BISMARCK, ND — The first person to spot it was a shovel operator working the overnight shift, eyeing a glint of white as he scooped up a giant mound of dirt and dropped it into a dump truck.

Later, after the truck driver dumped the load, a dozer driver was ready to flatten the dirt but stopped for a closer look when he, too, spotted that bit of white.

Only then did the miners realize they had unearthed something special: a 2-meter-long mammoth tusk that had been buried for thousands of years.

“We were very fortunate, lucky to find what we found,” said David Straley, an executive of North American Coal, which owns the mine.

The miners unearthed the tusk from an old streambed, about 12.1 meters deep, at the Freedom Mine near Beulah, North Dakota. The 18,210-hectare surface mine produces up to 14.5 million metric tons of lignite coal per year.

After spotting the tusk, the crews stopped digging in the area and called in experts, who estimated it to be 10,000 to 100,000 years old.

Jeff Person, a paleontologist with the North Dakota Geologic Survey, was among those to respond. He expressed surprise that the mammoth tusk hadn’t suffered more damage, considering the massive equipment used at the site.

“It’s miraculous that it came out pretty much unscathed,” Person said.

A subsequent dig at the discovery site found more bones. Person described it as a “trickle of finds,” totaling more than 20 bones, including a shoulder blade, ribs, a tooth and parts of hips, but it’s likely to be the most complete mammoth found in North Dakota, where it’s much more common to dig up an isolated mammoth bone, tooth or piece of a tusk.

“It’s not a lot of bones compared to how many are in the skeleton, but it’s enough that we know that this is all associated, and it’s a lot more than we’ve ever found of one animal together, so that’s really given us some significance,” Person said.

Mammoths once roamed across parts of Africa, Asia, Europe and North America. Specimens have been found throughout the United States and Canada, said Paul Ullmann, a University of North Dakota vertebrate paleontologist.

The mine’s discovery is fairly rare in North Dakota and the region, as many remains of animals alive during the last Ice Age were destroyed by glaciations and movements of ice sheets, Ullmann said.

Other areas have yielded more mammoth remains, such as bonebeds of skeletons in Texas and South Dakota. People even have found frozen carcasses in the permafrost of Canada and Siberia, he said.

Mammoths went extinct about 10,000 years ago in what is now North Dakota, according to the Geologic Survey. They were larger than elephants today and were covered in thick wool. Cave paintings dating back 13,000 years depict mammoths.

Ullmann calls mammoths “media superstars almost as much as dinosaurs,” citing the Ice Age film franchise.

This ivory tusk, weighing more than 22.6 kilograms, is considered fragile. It has been wrapped in plastic as paleontologists try to control how fast it dehydrates. Too quickly, and the bone could break apart and be destroyed, Person said.

Other bones also have been wrapped in plastic and placed in drawers. The bones will remain in plastic for at least several months until the scientists can figure how to get the water out safely. The paleontologists will identify the mammoth species later, Person said.

The mining company plans to donate the bones to the state for educational purposes.

“Our goal is to give it to the kids,” Straley said.

North Dakota has a landscape primed for bones and fossils, including dinosaurs. Perhaps the best-known fossil from the state is that of Dakota, a mummified duckbilled dinosaur with fossilized skin, Ullmann said.

The state’s rich fossil record is largely due to the landscape’s “low-elevation, lush, ecologically productive environments in the past,” Ullmann said.

North Dakota’s location adjacent to the Rocky Mountains puts it in the path of eroding sediments and rivers, which have buried animal remains for 80 million years or more, he said.

“It’s been a perfect scenario that we have really productive environments with a lot of life, but we also had the perfect scenario, geologically, to bury the remains,” Ullmann said.
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sydney — With fangs that could pierce a human fingernail, the largest male specimen of the world’s most venomous arachnid has found a new home at the Australian Reptile Park where it will help save lives after a member of the public discovered it by chance.

The deadly Sydney funnel-web spider dubbed Hercules was found on the Central Coast, about 50 miles north of Sydney, and was initially given to a local hospital, the Australian Reptile Park said in a statement Thursday.

Spider experts from the nearby park retrieved it and soon realized it was the largest male specimen ever received from the public in Australia.

The spider measured 7.9 centimeters from foot to foot, surpassing the park’s previous record-holder from 2018, the male funnel-web named Colossus.

Sydney funnel-web spiders usually range in length from 1 to 5 centimeters, with females being generally larger than their male counterparts but not as deadly. They are predominantly found in forested areas and suburban gardens from Sydney, Australia’s most populous city, to the coastal city of Newcastle in the north and the Blue Mountains to the west.

Hercules will contribute to the reptile park’s anti-venom program. Safely captured spiders handed in by the public undergo “milking” to extract venom, essential for producing life-saving anti-venom.

“We’re used to having pretty big funnel-web spiders donated to the park, however receiving a male funnel-web this big is like hitting the jackpot,” said Emma Teni, a spider keeper at Australian Reptile Park. “Whilst female funnel-web spiders are venomous, males have proven to be more lethal. With having a male funnel-web this size in our collection, his venom output could be enormous, proving incredibly valuable for the park’s venom program.”

Since the inception of the program in 1981, there has not been a fatality in Australia from a funnel-web spider bite.

Recent rainy, humid weather along Australia’s east coast has provided the ideal conditions for funnel-web spiders to thrive.
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NEW YORK — The flu season in the U.S. is getting worse but it’s too soon to tell how much holiday gatherings contributed to a likely spike in illnesses.

New government data posted Friday for last week — the holiday week between Christmas and New Year’s — show 38 states with high or very high levels for respiratory illnesses with fever, cough and other symptoms. That’s up from 31 states the week before.

The measure likely includes people with COVID-19, RSV and other winter viruses, and not just flu. But flu seems to be increasing most dramatically, according to the Centers for Disease Control and Prevention.

“We expect it to be elevated for several more weeks,” said the CDC’s Alicia Budd. So far, though, this is a moderate flu season, she said.

Interpreting flu reports during and after the holidays can be tricky, she noted. Schools are closed. More people are traveling. Some people may be less likely to go see a doctor, deciding to just suffer at home. Others may be more likely to go.

The flu season generally peaks between December and February; CDC Director Dr. Mandy Cohen said she expects it to peak by the end of this month. Officials say this season’s flu shots are well-matched to the strain that is spreading the most.

According to CDC estimates, since the beginning of October, there have been at least 10 million illnesses, 110,000 hospitalizations, and 6,500 deaths from flu so far this season. The agency said 27 children have died of flu.

COVID-19 illnesses may not be escalating as quickly as flu this winter. CDC data indicates coronavirus-caused hospitalizations haven’t hit the same levels they did at the same point during the last three winters. Still, COVID-19 is putting more people in the hospital than flu, CDC data shows.

Lauren Ancel Meyers of the University of Texas said the nation is seeing a second rise in COVID-19 after a smaller peak in September.

“There is a lot of uncertainty about when and how high this current surge will peak,” said Meyers, who runs a team that forecasts COVID-19, flu and RSV trends.

A new version of the coronavirus, called JN.1, is accounting for nearly two-thirds of U.S. cases, according to a CDC estimate. But health officials say there’s no evidence that it causes more severe disease than other recent variants. 
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WASHINGTON — At a time when growing numbers of young Americans are diagnosed with mental health conditions, media are looking at ways to cover the issue more responsibly.

Data shows a rise in young adults being diagnosed with conditions such as depression or anxiety. But media reports of public incidents involving mental health sometimes use damaging language, experts say.

Terms such as “unhinged” or “erratic” — language used to describe a homeless man killed on the New York subway last year — are held up as poor examples of coverage.

Reporters on the health beat and experts who specialize in mental health say that such terms are damaging for those who have a medical condition and that they can be misleading.

“Media plays an important role in shaping public perception of many things, including mental illness,” said Christine Herman, a freelancer journalist.

Coverage can make it appear as if the illness is a moral failing or lack of character, Herman told VOA.

“Sometimes mental health issues are criminalized in our society,” she said, citing how some news outlets still use terms such as “commit suicide” when reporting on someone who has taken their own life.

The term dates to when suicide was still criminalized in the United States.

“The language we use and the way we describe and talk about mental health conditions can really contribute and shape perception,” Herman said.

Rebecca Brendel, a medical doctor and former president of the American Psychiatric Association, said she believes media plays an important role in explaining health conditions.

“We know that to get treatment and to be healthy, we need to have health literacy,” she told VOA. “We need to have an awareness. We need to have reliable information as consumers of health care and mental health care.”

The late first lady Rosalynn Carter was an early advocate for responsible reporting on mental health. Through the Carter Center, she created a fellowship that offers training to journalists on how to better cover the issue.

“Informed journalists can have a significant impact on public understanding of mental health issues as they shape debate and trends with the words and pictures they convey,” Carter said, as cited by the Center.

When Carter died in November, staff at the Center paid tribute to her legacy.

“She taught generations of journalists how to report about behavioral health in a way that reduces stigma and stimulates understanding and equitable treatment,” a statement read.

Since the fellowship started in 1996, more than 250 journalists have benefited from the program — including Herman.

“It’s important because the type of coverage we do … people in our communities read it, or people across the country read this coverage,” said Herman, who started her career in public radio.

Based in Champaign, Illinois, Herman said that as she started to cover health issues more regularly, her interest in mental health grew.

Her reporting on the obstacles for families trying to access mental health care was recognized with an award last year.

Herman, who serves on the board of the Association of Health Care Journalists, said the most effective reporting is accurate, based on science and puts a focus on the person not the condition.

She advocates for compassionate coverage that includes the voices and perspectives of the people affected.

“These are all things that can help contribute to dismantling stigma and ending discrimination toward people who have mental health conditions in our society,” she said.

Data from the American Psychiatric Association shows 1 in 5 Americans experiences a mental health disorder.

“We know that Americans are struggling with their mental health now more than ever before, following the COVID-19 pandemic,” said Brendel of the American Psychiatric Association. “In fact, in mental health circles, we’ve even called it a twin pandemic, a pandemic of mental health.”

She and Herman say they have seen an improvement in how media reports on mental illness, due in part to the Carter fellowship program.

Having the skills to report in a way “that is both accurate and actionable,” Herman said, ensures coverage that contributes to “better public understanding of these issues and ideally to dismantling stigma.”
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A busy week for SpaceX launches. NASA eyes an upcoming moon mission. And Australian buffaloes get a high-tech upgrade. VOA’s Arash Arabasadi brings us The Week in Space.
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NEW YORK — More U.S. hospitals are requiring masks and limiting visitors as health officials face an expected but still nasty post-holiday spike in flu, COVID-19 and other illnesses.

While many experts say this season likely won’t prove to be as deadly as some other recent winters, it still could mean hundreds of thousands of hospitalizations and many thousands of deaths across the country.

New York City last week instituted a mask mandate for the city’s 11 public hospitals. Similar measures were ordered last week at some hospitals in Los Angeles and Massachusetts. Some hospitals reinstated masking rules for employees months ago, in anticipation of a seasonal rush of sick people.

Flu and COVID-19 infections have been increasing for weeks, with high levels of flu-like illness reported in 31 states just before Christmas. Updated national numbers are to be released Friday, but health officials predict infections will grow in many states well into January.

“What we’re seeing right now, in the first week of January, is really an acceleration — of flu cases, in particular,” said Dr. Mandy Cohen, director of the Centers for Disease Control and Prevention.

There is some good news. Flu and COVID-19 cases may peak by the end of the month and then drop, Cohen said. Though the flu has been skyrocketing, this year’s cases are being caused by a strain that usually doesn’t cause as many deaths and hospitalizations as some other versions. What’s more, signs suggest current flu vaccines are well-matched to the strain.

“I don’t think it’s going to be overwhelming,” said Dr. William Schaffner, Vanderbilt University infectious diseases expert. He deemed the current season “moderately severe.”

The CDC is pointing the public to an agency website where people can look up their county, which can help them make decisions about whether to wear masks or take other precautions. Cohen urged people to get vaccinated and to seek treatment for flu and COVID-19.

Vaccinations are down this year, officials say. About 44% of U.S. adults had gotten flu shots by Dec. 23, according to the most recently available CDC vaccination survey data. Only about 19% of U.S. adults were reported to have received an updated COVID-19 shot as of early December.

COVID-19 cases are causing more severe disease than the flu but have been rising less dramatically. Health officials are keeping an eye on JN.1, a new version of the ever-evolving coronavirus. The omicron variant was first detected in the U.S. in September and just before Christmas accounted for an estimated 44% of COVID-19 cases.

The JN.1 variant may spread easier or be better at evading our immune systems, but there is no evidence that it causes more severe disease than other recent variants, health officials say. Current evidence indicates vaccines and antiviral medications work against it.

The CDC also has reported disappointing vaccination rates against another seasonal bug, respiratory syncytial virus, or RSV. That is a common cause of mild cold-like symptoms, but it can be dangerous for infants and older people. RSV cases rose in the fall but appear to have plateaued and are even going down in some places, according to the latest data.

At Hillsdale Hospital in southern Michigan, a 65% increase in respiratory illness activity in late December triggered a limitation to visitors in the birthing center. Only a spouse, a support person and grandparents can visit. They all must wear a mask and not show symptoms of sickness.

The restriction is common for the hospital around this time of year, said Dr. Nichole Ellis, a pediatrician who is the hospital’s medical chief of staff. But it’s more difficult this season, she added.

“In the past, we would have one … disease that we were tracking or monitoring at one time,” Ellis said. “But now, babies and children will have multiple diseases at the same time. It’s not that they just have RSV … but they’re getting RSV and COVID at the same time, or influenza and RSV at the same time because all of the diseases are prevalent in our community.”
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WASHINGTON — Federal officials are seizing more shipments of unauthorized electronic cigarettes at U.S. ports, but thousands of new flavored products continue pouring into the country from China, according to government and industry data reviewed by The Associated Press.

The figures underscore the chaotic state of the nation’s $7 billion vaping market and raise questions about how the U.S. government can stop the flow of fruit-flavored disposable e-cigarettes used by 1 in 10 American teens and adolescents. 

More than 11,500 unique vaping products are being sold in U.S. stores, up 27% from 9,000 products in June, according to tightly held industry data from analytics firm Circana.

“FDA whacks one product and then the manufacturers get around it and the kids get around it,” said Bonnie Halpern-Felsher, a Stanford University psychologist who develops anti-vaping educational materials. “It’s too easy to change your product a little bit and just relaunch it.”

Halpern-Felsher says she is “constantly” updating her curriculum to keep pace with new vaping brands and trends.

Nearly all the new products are disposable e-cigarettes, according to the sales data gathered from gas stations, convenience stores and other shops. The products generated $3.2 billion in the first 11 months of this year.

The FDA has authorized a handful of e-cigarettes for adult smokers and is still reviewing products from several major companies, including Juul. Regulators consider nearly all other e-cigarettes to be illegal.

“Those committing illegal acts don’t advertise their crimes, and those trying to import illegal tobacco products into the United States are no different,” said FDA’s tobacco director, Brian King, in a written response to AP questions. “The FDA and our federal partners are using tools, like import alerts, to stop these illegal tobacco products at the border and to deter countless others.”

The rise in e-cigarettes sold continues despite a record number of products detained.

An FDA database shows officials “refused” entry to 148 containers or pallets of “tobacco” goods last month, consisting almost entirely of vaping products from China. Refused imports are typically destroyed.

Through the end of November, U.S. officials had refused 374 such shipments this year, more than double the 118 refused in 2022.

This year’s items included $400,000 worth of Esco Bars, a disposable brand placed on a list of banned imports in May. The agency’s posted data is often preliminary because it takes time to finalize refusals.

But recent history shows how easily companies can maneuver around import bans.

In July 2022, the FDA barred dozens of e-cigarettes from Chinese manufacturer Fume, including flavors Pineapple Ice and Blue Razz.

Fume sales dipped after the ban, but the company launched a slew of new products, posting $42 million in U.S. sales in the third quarter of 2023, the data shows. Roughly 98% of sales came from products not on the FDA’s “red list” of products that can be detained.

Industry shipping tactics are also challenging the usefulness of import restrictions.

In July, FDA and customs officials intercepted $18 million worth of illegal vapes, including leading brand Elf Bar. But the shipments were mislabeled as shoes, toys and other items — not e-cigarettes — requiring officials to individually open and verify the contents of more than two dozen containers.

Circana, formerly IRI, restricts access to its data, which it sells to companies and researchers. A person not authorized to share it gave the AP access on the condition of anonymity.

The FDA has no schedule for updating its import lists but said it is “closely monitoring” instances where companies try to avoid detection.

“The FDA has a variety of tools at our disposal to take action against these tactics,” FDA’s King said.

The agency has limited powers to penalize foreign companies. Instead, regulators have sent hundreds of warning letters to U.S. stores selling their products, but those are not legally binding.

Even as the FDA attempts to work with customs officials, it is struggling to complete a yearslong review of applications submitted by manufacturers hoping to market their products to adults.

The few tobacco-flavored products currently authorized by FDA are deeply unpopular. Their combined sales were just $174 million, or 2.4% of the vaping marketplace this year, according to Circana.

“Nobody wants them,” says Marc Silas, owner of 906 Vapor shop in Michigan. “If people wanted them, they’d be on the shelves and they’re not.”

Deeply frustrated with the pace of FDA’s review, public health groups have successfully sued the agency to speed up the process. The agency aimed to complete all major outstanding applications this year, but it recently said the process would stretch into next year.

The delays have raised questions about the viability of the current regulatory framework for e-cigarettes.

“FDA is trying to operate with an old model when the whole environment has changed,” said Scott Ballin, a health policy consultant who previously worked for the American Heart Association. “They have this long line of products that have to be reviewed one by one and now they’re in a giant hole.” 
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AMSTERDAM — Climate activists blocked part of the main highway around Amsterdam near the former headquarters of ING bank Saturday to protest its financing of fossil fuels.

Amsterdam Municipality said in a message on X, formerly Twitter, that traffic authorities closed part of the road and diverted traffic “to prevent a life-threatening situation.”

Hundreds of activists walked onto the road in the latest road blockade organized by the Dutch branch of Extinction Rebellion. Earlier this year, the activist organization repeatedly blocked a highway leading into The Hague.

Some of Saturday’s protesters walked along the closed A10 highway carrying a banner emblazoned with the words “Change or die” as two police vans drove slowly behind them.

Another person carried a handwritten banner that said: “ING get out of oil and gas now!” Others glued their hands to the road surface.

Police criticized the protesters for blocking the road close to the VU medical center, one of Amsterdam’s main hospitals.

“The blockade is very undesirable given its impact on the traffic in the city and, for example, employees at the nearby VU medical center and people visiting patients,” Amsterdam police said in a statement.

The protest took place despite ING announcing earlier this month that it is accelerating its moves to phase out loans for fossil fuel exploration.

ING made its announcement a week after nearly 200 countries at the COP28 climate meeting in Dubai agreed to move away from planet-warming fossil fuels in a document that critics said contained significant loopholes.

Extinction Rebellion spokesperson Let de Jong said the phase-out plan was not fast enough.

“We demand that ING immediately stops all fossil fuel financing,” De Jong said in a statement ahead of the protest. “Every day, people are dying around the world because of the climate and ecological crisis. That has to stop.”

At past protests in The Hague, police used a water cannon to force activists off the road and arrested hundreds of people.
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BILLINGS, Mont. — Since passage of the Endangered Species Act 50 years ago, more than 1,700 plants, mammals, fish, insects and other species in the U.S. have been listed as threatened or endangered with extinction. Yet federal government data reveals striking disparities in how much money is allocated to save various biological kingdoms.

Of the roughly $1.2 billion a year spent on endangered and threatened species, about half goes toward recovery of just two types of fish: salmon and steelhead trout along the West Coast. Tens of millions of dollars go to other widely known animals including manatees, right whales, grizzly bears and spotted owls.

But the large sums directed toward a handful of species means others have gone neglected, in some cases for decades, as they teeter on potential extinction.

At the bottom of the spending list is the tiny Virginia fringed mountain snail, which had $100 spent on its behalf in 2020, according to the most recent data available. The underground-dwelling snail has been seen only once in the past 35 years, according to government records, yet it remains a step ahead of more than 200 imperiled plants, animals, fish and other creatures that had nothing spent on their behalf.

With climate change increasing threats to organisms around the planet and adding to the number that qualify for protection under the Endangered Species Act, government officials are struggling in many cases to execute recovery actions required under the law.

Some scientists even argue for spending less on costly efforts that may not work and putting the money toward species with less expensive recovery plans that have languished.

“For a tiny fraction of the budget going to spotted owls, we could save whole species of cacti that are less charismatic but have an order of magnitude smaller budget,” said Leah Gerber, a professor of conservation science at Arizona State University.

An Associated Press analysis of 2020 data found fish got 67% of the spending, the majority for several dozen salmon and steelhead populations in California, Oregon and Washington. Mammals were a distant second with 7% of spending and birds had about 5%. Insects received just 0.5% of the money and plants about 2%. Not included in those percentages is money divided among multiple species.

Species drawing no spending at all included stoneflies threatened by climate change in Montana’s Glacier National Park, the stocky California tiger salamander that has lost ground to development and flowering plants such as the scrub lupine around Orlando, Florida, where native habitat has been converted for theme parks.

Such spending inequities are longstanding and reflect a combination of biological realities and political pressures. Restoring salmon and steelhead populations is expensive because they are widespread and hemmed in by massive hydroelectric dams. They also have a broad political constituency with Native American tribes and commercial fishing interests that want fisheries restored.

Congress over decades has sent massive sums of money to agencies such as the Bonneville Power Administration that operate dams along rivers the fish once traveled up to spawn. The money pays for fish ladders around dams, habitat restoration projects, monitoring by scientists and other needs.

More than half the species protected under the Endangered Species Act are plants, but the entire plant kingdom was almost excluded from the landmark conservation law when it was adopted in 1973, according to the Congressional Record and Faith Campbell, who interviewed people involved in the bill’s passage for a 1988 study published in the Pace Environmental Law Review.

Plants initially were left out when the measure passed the Senate, with opposition led by influential Republican Sen. Ted Stevens of Alaska. They were added back at the 11th hour following a push by botanists from the Smithsonian Institution and Lee Talbot, a senior scientist at the White House Council on Environmental Quality, according to Campbell.

Botanists at the time proposed more than 2,500 plants as threatened with future extinction. However, most failed to get protections because federal officials failed to act prior to a Congressional deadline.

Today more than 900 trees, ferns, flowers and other flora are protected. Combined, they received about $26 million in 2020.

“In terms of numbers they’re catching up, but as far as money and attention they’re still not getting their share,” said Campbell, a longtime environmental advocate who now works at the Center for Invasive Species Prevention. “The threats are serious, they’re the same as the threats to animals. Yet they don’t have the political clout of, say, a couple dozen of the big animal species that attract favorable attention or get in people’s way.”

Most plants receive less money than recommended under their recovery plans, according to Gerber and others. Researchers say that has direct consequences: species tend to decline when allocated less funding than needed, while they have a higher chance of recovery when receiving enough money.

Gerber has suggested redirecting some money from species getting more than their recovery plans seek — the bull trout, the gopher tortoise and the Northern spotted owl among them — to those receiving little or none. Her ideas have stirred pushback from some conservationists.

Former U.S. Fish and Wildlife Service Director Jamie Rappaport Clark said debating how to allocate scarce resources for rescuing endangered species is a distraction.

“The issue is not where the money is spent,” said Clark, now president of Defenders of Wildlife. “The issue is that there isn’t nearly enough of it.”

Gerber said she doesn’t want to let anything go extinct but that a strategic approach is needed with the shortage of resources.

“Unfortunately, the clock is ticking,” she added. “We need to take action.”

Wildlife officials say they are trying to do just that with money for endangered species in the climate law signed last year by President Joe Biden.

It included $62.5 million officials said will allow them to hire biologists to craft recovery plans to guide future conservation work, initially for 32 species and for as many as 300 over coming years.

Among them are a colorful fish known as the candy darter that lives in rivers in the southeastern U.S., a flowering shrub from the Virgin Islands called marron bacora, the Panama City crayfish of Florida and the pocket-sized Stephens’ kangaroo rat in southern California.

The extra money is intended to provide some relief after the agency’s environmental review staff fell 20% over the past two decades, even while new species were listed, according to officials. Increased funding is especially important because more than half the agency’s existing recovery plans are more than two decades old, according to Lindsay Rosa, vice president for conservation research at Defenders of Wildlife.

Also in the law was $5.1 million for recovery projects that could benefit hundreds of species from four groups that officials said have historically been underfunded: Hawaii and Pacific island plants, butterflies and moths, freshwater mussels and desert fish in the southwestern U.S.

“Each of these species are part of this larger web of life,” Fish and Wildlife Service Director Martha Williams said in an interview. “They’re all important.”
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SACRAMENTO, Calif. — More than 700,000 immigrants living illegally in California will gain access to free health care starting Monday under one of the state’s most ambitious coverage expansions in a decade.

It’s an effort that will eventually cost the state about $3.1 billion per year and inches California closer to Democrats’ goal of providing universal health care to its roughly 39 million residents.

Democratic Gov. Gavin Newsom and lawmakers agreed in 2022 to provide health care access to all low-income adults regardless of their immigration status through the state’s Medicaid program, known as Medi-Cal.

California is the most populous state to guarantee such coverage, though Oregon began doing so in July.

Newsom called the expansion “a transformative step towards strengthening the health care system for all Californians” when he proposed the changes two years ago.

Newsom made the commitment when the state had the largest budget surplus in its history. But as the program kicks off next week, California faces a record $68 billion budget deficit, raising questions and concerns about the economic ramifications of the expansion.

“Regardless of what your position is on this, it doesn’t make sense for us to be adding to our deficit,” said Republican Sen. Roger Niello, the vice-chair of the Senate Budget and Fiscal Review Committee.

Immigration and health care advocates, who spent more than a decade fighting for the changes, have said the expanded coverage will close a gap in health care access and save the state money in the long run. Those who live in the state illegally often delay or avoid care because they aren’t eligible for most coverage, making it more expensive to treat them when they end up in emergency rooms.

“It’s a win-win, because it allows us to provide comprehensive care and we believe this will help keep our communities healthier,” said Dr. Efrain Talamantes, chief operating officer at AltaMed in Los Angeles, the largest federally qualified health center in California.

The update will be California’s largest health care expansion since the 2014 implementation of former President Barack Obama’s Affordable Care Act, which allowed states to include adults who fall below 138% of the federal poverty level in their Medicaid programs. California’s uninsured rate dropped from about 17% to 7%.

But a large chunk of the population was left out: adults living in the United States without legal permission. They are not eligible for most public benefit programs, even though many have jobs and pay taxes.

Some states have used their tax dollars to cover a portion of health care expenses for some low-income immigrants. California first extended health care benefits to low-income children without legal status in 2015 and later added the benefits for young adults and people over the age of 50.

Now the last remaining group, adults ages 26-49, will be eligible for the state’s Medicaid program.

The state doesn’t know exactly how many people will enroll through the expansion, but state officials said more than 700,000 people will gain full health coverage allowing them to access preventative care and other treatment. That’s larger than the entire Medicaid population of several states.

“We’ve had this asterisk based on immigration status,” said Anthony Wright, executive director of Health Access California, a consumer advocacy group. “Just from the numbers point of view, this is a big deal.”

Republicans and other conservative groups worry the new expansion will further strain the overloaded health care system and blasted the cost of the expansion.

State officials estimated the expansion will cost $1.2 billion the first six months and $3.1 billion annually thereafter from the budget. Spending for the Medi-Cal program, which is now about $37 billion annually, is the second-largest expense in the California budget, according to an analysis by the nonpartisan Legislative Analyst’s Office.

Earlier this month, the state Department of Finance sent a letter urging state agencies to cut costs in light of the deficit. It has not given specific directions about the Medicaid expansion, state officials told The Associated Press in December.

California’s expansion of Medicaid will face other challenges. The state is chugging through a review of Medicaid enrollees’ eligibility for the first time in more than three years that was prompted by the end of some federal pandemic policies. Many immigrants who had their coverage protected during the COVID-19 pandemic now find themselves ineligible because they no longer financially qualify.

John Baackes, CEO of L.A. Care Health Plan, the state’s largest Medi-Cal plan with nearly 2.6 million members, said roughly 20,000 members have lost their Medicaid coverage during the review process this past year and are looking to secure new insurance plans. His organization is juggling to help people navigate through both processes.

“People are being bombarded with information,” Baackes said. “I can’t imagine if somebody were having to maneuver through all this, why they wouldn’t be terribly confused.”

“The phones are ringing off the walls,” he said.

Fear and distrust are also barriers for the expansion, said Sarah Dar, policy director for the California Immigrant Policy Center. 

Many immigrants avoid accepting any public programs or benefits out of fear it will eventually prevent them from gaining legal status under the “public charge” rule. The federal law requires those seeking to become permanent residents or gain legal status to prove they will not be a burden to the U.S., or a “public charge.” The rule no longer considers Medicaid as a factor under President Joe Biden’s administration, but the fear remains, she said.

More resources and effort are required to reach this population “because of the history of just being completely excluded and not interfacing with the health care system or with government programs at all for so long,” Dar said. 

California has more work to do to see the state’s uninsured rate hit zero, known as “universal coverage,” Dar said.

For one thing, immigrants living in the U.S. without legal permission are still not eligible to purchase insurance from Covered California, the state-run exchange offering steep discounts for people who meet certain income requirements. A bill pending in the state Legislature, supported by the California Immigrant Policy Center, would change that.

“It’s going to be another really big undertaking,” Dar said. “And we know that revenues are down … but it’s our job to make the case that, in times of economic downturn and whatnot, these are the communities that need the support the most.”
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MEXICO CITY — Mexico’s president inaugurated a huge “super pharmacy” Friday in a bid to help patients throughout the country who are told they need a specific medicine, but their hospital doesn’t have it.

President Andrés Manuel López Obrador’s solution was to outfit a big warehouse on the outskirts of Mexico City to centralize a supply and send it to hospitals throughout the country.

“The pharmacy is going to be big, big, big, and it is going to have all the medications that are used in the health system,” López Obrador said Friday.

The pharmacy is intended to complement local health facilities. If a patient can’t get needed medications at a local hospital, the patient, the patient’s doctor or the pharmacist would be able to have it delivered from the 40,000-square-meter Mexico City warehouse.

The armed forces, or the government-run pharmaceutical company Birmex, will ship the drugs by land or air “within 24 to 48 hours,” López Obrador pledged.

The question is whether Mexico can overcome its history of being bad at regulating the pharmaceutical industry, bad at buying medicines, bad at storing them, and bad at distributing them. Extreme centralization also hasn’t helped Mexico much in the past in many areas.

The most visible face of this problem are the parents of children with cancer, who frequently stage protests because they say that in recent years chemotherapy and other drugs have been impossible to obtain.

The problems have killed otherwise healthy people. Because Mexico has had problems in obtaining enough morphine, anesthesiologists in Mexico have had to carry around their own vials of the sedative, drawing multiple doses out of a single vial for routine procedures.

That has led to contamination of the vials, triggering outbreaks of injection-induced meningitis in two Mexican states that have killed dozens of people, including some Americans who sought treatment at clinics in the border city of Matamoros, across from Brownsville, Texas.

In the United States, where there is no shortage of morphine, doctors are advised to draw a single dose from a vial and throw the remainder out.

López Obrador mounted a major effort to obtain COVID-19 vaccines in 2021, using the armed forces to distribute them and volunteers to administer them. By the end of that year just about anybody in Mexico who wanted a vaccine got one, for free.

But trying to replicate that model of centralized government purchasing and army distribution on a national scale for thousands of medications is not the same, according to Mauricio Rodríguez-Dorantes, a professor at the School of Medicine at Mexico’s National Autonomous University.

“This is crazy,” said Rodríguez-Dorantes, noting the government is opening the centralized warehouse without answering how the system will operate, especially for urgently needed medications. He noted that concentrating all the drugs at one site increases risks and could sideline some existing distribution systems.

For decades, there have been scandals involving millions of dollars’ worth of medicines that have expired at warehouses while hospitals couldn’t get them.

The country’s medicine regulatory agency, known by its Spanish acronym as Cofepris, was so riddled with corruption before López Obrador that regulators would hide applications for approval of new medicines for years and demand bribes to approve them.

And with alarming frequency, regulators in Mexico send out alerts about falsified or knock-off medications being sold for treating everything from cancer to heart disease. Boxes, labels, vials and certifications are copied with amazing accuracy, but the bottles often contain little or none of the medication.

The fake medicine trade is so common and so lucrative in Mexico because patients or their relatives are often told by doctors to buy medications at private drug stores when they are unavailable at government hospitals.

The civic group Zero Shortages said there was a 142% increase in the number of alerts about falsified medicines between 2021 and 2022.

But some of the problems are of López Obrador’s own making. Angry at what he claimed were inflated profits made by drug distributors and importers, the president simply cut the private companies out and decided the government should directly buy all medications.

Because the government did not have much infrastructure, contacts or experience in such a massive effort, López Obrador signed an agreement with the World Health Organization to help Mexico in purchasing. But even with that help, Mexico was unable to obtain some specialized medication.

Zero Shortages said the number of prescriptions that went unfilled in Mexico rose from 1.5 million in 2019 to 22 million in 2021; disruptions because of COVID-19 probably played a role.

But even in 2022, about 12.5 million prescriptions went unfilled. 
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CAPE CANAVERAL, Florida — The U.S. military’s secretive X-37B robot spaceplane blasted off from Florida on Thursday night on its seventh mission, the first launched atop a SpaceX Falcon Heavy rocket capable of delivering it to a higher orbit than previous missions.

The Falcon Heavy, composed of three rocket cores strapped together, roared off its launch pad from NASA’s Kennedy Space Center at Cape Canaveral in a spectacular nighttime liftoff carried live on a SpaceX webcast.

The launch followed more than two weeks of false starts and delays. Three earlier countdowns were aborted due to poor weather and unspecified technical issues, leading ground crews to roll the spacecraft back to its hangar before proceeding with Thursday’s fight.

It came two weeks after China launched its own robot spaceplane, known as the Shenlong, or “Divine Dragon,” on its third mission to orbit since 2020, adding a new twist to the growing U.S.-Sino rivalry in space.

The Pentagon has disclosed few details about the X-37B mission, which is conducted by the U.S. Space Force under the military’s National Security Space Launch program.

The Boeing-built vehicle, roughly the size of a small bus and resembling a miniature space shuttle, is built to deploy various payloads and conduct technology experiments on long-duration orbital flights. At the end of its mission, the craft descends back through the atmosphere to land on a runway much like an airplane.

It has flown six previous missions since 2010, the first five of them carried to orbit by Atlas V rockets from United Launch Alliance, a joint venture of Boeing and Lockheed Martin, and most recently, in May 2020, atop a Falcon 9 booster furnished by Elon Musk’s SpaceX.

Thursday’s mission marked the first launched aboard SpaceX’s more powerful Falcon Heavy rocket, capable of carrying payloads even heavier than the X-37B farther into space, possibly into geosynchronous orbit, more than 35,000 kilometers above the Earth.

The X-37B, also called the Orbital Test Vehicle, has previously been confined to flights in low-Earth orbit, at altitudes below 2,000 kilometers.

New orbital regimes

The Pentagon has not said how high the spaceplane will fly this time out. But in a statement last month, the Air Force Rapid Capabilities Office said mission No. 7 would involve tests of “new orbital regimes, experimenting with future space domain awareness technologies.”

The X-37B also is carrying a NASA experiment to study how plant seeds are affected by prolonged exposure to the harsh environment of radiation in space. The ability to cultivate crops in space has major implications for keeping astronauts nourished during future long-term missions to the moon and Mars.

China’s equally secretive Shenlong was carried to space on December 14 by a Long March 2F rocket, a launch system less powerful than SpaceX’s Falcon Heavy and believed to be limited to delivering payloads to low-Earth orbit.

Still, Space Force General B. Chance Saltzman told reporters at an industry conference earlier this month he expected China to launch Shenlong around the same time as the X-37B flight in what he suggested was a competitive move.

“It’s no surprise that the Chinese are extremely interested in our spaceplane. We’re extremely interested in theirs,” Saltzman said, according to remarks published in Air & Space Forces Magazine, a U.S. aerospace journal.

“These are two of the most watched objects on orbit while they’re on orbit. It’s probably no coincidence that they’re trying to match us in timing and sequence of this,” he said.

The planned duration of the latest X-37B mission has not been made public, but it will presumably run until June 2026 or later, given the prevailing pattern of successively longer flights.

Its last mission remained in orbit for well over two years before a return landing in November 2022.
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portland, oregon — As native trees in the Pacific Northwest die off due to climate change, the U.S. Forest Service, the city of Portland, Oregon, and citizen groups around Puget Sound are turning to a deceptively simple climate adaptation strategy called “assisted migration.”

As the world’s climate warms, tree growing ranges in the Northern Hemisphere are predicted to move farther north and higher in elevation.

Trees, of course, can’t get up and walk to their new climatic homes. This is where assisted migration is supposed to lend a hand.

The idea is that humans can help trees keep up with climate change by moving them to more favorable ecosystems faster than the trees could migrate on their own.

Yet not everyone agrees on what type of assisted migration the region needs — or that it’s always a good thing.

In the Pacific Northwest, a divide has emerged between groups advocating for assisted migration that would help struggling native trees, and one that could instead see native species replaced on the landscape by trees from the south, including coast redwoods and giant sequoias.

“There is a huge difference between assisted population migration and assisted species migration,” said Michael Case, forest ecologist at the Virginia-based Nature Conservancy.

Case currently runs an assisted population migration experiment at the Conservancy’s Ellsworth Creek Preserve in western Washington.

Assisted population migration involves moving a native species’ seeds, and by extension its genes, within its current growing range.

By contrast, assisted species migration involves moving a species well outside its existing range, such as introducing redwoods and sequoias to Washington.

A third form of assisted migration, called “range expansion,” amounts to moving a species just beyond its current growing range.

Case’s project involves testing whether breeds of native Douglas fir and western hemlock from drier parts of the Pacific Northwest can be used to help western Washington forests adapt to climate change. He says the Nature Conservancy is focusing on population migration because it has fewer ecological risks.

“Whenever you plant something in an area where it is not locally found you increase the risk of failure,” Case said. “You increase the risk of disturbing potential ecosystem functions and processes.”

Population migration is the only form of assisted migration currently practiced nationwide by the Forest Service, according to Dr. David Lytle, the agency’s deputy chief for research and development.

“We are very, very cautious and do not engage in the long-distance movement and establishment of plant material outside and disjunct from the historic range of a species,” Lytle said.

The Forest Service is pursuing assisted population migration because it’s likely to have few if any “negative consequences” to ecosystems, he said.

Douglas Tallamy, professor of entomology and wildlife ecology at the University of Delaware, said one potential negative consequence of species migration is the possibility that native caterpillars might not eat the leaves of migrated nonnative tree species. Because caterpillars feed birds and other animals, this could lead to disruptions to the food web.

This could happen if the City of Portland migrates oak species from places to the south, Tallamy noted.

“Oaks are the most important plant for supporting wildlife that we have in North America,” he said, “but when you move them out of range, the things that are adapted to eating them no longer have access to them.”

The City of Portland’s Urban Forestry program is currently experimenting with the assisted migration of 11 tree species, including three oak species to the south: California black oak, canyon live oak and interior live oak.

Asked via email about potential ecological disruptions, Portland’s City Forester & Urban Forestry Manager Jenn Cairo responded: “We use research from universities, state and federal sources, and local and regional field practitioner experience.”

Another advocate for species migration is the Puget Sound-based, citizen-led PropagationNation. The organization has planted trees in several parks in the Seattle area and has the ambitious goal of “bringing a million coast redwoods and giant sequoias to the Northwest,” according to its website.

The PropagationNation website also recommends planting redwoods in areas where native western red cedar, western hemlock, Sitka spruce and big leaf maple already grow.

Western red cedar, western hemlock and big leaf maple have all seen die-offs and growth declines in recent years tied to climate.

Philip Stielstra, PropagationNation’s founder and president, and a retired Boeing employee, declined to comment for this story.

David Milarch, founder of the Michigan-based Archangel Ancient Tree Archive, which has supplied PropagationNation with redwoods and sequoias, says his trees aren’t intended to replace Pacific Northwest native species.

“All we are doing is extending the range [of redwoods and sequoias] north in the hopes that they will still be here in 100 to 200 years and not join the list of trees that are going extinct,” Milarch said.

This story is part of a collaboration between The Associated Press and Columbia Insight, exploring the impact of climate on trees in the Pacific Northwest.
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