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Greetings All,
Despite the Herculean efforts of Leonard’s attorneys and doctors, his medical transfer was denied. The BOP has refused to treat Leonard’s vision for over a year. On New Year’s Eve, he was rushed to the hospital when a blood vessel ruptured in his eye. Leonard Peltier is going blind.
If Biden does not grant Clemency, we must hit the ground running. Please see www.freeleonardpeltiernow.org to view the Red Road Home Campaign, designed by Leonard’s lead counsel.
It is our great hope that Biden will grant Clemency and Leonard Peltier can speak on what he faced. Join us as we talk about Leonard Peltier and Indigenous Genocide on January 25th. Registration link:
https://zoom.us/webinar/register/WN_-Uy0V_ZDTLm0aQy8XQu9ZA#/registration
Two people who have stood with Leonard for decades and have had a profound impact on the world, Rose Styron and Alex Matthiessen, had an excellent piece published in the Guardian:
https://www.theguardian.com/commentisfree/2025/jan/07/joe-biden-leonard-peltiers-clemency
The people holding Leonard have vast resources. The New York Times has begged Rose for her exquisite writing — they would not touch this piece. Neither would the Washington Post. There is a media white-out on Leonard Peltier. The conditions in which he is being held are atrocious under even third-world standards — lockdowns that keep everyone in solitary confinement for weeks at a time. This is not mentioned in the media. State prisons have oversight laws. Federal prisons do not. Federal prisoners are allowed no communication with anyone while in lockdown. Coleman 1 operates in the dark. Please visit our Advocacy page if you would like to know more:
https://www.freeleonardpeltiernow.org/advocacy
Please consider raising your voice. Ask Congress to be Congress and hold these people accountable. If you are overseas, let the Senate Judiciary Committee know what this looks like to other nations. The United States is guilty of human rights violations that should distress everyone. As stated, it operates in the dark. It is time to shine a hard light on what it is doing to our people.
If you want to send a message of solidarity or a good joke to Leonard, he would love to hear from you. He likes the bad jokes also. Please write in 22-point bold font so he can make the words out. Leonard said to tell you all he deeply appreciates your letters, but he would love to be able to read them. Please number the pages in large numbers — the prison gives him copies of letters, and the pages are not in order.
LEONARD PELTIER #89637-132
USP COLEMAN I
PO BOX 1033
COLEMAN FL 33521-1033
Thank you all for your continuous efforts and support of Leonard Peltier. You are appreciated more than you know.
https://www.freeleonardpeltiernow.org/donate
In Solidarity,
Dawn Lawson
Personal Assistant Leonard Peltier
Executive Assistant Jenipher Jones, Esq.
Leonard Peltier Ad Hoc Committee
1-800-901-4413
dawn@freeleonardpeltiernow.org
www.freeleonardpeltiernow.org
Questions and comments may be sent to:
info@freedomarchives.org
To unsubscribe contact:
http://freedomarchives.org/mailman/options/ppnews_freedomarchives.org
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We need a united, independent, democratically organized mass movement for peace, justice and equality in solidarity with similar movements worldwide if we are to survive the death agony of capitalism and its inevitable descent into fascism and barbarism before it destroys the world altogether!
—Bonnie Weinstein
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On this Wrongful Conviction Day, Leonard Peltier, the longest-serving Indigenous political prisoner, is incarcerated in lockdown-modified operations conditions at USP Coleman I, operated by the U.S. Federal Bureau of Prisons (BOP).
Yet, in this moment of silence, Leonard speaks.
To honor his birthday and all those who are unjustly convicted and incarcerated, the Leonard Peltier Official Ad Hoc Committee has released a video of Leonard Peltier that is going viral. Narrated by renowned scholar Ward Churchill and set to a video created by award-winning filmmaker Suzie Baer, the film most importantly centers Leonard’s personal reflection on his 80th year.
Jenipher Jones, Mr. Peltier's lead counsel, commented, "This powerfully moving film captures the essence of who I know Leonard to be. I am grateful to Professor Churchill and Suzie Baer for their work and longstanding advocacy of Leonard. As the recent execution of Marcellus Williams-Imam Khaliifah Williams shows us, we as a society bear a responsibility to uplift the cases of all those who are wrongfully convicted and also hold the government accountable to do that for which it professes to exist. We must challenge our impulses of blind blood-thirst for guilt and the use of our legal systems to carry out this malignant pathology. There is absolutely no lawful justification for Leonard's incarceration."
“Leonard Peltier is Native elder whose wrongful incarceration is shameful. His continued imprisonment exemplifies the historical cruelty of the US Government toward Native people. The US BOP's treatment of Leonard Peltier is unlawful, and he deserves his freedom.” —Suzie Baer
Leonard's Statement: Peltier 80th Statement.pdf:
https://onedrive.live.com/?authkey=%21ABHSRNdyB8SKn0I&id=DFF2DD874157D44A%21118178&cid=DFF2DD874157D44A&parId=root&parQt=sharedby&o=OneUp
To view the film, please visit:
https://tinyurl.com/Peltier80thPresentation
We hope to have additional updates on Leonard soon. In the meantime, please engage our calls to action or donate to his defense efforts.
Miigwech.
Donate/ActNow:
Write to:
Leonard Peltier 89637-132
USP Coleman 1
P.O. Box 1033
Coleman, FL 33521
Note: Letters, address and return address must be in writing—no stickers—and on plain white paper.
Sign our petition urging President Biden to grant clemency to Leonard Peltier:
https://www.freeleonardpeltier.com/petition
Email: contact@whoisleonardpeltier.info
Address: 116 W. Osborne Ave. Tampa, Florida 33603
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Russia Confirms Jailing of Antiwar Leader Boris Kagarlitsky
In a secret trial on June 5, 2024, the Russian Supreme Court’s Military Chamber confirmed a sentence of five years in a penal colony for left-wing sociologist and online journalist Boris Kagarlitsky. His crime? “Justifying terrorism” — a sham charge used to silence opponents of Putin’s war on Ukraine. The court disregarded a plea for freedom sent by thirty-seven international luminaries.
Kagarlitsky, a leading Marxist thinker in Russia’s post-Soviet period, recently addressed socialists who won’t criticize Putin:
“To my Western colleagues, who…call for an understanding of Putin and his regime, I would like to ask a very simple question. [Would] you want to live in a country where there is no free press or independent courts? In a country where the police have the right to break into your house without a warrant? …In a country which…broadcasts appeals on TV to destroy Paris, London, Warsaw, with a nuclear strike?”
Thousands of antiwar critics have been forced to flee Russia or are behind bars, swept up in Putin’s vicious crackdown on dissidents. Opposition to the war is consistently highest among the poorest workers. Recently, RusNews journalists Roman Ivanov and Maria Ponomarenko were sentenced to seven, and six years respectively, for reporting the military’s brutal assault on Ukraine.
A massive global solidarity campaign that garnered support from thousands was launched at Kagarlitsky’s arrest. Now, it has been revived. This internationalism will bolster the repressed Russian left and Ukrainian resistance to Putin’s imperialism.
To sign the online petition at freeboris.info
—Freedom Socialist Party, August 2024
https://socialism.com/fs-article/russia-jails-prominent-antiwar-leader-boris-kagarlitsky/#:~:text=In%20a%20secret%20trial%20on,of%20Putin's%20war%20on%20Ukraine.
Petition in Support of Boris Kagarlitsky
We, the undersigned, were deeply shocked to learn that on February 13 the leading Russian socialist intellectual and antiwar activist Dr. Boris Kagarlitsky (65) was sentenced to five years in prison.
Dr. Kagarlitsky was arrested on the absurd charge of 'justifying terrorism' in July last year. After a global campaign reflecting his worldwide reputation as a writer and critic of capitalism and imperialism, his trial ended on December 12 with a guilty verdict and a fine of 609,000 roubles.
The prosecution then appealed against the fine as 'unjust due to its excessive leniency' and claimed falsely that Dr. Kagarlitsky was unable to pay the fine and had failed to cooperate with the court. In fact, he had paid the fine in full and provided the court with everything it requested.
On February 13 a military court of appeal sent him to prison for five years and banned him from running a website for two years after his release.
The reversal of the original court decision is a deliberate insult to the many thousands of activists, academics, and artists around the world who respect Dr. Kagarlitsky and took part in the global campaign for his release. The section of Russian law used against Dr. Kagarlitsky effectively prohibits free expression. The decision to replace the fine with imprisonment was made under a completely trumped-up pretext. Undoubtedly, the court's action represents an attempt to silence criticism in the Russian Federation of the government's war in Ukraine, which is turning the country into a prison.
The sham trial of Dr. Kagarlitsky is the latest in a wave of brutal repression against the left-wing movements in Russia. Organizations that have consistently criticized imperialism, Western and otherwise, are now under direct attack, many of them banned. Dozens of activists are already serving long terms simply because they disagree with the policies of the Russian government and have the courage to speak up. Many of them are tortured and subjected to life-threatening conditions in Russian penal colonies, deprived of basic medical care. Left-wing politicians are forced to flee Russia, facing criminal charges. International trade unions such as IndustriALL and the International Transport Federation are banned and any contact with them will result in long prison sentences.
There is a clear reason for this crackdown on the Russian left. The heavy toll of the war gives rise to growing discontent among the mass of working people. The poor pay for this massacre with their lives and wellbeing, and opposition to war is consistently highest among the poorest. The left has the message and resolve to expose the connection between imperialist war and human suffering.
Dr. Kagarlitsky has responded to the court's outrageous decision with calm and dignity: “We just need to live a little longer and survive this dark period for our country,” he said. Russia is nearing a period of radical change and upheaval, and freedom for Dr. Kagarlitsky and other activists is a condition for these changes to take a progressive course.
We demand that Boris Kagarlitsky and all other antiwar prisoners be released immediately and unconditionally.
We also call on the authorities of the Russian Federation to reverse their growing repression of dissent and respect their citizens' freedom of speech and right to protest.
Sign to Demand the Release of Boris Kagarlitsky
https://freeboris.info
The petition is also available on Change.org
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Mumia Abu-Jamal is Innocent!
FREE HIM NOW!
Write to Mumia at:
Smart Communications/PADOC
Mumia Abu-Jamal #AM-8335
SCI Mahanoy
P.O. Box 33028
St. Petersburg, FL 33733
Join the Fight for Mumia's Life
Since September, Mumia Abu-Jamal's health has been declining at a concerning rate. He has lost weight, is anemic, has high blood pressure and an extreme flair up of his psoriasis, and his hair has fallen out. In April 2021 Mumia underwent open heart surgery. Since then, he has been denied cardiac rehabilitation care including a healthy diet and exercise.
Donate to Mumia Abu-Jamal's Emergency Legal and Medical Defense Fund, Official 2024
Mumia has instructed PrisonRadio to set up this fund. Gifts donated here are designated for the Mumia Abu-Jamal Medical and Legal Defense Fund. If you are writing a check or making a donation in another way, note this in the memo line.
Send to:
Mumia Medical and Legal Fund c/o Prison Radio
P.O. Box 411074, San Francisco, CA 94103
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Updates From Kevin Cooper
A Never-ending Constitutional Violation
A summary of the current status of Kevin Cooper’s case by the Kevin Cooper Defense Committee
On October 26, 2023, the law firm of Orrick, Herrington & Sutcliffe, LLP wrote a rebuttal in response to the Special Counsel's January 13, 2023 report upholding the conviction of their client Kevin Cooper. A focus of the rebuttal was that all law enforcement files were not turned over to the Special Counsel during their investigation, despite a request for them to the San Bernardino County District Attorney's office.
On October 29, 2023, Law Professors Lara Bazelon and Charlie Nelson Keever, who run the six member panel that reviews wrongful convictions for the San Francisco County District Attorney's office, published an OpEd in the San Francisco Chronicle calling the "Innocence Investigation” done by the Special Counsel in the Cooper case a “Sham Investigation” largely because Cooper has unsuccessfully fought for years to obtain the police and prosecutor files in his case. This is a Brady claim, named for the U.S. Supreme court’s 1963 case establishing the Constitutional rule that defendants are entitled to any information in police and prosecutor's possession that could weaken the state's case or point to innocence. Brady violations are a leading cause of wrongful convictions. The Special Counsel's report faults Cooper for not offering up evidence of his own despite the fact that the best evidence to prove or disprove Brady violations or other misconduct claims are in those files that the San Bernardino County District Attorney's office will not turn over to the Special Counsel or to Cooper's attorneys.
On December 14, 2023, the president of the American Bar Association (ABA), Mary Smith, sent Governor Gavin Newsom a three page letter on behalf of the ABA stating in part that Mr.Cooper's counsel objected to the state's failure to provide Special Counsel all documents in their possession relating to Mr.Cooper's conviction, and that concerns about missing information are not new. For nearly 40 years Mr.Cooper's attorneys have sought this same information from the state.
On December 19, 2023, Bob Egelko, a journalist for the San Francisco Chronicle wrote an article about the ABA letter to the Governor that the prosecutors apparently withheld evidence from the Governor's legal team in the Cooper case.
These are just a few recent examples concerning the ongoing failure of the San Bernardino County District Attorney to turn over to Cooper's attorney's the files that have been requested, even though under the law and especially the U.S. Constitution, the District Attorney of San Bernardino county is required to turn over to the defendant any and all material and or exculpatory evidence that they have in their files. Apparently, they must have something in their files because they refuse to turn them over to anyone.
The last time Cooper's attorney's received files from the state, in 2004, it wasn't from the D.A. but a Deputy Attorney General named Holly Wilkens in Judge Huff's courtroom. Cooper's attorneys discovered a never before revealed police report showing that a shirt was discovered that had blood on it and was connected to the murders for which Cooper was convicted, and that the shirt had disappeared. It had never been tested for blood. It was never turned over to Cooper's trial attorney, and no one knows where it is or what happened to it. Cooper's attorneys located the woman who found that shirt on the side of the road and reported it to the Sheriff's Department. She was called to Judge Huff's court to testify about finding and reporting that shirt to law enforcement. That shirt was the second shirt found that had blood on it that was not the victims’ blood. This was in 2004, 19 years after Cooper's conviction.
It appears that this ongoing constitutional violation that everyone—from the Special Counsel to the Governor's legal team to the Governor himself—seems to know about, but won't do anything about, is acceptable in order to uphold Cooper's conviction.
But this type of thing is supposed to be unacceptable in the United States of America where the Constitution is supposed to stand for something other than a piece of paper with writing on it. How can a Governor, his legal team, people who support and believe in him ignore a United States citizen’s Constitutional Rights being violated for 40 years in order to uphold a conviction?
This silence is betrayal of the Constitution. This permission and complicity by the Governor and his team is against everything that he and they claim to stand for as progressive politicians. They have accepted the Special Counsel's report even though the Special Counsel did not receive the files from the district attorney that may not only prove that Cooper is innocent, but that he was indeed framed by the Sheriff’s Department; and that evidence was purposely destroyed and tampered with, that certain witnesses were tampered with, or ignored if they had information that would have helped Cooper at trial, that evidence that the missing shirt was withheld from Cooper's trial attorney, and so much more.
Is the Governor going to get away with turning a blind eye to this injustice under his watch?
Are progressive people going to stay silent and turn their eyes blind in order to hopefully get him to end the death penalty for some while using Cooper as a sacrificial lamb?
An immediate act of solidarity we can all do right now is to write to Kevin and assure him of our continuing support in his fight for justice. Here’s his address:
Kevin Cooper #C65304
Cell 107, Unit E1C
California Health Care Facility, Stockton (CHCF)
P.O. Box 213040
Stockton, CA 95213
www.freekevincooper.org
Call California Governor Newsom:
1-(916) 445-2841
Press 1 for English or 2 for Spanish,
press 6 to speak with a representative and
wait for someone to answer
(Monday-Friday, 9:00 A.M. to 5:00 P.M. PST—12:00 P.M. to 8:00 P.M. EST)
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Resources for Resisting Federal Repression
https://www.nlg.org/federalrepressionresources/
Since June of 2020, activists have been subjected to an increasingly aggressive crackdown on protests by federal law enforcement. The federal response to the movement for Black Lives has included federal criminal charges for activists, door knocks by federal law enforcement agents, and increased use of federal troops to violently police protests.
The NLG National Office is releasing this resource page for activists who are resisting federal repression. It includes a link to our emergency hotline numbers, as well as our library of Know-Your-Rights materials, our recent federal repression webinar, and a list of some of our recommended resources for activists. We will continue to update this page.
Please visit the NLG Mass Defense Program page for general protest-related legal support hotlines run by NLG chapters.
Emergency Hotlines
If you are contacted by federal law enforcement, you should exercise all of your rights. It is always advisable to speak to an attorney before responding to federal authorities.
State and Local Hotlines
If you have been contacted by the FBI or other federal law enforcement, in one of the following areas, you may be able to get help or information from one of these local NLG hotlines for:
Portland, Oregon: (833) 680-1312
San Francisco, California: (415) 285-1041 or fbi_hotline@nlgsf.org
Seattle, Washington: (206) 658-7963
National Hotline
If you are located in an area with no hotline, you can call the following number:
National NLG Federal Defense Hotline: (212) 679-2811
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1) How a Company Makes Millions Off a Hospital Program Meant to Help the Poor
A private business has helped supercharge a controversial federal drug program. Patients and insurers have been left with big bills.
By Ellen Gabler, Jan. 15, 2025
Virginia King was charged more than $2,500 after receiving a cancer drug, even though the clinic was enrolled in a federal discount program. Credit...Adria Malcolm for The New York Times
Soon after being diagnosed with metastatic breast cancer, Virginia King sat in an outpatient clinic in Santa Fe, N.M., while a nurse injected her with a powerful drug to slow damage to her spine, where the disease had spread.
Even though the drug had a list price of about $2,700, the hospital that owned the cancer center billed Mrs. King’s insurance company $22,700. Her insurer paid $10,000, but the hospital wanted more.
She got a bill for over $2,500 — “more than half my take-home salary for a month,” said Mrs. King, 65.
She had unknowingly sought care from a hospital that participates in a federal program allowing it to buy drugs at a steep discount and charge patients and insurers a higher amount, keeping the difference.
The intention behind the program was for a small number of safety-net providers to have access to affordable drugs and be able to expand their care for needy patients. But instead, the program has exploded: Now, more than half of nonprofit hospitals in the United States take part. While some providers say it has helped keep their doors open, others — especially large nonprofit health systems — have been accused of maximizing payouts and swallowing the profits.
The program’s escalation has driven up health care costs for employers, patients and taxpayers, studies show.
In 2023, for instance, New York changed the way it administers drug benefits for Medicaid patients, in part because the state had discovered the cost of the federal program had increased by more than 200 percent over three years, said Amir Bassiri, the state’s Medicaid director.
“The numbers and the growth were staggering,” he said. “We all bear the cost.”
Along the way, one little-known middleman has been cashing in, The New York Times found.
The company, Apexus, has worked behind the scenes to supercharge the program, according to interviews with current and former employees and emails, internal reports and other documents.
Twenty years ago, the federal government chose Apexus to manage what was then a small program, negotiating with drug distributors and manufacturers to secure better prices and access to medications. But Apexus is allowed to collect a fee for almost every drug sold under the program, giving the company an incentive to help hospitals and clinics capture as many prescriptions as possible:
Its “purchasing optimization team” shows hospitals how they can make more money by buying different drugs.
A certification program and an Apexus-run “university” trains providers in boosting earnings.
Apexus employees give advice that broadly interprets the rules of the program so hospitals can claim additional patients and drugs.
Apexus was on track to double its revenue from 2018 to 2022, projecting $227 million that year, according to a 2022 internal memo written for the directors of Apexus’ parent corporation and reviewed by The Times. The company costs relatively little to operate and has enjoyed profit margins above 80 percent, according to that memo and three former employees.
In a statement, Apexus said it simply executed its government contract and did not contribute to the growth of the program, called the 340B Drug Pricing Program. “The drivers of growth are multifaceted,” the statement said.
But in the 2022 memo, the president of Apexus, Chris Hatwig, posed a question: “Are there other areas for program expansion within 340B that we are not thinking about?”
Government officials have told Apexus to focus solely on administering the program and not to influence drug purchases. But Apexus leaders have sometimes ignored that request, according to two complaints filed with a government watchdog and six current and former employees, speaking on the condition of anonymity because they feared professional or legal retribution.
In its statement, Apexus said it was “fully transparent” with the Department of Health and Human Services and had never breached its contractual obligations.
The Health Resources and Services Administration, an agency within H.H.S. that oversees the program, declined to answer detailed questions from The Times. But in a statement, a spokeswoman said the agency “conducts rigorous oversight of all contracts,” and “to our knowledge, Apexus has not violated” its contract. Regulators and leaders of the company meet frequently to discuss the company’s work and prevent conflicts of interest, the spokeswoman said.
The growth of 340B has drawn criticism for years from Congress, drugmakers and employers, who say it has added to ballooning health care costs. But the role of Apexus has largely gone unexamined.
“They’ve got a license to hunt,” said Marsha Simon, who as a staff member of a congressional committee helped write the bill that authorized the program.
$66 Billion in Sales
Established in 1992, the 340B program essentially requires pharmaceutical manufacturers to offer discounts on outpatient drugs to hospitals and clinics that treat a greater share of low-income and uninsured patients.
The hospitals then can charge insurers and patients the standard price and keep the profits. Although the money is supposed to encourage care for impoverished patients, there are few rules to enforce that.
Patients rarely know they are part of this system. Their prescriptions can be counted as 340B when they get outpatient treatment at a hospital or clinic that qualifies for the program, regardless of the patients’ own income or insurance status. The provider can continue to make money off the patients’ future outpatient prescriptions, even if they get them somewhere else.
Apexus has had contracts to handle the program since the early 2000s. The government does not pay Apexus — instead, drugmakers and distributors pay the company a small percentage of sales.
Based in Irving, Texas, it is a subsidiary of Vizient, a private business owned by hospitals that negotiates a range of health care discounts. Apexus was established as a small nonprofit in 2007 but became a for-profit company in 2014.
Around the same time, 340B began to explode for a number of reasons. More hospitals qualified for the program after the Affordable Care Act expanded the number of people on Medicaid. Other health care systems qualified after acquiring hospitals and clinics in poor areas. Some, already eligible for 340B, bought up practices that used high-margin drugs, like oncology clinics. And a government rule change meant hospitals could make money from prescriptions filled at a greater number of pharmacies.
A decade ago, sales of 340B drugs were $12 billion. In 2023, they reached a high of $66 billion.
Fighting the program’s growth has become a top priority for drugmakers, as well as some employers and insurers.
In North Carolina, prescription drug spending for state employees jumped almost 50 percent from 2018 to 2022. A report in May from the state treasurer’s office found that 340B was partly to blame: Hospitals that participated in the program billed the state health plan far more than hospitals that did not — almost 85 percent more for certain cancer drugs. In one example, hospitals bought a drug commonly used to treat melanoma for an average of $8,000 but billed the state $21,512.
In some cases, costs are passed along to patients.
Mrs. King, the cancer patient in New Mexico, refused to pay her $2,500 bill, and the hospital, Christus St. Vincent, sent it to collections in July.
After The Times asked about the bill last month, a spokeswoman for Christus St. Vincent said the charge was “a misunderstanding and has been resolved,” adding that the drug program helped the hospital provide charity care and reinvest in cancer treatment and primary care.
Mrs. King switched to a free-standing oncology clinic that does not qualify for the federal drug program. That clinic billed her insurance $8,000 for the injection, about a third of what Christus St. Vincent had charged. Her responsibility was nothing.
An Ever-Growing Portfolio
Ms. Simon, who helped draft the legislation creating 340B, said the government chose an outside contractor like Apexus in order to negotiate with distributors and drugmakers on behalf of small hospitals and clinics without a lot of buying power.
But regulators and Apexus have expanded that role, allowing the company to build a highly profitable business off the program and the loosely written statute that authorized it. The company has been “aggressive” in helping health care facilities maximize their revenue from the program, said Shawn Gremminger, chief executive of the National Alliance of Healthcare Purchaser Coalitions, which represents employers who buy health insurance for more than 45 million people in the United States.
“This is a government contractor, and the goal of the government should not be, ‘How do we make more money for 340B providers?’” said Mr. Gremminger, whose organization has pushed for the program to be overhauled.
Over the past two decades, Apexus has adapted its business model to harness 340B’s tremendous growth. A 2022 PowerPoint presentation obtained by The Times showed that Apexus employees received bonuses if the company increased its revenue each year.
With exclusive access to sales data, Apexus’ “purchasing optimization team” will analyze a hospital system’s drug-buying habits and compare them with those of their competitors, according to four current and former employees. In some cases, Apexus will suggest that a hospital buy more 340B drugs or tweak its inventory in ways that can churn more cash.
Apexus declined to answer detailed questions about its optimization team, but said in a statement that the company “only provides technical assistance” in keeping with regulations.
Apexus also holds “340B University” events to help providers and others in the health care industry understand the program, and it fields questions through a national call center. But the rules governing the program are ambiguous, and Apexus offers broad interpretations, according to four current and former employees.
For instance, one of the thorniest issues is which patients can be claimed by hospitals for discounted drugs. The further a hospital casts its net, the more patients and drugs it can include under the program, and the more money it can make. Apexus has advised hospitals that they can mine records as far back as 36 months for eligible patients they may have missed, two of those employees said.
Similarly, Apexus employees have showed hospitals how to maximize the number of pharmacies they work with, boosting the number of prescriptions that can qualify for discounts, those employees said.
In its statement, Apexus said those examples were inaccurate but would not say how. It added that the company encouraged “conservative and responsible stewardship” of the 340B program, and that all information it provided was approved by regulators.
A spokeswoman for H.R.S.A. said it reviewed materials prepared by Apexus but declined to comment on that specific advice.
The company has developed other ventures that have brought in revenue:
About eight years ago, Apexus began selling a $750 course for people to become “certified experts” in 340B.
It started a business to give hospitals better access to specialty drugs — for conditions like cancer, H.I.V. and autoimmune diseases — which are major drivers of 340B’s growth. That company, Acentrus, helped hospitals and clinics provide data to manufacturers in exchange for deeper discounts and access to those drugs. It was sold last year.
The company charges 3 percent in fees for a line of generic drugs that are managed and provided by drug distributors, according to former employees. Apexus simply provides access to the health systems.
For the last decade, Apexus has earned millions of dollars on drug purchases made outside the 340B program: Because not all outpatient drugs qualify for 340B discounts, hospitals must stock their pharmacies with medication purchased through different channels. Apexus acts as a middleman, making fees off those transactions.
That has frustrated drugmakers and competitors. In 2021, the drug manufacturer Baxter wanted to sell non-340B drugs to hospitals without going through Apexus, according to emails obtained under public-records laws. But government regulators would not allow it, a spokeswoman for Baxter said.
In early November, Premier, the main competitor to Apexus’s parent company, Vizient, sued the federal government over these sales. The setup, the suit argued, forces hospitals to pay higher prices for those non-340B drugs and drives revenue to drug manufacturers and Apexus.
In its statement, Apexus said its federal contract did not preclude it from developing other businesses, as long as they were not in conflict with the terms of the agreement.
Regulators were aware of these ventures, the company said, noting that its specialty drug business, Acentrus, was in “no way associated with” the 340B program. The 2022 company memo, however, said Acentrus “resulted in an additional $20 million” in revenue within the 340B program.
H.R.S.A. declined to comment on the scope of its authority over Apexus and whether it knew about all the company’s revenue-generating arms.
Criticized, but Pushing Ahead
About six years ago, Krista Pedley, then the director of the H.H.S. office in charge of 340B, reprimanded Apexus leaders in a Skype meeting, saying it was acting more like a sales-driven business than a program administrator. She reminded them that Apexus’ role was not to help 340B grow, according to five former or current employees familiar with the meeting.
For about a month afterward, regulators reviewed any communication Apexus had with health care facilities to make sure the company didn’t overstep, the employees said.
But that did not seem to dampen the company’s pursuits. (In an email, Ms. Pedley said she did not recall that meeting, and noted that her former office met regularly with Apexus.)
In 2021, an unnamed Apexus employee filed a complaint with H.H.S.’s Office of Inspector General, an internal watchdog, saying the company was “always trying to grow the program.” The company, the employee wrote, had hired “sales-type” staff to influence hospitals’ drug-purchasing decisions.
The complaint said that regulators did not understand Apexus’ business, and that employees had been told by company leaders to describe its work as “education.”
Another anonymous complaint, filed in 2022, echoed the allegation that Apexus had hired staff to help shape hospitals’ purchasing decisions, and said it was using “data in ways to drive revenue for itself, without asking (or asking and disregarding) the government’s opinion.”
Apexus declined to answer specific questions about the meeting with Ms. Pedley, but said The Times's account was a “mischaracterization of our day-to-day, collaborative discussions” with the agency.
Apexus rejected the allegations in the anonymous complaints and said it had been unaware of them until The Times provided it with copies. The spokeswoman for H.R.S.A. said that it, too, had been unaware of the complaints.
In interviews, four current and former employees said that for years, Mr. Hatwig, Apexus’ president, acknowledged that regulators did not want the company to develop sales-focused arms of the business but encouraged his staff to do so anyway, saying that the government would not know.
Apexus denied that, saying that “everyone at Apexus understands the expectation that they conduct themselves and perform their work in an ethical and compliant manner.”
Julie Tate and Carson Kessler contributed research.
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2) Live Updates: Disputes Hold Up Israeli Cabinet Vote on Cease-Fire Deal
The agreement, which would include the release of hostages, was met with cautious optimism. But Israel’s cabinet needs to ratify the deal, and the prime minister’s office said it was unlikely that a vote would come Thursday.
By Adam Rasgon and Aaron Boxerman, Reporting from Jerusalem
Last-minute disputes on Thursday held up an expected Israeli cabinet vote on a cease-fire deal with Hamas, which has raised hopes for an end to the violence after 15 months of devastating war in Gaza.
Israeli ministers were unlikely to meet before Friday to ratify the agreement, the prime minister’s office said, citing disagreements with Hamas. The holdup prompted fears of further delays in carrying out the agreement, which was announced on Wednesday by brokers Qatar, Egypt and the United States.
Mediators hope the deal — which would begin with a 42-day truce and the release of hostages for Palestinian prisoners — will ultimately end the war that began with the Hamas-led attack in October 2023 in which 1,200 people in Israel were killed and 250 taken hostage. The subsequent Israeli military campaign has killed tens of thousands of Gazans and forced nearly the entire population of the enclave to flee their homes.
On Thursday, the office of Benjamin Netanyahu, the Israeli prime minister, accused Hamas of trying to renegotiate parts of the deal. Omer Dostri, the prime minister’s spokesman, said Hamas had demanded changes to the deployment of Israeli troops along Gaza’s border with Egypt, as well as the release of “certain terrorists” unacceptable to Israel.
“There isn’t any deal at the moment,” Mr. Dostri said in a text message. “Therefore, there’s no cabinet meeting.”
Izzat al-Rishq, a senior Hamas official, said the group was committed to the deal. Hamas officials did not immediately answer specific questions about the latest disputes.
The Biden administration said that its team was continuing to work with Israeli officials and mediators to settle the remaining details. Secretary of State Antony J. Blinken called the cease-fire agreement “a moment for historic possibility for the region and well beyond.”
As Gazans expressed tempered relief over the possibility of a deal, the fighting continued: Israeli strikes have killed more than 80 Palestinians over the past day, according to the Gazan health ministry, which doesn’t distinguish between civilians and combatants.
In Israel, some hard-line members of Mr. Netanyahu’s government have opposed the deal. But if it comes to a vote, it is expected to gain cabinet approval even without the support of the coalition’s two far-right parties, which do not command a majority in the cabinet.
Here’s what else to know:
· The first phase: The cease-fire deal would begin with an initial phase lasting six weeks. It would involve the release of 33 hostages and hundreds of Palestinian prisoners and allow the entry into Gaza of 600 trucks carrying humanitarian relief daily, according to a copy of the agreement obtained by The New York Times.
· Cautious hope: Many Gazans reacted with wary hope mixed with sadness, exhaustion and fear. “How can we ever rebuild?” asked Suzanne Abu Daqqa, who lives near the southern city of Khan Younis. “Where will we even begin?” In Israel, the joy and relief that families of hostages expressed has been matched with anxiety that many could be left behind.
· A diminished Hamas: The nearly uninterrupted fighting in Gaza has left the militant group severely battered, with many of its military commanders killed, including its longtime leader in Gaza, Yahya Sinwar.
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3) Deadly strikes in Gaza continue despite the announcement of a cease-fire deal.
By Hiba Yazbek, Reporting from Jerusalem, January 16, 2025
https://www.nytimes.com/live/2025/01/16/world/israel-hamas-gaza-cease-fire
Despite the announcement of a cease-fire deal between Israel and Hamas, deadly strikes in Gaza have continued.
Gaza’s health ministry said on Thursday morning that at least eight Israeli attacks in the territory had killed 81 people and injured nearly 200 others over the previous 24 hours.
The Palestinian Civil Defense, an emergency service, said that Israeli strikes had killed at least 77 people since the deal had been announced. The Israeli military did not immediately comment on the strikes. The claims could not be independently verified.
“The reality in the strip remains very difficult and catastrophic,” said Mahmoud Basal, the rescue and emergency service’s spokesman.
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4) Israeli Security Cabinet Approves Gaza Cease-Fire Deal
Prime Minister Benjamin Netanyahu’s office said the deal, which is expected to be greenlit by the full cabinet later today, could go into effect as early as Sunday.
By Aaron Boxerman, Adam Rasgon and Ephrat Livni, Jan. 17, 2025
Here’s the latest on the agreement.
Israel’s security cabinet approved a Gaza cease-fire and hostage release agreement on Friday, overcoming a key hurdle after Israeli and Hamas negotiators resolved remaining disputes over a deal seen as the best chance to end a devastating, 15-month war.
With the endorsement of the security cabinet, a small forum of senior ministers, the next step is for the full Israeli cabinet of more than 30 ministers to green-light it, which they are expected to do in meeting later on Friday. Hamas said on Friday that there were no longer any barriers to the agreement.
Qatar and Egypt mediated the cease-fire deal alongside the Biden and incoming Trump administrations. Mediators hope the cease-fire will ultimately bring an end to the war that has devastated the Gaza Strip, killing tens of thousands of Palestinians. Hamas-led militants began the fighting with a surprise attack on Israel on Oct. 7, 2023, killing 1,200 people and taking about 250 others hostage.
Under the agreement, both sides will begin the cease-fire with a six-week truce during which Israeli forces will withdraw eastward, away from populated areas. Hamas will free some 33 of the hostages still in captivity, mostly women and older people.
Israel will also release hundreds of Palestinian prisoners, including some serving long sentences for attacks on Israelis. After the Israeli government signs off on the deal, Israeli civilians will have a short window to file objections, but the courts are widely expected to allow the agreement to go forward.
The cease-fire would be the first since November 2023, when 105 hostages were freed in a weeklong truce in exchange for 240 Palestinian prisoners.
Here’s what else to know:
· Delays overcome: The security cabinet vote had been expected on Thursday, but it was held up amid last-minute conflicts between Israel and Hamas, as well as widening rifts over the agreement inside the governing coalition of Prime Minister Benjamin Netanyahu.
· Israel’s right wing: Itamar Ben-Gvir, Israel’s hard-line national security minister, threatened to resign and remove his party from Mr. Netanyahu’s government if the cabinet approved the cease-fire, saying that it would leave Hamas in power in Gaza. While Mr. Ben-Gvir’s threat could destabilize Mr. Netanyahu’s coalition at a critical time, it was unlikely to scuttle the cease-fire deal. Opposition lawmakers have pledged to support Mr. Netanyahu’s push for a cease-fire if more hard-line allies leave the coalition.
· Biden on Netanyahu: President Biden, in his final television interview in office, which aired on MSNBC on Thursday night, defended his steadfast support for Israel throughout the conflict, but said he had pushed Mr. Netanyahu to prevent Palestinian civilian deaths.
· Trump’s inauguration: President-elect Donald J. Trump, who had pressured the parties to reach an agreement before his inauguration, repeated in an interview that aired on Thursday that he wanted the deal closed before he takes office on Monday.
· Attacks in Gaza: Deadly strikes have continued since the cease-fire deal was announced. The Palestinian Civil Defense, an emergency service organization, said Friday that Israeli strikes had killed more than 100 people since the announcement. That figure could not be independently verified. The Israeli military said on Thursday that it had struck about 50 targets across the Gaza Strip over the previous day, adding that “numerous steps” were taken to prevent civilian harm before the strikes.
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5) Dozens of Gazans have been killed in Israeli strikes since the deal was announced, emergency officials say.
By Rawan Sheikh Ahmad, Reporting from Haifa, Israel, Jan 17. 2025
Since the cease-fire agreement between Hamas and Israel was announced on Wednesday, Israeli airstrikes have continued across the Gaza Strip, with northern Gaza facing the heaviest attacks, emergency officials in the territory said on Friday morning.
Palestinian Civil Defense, an emergency services organization, said that more than two dozen children were among those killed, and that more than 200 people were injured across the territory. The highest toll was in Gaza City, where more than 80 Palestinians had been killed, Civil Defense said.
The group’s figures could not be independently confirmed. The Israeli military did not immediately comment.
Wafa, the Palestinian Authority’s official news agency, said that Israeli warplanes had struck homes in northeastern Gaza City, resulting in deaths and injuries. Rescue workers and ambulance teams have been unable to reach the area to recover bodies, Wafa said.
Ahmad al-Mashharwi, who has been sheltering with more than a dozen family members in a rented house in Gaza City, described the attacks as relentless.
“The cease-fire feels meaningless,” he said in a phone interview. “Artillery and airstrikes continue around us, especially in northern Gaza.”
The cease-fire, if it goes into effect, is supposed to pave the way for more humanitarian aid to reach Gaza. Mr. al-Mashharwi said that conditions in northern Gaza were dire, with prices soaring and even the most basic goods in short supply.
“We can’t afford food or clean water, and my children are going hungry,” he said. “We’ve been stripped of everything — there’s no safety, no resources, nothing to help us survive.”
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6) After 15 Months of War, Gazans Dream of Returning Home
They daydreamed about the people they would hug as soon as the truce took hold, the graves they would visit and the homes they would rebuild.
By Vivian Yee and Bilal Shbair, Reporting from Cairo and Deir al Balah, Gaza Strip, Jan. 17, 2025
It is almost over, the end so close they can practically feel the keys they have kept all these months sliding into the locks of their old homes, the doorknobs turning in their hands, the beds they will sink into for their first night’s peaceful rest in more than 15 months — their own beds. Just a couple more days to go.
Two nights before the first stage of a cease-fire in Gaza was announced, Layan al-Mohtaseb, 15, dreamed of being back in her bedroom in Gaza City, cleaning it as she used to before her family fled during the war.
“This time, it feels like we’re truly going home,” she said.
That may be true only for those whose homes are still standing after months of destruction. And there is always a chance the fighting might resume after the six-week initial truce if talks over a permanent one collapsed. But across Gaza, people were daydreaming of the first moments of peace, the people they would hug as soon as the truce took hold, the graves they would visit. They already knew they would be shedding tears, tears they hardly knew whether to attribute to joy or to grief.
If Wednesday night was for celebrating the news that a cease-fire deal had been struck, the following days were for making preparations. As the Israeli security cabinet convened to vote on the cease-fire and hostage release agreement on Friday, Palestinians were calling around for trucks they could rent to move their things back to northern Gaza, or vans, or even donkey carts; they were packing up their tents, wondering where they would live if their houses were no longer there.
Fedaa al-Rayyes, 40, was already buying ingredients to make small festive sweets to welcome the war’s end. But the first thing she planned to do when the bombs and drones fell silent was to search for relatives she hadn’t seen in months, to find out who was still alive and to mourn for those who did not live to see this day.
“It’s impossible to describe this mix of relief and grief,” she said. “I’m happy we survived and grateful for the kind people who helped us. Yet, I’m deeply sad — sad for the relatives and friends we lost and for the neighborhood we’ll return to without them.”
There were practical matters to think of, too. She would remind her children to “stay away from anything that might still be dangerous or explosive,” she said — from all the unexploded ordnance littering Gaza that could keep adding to the war’s casualty count, one accidental blast at a time, for months or years to come.
Most of Gaza’s population of more than two million people have had to huddle into tents and schools and other people’s apartments for much of the war, driven by Israel’s airstrikes and evacuation orders from their houses or the earlier shelters they had tried. Now they could think of little else but going home. Even if those homes were damaged. Even if they were now no more than rubble and ash.
Manal Silmi, 34, a psychologist for an international aid group, planned first to go hug her mother and her siblings and “cry, letting out all the pain we’ve carried for these 15 months,” she said.
Then the trek home could begin. Per the agreement, people displaced from northern Gaza to the south will be allowed to return on the seventh day after the cease-fire takes effect on Sunday. Her family was already looking for a big van to drive all their tents and bedding back up north. Her friends and the few relatives she had left in Gaza City had already called, making plans to meet them at the crossing point dividing northern and southern Gaza.
“We’ll hug, we’ll cry and we’ll thank God over and over for surviving this war,” she said.
Al-Hassan al-Harazeen, 23, a college senior majoring in computer science, knew his family’s house in eastern Gaza City was in ruins, he said. But he would still head straight there as soon as the cease-fire began.
He was imagining spray-painting his family’s name on any brick that was still in one piece, picturing himself sitting on the rubble for a while, he said, “to embrace those broken stones and bricks as if they’re a part of me.”
Then he would visit the grave where they had buried his grandfather at the start of the war to recite the opening verses of the Quran for him.
Even as mediators announced the deal on Wednesday, Israel was still heavily bombing Gaza. Two of Jamal Mortaja’s employees from the solar-panel business he owned before the war were killed the day before. They would be in his thoughts, said Mr. Mortaja, 65, when he headed back to Gaza City to visit what remained of his home before checking on his stores at the al-Ansar roundabout.
Raed al-Gharabli, too, wanted to return to Gaza City, despite his home’s destruction, just to say goodbye before the rubble was removed. He wanted to walk through his neighborhood, Shuja’iyya, greeting neighbors who had stuck it out all these long months. He would take his makeshift tent from the central Gaza city of Deir al Balah, where he had fled with his family, and set it up next to the ruins of his house.
“I can’t wait to see this moment become real,” said Mr. al-Gharabli, 48, a tailor. “If I could, I’d fly straight north and land on the rubble of my home.”
To speed things up, he said his family would leave some belongings with neighbors in Deir al Balah, where they and other displaced people had come to trust and rely on people who had been total strangers at the war’s beginning.
There was even a part of them that was already nostalgic for it, the camaraderie that had formed between them and their temporary neighbors.
After his home in the southern city of Khan Younis was destroyed, Ismail al-Sheikh, 39, a university lecturer, had moved to a tent nearby, where he got to know two men in nearby tents. The new friends spent their evenings reminiscing about life before Oct. 7, 2023, when the war began, and imagining aloud what would happen once the nightmare was over. What they would do. Where they would go.
For Mr. al-Sheikh, who taught at al-Aqsa University, the daydreams were nothing crazy. He just wanted his normal life back, teaching his classes, meeting up with friends at night at the Titanic Restaurant in Khan Younis. The Titanic, which he’d heard had collapsed into rubble.
Now, with the war nearing its close, his new friends were getting ready to return to Gaza City, where they were from.
“I’ll deeply miss those gatherings,” Mr. al-Sheikh said. “It’s truly a mix of emotions — happiness for their return, sadness for the farewells and hope for what lies ahead.”
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7) What Doctors and Nurses Can Do to Protect Undocumented Immigrants
By Danielle Ofri, Dr. Ofri is a primary care doctor in New York, Jan. 17, 2025
"As a profession, we should not be afraid to publicly oppose government policy. Doctors who feel hesitant about stepping in the fray should remember that the American Medical Association’s code of ethics charges us with a 'responsibility to seek changes in those requirements which are contrary to the best interests of the patient.' The nursing code of ethics stresses the duty 'to protect human rights.'”
Joanne Joo
It was hardly two weeks after the election when a doctor in our clinic received a letter from one of her patients, an undocumented immigrant who feared that Immigration and Customs Enforcement might detain her under a second Trump term.
The patient had diabetes and suffered from rotator cuff tendinitis, which makes reaching backward quite painful. “Is there any possibility you can write a letter,” she asked, “stating that if they handcuff me, can they please handcuff me with my hands in front of me?” She was also panicked about her diabetes. “I am scared that they will not allow me to take any medications in the immigration camps.”
The patient asked that if the doctor needed an in-person visit with her, “may it be scheduled before January?” She would do only virtual visits after Trump took office. “I’m scared I.C.E. will be in train stations and bus stops,” she said.
As a physician, it was hard to read this without feeling sickened. It brought back the tumultuous months of 2017, defined by the first Trump administration’s travel bans and vitriol against immigrants. So many of our patients were terrified by the rhetoric; anxiety levels and blood pressure skyrocketed. But what seemed like an electoral aberration now feels like an American retrenchment. Tom Homan, tapped to become the so-called border czar, has promised “shock and awe” on Day 1.
To be sure, every presidential administration for the past 30 years has deported undocumented immigrants, though mostly at or near the border. What feels different about this upcoming term — and why medical professionals will need to play a more active role in protecting their patients — is the scope. The specter of mass and potentially indiscriminate roundups feels more akin to the shameful internment of Japanese immigrants and Japanese American citizens during World War II.
Historically, health care workers have not always risen to the occasion when our patients have been targeted. Our recent history is tarnished by failures to report abuses or intervene at Abu Ghraib and Guantánamo Bay, as well as by forced sterilizations of prisoners, women of color and people with disabilities.
But patient advocacy is integral to health care. Medical professionals constantly battle insurance companies and pharmacy benefit managers to get our patients’ medical treatments covered. We tussle with our own institutions to expedite CT scans and medical appointments. We write advocacy letters for things like walkers and dental clearance and problems with bathroom mold and jury duty. But in this upcoming era we may have to face off against our own federal government.
From a medical perspective — as our patient’s letter poignantly illustrates — no law even needs to go into effect for harm to be done; fear alone can keep patients from seeking care. The only safe option this patient can imagine is to hole up at home.
Even if policies are directed, for example, only toward immigrants with a criminal record, the effects could be far-reaching. A study in the journal Health Affairs found that after episodes of increased deportations by I.C.E. there was a noticeable drop in primary care checkups for Hispanic patients as a whole, regardless of immigration status. (Non-Hispanic patients did not register any decrease.) Other data suggest that increased I.C.E. activity is associated with a drop in Medicaid enrollment for children who were eligible.
Frightening people away from medical care is a sure way to increase expenses when controllable conditions such as diabetes explode into medical emergencies. It also has the potential to kindle outbreaks of infectious diseases. As Covid surely taught us, our health is intimately intertwined with our community’s. Managing emerging infections such as bird flu as well as stalwarts like tuberculosis, syphilis and measles will be hampered if people are too afraid to seek medical care.
Health care workers have an obligation to help protect our patients, reassuring them that our primary duty is to them and their health. Simple actions, such as posting signage indicating all patients are welcome, can help. We can reiterate that exam-room conversations are confidential and that privacy laws protect information in the medical record, including identifying details. As a practical matter, we should avoid commenting on our patients’ immigration status in our notes, in case such laws are changed.
If patients feel uncomfortable coming to our facilities, we can offer telehealth options. When in-person care is necessary, appointments and tests should be consolidated into a single day to minimize travel. If our patients are admitted to the hospital, we should inform them of their right to decline being listed in the hospital registry.
Medical personnel can also decline to participate in immigration enforcement, such as the recent Texas executive order requiring hospitals to ask patients about immigration status. Even before the question is asked, explicitly informing patients that they are not required to answer it can be an effective way of defanging such tactics. We must insist that medical facilities and their immediate surroundings continue to be treated as “sensitive areas” like schools and houses of worship, and remain off limits to I.C.E. No one should be arrested or deported while obtaining medical treatment.
As a profession, we should not be afraid to publicly oppose government policy. Doctors who feel hesitant about stepping in the fray should remember that the American Medical Association’s code of ethics charges us with a “responsibility to seek changes in those requirements which are contrary to the best interests of the patient.” The nursing code of ethics stresses the duty “to protect human rights.”
For every patient who has the courage to reach out to a doctor with their deepest fears, there are many who are too afraid. Medical professionals should reassure all of our patients of our commitment to care for them, no matter the political environment, and be ready to do more than assuage our patients’ fears about which way they might be handcuffed.
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8) Support for Trump’s Policies Exceeds Support for Trump
A new poll found the public is sympathetic to the president-elect’s plans to deport migrants and reduce America’s presence overseas.
By Jeremy W. Peters and Ruth Igielnik, Jan. 18, 2025
Jeremy Peters and Ruth Igielnik wrote the questions for a poll of 2,128 Americans and analyzed the results for this article.
“There is a widespread belief, across parties, that Washington is corrupt, with two-thirds of Democrats and 80 percent of Republicans saying the government serves itself and the powerful over ordinary people. Two-thirds of Americans say the economic system unfairly favors the wealthy.”
Migrants walking along the Rio Grande at the border between the United States and Mexico. Credit...Paul Ratje for The New York Times
Many Americans who otherwise dislike President-elect Donald J. Trump share his bleak assessment of the country’s problems and support some of his most contentious prescriptions to fix them, according to a new poll from The New York Times and Ipsos.
A little more than half of the country expresses some desire to see Mr. Trump follow through with his harshest threat to deal with illegal immigration: deporting everyone living in the United States without authorization.
The poll, which surveyed 2,128 adults from Jan. 2 to 10, found that 55 percent of Americans either strongly or somewhat support such mass deportations.
Americans are more evenly split on whether Mr. Trump should implement tariffs on countries like China and Mexico, which he has vowed to do as a way to reduce reliance on foreign goods. Still, 46 percent say that trade with foreign nations should be subject to increased tariffs.
And a large majority is sympathetic to efforts to strictly limit how doctors can treat children struggling with their gender identity — an issue Mr. Trump and other Republicans made central to their campaigns for office. Seventy-one percent said that no one under 18 should be prescribed puberty-blocking drugs or hormones. The Supreme Court is expected to issue a decision on the matter later this year.
The poll tells the story of a country turning inward, where people are more aligned with Mr. Trump’s “America First” agenda than they were during his first term in office.
For a political figure so divisive — Americans view him more negatively than any other president about to take office in the last 70 years — the level of support for his ideas is striking. Most Americans say the United States has ignored serious problems at home while entangling itself in costly conflicts abroad, the poll found. A majority believe the government is sending too much money to Ukraine. And many are expressing less tolerance of immigrants overall.
“Something needs to happen on immigration,” said Jose Hernandez, 48, of Atlanta, who works with a hotel chain on new projects. “I’m an immigrant myself, from Mexico, but I waited 25 years. I came to this country legally.” He added, “There’s no control over the system.”
Mr. Hernandez said he voted for Hillary Clinton in 2016 and Joseph R. Biden in 2020, and considers himself aligned with Democrats on social justice. But in 2024, he supported Mr. Trump as more of a vote “against Kamala” than anything else, he explained.
Though Mr. Hernandez said he does not want to see mass deportation, he described the current situation at the border as “unsustainable.”
“We establish rules and guidelines. When you’re not following those rules, that’s it,” he said.
Mr. Trump has vowed to carry out the largest deportation operation in American history. And the public is with him, to a point.
A vast majority of Americans — 87 percent — support deporting undocumented immigrants with a criminal record, which Mr. Trump has said would be one of the first orders of business he carries out.
Nearly two-thirds of all Americans — including 54 percent of Hispanics and 44 percent of Democrats — support deporting people who entered the country illegally during the last four years of the Biden administration, after it reversed many of Mr. Trump’s immigration restrictions from his first term. In that time, legal and illegal immigration soared to the highest levels in U.S. history.
A slim majority — 56 percent — said they believe that immigrants strengthen the country. About 41 percent agreed with the statement “immigrants today are a burden on our country.” That sentiment had subsided over the last decade, according to several public polls, but now appears to be rising.
The undocumented population was 11 million people in 2022, according to the latest government estimates. Demographers agree that the current number is higher, between 13 million and 14 million.
Americans are also eager to see their country less enmeshed in world affairs. Asked if it was better for the United States to be active in world affairs or, instead, to concentrate less on problems overseas and pay more attention to issues at home, 60 percent of Americans prefer less foreign engagement, according to the poll.
As recently as 2019, a smaller share of Americans expressed a desire to pull back from international affairs, splitting about 50-50 on the question, according to Pew Research Center.
The Ipsos survey, conducted for The New York Times, aimed to measure support for specific policy proposals Mr. Trump said he would implement if elected. It also surveyed public sentiment on a range of issues that have been the subject of partisan disagreement, from the scope of presidential power to programs designed to promote diversity.
The country remains deeply divided over Mr. Trump, the poll found, despite his inflated claims of winning “a powerful and unprecedented mandate.” Roughly the same share of people told The Times that they are worried or pessimistic about the next four years as excited or optimistic. His favorability rating, according to an average of polls from the website FiveThirtyEight, has hovered just below 50 percent lately. That matches his share of the popular vote in 2024.
Americans are far from willing to give Mr. Trump carte blanche. For instance, even though most people expect he will use the government to investigate and prosecute his political opponents, a vast majority of Americans do not want him to. That includes a majority of Republicans.
Overall, 73 percent of Americans say they oppose the idea of Mr. Trump pursuing legal charges against his adversaries — with 49 percent saying they are strongly opposed.
Mr. Trump would also lack majority support to eliminate the constitutional guarantee to citizenship for anyone born on American soil, the poll found.
The poll also revealed that Americans hold their government in exceedingly low esteem — far lower than during the Watergate era. Majorities across races, genders and partisan stripe say the political system is broken and that the economy works against them — a pessimism that tracks with some of Mr. Trump’s grimmer rhetoric.
There is a widespread belief, across parties, that Washington is corrupt, with two-thirds of Democrats and 80 percent of Republicans saying the government serves itself and the powerful over ordinary people. Two-thirds of Americans say the economic system unfairly favors the wealthy.
In interviews, respondents to the poll reflected the foul mood of the country.
“So many elected officials have the service of their constituencies at the bottom,” said Tarra Williams, 49, a compliance manager in Mooresville, N.C., who said she voted for Vice President Kamala Harris.
Ms. Williams said she did not trust Republicans, Democrats or the federal government. “The whole country is on cognitive dissonance autopilot,” she said. “We need a whole governmental reboot.”
Among some Democrats, there was a certain ambivalence about Mr. Trump’s second inauguration.
“I don’t think Trump becoming president is a good or bad thing,” said Booker Preston, 50, a mechanic in Fort Worth, Texas, who said he voted for Ms. Harris. Perhaps, he suggested, the government might spend some of the money it sends abroad tackling problems at home.
“I really feel that we spend a lot of money overseas that we might not be able to recoup — nor do we get enough benefits to offset,” he said. “We could spend those billions of dollars here to really help people here.”
Mr. Trump’s promise to do a better job managing inflation and the economy persuaded many voters. More Americans expect that Mr. Trump’s policies will help rather than hurt the economy. Even among Democrats, about one-third say he will help the economy or, at least, not make much of a difference.
Americans were mixed on whether Mr. Trump would be able to make good on some of those economic promises. Most Republicans expect that prices will go down during Mr. Trump’s tenure; most Democrats expect they will not.
But Americans largely expect him to follow through on what he said he would do. Nearly unanimously, and across parties, majorities said they thought he was likely to carry out mass deportations and that he would raise tariffs on China and Mexico.
A slightly narrower majority of Americans expect that Mr. Trump would involve the country in fewer wars. Republicans are about twice as likely to expect this as Democrats.
Like it or not, Mr. Trump did not begin any major wars, said Tim Malsbary, 56, a nurse in Cincinnati, who said he voted for Mr. Trump this election but used to consider himself a Democrat.
“The Democratic Party has made me bitter,” he added.
Though the issue of rights for gay and transgender people ranks far down most Americans’ list of priorities — only 4 percent cited it as one of their most important issues — Republicans have focused on it heavily. And Mr. Trump, who ran attention-grabbing ads attacking Ms. Harris as a radical on the issue, appears to have been more in sync with public sentiment.
The survey found, for instance, that just 18 percent of Americans believe transgender female athletes — those who were male at birth — should be allowed to compete in women’s sports. Nearly 80 percent say they should not.
On social issues, Republicans have also gone after attempts to increase racial diversity. When it comes to such efforts in schools and government agencies, Americans are evenly divided, with 48 percent saying they want to end such programs and 47 percent who want to keep them.
About 22 percent of Black Americans and 40 percent of Hispanic Americans support ending these programs.
Still, as polarizing as many Americans find Mr. Trump, some are withholding judgment.
Ali Romero, 43, of Moab, Utah, said she found it difficult to support some of Mr. Trump’s decisions on things like reproductive rights and social justice. But she did not see Ms. Harris as a compelling alternative, even though she leans Democratic.
“So instead of voting for someone and feeling not great about it,” she said, “I voted for nobody and I feel great about it.”
At the very least, a Trump presidency will be different, she said. “It’s not the status quo.”
Christine Zhang contributed.
How This Poll Was Conducted
Here are the key things to know about this poll from The New York Times and Ipsos:
· 2,128 Americans were surveyed nationwide from Jan. 2 to 10, 2025.
· The poll was conducted using the KnowledgePanel, a probability-based web panel hosted by Ipsos. You can see the exact questions that were asked and the order in which they were asked here.
· The sample was drawn from KnowledgePanel, which is recruited using address-based sampling to ensure representative coverage of the entire United States. Americans were then selected for this survey out of that panel.
· The margin of sampling error among all Americans is about plus or minus 2.6 percentage points. In theory, this means that the results should reflect the views of the overall population most of the time, though many other challenges create additional sources of error.
You can see full results and a detailed methodology here. You can view the cross tabs here.
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9) Live Updates: Israel’s Cease-Fire Deal With Hamas to Take Effect Sunday
The truce will begin at 8:30 a.m., according to the Foreign Ministry of Qatar, a mediator in the talks. U.S. and other diplomats see the deal as the best chance to end the 15-month war that has devastated Gaza.
By Aaron Boxerman, Reporting from Jerusalem, Jan 18, 2025
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Khan Younis, southern Gaza, Mourners prayed over the bodies of Palestinians killed by an Israeli strike.
Latest updates on the cease-fire deal.
Israel’s cease-fire agreement with Hamas will go into effect on Sunday, according to Qatar’s Foreign Ministry and the office of Prime Minister Benjamin Netanyahu of Israel. A ministry spokesman said the truce would begin at 8:30 a.m. local time, setting up a reprieve in the 15-month war that has devastated the Gaza Strip.
Israel’s government approved the deal early Saturday after hours of deliberations.
The Israeli security cabinet approved the deal on Friday morning, two days after it was announced, and the full cabinet followed with final approval during a meeting that continued into the Jewish Sabbath. Israeli civilians will have a short window to file objections, but the courts are widely expected to allow the agreement to go forward.
In announcing the timing of the start of the cease-fire, Majed al-Ansari, a spokesman for Qatar’s Foreign Ministry, urged Gaza residents to be cautious. “Wait for directions from official sources,” he said in a statement. Qatar, alongside Egypt and the United States, mediated the cease-fire talks.
U.S. and other diplomats see the deal as the best chance to end the war, which began after Hamas led an attack on Israel on Oct. 7, 2023, killing 1,200 people and taking 250 hostage. Israel’s ensuing military campaign has leveled much of Gaza. Tens of thousands of Palestinians and hundreds of Israeli troops have been killed.
Under the terms of the deal, Israel and Hamas will observe a 42-day truce, during which Hamas will release 33 of the roughly 98 hostages it still holds. In exchange, hundreds of Palestinian prisoners are to be freed. Dozens of the hostages are believed to be dead.
During the truce, the deal calls for negotiations on an end to the war and the withdrawal of Israeli forces from Gaza. It is not clear how long the cease-fire will hold, and the negotiations are likely to be bitter and difficult. Mr. Netanyahu also faces internal rifts in his governing coalition over the deal.
Here’s what else to know:
· Aid for Gaza: Desperately needed aid is expected to pour into Gaza once the cease-fire begins. Egypt, which shares a border with the enclave, was intensifying preparations on Friday to deliver assistance including food and tents, according to Al Qahera News, an Egyptian state broadcaster. However, an Israeli ban on the operation of UNRWA, the U.N. agency that is the main administrator of aid in the territory, is set to go into effect in about two weeks.
· Strikes in Gaza: The Palestinian Civil Defense, an emergency service organization, said Friday that Israeli strikes had killed more than 100 people since the cease-fire deal was announced, a figure that could not be independently verified.
· Israeli preparations: Health officials have been preparing isolated areas at hospitals where freed hostages can begin recuperating in privacy. Israel’s Health Ministry has drafted an extensive protocol for their psychological and physical treatment. In particular, there are concerns that they might be severely malnourished.
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10) As deadly strikes continue, Gazans anticipate first moments of peace.
By Rawan Sheikh Ahmad, Reporting from Haifa, Israel, Jan. 18 2025
As Gazans look forward to the expected start of a cease-fire seen as the best chance to end 15 months of war, strikes have continued to hit the enclave, particularly in the north, where Israel has been trying to put down a Hamas insurgency.
Over the past 24 hours, 23 Palestinians were killed and 83 others wounded, Gaza’s health ministry said on Saturday morning.
Since the cease-fire agreement between Hamas and Israel was announced on Wednesday, the Gaza Civil Defense, an emergency services organization, has reported 122 deaths in the Gaza Strip, with 92 of those in Gaza City, in the north. Among the casualties were 33 children, the group said.
Late Friday, Wafa, the Palestinian Authority’s news agency, reported that three residents had been killed and others wounded in an Israeli drone strike in Al Tuffah, a neighborhood of Gaza City.
The reports could not be independently confirmed. The Israeli military did not immediately comment.
The cease-fire agreement is expected to go into effect on Sunday, and many Palestinians are anticipating those first moments of peace with both joy and trepidation.
In Jabaliya, in northern Gaza, Mariam Moeen Awwad, 23, a content writer displaced at least six times, shared her mixed emotions during what she described as the war’s final hours.
“It’s a mix of joy, sadness, and longing for a new beginning,” she said.
Ms. Awad had planned to move into her newly furnished apartment with her husband in November 2023. The war derailed those plans, leaving the couple in an overcrowded property with relatives in another part of Jabaliya.
She longs to return to her own home but fears what she may find.
“I want to see my apartment,” she said. “If it’s even still there.”
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11) Live Updates: First Hostages Return to Israel as Gaza Cease-Fire Takes Hold
The initial stage of a truce between Israel and Hamas prompted celebrations in Gaza and hope for an end to the 15-month war. Three women were the first Israeli hostages to be released. In exchange, Israel has agreed to release dozens of Palestinian prisoners.
By Isabel Kershner, Hiba Yazbek, Aaron Boxerman and Bilal Shbair, Reporting from Jerusalem and Deir al Balah, Gaza Strip, Jan. 19, 2025
Here’s the latest on the cease-fire.
Three hostages were released from Gaza on Sunday and reunited with family members in Israel, the Israeli military said, as a long-awaited cease-fire agreement between Israel and Hamas went into effect. The truce prompted celebrations in Gaza, relief for families of Israeli captives and hope for an end to a devastating 15-month war.
Prime Minister Benjamin Netanyahu’s office identified the freed hostages as Romi Gonen, Emily Damari and Doron Steinbrecher. They were captured during the Oct. 7, 2023, Hamas-led attacks in Israel that set off the war. Israel was expected to release 90 Palestinian prisoners, all women or minors, later on Sunday in exchange for the hostages.
As the truce took effect on Sunday morning, joyful Palestinians honked car horns and blasted music in the central Gaza city of Deir al Balah, where celebratory gunfire rang out and children ran around in the streets.
And as Israeli officers said their forces had begun to withdraw from parts of Gaza, including two towns north of Gaza City, Hamas sought to signal that it was still standing and moving to reassert control, with masked gunmen parading through cities. The Hamas-run police force in Gaza, whose uniformed officers had all but disappeared from the streets to avoid Israeli attacks, said that it was deploying personnel across the territory to “preserve security and order,” according to the government media office.
Achieving the agreement on a delicate, multistage cease-fire required months of talks mediated by Qatar, Egypt and the United States. The start of an initial, six-week phase on Sunday was delayed by almost three hours, with Israel saying it had not formally received the names of the first three hostages to be released.
During the delay, the Israeli military continued striking in Gaza. The Palestinian Civil Defense, an emergency service, said that at least 19 people had been killed and more than three dozen were wounded in the attacks. It wasn’t possible to confirm the figures independently. The truce finally came into effect at 11:15 a.m. local time (4:15 a.m. Eastern), and in the first several hours no additional attacks were reported in Gaza.
Here’s what we’re covering:
· Hostage and prisoner releases: Israel and Hamas have agreed to observe a 42-day truce, during which Hamas is expected to stagger the release of 33 of the roughly 100 hostages it still holds, some of whom are believed to be dead. In exchange, Israel is expected to begin releasing more than 1,000 Palestinian prisoners held in Israeli jails.
· Gaza’s destruction: The start of the cease-fire capped a 470-day war that has killed more than 46,000 Palestinians and injured more than 110,000 others, according to the Gaza health ministry, which does not distinguish between combatants and civilians. Much of Gaza has been destroyed, and most of its roughly two million people have been displaced at least once by the war, which began after Hamas invaded southern Israel, killing roughly 1,200 people and capturing 250 hostages.
· Humanitarian aid: United Nations trucks carrying humanitarian supplies began entering Gaza just 15 minutes after the cease-fire took effect, according to Jonathan Whittall, the head of the U.N. humanitarian office for the Palestinian territories. The cease-fire deal calls for 600 trucks to be allowed to bring aid to Gazans daily, although it was not clear how the supplies would be distributed.
· Next phase: Big diplomatic hurdles lie ahead. Israel and Hamas reached the cease-fire agreement in part by putting off their most intractable disputes until a nebulous “second phase” that neither side is sure it will reach.
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12) With fighters on the streets, Hamas tries to show it’s back in charge in Gaza.
By Adam Rasgon, Reporting from Jerusalem, Jan. 19, 2025
https://www.nytimes.com/live/2025/01/19/world/israel-hamas-gaza-ceasefire
As the cease-fire in Gaza was coming into effect on Sunday, masked gunmen, crowded into white pickup trucks, paraded through the streets of Gaza while supporters chanted the name of Hamas’s military wing. By sending its fighters out in an unmistakable show of force, Hamas was trying to deliver an unequivocal message to Palestinians in Gaza, to Israel and to the international community: that despite heavy losses during the war among Hamas’s fighters, police officers, political leaders and government administrators, it remains the dominant Palestinian power in Gaza.
“The message is that Hamas is ‘the day after’ for the war,” said Ibrahim Madhoun, an analyst close to Hamas based in Turkey, using a phrase that refers to the future administration of Gaza.
“They’re conveying that Hamas must be a part of any future arrangements, or at least, be coordinated with,” he added.
On Sunday, the Hamas-run government media office announced that thousands of police officers were beginning to deploy throughout the territory to “preserve security and order.” Government ministries and institutions, the media office said, were prepared to start working “according to the government plan to implement all the measures that guarantee bringing back normal life.”
At the Nasser Medical Complex in the southern city of Khan Younis, at least three uniformed police officers were standing as the Palestinian national anthem played in the background, according to a video posted on social media and verified by The New York Times.
Later on Sunday, dozens of uniformed, gun-toting Hamas militants were seen in Saraya Square in Gaza City next to a car holding Israeli hostages before they were handed over to the Red Cross. The militants were attempting to push away crowds of people pressing toward the car.
Even as Hamas attempts to project that it still controls Gaza and plans to play a key role in its administration, its future there remains uncertain. Israeli officials have said they have not given up on their stated war goal of dismantling Hamas’s military wing and government, strongly suggesting that they could resume the war against the militant group after the freeing of some hostages.
Gideon Saar, the Israeli foreign minister, said on Sunday that Hamas’s rule was dangerous for Israel’s security and emphasized that Israel had not agreed to a permanent cease-fire that leaves Hamas in power.
“We are determined to achieve the objectives of the war,” he said.
While some analysts could eventually remove Hamas from power, other say it would struggle to resume the war in the face of international pressure. And even if it does, those analysts say, Israeli forces will face immense challenges in uprooting Hamas from Gaza without carrying out a direct occupation.
Ali Jarbawi, a political science professor at Birzeit University, said Hamas’s parades through Gaza on Sunday were more than a message to the international community that it was in control. They also reflect the reality on the ground, he said.
“Hamas was there before the war and they’re there now,” he said.
Aritz Parra contributed reporting.
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