First Person

My Sister Served in the Army. The Biggest Threat to Her Survival is Congress.

My older sister, Lynn, was always getting into trouble when we were kids. I was the goody two-shoes in the family, but if I did ever get myself in trouble, she’d get in even more trouble to help me out. She was a good sister in that way—always looking out for me. When I was little, I didn’t like to sleep by myself during thunderstorms, and she’d let me crawl into bed with her because she knew I was afraid.

Now, in some ways, I’m her big sister. I do my best to take care of her.

Lynn—a 62-year-old army veteran—cannot walk. Her dementia makes it impossible for her to remember to take her medicine. Her forgetfulness has life-or-death implications, since she has diabetes, high blood pressure, and high cholesterol. As a result, Lynn has been in a nursing home for the past four years. Medicaid pays the bills for that—just like it does for most people who need nursing home care—and I’m terrified of what would happen without it.

Lynn joined the army right out of high school. When she was in boot camp, she had a traumatic head injury during basic training. The military doctors held her for observation, diagnosed her with a concussion, and then released her. She served her time as a private, then was honorably discharged and got married.

A few years later, she was struck by a car. She was at a crosswalk, and the car in front of her stopped to let her cross. But the car behind it was impatient, so it swerved around the first car, plowing into the crosswalk and hitting my sister. That left her with another traumatic head injury, as well as the beginning of hip problems that will plague her for the rest of her life.

Over time the hip problems worsened, until she finally had a hip replacement in her mid-50s. She was able to walk without pain for a while, but she then contracted a MRSA infection in her new hip joint. That can happen with artificial joints—it’s rare, but once you have the infection it’s hard to remove. Lynn’s infection spread quickly, and it almost killed her. Doctors tried to treat her with some very powerful drugs at first, which made her thoughts so fuzzy that she said her brain was buzzing.

Eventually, doctors had to remove her hip bone to control the MRSA. Medicaid paid for this surgery, too—otherwise, we wouldn’t have been able to afford it.

Just four years ago, Lynn was working multiple jobs to put her daughter through college: in the cafeteria at her daughter’s school, at Walmart, and at a deli. Now Lynn can no longer walk, or work. The doctors say the drugs impaired her brain and made her dementia onset much more quickly.

She’s not trying to take more than her fair share of the pie.

But this isn’t a sob story. I don’t want you to feel badly for her, or take pity on her. Lynn is still the same person I’ve always known, full of life and warmth. She can break the tension in a moment better than anyone I know. I still remember a moment a few years ago, when she was recovering from her first hip surgery. She flew into Washington, D.C., to visit us, and we were trying to get her out of baggage claim and into the elevator in her wheelchair. The doors started to close, and nobody wanted to hold them—she was far away, and she was moving so slowly. But she shouted, “I’m coming as fast as I can!” across the airport. They actually held the door for her. In the elevator, she chatted with them amicably, asking how their Christmas was going. Strangers were smiling and talking to her—that’s a rare sight in D.C.

Lynn would be lost without Medicaid. She served her country and worked hard to provide for her family. She’s not trying to take more than her fair share of the pie. She’s just somebody who needs care—and she didn’t expect to need the care that she needs as young as she is.

When our elected representatives decide to cut Medicaid—whether through repeated attempts to repeal the Affordable Care Act or a budget that cuts $3.6 trillion from services such as Medicare and Medicaid—they should think about what this means to people like me and my family. They should think about Lynn, and the millions of other veterans who have turned to Medicaid.



Tension Builds as St. Louis Awaits Another Police Killing Verdict

On Labor Day, there was a candlelight vigil on the corner where Anthony Lamar Smith was killed. He was shot by Jason Stockley in 2011, who remained a St. Louis police officer until 2013. That’s the year the city paid out a wrongful death settlement to Smith’s family. Now, Stockley’s murder trial has concluded. The city has been waiting on a verdict since August 9.

St. Louis residents are used to being told to wait for justice, and this all feels familiar. In 2014, it took months to get the grand jury’s decision not to charge Darren Wilson for the shooting of Michael Brown.

Now, any time something big happens in St. Louis—like a verdict or an important anniversary—people converge on the city. Activists, journalists, residents, and protesters head back to the same street corners and the same cafes, and everybody speculates, though there’s no telling what might happen next.

This year’s unseasonably early cold snap makes it feel like that November when we all waited for Wilson’s verdict. Again, the waiting has stretched into months, and there’s an edgy monotony of checking the news and reporting on local events, and wondering how long tension can build before it bursts.

On September 1, two officers were shot and a woman was killed by a stray bullet near the downtown area. A few hours later, residents who’d gathered in the area spotted heavily armed officers a few blocks away. It turned out to be a search of nearby abandoned buildings, presumably for a suspect in the shooting. Five cruisers and at least as many undercover units gathered and milled about, while residents speculated that it was a raid of someplace nearby.

“I saw the cops converge behind this building for something or somebody,” said Megan Macarey, a yoga teacher at a nearby charity. “Police are militarizing the neighborhood.”

Macarey had been calling her friends, telling everyone they might have to come outside and keep an eye on things. Most neighborhoods that are the target of police in St. Louis are like that, with informal networks and a practiced sequence of events. Cops show up, everyone comes out and videos everything. Macarey said, “Tensions are high, and we know police are putting up the barricades,” which the city had erected earlier that day in anticipation of the verdict’s release.

Annie Smith is, like many people, tired of waiting for justice.

That is how policing is done in St. Louis: opaquely and usually with a show of force. There are times when the police can be perfectly lovely, such as at the Labor Day parade when they were playing with children. But policing of protests is decidedly less friendly in many instances, and given that two officers have just been shot, few people in the activist community expect the police to be in a conciliatory mood any time soon.

Over Labor Day weekend, there were protests going on at nearly any hour. Sunday night, local activists marched through a bar district, gaining a fair amount of support from patrons who joined them to chant, “Out of the bars and into the streets!” Monday morning, Fight for $15 shut down a local McDonald’s before joining the Labor Day parade, which featured thousands of union workers alongside ads for Boeing and Lockheed Martin.

Monday evening was the vigil for Smith, which was supposed to be candlelit until a storm roiled above us and forced everyone to use their cell phone lights instead. Annie Smith, Anthony Smith’s mother, gave a statement: “Why has it taken so long for the verdict?” Smith is, like many people, tired of waiting for justice. “I lost my voice yelling, and I’m tired of yelling,” she said.

The verdict could feasibly come back guilty. But although roughly 11,000 people were shot and killed by police officers from 2005 to 2016, only 77 officers were charged—and only 26 were eventually convicted. It’s more likely that Stockley will be found not guilty. When that happens, the people here will be reacting to not just this verdict, but to every verdict this feels like, each piling on top of one another.

Editor’s note: This is the first in a three-part series on the trial over the killing of Anthony Lamar Smith.



A Historian Explains How Immigration Restrictions Have Always Been About Race

President Donald Trump’s decision to rescind Deferred Action for Childhood Arrivals (DACA)—an Obama-era executive order protecting DREAMers DREAMers are undocumented immigrants who came to the United States as children. DACA allows them to defer deportation and legally reside in the United States for two years, and makes it possible to obtain driver's licenses, enroll in college, and hold jobs. Latest government figures estimate that there are nearly 800,000 DREAMers living in the United States. —earned near-universal condemnation from Democrats and Republicans. But while targeting immigrants who were brought here as children is new, Trump’s actions are consistent with a strain of American politics going back centuries.

Nativism—the often racialized view that local interests should be protected over those of immigrants—is as old as the country itself. The anti-immigrant and anti-Catholic “Know-Nothing Party” was a major political force in the middle of the 19th century, electing eight governors and more than 100 members of Congress. The Immigration Act of 1924 severely restricted immigration from Southern and Eastern Europeans, targeting Italians and Jews. Just this week, former White House adviser Steve Bannon revived anti-Catholic tropes in voicing his opposition to DACA.

I spoke with Tyler Anbinder, a historian at The George Washington University and expert on the history of nativism in the United States, about how Trump’s decision fits into nativist politics throughout the country’s history.

Jeremy Slevin: You’ve written a lot about this concept of nativism. Can you start by explaining what it means and where Donald Trump fits into it?

Tyler Anbinder: Nativism is the fear of or dislike of immigrants and the belief that immigrants make the United States a worse place to live. Donald Trump fits in the pattern of American nativism that we’ve had for several centuries in that there’s always been a certain portion of the population that has a gut reaction that immigrants are a bad thing, that they take jobs from other Americans, that they change American culture for the worse, that immigrants can never become true Americans. Those tend to be the strains of nativist thought.

JS: Is there precedent for this level of vitriol and this level of nativism at the presidential level?

TA: Probably not at the presidential level. Typically, it’s been Congress that’s been much more anti-immigrant than presidents. In the past, when you had Congress pass anti-immigrant legislation, presidents have repeatedly vetoed it, and that happened in the late 19th and early 20th centuries with presidents such as Taft and Wilson vetoing immigrant-restriction legislation.

This is a rare case in which the president is the leader of the anti-immigrant movement.

So this is a rare case in which the president tends to be the leader of the anti-immigrant movement and Congress is maybe a little less willing to go along.

JS: Obviously the big news this week is DACA, rolling back President Obama’s executive order protecting DREAMers. I think what makes this shocking to a lot of people is that these are people brought here as kids, traditionally a sympathetic political group. Has there been a singling out of immigrant children, either for good or for ill, in the past? Or is this a new territory?

TA: This is pretty much a new territory, because for most of American history, children have not been immigrants. Immigrants would overwhelmingly be people in their 20s especially, late teens, maybe early 30s … immigrants rarely brought children to America. They typically came to America unmarried, trying to strike out in the world on their own. There were exceptions—during the Irish potato famine for instance, or when Eastern European Jews were escaping the Pogroms in Russia. But typically, children haven’t been a very big part of the American immigration story.

JS: The not-so-subtle subtext of all this is racism, whether against Muslims like we saw in the travel ban and now Latinos with the end of DACA. It seems like race and immigration have always been linked—how has that evolved over time?

TA: Certainly American nativism has always had a racial dimension, even though exactly what people mean by the term “race” has changed. In the 19th century, the big targets of the nativists were the Irish. The American nativists believed that the Irish were of a different race—that most white Americans were Anglo-Saxon in origin, and the Irish were different and therefore couldn’t become true Americans, and weren’t even intellectually capable of reaching the status of other Americans.

In the late 19th century, the same charges were leveled against Eastern European Jews and Italian immigrants, which were the two biggest immigrant groups in that period. People said the same things. They would go so far as to say that these groups weren’t really “white,” and therefore being “less than white,” they weren’t capable of the intellectual attainments that other whites were and they should be barred from the United States.

JS: Have nativists always wrapped themselves in the identity of whiteness?

TA: Yes, with some exceptions. In the 1920’s, when there were restrictions on Southern and Eastern European immigration, African Americans were big supporters of that. They supported it primarily because they said, “immigrants are taking our jobs, and if we have fewer immigrants, better jobs would go to African Americans.”

So it’s not just that nativism is solely something that whites participate in. It can be something that others partake in, too. But in terms of the majority of American nativism, there’s always been a sense that the new group isn’t part of what the current Americans define as being American. For a long time that meant being a certain type of Protestant. Then it meant all Protestants. Then it meant all Christians. Then it meant Judeo-Christians. And that’s where we are today, perhaps.

JS: Steve Bannon said today that American Catholics have an economic interest in unlimited illegal immigration, so you’re kind of seeing that Anglo-Saxon anti-Catholic sentiment creep up again.

TA: That’s so interesting, I didn’t hear about that. Yes, that would precisely fit in with that historic trend.

JS: At the same time, there’s a tension within the modern Republican party between business leaders and Republican elites who often support immigration because it’s seen as a boon to the economy. Has that tension always existed?

TA: Yes, although the important thing to understand is that the business community won out for most of American history. Even when immigration restrictions were in place, often there would be loopholes. A great example of that is in the 1920’s, when restrictions were put in place on Southern and Eastern European Jews, there was an exception for Latinos. And that’s so those employers say, “well, we may not be able to get those Eastern or Southern European workers, but we can get Mexicans instead to do the work that those other people used to do.”

It’s only really starting in the 1960’s, when the restrictions were relaxed on groups like Asians and Africans and Eastern Europeans, that the restrictions were put in place on Latinos.

JS: So it kind of shifted—when Eastern Europeans were the largest immigrant group, they were targeted, and now that Latinos are a larger immigrant group, they’ve become the target.

Obviously, you’re more accustomed to looking backward, but what do you think is next, after DACA? Do you think we’re on a more restrictionist path like the 1920’s, or do you think this has got to shift?

It’s hard to predict where Trump is going to go.

TA: Well, it’ll be really interesting. Until very recently, I’d have said that the restriction could not win out legislatively. Politicians have found that talking tough on immigration is good, but Congressional Republicans are split between a cultural wing and a business wing, and the business wing has been very adamantly against restricting immigration for the reasons that we talked about. Because of that, there’s been this 30-year stalemate where nothing has changed.

But typically, Republican presidents have leaned toward the business wing. Clearly, it’s hard to predict where Trump is going to go, but one option he has is removing the [undocumented] immigrants that are already here. That’s something that the president can do on his own; he doesn’t need Congress, since it’s just an enforcement matter. That seems like the most likely possibility.

The next possibility would be the bill that was proposed by Tom Cotton a few weeks ago calling for a reduction in the number of legal immigrants. I find it hard to imagine that bill passing Congress, but certainly a lot of the Trump base would support that proposal, I’d imagine. I still think the most likely thing is gridlock on that, but with stepped-up deportation.

But I have to say this is a whole new ballgame, so it’s hard to predict.

This interview was conducted for Off-Kilter and will air as part of a complete episode on September 15. It was edited for length and clarity. Listen to the full interview below.



Reminder: Hurricane Survivors Still Get Their Periods

Hurricanes Harvey and Irma are reminding us, with excruciating lucidity, just how tenuous the everyday can be. When catastrophe strikes, the search for food, potable water, and a roof instantly becomes an all-consuming task, alongside every other conceivable human need: a bed, a shower, diapers for the babies, tampons for the women.

Except that tampons are almost never mentioned.

Americans have an abiding discomfort, bordering on revulsion, toward any discussion of menstruation. In discourse both public and private, this most human of bodily functions is treated as secret and shameful, a demi-illness that must be concealed if the sufferer is to have any hope of being taken seriously in functional society. God forbid a man catch you with a tampon in your hand.

Even as our generosity is called upon to help meet the daily needs of hurricane survivors, though, the specific needs of menstruating people are largely forgotten. Some organizations, such as food and diaper banks, include requests for period supplies in their appeals; a handful of menstruation-specific nonprofits exist; and there have been occasional media mentions, but these are by far the exception rather than the rule. For the most part, the parts of being a victim that are deemed unpleasant are studiously ignored.

Of course, for many Americans, it doesn’t take a natural disaster for the everyday to become tenuous. The poor, the homeless, the unemployed, and underemployed must regularly choose between school supplies or winter coats, diapers or tampons.

Depending on type, brand, and coverage, tampons and pads cost roughly $6 to $9 for a package of about 40, which any menstruator can tell you may not even last a month. Four weeks later that expense comes by again, to the tune of $70 to $110 a year before sales tax. For people who make $15,000 working full time at a minimum-wage job, that’s the kind of expense that can easily mean the difference between paying a bill or defaulting.

In recent years a movement has emerged to lessen this burden by eliminating sales taxes on period supplies; recently enacted laws to that effect are both hugely welcome and not remotely sufficient. What’s really needed, nationwide, is something akin to the law passed last year in New York City providing tampons and pads free of charge at schools, shelters, and correctional facilities—a move echoed by the federal government in late August, when it issued a recommendation that all federal penitentiaries do likewise.

Half of human bodies were designed to function this way.

Because lest we forget, period supplies are not optional. At the end of the day, pads and tampons serve one purpose: to contain menstrual fluid. With nothing to stop it, the combination of vaginal secretions, uterine lining, and (yep) blood can become a powerful mess. It’s a feature of the human reproductive system, not a bug—half of human bodies were designed to function this way. Forgetting that humans need period supplies is like forgetting that they need toilets (and then shaming them for urinating).

Girls and women (and some trans boys and trans men) who can’t readily meet this need are forced to make do however they can, often resorting to inappropriate or fundamentally unsanitary solutions that threaten their health, fertility, and basic ability to get things done—it’s hard to focus in math class or on the job if you know you’re bleeding all over your chair. That’s why Human Rights Watch recently released a report recognizing that menstrual hygiene is in fact not just a question of finances, but a human right.

We are right to open our hearts and our wallets to those who have had to watch as all they hold dear is literally washed away. No matter the weather, families always need food, babies always need diapers, and people who menstruate always need pads or tampons.

But what is true for the survivors of hurricanes is also true for the survivors of poverty. The deeply held misogyny that prevents us from treating female bodies as normal intersects with our dehumanization of poor people, and it prevents us from seeing that need (much less meeting it).

As we struggle to build a world that’s fairer for everybody who lives in it, it’s not enough to consider only the bodies we feel comfortable talking about. Whether rising to the challenge posed by natural disasters or acting to mitigate the unnatural disaster of poverty, we must begin to acknowledge the full humanity of all affected, reproductive organs included.



Trump Administration’s Response to the Opioid Crisis: Re-Igniting the War on Drugs

Three weeks ago, President Donald Trump announced that he considers the opioid crisis, which is now the worst addiction crisis in the country’s history, a “national emergency.” But nearly a month later, a national emergency still hasn’t been formally declared, and the administration hasn’t taken any steps to expand treatment. In the meantime, close to 2,500 more Americans have died from opioid overdose.

Now the Trump administration and congressional Republicans seem to be coalescing around a response: They are preparing to open a new front in the war on drugs.

The House’s fiscal year 2018 budget, which could be up for a vote as early as next week, shifts resources from treatment to enforcement. It strips hundreds of millions of dollars from public health agencies: $306 million from the Substance Abuse and Mental Health Services Administration (SAMHSA) and $198 million from the Centers for Disease Control and Prevention. Furthermore, the Centers for Medicare and Medicaid Services will lose $219 million if the bill is passed, and Medicaid itself—which covers more than 40 percent of opioid treatment in the hardest-hit states—is also facing extreme cuts. Meanwhile the FBI will get $48 million more, the Department of Homeland Security will get nearly $1.9 billion more, and the Drug Enforcement Administration will get an increase of $98 million from 2017 levels.

By beefing up law enforcement and cutting funding for treatment, the House budget builds on the priorities outlined in Attorney General Jeff Sessions’ notorious memo that re-ignites the war on drugs. In it, he orders federal prosecutors to seek maximum sentences for nonviolent, low-level drug offenses, re-implementing draconian policies that are emotionally and economically devastating to low-income and minority communities.

Decades of evidence make it clear that war on drugs policies don’t work.

Decades of evidence already make it clear that war on drugs policies don’t work. The United States’ last experiment with this approach left the country with the largest prison population in the world, without addressing the root causes of drug use and addiction. Ninety-five percent of addicts return to substance abuse when they’re released from prison, compared with just 40 to 60 percent who complete a rehabilitation program.

These relapse rates are especially relevant now, as the opioid epidemic spreads on a massive scale. There were 33,091 opioid drug overdose deaths in 2015—roughly the same amount of lives claimed by firearms and motor vehicle accidents the previous year.

Screen Shot 2017-09-05 at 10.09.05 AM

Source: Kaiser Family Foundation.

To minimize this widespread growth, addiction must be met with treatment—not punishment. But currently only 1 in 10 of the roughly 20 million adults in the United States with an addiction disorder receive the treatment they need. Hacking away at the limited budget that does exist for treatment is unlikely to improve the likelihood that people with addiction disorders get help.

Unlike previous drug crises, the American people want addicts to receive treatment. At least in part due to the race of the people affected—about 90 percent of the people who died from opioid overdose were white—this crisis has garnered sympathetic attention from politicians, the media, medical researchers, nonprofits, and the public, and has largely been framed as a public health crisis. Until recently, the attention set the country up to craft a progressive, proactive policy response to the crisis; a response that needs to be scaled up in order to effectively fight this epidemic.

In March 2016, for instance, the Department of Health and Human Services released $94 million in new funding to 271 Community Health Centers with a special focus on expanding medication-assisted treatment (MAT) in underserved communities—expected to treat nearly 124,000 new patients with substance abuse disorders. Furthermore, up to 11 states expanded their MAT services due to SAMHSA funding grants.

If Congress passes this budget and builds on the Sessions approach to criminal justice, the progress that’s been made in treating addiction as a public health issue—along with hundreds of thousands of American lives—will be lost.