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Eleven years after President Barack Obama signed the Affordable Care Act, the reach of the law is growing, with hundreds of thousands flocking to its marketplace and even deeply conservative states considering its Medicaid expansion.
More than 200,000 Americans signed up for health insurance under the law during the first two weeks of an open enrollment period created by President Biden — a sign that those who lost insurance during the pandemic remain in desperate need of coverage, according to federal officials and health policy experts.
And a provision in the president’s $1.9 trillion stimulus law to make Medicaid expansion more fiscally appealing has convinced deep-red Alabama and Wyoming to consider expanding the program to residents whose incomes are too high to qualify now but too low to afford private health plans.
Tuesday is the 11th anniversary of the health law’s signing, and the Biden White House is going to mark the occasion in a big way. The president will travel to Ohio as part of his “Help Is Here” tour to talk up the stimulus bill, which also expanded subsidies to make insurance affordable for middle-class people. And his newly installed health secretary, Xavier Becerra, will travel to Carson City, Nev.
But Mr. Biden now has a new challenge: living up to his campaign promise to expand the law, including creating a “public option” for a government-run insurance plan, and tackling not only the rising cost of health insurance premiums but also the costs of prescription drugs. For that, he will need the cooperation of Congress.
“The Affordable Care Act was about trying to create the ground rules so that health insurance was real, it provided real financial security and was affordable, but we’re at this point where we’ve got to address the other side of the equation,” said Frederick Isasi, executive director of Families U.S.A., a consumer advocacy group.
“We’ve got to address the sector’s pricing abuses, and that’s fundamentally the big question the administration and Congress are facing,” Mr. Isasi added. “Are they going to have the political will to do that?”
On Capitol Hill, progressives recently introduced legislation to create what they call Medicare for all, a broad government-run insurance program that has been embraced by Senator Bernie Sanders, independent of Vermont, and Representative Alexandria Ocasio-Cortez, Democrat of New York.
Expanding access to health care has been a core issue for Mr. Biden, both when he was vice president and during his campaign for the White House. A week after he took office, he ordered the law’s insurance marketplaces to reopen for three months, from February to May 15, to help people struggling to find coverage.
In previous years, only those who had “qualifying life events,” including job losses, were eligible to sign up outside of the traditional fall enrollment period, and the current surge in enrollment is more than double the number of people who signed up during the same two-week periods in 2019 and 2020.
Gov. Kristi Noem of South Dakota, an enthusiastic backer of former President Donald J. Trump who is seen as a possible 2024 presidential candidate, finds herself in the crossfire of a culture-war issue promoted by Mr. Trump: transgender students’ participation in sports.
On Friday, Ms. Noem announced that she would not sign a bill passed by the Republican-controlled state legislature banning transgender girls and women from participating in girls’ or women’s sports at all levels — proposing instead that the restrictions apply to middle school and high school athletic competitions, but not college sports.
Ms. Noem’s goal, she said on Monday, was to avoid punishment by the N.C.A.A. that could be financially damaging to schools and surrounding communities in South Dakota, even though the association has not yet issued an official rebuke to the 20 other states that are enacting or considering similar bills.
“South Dakota’s chances of winning a lawsuit against the N.C.A.A. are very low,” Ms. Noem said at a news conference in Pierre, the state capital, on Monday.
“The N.C.A.A. is a private association — that means they can do what they want to do,” said Ms. Noem, who consulted widely for legal advice on the measure. “If South Dakota passes a law that’s against their policy, they will likely take punitive action against us. That means they can pull their tournaments from the state of South Dakota, they could pull their home games, they could even prevent our athletes from playing in their league.”
Ms. Noem’s decision, which she announced after weeks of silence, reflects the volatile politics surrounding the issue, even in a deep-red state Mr. Trump won by 25 points in November.
On one hand, by not issuing an outright veto, Ms. Noem is acknowledging that laws like this are popular with the social conservatives who make up a significant voting bloc in the Republican Party — and in particular in states like Iowa that are important to any politician who is considering a presidential run.
But beyond the base, there has not been much appetite for laws, pushed by the right, to restrict what access transgender people can have to school sports and medical care.
In fact, the laws are generally opposed by influential players in business and academics. After Ms. Noem indicated that she was in favor of the bill, the Greater Sioux Falls Area Chamber of Commerce wrote an open letter expressing its opposition.
Ms. Noem’s equivocation did not win her much breathing room with conservatives.
Margot Cleveland, a conservative legal commentator, accused the governor of “bowing to corporate demands for a watered-down bill,” and said Ms. Noem’s other proposed changes would hamstring enforcement of the middle and high school bans.
There are currently no openly transgender girls competing in girls’ high school sports in the state, officials with the South Dakota High School Activities Association told The Associated Press.
The association reported that only one transgender girl had ever competed in girls’ sports in the state.
Nonetheless, Mr. Trump has long embraced the issue as a way of riling up his base.
During his first post-presidential speech this month, he falsely claimed that many “young girls and young women” had to regularly compete against “biological males,” despite the relatively low proportion of athletes who are transgender.
Democrats on a key House panel are pushing on Monday for Washington, D.C., to be granted statehood, the latest sign that the long-suffering movement has shifted from the political fringe to the mainstream liberal agenda.
The House Oversight Committee is holding a hearing on legislation that the House passed last summer to establish a 51st state — Washington, Douglass Commonwealth, named in honor of Frederick Douglass — and grant it two senators and a voting representative in the House. The bill, which passed nearly along party lines, stalled in the Republican-controlled Senate.
“Congress can no longer allow D.C. residents to be sidelined in the democratic process, watching as Congress votes on matters that affect the nation with no say of their own, or watching as Congress votes to overturn the laws of the duly elected D.C. Council with no say of their own,” Representative Eleanor Holmes Norton, the district’s lone nonvoting delegate, said in prepared remarks before the committee. “Full democracy requires much more.”
President Biden breathed new life into hopes for the bill last week. The White House press secretary, Jen Psaki, confirmed on Thursday that Mr. Biden supported statehood, in a stark culmination of a decades-long campaign to increase support for the measure among lawmakers in Washington.
The bill faces an uphill climb in Congress. Republicans are uniformly opposed to the idea, questioning its constitutional merits and accusing Democrats of backing it in an attempt to bolster their majorities in the House and the Senate.
Should the House approve the legislation again this session, it would join other marquee Democratic measures — including bills on voting rights, police bias and misconduct, and gay and transgender rights — passed in part to drive home the idea that the party cannot move forward on the major issues of the moment with the legislative filibuster in place.
Proponents of statehood argue that the more than 700,000 taxpaying residents of the District of Columbia deserve federal representation, and have noted that the disenfranchisement of Washington’s residents disproportionately affects minorities. In some of the pandemic relief legislation in 2020, the district did not receive as much funding to counter the toll of the pandemic as local officials expected because it was treated as a territory, not a state.
“As time passed, and the District became majority African-American, the drive to correct the wrong was replaced by racist efforts to subvert a growing and thriving majority Black city,” Mayor Muriel E. Bowser said in her own prepared remarks. “Historic records are replete with statements of successive members of Congress referencing the ‘Negro problem’ and the ‘color problem’ within D.C. as a justification to withhold congressional representation.”
Supporters also argue that events of the past year have demonstrated the urgency of adopting statehood. Over the summer, the Trump administration deployed federal officers in the city and approved the violent removal of peaceful protesters near the White House. During the Jan. 6 attack on the Capitol, congressional leaders were left to beg neighboring states’ governors to send in their National Guard troops because Ms. Bowser does not have the authority to summon the D.C. Guard.
“Washington, D.C., has been a true partner to the federal government in every possible aspect, even though Congress and the presidents have been sporadic partners to us,” Ms. Bowser added in her testimony. “The events of Jan. 6, where Congress was overtaken by insurrectionist mobs, show that Congress need not fear the new state of Washington, D.C., as it does not currently fear the states of Maryland and Virginia. Rather, the new state will be a necessary partner to securing the federal interests, not a detractor.”
President Biden on Monday nominated Lina Khan to the Federal Trade Commission, installing a vocal critic of Big Tech into a key oversight role of the industry.
If her nomination is approved by the Senate, Ms. Khan, 32, would fill one of two empty seats earmarked for Democrats at the F.T.C.
Ms. Khan became recognized for her ideas on antitrust with a Yale Law Journal paper in 2017 called “Amazon’s Antitrust Paradox” that accused Amazon of abusing its monopoly power and put a critical focus on decades-old legal theories that relied heavily on price increases as the underlying measure of antitrust violations.
She served as a senior adviser to Rohit Chopra when he was F.T.C. commissioner. Most recently, she was a leading counsel member to a 16-month-long investigation of online platforms and competition by the House antitrust subcommittee. As a result, Democratic leaders on the subcommittee called for the breakup of Big Tech and legislation to strengthen enforcement of competition violations across the economy.
“As consumers, as users, we love these tech companies,” Ms. Khan said in an interview with The New York Times in 2018. “But as citizens, as workers, and as entrepreneurs, we recognize that their power is troubling. We need a new framework, a new vocabulary for how to assess and address their dominance.”
Ms. Khan is the second prominent advocate of breaking up the large tech companies placed by the Biden administration in top antitrust roles. Also this month, Mr. Biden picked Tim Wu, a prominent critic of Google, Facebook and Amazon, as special assistant to the president on competition policy.
Jerome H. Powell, the head of the Federal Reserve, will tell lawmakers on Tuesday that the economy is healing, saying that while many workers and businesses continue to suffer, the aggressive response from the central bank, Congress and the White House helped to avoid the most devastating economic scenarios.
“While the economic fallout has been real and widespread, the worst was avoided by swift and vigorous action,” Mr. Powell will tell the House Financial Services committee, according to prepared remarks.
He will point out that the economy has recently improved, including the labor market, which has begun adding back jobs after a winter lull.
“However, the sectors of the economy most adversely affected by the resurgence of the virus, and by greater social distancing, remain weak, and the unemployment rate — still elevated at 6.2 percent — underestimates the shortfall,” Mr. Powell is set to say.
The Fed chair will add that the central bank, which currently has rates at near-zero and is buying bonds to keep credit flowing and to bolster the economy, “will not lose sight of the millions of Americans who are still hurting.”
Mr. Powell will say the Fed’s many market-facing programs in 2020, which supported credit to corporations, midsize businesses and municipalities, helped to “keep organizations from shuttering and put employers in both a better position to keep workers on and to hire them back as the recovery continues.”
And he will underline that the programs, in most cases, have either shut down or will soon end. Mr. Powell consistently has said that the lending efforts, supported by the Treasury, were emergency tools that the Fed would stop using once conditions were stable.
Vice President Kamala Harris traveled on Monday to Jacksonville, Fla., to tour a vaccination center and host an event at a food pantry, two stops designed to promote the Biden administration’s pandemic stimulus package to Americans in a state where officials are fearing another coronavirus surge.
Ms. Harris was scheduled to tour one of the federally supported vaccination centers that have administered tens of thousands of shots in recent days. She is arriving at the site, at the Gateway Town Center shopping complex, at a time marked by tensions over how best to contain the virus within the state.
Florida has logged more than two million cases of coronavirus since the pandemic began, according to a New York Times database. An influx of spring breakers to South Florida, and Miami Beach in particular, has caused officials to institute mandatory curfews over concerns that the virus will continue to spread.
Answering questions from reporters traveling with her, Ms. Harris did not offer any specifics from the administration on how local officials, who have largely opened the state for business, should get the virus under control.
“I’m here to emphasize the importance of vaccinations and getting the vaccine,” Ms. Harris said. “One thing is for sure, if you get vaccinated when it’s your turn, you are much more likely to avoid contracting Covid.”
Later on Monday, Ms. Harris will host an event at Feeding Northeast Florida, a food pantry, to emphasize one of the $1.9 trillion relief package’s biggest selling points: The plan aims to reduce child poverty through a generous tax credit.
Ms. Harris also fielded questions on whether she would visit the U.S.-Mexico border — “not today,” she replied — and said the Biden administration had been left with “a very challenging situation,” a reference to the zero-tolerance immigration policies under the Trump administration.
“We’ve got to treat this issue in a way that is reflective of our values as Americans, and do it in a way that is fair and is humane,” she said.
President Biden’s economic advisers are preparing to recommend spending as much as $3 trillion on a sweeping set of efforts aimed at boosting the economy, reducing carbon emissions and narrowing economic inequality, beginning with a giant infrastructure plan that may be financed in part through tax increases on corporations and the rich.
After months of internal debate, Mr. Biden’s advisers are expected to present a proposal to the president this week that recommends carving his economic agenda into separate legislative pieces, rather than trying to push a mammoth package through Congress, according to people familiar with the plans and documents obtained by The New York Times.
The total new spending in the plans would most likely be $3 trillion, a person familiar with them said. That figure does not include the cost of extending new, temporary tax cuts meant to fight poverty, which could reach hundreds of billions of dollars, according to estimates prepared by administration officials. Officials have not yet determined the exact breakdown in cost between the two packages.
Mr. Biden supports all of the individual spending and tax cut proposals under consideration, but it is unclear whether he will back splitting his agenda into pieces, or what legislative strategy he and Democratic leaders will pursue to maximize the chances of pushing the new programs through Congress given their narrow majorities in both chambers.
Administration officials caution that details of the spending programs remain in flux. But the scope of the proposal under consideration highlights the aggressive approach the Biden administration wants to take as it tries to harness the power of the federal government to narrow economic inequality, reduce the carbon emissions that drive climate change, and improve American manufacturing and high-technology industries in an escalating battle with China and other foreign competitors.
The first legislative piece under discussion, which some Biden officials consider more appealing to Republicans, business leaders and many moderate Senate Democrats, would combine investments in manufacturing and advanced industries with what would be the most aggressive spending yet by the United States to reduce carbon emissions and combat climate change.
It would spend heavily on infrastructure improvements, clean energy deployment and the development of other “high-growth industries of the future” like 5G telecommunications. It includes money for rural broadband, advanced training for millions of workers and one million affordable and energy-efficient housing units. Documents suggest it would include nearly $1 trillion in spending alone on the construction of roads, bridges, rail lines, ports, electric vehicle charging stations and improvements to the electric grid and other parts of the power sector.
The second plan under discussion is focused on what many progressives call the nation’s human infrastructure — students, workers and people left on the sidelines of the job market — according to documents and people familiar with the discussions. It would spend heavily on education and on programs meant to increase the participation of women in the labor force, by helping them balance work and caregiving. It includes free community college, universal pre-K education, a national paid leave program and efforts to reduce child care costs.
That plan would also make permanent two temporary provisions of Mr. Biden’s recent relief bill: expanded subsidies for low- and middle-income Americans to buy health insurance and tax credits aimed at cutting poverty, particularly for children.
The Biden administration, with hundreds of billions of dollars to spend to end the Covid-19 crisis, has set aggressive benchmarks to determine whether the economy has fully recovered.
That includes returning to historically low unemployment and helping more than a million Black and Hispanic women return to work within a year.
President Biden made grand promises in pushing his $1.9 trillion American Rescue Plan to swift passage in Congress this month, and he got virtually everything he wanted. Now administration officials must make good on his vow.
The legislation he signed centers on $1,400 direct payments to low- and middle-income Americans, expanded unemployment benefits, aid to renters facing eviction and a variety of programs to help the poor. The president and his aides have said that spending is intended to help the most vulnerable people in the country stay in their homes and keep food on the table.
In keeping with Mr. Biden’s focus on racial equity across a wide range of policy endeavors, administration officials say they will look at how quickly women of color rejoin the labor force to gauge how well equity efforts are working.
Privately, Mr. Biden’s aides are tracking health and economic data — like the capacity levels of day care centers — to gauge their success. They are also watching broad targets, like a return to an unemployment rate near 4 percent, which would be just above the nation’s prepandemic rate, by next year. Private forecasters already expect the rate to fall to 4 percent in 2022. Mr. Biden has promised the economy will return to “full employment,” which is likely a rate lower than 4 percent.
Responding to criticism from some female troops and Congress, the Army has altered its latest fitness test, officials said Monday.
Since 1980, all active-duty soldiers have been required to take a test that measures their ability to do situps, push-ups and a two-mile run. In recent years, the Army realized that soldiers lacked the upper body strength for many combat-related tasks, and that many were injuring themselves because they were not fit enough even in training. It introduced a new test with several different exercises, and also sought to take gender out of the scoring equation.
However, fearing that the new standards were too difficult, Congress mandated that the test not be used for promotions and other official capacities, and called for more research and data collection.
One component of the test caused particular angst: a leg tuck in which soldiers were required to hang from a bar and tuck their legs to their chest. Soldiers will now be able to choose, without penalty, between a leg tuck and a plank to test core strength, officials announced Monday.
“Army senior leaders are listening to what our soldiers are saying,” said Maj. Gen. Lonnie G. Hibbard, the commanding general for the United States Army Center for Initial Military Training.
The Army is also considering a new evaluation system with five categories — green, bronze, silver, gold and platinum — that might rank soldiers’ performances against others of their own gender, a nod to the competitive nature of fitness testing that prevails in Army culture.
For now, test performance will not be used administratively. The Army is aiming to use the test for passing and promotion purposes in March 2022 but will need more data before moving forward, officials said.
Jody Hice, a Republican congressman, announced Monday a run against the Georgia secretary of state, Brad Raffensperger, who refused to overturn the state’s Nov. 3 election results, and former President Donald J. Trump immediately endorsed the new candidate.
Mr. Trump’s endorsement of Mr. Hice is the most prominent effort the former president and his aides have made to try to punish elected officials who they believe crossed Mr. Trump. Mr. Raffensperger, a Republican, is among the top targets for Mr. Trump, along with the state’s governor, Brian Kemp.
In a statement issued shortly after Mr. Hice announced his candidacy, Mr. Trump praised him as “one of our most outstanding congressmen,” and alluded to his own baseless claims of voter fraud, which he has said deprived him of victory in the state. “Unlike the current Georgia Secretary of State, Jody leads out front with integrity,’’ Mr. Trump said, adding “Jody will stop the Fraud and get honesty into our Elections!’’
Mr. Raffensperger and other Georgia election officials certified President Biden’s victory after conducting several recounts, and have said the results are fair and accurate.
Mr. Hice, who represents Georgia’s 10th congressional district, stretching south and east from Atlanta, is a Trump loyalist who in January condemned the second House impeachment of the former president as “misguided” and aimed at “scoring cheap political points.” In the weeks after the November election, he supported Mr. Trump’s false claims of election fraud, including a challenge before the Supreme Court that sought to overturn the results in states Mr. Trump lost.
Mr. Hice also served in the House Freedom Caucus with former Rep. Mark Meadows, Mr. Trump’s fourth and last chief of staff.
As he seeks to retain control of the Republican Party, Mr. Trump is determined to remain a kingmaker for down-ballot elections, while seeking retribution against those he perceives as having betrayed him. So far, he has endorsed only one other candidate running against someone he feels personally aggrieved by: Max Miller, a former White House aide, who is currently challenging Representative Anthony Gonzalez, a Republican representing Ohio’s 6th congressional district. Mr. Gonzalez was one of 10 House members who voted for Mr. Trump’s impeachment.
Mr. Hice’s challenge — against a Trump nemesis in a critical swing state — will be a more high-profile test of Mr. Trump’s political clout among Republicans.
The move to back Mr. Hice against the sitting secretary of state is also extraordinary given that Mr. Raffensperger has confirmed his office is investigating Mr. Trump’s attempts to influence the election, including the phone call the former president made to him. Mr. Trump is also under investigation by Fulton County prosecutors into whether he and others tried to improperly influence the election.
Mr. Raffensperger was on the receiving end of a now-infamous call in early January, in which Mr. Trump pushed baseless claims of widespread irregularities and asked the secretary of state to “find’’ enough votes to reverse the win for President Biden.
“All I want to do is this: I just want to find 11,780 votes, which is one more than we have, because we won the state,” Mr. Trump said during the call.
Mr. Raffensperger repeatedly told him his data was wrong. “We have to stand by our numbers,” Mr. Raffensperger said. “We believe our numbers are right.”
Mr. Trump, when he had a Twitter feed, repeatedly attacked Mr. Raffensperger for not acceding to his demands.
In a statement Monday afternoon, Mr. Raffensperger was scathing about his future opponent. “Few have done more to cynically undermine faith in our election than Jody Hice,” he said, adding, “Georgia Republicans seeking a candidate who’s accomplished nothing now have one.”
Months after an election that thrust problems at the United States Postal Service into the national glare, the beleaguered agency has failed to restore its target delivery times and has proposed changes that are only in the preliminary stages.
The on-time rate rebounded to 84 percent by the week of March 6, but it remained below the agency’s target of about 96 percent. It had fallen to 62 percent of first-class mail delivered on time over the holidays, the lowest level in years, according to Postal Service data.
“It hasn’t really gotten better as much as we would have hoped at this point,” said Dave Lewis, the president of SnailWorks, a company that tracks commercial mail and has found that delivery now takes four to five days, after years of averaging 3.5.
Plans to fix the system are in the works. But they have been muddled by the fight over the service’s postmaster general, Louis DeJoy, who was appointed by former President Donald J. Trump and who is completing a plan to stabilize the agency’s finances over 10 years that is expected to prioritize reliability and cost effectiveness over speed.
Mr. DeJoy’s report is expected to propose eliminating the use of planes for first-class mail service to transport letters and other flat mail in the contiguous United States, according to someone familiar with the planning.
It is also expected to propose lengthening the agency’s standard delivery time for first-class mail, which includes many envelopes and lightweight packages, from within three days to within five days.
Among other ideas under consideration: closing processing facilities and reducing some post office hours, part of an effort by the agency to shift resources to shipping packages, which have become a growing share of its business, according to the plan, which was reported earlier by The Washington Post.
The proposal is almost certain to prompt resistance from the Democrats who control Congress and the White House, but it is also unclear what they will do about it.
In the past 14 fiscal years, the Postal Service has lost $87 billion, including $9.2 billion in the 2020 fiscal year alone, and it expects to lose $9.7 billion in 2021.
In July, the service reached an agreement with the Treasury Department on a $10 billion loan as part of a coronavirus relief bill.
The Supreme Court on Monday said it would review an appeals court’s decision that threw out the death sentence of Dzhokhar Tsarnaev, who was convicted of helping carry out the 2013 Boston Marathon bombings.
Last year, a three-judge panel of the U.S. Court of Appeals for the First Circuit, in Boston, upheld Mr. Tsarnaev’s convictions on 27 counts. But the appeals court ruled that his death sentence should be overturned because the trial judge had not questioned jurors closely enough about their exposure to pretrial publicity and had excluded evidence concerning Tamerlan Tsarnaev, Dzhokhar’s older brother and accomplice.
“A core promise of our criminal justice system is that even the very worst among us deserves to be fairly tried and lawfully punished,” Judge O. Rogeriee Thompson wrote for the panel.
“Just to be crystal clear,” Judge Thompson wrote, “Dzhokhar will remain confined to prison for the rest of his life, with the only question remaining being whether the government will end his life by executing him.”
The bombings, near the finish line of the marathon, killed three people and injured 260, many of them grievously. Seventeen people lost limbs. A law enforcement officer was killed as the brothers fled a few days later. Tamerlan Tsarnaev died in a shootout with the police.
Judge Thompson wrote that the trial judge should not have excluded evidence that Tamerlan Tsarnaev had been involved in a triple murder in 2011, which could have bolstered an argument from defense lawyers that he had dominated and intimidated his younger brother.
Lawyers for the federal government urged the Supreme Court to hear the case even though it did not satisfy some of the usual criteria for review.
“Although the court of appeals’ errors are largely case-specific, the context of this case makes them exceptionally significant,” the government’s brief said.
“To reinstate the sentences that the jury and the district court found appropriate for respondent’s heinous acts, the government will have to retry the penalty phase of the case; the court will have to conduct (and prospective jurors will have to undergo)” questioning “that will presumably be much longer and more onerous than the original 21-day proceeding; and the victims will have to once again take the stand to describe the horrors that respondent inflicted on them.”
Nancy Gertner, a retired federal judge who now teaches at Harvard Law School, said the Biden administration should consider whether it wants to pursue the appeal, noting that the Trump administration had sought Supreme Court review.
“Given that Mr. Tsarnaev will never leave prison,” she said in a statement, “the government should consider whether continuing to pursue a death sentence for him is unnecessarily traumatizing for the victims’ families and the City of Boston.”
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