t know that the gold-standard treatment for teens addicted to opioids is buprenorphine, a long-acting opioid that strips away withdrawal symptoms and cravings and protects against overdose. Each year, on average, only 372 kids between the ages of 12 and 17 are getting the drug, according to the best national data. Most pediatricians aren’t trained in addiction and don’t feel comfortable prescribing the medication, and many clinics are afraid of the liability that comes with treating minors. A recent study in the Journal of the American Medical Association found that only 39 rehabs in the country offer buprenorphine to those under 18. Carrie called the most comprehensive national resource hotline in the country, run by the federal Substance Abuse and Mental Health Services Administration; it pointed her to Libertas, one of the only centers for adolescents in Green Bay. But when she reached Libertas, which doesn’t offer buprenorphine to kids, it had closed its inpatient program for teens.

After five days of calls to every rehab she could find, Carrie heard back from a residential facility in Minnesota, a Hazelden Betty Ford clinic. For the first time, it seemed like she’d found a solution. Before Jack left home, he wrote to his girlfriend’s mom to say that her daughter needed help. “We chose the wrong road to walk, and it is worse than I thought,” he texted. “I need you to make sure you keep her away from these kinds of drugs no matter what the case is. I can’t lose her to addiction, she is going to tell you that she hates you and tell you things to make you feel terrible about yourself and your job as a parent. But what I feel for her is real love and I wouldn’t be saying this if I didn’t care.” To his mom, he scribbled, “I’m trying to do better to be a better son. I hope you can forgive me for everything.”

Jack wrote his mom a note before he went to rehab. (Courtesy of Carrie Harrison)

The same spring that Jack entered rehab, Maylia was introduced to blues by her older sister Marianna. Since leaving home at the age of 13, Marianna had been bouncing between relatives and a boyfriend, between a local shelter and the back seat of a car. She’d sold weed to support herself, and then she’d leveled up to percs. She’d climbed so high that some considered her Green Bay’s biggest dealer.

Maylia was captivated by her sister — she was “self-made and self-paid.” Marianna could buy at $3 a pill and sell at $20. At 18, she owned a midnight blue Mercedes Benz and an apartment on Imperial Lane, the main stretch in one of the city’s poorest neighborhoods. She had decorated it with silver-studded couches and filled it with a collection of Nike sneakers and Louis Vuitton purses. With their mom caught up in her own addiction, Marianna took the girls in. Often, when she crisscrossed the city selling, Maylia sat shotgun, looking out for cops. She took photos of her sister, draped in long, neon-orange wigs, smirking next to 4-foot stacks of cash. Sometimes, they flashed fans of bills together.

In August of 2022, Marianna was arrested for dealing fentanyl and held in Brown County Jail. Maylia and Maliasyn went to stay with their grandmother, a manager at Family Dollar, who they said rarely stocked the kitchen. Soon, Maylia’s phone would not stop ringing. Marianna’s clients were asking if she had any idea where they could buy blues. “Money kept calling,” Maylia said. “It was calling me.”

Through Marianna’s contacts, Maylia bought a hundred pills for $500. She could double her money in a day. In the mornings before school, she tucked a handful of pills in her panties and another handful in her purse. Customers came to her. The 19-year-olds told the 18-year-olds, who told the 17-year-olds, and then the kids she had known as infants. Maylia was a good student with a quiet, observant demeanor. She didn’t like to sell on campus. Sometimes, classmates begged. The stink, like burnt popcorn, hung in the girls’ bathroom. Kids walked the hallways scratching their faces.

The only experience Maylia enjoyed more than smoking weed was surprising Maliasyn with a gift and seeing the look on her face. “Sometimes, I just wished that everything, everybody around us, would disappear, and it could just be me and my sister,” she said. Maylia hid packets of ramen and goldfish and hot Cheetos around their bedroom; she bought Maliasyn pink low-top Nike Dunks and brought home a PlayStation a customer had traded for blues. She promised she’d stop selling once she’d saved $3,000 for a car, which she couldn’t yet buy because she wasn’t old enough to drive. Maliaysn reminded her to be smooth and slow down. Instead, she kept going. “Her name was ringing in the streets,” a competing dealer told me. Maylia loved being one of the only girls in the game. For as long as she could remember, people had called her Princess. Now they called her Hollywood, for her big curly wigs, thick feline lashes and how little interest she showed in the kids at school.

Left photo: Maliaysn, left, and Maylia. Right photo: Marianna, left, and Maylia. (Collage by Han Cao for ProPublica. Source images: Courtesy of Maylia’s sisters.)

Maylia knew that people were overdosing, but she didn’t realize that a tiny amount of fentanyl could kill: 2 milligrams, which, if poured on a penny, would only cover Abraham Lincoln’s ear. On Dec. 1, 2022, just after the informant bought from Maylia, a customer told her that his girlfriend died from pills and he didn’t want to use anymore. Maylia sent her condolences, adding: “im glad you thinkin smarter.” Two days later, she saw Jack’s girlfriend’s Facebook story announcing that Jack had died. She’d hung out with his girlfriend once and messaged right away. “I’m so sorry for your loss mami keep your head up 💔,” she wrote. “Can I asked what happened?”

Jack had returned to Green Bay that fall. He’d spent 24 days at Hazelden, where he told staff that he didn’t have a problem. This wasn’t unusual. Jack’s counselor attributed his resistance to “significant shame and fear” and predicted that Jack would open up. He never did. The counselor noted in his file that Jack had a moderate Percocet disorder but made no mention of fentanyl. Nor did a doctor prescribe buprenorphine or explain the importance of the medication to Carrie. (Though Hazelden was given a medical release form, a spokesperson said it would not comment on Jack’s care for confidentiality reasons.)

In May, Jack was discharged to his dad, who had moved to Arizona. Carrie begged him to stay there and start over, but once Jack turned 18, he came back, moving in with his grandparents. Mason saw Jack once, in late November, and he could tell that he was still using. He told Jack he wouldn’t speak to him until he stopped.

On Dec. 2, Jack went to his girlfriend’s house and logged into her Facebook. He ordered a pill from Maylia. It was the first time he had bought from her. At 9 p.m., he took an Uber home, changed into his pajamas and kissed his grandmother goodnight. “Mmm you should smoke wimme mamita ❤️,” he texted his girlfriend hours later. The next morning, when his grandparents couldn’t open his bedroom door, they called the police. Officers found him sitting cross-legged in bed, unresponsive.

It wasn’t until Carrie arrived at her parents’ house that morning that she realized Jack was using fentanyl. She had always thought he was smoking real Percocet, which was terrifying enough. But as she tried to keep breathing, she noticed that the officers weren’t touching Jack’s belongings, as if any contact could kill. She had no idea that all the fake Percocet in town now contained fentanyl. Tracy Liska, the police officer at Southwest, hadn’t told her. (Liska says she must have mentioned fentanyl, though she didn’t note this in her reports.) The Drug Enforcement Administration was claiming that 60% of all fentanyl-laced pills it analyzed were potentially lethal, but the person on the federal government hotline hadn’t warned her, either. Hazelden hadn’t tested Jack’s urine for fentanyl or told Carrie that Percocet bought on the street was often contaminated with the drug. “You think you’ve talked to the police, doctors, teachers,” she said. “I didn’t fathom that it would be fentanyl.”

Aaron Hanson, the De Pere detective assigned to investigate Jack’s death, was the first person in a position of authority who seemed to care about Jack and want to do something for him. He checked in often, keeping Carrie apprised of what he was uncovering. After Jack’s autopsy confirmed that the cause of death was fentanyl intoxication, Hanson told her that the state would be pursuing a homicide charge. The term “homicide” didn’t seem to fit — she pictured a person shooting a gun or wielding a knife — but she was relieved to hear that a dealer would be taken off the streets. In early January of 2023, Hanson let her know that the seller was a 15-year-old girl. She would be charged as an adult. Carrie had imagined an older man with clout, maybe a warehouse full of drugs. “How could this happen? Any of it?” she wondered. She also thought, “Put her away.”

Over the past 15 years, as the number of opioid overdoses has risen sharply, leaders in law enforcement have promoted homicide charges as a key component of the nation’s response. The goal, they say, is to send a message that dealing drugs comes with great risk. Prosecutions have soared in the 30 states with the statutes on the books. Wisconsin is one of the most aggressive. Its counties filed nearly 400 cases between 2019 and 2023. The charges often attach to friends or relatives or partners who use with the person who overdosed rather than people who deal in any significant quantity. Even when the charges fall on habitual drug sellers, they rarely reach high-level operators. With each step up the distribution ladder, causation is tougher to prove, so the typical investigation ends with the person who delivered the drugs. These sellers, like Maylia, tend to have no control over whether the pills are cut with fentanyl or, if they are, whether it’s a fatal dose.

When the person who provides the drug is a teen and the charge is homicide, most states allow or require the accused to be treated as an adult. These laws are a legacy of the 1990s tough-on-crime era, when criminologists and politicians warned of “super-predators” and an imminent “bloodbath” from teen violence. The prediction never materialized, but almost every state passed laws that made it easier to transfer minors into the adult system. In at least 31 states, a child charged with certain serious crimes, like rape or homicide, must be tried in adult criminal court, according to recent research by Juvenile Law Center. Eight additional states allow prosecutors to choose whether to file in juvenile or criminal court. (In some, like Wisconsin, defendants can request to be tried in the juvenile system.) In 2019, the last year for which there is data, an estimated 53,000 juveniles were charged in adult criminal courts because judges, prosecutors or state law transferred them there.

Once the homicide charge was filed against Maylia, under the law, she morphed from dealer to killer, then from juvenile to adult. In Wisconsin, anyone older than 9 charged with homicide — whether it’s violent or drug-induced — is automatically sent to adult criminal court. When the officer picked up Maylia at shelter care with a warrant for her arrest, he drove her to Brown County Jail.

“This is big-boy jail,” Maylia thought as she walked into the booking room, where adults sat on benches. It’s where Marianna was. Brown County Jail had no designated area for girls, so Maylia was led down a dark hallway into an adult section, where men in orange jumpsuits were housed. There, she was held in a separate cell with another girl. Instead of the board game marathons, arts and crafts afternoons and school days she’d grown used to in juvenile detention, Maylia got a deck of cards, permission to walk laps, and an hour or two of classes.

In February of 2023, Trisha Fritz, the attorney assigned to Maylia by the public defenders’ office, asked the judge to move the homicide case to juvenile court. She knew chances were slim, but in criminal court, Maylia would be subject to the same sentencing guidelines as adults, which are focused on retribution and deterrence; she could face up to 40 years in prison. The goal of most juvenile courts, by contrast, is to balance public safety with rehabilitation and the best interests of the child. In a juvenile correctional facility, teens get clinical counseling, skills classes, education and, through their participation, the chance to earn their return to the community.

The juvenile system is notoriously erratic, but there’s little question that a judge there would take into account the circumstances of Maylia’s childhood and whether child protective services had intervened. Before Maylia turned 1, CPS documented that her mother overdosed on cocaine and Adderall with seven children in her home. When she was 5, a caller told the agency that Maylia’s mom was “high as a kite” and her boyfriend was violent. The next year, a mandated reporter alerted CPS that there was “absolutely no food in the home” and that the kids witnessed their mother using heroin. When she was 7, there was a substantiated finding that a man “opened his pants, pulled out his penis and masturbated” in front of one of Maylia’s sisters. That same year, a woman overdosed on crack in the house; a social worker wrote that Maylia’s mom “would not call rescue or the police because [she] did not want her children removed.” An elementary school employee reported that Maylia missed half the school year. After Maylia turned 8, CPS noted that her mom allegedly started hitting her.

When social workers came to the front door, Maylia’s mom ignored them. She told the girls to lay down and be quiet. When the agency called, she let the phone ring to voicemail. (Maylia’s mom could not be reached for comment.) During Maylia’s childhood, 20 referrals were made to CPS. The agency’s policy directed staff to note when they tried to make contact with a parent, but there was no requirement to do anything more. CPS could only identify a “maltreater” if staff interviewed that person or found other evidence, like a police report. Workers kept noting that Maylia’s mom had “referrals in all areas of child protection; sexual abuse to her children allegations, neglect, homelessness, drinking, drug history, relationship issues,” but she refused to meet with them. Going no further, staff closed case after case.

Top photo: Maylia’s mom holds her in the hospital with her three older sisters. Bottom photo: Maylia as a baby. (Collage by Han Cao for ProPublica. Source images: Courtesy of Mariah Zimmer.)

When Maylia was 14, child protection workers saw that her mother was hallucinating, revealing a “detachment from reality,” and they decided that the girls should no longer be under her care. The agency, though, offered no assistance with counseling or school. Maylia and Maliasyn began shuttling between the homes of their older sisters and their grandmother. Imani Hollie, a former Brown County public defender who represented Maylia when CPS finally got involved, told me that she’d seen the agency fail to protect kids in all sorts of extreme situations, but Maylia’s case stood out. Social workers had ignored her needs since she was an infant, and when the state did act, it sent her directly to criminal court. “Everyone,” Hollie said, “wanted to back away and treat her as an adult, rather than, ‘This is a child who is in the system, who has lived through horrendous allegations, and who went 14 years without any intervention.’”

As Fritz was preparing for a hearing on moving Maylia’s homicide case to juvenile court, she was struck by two pages in the narcotics investigation report. The Brown County Drug Task Force had learned that Maylia was selling fentanyl three days before she sold to Jack, but they didn’t arrest her. They could have requested a search warrant for her phone. They could have continued surveilling her or notified child protective services. They could have brought her in for dealing. Why, instead, did they let a minor continue handling a potentially lethal substance?

The drug task force, like most law enforcement agencies, has no internal guidelines governing interactions with suspects under the age of 18. In a series of cases referred to as the Miller trilogy, named after the 2012 Miller v. Alabama decision, the U.S. Supreme Court has recognized that children are different in the eyes of the law. Relying on brain science and psychological research, it found that children “have limited ‘control over their own environment’ and lack the ability to extricate themselves from horrific, crime-producing settings.” They are more impulsive, more easily pressured, less capable of assessing consequences and more capable of change than adults. These rulings have led the country through major reforms in the juvenile justice system, particularly when it comes to sentencing. But they have not led to much change in law enforcement.

Nicholas Ronsman, who was 27 and a first-year narcotics investigator on the drug task force, had no issue treating a 15-year-old as he would an adult. He learned about Maylia when he asked an informant for a list of dealers along with their prices for blues; whoever charged the least, he reasoned, had the largest supply. The informant knew the girl by her Facebook name, and she was offering the best prices. Ronsman passed her profile page to an intel analyst, who found that it belonged to Maylia. “At first I was like, ‘She’s 15, she can’t be that big of a player,’” Ronsman told me. “But then I look at her family, her sister Marianna.”

Ronsman had worked Marianna’s case. His team had confiscated $11,329 and about 8,400 fake Percocet pills at her grandmother’s place while Maylia and Maliasyn were there. (Soon after, they seized $27,200 more from another apartment.) The drug task force has a protocol to report to CPS whenever they encounter minors who are living in a house with narcotics, but the officers never did. (“We were not aware of any kids in the house,” Matthew Ronk, the director of the task force, told me. Probation agents found the drugs, so when they called for task force assistance, he said, his officers saw no need to do their own room-to-room search.) By the time Maylia’s name came to Ronsman, she was no longer just a child deserving of safety but a suspect. “We figured, ‘Hey, she probably learned from her sister, she’s got to learn from somewhere.’ So that was my mindset: She’s 15, but she’s got connections, she probably might be a legitimate, larger target.”

Once the informant completed the buy, Ronsman believed that if he arrested Maylia, a juvenile intake worker would likely release her and she’d go back to selling. “The goal of juvenile justice isn’t to put juveniles in prison, which it shouldn’t be. It’s obviously to get them help,” he told me. “So, from my experience with selling a controlled substance, they would have let her out.” As a narcotics investigator, he is a mandatory reporter, but he didn’t think connecting her with social workers was the answer, either. “If I called CPS and they go talk to her, and she says, ‘No, I’m not selling fentanyl, blah blah blah,’ would that do anything? Who knows? Also, it would have interfered with any investigation.”

In the summer of 2023, six months after Maylia’s arrest, she was shuttled from jail to Brown County Circuit Court for her transfer hearing. Carrie sat in the gallery with Ryan and her parents. Ronsman took the stand. He testified that in a shoebox in Maylia’s bedroom, his team had found 775 pills and $3,976. He said he had gone through Maylia’s text messages and found that the average age of the customers he could identify was 18. When Wendy Lemkuil, the prosecutor, asked if Maylia was the largest known fentanyl dealer in Brown County schools, he said that she was.

Fritz cross-examined him. Ronsman had documented two instances in which Maylia had sold at West High School. “Yeah,” he said. She wanted to know how he would explain his decision to do nothing when he first discovered that Maylia was selling.

“So, fentanyl is dangerous?” she asked Ronsman in court.

“Correct,” he said.

“And the drug task force had information that Ms. Sotelo sold five fentanyl pills to somebody Nov. 29 of 2022, correct?”

“That’s correct.”

“And did not arrest her?”

“That’s correct.”

“Why?”

“It’s our common policy and procedure in the Brown County Drug Task Force to build a case, to show that there is a habit of selling drugs and that they just didn’t sell drugs one time.”

At first, Carrie thought she must have misheard. She noticed her body shaking, and Ronsman’s low-pitched voice — “build a case” — repeated in her head. She couldn’t comprehend that the officers knew Maylia was selling fentanyl days before Jack died and did not arrest her. The police department had been the first institution that appeared to believe that Jack’s life mattered. Jack’s school counselor had dismissed Carrie’s concerns, the local clinics were no help, the staff at Hazelden hadn’t provided guidance. The police had made it seem like this investigation was for Jack. Now she realized that he didn’t mean anything to the officers: He wasn’t a person to them but a piece of evidence to be used against Maylia.

After each hearing, Maylia turned on the news and watched herself in handcuffs. The anchors parroted the prosecutor’s language, calling her “the largest dealer of fentanyl in Brown County schools.” She wasn’t the largest — she knew bigger — and she hated any insinuation that she was malicious or uncaring. Still, she started to grasp how she came across to others. Maylia had never paid attention to the news before, and now she kept seeing segments on fentanyl, hearing there was an epidemic. She had assumed that only a mixture of many drugs could kill, but kids were dying from a single fake Percocet. “Before, it was like, ‘I’m doing drugs, they’re doing drugs, everybody does drugs,’” she told me.

Often, Maylia spoke about herself as if she were split in two. There was a former Maylia, who was rash and inattentive, and a present Maylia, who had insight. The first Maylia, as she saw it, had been so self-deluded or naive that she let herself believe that she wasn’t causing harm: Her buyers would find percs even if she wasn’t the one selling. She started off thinking she was helping Maliasyn and was soon seduced by the money. “I thought for a long time that the way out of this labyrinth was to pretend that it did not exist, to build a small self-sufficient world in a back corner,” she wrote in her journal. That version of Maylia hadn’t even considered the consequences for Marianna. “I don’t know why it didn’t click for me that she’d just got indicted,” she told me.

When the former Maylia got to jail, she blamed everyone around her. Her mother, who left her to fend for herself. The customer who snitched. Even Jack, who came back to Green Bay and decided to use. She couldn’t understand why he kept smoking percs after he’d had the chance to get sober. Maylia couldn’t blame Marianna — they carried the same unspoken memories, like veterans from the same squad. Each day on her way to class, Maylia passed Marianna, who was waiting in her cell. Behind glass, she curled her fingers into a heart and mouthed, “I miss you.” Maylia marveled at how pretty she looked.

The other Maylia, the one in the present, blamed herself and felt disgusted. When the judge quickly rejected her request to move the homicide case to juvenile court, she accepted that she would be going to prison, but she no longer saw herself as a victim. After Marianna was sentenced to eight years in federal prison, Maylia wasn’t outraged, either. It was a long time, she thought, but it could have been worse. She rarely brought up the violence in her home, and when she talked about it at all, she downplayed it. Her mom didn’t “strangle” Marianna, she just “grabbed her by the neck.” Her sisters always said that their mother was an addict, and while she didn’t think that was wrong, she hated when they said it. “She was just — she didn’t know how to be a mother.” Maylia wrote in her journal that while her upbringing had affected her decision-making, she could determine her own future. “I contributed to creating my current experience,” she wrote. “I can now make conscious choices which will bring the changes I want!”

Part of this shift came from reading; for the first time in her life, she could count on three meals a day, which allowed her to relax. She was attending Bible study and devouring books — Joyce Meyer’s “Battlefield of the Mind,” Oprah Winfrey’s “What Happened to You?” At night, she took notes on trauma’s effects on the brain and how to break a “generational curse.”

It was the stories of fellow inmates that transformed her perspective on addiction. She had always tried to keep distance from her customers, but in jail, many were incarcerated with her. She watched one teenager beg her mother to allow her back into her home — the pitch of her voice rising, banging the phone around, yelling she’d stop using — and get nowhere. She’d hear adults say that the first thing they planned to do when they got out was get high. She had previously thought that using was a choice; now she understood that the opioids were in control. She watched a 17-year-old girl try to sleep through withdrawals, too weak to stand to shower, peeing herself. Another had been found facedown in a snowbank, near dead. Often, she thought about Jack and how she wished she could tell him what she’d seen and what she’d learned. She hated that she had fed her customers’ darkest impulses. Many had childhoods similar to hers: parents with addiction, abuse in the home, the shame of abandonment. “They just took a different way out.”

In the 15 years before Maylia’s case, only one juvenile in Wisconsin had been charged in criminal court with drug-induced homicide — in that instance, the drug was heroin. Once the district attorney in Brown County charged Maylia, though, prosecutors across the state began to do the same. In Fond du Lac, after an 18-year-old overdosed on fentanyl, the district attorney brought homicide charges against three boys under 18, all in the adult system. (Two pleaded no contest, and the third is trying to raise money for a lawyer to represent him at trial.) In Rock County, south of Madison, a 15-year-old was charged in criminal court. He admitted to a detective that he delivered two percs to a boy who later died from fentanyl intoxication. The detective showed up at his house after a school police officer noticed him crying. “It’s all my fucking — it’s all my fault,” he told the officer. “I wish I would have never done that.” He pleaded guilty and was sentenced to 19 months in prison.

It’s impossible to know how many teens in the country are being charged with drug-induced homicide. There is no national database, many states do not aggregate cases, and when prosecutors file in juvenile court, the records are sealed. As a result, there’s been almost no scrutiny of how these laws are used against kids, said Katie McCreedy, a Northeastern University doctoral researcher who studies these charges. “How can young people in media stories be simultaneously assumed to know nothing about how deadly the drugs are and also held accountable for homicide?”

Both drug-induced homicide charges and transfer laws have been presented as tools to deter crime, but there’s no clear evidence that either work. In fact, many scholars argue that drug-induced homicide prosecutions may lead to more overdose deaths, as they can reduce the chances that a witness will call 911. Most criminologists agree that charging and sentencing juveniles as adults has not been shown to reduce recidivism. A series of large-scale studies found that minors prosecuted in criminal court are more likely to be rearrested than similar offenders in the juvenile system; also, Black kids are disproportionately charged in criminal court. As adolescents continue to sell fentanyl, police and prosecutors are faced with the choice of whether to consider minors as the Supreme Court has cast them — kids who can’t compute consequences the way adults can — or as killers, subject to adult sentences.

States and counties play a major role in this calculation. In recent years, as pharmaceutical money from opioid settlements has been distributed, they have been charged with investing in evidence-based solutions. According to public records, Wisconsin has earmarked only a tiny percentage of funding for treating minors. Brown County has funneled most of its spending to the sheriff’s office. In addition to paying for fentanyl test strips and Narcan, a nasal spray that delivers an overdose-reversal drug, the county decided to hire two “overdose investigators” for the drug task force. Their mandate is to pursue all fatal overdoses as homicides.

In May of 2024, Maylia pled no contest to first-degree reckless homicide. She was convinced she’d lose her appeal to send the case to the juvenile system, and she was ready to stop fighting. She was also impatient to get to a facility where she could spend time outside. It had been more than a year.

Two months later, Maylia was driven to the courtroom for sentencing. Carrie had been unable to sleep for days. Her best guess was that she was panicked that the case was ending. At least there was purpose in showing up to each hearing. It was a way of keeping Jack alive.

In court, Lemkuil, the prosecutor, kept returning to what Maylia ought to have known. “Maylia had a crystal ball of what could happen to her if she delivered drugs just like her sister did,” she said. She asked the judge for 10 years of initial confinement, followed by 10 years of extended supervision. Fritz referred to Miller v. Alabama. The judge, seemingly unaware of the case, asked her to repeat the name. She explained how the court’s language reminded her of Maylia, who had an underdeveloped sense of responsibility and received almost no parenting. Fritz asked the judge for extended probation or a maximum sentence of five years of confinement.

For the first time in the 19-month-long case, Maylia spoke in court. In jail, her friends had coached her to appear remorseful but not to cry, because no one likes self-pity. Within seconds, she couldn’t stop herself. Sitting with her hands shackled in her lap, she choked on her words. Fritz held Maylia’s written testimony close to her face so she could read. She wasn’t asking for sympathy, she said, “because I know I’m not the one who deserves it. I am speaking today to assure you that I will do everything and anything to change.” She added, “I understand the seriousness of what I have done, and I understand that there will be consequences for my actions, and I will accept those.”

At the start of the investigation, Carrie wanted retribution, and she thought she knew what justice meant. She wasn’t so sure anymore. When she addressed the court, she talked about Jack, how loyal and opinionated he was, how she had dedicated her life to him, and how that life was now meaningless, devoid of a future. She called out the drug task force for continuing to allow Maylia to deal when investigators knew she was selling fentanyl. Ronsman, who was watching from the gallery, raised his eyebrows. He understood the impulse to play Monday morning quarterback but, he thought, he wouldn’t have done anything differently given what he knew at the time. Carrie continued: “I do believe that you, Maylia, are responsible for Jack’s death.” At the front of the courtroom, she forced herself to look at Maylia. “However, I also believe that you are deserving of forgiveness. I do forgive you, Maylia.”

The judge said that considering how much Maylia was selling, she was bound to kill at some point. He was disturbed by the photos of money on her phone. “In one of them, it’s almost like someone is bathing in the cash,” he said. Yes, she was young, but he needed to keep in mind “the substantial negative impact of drug trafficking on the community.” Young users in particular, he added, “don’t really have any idea what they’re doing or what they’re getting into when they start using.” He sentenced Maylia to 10 years in prison and 10 years of extended supervision.

That evening, Carrie leaned into the corner of her living room couch next to Ryan, facing the door to Jack’s bedroom, which remained almost exactly as he had left it. She had been hoping for some epiphany, for a grand finale, but there was none. She was struck by Maylia’s voice — she sounded like a little kid, not like the girl in the flashy photos she’d posted on social media. During the hearing, Carrie had watched Maylia’s mom on the opposite side of the gallery. She kept tossing her headband in the air, spitting loudly into napkins and walking up and down the aisle in a blue suit, fur-lined snow boots and a hard hat on an 83-degree day.

“I’ve never seen anything like that before,” Carrie said to Ryan, holding her face in her hand.

“A homicide case?”

“Well, that, of course, but I’ve never been exposed to that, I guess, that lifestyle. A child who grew up in a drug-trafficking home.”

Ryan didn’t see a reason to wish for a shorter sentence. Maylia would just be released back into the same circumstances. “This is where the problem was in the first place,” he said.

“But it’s what she knows, you know?” Carrie replied. All kids want to come home. “Look at Jack.”

She could trace the progression of her grief through the hearings in the case. How the anger had overwhelmed her at first, how she’d blamed herself for not doing more, how she had stopped wanting to live, how she had lost her trust in the police. Now she noticed a new sensation. She felt strangely protective of Maylia, and she couldn’t quite figure out why. How could CPS ignore what was happening in that home? She kept picturing Maylia’s limp face in the brief moment when they had looked at each other during the hearing.

“Maybe this is part of it,” she said. “I lost my son, my only child. And here is Maylia, who didn’t have a mother. So, it’s like, I’m childless, she’s motherless, and we’re in this situation together, but against each other.”

Carrie a year and a half after Jack’s death (Photo by Akilah Townsend for ProPublica. Photo illustration by ProPublica and Han Cao.) How We Reported This Story

Lizzie Presser interviewed scores of pediatricians, addiction specialists, counselors, teachers, lawyers, law enforcement officers, parents of kids with addiction, and teenagers in recovery. She reported from Baltimore, Denver, Monterey, California, and Green Bay, Wisconsin. She spent a week shadowing health care providers and meeting their patients. To reconstruct Maylia Sotelo’s path into the criminal justice system, she drew from hundreds of pages of child protective services and police records, court transcripts and statements, Maylia’s text messages, journals and letters, and interviews with Maylia, her sisters, people she met in jail, and those who had seen conditions in her home. (Her grandmother did not provide a comment.) To reconstruct Jack McDonough’s life, Presser drew from extensive medical records, school reports and emails, text messages, and interviews with his mother, other relatives, friends and girlfriend. Through public records requests, Presser established the timeline of the investigation into Jack’s death and the scope of drug-induced homicide charges brought against teens in Wisconsin.

by Lisa Song

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In a landmark lawsuit filed this week, the California attorney general accused ExxonMobil of “deceptively” promoting chemical recycling as a solution for the plastics crisis, citing ProPublica’s recent reporting and expanding on our findings.

In June, we examined the oil giant’s claim that it had transformed discarded plastic into new fruit cups through an “advanced” chemical recycling technology called pyrolysis. We broke down the math to show just how little recycled content winds up in products made this way and how companies inflate that percentage in their marketing.

The lawsuit cited the fruit cup example alongside the attorney general’s own discoveries, which reveal an even more extreme gap between what ExxonMobil advertises and how much recycled plastic its products actually contain.

ProPublica reported that plastic made via pyrolysis can’t contain more than 10% recycled content. Because the technology is shrouded in secrecy, we could not determine the specific amount in ExxonMobil’s products.

Citing internal company documents, the lawsuit said ExxonMobil’s process yields less than 0.1% recycled plastic content.

Yet it marketed the cups as containing “30% ISCC PLUS certified-circular content” — shorthand for 30% recycled — through a controversial accounting method called mass balance, which allows recyclers to pump up the advertised recycledness of one product by reducing the advertised recycledness of other, less lucrative products.

The lawsuit cited ProPublica’s reporting on the first federal action against mass balance, taken last month when the Environmental Protection Agency prohibited its use in a voluntary program for sustainable products. The California lawsuit said mass balance is “widely criticized, including by some members of the plastics industry, precisely because it is deceptive to the public.”

ExxonMobil has a “massive financial interest” in ensuring that mass balance methods are “accepted broadly and even enshrined in law,” the lawsuit stated. “Indeed, continuing the public deception is ExxonMobil’s business model.”

During a press conference on Monday, California Attorney General Rob Bonta blasted the oil giant for “falsely touting ‘advanced recycling’” as a solution to the plastic crisis, calling it ExxonMobil’s “biggest greenwashing campaign.”

In a statement, an ExxonMobil spokesperson insisted that advanced recycling works. “To date, we’ve processed more than 60 million pounds of plastic waste into usable raw materials, keeping it out of landfills.” California officials have known for decades that the state’s recycling system isn’t effective, the statement said. “Instead of suing us, they could have worked with us to fix the problem.”

The California lawsuit does not focus solely on chemical recycling. It accused ExxonMobil of misleading the public for decades about the sustainability of plastic, first by promoting traditional recycling despite knowing that plastic is functionally not recyclable, and more recently by marketing advanced recycling as a cure-all. Unlike traditional recycling, advanced recycling uses heat or chemicals to break plastic down to its molecular building blocks. But it’s done little to improve America’s 5% plastic recycling rate and can’t solve the environmental damage or health problems caused by microplastics and toxic chemicals.

Plastic recycling is “a farce, a lie, a deceit,” Bonta said during the press conference. “One thing ExxonMobil actually does is recycle its lies.”

Judith Enck, founder of the advocacy group Beyond Plastics, called California’s action “the most consequential lawsuit in the country” in terms of holding the plastics industry accountable and told ProPublica it reminded her of the tobacco lawsuits from the 1990s, which eventually led to billions of dollars in settlements for deceptive advertising on the risks of smoking.

The lawsuit seeks an abatement fund to mitigate the harm caused by the company’s actions. Bonta told reporters that the fund — which he hopes will be “to the tune of billions of dollars” — will pay for efforts such as educating the public about the truth of plastic recycling. Enck said she wants the money to expand the refill-and-reuse infrastructure in California. That could include installing dishwashing equipment in schools and hospitals to reduce single-use plastic, or adding water bottle refill stations, which appear in airports but are rare in other public spaces.

Bonta’s lawsuit was filed on the same day as a separate lawsuit from four environmental groups, including the Sierra Club. The suit similarly accuses ExxonMobil of misleading the public about the recyclability of plastic. Bonta and the groups’ leaders spoke at the same press conference.

Enck said ProPublica’s reporting and other news outlets “created breadcrumbs for litigators.” The California lawsuit comes two years after Bonta’s office sent subpoenas to ExxonMobil and industry trade groups to investigate their “historic and ongoing efforts to deceive the public.”

The lawsuit also cited the company’s collaboration with trade groups like the American Chemistry Council. From 2020-2023, for instance, the company gave the council $19.4 million for an ad campaign and national policy work on advanced recycling. One video, which got more than 8 million YouTube views, declared: “Imagine a future where plastic is not wasted but instead remade over and over into the things that keep our food fresher, our families safer and our planet cleaner.”

This ad campaign, “with ExxonMobil at the helm, deceptively seeks to convince consumers that recycling, especially ‘advanced recycling,’ will save the day in order to continue saturating the public and the planet with single-use plastic,” the lawsuit said.

“It is disappointing that legal action has diverted time and resources away from our industry’s efforts to scale up a circular economy for plastics,” the American Chemistry Council said in a statement. “Regardless, we remain steadfast in our mission to advocate for effective policy, collaborate with communities, and invest in new technologies that help to increase plastics recycling and recycled plastic use in products, contributing to a more sustainable future.”

ExxonMobil’s ads are misleading because the company knows its advanced recycling process is not economically viable and can only handle small amounts of consumer waste, the lawsuit noted. In fact, only about 8% of the waste plastic fed into its advanced recycling system becomes new plastic; the rest gets burned up as fuel or becomes other nonplastic products. Even if ExxonMobil operated a potential future project that’s more efficient, it would only be able to turn 13% of the waste plastic into new plastic.

“The truth is ExxonMobil’s ‘advanced recycling’ program is less like a recycling program,” the lawsuit said, “and more like a waste disposal or destruction program akin to the incineration solutions advocated by ExxonMobil in the past.”

by B. “Toastie” Oaster, High Country News

This article was produced for ProPublica’s Local Reporting Network in partnership with High Country News. Sign up for Dispatches to get stories like this one as soon as they are published.

I’m standing at an Indigenous sacred site, looking at something I’m not supposed to see. Signs of ceremony are all around: little animal skulls, ribbons, a stump of freshly burnt sage stems in ashes, tied together with red yarn. It looks like a ceremony happened in the last week.

I’m here with a source who wants their story told — who wants to expose the harm that the public and private sectors are inflicting on tribal cultures in pursuit of renewable energy development. But the source also wants to protect these cultural sites from public exposure. So I don’t take any photos. I don’t record it in my notes. I walk away and do not publish what I see.

Another month, in another part of the Pacific Northwest, I’m at a tribal community event, not reporting, exactly, but relationship building — an important component of establishing trust in Indigenous journalism. I overhear an elder talking about a ceremonial rite of passage that takes place at a location where I have been reporting, a location sited for renewable energy development. The public isn’t supposed to know about this ceremony, which means I’m not supposed to know either. So I pretend I didn’t hear.

I’m engaged in a yearlong investigation, a partnership between two newsrooms, documenting how proposed developments are threatening sacred lands and Indigenous cultural resources. I usually write for an Indigenous editor, but none of my editors are Native right now on this story. I return to the virtual newsroom, and they’re eager to hear about what makes these sites sacred; we need to be able to communicate this to readers, they say, particularly when we dig into the legal and political mechanisms threatening the sites.

I want the public to understand the importance of these places, and part of me wants to tell my editors everything. But if I do, and the information escapes, it will be on me. I’m Native, too, and I have to handle this information responsibly, without selling out my kin. In the Native world, we tend to view each other — and all living things — as relatives. At the same time, my tribe is not from here, and I’m still learning about the cultures I’m reporting on. Language that would bring the location vibrantly to life is right there in my mind, but I don’t feel right about using it. The most I seem to be able to tell my editors — speaking accurately and honestly while respecting cultural concerns — is that tribal leaders won’t share that information with me.

I mention some rock features. My editors ask what the features are used for. A variety of purposes, I say, thinking carefully — hunting, storage, cooking. I’m leaving information out, but everything I say is true. Even mentioning the archaeological features could endanger them, putting them in the crosshairs of looters and vandals. Write one too-specific article, and tribal historic preservation officers might find themselves fighting off new age gatherings of non-Natives appropriating Indigenous worship. Or worse: Western scientists destroying ancestral remains for anthropological “research.”

During our discussion, my editors seem to believe that sharing as much information as possible is a public good. It’s a value assumption of investigative journalism — a very American value, and one I sometimes share. Transparency is what empowers the watchdog press. And of course we aren’t withholding information that’s critical to the investigation. But tribal cultures don’t necessarily put such a premium on transparency. In many Indigenous cultures, information is carefully guarded by storytellers, shared orally and only with select people or at certain times, if at all.

I sit down at my laptop to write, thinking again about words. How do I write about plants and sites and ceremonies I can’t write about?

During my reporting, a tribal government sends me, at my request, a set of guidelines about cultural information it doesn’t want published, like the names or pictures of the first foods that grow where I’m reporting. On the one hand, I don’t work for tribal governments, so I don’t have to do what they say. And I’ve worked with neighboring tribes who publicly identify some of the very same plants, which are threatened by renewable energy development. Yet I know I’d be responsible to the community if that information got out.

My own tribal citizenship impacts the reporting process, too. “Toastie, where are you from originally?” began a conversation I recently had with a Chickasaw legal expert. “You’re Choctaw. We're kind of cousins.” I’m still taken aback sometimes when I hear a question like this from another professional. Normally, I wouldn’t feel obligated to talk about my family history at work. But this part of our conversation is how we recognize each other and orient ourselves in relational space. My conduct as a reporter will reflect on my community. So we talk like Natives a bit before settling into our official roles.

I sit down at my laptop to write, thinking again about words. How do I write about plants and sites and ceremonies I can’t write about? And then one of my editors forwards me a note from another, paraphrasing a third editor: “Readers may say: They are only roots. How do we get them to think beyond that?”

I leave my desk, play some guitar, go for a walk, trying to shake off frustration. I know my editors are speaking for a readership we can’t assume is educated about Native issues like food sovereignty — the ability of a people to govern its own food sourcing. But I have to walk a narrow line between educating and oversharing. I find myself wishing everyone in America, myself included, had learned more about Native issues in school. Then we could avoid situations like this.

The problem haunts me over the dinner stove. “Root gathering,” a phrase I’ve heard Natives use, might be the simplest language to choose. But it sounds primitive, like something hunter-gatherers do; “civilized” people “harvest vegetables.” I pace around my apartment, searching for wording that might clarify what’s at stake. Indignation flashes through my mind as I reflect on how terms like “heirloom” are applied almost exclusively to European foods — Italian tomatoes, say, even though tomatoes were originally engineered by Indigenous scientists in South America.

I find myself wishing everyone in America, myself included, had learned more about Native issues in school. Then we could avoid situations like this.

What would these Indigenous roots be called if they were in rustic-looking display crates at Whole Foods? Finally, I think I’ve found a solution: I write “endemic, heirloom, organic root vegetable harvests.” True, it’s a word salad, but the plants themselves remain anonymous, and non-Native readers could better understand why they’re valuable.

I Slack the phrase to one of my editors. She laughs, understanding the jab at bourgeois vernacular. Few of those modifiers will make it past top edits; what remains in the final draft is simply a “root vegetable harvest.” Not as obvious, but at least we avoided “root gathering.”

It’s difficult to write for Natives and non-Natives at the same time. If a non-Native editor puts the term “first foods” in quotes, that could alienate Native readers. But a non-Native reader may never have encountered the term, and the quotes might help explain that it’s a common phrase.

It’s even more difficult when terms mean different things to different audiences, like the word “sacred.” Natives use it a lot, but I’ve seen it spark scorn in some non-Natives. (“Sacred land? It’s 2024!” reads a social media comment on one of our most recent stories.) Others seem to use it with a shallow understanding.

Handling information amid these tensions, created by different value systems, is the challenge and responsibility of a journalist. Of course, we can’t get into all this in the draft itself. So the challenge remains: How do you write about a sacred site without saying why it’s sacred, in a way that will help non-Natives care? There’s no clear dividing line between too much information and not enough. It’s the liminal space in which a lot of Indigenous affairs reporting takes place.

by Jessica Priest and Lomi Kriel, ProPublica and The Texas Tribune, and Eleanor Klibanoff, The Texas Tribune

Hundreds of thousands of Texas families have been waiting months for the state to process their Medicaid applications. The median processing time is 79 days despite a federal requirement to do so in 45 days. We’ve heard from families who say they could not access critical care during that time, such as not being able to afford to reset their child’s broken nose. Health care providers have reported patients struggling to get lifesaving heart surgeries.

The delays worsened after the federal government lifted pandemic-era protections last year. Our reporting shows that Texas rushed through the process, removing more than 900,000 children not because they were ineligible, but for procedural reasons like their families failing to fill out a form.

The backlog for food benefits is not much better. The state most recently reported having nearly 97,000 applications to process for the Supplemental Nutrition Assistance Program, or SNAP — often referred to as food stamps — and said that the median time it took was 33 days.

We are committed to reporting on long-standing issues with Texas’ social safety net and their root causes. We need help from those who know the delays firsthand and the harm they may cause: the families who rely on and are currently waiting for benefits. We want to show any failures to the people who are responsible for overseeing these systems — lawmakers, advocates, even the federal government — and explain where the state may be falling short of its obligations.

Please fill out the form below if:

• You’ve been waiting more than a month to hear about your Medicaid or SNAP application and have faced medical or financial consequences.
• You’ve worked with the state and can help us understand the reasons behind the persistent backlog, including IT glitches, staffing issues and funding shortages related to Medicaid or SNAP.
• You help people apply for benefits, or you are a health care worker or other expert with insight on this issue.

Filling out the form is the best way to get in touch, but we understand that life gets busy and sharing details of your situation may be easier to do with a reporter by phone. Please indicate on the form below if that is what you’d prefer.

You can also call 602-848-9609 and leave us a voice message with your name, phone number and the best time to get in touch. We may call and ask you these same questions. The call should take about 10 minutes.

We appreciate you sharing your story, and we take your privacy seriously. We are gathering these stories for the purposes of our reporting and will contact you if we wish to publish any part.

If you would prefer to use Signal, an encrypted messaging app, see our advice at propublica.org/tips/#signal. You can also email our reporting team.

by Eleanor Klibanoff, The Texas Tribune, and Lomi Kriel, ProPublica and The Texas Tribune

This article is co-published with The Texas Tribune, a nonprofit, nonpartisan local newsroom that informs and engages with Texans. Sign up for The Brief Weekly to get up to speed on their essential coverage of Texas issues.

For three years during the coronavirus pandemic, the federal government gave Texas and other states billions of dollars in exchange for their promise not to exacerbate the public health crisis by kicking people off Medicaid.

When that agreement ended last year, Texas moved swiftly, kicking off more people faster than any other state.

Officials acknowledged some errors after they stripped Medicaid coverage from more than 2 million people, most of them children. Some people who believe they were wrongly removed are desperately trying to get back on the state and federally funded health care program, adding to a backlog of more than 200,000 applicants. A ProPublica and Texas Tribune review of dozens of public and private records, including memos, emails and legislative hearings, clearly shows that those and other mistakes were preventable and foreshadowed in persistent warnings from the federal government, whistleblowers and advocates.

Texas’ zealousness in removing people from Medicaid was a choice that contradicted federal guidelines from the start. That decision was devastating in Texas, which already insures a smaller percentage of its population through Medicaid than almost any other state and is one of 10 that never expanded eligibility after the passage of the Affordable Care Act.

“The difference in how Texas approached this compared to a lot of other states is and was very striking. It wanted everybody off, anybody extra off, even though we knew that meant that state systems would buckle under the pressure,” said Erin O’Malley, a senior policy analyst with Every Texan, a left-leaning statewide advocacy group.

Medicaid rolls swelled nationally during the pandemic, with tens of millions of people added to the program and no one removed. In Texas, the number of people receiving Medicaid benefits grew by more than 50%, to 6 million. When the federal government stopped requiring continuous coverage in April 2023, states had to determine who was no longer eligible.

The question wasn’t whether to remove people but instead how to do it in a way that caused the least disruption and ensured those who qualified stayed on.

To that end, the federal Centers for Medicare and Medicaid Services advised states to proceed slowly and rely heavily on existing government data to automatically renew eligible residents, steps the agency believed would prevent poor families from wrongly losing coverage. Congress gave states a year for the so-called “Medicaid unwinding.”

But Texas opted for speed, launching reviews of about 4.6 million cases in the first six months. It also decided against the more vigorous use of automatic renewals urged by the federal government, forcing nearly everyone to resubmit documents proving they qualified. Nearly 1.4 million of those who lost coverage were disenrolled for bureaucratic reasons like failing to return a form or completing one incorrectly, not because they weren’t eligible.

The decision to buck federal government guidelines was one of many that led to serious repercussions for Texas residents who rely on the program.

Among them were children forced to forgo or postpone lifesaving operations such as heart surgeries, said Dr. Kimberly Avila Edwards, an Austin pediatrician and Texas representative for the American Academy of Pediatrics. Children with severe diseases such as sickle cell anemia, as well as those with neurodevelopmental delays and autism, also unnecessarily lost critical care.

One of her colleagues treated a boy with a rare heart condition who lost Medicaid coverage in January after his parents failed to sign a form that even his caseworker was not aware the family needed to complete.

The boy’s parents couldn’t afford his $6,000 monthly pulmonary hypertension medication, nor could they pay for an ultrasound that would help determine whether he could survive without the drugs, said Avila Edwards, who declined to identify him because of medical privacy laws.

“If we have children who are less healthy, who are unable to get the preventative care they need for their chronic medical conditions, that fundamentally should raise concern for all of us,” she said.

The boy was eventually reenrolled in Medicaid after Texas pediatricians persuaded the state health agency to restore his coverage, Avila Edwards said. A Texas Health and Human Services Commission spokesperson said the agency would not restore coverage based on pediatricians’ intervention.

Thomas Vasquez, an HHSC spokesperson, acknowledged that the agency “learned many lessons” and is working to improve eligibility processes. HHSC representatives defended the rollout, saying that the agency conducted community outreach and hired more than 2,200 employees.

Texas’ approach to the Medicaid unwinding reflected the state’s long-standing conservative ideology regarding the government-subsidized program, said Simon Haeder, an associate professor at Texas A&M University’s School of Public Health.

As attorney general more than a decade ago, Gov. Greg Abbott helped lead a successful lawsuit against the federal government to ensure states didn’t have to cover more residents under Medicaid as part of the Affordable Care Act. Since then, Abbott and state lawmakers have continued to severely limit the program to mostly children, pregnant women and disabled adults. Poor adults aren’t typically eligible for Medicaid unless they have children. Parents of two kids must earn a combined income of less than $285 monthly to qualify for coverage.

A spokesperson for Abbott declined an interview on his behalf and did not respond to a request for comment on the state’s handling of the unwinding.

Texas’ stance during the unwinding, Haeder said, was, “We don’t do anything illegal, but we want to get our program as fast as we can down to what it was before the pandemic.”

Ignored Warnings

It was inevitable that the COVID-19 public health emergency would eventually end, as would the prohibition against pushing people off the rolls. Federal officials worried about the effects of the unwinding on vulnerable Americans almost from the start. In fact, the Biden administration repeatedly extended the emergency declaration, even after the peak of the crisis, to maintain safeguards that included keeping millions of low-income people on Medicaid.

Once the emergency officially ended in April 2023, states were free to cull their rolls. In preparation, federal officials advised states not to review more than 11% of their caseloads each month, cautioning that moving more quickly could overwhelm their systems and lead to the wrongful removal of eligible people.

But that was guidance, not a requirement, and Texas chose a far more aggressive plan.

In the first month of the unwinding, the state started the review process for about a million cases, or 17% of its caseload.

The federal government in May 2023 pressed Texas on why the state was moving so quickly. State officials downplayed the concerns, writing in an email obtained by the news organizations that they were frontloading people who most likely no longer qualified and were reviewing entire households at once.

Within the first four months of the unwinding, the state dropped more than 600,000 people from Medicaid. The vast majority were removed not because the state determined they were no longer eligible but for reasons such as failing to provide the proper documents in time.

That July, U.S. Health and Human Services Secretary Xavier Becerra called on Texas and other states to increase the number of eligible people they automatically renewed with existing government data. He warned in a letter that his agency would take action against states that were not complying.

In the same week, a group of employees anonymously emailed HHSC Executive Commissioner Cecile Young and media organizations, claiming senior management had alerted them that tens of thousands of people had improperly lost Medicaid due to the agency’s poor handling of the unwinding. Young’s chief of staff responded in an email that she couldn’t address the allegations of unidentified whistleblowers.

Texas alerted the federal government days later that it had erroneously dropped nearly 100,000 people, according to records obtained by the news organizations.

In August 2023, CMS once again implored the state to stop requiring eligible people to resubmit paperwork proving they still qualified. The federal agency said it appeared that many people didn’t know they needed to reenroll, didn’t understand the forms or faced obstacles in submitting the required information.

Other states that had taken a similar approach, such as Pennsylvania and Maine, made significant changes. Not Texas.

The state agency flagged to CMS last September that more than 30,000 kids lost their coverage, even though most of them should have been moved from Medicaid to the Children’s Health Insurance Program, according to emails the news organizations obtained through the state’s Public Information Act.

State officials later told the news organizations that 95,000 people had been wrongly removed, instead of close to 130,000, as originally reported to CMS. Asked why the figures had decreased, a spokesperson said the agency “provided approximate numbers as we worked to resolve the issue.” Agency representatives said the state quickly reinstated coverage and implemented changes to prevent further improper denials. They did not provide specifics.

Alarmed by the deluge of disenrollments, advocacy groups, health providers and newspaper editorial boards began calling on the state last summer to pause the unwinding and ensure people were not incorrectly losing coverage. It did not do so.

In October, after Texas had already disenrolled more than 1.2 million people, the state gave about 400,000 people who likely qualified for Medicaid an extra month to submit paperwork, according to an agency spokesperson.

Still, problems persisted.

In December, Becerra appealed directly to Abbott and eight other governors of states with the highest shares of children who had lost coverage. Texas accounted for nearly a quarter of all children in the U.S. who had lost Medicaid or CHIP during the unwinding, Becerra wrote. He again urged the state to employ a series of actions, including automatically renewing eligible people.

Without providing details, Becerra said the federal government would not hesitate to take action against states that did not comply with federal requirements.

“A One-Two Punch”

Three months later, Micaela Hoops’ children lost the government-subsidized health insurance for which they had qualified their entire lives. After years of not having to renew their Medicaid coverage under the pandemic rules, the 37-year-old North Texas mother said she was confused about when she was required to reapply and missed the deadline to provide proof of the family’s income.

Hoops sifts through paperwork from the Texas Health and Human Services Commission at her home in Sherman, Texas. (Danielle Villasana for ProPublica and The Texas Tribune)

In other states, the kids might have been automatically renewed using other government information, like quarterly payroll data reported by employers to the state or federal tax records. Instead, Hoops had to frantically reapply seven days after the coverage lapsed in March, submitting 24 pay statements for her husband’s weekly wages as a marketing director for a real estate company. This put the family at the back of a monthslong waiting list.

During that time, Hoops, a stay-at-home mom who homeschools the children, had to take her eldest son to the emergency room for a debilitating migraine. The visit came with a $3,000 bill that she and her husband could not pay. A few months later, the 14-year-old broke his nose while playing with his brother on a trampoline. She paid a few hundred dollars out of pocket for the doctor but couldn’t afford the CT scan required to reset his nose.

More than 100 days after Hoops reapplied, the state restored her children’s coverage retroactively. She hopes Medicaid will cover the hospital visit, but her son’s nose remains crooked.

“My children didn’t deserve to go without insurance,” Hoops said. “They’re kids. They have medical emergencies, things happen, and they deserve to be taken care of.”

Coverage for Hoops’ children wasn’t restored until more than 100 days after she reapplied. (Danielle Villasana for ProPublica and the Texas Tribune)

While Hoops’ children got their Medicaid back, some families that believe they wrongly lost Medicaid are still waiting after being forced to reapply. Texas’ median processing time for Medicaid applications is almost three months, according to a recent agency briefing obtained by the news organizations. This exceeds the federal limit of 45 days for most cases.

The sudden suspension of health insurance for a population the size of New Mexico has had additional ramifications in Texas, including higher treatment costs for hospitals and clinics forced to take on more uninsured patients.

Texas Children’s Hospital in Houston, the largest pediatric hospital in the country, laid off employees this year after significant budget shortfalls. A hospital spokesperson declined to comment, but, in a recent financial filing, the hospital attributed some of the challenges to losing Medicaid patients during the state’s unwinding process.

Across the state, some safety net clinics reported a 30% decrease in Medicaid revenue due to the unwinding, said Jana Eubank, who heads the Texas Association of Community Health Centers. She said the extra costs added to challenges for the already financially strapped facilities.

“Some centers are having to lay off staff. Some centers are furloughing staff,” Eubank said. “I’ve got a couple of CEOs that aren’t taking a salary right now. I’ve had centers that are unfortunately having to cut back certain services or extended hours, like behavioral health services, dental services, just because they can’t afford to continue to offer that care.”

Separately, some families that were pushed off Medicaid are also waiting more than a month for food assistance because Texas uses the same eligibility system to process applications for both.

San Antonio Food Bank CEO Eric Cooper said the nonprofit was crushed by demand this summer when families faced sudden medical bills, kids were out of school and the state had a backlog of more than 277,000 food stamp applications. The situation worsened when Texas declined to participate in a federal nutrition program, turning down an estimated $450 million that could have helped feed nearly 3.8 million poor children during the summer. HHSC officials said they could not get the program running in time.

“It’s felt like a one-two punch, the double whammy,” Cooper said.

“We haven’t really felt any relief since the Medicaid unwinding and the official end of the public health emergency,” he added. “It’s still an emergency. It’s still a crisis.”

Federal Investigation

In May, after Texas’ unwinding ended, the federal government launched an investigation into long waits faced by people who had applied for Medicaid coverage. Addressing these persistent delays was especially important because they affected eligible people who lost coverage in the past year, Sarah deLone, director of CMS’ Children and Adults Health Programs Group, wrote in a letter to the state.

Former federal officials and health policy experts called the probe a significant step by the agency, which typically works with states behind the scenes.

But CMS has few options to hold Texas accountable if it finds wrongdoing, said Joan Alker, executive director of the Center for Children and Families at Georgetown University in Washington, D.C. The Biden administration’s major enforcement tool is yanking federal funding, but that could cause low-income people to lose health insurance and invite a lawsuit from Texas, Alker said. And the investigation likely won’t go anywhere if Donald Trump wins in November, she said, since the former president previously encouraged states to restrict Medicaid access and promised to undo the Affordable Care Act entirely.

CMS spokesperson Stephanie Rossy declined to comment directly on its investigation or on Texas’ handling of the unwinding. But in a statement she wrote that “states’ choices have real consequences for eligible people’s ability to stay covered.”

Texas officials also declined to discuss the probe, but in a letter to the federal agency two weeks after the May investigation announcement, the state’s Medicaid director, Emily Zalkovsky, acknowledged that Texas experienced “severe operational and systems challenges” during the unwinding.

Although the federal probe was welcomed by advocacy groups, as well as some health care providers and Texas families, it’s unlikely to immediately help eligible people who lost Medicaid during the unwinding and are waiting to get back on.

While Hoops’ children have regained coverage, she believes that what her family endured reflects state leaders’ attitudes toward low-income people.

“Maybe they didn’t realize they were making cruel decisions,” she said. Still, she feels like the state’s mentality is basically, “Well, you just shouldn’t be dependent on us.”

Caught in Texas’ Medicaid and Food Stamp Application Backlog? Know Someone Who Is? Help Us Report.

Update, Sept. 27, 2024: This story was updated to include comment from the Texas Health and Human Services Commission about the case of a boy with a rare heart condition who lost Medicaid coverage.

by Megan O’Matz and Joel Jacobs

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up for Dispatches, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.

The sprawling business empire created by tribal leaders in northern Wisconsin was born of desperate times, as the Lac du Flambeau Band of Lake Superior Chippewa Indians faced financial ruin. Its subsequent success would be built on the desperate needs of others far from the reservation.

The tribe had made some poor choices as it sought to expand its fortunes beyond a modest casino in its home state of Wisconsin two decades ago. Grand plans for a floating casino off Cancun, Mexico, collapsed, and a riverboat gambling venture in Mississippi required more cash than the tribe had on hand.

The resulting loans — $50 million in bonds issued in 2008 at 12% — proved crushing. Struggling to make debt payments, tribal officials soon were forced to slash spending for essential programs on the reservation and lay off dozens of employees.

Protests erupted, with demonstrators barricading themselves inside a government building and demanding audits and investigations. When angry tribal members elected a new governing council, it refused to pay anymore. The tribe defaulted on a loan it had come to regret.

The LDF tribe turned to the one asset that could distinguish it in the marketplace: sovereign immunity.

This special status allowed it as a Native American tribe to enter the world of internet lending without interest rate caps, an option not open to other lenders in most states. The annual rates it charged for small-sum, installment loans frequently exceeded 600%.

Business partners, seeing the favorable math, were easy to find. So, too, were consumers who had run out of options to pay their bills. Their decisions to sign up for LDF loans often made things worse.

ProPublica traced the key decisions that put LDF on the path to becoming a prominent player in a sector of the payday lending industry that has long skirted regulation and drawn controversy.

LDF did not just dabble in this type of lending; it fully embraced it. Like other tribes that have taken this route, LDF built its success on a series of complex business arrangements, with roles and motives difficult to unravel.

Over time, ProPublica found, LDF signed off on deals involving outsiders with histories of predatory practices — associations that carried profound implications for the tribe. Not only did they put the tribe’s reputation at risk, they generated a barrage of costly lawsuits and questions of whether LDF was allowing partners to take advantage of tribal rights to skirt state usury laws.

In Boston, Brian Coughlin initially had no idea that a Native American tribe was involved in the small loan he took out with a high interest rate. He only learned about LDF after he filed for bankruptcy to seek protection from his creditors.

“I was definitely surprised,” he said. “I didn’t think they operated things like that.”

During the bankruptcy process, an LDF partner still hounded him to pay, which Coughlin said pushed him to a breaking point and a suicide attempt. Federal law prohibits chasing debtors who have filed for bankruptcy, and Coughlin sued the tribe in a dispute that went all the way to the U.S. Supreme Court. Last year, the court — in a decision with far-reaching implications for tribes — ruled that LDF could be held liable under the Bankruptcy Code.

Brian Coughlin initially had no idea that LDF was involved in the small loan he took out with a high interest rate. He filed for bankruptcy, but an LDF partner still hounded him to pay. (Bob Croslin for ProPublica)

His and other consumer lawsuits paint LDF as a front for outsiders who take an oversized cut of the proceeds, leaving LDF with only dollars per loan. Interviews and ProPublica’s review of records also show how heavily LDF relies on its partners for most of the essential operations. These descriptions are disputed by LDF, which has told ProPublica that it merely is outsourcing for much-needed expertise while still maintaining control.

In a statement to ProPublica this year, John Johnson Sr., LDF’s president, described the tribe’s lending business as “a narrative of empowerment, ethical business practice, and commitment to community enrichment.” He has declined to be interviewed and did not respond to written questions for this story.

Over time, LDF has set up at least two dozen internet lending companies and websites, ProPublica determined. Its loans are so pervasive the LDF tribe showed up as a creditor in roughly 1 out of every 100 bankruptcy cases sampled nationwide, as ProPublica reported in August.

This year, LDF and some of its business affiliates agreed to a federal class-action settlement in Virginia that, if finalized, will erase $1.4 billion in consumer debt and provide $37 million in restitution. Tribal defendants are responsible for $2 million of that; the tribe in a statement has indicated that its business arm would pay.

Tribal officials have consistently denied wrongdoing. A newsletter to tribal members as LDF was starting up its venture said the tribe “is not practicing any type of predatory lending.” In his statements to ProPublica for the August story, Johnson stressed that the tribe complies with tribal and federal law, that its lending practices are transparent, that its collections are done ethically and that the loans help distressed borrowers who have little access to credit.

LDF leaders have not publicly stated any desire to alter their business practices, even as some community members express concern.

“Feeding greed with unscrupulous business practices is crushing us,” one LDF member recently wrote on a community Facebook page.

“The Money Is Dirty”

After the bond debacle in the 2000s, LDF leaders felt stung by their outside financial advisers, believing they were deceived about the terms of the transaction and risks involved.

Moving forward, they wanted someone they could trust. They found that in Brent McFarland.

McFarland was not a tribal member, but he grew up near the reservation and had friends on the Tribal Council. McFarland, an investment adviser who’d run a restaurant and worked in real estate, offered some helpful advice to the tribe, and the council eventually hired him for a wider role. He helped it establish the Lac du Flambeau Business Development Corporation in 2012, governed by a board answerable to the Tribal Council. And he looked for ways LDF could make money, apart from gaming.

“I ended up meeting some people that were doing online lending,” he said in an interview.

Tribes could get into the industry — attracting willing partners with expertise in lending — without putting up any capital because sovereign immunity was its own bounty.

But as certain as LDF was that state laws wouldn’t apply to its operations, the tribe took a careful approach. LDF decided it would not lend to people in Wisconsin, including its own members. “It keeps our relationship with the state of Wisconsin healthy,” McFarland told the Milwaukee Journal Sentinel.

Peter Bildsten, who ran the state Department of Financial Institutions then, remembers visiting the reservation as it was embarking on the new venture. He recalled that he met some of LDF’s business partners, who recognized that the lending operation would be extremely lucrative but also potentially controversial.

“They talked about yeah, we are doing it, and we know there’s virtually nothing you can do about it and especially if we don’t lend to any people in Wisconsin. You can’t do anything,” Bildsten said. “It was almost kind of a dare.”

Many tribes, still suffering from a legacy of racism and inadequate federal resources, struggle to find economic solutions for their people. McFarland, who no longer works for LDF but does consulting for tribes, defended LDF’s decision to move into high-interest loans as a legitimate option.

“The business is offering a service where the interest rates and cost of borrowing are well disclosed to consumers,” he told ProPublica in an email. “It’s expensive, but if used responsibly can be more affordable than many other options. The costs and risks are not hidden from consumers.”

Johnson, LDF’s president, has said there was a rational reason for the tribe’s business partnerships: It needed outside expertise as it entered a new industry.

“But let me be more specific: Zero I.T. enterprise architects, data analysts, or marketing strategists lived on the Lac Du Flambeau reservation when the Tribal Council decided to enter this industry,” he wrote in an email to ProPublica in August.

LDF’s partners run their operations far from tribal land. ProPublica identified several Florida lawsuits that allege a straight-forward process: “The LDF Tribe mints a new ‘tribal’ limited liability company, supposedly organized under Tribal law, for each new investor. Each new investor then runs his or her own ‘tribally owned’ website, offering consumers loans at interest rates between 450% and 1100% annually.”

Those cases were settled or dismissed without LDF addressing the allegations.

LDF does not publicly disclose its partners. ProPublica identified one of them as RIVO Holdings, a fintech firm based in a high-rise in downtown San Diego that has serviced two LDF websites.

First image: The Lac du Flambeau Business Development Corporation in Wisconsin. Second image: The office building where RIVO Holdings operates in San Diego. (First image: Tim Gruber for ProPublica. Second image: Philip Salata for ProPublica.)

RIVO is an acronym for respect, integrity, value and opportunity. The company’s founder and CEO is Daniel Koetting. His personal website touts his employment of “over 200 local employees at RIVO.” His brother Mark, of Kansas, managed a separate lending portfolio for the tribe.

The brothers entered the tribal lending industry after facing regulatory scrutiny for previous lending operations. In 2006, Califonia issued a cease-and-desist order to both men for unlicensed lending; Daniel Koetting received a similar demand from New Hampshire in 2011.

Initially, the Koettings partnered with the Big Lagoon Rancheria tribe in California to offer high-interest loans beginning in 2013. But that relationship began to fall apart several years later.

The tribe alleged that the Koettings surreptitiously pushed customers to new lending companies set up with LDF, and an arbitrator awarded Big Lagoon Rancheria $14 million in 2018. Years of litigation followed as the Koettings fought the decision. The case is still pending.

“I actually called Lac du Flambeau and warned them and informed them that they were getting into business with Big Lagoon’s client list,” Virgil Moorehead, Big Lagoon Rancheria’s chairperson, told ProPublica.

Joseph Schulte Jr., who once worked at RIVO, likened one area of the company’s San Diego office to a Wall Street trading floor, with exuberant staff celebrating short-term wins, such as meeting daily sales goals. To keep the staff pumped up, he said, management brought in pallets of free Celsius energy drinks.

“People were making a lot of money working there,” Schulte said of RIVO Holdings.

Although figures for LDF’s loan portfolios are private, Daniel Koetting’s previous venture with the Big Lagoon Rancheria amassed approximately $83 million in revenue over five years, according to a legal filing.

Court papers, including divorce filings, show Daniel Koetting enjoying a lavish lifestyle in recent years, living in a five-bedroom, five-bath house in La Jolla, an affluent seaside enclave of San Diego. He owned thoroughbred horses, drove a Porsche and dabbled in motion pictures. He and his wife had three children. In the divorce, he reported household expenses in 2021 that included an average of $7,000 a month on groceries and eating out, plus an additional $5,000 a month for “entertainment, gifts and vacation.”

Daniel and Mark Koetting did not reply to emails, calls or letters from ProPublica seeking comment.

Meanwhile, the two companies that RIVO and LDF run — Evergreen Services and Bridge Lending Solutions — are associated with more than 200 complaints from customers since 2019, frequently about onerous interest rates and payment terms. “I just don’t understand how people can do this,” a California resident protested to the Consumer Financial Protection Bureau. “This is a predatory lender and I am a victim.”

Early on in LDF’s leap into lending, the large building on the corner of this shopping center housed a call center above a smoke shop. (Tim Gruber for ProPublica)

Bildsten, the former Wisconsin department head, believes that LDF tribal leaders are trying to help the reservation improve services, such as dental care, for its members and that the lending business is part of that laudable goal.

“They’re able to do some good stuff,” Bildsten said, “but the money is dirty.”

An Ill-Fated Loan With Profound Ramifications

Brian Coughlin lit a cigar. Sitting in his Chevy Malibu with the sunroof open to let out the smoke and a bottle of pills next to him, he wondered: When will this end?

He’d faced many hurdles in life, from serious physical and mental health issues to the loss of his father. He’d also used bad judgment, overspending and loading up on multiple credit cards as he blew through a decent paycheck as head of trash collection for the city of Boston.

Like many other Americans with little to no savings and poor credit scores, he was enticed by online pitches for quick cash — offers that came with exorbitantly high interest rates.

Months earlier, in December 2019, he’d filed for bankruptcy, expecting relief. There would be payment plans and a court injunction halting contact from creditors — a key protection laid out in U.S. bankruptcy law. But one creditor would not give up.

Lendgreen, one of LDF’s initial companies, had loaned Coughlin $900 at an annual percentage rate of 741%. At the time of the bankruptcy, he owed $1,595. The company continued to call, email and text him, fueling his anxiety. A phone log shows Lendgreen called Coughlin 50 times during one four-month period.

Brian Coughlin’s Three-Month Loan Came With a 741% APR Source: Brian Coughlin’s loan agreement. (Lucas Waldron/ProPublica)

“This is all for nothing,” Coughlin recalls thinking of the bankruptcy process.

That night in his Chevy, Coughlin took a fistful of pills and ended up in the hospital. Lendgreen still was calling him while he recovered. But now he was ready to fight.

Coughlin’s attorney filed a motion with the bankruptcy court in March 2020 asking a judge to order Lendgreen, the LDF tribe and LDF Business Development Corporation to stop harassing him.

The case was about more than just harassment, however. Coughlin wanted compensation for all that had happened. He asked the court to award him attorneys fees, medical costs, expenses for lost time from work while hospitalized and punitive damages.

Coughlin (Bob Croslin for ProPublica)

To Coughlin’s surprise, LDF told the court that sovereign immunity protected it even in a federal bankruptcy case, and the bankruptcy judge in Massachusetts agreed. When Coughlin took the case to the 1st U.S. Circuit Court of Appeals and won, the tribe appealed to the U.S. Supreme Court.

As they dug into who actually violated the collections ban, Coughlin’s attorneys needed to unravel the business relationships surrounding Lendgreen, which no longer has an active website. That led them on an international paper chase from Wisconsin to Ontario, Latvia and Malta, an island in the Mediterranean, where an entity that provided capital for Lendgreen appeared to be based.

In gathering evidence, Coughlin’s lawyers obtained an agreement between Lendgreen and another company — Vivus Servicing Ltd. of Canada — showing Vivus was to handle most all operations of issuing and collecting the loans made in Lendgreen’s name. It also would retain most of the profits.

For each new or renewed loan, the contract called for Vivus to share $3.25 with LDF as well as $3.25 per loan payment, or not less than $10,000 a month.

Vivus Servicing had subcontracted certain administrative functions of the Lendgreen loans to 4finance Canada, an affiliate company of a European lending conglomerate based in Latvia, court records show. An attorney who represents Vivus and 4finance declined to comment.

“There’s money flowing to all sorts of places,” Coughlin’s attorney Richard Gottlieb said.

As he began to better understand the web of connections, Gottlieb concluded that LDF’s role in its lending operations was minimal. The partners, he said, performed all the key functions — “from the creation of the loans themselves to the maintenance of the computer software and internet sites to the collections personnel to the customer service reps to the management.”

Even though LDF fought in court to be able to pursue collections against people in bankruptcy, internal documents indicate that the head of LDF Holdings, which oversees the tribe’s lending enterprise, was not pleased with how a business partner treated Coughlin.

“I Shouldn’t Be Getting Phone Calls”

Coughlin inquires with Lendgreen about why its phone calls have not ceased.

(Brian Coughlin)

Jessi Lorenzo, president of LDF Holdings at the time, communicated in May 2020 with 4finance Canada about Coughlin’s loan. Why had they not stopped soliciting repayment once notified that Coughlin had filed for bankruptcy, she asked in an email.

“Everything should have ceased then,” wrote Lorenzo, who was based in Tampa.

In a brief interview on her porch, Lorenzo declined to comment on the Coughlin case and said she did not want to be part of a tribal lending story that might be negative. Later, in an email, she wrote that she was proud to have worked for LDF as it “built a business that benefited their community, providing modern careers with upward mobility and good benefits in a remote part of Wisconsin.”

A Future Clouded by Legal Challenges

LDF tribal leaders don’t talk much about their business with outsiders. But there is little doubt that the lending business has altered the shape of the tribe’s finances, allowing LDF to move past its costly mistake of issuing $50 million in bonds for the Mississippi casino boat.

The Tribal Council agreed in 2017 to pay $4 million and finance an additional $23 million to settle claims against it after defaulting.

But the tribe and its partners continue to face new threats from a range of legal actions.

The attorneys in the Virginia case have promised future litigation against more LDF partners. And as LDF keeps lending, it opens its companies up to additional consumer lawsuits. Dozens of such cases have been filed since 2019, most of which end quickly, with undisclosed settlements.

McFarland takes issue with these types of cases against tribes. “The law firms filing class action lawsuits seek to paint tribes as either victims or villains in online lending,” he said in an email. “This approach has been employed against tribes since Europeans came to the Americas, whether Tribes are entering gaming, cannabis, selling tobacco, and a host of business opportunities.”

When Coughlin’s suit reached the Supreme Court, some of the issues involving tribal-lending partnerships were touched on, if only briefly.

During a hearing in April 2023, Justice Samuel Alito interrupted LDF’s lawyer as he was talking about sovereign immunity and the Constitutional Convention. Alito inquired about the tribe’s relationship with Lendgreen.

“Who actually operates this?” he asked.

“The tribe does, Your Honor,” replied attorney Pratik Shah, representing LDF. “This is not a rent-a-tribe situation.”

Shah said the enterprise employed 50 to 60 people working out of a headquarters on the reservation, though “they use third-party vendors, servicers and all, like any other business.”

Shah added: “This is a fully tribal operation.”

But the central issue was whether the tribe could be held liable for violating bankruptcy rules.

“What the tribe is saying is you can’t sue them for hundreds of thousands of dollars of actual damages,” Shah told the court. “That’s at the core of sovereign immunity.”

In June of last year, the high court sided with Coughlin, ruling 8-1 that there’s no sovereign immunity for tribes when it comes to the Bankruptcy Code.

Justice Clarence Thomas concurred in the ruling, not because of his reading of the Bankruptcy Code, but because he held that sovereign immunity does not apply to lawsuits arising from a tribe’s commercial activity conducted off-reservation.

Coughlin, far left, in front of the Supreme Court with his attorneys Terrie Harman, Richard Gottlieb, Gregory Rapawy and Matthew Drecun (Courtesy of Richard Gottlieb)

Back in Bankruptcy Court, Coughlin continued to pursue LDF and Lendgreen for damages and legal fees. In mid-August, in the midst of settlement talks, Coughlin asked the court to pause the process required to unmask the outside entities involved with LDF as all sides tried to resolve the dispute. In September, a judge approved a settlement in which the tribe and Lendgreen agreed to pay Coughlin $340,000. LDF denied liability as part of the agreement.

At the same time, pressure is mounting on the tribe’s business partners. As part of the deal, the tribe will give Coughlin documents “with respect to the culpability and responsibility” of the outside partners, according to the settlement. That will enable Coughlin’s lawyers to dig further. LDF also will make a corporate representative available to testify in legal actions against their former business allies, if necessary.

“I want to see all the actors that are actually part of this scheme brought to justice, in a way,” said Coughlin, who now lives in Florida.

“I don’t necessarily believe the tribe is the orchestrator of this whole mess. I think they’re a pawn, unfortunately.”

To do the best, most comprehensive reporting on this opaque industry, we want to hear from more of the people who know it best. Do you work for a tribal lending operation, either on a reservation or for an outside business partner? Do you belong to a tribe that participates in this lending or one that has rejected the industry? Are you a regulator or lawyer dealing with these issues? Have you borrowed from a tribal lender? All perspectives matter to us. Please get in touch with Megan O’Matz at megan.omatz@propublica.org or 954-873-7576, or Joel Jacobs at joel.jacobs@propublica.org or 917-512-0297. Visit propublica.org/tips for information on secure communication channels.

Mariam Elba contributed research.

by A.C. Thompson, James Bandler and Brandon Roberts

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

This story is part of a collaboration between FRONTLINE and ProPublica that includes an upcoming documentary.

The recent crackdown on the social media platform Telegram has triggered waves of panic among the neo-Nazis who have made the app their headquarters for posting hate and planning violence.

“Shut It Down,” one person posted in a white supremacist chat on Tuesday, hours after Telegram founder Pavel Durov announced he would begin sharing some users’ identifying information with law enforcement.

With over 900 million users around the globe, Telegram has been both revered and reviled for its hands-off approach to moderating posted content. The platform made headlines this summer when French authorities arrested Durov, seeking to hold him responsible for illegal activity that has been conducted or facilitated on the platform — including organized drug trafficking, child pornography and fraud.

Durov has called the charges “misguided.” But he acknowledged that criminals have abused the platform and promised in a Telegram post to “significantly improve things in this regard.” Durov’s announcement marked a considerable policy shift: He said Telegram will now share the IP addresses and phone numbers of users who violate the platform’s rules with authorities “in response to valid legal requests.”

This was the second time in weeks that extremists had called on their brethren to abandon Telegram. The first flurry of panic followed indictments by the Justice Department of two alleged leaders of the Terrorgram Collective, a group of white supremacists accused of inciting others on the platform to commit racist killings.

“EVERYONE LEAVE CHAT,” posted the administrator of a group chat allied with the Terrorgram Collective the day the indictments were announced.

An analysis by ProPublica and FRONTLINE, however, shows that despite the wave of early panic, users didn’t initially leave the platform. Instead there was a surge in activity on Terrorgram-aligned channels and chats, as allies of the group tried to rally support for their comrades in custody, railed against the government’s actions and sought to oust users they believed to be federal agents.

Federal prosecutors in the U.S. have charged Dallas Humber and Matthew Allison, two alleged leaders of the Terrorgram Collective, with a slew of felonies including soliciting the murder of government officials on Telegram.

Humber has pleaded not guilty. She made a brief appearance in federal court in Sacramento, California, on Sept. 13, during which she was denied bail. Humber, shackled and clad in orange-and-white jail garb, said nothing. Allison, who has not yet entered a plea, was arrested in Idaho but will face trial in California.

Attorneys for Humber and Allison did not respond to separate requests for comment.

The two are alleged Accelerationists, a subset of white supremacists intent on accelerating the collapse of today’s liberal democracies and replacing them with all-white ethno-states, according to the indictment.

Through a constellation of linked Telegram channels, the collective distributes books, audio recordings, videos, posters and calendars celebrating white supremacist mass murderers, such as Brenton Tarrant, who in early 2019 stormed two mosques in New Zealand and shot to death 51 Muslim worshippers.

The group explicitly aims to inspire similar attacks, offering would-be terrorists tips and tools for carrying out spectacular acts of violence and sabotage. A now-defunct channel allegedly run by Humber, for example, featured instructions on how to make a vast array of potent explosives. After their arrests, channels allegedly run by Humber and Allison went silent.

But within days of the indictments, an anonymous Telegram user had set up a new channel “dedicated to updates about their situation.”

“I understand that some people may not like these two, however, their arrests and possible prosecution affects all of us,” the user wrote. The criminal case, they argued, “shows us that Telegram is under attack globally.”

The channel referred to Humber and Allison by their alleged Telegram usernames, Ryder_Returns and Btc.

A long-running neo-Nazi channel with more than 13,000 subscribers posted a lengthy screed. “We are very sad to hear of the egregious overreach of government powers with these arrests,” stated the poster, who used coded language to suggest that white supremacists should forcefully overthrow the U.S. government.

One group closely aligned with the Terrorgram Collective warned like-minded followers that federal agents could be lurking. In a post, it said that it had been in contact with Humber since her arrest, and that she gave them information about an undercover FBI agent who had infiltrated the Accelerationist scene.

“If this person is in your chats, remove them,” said one post, referring to the supposed agent. “Don’t threaten them. Don’t say anything to them. Just remove them from contacts and chats.”

Matthew Kriner, managing director of the Accelerationism Research Consortium, said the Terrorgram Collective had already been badly weakened by a string of arrests in the U.S., Europe and Canada over the past two years. “Overall, the arrests of Humber and Allison are likely the final blow to the Terrorgram Collective,” Kriner said.

In the U.S., federal agents this year have arrested at least two individuals who were allegedly inspired by the group. The first was Alexander Lightner, a 26-year-old construction worker who was apprehended in January during a raid on his Florida home. In a series of Telegram posts, Lightner said he planned to commit a racially or ethnically motivated mass killing, according to prosecutors. Court records show that agents found a manual produced by the Terrorgram Collective and a copy of “Mein Kampf” in Lightner’s home.

Lightner has pleaded not guilty to charges of making online threats and possessing an illegal handgun silencer. His attorney declined to comment.

This summer, prosecutors charged Andrew Takhistov of New Jersey with soliciting an individual to destroy a power plant. Takhistov allegedly shared a PDF copy of a different Terrorgram publication with an undercover agent. The 261-page manual includes detailed instructions for building explosives and encourages readers to destabilize society through murder and industrial sabotage. Takhistov has not yet entered a plea. His attorney did not respond to a request for comment.

Durov’s August arrest also sent a spasm of fear through the extremist scene. “It’s over,” one user of a white supremacist chat group declared.

“Does this mean I have to Nuke my Telegram account?” asked another member of the group. “I just got on.”

Their concerns grew when Telegram removed language from its FAQ page stating that the company would not comply with law enforcement requests regarding users in private Telegram chats.

Alarmed, Accelerationists on Telegram discussed the feasibility of finding another online sanctuary. Some considered the messaging service Signal, but others warned it was likely controlled by U.S. intelligence agencies. One post suggested users migrate to more obscure encrypted messaging apps like Briar and Session.

In extremist circles, there was more discussion about fleeing Telegram after Durov’s announcement this week. “Time is running out on this sinking ship,” wrote one user. “So we’re ditching Telegram?” asked another.

“Every time we have a success against one of them, they learn, they adapt, they modify,” said Don Robinson, who as an FBI agent conducted infiltration operations against white supremacists. “Extremists can simply pick up and move to a new platform once they are de-platformed for content abuses. This leaves law enforcement and intelligence agencies playing an endless game of Whac-a-Mole to identify where the next threat may be coming from.”

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by Brett Murphy

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The U.S. government’s two foremost authorities on humanitarian assistance concluded this spring that Israel had deliberately blocked deliveries of food and medicine into Gaza.

The U.S. Agency for International Development delivered its assessment to Secretary of State Antony Blinken and the State Department’s refugees bureau made its stance known to top diplomats in late April. Their conclusion was explosive because U.S. law requires the government to cut off weapons shipments to countries that prevent the delivery of U.S.-backed humanitarian aid. Israel has been largely dependent on American bombs and other weapons in Gaza since Hamas’ Oct. 7 attacks.

But Blinken and the administration of President Joe Biden did not accept either finding. Days later, on May 10, Blinken delivered a carefully worded statement to Congress that said, “We do not currently assess that the Israeli government is prohibiting or otherwise restricting the transport or delivery of U.S. humanitarian assistance.”

Prior to his report, USAID had sent Blinken a detailed 17-page memo on Israel’s conduct. The memo described instances of Israeli interference with aid efforts, including killing aid workers, razing agricultural structures, bombing ambulances and hospitals, sitting on supply depots and routinely turning away trucks full of food and medicine.

Lifesaving food was stockpiled less than 30 miles across the border in an Israeli port, including enough flour to feed about 1.5 million Palestinians for five months, according to the memo. But in February the Israeli government had prohibited the transfer of flour, saying its recipient was the United Nations’ Palestinian branch that had been accused of having ties with Hamas.

Separately, the head of the State Department’s Bureau of Population, Refugees and Migration had also determined that Israel was blocking humanitarian aid and that the Foreign Assistance Act should be triggered to freeze almost $830 million in taxpayer dollars earmarked for weapons and bombs to Israel, according to emails obtained by ProPublica.

The U.N. has declared a famine in parts of Gaza. The world’s leading independent panel of aid experts found that nearly half of the Palestinians in the enclave are struggling with hunger. Many go days without eating. Local authorities say dozens of children have starved to death — likely a significant undercount. Health care workers are battling a lack of immunizations compounded by a sanitation crisis. Last month, a little boy became Gaza’s first confirmed case of polio in 25 years.

The USAID officials wrote that because of Israel’s behavior, the U.S. should pause additional arms sales to the country. ProPublica obtained a copy of the agency’s April memo along with the list of evidence that the officials cited to back up their findings.

USAID, which is led by longtime diplomat Samantha Power, said the looming famine in Gaza was the result of Israel’s “arbitrary denial, restriction, and impediments of U.S. humanitarian assistance,” according to the memo. It also acknowledged Hamas had played a role in the humanitarian crisis. USAID, which receives overall policy guidance from the secretary of state, is an independent agency responsible for international development and disaster relief. The agency had for months tried and failed to deliver enough food and medicine to a starving and desperate Palestinian population.

It is, USAID concluded, “one of the worst humanitarian catastrophes in the world.”

In response to detailed questions for this story, the State Department said that it had pressured the Israelis to increase the flow of aid. “As we made clear in May when [our] report was released, the US had deep concerns during the period since October 7 about action and inaction by Israel that contributed to a lack of sustained delivery of needed humanitarian assistance,” a spokesperson wrote. “Israel subsequently took steps to facilitate increased humanitarian access and aid flow into Gaza.”

Government experts and human rights advocates said while the State Department may have secured a number of important commitments from the Israelis, the level of aid going to Palestinians is as inadequate as when the two determinations were reached. “The implication that the humanitarian situation has markedly improved in Gaza is a farce,” said Scott Paul, an associate director at Oxfam. “The emergence of polio in the last couple months tells you all that you need to know.”

The USAID memo was an indication of a deep rift within the Biden administration on the issue of military aid to Israel. In March, the U.S. ambassador to Israel, Jack Lew, sent Blinken a cable arguing that Israel’s war cabinet, which includes Prime Minister Benjamin Netanyahu and Defense Minister Yoav Gallant, should be trusted to facilitate aid shipments to the Palestinians.

Lew acknowledged that “other parts of the Israeli government have tried to impede the movement of [humanitarian assistance,]” according to a copy of his cable obtained by ProPublica. But he recommended continuing to provide military assistance because he had “assessed that Israel will not arbitrarily deny, restrict, or otherwise impede U.S. provided or supported” shipments of food and medicine.

Lew said Israeli officials regularly cite “overwhelming negative Israeli public opinion against” allowing aid to the Palestinians, “especially when Hamas seizes portions of it and when hostages remain in Gaza.” The Israeli government did not respond to a request for comment but has said in the past that it follows the laws of war, unlike Hamas.

In the months leading up to that cable, Lew had been told repeatedly about instances of the Israelis blocking humanitarian assistance, according to four U.S. officials familiar with the embassy operations but, like others quoted in this story, not authorized to speak about them. “No other nation has ever provided so much humanitarian assistance to their enemies,” Lew responded to subordinates at the time, according to two of the officials, who said the comments drew widespread consternation.

“That put people over the edge,” one of the officials told ProPublica. “He’d be a great spokesperson for the Israeli government.”

A second official said Lew had access to the same information as USAID leaders in Washington, in addition to evidence collected by the local State Department diplomats working in Jerusalem. “But his instincts are to defend Israel,” said a third official.

“Ambassador Lew has been at the forefront of the United States’ work to increase the flow of humanitarian assistance to Gaza, as well as diplomatic efforts to reach a ceasefire agreement that would secure the release of hostages, alleviate the suffering of Palestinians in Gaza, and bring an end to the conflict,” the State Department spokesperson wrote.

The question of whether Israel was impeding humanitarian aid has garnered widespread attention. Before Blinken’s statement to Congress, Reuters reported concerns from USAID about the death toll in Gaza, which now stands at about 42,000, and that some officials inside the State Department, including the refugees bureau, had warned him that the Israelis’ assurances were not credible. The existence of USAID’s memo, Lew’s cable and their broad conclusions were also previously reported.

But the full accounting of USAID’s evidence, the determination of the refugees bureau in April and the statements from experts at the embassy — along with Lew’s decision to undermine them — reveal new aspects of the striking split within the Biden administration and how the highest-ranking American diplomats have justified his policy of continuing to flood Israel with arms over the objections of their own experts.

Stacy Gilbert, a former senior civil military adviser in the refugees bureau who had been working on drafts of Blinken’s report to Congress, resigned over the language in the final version. “There is abundant evidence showing Israel is responsible for blocking aid,” she wrote in a statement shortly after leaving, which The Washington Post and other outlets reported on. “To deny this is absurd and shameful.

“That report and its flagrant untruths will haunt us.”

The State Department’s headquarters in Washington did not always welcome that kind of information from U.S. experts on the ground, according to a person familiar with the embassy operations. That was especially true when experts reported the small number of aid trucks being allowed in.

“A lot of times they would not accept it because it was lower than what the Israelis said,” the person told ProPublica. “The sentiment from Washington was, ‘We want to see the aid increasing because Israel told us it would.’”

Aid trucks wait in Egypt at the border with Gaza on Sept. 9. (AFP/Getty Images)

While Israel has its own arms industry, the country relies heavily on American jets, bombs and other weapons in Gaza. Since October, the U.S. has shipped more than 50,000 tons of weaponry, which the Israeli military says has been “crucial for sustaining” the Israel Defense Forces’ “operational capabilities during the ongoing war.”

The U.S. gives the Israeli government about $3.8 billion every year as a baseline and significantly more during wartime — money the Israelis use to buy American-made bombs and equipment. Congress and the executive branch have imposed legal guardrails on how Israel and other partners can use that money.

One of them is the Foreign Assistance Act. The humanitarian aid portion of the law is known as 620I, which dates back to Turkey’s embargo of Armenia during the 1990s. That part of the law has never been widely implemented. But this year, advocacy groups and some Democrats in Congress brought it out of obscurity and called for Biden to use 620I to pressure the Israelis to allow aid freely into Gaza.

In response, the Biden administration announced a policy called the National Security Memorandum, or NSM-20, to require the State Department to vet Israel’s assurances about whether it was blocking aid and then report its findings to lawmakers. If Blinken determined the Israelis were not facilitating aid and were instead arbitrarily restricting it, then the government would be required by the law to halt military assistance.

Blinken submitted the agency’s official position on May 10, siding with Lew, which meant that the military support would continue.

In a statement that same day, Sen. Chris Van Hollen, D-Md., criticized the administration for choosing “to disregard the requirements of NSM-20.”

“Whether or not Israel is at this moment complying with international standards with respect to facilitating humanitarian assistance to desperate, starving citizens may be debatable,” Van Hollen said. “What is undeniable — for those who don’t look the other way — is that it has repeatedly violated those standards over the last 7 months.”

As of early March, at least 930 trucks full of food, medicine and other supplies were stuck in Egypt awaiting approval from the Israelis, according to USAID’s memo.

The officials wrote that the Israeli government frequently blocks aid by imposing bureaucratic delays. The Israelis took weeks or months to respond to humanitarian groups that had submitted specific items to be approved for passage past government checkpoints. Israel would then often deny those submissions outright or accept them some days but not others. The Israeli government “doesn’t provide justification, issues blanket rejections, or cites arbitrary factors for the denial of certain items,” the memo said.

Israeli officials told State Department attorneys that the Israeli government has “scaled up its security check capacity and asserted that it imposes no limits on the number of trucks that can be inspected and enter Gaza,” according to a separate memo sent to Blinken and obtained by ProPublica. Those officials blamed most of the holdups on the humanitarian groups for not having enough capacity to get food and medicine in. USAID and State Department experts who work directly with those groups say that is not true.

In separate emails obtained by ProPublica, aid officials identified items in trucks that were banned by the Israelis, including emergency shelter gear, solar lamps, cooking stoves and desalination kits, because they were deemed “dual use,” which means Hamas could co-opt the materials. Some of the trucks that were turned away had also been carrying American-funded items like hygiene kits, the emails show.

In its memo to Blinken, USAID also cited numerous publicly reported incidents in which aid facilities and workers were hit by Israeli airstrikes even sometimes after they had shared their locations with the IDF and received approval, a process known as “deconfliction.” The Israeli government has maintained that most of those incidents were mistakes.

USAID found the Israelis often promised to take adequate measures to prevent such incidents but frequently failed to follow through. On Nov. 18, for instance, a convoy of aid workers was trying to evacuate along a route assigned to them by the IDF. The convoy was denied permission to cross a military checkpoint — despite previous IDF authorization.

Then, while en route back to their facility, the IDF opened fire on the aid workers, killing two of them.

Inside the State Department and ahead of Blinken’s report to Congress, some of the agency’s highest-ranking officials had a separate exchange about whether Israel was blocking humanitarian aid. ProPublica obtained an email thread documenting the episode.

On April 17, a Department of Defense official reached out to Mira Resnick, a deputy assistant secretary at the State Department who has been described as the agency’s driving force behind arms sales to Israel and other partners this year. The official alerted Resnick to the fact that there was about $827 million in U.S. taxpayer dollars sitting in limbo.

Resnick turned to the Counselor of the State Department and said, “We need to be able to move the rest of the” financing so that Israel could pay off bills for past weapons purchases. The financing she referenced came from American tax dollars.

The counselor, one of the highest posts at the agency, agreed with Resnick. “I think we need to move these funds,” he wrote.

But there was a hurdle, according to the agency’s top attorney: All the relevant bureaus inside the State Department would need to sign off on and agree that Israel was not preventing humanitarian aid shipments. “The principal thing we would need to see is that no bureau currently assesses that the restriction in 620i is triggered,” Richard Visek, the agency’s acting legal adviser, wrote.

The bureaus started to fall in line. The Middle East and human rights divisions agreed and determined the law hadn’t been triggered, “in light of Netanyahu’s commitments and the steps Israel has announced so far,” while noting that they still have “significant concerns about Israeli actions.”

By April 25, all had signed off but one. The Bureau of Population, Refugees and Migration was the holdout. That was notable because the bureau had among the most firsthand knowledge of the situation after months of working closely with USAID and humanitarian groups to try to get food and medicine to the Palestinians.

“While we agree there have been positive steps on some commitments related to humanitarian assistance, we continue to assess that the facts on the ground indicate U.S. humanitarian assistance is being restricted,” an official in the bureau wrote to the group.

It was a potentially explosive stance to take. One of Resnick’s subordinates in the arms transfer bureau replied and asked for clarification: “Is PRM saying 620I has been triggered for Israel?”

Yes, replied Julieta Valls Noyes, its assistant secretary, that was indeed the bureau’s view. In her email, she cited a meeting from the previous day between Blinken’s deputy secretary and other top aides in the administration. All the bureaus on the email thread had provided talking points to the deputy secretary, including one that said Israel had “failed to meet most of its commitments to the president.” (None of these officials responded to a request for comment.)

But, after a series of in-person conversations, Valls Noyes backed down, according to a person familiar with the episode. When asked during a staff meeting later why she had punted on the issue, Valls Noyes replied, “There will be other opportunities,” the person said.

The financing appears to have ultimately gone through.

Less than two weeks later, Blinken delivered his report to Congress.

Do you have information about how the U.S. arms foreign partners? Contact Brett Murphy on Signal at 508-523-5195 or by email at brett.murphy@propublica.org.

Mariam Elba contributed research.

by Ziva Branstetter

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The Georgia hospital that failed to save Amber Thurman may have broken a federal law when doctors there waited 20 hours to perform a procedure criminalized by the state’s abortion ban, according to Sen. Ron Wyden, chair of the Senate Finance Committee.

The Emergency Medical Treatment and Labor Act, or EMTALA, requires hospitals to provide emergency care to stabilize patients who need it — or transfer them to a hospital that can. Passed nearly four decades ago, the law applies to any hospital with an emergency department and that accepts Medicare funding, which includes the one Thurman went to, Piedmont Henry in suburban Atlanta. The finance committee has authority over the regulatory agency that enforces the law.

In a letter sent Monday, Wyden, an Oregon Democrat, cites ProPublica’s investigation into Thurman’s death, which was found preventable by a state committee of maternal health experts. The senator’s letter asks Piedmont CEO David Kent whether the hospital has delayed or denied emergency care to pregnant patients since Georgia’s abortion ban went into effect. (Kent did not respond to requests for comment.)

“It is my duty to conduct oversight of potential violations of patients’ rights under these laws,” Wyden wrote. The senator asked for the hospital’s policies covering treatment of patients with emergencies that require abortion care. He also asked for a list of personnel involved in making those decisions. He gave the hospital a deadline of Oct. 24 to provide those and other requested records and answers.

Wyden sent the same letter citing ProPublica’s reporting on Thurman to seven hospitals in North Carolina, Florida, Missouri, Louisiana and Texas. One letter seeks information from a Texas hospital where Yeniifer Alvarez-Estrada Glick died in 2022 from complications of pregnancy including hypertension, as reported by The New Yorker. Other letters seek information from hospitals where women have reportedly been turned away or experienced delayed care.

The hospitals’ answers could lead to proposed legislation or executive actions to strengthen compliance. The federal Centers for Medicare and Medicaid Services investigates complaints and can take actions including levying fines against hospitals that violate EMTALA.

Wyden’s committee plans to hold a hearing on Tuesday, saying in a news release it will “examine how Donald Trump’s successful overturn of Roe v. Wade and subsequent state abortion bans have threatened access to life-saving medical care for women nationwide.”

Piedmont did not respond to multiple requests seeking comment about Wyden’s letter or whether it is aware of an investigation into an EMTALA violation. Doctors who handled Thurman’s care have previously declined to explain their thinking and did not respond to questions from ProPublica.

A spokesperson for the U.S. Department of Health and Human Services, which oversees the regulatory agency that enforces the law, said in an email: “No woman or her family should have to worry that she could be denied life-saving treatment. While we can’t comment on complaints or investigations, we are committed to ensuring that every woman gets the care she needs.”

But some hospitals in abortion-ban states continue to deny or delay emergency care to pregnant women.

A recent Associated Press review of federal investigations found that more than 100 pregnant women in medical distress who sought help from emergency rooms were turned away or treated negligently since 2022, when the Supreme Court overturned Roe v. Wade. Last year, a federal investigation found that hospitals in Missouri and Kansas involved in the care of a patient, Mylissa Farmer, violated the law.

Vice President Kamala Harris has singled out Thurman’s case as evidence that a national law is needed to restore the right to abortion. Harris’ office didn’t respond to ProPublica’s questions about what federal actions she might pursue as president apart from signing a law, which would have to be passed by a divided Congress.

Former President Donald Trump has bragged about appointing three Supreme Court justices who voted to overturn Roe. Project 2025, the controversial playbook and policy agenda for a right-wing presidential administration, calls for doing away with Biden administration guidance that EMTALA requires hospitals to provide abortion care in emergency situations, even in states that ban it, or transfer the patients to a hospital that can provide the needed care.

Trump’s campaign pointed to previous statements by the former president that Project 2025 does not represent his plans for a second term. Leavitt said the former president “has always supported exceptions for rape, incest and the life of the mother, which Georgia’s law provides. With those exceptions in place, it’s unclear why doctors did not swiftly act to protect Amber Thurman’s life.”

Georgia Gov. Brian Kemp, too, has said his state’s six-week ban has clear exceptions to protect the “life of the mother.” In a statement, he blamed “partisan activists and so-called journalists” for spreading “misinformation and propaganda that fostered a culture of fear and confusion.”

But doctors have warned for years that these laws use language not rooted in science and begged for clearer exceptions. The confusion is apparent: In the wake of the bans, some hospitals have refused to even issue written policies informing doctors when and how to provide emergency abortions.

Legal reproductive rights scholars told ProPublica they believe Thurman’s treatment is a clear violation of EMTALA.

“It’s not even a question,” said Sara Rosenbaum, a George Washington University health law and policy professor and former adviser to President Bill Clinton. She helped develop EMTALA while at the Children’s Defense Fund. “I think the hospital, like all hospitals in these situations, is caught between violating EMTALA and state prosecution,” she said.

Thurman was rushed to the hospital on Aug. 18, 2022, in need of immediate care. Days earlier, she had taken abortion medication to end her pregnancy but was facing a rare complication: Some of the tissue remained inside her body, causing a grave infection.

To clear the infected tissue, she needed a dilation and curettage, or D&C, a procedure used to empty the uterus for both abortions and routine miscarriage care. Medically speaking, Thurman’s pregnancy had already ended. But the state’s abortion ban had criminalized performing a D&C and threatened doctors with up to 10 years in prison if prosecutors decided they violated it.

Records obtained by ProPublica show doctors discussed the procedure at least twice as Thurman’s condition deteriorated over 20 hours. Experts on the state maternal mortality review committee agreed there was a “good chance” Thurman would have survived if the D&C was provided sooner.

After the Supreme Court overturned the constitutional right to abortion, the federal government reminded hospitals and doctors they had to follow EMTALA and provide abortion procedures to patients if necessary in emergency situations, regardless of abortion bans. Some Republican officials have aggressively pushed back and said hospitals do not need to follow EMTALA, even for high-risk situations.

In Texas, Attorney General Ken Paxton threatened to prosecute a doctor for providing an emergency abortion to a woman with a high-risk pregnancy, whose fetus had a fatal anomaly and whose pregnancy threatened her health and future ability to have children.

He argued in court that she did not meet the state ban’s criteria. He also filed a lawsuit arguing the federal government cannot force Texas to follow the guidance on providing emergency abortions to patients.

In an opinion written by a Trump-appointed judge, a federal appeals panel agreed. That means enforcement of EMTALA in emergency abortion cases is barred in that state.

The Supreme Court last summer considered a lawsuit brought by the Biden administration challenging Idaho’s abortion ban, which lacks health exceptions and appears to conflict with EMTALA. A lawyer for the state acknowledged that Idaho’s abortion ban was written to prevent doctors from offering abortions even if the woman could suffer a serious medical complication like losing an organ.

Conservative justices in that case raised arguments about the rights of the fetus. The court issued a ruling that meant the case would be returned to a lower court, which upheld EMTALA while the case continues.

Rosenbaum said the federal government is not doing enough to require hospitals to follow EMTALA in states that banned abortion: “The federal government has no resources. It was only recently that the Biden administration has made it clear how to file complaints. The complaints go uninvestigated or poorly investigated.”

Wyden’s letters sum up the perilous landscape for patients and doctors.

“Across the country, there are reports that women are being turned away by emergency departments when they seek emergency reproductive health care, even in instances where medical professionals determine that, without such care, the patient is at risk of serious complications, infection, or even death. These women are caught between dangerous state laws that are in clear conflict with — and preempted by — EMTALA.”

On Tuesday, Thurman’s sister, Cjauna Williams, visited Thurman’s grave near Atlanta. She arrived to find fresh flowers and birthday balloons left there by people she and her family had never met. Thurman would have turned 31 the day before, and the story of her desperate wait for the medical care she needed had reverberated across the country.

“Hopefully her death won’t be in vain and something good can come of it,” Williams said.

Kavitha Surana and Nydia Blas contributed reporting. Cassandra Jaramillo, Mariam Elba, Jeff Ernsthausen and Kirsten Berg contributed research.

by Eli Sanders for ProPublica, illustrations by Michael Haddid, special to ProPublica

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For headline-grabbing drama, few Supreme Court decisions could equal the justices’ July ruling that former presidents are immune from criminal prosecution for virtually all of their official acts. But a decision in the seemingly humdrum realm of administrative law could end up having far broader consequences, affecting vast areas of American life by slashing the power of federal regulatory agencies that police pollution, food safety, health care and countless other aspects of modern society.

Lower court judges have already cited the Supreme Court’s 6-3 decision, in a case known as Loper Bright, to halt implementation of Biden administration rules on overtime pay and health care discrimination. In the past three months, Loper Bright also has been invoked to challenge regulations on everything from hidden airline fees to gun sales to abortion referrals.

Justice Neil Gorsuch, who was part of the conservative majority in Loper Bright, described it as placing “a tombstone” on a doctrine that had existed for 40 years. That doctrine, known as Chevron deference, was named after the 1984 Supreme Court case in which it emerged, and it offered an answer to a recurring question: What happens when Congress passes a law granting power to a federal agency but fails to precisely define the boundaries of that power?

In such situations, the doctrine of Chevron deference instructed federal judges to rely on the interpretations made by federal agencies, as long as those interpretations were reasonable, since agencies typically have greater expertise in their subject areas than judges. The Loper Bright decision erased that, commanding federal judges to “exercise their independent judgment in deciding whether an agency has acted within its statutory authority.”

Dissenting, Justice Elena Kagan noted that federal courts had cited Chevron deference 18,000 times, making it “part of the warp and woof of modern government, supporting regulatory efforts of all kinds — to name a few, keeping air and water clean, food and drugs safe, and financial markets honest.” She warned of “large-scale disruption.”

Legal experts view Loper Bright as a major transfer of power from agencies to judges. “You have incredibly technical areas of law for which the U.S. Supreme Court in Loper Bright has now paved a path for individual judges, or panels of three judges, to make decisions without having the technical expertise,” said Sanne Knudsen, a professor at the University of Washington School of Law, whose scholarship on deference doctrines has been cited by the Supreme Court.

Critics of the Chevron doctrine argued that letting agencies make legal interpretations led to constant uncertainty, with each presidential administration appointing new agency leaders who theoretically could change their interpretation of the law. But critics of the Loper Bright ruling counter that the same risk exists today — at the hands of judges rather than regulators.

Dan Weiner, director for elections and government at the Brennan Center for Justice, sees Loper Bright as the capstone of a series of recent Supreme Court rulings that limit agency power. Weiner called it the “culmination of a broader project to just cut the legs out from under government as we’ve known it since the New Deal.”

In theory, Congress could respond by writing more detailed legislation when it comes to federal agency power. But in the current political landscape, Knudsen said, that’s unlikely. As she put it, “cases like Loper Bright put more power in the hands of individual judges to decide policy questions, taking them further from the hands of the experts that Congress has otherwise delegated power to.”

Loper Bright has been celebrated by foes of regulation. The decision “gives us the thunder and lightning we need to beat back the aggressive anti-gun agenda of the rogue Biden Administration,” Gun Owners of America exulted in a press release after the ruling.

The advocacy group Democracy Forward counted 110 federal cases in which parties or judges have cited Loper Bright as of Sept. 6 — and that figure will only rise in the coming months and years. Here are some of the most consequential pending cases.

Labor Who is eligible for overtime pay?

It took only hours for the decision to ripple into a lower court. On June 28, the day Loper Bright was announced, a federal judge in Texas issued a preliminary injunction against a new Department of Labor rule expanding eligibility for overtime pay. The judge blocked the rule from being enforced against the state of Texas as an employer, explaining that his decision “carefully follows Loper Bright’s controlling guidance.”

Among other things, the regulation seeks to prevent employers from deeming someone an “executive,” and thus exempt from overtime pay, if that person’s salary is below $43,888 (or below $58,656 next year). “Too often, lower-paid salaried workers are doing the same job as their hourly counterparts but are spending more time away from their families for no additional pay,” acting Secretary of Labor Julie Su said when the regulation was announced in April. “That is unacceptable.”

Texas challenged the rule, arguing the DOL had exceeded the authority granted by Congress in the Fair Labor Standards Act; the judge wrote that he expects to reach a final decision “in a matter of months.”

Health Care Does Obamacare protect transgender people from discrimination?

On July 3, three federal judges in different states, all citing Loper Bright, issued orders blocking implementation of a new rule from the Department of Health and Human Services that would prohibit discrimination in health care based on gender identity.

Mary Rouvelas, legal advocacy director for the American Cancer Society Cancer Action Network, said her group had supported the regulation because “nondiscrimination is critical for LGBTQ individuals, who suffer a disproportionate cancer burden.” However, the rule had become “a political football” amid debates over gender affirming care, Rouvelas said, and under Loper Bright federal judges no longer had to defer to HHS’ determination that gender identity is protected under the Affordable Care Act, which prohibits discrimination “on the basis of sex” but does not use the phrase “gender identity.”

Fifteen states sued in Mississippi federal court, arguing that HHS overstepped its authority. The states claimed the rule would force them to “use taxpayer funds to pay for unproven and costly gender-transition interventions through Medicaid and state health plans — even for children who may suffer irreversible harms.” District Judge Louis Guirola Jr. issued a nationwide injunction against the rule. The case will continue while the regulation is on hold, as will similar cases in Texas and Florida.

Transportation Can a federal agency force airlines to reveal fees?

The Department of Transportation issued a rule in April that requires airlines to, in the words of Secretary Pete Buttigieg, “inform you, before you buy a ticket, of fees they will charge you.” The rule specifies that baggage, change and cancellation fees must be disclosed the first time an airline quotes a price to a customer. At present, according to DOT court filings, “surprise costs” cause consumers to “overpay by half a billion dollars annually.”

In May, a group of airlines sued to stop the rule, claiming that the DOT exceeded its authority. According to the airlines, the agency can order them to halt unfair or deceptive practices after they’ve occurred, but it cannot tell them what their practices should be going forward. The airlines sought a stay. The DOT counters that its new regulation is based on “well-established” legal authority.

On July 1 — the Monday following the Friday issuance of the Loper Bright ruling — lawyers for the airlines cited the case, telling the 5th U.S. Circuit Court of Appeals that “resolving this statutory-interpretation issue is a task for this Court, especially because, with Chevron overruled, only courts have ‘the power to authoritatively interpret the statute.’”

At the end of July, a panel of three 5th Circuit judges stayed the rule, concluding that the airlines had “made a strong showing that the Rule exceeds the agency’s authority.” They placed the case on an expedited path toward a final determination of whether the rule should be struck down.

Employment Can the FTC ban agreements that prohibit employees from joining a rival company?

In April, after six years of study, the Federal Trade Commission issued a rule banning noncompete agreements, which restrict workers from accepting employment with competitors for a period of time after leaving their current jobs. The FTC determined the rule was needed because such contracts impair “the fundamental freedom of workers to change jobs,” harm innovation and are “often exploitative.” Of the more than 26,000 comments the agency had received about the proposed ban, over 25,000 were supportive, the FTC said. A group of plaintiffs that includes the U.S. Chamber of Commerce filed suit in federal court in Texas, arguing the FTC had exceeded its authority.

On Aug. 20, citing Loper Bright, the judge in this case agreed with the plaintiffs and issued a final order that set aside the ban on noncompetes, declaring that the FTC had “promulgated the Non-Compete Rule in excess of its statutory authority.” The Chamber of Commerce called it a “significant win” in the group’s “fight against government micromanagement of business decisions.” An FTC spokesperson told ProPublica that the agency is “seriously considering a potential appeal” and added that the “decision does not prevent the FTC from addressing noncompetes through case-by-base enforcement actions.”

Guns Can the government require background checks for firearms sold at gun shows?

In April, the Bureau of Alcohol, Tobacco, Firearms and Explosives issued a rule that would close a loophole through which guns are sold without background checks online and at gun shows. Attorney General Merrick Garland called it “one of the most significant gun regulations in decades.” Under the rule, he said: “It does not matter if guns are sold on the internet, at a gun show or at a brick-and-mortar store. If someone sells a gun predominantly to earn a profit, they must be licensed, and they must conduct a background check to ensure that the buyer is not barred by law from having a gun.”

In May, 21 states sued to block the regulation in federal court in Arkansas. The complaint noted that the Supreme Court would soon be hearing arguments in Loper Bright and contended the ATF had exceeded its authority in adopting the rule.

Another group of plaintiffs filed suit in the Northern District of Texas, also seeking to block the ATF rule. Those plaintiffs include the states of Texas, Louisiana, Mississippi and Utah, as well as Gun Owners of America, which has called the rule “tyrannical.” On June 11, weeks before Loper Bright was decided, the judge in the Texas case, Matthew Kacsmaryk, issued a preliminary injunction banning enforcement of the rule against any of the plaintiffs in the Texas case. Kacsmaryk based his decision in part on his belief that the plaintiffs would likely succeed in proving, in further proceedings, that the ATF had exceeded its authority. The Justice Department appealed the preliminary injunction to the 5th Circuit.

On July 10, less than two weeks after the Loper Bright decision, the judge in Arkansas went the opposite direction from the judge in Texas, denying the request from the 21 other states that he block the ATF rule closing the gun-show loophole. In doing this, the Arkansas judge cited a passage in Loper Bright that he views as supporting the ATF’s authority to close the loophole.

Much remains to be argued in the Texas and Arkansas lawsuits; both injunction rulings are being appealed on multiple grounds. But the Arkansas judge’s use of Loper Bright to support an agency’s authority to regulate highlights the still-unsettled nature of the high court’s pronouncements in Loper Bright. As the U.S. Chamber of Commerce noted, there is a need for lower courts to “interpret” certain aspects of the decision going forward.

Abortion Can federal aid for family planning be withheld from states that prohibit abortion?

In 2021, HHS issued a rule related to Title X grants, which have existed since 1970 and are intended to fund family planning programs. This rule, as described by the 6th U.S. Circuit Court of Appeals, requires states receiving Title X grants to “provide neutral, nondirective counseling and referrals for abortions to patients who request it.” Tennessee had received Title X grants for more than 50 years. But after the Supreme Court overturned Roe v. Wade in 2022, Tennessee banned abortions with exceptions only to “prevent the death of the pregnant woman or prevent serious risk of substantial and irreversible impairment of a major bodily function.” Tennessee said it would provide counseling and referrals only for abortions that are legal in the state. In response, HHS ended Tennessee’s Title X funding. The state sued, seeking an injunction to prevent the grant from ending and claiming that HHS exceeded its authority by requiring unbiased abortion counseling and referrals as a condition for Title X aid.

Just a year earlier, the 6th Circuit, in a similar case, had ruled that HHS did have the statutory authority to condition Title X funding in this manner. In doing so, the 6th Circuit relied on Chevron deference, finding that the new HHS regulation was based on a reasonable interpretation of this ambiguous statute. (The appeals court also cited a second precedent, a Supreme Court decision from 1991 that applied Chevron deference to the same Title X issue.)

Given the end of Chevron deference, should the 6th Circuit’s 2023 decision upholding HHS’ abortion counseling and referral rule be stripped of any precedential effect? Tennessee certainly thought so. But two judges from the 6th Circuit disagreed, pointing to a line in Loper Bright that says “we do not call into question prior cases that relied on the Chevron framework.” Therefore, the 6th Circuit reasoned, its 2023 precedent upholding HHS’ rule had withstood the death of Chevron deference and, as a result, the injunction requested by Tennessee was unwarranted. One judge on the 6th Circuit’s three-judge panel disagreed, however, citing different passages from Loper Bright to reach the opposite conclusion. The case is now continuing in the Tennessee district court where it was originally filed.

Taxes Can the FTC stop a tax-preparation company from making misleading claims?

In January, after an investigation prompted by ProPublica’s reporting, the FTC concluded that Intuit, the maker of TurboTax, used deceptive advertising to lure customers into paying for tax preparation services when they were eligible to file for free under a program sponsored by the government. Purchases by such customers generated roughly $1 billion in revenue for Intuit and other tax prep companies in 2019 alone, according to a government audit.

The FTC ordered Intuit to cease and desist from making any misleading “free” claims in its advertising. In response, Intuit appealed the FTC’s ruling to the 5th Circuit and asserted that Loper Bright had strengthened its argument for jettisoning the decision. “Whatever ‘deference’ the FTC claimed its interpretation of the FTC Act was due did not survive the Supreme Court’s intervening holding,” lawyers for the company wrote.

Intuit is also citing a recent Supreme Court decision that found the Securities and Exchange Commission can’t bring certain kinds of suits before its own administrative law judges; Intuit argues the decision, which focused on a securities fraud case in which civil penalties were sought, should apply to the FTC, too. The FTC disagrees, arguing that its action, originally brought before an FTC administrative law judge, is different from the relevant SEC action. For example, no civil penalties were involved in the action against Intuit. In a sign of how much rides on the outcome in this appeal, amicus briefs have been filed on both sides by a group of more than 20 states; numerous consumer advocate groups, including Public Citizen and the Consumer Federation of America; business groups like the U.S. Chamber of Commerce and the National Federation of Independent Business; and the libertarian Cato Institute.

Immigration Can a judge review the revocation of an immigrant’s opportunity for citizenship by marriage?

During the Supreme Court’s next term, it will hear a case involving the intricate rules for becoming a U.S. citizen through marriage. The case, Bouarfa v. Mayorkas, asks the justices to consider a very specific scenario, in which a Palestinian national married a U.S. citizen named Amina Bouarfa, who then petitioned to make her new husband eligible for citizenship through marriage. The United States Citizenship and Immigration Services approved Bouarfa’s petition but then, two years later, revoked that approval, saying the couple’s union had been “a sham marriage” for “the purpose of evading immigration laws.” The question in this case is whether that revocation is subject to judicial review.

The case also reveals an unexpected potential consequence of the Loper Bright ruling. It’s typically perceived as a victory for conservative foes of regulation, but liberals may be able to use the ruling to their advantage in certain areas. For example, in the realm of immigration, conservatives typically want more vigorous federal regulation. But in this case, liberal advocates of immigration reform are attempting to use Loper Bright to check the power of an immigration agency. “We’ll see whether the people who advanced Loper Bright might end up having a little bit of buyer’s remorse,” Weiner, of the Brennan Center for Justice, said.

Advocates for immigration reform have filed an amicus brief that supports Bouarfa’s right to judicial review by citing passages from Loper Bright. In addition, lawyers for Bouarfa have cited another major administrative law ruling last term from the Supreme Court’s conservative majority, Corner Post v. Board of Governors of the Federal Reserve, which greatly expanded the possibilities for suing federal agencies. That ruling led dissenting Justice Ketanji Brown Jackson to warn that the “tsunami of lawsuits against agencies that the Court’s holding in this case and Loper Bright have authorized has the potential to devastate the functioning of the Federal Government.”

It’s too early to say whether a legal tsunami is coming, but with the Supreme Court set to open its new term in two weeks, it’s clear that a wave is already growing.

Eli Sanders won the 2012 Pulitzer Prize for feature writing and is a recent law school graduate.

by Tony Schick, Oregon Public Broadcasting

This article was produced for ProPublica’s Local Reporting Network in partnership with Oregon Public Broadcasting and with assistance from High Country News. Sign up for Dispatches to get stories like this one as soon as they are published.

The Department of Energy gave the Confederated Tribes and Bands of the Yakama Nation what seemed like very good news earlier this year: It had won a $32 million grant for a novel solar energy project in Washington state. Built over a series of old irrigation canals, the proposed solar panels would generate electricity for tribal members without removing farm acreage from cultivation. The location would preserve the kinds of culturally sensitive land that have prompted concerns about other renewables projects.

Months after announcing the grant, the same department is making it nearly impossible for the tribal nation to access the money.

“It is because literally the feds cannot get out of their own way,” said Ray Wiseman, general manager of Yakama Power, the tribally owned utility.

The bureaucratic whiplash stems from the fact that while one part of the Energy Department hands out money for clean energy projects, another part decides which projects get access to the Northwest electrical grid. The Bonneville Power Administration’s process for approving connections comes with such exorbitant costs and is mired in such long delays that the federal grant could well expire before the tribe can touch a dime.

It’s a dilemma that persists despite the Biden administration’s explicit promise last year to help tribes create new sources of renewable power affordably and quickly.

Bonneville and the Energy Department blame the holdup on a glut of renewable energy proposals that are creating a need for massive transmission upgrades across the country. In a joint statement on behalf of Bonneville and its parent agency, Energy Department spokesperson Chris Ford said the government is required to put all energy proposals through the same process with the same costs.

But Ford added that federal agencies are “exploring different options within the law to both speed the process and reduce the costs the Yakama Nation would have to pay.”

It is because literally the feds cannot get out of their own way.

—Ray Wiseman, general manager of Yakama Power

The White House Council on Environmental Quality, which brokered the agreement pledging to help tribes build renewables, said in a statement the administration is coordinating with tribes and others in “taking action to deliver a clean, reliable electric grid and make federal permitting of new transmission lines more efficient.”

But council spokesperson Justin Weiss didn’t answer questions from Oregon Public Broadcasting and ProPublica about why the Yakama project was stalled and what specific steps the White House has taken to help speed tribal energy connections.

Renewable energy supporters say the Yakama solar case shows that if the White House can’t keep the federal bureaucracy from undermining its own goals, then it’s making promises it can’t keep.

Nancy Hirsh, who’s worked since the 1990s for a coalition that advocates for clean power in the Northwest, said the situation is exactly what she feared would happen after the tribal agreement was signed.

“This is just the thing that we need to fix,” Hirsh said, “the left hand not connected with the right hand.”

An Unprecedented Promise

The Yakama reservation in Central Washington bears the scars of the federal government’s energy policies.

Transmission lines stretching across tribal properties were built a century ago without permission. The country’s largest nuclear waste cleanup site, Hanford, has poisoned parts of the tribe’s ancestral land under the Department of Energy’s watch.

Families on the reservation were displaced from their homes along the river to make way for massive reservoirs and hydroelectric dams. Those dams nearly wiped out runs of wild salmon that are vital to Indigenous cultures and that the U.S. government swore in treaties it would preserve.

Even today, the development of renewable energy often risks encroaching on land held sacred by tribes, who have argued they are cut out of the decision-making process.

President Joe Biden seemed to offer a fresh approach to tribal sovereignty, declaring it a priority for his administration shortly after taking office in 2021.

Soon, the White House began negotiations to end a decades-old lawsuit by tribes and environmental groups who want some of the Northwest’s federal dams torn down to keep local salmon populations from going extinct.

The result of the talks was what the administration called a “historic” deal. The tribes would put their lawsuit on hold. In return, the White House promised to help tribes develop up to 3 gigawatts of renewable energy. That could power all the homes in a city roughly the size of Portland, Oregon. More significantly to the tribes, it’s enough to replace the output of the four dams on the lower Snake River deemed most detrimental to salmon.

“It will take all of us committing to this partnership now and for years to come to lift the words off the page and bring this agreement to life,” White House senior adviser John Podesta said at the signing of the agreement with Northwest tribes in February. “I want you to know that President Biden and Vice President Harris and the whole administration are committed to making that happen.”

Yakama Nation Chair Gerald Lewis also voiced hope when he signed the agreement with the Biden administration. “The last time energy was developed in the Columbia Basin, it was done on the backs of tribal communities and tribal resources,” Lewis said at the time. “Now we have an opportunity to do better.”

It will take all of us committing to this partnership now and for years to come to lift the words off the page and bring this agreement to life.

—John Podesta, White House senior adviser

The Yakama Nation’s proposal would seem to exactly fit the bill.

Its initial plan was to cover 10 miles of irrigation canals with solar panels and to outfit the canals themselves with small-scale hydroelectric turbines. That would generate enough electricity to power a few thousand homes on the reservation, which has a population of about 30,000.

In addition to avoiding the tribe’s culturally sensitive lands, the project wouldn’t encroach on any wildlife habitats. And covering the irrigation canals would shade the water so that less of it evaporates in the sun.

The Department of Energy awarded its $32 million grant for the project at the end of February. Soon after, the agency posted an interview about the plan with Lewis and Energy Secretary Jennifer Granholm on its Facebook page bearing the caption, “Sometimes, the great ideas are the ones right in front of us.”

Washington’s U.S. senators, Democrats Maria Cantwell and Patty Murray, each issued news releases announcing the grant and praising the project, saying the canals could boost water conservation by 20% and cut the reservation’s power bills by 15%.

But those ambitions quickly ran up against stark realities, according to the people directly involved in bringing the project to life.

“Everybody thinks that the federal government gave us 32 million bucks,” Wiseman, the general manager for Yakama Power, said. “They did not.”

Stuck in Bureaucracy

In its landmark accord with tribes, and in documents supporting the accord’s implementation, the White House promised more than money. It vowed to muster the full clout of the federal government to achieve the plan’s goals. Specifically, the agreement said the energy department, working with Indigenous leaders, would find “legal and regulatory options” for getting projects connected to the grid faster and for making them affordable for tribes.

That didn’t prevent the first tribal project to come along — the Yakama Nation’s — from getting caught in a snare of bureaucracy.

In addition to the grant from the Energy Department’s Office of Clean Energy Demonstrations, Yakama Power was promised a nearly $100 million rural clean energy loan from the Department of Agriculture. But it cannot access any of the federal money without first obtaining a “power purchase agreement,” which essentially offers proof that the electricity the tribal utility plans to generate has a destination.

That’s hard for the tribe to do because it can’t get a purchase agreement until its project connects to the grid, which is owned by Bonneville, itself an arm of the Energy Department. Bonneville’s earliest estimate of when it will finish studying connection requests such as the Yakama Nation’s is 2027, but the federal agency says it could be longer.

That’s just one of many steps. The tribe can’t distribute electricity from the new solar project until Bonneville completes upgrades to the section of its transmission system that serves the reservation, including the installation of a new electrical substation.

The federal agency’s estimate for what it would charge for the substation alone: $144 million. Building transmission lines to and from the new solar array would drive the cost higher still, but Bonneville hasn’t done those estimates yet. The Yakama would have to bear those costs.

The tribe had counted on some rate increases to pay for the solar array, but covering the unexpectedly high cost of the upgrade would add hundreds of dollars more to a household’s monthly utility bill, Wiseman said. That’s on a reservation where nearly 20% of residents have incomes below the poverty line.

Another financial hurdle: Inflation has driven up construction costs for the solar array itself in the two years since the project was proposed.

Even if the tribe can come up with all the extra money needed, time is working against the project. Bonneville says it will take five to seven years to build the substation after it’s paid for.

All the delays will push the tribe up against a 2031 deadline to use or lose its $32 million grant and $100 million loan. They were funded under the bipartisan infrastructure bill and the Inflation Reduction Act, which both expire that year.

Wiseman is no longer confident of how many miles of canal, if any, the utility can cover with solar panels. He’s unsure whether Yakama Power will need to opt for a much smaller solar array that lacks the specialized hardware needed to suspend the panels above the irrigation canals.

“I have serious questions about whether or not these things will survive to go forward,” Wiseman said.

The Green Energy Traffic Jam

The Yakama Nation in many ways faces the same pressures that are holding back new wind and solar farms across the country.

The surge in such projects over the past decade has jammed up the system that grid operators like Bonneville Power Administration use when evaluating requests to connect to the grid. The onslaught of green power has also taxed a grid designed to carry much less energy. And yet the new supply is badly needed to meet soaring demand, driven in part by thearrival of energy-guzzling data centers in the past decade.

Bonneville is changing the way it studies energy proposals to streamline the process. But renewable developers, advocates and industry analysts have published a white paper with a list of more than 20 recommendations that they say can create the grid the Northwest needs and that, for the most part, they say Bonneville has not addressed.

In the meantime, despite the Biden administration’s agreement last year to help tribes, their projects have not moved to the head of the line.

Hirsh’s group, the clean and affordable energy coalition, was party to the lawsuit that the tribal deal was meant to settle. She said the government’s failure to deliver on its clean energy promises “could jeopardize the agreement.”

Yakama Nation leaders say because of the long history of energy development violating tribal rights, and because reservations were set up with marginal infrastructure, the federal government should not treat tribes the way it does any other energy developer.

The Department of Energy, however, says its lawyers have yet to find a way through federal energy regulations or treaty law to let the agency deal with tribal projects differently.

Wiseman continues to incur costs on behalf of Yakama Power, planning for the solar project while doubts linger over whether all the pieces will come together in time.

“If I can’t get the transmission access that we need — whether intentional, unintentional, whatever you want to call it — Bonneville will have single-handedly killed these projects,” Wiseman said. “And that’s why at this point, I feel incredibly frustrated, because beating them up doesn’t do me any good.”

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by Jessica Lussenhop, ProPublica, and Michelle Griffith, Madison McVan and Deena Winter, Minnesota Reformer

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up for Dispatches, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.

In the spring of 2021, Minnesota Gov. Tim Walz faced multiple crises.

The trial of former Minneapolis police officer Derek Chauvin for the murder of George Floyd was coming to a close. As the one-year anniversary of Floyd’s death approached, authorities were preparing for the kind of unrest that had damaged or destroyed long stretches of the city in 2020. Meanwhile, a package of police reform bills was stalled in the divided Minnesota state Legislature.

Then, on April 11, 2021, a police officer shot and killed 20-year-old Daunte Wright during a traffic stop in the northern Minneapolis suburb of Brooklyn Center, touching off a fresh round of protests, clashes with the police, and criticism of Walz after he sent in hundreds of officers and armored vehicles that had been readied in anticipation of the trial’s aftermath.

In the midst of all this, Walz still saw an opening to bring police reform to Minnesota and provide a national model for systemic change. He feared the 2021 session would be his last, best chance to do so. But he told the Rev. Jesse Jackson, who made repeated trips to Minneapolis during the upheaval after Floyd’s death, that local politics were getting in the way.

“I wish I could report more on our progress,” Walz told Jackson in a call transcribed by a staff member. “Both you and President Obama mentioned that Minnesota should be the state that could get this right. That’s a responsibility that we have in Minnesota.”

A transcript of a conversation that Gov. Tim Walz and the Rev. Jesse Jackson had the day before the first anniversary of George Floyd’s murder. (Document obtained by Tony Webster, screenshot highlighted by ProPublica)

The clamorous close of the 2021 legislative session, and Walz’s role in trying to enact police reform in response to the police killings of Floyd and Wright, plays out in a cache of thousands of internal emails from the Walz administration obtained by ProPublica and the Minnesota Reformer. The emails were requested that summer by independent journalist Tony Webster, but the administration only recently finished turning them over. Webster shared them with the news organizations.

Though the emails are limited, covering about 11 weeks from April to June 2021, they provide a closer, more detailed look at how Walz tried to leverage his influence on the legislative process. They reveal a politician who seems to be a careful listener in one-on-one conversations with grieving mothers and Black activists, freely giving out his personal cellphone number and invitations to the governor’s mansion.

And they show how Walz struggled to balance the need for order in the streets against his credibility with activist allies, while simultaneously trying to bridge the ideological divide between progressives in his party and pro-law-enforcement conservatives.

“He likes being liked,” former state Rep. Patrick Garofalo, a Republican, said of how Walz operates. “He’s thinking about political survival, and it’s nothing more complicated than that. The guy’s not an ideologue.”

Since Vice President Kamala Harris selected Walz to be her running mate, the governor has rocketed to national prominence, praised by Democrats for his progressive “Midwestern dad” image while labeled a “dangerously liberal extremist” who wants to defund the police by Harris’ opponent, former President Donald Trump. Walz has never advocated defunding the police.

The Trump campaign has also tried to cast Walz’s response to the 2020 unrest as weak and ineffectual, despite the fact that, at the time, Trump praised Walz for deploying the National Guard, calling it a “beautiful thing to watch.”

In the end, Walz emerged from the 2021 special legislative session with a compromise bill on police reform that seemingly satisfied no one. For some Democrats, it didn’t go far enough. Many called the bill a disappointment. Some Republicans felt it went too far. The next year, facing reelection, Walz received no major law enforcement endorsements.

“He is not a radical,” said Michelle Phelps, a University of Minnesota sociology professor and author of “The Minneapolis Reckoning.” “He is, I think, a sort of a vanguard of what a more progressive, but still centrist, liberal Democratic wing of the party could look like.”

In response to questions, Teddy Tschann, a spokesperson for Walz, said in a statement that the governor “is committed to bringing people with different views and backgrounds together to find common ground and get things done.”

After Wright was killed, as demonstrations escalated outside the Brooklyn Center police station, texts streamed into Walz’s phone.

“Can you please get those cops out of there and send in the national guard?” one Democratic lawmaker texted him.

That night residents, protesters and journalists in Brooklyn Center met with members of Operation Safety Net, an aggressive coalition of Minnesota National Guard soldiers, state troopers and local police who used tear gas and flash-bangs to clear the streets. A prominent union leader texted Walz less than 24 hours later: “Escalating with tanks and national guard is not helping. You can calm the situation, but this isn’t the way.”

An attorney representing 30 national and local media organizations would later write to Walz with a detailed list of documented abuses the group said journalists were subjected to at the hands of law enforcement, warning that the state agencies under Walz’s control seemed to have no regard for the First Amendment.

Despite renewed tension and unrest, emails from Walz staffers document his outreach to members of Black activist groups and the families of people killed by police in Minnesota. On April 20, the day a jury found Chauvin guilty of murdering Floyd, Walz staff logged phone conversations with the Floyd family, the Rev. Al Sharpton and former President Barack Obama. In one phone conversation on the anniversary of Floyd’s death — a day on which Walz called for 9 minutes and 29 seconds of silence acknowledging the length of time Chauvin pressed his knee into Floyd’s neck — Walz reflected on his own “inherent racial bias.”

“I wanted to be thoughtful and be intentional around race and the murder of George Floyd. I am trying to learn this year,” he said, according to a staffer’s transcript of a call with the leader of a local foundation. “If it takes a village to raise a child, it takes a lot of villages to raise a governor.”

Walz speaks at a press conference in 2021 during a stretch of days in which he was working with the National Guard to quell unrest in the streets and reaching out to Black activist groups. (Stephen Maturen/Getty Images)

With Walz, some advocates felt acknowledged in a way that was initially refreshing.

“The governor looked me in my eyes and said, ‘John, I need you to get me some legislation,’” said Johnathon McClellan, president of the Minnesota Justice Coalition, a racial equity nonprofit that advocates for social justice reform. “He understood the protests. He understood what the people were asking for.”

Walz received a flood of advice and opinions on what the next legislative steps should be, some from less-expected entities. The Minnesota Business Partnership, a group representing the CEOs of companies like 3M and Cargill as well as other business leaders, urged Walz to advocate for training policy changes and measures to make it harder to hire police officers who’d engaged in misconduct, while stressing that the group was broadly pro-law enforcement.

“Minnesota’s reputation matters,” said Charlie Weaver, the partnership’s executive director at the time. “If we had a reputation as a hostile environment for minority workers, that’s a big problem for our large companies.”

The Walz administration leapt at the chance to arrange a meeting between lawmakers and Weaver, a former chief of staff for Republican Gov. Tim Pawlenty. “We need their help pushing key issues in the Senate,” wrote one policy adviser.

But the leadership of the Republican-controlled Senate criticized broader reform efforts as “anti-police.” Behind the scenes, according to an internal memo, the Senate agreed to just three of the dozens of proposals the Democrat-controlled House had advanced and Walz had supported.

“I wasn’t going to take things that I knew would hinder a good police officer from doing their job, and also hinder us from getting quality police in the future,” said then-Senate majority leader Paul Gazelka in an interview.

In response, Walz brokered a meeting between Gazelka and Families Supporting Families Against Police Violence. The group’s founder, Toshira Garraway, lost her fiance in 2009 after he was chased by the St. Paul police and later found dead in a bin at a recycling facility. She wanted to advocate for a bill eliminating the statute of limitations on wrongful death suits against police. (Garraway did not respond to requests for comment.) Gazelka said that the request for the meeting, coming straight from Walz, was unusual.

“I certainly was willing to do that, and did listen to them,” Gazelka said.

That meeting took place on June 3, 2021, the same day that a U.S. Marshals Service task force shot and killed Winston Smith Jr. in a parking garage in Minneapolis while trying to arrest him on an outstanding warrant. Walz’s office once again put the National Guard on notice and made repeated requests to the Biden administration to address its role in the incident and ease pressure on local authorities.

“DOJ in DC is a hard ‘no’ on doing a press conference,” staffers wrote in the days after Smith’s death. A spokesperson for the Department of Justice declined to comment.

Walz couldn’t avoid blowback, even from prominent local activists with whom he shared a cordial relationship. A letter sent by Nekima Levy Armstrong, a civil rights attorney and the founder of the Racial Justice Network who was in contact with the administration throughout the spring, demanded that Walz create an independent entity to investigate Smith’s death, criticizing the Minnesota Bureau of Criminal Apprehension as hopelessly biased. Staff from both Walz’s office and the Minnesota Department of Public Safety wrote a draft of a response that said the BCA, which investigates incidents where police kill people, had the administration’s “utmost trust and confidence.” Although Levy Armstrong could not confirm that she got the reply, the BCA retained control of the case.

Protests over Smith’s death continued until a drunk driver plowed into a group of demonstrators, killing one woman and injuring others. The next day, on June 14, the Minnesota Legislature entered a special session with no movement on police reform and the threat of a government shutdown looming over negotiations. Roughly 38,000 potential layoff notices had already been sent to state employees, and Walz and Senate and House lawmakers had two and a half weeks to come to an agreement. Republicans were particularly eager to pass a bill that would end Walz’s COVID-19-era emergency powers.

“It was very nerve-wracking,” said House Speaker Melissa Hortman, a Democrat. “There were two pressures coming for a shutdown: the Republicans were interested in shutting down the government if the governor didn’t give up his emergency powers. My caucus was interested in shutting down the government if we didn’t have some public safety reforms.”

After the first day of the special session, Walz staffers noted that Senate Republicans had “retracted policy concessions” and seemed “withdrawn from negotiations.” Around the same time, Walz policy advisers were also doing damage control after sending an email that erroneously announced that the Minnesota Justice Coalition and Families Supporting Families Against Police Violence had pared down their list of desired legislation from nine bills to four, prompting an angry press release from the groups: “WE WANT TO MAKE IT CRYSTAL CLEAR THAT WE MADE NO SUCH AGREEMENT.” Kristin Beckmann, then Walz’s deputy chief of staff, admonished the policy advisers for speaking out of turn.

“This is a major set back in that trust. It’s really frustrating,” she wrote. Beckmann did not respond to requests for comment.

In a June 7, 2021, email, Walz’s then-deputy chief of staff admonished other members of his team for how they described the policy positions of activists Walz was trying to build a relationship with. (Document obtained by Tony Webster, screenshot highlighted by ProPublica)

The emails end in mid-June with Walz’s schedulers batting away invitations and meetings to allow for all-day negotiation sessions while staffers tried to craft messaging for increasingly anxious state employees. “We’re getting a lot of internal pushback that we haven’t been able to provide enough information,” one state communications worker wrote.

Reform advocates had been urging Walz for weeks to take a hard-line stance during the final budget negotiations, even allowing the government to shut down to force more sweeping changes. But the governor made it clear that was a line he would not cross, according to staff notes on the conversations.

Walz said that he “had concerns over shutting down the government and that this hurts many of the people the administration is trying to help. He said he was hopeful on a few items passing this year,” according to the summation of a phone call with McClellan, the president of the Minnesota Justice Coalition. “He made it clear it was unlikely that everything he’s pushing for will pass.”

A conversation transcribed by staff shows Johnathon McClellan, president of Minnesota Justice Coalition, urging Walz to allow a government shutdown to force more concessions on police reform policy from Republicans. (Document obtained by Tony Webster, screenshot highlighted by ProPublica)

The notes proved prophetic. Three days before the deadline, Walz, Gazelka and Hortman announced a deal. The final bill included new restrictions on no-knock warrants, a law requiring 911 operators to alert mental health crisis teams under certain circumstances, and the creation of a kind of warrant that doesn’t require police to take suspects into custody. The package also included salary increases for state law enforcement, money for body cameras and enhanced penalties for the attempted murder of officers.

Through an executive action, Walz also directed state law enforcement agencies to turn over body camera footage from deadly police encounters to the affected families within five days.

Garraway’s bill to eliminate the statute of limitations on wrongful death suits against the police hit the cutting room floor, as did bills that would disallow police from making a number of equipment-related traffic stops, like ones for expired registration tags, and a bill that would form a civilian oversight board. In an interview with The Washington Post, Walz said he felt he’d “failed” Garraway.

At the end of one of Walz’s last press conferences that session, Jaylani Hussein, the executive director of the Minnesota chapter of the Council on American-Islamic Relations and one of the people the Walz administration had kept in close contact with that spring, pushed through reporters to ask Walz to veto the compromise bill, saying it actually provided more cover for police. Walz, looking tired, listened, addressed Hussein by his first name and said he would not veto the bill.

“This is the challenge of democracy,” Walz said. “There are going to be a lot of people in this moment [who] see this as not acceptable. I understand that.”

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Tony Webster contributed reporting.

by Sharon Lerner

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More than three years ago, a small group of government scientists came forward with disturbing allegations.

During President Donald Trump’s administration, they said, their managers at the Environmental Protection Agency began pressuring them to make new chemicals they were vetting seem safer than they really were. They were encouraged to delete evidence of chemicals’ harms, including cancer, miscarriage and neurological problems, from their reports — and in some cases, they said, their managers deleted the information themselves.

After the scientists pushed back, they received negative performance reviews and three of them were removed from their positions in the EPA’s division of new chemicals and reassigned to jobs elsewhere in the agency.

On Wednesday, the EPA inspector general announced that it had found that some of the treatment experienced by three of those scientists — Martin Phillips, Sarah Gallagher and William Irwin — amounted to retaliation.

Three reports issued by the inspector general confirmed that the scientists’ negative performance reviews as well as a reassignment and the denial of an award that can be used for cash or time off were retaliatory. They also detailed personal attacks by supervisors, who called them “stupid,” “piranhas” and “pot-stirrers.”

The reports called on the EPA to take “appropriate corrective action” in response to the findings. In one case, the inspector general noted that supervisors who violate the Whistleblower Protection Act should be suspended for at least three days.

The reports focus only on the retaliation claims. The inspector general is expected to issue reports in the future about the whistleblowers’ scientific allegations.

In an email sent to the staff of the Office of Chemical Safety and Pollution Prevention after the reports were released, EPA Assistant Administrator Michal Freedhoff wrote that the office plans to hold a “refresher training on both scientific integrity and the Whistleblower Protection Act” for all managers in the office. Freedhoff also wrote that the office is “reviewing the reports to determine whether additional action may be necessary.”

In a statement to ProPublica, the EPA tied the problems laid out in the report to Trump. “The events covered by these reports began during the previous administration when the political leadership placed intense pressure on both career managers and scientists in EPA’s new chemicals program to more quickly review and approve new chemicals,” the agency wrote, going on to add that the “work environment has been transformed under Administrator Michael Regan’s leadership.”

Trump campaign spokespeople did not immediately respond to requests for comment.

A second Trump presidency could see more far-reaching interference with the agency’s scientific work. Project 2025, the radical conservative policy plan to overhaul the government, would make it much easier to fire scientists who raised concerns about industry influence.

“I’m worried about the future because there are groups out there pushing for changes to the civil service that would make it so I could be fired and replaced with a non-scientist,” said Phillips, a chemist. Publicly available versions of the inspector general’s reports redacted the names of all EPA employees, including the scientists, but Phillips, Gallagher and Irwin confirmed that the investigations focused on their complaints.

Phillips said the experience of having his work changed, facing hostility from his supervisors and agonizing about whether and how to alert authorities was traumatic. He began pushing back against the pressure from his bosses in 2019, trying to explain why his calculations were correct and refusing their requests to change his findings, he said.

In one case, someone had deleted a report he had written that noted that a chemical caused miscarriages and birth defects in rats and replaced it with another report that omitted this critical information. After Phillips asked that the original report be restored, he was removed from his position within the EPA’s division of new chemicals and assigned a job elsewhere in the agency.

“I was turned into a pariah,” Phillips told ProPublica about the almost yearlong period when he was sparring with his managers in the new chemical’s division. “I lost sleep. I dreaded going to work. I was worried every time I had to meet with my supervisor or other members of the team. It made me question whether I wanted to continue in my job.”

He and the other scientists said they felt vindicated by the inspector general’s findings.

“It’s gratifying and a relief,” said Irwin, who has worked at the EPA for 15 years.

Irwin, who has a doctorate in biochemistry and molecular biology and three board certifications in toxicology, was transferred from the new chemicals division into a division of the agency he calls “existing chemicals,” after refusing to change several reports, including one on a chemical that he suspected of causing reproductive, immune and neurological problems. Irwin said his supervisor later cited his refusal to sign off on that assessment as a reason to downgrade his rating in his annual performance review.

The division where Irwin and the other scientists worked plays a critical role within the EPA. Companies that develop new chemicals are required to get permission from the EPA to introduce them to the market. If the agency finds that they could pose an unreasonable risk to health or the environment, it must, by law, regulate them, which can involve limiting or forbidding their production or use.

Irwin feels he is particularly suited to the work on new chemicals. “I have a strong ability to look at a chemical and pick out what its toxicity would be based on the structure.” When he was transferred, he said, “I got put on something I didn’t want to do.”

After they were forced to leave their jobs assessing new chemicals, the scientists filed the first of what would be six complaints with the EPA inspector general in June 2021. Their allegations, which detailed industry pressure that continued under the administration of President Joe Biden and pointed fingers at career officials who still worked for the EPA, were the subject of a 10-part series I published in The Intercept. Three of those career scientists named in the complaints subsequently left the EPA. And the agency ordered changes to address the corruption the whistleblowers had alleged, including the creation of two internal science policy advisory councils aimed at shoring up scientific integrity.

“These whistleblowers have been beaten down, ostracized and punished, when all they were trying to do was to protect us,” said Kyla Bennett, director of science policy at Public Employees for Environmental Responsibility, an organization that helped the scientists draft the complaints to the EPA inspector general.

The inspector general’s reports said supervisors defended their actions, claiming that the whistleblowers took an overly conservative approach in their assessments and that, in some cases, criticisms the supervisors had relayed from the companies that submitted the chemicals were valid. One supervisor said scientists “were expected to make compromises to complete the new chemicals assessments.”

The inspector general released two additional reports that did not substantiate allegations of retaliation made by two other scientists.

Bennett said she was particularly concerned about how the outcome of the upcoming presidential election could affect the whistleblowers. “If there is another Trump administration, I will be petrified for them,” she said.

If Trump fulfills even some of the promises made in Project 2025, job security for the whistleblowers — and all EPA scientists — will become much more tenuous. Project 2025 specifically calls for new chemicals to be approved quickly and proposes that all employees whose work touches on policy in federal agencies would become at-will workers, allowing them to be fired more easily.

Although Trump has attempted to distance himself from the effort, saying, “I don’t know what the hell it is,” reporting by ProPublica showed that 29 out of 36 speakers in Project 2025 training videos worked for him in some capacity.

All three scientists who were found to have been the victims of retaliation said they worry that the underlying problems they raised have not been adequately addressed and might worsen.

The scientists said they were still concerned about industry pressure on the EPA’s chemical approval process.

“It’s been four years since we first started raising concerns about what was happening, and we haven’t seen a resolution yet,” Gallagher said. “We haven’t gotten assurance that the concerns we’ve been raising will be fixed.”

Still, Gallagher said she thinks the inspector general’s investigation might begin to lessen the burdens she’s felt since she blew the whistle at the EPA. “I’m hoping that I’ll be able to feel valued in my job again,” she said.

by Kavitha Surana

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

Candi Miller’s health was so fragile, doctors warned having another baby could kill her.

“They said it was going to be more painful and her body may not be able to withstand it,” her sister, Turiya Tomlin-Randall, told ProPublica.

But when the mother of three realized she had unintentionally gotten pregnant in the fall of 2022, Georgia’s new abortion ban gave her no choice. Although it made exceptions for acute, life-threatening emergencies, it didn’t account for chronic conditions, even those known to present lethal risks later in pregnancy.

Why should I trust your reporting? I (Kavitha Surana) am a reporter that has been covering reproductive health care access since Roe v. Wade was overturned. I’ve spoken with doctors, community workers and patients across the country about how abortion bans have made pregnancy more dangerous in America, and I’ve written about the Republican lawmakers who refused to listen.

If you want to get in touch and learn more about how I work, email me. I take your privacy very seriously.

At 41, Miller had lupus, diabetes and hypertension and didn’t want to wait until the situation became dire. So she avoided doctors and navigated an abortion on her own — a path many health experts feared would increase risks when women in America lost the constitutional right to obtain legal, medically supervised abortions.

Miller ordered abortion pills online, but she did not expel all the fetal tissue and would need a dilation and curettage procedure to clear it from her uterus and stave off sepsis, a grave and painful infection. In many states, this care, known as a D&C, is routine for both abortions and miscarriages. In Georgia, performing it had recently been made a felony, with few exceptions.

Her teenage son watched her suffer for days after she took the pills, bedridden and moaning. In the early hours of Nov. 12, 2022, her husband found her unresponsive in bed, her 3-year-old daughter at her side.

An autopsy found unexpelled fetal tissue, confirming that the abortion had not fully completed. It also found a lethal combination of painkillers, including the dangerous opioid fentanyl. Miller had no history of drug use, the medical records state; her family has no idea how she obtained them or what was going through her mind — whether she was trying to quell the pain, complete the abortion or end her life. A medical examiner was unable to determine the manner of death.

Her family later told a coroner she hadn’t visited a doctor “due to the current legislation on pregnancies and abortions.”

When a state committee of experts in maternal health, including 10 doctors, reviewed her case this year at the end of August, they immediately decided it was “preventable” and blamed the state’s abortion ban, according to members who spoke to ProPublica on the condition of anonymity.

They came to that conclusion after weighing the entire chain of events, from Miller’s underlying health conditions, to her decision to manage her abortion alone, to her reticence to seek medical care. “The fact that she felt that she had to make these decisions, that she didn’t have adequate choices here in Georgia, we felt that definitely influenced her case,” one committee member told ProPublica. “She’s absolutely responding to this legislation.”

This is the second preventable death related to abortion bans that ProPublica is reporting this week. Amber Thurman, 28, languished in a suburban Atlanta hospital for 20 hours before doctors performed a D&C to treat sepsis that resulted from an incomplete abortion. It was too late. “This young mother should be alive, raising her son and pursuing her dream of attending nursing school,” Vice President Kamala Harris said of Thurman on Tuesday. “This is exactly what we feared when Roe was struck down.”

There are almost certainly other deaths related to abortion access. Georgia’s committee, tasked with examining pregnancy-related deaths to improve maternal health, has only reviewed cases through fall 2022. Such a lag is common in these committees, which are set up in each state; most others have not even gotten that far.

The details of their reviews are not shared with the public, but ProPublica obtained the Georgia committee’s summary report of Miller’s death. ProPublica also reviewed death records and Miller’s autopsy and spoke to her family.

Her case adds to mounting evidence that exceptions to abortion bans do not, as billed, protect the “life of the mother.” Harrowing stories about denied care have been at the center of the upcoming presidential election, during which the right to abortion is on the ballot in 10 states. ProPublica’s new reporting makes clear, for the first time, that in the wake of bans, women are losing their lives in ways that experts have deemed preventable.

It also underscores the reality that abortion bans have not actually led to a decrease in abortions. But for people like Miller, they have increased the degree of difficulty and risk.

Miller’s husband, Alex, and son Christian, with her ashes, at home in Atlanta (Rita Harper, special to ProPublica) No Health Exceptions

Miller grew up in Alabama and spent most of her adulthood in Atlanta, where she made a living braiding hair and doing nails. She had a soft spot for stray cats, nurtured a garden and was known to break into dance at the sound of old school funk like the Commodores. At 4 foot 9, she was a “firecracker,” her family said — quick to stand up for those she loved. That included her three kids, who range in age from 5 to 16.

But about eight years ago, she was diagnosed with lupus, an autoimmune disease in which the body attacks healthy tissue, her sister said. Symptoms include extreme fatigue; painful, swollen joints; heart complications; and kidney disease.

Miller experienced flare-ups of debilitating pain for which she had to seek radiation treatments. She often wasn’t able to stand for long periods and her hair fell out. It distressed her how often doctors dismissed her pain; she grew to doubt they could give her help when she needed it.

Soon after she was diagnosed, she suffered a major depressive episode, Tomlin-Randall said. For months, she barely left her bed. Tomlin-Randall cared for her sister’s children during that time.

Miller, right, and Turiya Tomlin-Randall (Courtesy of Turiya Tomlin-Randall)

There is no cure for lupus, but patients can manage symptoms with a mixture of drugs and therapies; 90% of those afflicted are women, and the condition is three times more common in Black women than white.

Miller also had diabetes and hypertension. Those conditions, layered on top of her lupus, can be dangerously exacerbated by pregnancy and are highly unpredictable, during both the pregnancy and the aftermath, according to the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine. Patients with those conditions are also more likely to have a pregnancy that ends in miscarriage or premature birth and are more likely to need a cesarean section, a major surgery that is especially hard for patients with diabetes to recover from.

With support, some patients can remain stable and have healthy pregnancies, though the experience can be physically taxing and painful. In the worst cases, pregnancy with lupus can lead to high blood pressure that can quickly progress to seizures, kidney and liver dysfunction and, ultimately, death. Studies have found the maternal death rate for women with lupus is 20-fold higher than for those without lupus. The chance of relapses and flare-ups are also high in the postpartum period.

Each patient’s situation is different and needs careful evaluation of their particular health risks, including discussion of the option to end the pregnancy, said Dr. Sarah Horvath, an OB-GYN representing ACOG.

Politicians who support abortion bans often point to their exceptions, which they say protect “the life of the mother.” During last week’s debate, former President Donald Trump called them “very important.”

But the anti-abortion groups that drafted the bans wrote the exceptions to be as narrow as possible and persuaded lawmakers to impose steep criminal penalties, fearing doctors might stretch definitions to create loopholes.

The exceptions are limited to acute emergencies, usually defined as when “necessary in order to prevent the death of the pregnant woman or the substantial and irreversible physical impairment of a major bodily function.” They also specifically prohibit mental health reasons from counting as health emergencies, even if a pregnant woman says she is thinking about harming herself. In Georgia, violating the law can cost doctors their license and subject them to prison terms of up to 10 years.

The laws typically don’t include any leeway for intervening earlier to treat patients with broader health risks that could make pregnancy more dangerous, such as lupus.

ProPublica surveyed dozens of doctors in nine states with abortion bans. None of their hospitals approve abortions for women with high-risk complications like lupus or diabetes unless the patient is already deteriorating and the issue is urgent.

Horvath regularly sees patients with complications from those conditions in Pennsylvania because they can’t get care in their own state. Often, the delay in figuring out where to go means their pregnancy is further along — and, as a result, their conditions have become more dangerous. They show up to outpatient clinics already displaying signs of trouble, Horvath said, and immediately have to be sent to the hospital where there’s an operating room and a blood bank.

It often takes time for patients and their providers to coordinate care in other states because there is so much confusion about the laws.

“People who are really suffering in these pregnancies really don’t know where to go,” Horvath said. “Or if they even can.”

Miller’s husband, Alex, wears her engagement ring around his neck. (Rita Harper, special to ProPublica) An Unsupervised Alternative

Miller’s third pregnancy was difficult and she never fully recovered, Tomlin-Randall said.

When Miller learned she was pregnant again in 2022, she ordered abortion pills for about $80 from a website called AidAccess, according to her 16-year-old son, Christian Cardenas.

The organization, based in the Netherlands, is devoted to expanding abortion access to places where it is not legal. Patients contact a doctor in Europe who sends them pills from a supplier in India. According to one researcher, Aid Access serves about 7,000 patients a month in the U.S., nearly 90% of them in states with abortion bans or severe restrictions. Its founder, Dr. Rebecca Gomperts, said it was clear the abortion pill did not cause her death.

The committee also did not believe Miller’s death was caused by the abortion medication. Her autopsy found extremely high doses of diphenhydramine (the main ingredient in Benadryl) and acetaminophen (what’s found in Tylenol) in Miller’s system, along with the fentanyl. Considering the quantity of drugs and the timing of her death, the committee also did not suspect the abortion pills themselves were in any way tainted.

Self-managing abortions at home has skyrocketed since the Supreme Court overturned the constitutional right to abortion, because of access to pills that can be ordered online, researchers say.

Major studies, the Food and Drug Administration and the World Health Organization have found abortion pills to be more than 90% effective when taken correctly and in the first trimester. Deaths due to abortion pills are exceedingly rare. Complications can develop if some fetal tissue remains in the uterus, where it can lead to sepsis, a grave infection. Patients are supposed to follow up with a doctor to make sure the abortion has fully completed and go to the hospital if bleeding heavily or exhibiting other symptoms.

Miller’s family does not know how far along her pregnancy was when she took the abortion pills.

But soon enough, she was in excruciating pain.

And that’s how she remained, for days, until she took the potent drug mixture. Her family doesn’t know what she was thinking when she did it, but can’t fathom that she would want to end her life; she was excited about the future and drawing closer to her church, her sister Tomlin-Randall said.

“She was trying to terminate the pregnancy, not terminate herself,” she said.

Miller’s 16-year-old son, Christian, holds his mother’s ashes at home in Atlanta. (Rita Harper, special to ProPublica)

It was significant to the state maternal mortality review committee that Miller did not feel she could seek medical care.

Although Georgia courts have said women can’t be prosecuted for getting abortions, the state has sent mixed messages. While some state bans explicitly say women can’t be prosecuted, Georgia’s ban leaves open that possibility. In 2019, a district attorney on the outskirts of metro Atlanta called abortion “murder” and said women “should prepare for the chance that they could be criminally prosecuted for having an abortion.”

That was the understanding in Miller’s family.

“If you get caught trying to do anything to get rid of the baby,” her son Christian told ProPublica, “you get jail time for that.”

Cassandra Jaramillo contributed reporting. Mariam Elba, Jeff Ernsthausen and Kirsten Berg contributed research.

by Jake Pearson

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

The chair of the New York City Council’s Committee on Aging is calling on Gov. Kathy Hochul and legislative leaders to overhaul the state’s beleaguered guardianship system in response to a ProPublica investigation that found elderly and infirm New Yorkers living in dire conditions while under court-mandated oversight.

City Councilmember Crystal Hudson introduced a resolution last week intended to force Albany to take up the cause of those whom judges have deemed incapable of managing their own affairs — a constituency without powerful lobbyists or political influence whose needs have long been ignored by state legislators.

“Too many people have been failed by this system, and a real overhaul is long overdue,” said Hudson, a Democrat. “We need a system that instills confidence — one that guarantees people in need of guardianships a dignified existence.”

More than 28,000 people statewide are currently under the care of court-appointed guardians, and nearly 60% of them live in New York City.

Hudson’s bill, which calls for an annual infusion of state funding to serve poor New Yorkers in the system, will be the subject of public hearings later this fall.

The proposal cites a series of stories this year by ProPublica that revealed how thousands of residents who have no family or friends to look after them are ill-served by many of the nonprofits and private attorneys that judges appoint to oversee their well-being. In the guardianship industry, this group of wards is known as “the unbefriended.”

The news organization found that there are too few guardians available to serve the people who need them and even fewer overseers, called examiners, to review the guardians’ work. A dearth of court staff and judges has compounded the problem. ProPublica found that annual assessments of guardians’ care can take years to complete, and even then the court oversight mostly focuses on financial paperwork, with officials rarely visiting wards in person.

The lack of scrutiny and long delays can result in unchecked neglect, as well as financial exploitation of New York’s most vulnerable people. A woman featured in ProPublica’s reporting lived for years in a home that had no heat and was infested by bedbugs and rats — conditions her legally appointed guardian did not rectify and her examiner did not question. Another man’s guardian spent more than half of her ward’s life savings for care provided by her own private business — a flagrant conflict of interest that a judge permitted for years.

Hudson’s resolution would pressure state legislative leaders and the governor to bolster the system by allocating state money to pay for more guardians. The current system is largely unfunded. So judges often ask lawyers to take on cases pro bono or assign nonprofits, which take monthly fees directly from their wards’ accounts. For a small group of people in need, county social service departments pick up the tab, though judges say the groups they contract with to provide those services are overburdened and understaffed.

To fix the problem, the legislation suggests a plan developed by Guardianship Access New York, a coalition of nonprofit providers. It calls for a “significant and permanent statewide investment in nonprofit guardianship services” of $15 million annually. That’s similar to what happens in Florida, which publicly funds 16 nonprofits that serve thousands of eligible wards. In GANY’s proposal, the funding would go to vetted groups that would then serve 1,500 New Yorkers each year to “ensure access to an ethical, reliable, and effective guardian.”

Kimberly George, a leader of GANY who also runs Project Guardianship, a nonprofit group that serves as guardian to about 160 New York City wards, said in an interview that the proposal “wouldn’t fix the whole system, but it’s a big piece of it.”

“If judges have reliable good guardians to go to, maybe they won’t have to appoint ones that they know are questionable or aren’t sure about,” she said.

Judges, for example, have long relied on a guardianship company featured by ProPublica even as it failed to meet the needs of more than a dozen wards. In one case, it collected monthly fees from an elderly man even after he left the country — and also after he died. The group, which serves hundreds of poor New Yorkers, continues to receive appointments. The company has declined to answer questions about specific clients but previously told ProPublica that it was accountable to the court and that its work was scrutinized by examiners, who are empowered to raise any issues.

The city resolution comes as the state court system crafts its own guardianship proposals in advance of next year’s legislative session, which begins in January.

According to an internal proposal obtained by ProPublica, an advisory committee of judges and lawyers has recommended that the state’s top judicial leaders and court administrators ask Albany to create a “fully funded statewide entity” to serve as a public guardian. Such a government entity, the committee estimates, would cost $72 million to staff and would serve the “unbefriended” in each county — a population the proposal estimates represents about 20% of all wards statewide.

The committee also recommended that the courts seek to increase compensation for court examiners, as well as court evaluators, who assess the needs and capacities of people before a judge imposes guardianship. That money would come from funding that is now reserved for lawyers who represent the indigent in criminal cases, not from wards’ own funds.

A court spokesperson said the state’s top judicial leaders “have made clear to our partners in other branches of government that we support the creation of a statewide public guardianship program as a key component of an overhaul of the system.”

Spokesperson Al Baker added: “We are proud to be advocating for additional funding to cover the costs of guardianships, particularly to assist those who are the most economically constrained.”

State lawmakers last seriously addressed the court-appointed guardianship system 30 years ago, when they passed the state’s main guardianship statute, Article 81 of the Mental Hygiene Law. This year during budget negotiations, lawmakers secured just $1 million to fund a statewide helpline, despite a request to provide $5 million to combat some of the bigger problems detailed in ProPublica’s reporting. Spokespeople for the Senate majority leader, Andrea Stewart-Cousins, and Assembly speaker, Carl Heastie, didn’t respond to requests for comment on Hudson’s resolution.

Neither did the office of Hochul, whose support will be essential to any guardianship reform. The Democrat, who took office three years ago, has proposed a plan to confront the needs of the state’s aging population, which mentions guardianship, among other measures, though it spells out few details.

Advocates hope Hochul will be receptive to an overhaul, given her record on a related issue. In July 2022, she signed into law a bill that provides an alternative to guardianship for people with intellectual and developmental disabilities, permitting them, not a guardian, to make decisions about their own lives.

At the bill signing, according to a transcript, she acknowledged the power of government to better the circumstances of the vulnerable.

New York, she said, had “a well-intended Legislature and a governor who wanted to make sure if there’s any issue that comes to our attention where a wrong needs to be righted, we will take the pen and do just that. And that is what today is about.”

by Marilyn W. Thompson and Alex Mierjeski

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Federal Judge Aileen M. Cannon, the controversial jurist who tossed out the classified documents criminal case against Donald Trump in July, failed to disclose her attendance at a May 2023 banquet funded by a conservative law school.

Cannon went to an event in Arlington, Virginia, honoring the late Supreme Court Justice Antonin Scalia, according to documents obtained from the Law and Economics Center at George Mason University. At a lecture and private dinner, she sat among members of Scalia’s family, fellow Federalist Society members and more than 30 conservative federal judges. Organizers billed the event as “an excellent opportunity to connect with judicial colleagues.”

A 2006 rule, intended to shine a light on judges’ attendance at paid seminars that could pose conflicts or influence decisions, requires them to file disclosure forms for such trips within 30 days and make them public on the court’s website.

It’s not the first time she has failed to fully comply with the rule.

In 2021 and 2022, Cannon took weeklong trips to the luxurious Sage Lodge in Pray, Montana, for legal colloquiums sponsored by George Mason, which named its law school for Scalia thanks to $30 million in gifts that conservative judicial kingmaker Leonard Leo helped organize.

Current rates for standard rooms at Sage Lodge can exceed $1,000 per night, depending on the season. With both Montana trips, Cannon’s required seminar disclosures were not posted until NPR reporters asked about the omissions this year as part of a broader national investigation of gaps in judicial disclosures.

Cannon did not respond to repeated requests for comment.

In response to questions from ProPublica, the clerk in the Southern District of Florida wrote in an email that Cannon had filed the Sage Lodge trips with the federal judiciary’s administrative office but had “inadvertently” not taken the second step of posting them on the court’s website. She explained that “Judges often do not realize they must input the information twice.”

The clerk said she had no information about the May 2023 banquet.

“Judges administer the law, and we have a right to expect every judge to comply with the law,” said Virginia Canter, chief ethics counsel for the watchdog group Citizens for Responsibility and Ethics in Washington.

Cannon’s husband, Joshua Lorence, a restaurant executive, accompanied her to the 2021 and 2022 colloquiums, which featured noted conservative jurists, lawyers and professors as well as lengthy “afternoon study breaks,” according to records obtained by ProPublica. Cannon emailed university staff to submit airport parking expenses and inquire about rental car reimbursement.

The rule for paid seminars is among the policies set by the Judicial Conference. Federal judges are also required by law to file annual financial disclosures, listing items such as assets, outside income and gifts.

Cannon’s annual disclosure form for 2023, which was due in May and offers another chance to report gifts and reimbursements from outside parties, has yet to be posted. (Cannon reported the two Montana trips on her annual disclosure forms, but the required 30-day privately funded seminar reports had not been posted. In 2021, Cannon incorrectly listed the school as “George Madison University.”)

The court’s administrative office declined to say if she requested a one-time extension to give her until Aug. 13 to file. A spokesperson would not discuss whether she met the deadline or the status of her disclosure, which must be reviewed internally.

Cannon’s performance during almost four years of a lifetime appointment has drawn criticism from lawyers, former federal judges and courtroom observers who told ProPublica that she doesn’t render timely decisions and has made unpredictable rulings in both civil and criminal matters. On July 15, she threw out the case brought by Special Counsel Jack Smith that alleges Trump mishandled classified documents at his Mar-a-Lago residence; Cannon called Smith’s appointment unconstitutional since he was not nominated by the president and approved by the Senate.

Smith is appealing to the 11th U.S. Circuit Court of Appeals, and Citizens for Responsibility and Ethics in Washington has asked the court to remand her decision and replace her.

By contrast, Trump, who appointed Cannon in 2020 to the Fort Pierce courthouse, has praised her brilliance, and Federalist Society founder Steven Calabresi called her a heroine for throwing out the criminal case against Trump.

For decades, judicial education programs sponsored by George Mason’s Law and Economics Center have drawn in 5,000 state and federal judges and four current Supreme Court justices, according to its website. The school says its programs strive for balance and intellectual rigor. But conference agendas and speaker lists that the university must file with the courts detail lectures and panel discussions built around Federalist Society principles that are associated with conservative legal movements.

Ken Turchi, associate dean for external affairs, said the law school plays no role in judicial disclosures. “Judges’ decisions to submit (or not submit) disclosure forms are theirs alone — it’s a self-reporting process,” he said.

The guest list for the May 2023 Scalia Forum included William H. Pryor Jr., chief judge of the 11th Circuit, which is now hearing Smith’s appeal. Pryor and dinner speaker Kyle Duncan, a 5th Circuit judge, did file their required disclosures for the Scalia dinner.

Pryor’s court has overruled Cannon twice in the Trump case. It sided with the government in September 2022 on a motion for a stay and found that it “had established a substantial likelihood of success on the merits.” In December 2022, it ruled that she erred in naming a special master to examine classified documents seized from Mar-a-Lago. After that decision, Cannon had to dismantle an expensive operation set up by her special master, a senior federal judge in New York.

Gabe Roth, who directs Fix the Court, a nonprofit judicial reform group, said compliance with the privately funded seminar rule has improved in some circuits since his group pressed for compliance with the Administrative Office of the Courts.

“They’re a more effective way for litigants and the public to get a sense of what types of individuals and groups a judge might be hanging out with and learning from,” he said.

Records show that Cannon submitted minor reimbursement requests related to the Scalia Forum trip after she returned, including the 158 miles she drove round trip to the airport. She inquired with George Mason staff about details for an Alaska excursion recommended by a former lawyer in the Trump-era White House Counsel’s Office.

Cannon registered for George Mason’s Hill Country Colloquium at a Texas resort in December 2023 but had to back out for scheduling reasons.

“I hope to join that event, and others, in future years,” she wrote.

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If you have information about Judge Aileen M. Cannon, please contact Marilyn W. Thompson at marilyn.thompson@propublica.org.

by Eli Hager

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

The state of Ohio is giving taxpayer money to private, religious schools to help them build new buildings and expand their campuses, which is nearly unprecedented in modern U.S. history.

While many states have recently enacted sweeping school voucher programs that give parents taxpayer money to spend on private school tuition for their kids, Ohio has cut out the middleman. Under a bill passed by its Legislature this summer, the state is now providing millions of dollars in grants directly to religious schools, most of them Catholic, to renovate buildings, build classrooms, improve playgrounds and more.

The goal in providing the grants, according to the measure’s chief architect, Matt Huffman, is to increase the capacity of private schools in part so that they can sooner absorb more voucher students.

“The capacity issue is the next big issue on the horizon” for voucher efforts, Huffman, the Ohio Senate president and a Republican, told the Columbus Dispatch.

Huffman did not respond to ProPublica’s requests for comment.

Following Hurricane Katrina and the start of the COVID-19 pandemic, some federal taxpayer dollars went toward repairing and improving private K-12 schools in multiple states. Churches that operate schools often receive government funding for the social services that they offer; some orthodox Jewish schools in New York have relied on significant financial support from the city, The New York Times has found.

But national experts on education funding emphasized that what Ohio is doing is categorically different.

“This is new, dangerous ground, funding new voucher schools,” said Josh Cowen, a senior fellow at the Education Law Center and the author of a new book on the history of billionaire-led voucher efforts. For decades, churches have relied on conservative philanthropy to be able to build their schools, Cowen said, or they’ve held fundraising drives or asked their diocese for help.

They’ve never, until now, been able to build schools expressly on the public dime.

“This breaks through the myth,” said David Pepper, a political writer and the former chairman of the Ohio Democratic Party. Pepper said that courts have long given voucher programs a pass, ruling that they don’t violate the constitutionally mandated separation of church and state because a publicly funded voucher technically passes through the conduit of a parent on the way to a religious school.

With this latest move, though, Ohio is funding the construction of a separate, religious system of education, Pepper said, adding that if no one takes notice, “This will happen in other states — they all learn from each other like laboratories.”

The Ohio Constitution says that the General Assembly “will secure a thorough and efficient system of common schools throughout the state; but no religious or other sect, or sects, shall ever have any exclusive right to, or control of, any part of the school funds of this state.”

Yet Troy McIntosh, executive director of the Ohio Christian Education Network — several of whose schools received the new grants — recently told the Lima News that part of the reason for spending these public dollars on the expansion of private schools is that “we want to make sure that from our perspective, Christian school options are available to any kid who chooses that in the state.”

Administrators at Temple Christian School applaud during an August ribbon-cutting ceremony for their new building. (Mackenzi Klemann, The Lima (Ohio) News)

When they were implemented in the 1990s, vouchers in Ohio, like in many places, were limited in scope; they were available only to parents whose children were attending (often underfunded) public schools in Cleveland. The idea was to give those families money that they could then spend on tuition at a hopefully better private school, thus empowering them with what was called school choice.

Over the decades, the state incrementally expanded voucher programs to a wider and wider range of applicants. And last year, legislators and Gov. Mike DeWine extended the most prominent of those programs, called EdChoice, to all Ohio families.

It was the ultimate victory for Ohio’s school-choice advocates. The problem, though, was that in many parts of Ohio and other states, especially rural areas, parents can’t spend this new voucher money because private schools are either too far away or already at capacity.

This, in turn, has become a major political liability for voucher advocates in many states, with rural conservatives becoming increasingly indignant that their tax dollars are being spent on vouchers for upper-middle-class families in far-off metropolitan areas where there are more private schools.

In April, the Buckeye Institute, an Ohio-based conservative think tank affiliated with the Koch brothers’ political advocacy group Americans for Prosperity, recognized the problem. In a policy memo, the institute said that it was offering lawmakers “additional solutions to address the growing need for classroom space” in private and charter schools, “given the success of the Ohio EdChoice program.” Among its recommendations: draw funding from the Ohio One-Time Strategic Community Investment Fund, which provides grants of state money for the construction and repair of buildings, as well as other “capital projects.”

Within months, the Legislature did precisely that. Led by Huffman, Republicans slipped at least $4 million in grants to private schools into a larger budget bill. There was little debate, in part because budget bills across the country have become too large to deliberate over every detail and, also, Republicans have supermajorities in both chambers in Ohio.

According to an Ohio Legislative Service Commission report, the grants, some of them over a million dollars, then went out to various Catholic schools around the state. ProPublica contacted administrators at each of these schools to ask what they will be using their new taxpayer money on, but they either didn’t answer or said that they didn’t immediately know. (One of the many differences between public and private schools is that the latter do not have to answer questions from the public about their budgets, even if they’re now publicly funded.)

The total grant amount of roughly $4 million this year may seem small, said William L. Phillis, executive director of the Ohio Coalition for Equity & Adequacy of School Funding. But, he noted, Ohio’s voucher program itself started out very small three decades ago, and today it’s a billion-dollar system.

“They get their foot in the door with a few million dollars in infrastructure funding,” Phillis said. “It sets a precedent, and eventually hundreds of millions will be going to private school construction.”

Mollie Simon contributed research.

by Ziva Branstetter

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

When the Supreme Court overturned Roe v. Wade and the constitutional right to abortion in 2022, strict bans on the procedure kicked in across the country, leaving women in at least 22 states with fewer options to end pregnancies that in some cases endangered their lives.

ProPublica has uncovered at least two cases of women who died after their state banned abortion. In both cases, the women took pills to end their pregnancies and the abortion did not fully complete, causing complications, as can occur in a small number of cases involving abortion medication.

Their stories speak to the challenges women face when abortion is banned, not the safety of abortion pills when taken properly and with appropriate follow-up care.

We reviewed information from the U.S. Food and Drug Administration and from groups that closely track the latest medical advice and scientific evidence to answer the most frequently asked questions about abortion pills.

What is abortion medication?

What some people call the “abortion pill” is actually a combination of two pills — mifepristone and misoprostol — commonly called “abortion medication.”

Mifepristone tablets are also sold under the brand name Mifeprex, which has been approved by the U.S. Food and Drug Administration since 2000 to be used along with misoprostol to end an intrauterine pregnancy through 10 weeks gestation. (That is measured as 70 days or less since the first day of a patient’s last menstrual period.)

Abortion pills are now used in more than 60% of all abortions in the U.S. health care system.

How do abortion pills work?

Mifepristone blocks a hormone called progesterone that is needed for a pregnancy to continue. The FDA-approved regimen is to take 200 milligrams of mifepristone on the first day. Patients are directed to take misoprostol within 24 to 48 hours of the mifepristone. The misoprostol works to expel fetal tissue from the uterus.

In some cases, patients take a regime of misoprostol only to end a pregnancy.

Patients are directed to follow up with a health care provider about seven to 14 days after taking mifepristone or earlier if any unusual symptoms are noted. (See below.)

Are abortion pills safe?

Yes. The FDA first approved Mifeprex 25 years ago, so there’s an extensive record of safety involving this drug.

Out of nearly 6 million women who’ve taken mifepristone since then, only 32 deaths of women who used the drug to terminate pregnancies were reported to the FDA through the end of 2022, regardless of whether the drug played a role in the death.

Of those, 11 involved deaths of women who developed a deadly infection called sepsis. Most of the remaining cases involved intentional and accidental drug overdoses, suicide, homicide and ruptured ectopic pregnancies.

The American College of Obstetricians and Gynecologists has opposed laws and court rulings that limit or ban the availability of abortion pills. “Mifepristone has been used safely and effectively for medication abortion for more than two decades. That safety and efficacy is backed up by robust, evidence-based, clinical data and its observed use by millions of people with support from clinicians, including obstetricians-gynecologists,” the organization states on its website.

Who should not take abortion medication?

Abortion pills are not approved for use in some pregnancies. According to the FDA, people should not use abortion pills if they:

• Have an ectopic pregnancy (a pregnancy outside of the uterus).
• Have problems with the adrenal glands (the glands near the kidneys).
• Are being treated with long-term corticosteroid therapy (medications).
• Have had an allergic reaction to mifepristone, misoprostol or similar drugs.
• Have bleeding problems or are taking anticoagulant (blood-thinning) drug products.
• Have inherited porphyria (a rare disorder that can affect the liver and other organs).
• Have an intrauterine device in place. (It must be removed before taking mifepristone.)

What are the common side effects of abortion pills? How long do they usually last?

Bleeding and cramping initially are expected. If you have abdominal pain or discomfort, or you are feeling sick — including weakness, nausea, vomiting or diarrhea, with or without fever — more than 24 hours after taking misoprostol, doctors say to contact your health care provider without delay. These symptoms may be a sign of a serious infection or another problem.

In the days after treatment, if you have a fever of 100.4°F or higher that lasts for more than four hours, doctors say you should contact your health care provider or visit the nearest emergency room right away. Fever may be a symptom of a serious infection or another problem.

How much bleeding is normal with abortion pills?

Contact your health care provider right away if you bleed enough to soak through two thick full-size sanitary pads per hour for two consecutive hours or if you are concerned about heavy bleeding. If you can’t reach your health care provider, go to the emergency room to seek care.

How effective are abortion pills?

Taken as directed, they are highly effective. In about 1 in 100 women, a procedure will be required to remove remaining tissue. That’s why it’s important to seek follow-up care for any of the symptoms described above.

What happens if abortion pills don’t work?

Doctors say you should seek immediate medical attention if you experience any of the unusual symptoms described above. (This patient agreement form required by the FDA describes what to look for.)

While abortion medication is banned in 14 states, it is not a crime to seek medical attention because you took abortion pills. In fact, the federal government requires hospitals to treat urgent medical conditions like infection. Do not avoid seeking help from your doctor or at the emergency room if you have sustained bleeding, pain and/or fever. An infection of this kind is not likely to go away on its own and could be fatal.

Is it legal to order the abortion pills online?

Yes, in some states. In January 2023, the FDA lifted restrictions that prevented patients from obtaining medication abortion pills from a retail pharmacy and allowed them to be dispensed by mail, with certain requirements.

But patients can’t legally order abortion medication in 14 states that ban abortion: Alabama, Arkansas, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas and West Virginia. In 15 states, there are various restrictions that make it more difficult for patients to obtain abortion medication.

Some pharmacies and organizations that provide abortion medication through the mail are not approved by the FDA. Patients should exercise caution when ordering pills from unregulated pharmacies to determine whether the medication is authentic and safe.

by Kavitha Surana

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

In her final hours, Amber Nicole Thurman suffered from a grave infection that her suburban Atlanta hospital was well-equipped to treat.

She’d taken abortion pills and encountered a rare complication; she had not expelled all of the fetal tissue from her body. She showed up at Piedmont Henry Hospital in need of a routine procedure to clear it from her uterus, called a dilation and curettage, or D&C.

But just that summer, her state had made performing the procedure a felony, with few exceptions. Any doctor who violated the new Georgia law could be prosecuted and face up to a decade in prison.

Thurman waited in pain in a hospital bed, worried about what would happen to her 6-year-old son, as doctors monitored her infection spreading, her blood pressure sinking and her organs beginning to fail.

It took 20 hours for doctors to finally operate. By then, it was too late.

Why should I trust your reporting? I (Kavitha Surana) am a reporter that has been covering reproductive health care access since Roe v. Wade was overturned. I’ve spoken with doctors, community workers and patients across the country about how abortion bans have made pregnancy more dangerous in America, and I’ve written about the Republican lawmakers who refused to listen.

If you want to get in touch and learn more about how I work, email me. I take your privacy very seriously.

The otherwise healthy 28-year-old medical assistant, who had her sights set on nursing school, should not have died, an official state committee recently concluded.

Tasked with examining pregnancy-related deaths to improve maternal health, the experts, including 10 doctors, deemed hers “preventable” and said the hospital’s delay in performing the critical procedure had a “large” impact on her fatal outcome.

Their reviews of individual patient cases are not made public. But ProPublica obtained reports that confirm that at least two women have already died after they couldn’t access legal abortions and timely medical care in their state.

There are almost certainly others.

Committees like the one in Georgia, set up in each state, often operate with a two-year lag behind the cases they examine, meaning that experts are only now beginning to delve into deaths that took place after the Supreme Court overturned the federal right to abortion.

Thurman’s case marks the first time an abortion-related death, officially deemed “preventable,” is coming to public light. ProPublica will share the story of the second in the coming days. We are also exploring other deaths that have not yet been reviewed but appear to be connected to abortion bans.

Doctors warned state legislators women would die if medical procedures sometimes needed to save lives became illegal.

Though Republican lawmakers who voted for state bans on abortion say the laws have exceptions to protect the “life of the mother,” medical experts cautioned that the language is not rooted in science and ignores the fast-moving realities of medicine.

The most restrictive state laws, experts predicted, would pit doctors’ fears of prosecution against their patients’ health needs, requiring providers to make sure their patient was inarguably on the brink of death or facing “irreversible” harm when they intervened with procedures like a D&C.

“They would feel the need to wait for a higher blood pressure, wait for a higher fever — really got to justify this one — bleed a little bit more,” Dr. Melissa Kottke, an OB-GYN at Emory, warned lawmakers in 2019 during one of the hearings over Georgia’s ban.

Doctors and a nurse involved in Thurman’s care declined to explain their thinking and did not respond to questions from ProPublica. Communications staff from the hospital did not respond to multiple requests for comment. Georgia’s Department of Public Health, which oversees the state maternal mortality review committee, said it cannot comment on ProPublica’s reporting because the committee’s cases are confidential and protected by federal law.

The availability of D&Cs for both abortions and routine miscarriage care helped save lives after the 1973 Supreme Court ruling in Roe v. Wade, studies show, reducing the rate of maternal deaths for women of color by up to 40% the first year after abortion became legal.

But since abortion was banned or restricted in 22 states over the past two years, women in serious danger have been turned away from emergency rooms and told that they needed to be in more peril before doctors could help. Some have been forced to continue high-risk pregnancies that threatened their lives. Those whose pregnancies weren’t even viable have been told they could return when they were “crashing.”

Such stories have been at the center of the upcoming presidential election, during which the right to abortion is on the ballot in 10 states.

But Republican legislators have rejected small efforts to expand and clarify health exceptions — even in Georgia, which has one of the nation’s highest rates of maternal mortality and where Black women are three times more likely to die from pregnancy-related complications than white women.

When its law went into effect in July 2022, Gov. Brian Kemp said he was “overjoyed” and believed the state had found an approach that would keep women “safe, healthy and informed.”

After advocates tried to block the ban in court, arguing the law put women in danger, attorneys for the state of Georgia accused them of “hyperbolic fear mongering.”

Two weeks later, Thurman was dead.

Thurman and her son in a photo she posted on social media the year before her death (via Facebook)

Thurman, who carried the full load of a single parent, loved being a mother. Every chance she got, she took her son to petting zoos, to pop-up museums and on planned trips, like one to a Florida beach. “The talks I have with my son are everything,” she posted on social media.

But when she learned she was pregnant with twins in the summer of 2022, she quickly decided she needed to preserve her newfound stability, her best friend, Ricaria Baker, told ProPublica. Thurman and her son had recently moved out of her family’s home and into a gated apartment complex with a pool, and she was planning to enroll in nursing school.

The timing could not have been worse. On July 20, the day Georgia’s law banning abortion at six weeks went into effect, her pregnancy had just passed that mark, according to records her family shared with ProPublica.

Thurman wanted a surgical abortion close to home and held out hope as advocates tried to get the ban paused in court, Baker said. But as her pregnancy progressed to its ninth week, she couldn’t wait any longer. She scheduled a D&C in North Carolina, where abortion at that stage was still legal, and on Aug. 13 woke up at 4 a.m. to make the journey with her best friend.

On their drive, they hit standstill traffic, Baker said. The clinic couldn’t hold Thurman’s spot longer than 15 minutes — it was inundated with women from other states where bans had taken effect. Instead, a clinic employee offered Thurman a two-pill abortion regimen approved by the U.S. Food and Drug Administration, mifepristone and misoprostol. Her pregnancy was well within the standard of care for that treatment.

Getting to the clinic had required scheduling a day off from work, finding a babysitter, making up an excuse to borrow a relative’s car and walking through a crowd of anti-abortion protesters. Thurman didn’t want to reschedule, Baker said.

At the clinic, Thurman sat through a counseling session in which she was told how to safely take the pills and instructed to go to the emergency room if complications developed. She signed a release saying she understood. She took the first pill there and insisted on driving home before any symptoms started, Baker said. She took the second pill the next day, as directed.

Deaths due to complications from abortion pills are extremely rare. Out of nearly 6 million women who’ve taken mifepristone in the U.S. since 2000, 32 deaths were reported to the FDA through 2022, regardless of whether the drug played a role. Of those, 11 patients developed sepsis. Most of the remaining cases involved intentional and accidental drug overdoses, suicide, homicide and ruptured ectopic pregnancies.

Baker and Thurman spoke every day that week. At first, there was only cramping, which Thurman expected. But days after she took the second pill, the pain increased and blood was soaking through more than one pad per hour. If she had lived nearby, the clinic in North Carolina would have performed a D&C for free as soon as she followed up, the executive director told ProPublica. But Thurman was four hours away.

Thurman, left, and her best friend, Ricaria Baker, in 2020 (Courtesy of Ricaria Baker)

On the evening of Aug. 18, Thurman vomited blood and passed out at home, according to 911 call logs. Her boyfriend called for an ambulance. Thurman arrived at Piedmont Henry Hospital in Stockbridge at 6:51 p.m.

ProPublica obtained the summary narrative of Thurman’s hospital stay provided to the maternal mortality review committee, as well as the group’s findings. The narrative is based on Thurman’s medical records, with identifying information removed. The committee does not interview doctors involved with the case or ask hospitals to respond to its findings. ProPublica also consulted with medical experts, including members of the committee, about the timeline of events.

Within Thurman’s first hours at the hospital, which says it is staffed at all hours with an OB who specializes in hospital care, it should have been clear that she was in danger, medical experts told ProPublica.

Her lower abdomen was tender, according to the summary. Her white blood cell count was critically high and her blood pressure perilously low — at one point, as Thurman got up to go to the bathroom, she fainted again and hit her head. Doctors noted a foul odor during a pelvic exam, and an ultrasound showed possible tissue in her uterus.

The standard treatment of sepsis is to start antibiotics and immediately seek and remove the source of the infection. For a septic abortion, that would include removing any remaining tissue from the uterus. One of the hospital network’s own practices describes a D&C as a “fairly common, minor surgical procedure” to be used after a miscarriage to remove fetal tissue.

After assessing her at 9:38 p.m., doctors started Thurman on antibiotics and an IV drip, the summary said. The OB-GYN noted the possibility of doing a D&C the next day.

But that didn’t happen the following morning, even when an OB diagnosed “acute severe sepsis.” By 5:14 a.m., Thurman was breathing rapidly and at risk of bleeding out, according to her vital signs. Even five liters of IV fluid had not moved her blood pressure out of the danger zone. Doctors escalated the antibiotics.

Instead of performing the newly criminalized procedure, they continued to gather information and dispense medicine, the summary shows.

Doctors had Thurman tested for sexually transmitted diseases and pneumonia.

They placed her on Levophed, a powerful blood pressure support that could do nothing to treat the infection and posed a new threat: The medication can constrict blood flow so much that patients could need an amputation once stabilized.

At 6:45 a.m., Thurman’s blood pressure continued to dip, and she was taken to the intensive care unit.

At 7:14 a.m., doctors discussed initiating a D&C. But it still didn’t happen. Two hours later, lab work indicated her organs were failing, according to experts who read her vital signs.

At 12:05 p.m., more than 17 hours after Thurman had arrived, a doctor who specializes in intensive care notified the OB-GYN that her condition was deteriorating.

Thurman was finally taken to an operating room at 2 p.m.

By then, the situation was so dire that doctors started with open abdominal surgery. They found that her bowel needed to be removed, but it was too risky to operate because not enough blood was flowing to the area — a possible complication from the blood pressure medication, an expert explained to ProPublica. The OB performed the D&C but immediately continued with a hysterectomy.

During surgery, Thurman’s heart stopped.

Her mother was praying in the waiting room when one of the doctors approached. “Come walk with me,” she said.

Until she got the call from the hospital, her mother had no idea Thurman had been pregnant. She recalled her daughter’s last words before she was wheeled into surgery — they had made no sense coming from a vibrant young woman who seemed to have her whole life ahead of her:

“Promise me you’ll take care of my son.”

Thurman and her son in a selfie she posted online in 2020, two years before her death (via Facebook)

There is a “good chance” providing a D&C earlier could have prevented Amber Thurman’s death, the maternal mortality review committee concluded.

Every state has a committee of experts who meet regularly to examine deaths that occurred during or within a year after a pregnancy. Their goal is to collect accurate data and identify the root causes of America’s increasing maternal mortality rate, then translate those lessons into policy changes. Their findings and recommendations are sent to the Centers for Disease Control and Prevention, and their states publish an annual report, but their reviews of individual cases are never public.

Georgia’s committee has 32 regular members from a variety of backgrounds, including OB-GYNs, cardiologists, mental health care providers, a medical examiner, health policy experts, community advocates and others. This summer, the committee reviewed deaths through Fall 2022, but most states have not gotten that far.

After reviewing Thurman’s case, the committee highlighted Piedmont’s “lack of policies/procedures in place to evacuate uterus immediately” and recommended all hospitals implement policies “to treat a septic abortion on an ongoing basis.”

It is not clear from the records available why doctors waited to provide a D&C to Thurman, though the summary report shows they discussed the procedure at least twice in the hours before they finally did.

Piedmont did not have a policy to guide doctors on how to interpret the state abortion ban when Thurman arrived for care, according to two people with knowledge of internal conversations who were not authorized to speak publicly. In the months after she died, an internal task force of providers there created policies to educate staff on how to navigate the law, though they are not able to give legal advice, the sources said.

In interviews with more than three dozen OB-GYNs in states that outlawed abortion, ProPublica learned how difficult it is to interpret the vague and conflicting language in bans’ medical exceptions — especially, the doctors said, when their judgment could be called into question under the threat of prison time.

Take the language in Georgia’s supposed lifesaving exceptions.

It prohibits doctors from using any instrument “with the purpose of terminating a pregnancy.” While removing fetal tissue is not terminating a pregnancy, medically speaking, the law only specifies it’s not considered an abortion to remove “a dead unborn child” that resulted from a “spontaneous abortion” defined as “naturally occurring” from a miscarriage or a stillbirth.

Thurman had told doctors her miscarriage was not spontaneous — it was the result of taking pills to terminate her pregnancy.

There is also an exception, included in most bans, to allow abortions “necessary in order to prevent the death of the pregnant woman or the substantial and irreversible physical impairment of a major bodily function.” There is no standard protocol for how providers should interpret such language, doctors said. How can they be sure a jury with no medical experience would agree that intervening was “necessary”?

ProPublica asked the governor’s office on Friday to respond to cases of denied care, including the two abortion-related deaths, and whether its exceptions were adequate. Spokesperson Garrison Douglas said they were clear and gave doctors the power to act in medical emergencies. He returned to the state’s previous argument, describing ProPublica’s reporting as a “fear-mongering campaign.”

Republican officials across the country have largely rejected calls to provide guidance.

When legislators have tried, anti-abortion groups have blocked them.

In 2023, a group of Tennessee Republicans was unable to push through a small change to the state’s abortion ban, intended to give doctors greater leeway when intervening for patients facing health complications.

“No one wants to tell their spouse, child or loved one that their life is not important in a medical emergency as you watch them die when they could have been saved,” said Republican Rep. Esther Helton-Haynes, a nurse who sponsored the bill.

The state’s main anti-abortion lobbyist, Will Brewer, vigorously opposed the change. Some pregnancy complications “work themselves out,” he told a panel of lawmakers. Doctors should be required to “pause and wait this out and see how it goes.”

At some hospitals, doctors are doing just that. Doctors told ProPublica they have seen colleagues disregard the standard of care when their patients are at risk of infection and wait to see if a miscarriage completes naturally before offering a D&C.

Although no doctor has been prosecuted for violating abortion bans, the possibility looms over every case, they said, particularly outside of well-funded academic institutions that have lawyers promising criminal defense.

Doctors in public hospitals and those outside of major metro areas told ProPublica that they are often left scrambling to figure out on a case-by-case basis when they are allowed to provide D&Cs and other abortion procedures. Many fear they are taking on all of the risk alone and would not be backed up by their hospitals if a prosecutor charged them with a crime. At Catholic hospitals, they typically have to transfer patients elsewhere for care.

When they do try to provide care, it can be a challenge to find other medical staff to participate. A D&C requires an anesthesiologist, nurses, attending physicians and others. Doctors said peers have refused to participate because of their personal views or their fear of being exposed to criminal charges. Georgia law allows medical staff to refuse to participate in abortions.

Thurman’s family members may never learn the exact variables that went into doctors’ calculations. The hospital has not fulfilled their request for her full medical record. There was no autopsy.

For years, all Thurman’s family had was a death certificate that said she died of “septic shock” and “retained products of conception” — a rare description that had previously only appeared once in Georgia death records over the last 15 years, ProPublica found. The family learned Thurman’s case had been reviewed and deemed preventable from ProPublica’s reporting.

The sting of Thurman’s death remains extremely raw to her loved ones, who feel her absence most deeply as they watch her son grow taller and lose teeth and start school years without her.

They focus on surrounding him with love but know nothing can replace his mother.

On Monday, she would have turned 31.

A photo of Thurman that she posted online in 2020 (via Facebook) How We Reported the Story

ProPublica reporter Kavitha Surana reviewed death records and medical examiner and coroner reports to identify cases that may be related to abortion access. She first reached out to Amber Thurman’s family and friends a year ago. The family shared her personal documents and signed a release for ProPublica to access her medical information. The maternal mortality review committee reviewed Thurman’s case at the end of July 2024.

Do you have any information about how abortion bans have affected medical care? Reach out to ProPublica reporters covering reproductive health care including Kavitha Surana at kavitha.surana@propublica.org or Cassandra Jaramillo at cassandra.jaramillo@propublica.org.

Cassandra Jaramillo, Mariam Elba, Kirsten Berg and Jeff Ernsthausen contributed research.

by Aliyya Swaby

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up for Dispatches, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.

A year ago, sheriff’s deputies in Georgia showed up on the doorstep of middle school student Colt Gray. They were there to question him about an online threat to shoot up his school. Last week, the 14-year-old was charged with shooting and killing four people at Apalachee High School.

As details continue to emerge, the question now in front of Georgia legislators is: How should officials respond to these kinds of warning signs in the future?

Lawmakers are already indicating that they intend to take tougher action against students who make threats. In a Sept. 12 letter to members of the state House Republican Caucus, House Speaker Jon Burns wrote that one of his objectives in the next legislative session will be to “increase penalties for making terroristic threats in our schools — and make it clear that here in Georgia, threats of violence against our students will not be tolerated and will be prosecuted to the fullest extent of the law.” (Burns did not respond to a request for comment.)

But, as ProPublica has reported this year, there can be consequences to increasing penalties: trampling the rights of children who don’t pose a threat to anyone.

Two weeks before the Apalachee shooting, we published a story about a 10-year-old in Tennessee who was expelled from school for a year after he angrily pointed his finger in the shape of a gun. The article explored how a state law, passed in response to last year’s Covenant School shooting in Nashville that left six people dead, requires schools to kick students out for making threats of mass violence.

Another Tennessee law went into effect in July that increases the charge for making a threat of mass violence from a misdemeanor to a felony — without requiring officials to take actual intent into account. Many experts and some officials consider both laws an overreach.

There is no indication that the Tennessee 10-year-old whose case we examined posed a danger to his school or his community. The fifth grader had no access to a firearm, according to his mother. She said school officials described him as a good kid and expressed regret at having to expel him. (The assistant director of his school district declined to comment, even after his mother signed a form permitting school officials to do so.)

Meanwhile, Georgia law enforcement officials were warned a year ago that Gray was making threats, and they heard directly from his father that the teenager had access to guns. (School officials said the warnings were never passed on to them.)

As Georgia lawmakers consider what they can do to keep students safer, experts say they should consider the implications their decisions may have for a broad spectrum of children — from the 14-year-old with access to assault rifles to the 10-year-old pointing a finger gun. People who study the warning signs of and legislative reactions to school shootings have long warned that zero-tolerance policies, such as the ones Tennessee adopted, are not proven to make schools safer — and in fact can harm students.

To deter violence, experts maintain, the research suggests that the most effective strategy is not mandatory expulsions and felony charges but a different kind of tactic, one that federal officials have touted based on decades of interviews with mass shooters, political assassins and people who survived attacks. Threat assessments, when done effectively, bring together mental health professionals, law enforcement and others in the community to help school officials sort out the credible threats from the simply disruptive acts and provide students with needed help.

“It is the best option available for us to prevent these kinds of shootings,” said Dewey Cornell, a psychologist and a leading expert on the use of threat assessments in schools. A threat assessment team is supposed to interview anyone involved with a threat to assess whether the student poses an imminent risk to others. And it is supposed to warn any intended victims of major threats, take precautions to protect them and seek ways to resolve conflict.

Cornell said law enforcement involvement and harsh discipline should be reserved for the most serious cases — the exact opposite of zero-tolerance policies. Tennessee, along with 20 other states, requires threat assessments in schools. But because the state also mandates expulsions and felony charges, many students end up ostracized and isolated rather than getting the ongoing help that experts consider to be one of the greatest strengths of the threat assessment process.

The suggestion that schools and authorities should closely monitor and assist students who make threats may feel counterintuitive, especially with fear and frustration soaring, said Mark Follman, a journalist with Mother Jones and author of the 2022 book “Trigger Points: Inside the Mission to Stop Mass Shootings in America.”

It’s also easy to understand why people want a punitive response to threats, Follman said, but it can make the problem worse. Expelling a student who is potentially dangerous means school officials and others have little ability to monitor them. And, crucially, “you’re also potentially exacerbating their sense of crisis, their grievance, especially if it involves the school,” he said, moving them toward a point of attack instead of away from it.

For his book, Follman interviewed leading experts on threat assessments and embedded with a team at a school district in Oregon. He points out that for the threat assessment process to work, it has to be carried out correctly. “Most, if not all, examples I have seen of stories about threat assessment having negative impact on students and families are cases in which it’s not being done right,” Follman said.

Tennessee school officials carry out threat assessments inconsistently, our story last month found. Some allow police to take the lead in minor incidents, resulting in criminal charges for kids who made threats that school officials themselves did not consider credible.

At least one Tennessee lawmaker is responding to the shooting in Georgia by saying it validates the harsh penalties for students who make threats. Tennessee state Sen. Jon Lundberg, who co-sponsored both punitive Tennessee laws, told the Chattanooga Times Free Press this week, “The legislature is constantly looking at, What else can we do?”