Revealed: Anti-Trump Larry Hogan’s ties to Project 2025 and billionaire MAGA donors

Alexandria Jacobson, Investigative Reporter
October 3, 2024

RAW STORY 

Republican U.S. Senate hopeful Larry Hogan, former governor of Maryland (Bastien INZAURRALDE/AFP)

This article was paid for by Raw Story subscribers. 

As wealthy Republican donors funnel millions into Larry Hogan's U.S. Senate campaign, the former governor of Maryland has distanced himself from former President Donald Trump and the controversial conservative “presidential transition” plan, Project 2025.

Yet, according to a Raw Story analysis of federal financial records, Hogan’s campaign has still benefited from donations from billionaire Trump supporters and individuals working at organizations involved with Project 2025.

Hogan is running in a surprisingly competitive race in what’s typically solidly blue Maryland against Democrat Angela Alsobrooks. Last week, a poll from the Washington Post and the University of Maryland shows Alsobrooks, a Prince George’s County executive, with a double-digit lead over Hogan, who was previously heavily favored by voters in a March poll.

The Republican presidential nominee endorsed Hogan in June, but Hogan confirmed in an interview with CBS’s “Face the Nation” on Sunday that he would not be voting for Trump, whom he said he didn’t vote for in 2016 or 2020 either.

“I’ve said for years that Trump’s divisive rhetoric is something that we could do without. I think he’s his own worst enemy,” Hogan said in the interview with Robert Costa.

Hogan also has taken to blasting the Heritage Foundation's Project 2025, which calls for curtailing abortion access, increasing deportations, eliminating government agencies like the Department of Education and banning transgender athletes from sports as part of a plan for a conservative presidency.

In a Washington Post op-ed, Hogan said Project 2025 “shreds American values” and said calling its ideas “radical” is a “disservice.” In campaign communications, Hogan said codifying Roe v. Wade, the Supreme Court decision protecting the right to abortion, and leading the “fight against Project 2025” were part of his top five commitments.

Trump has disavowed Project 2025, but his running mate, Sen. J.D. Vance (R-OH), has close ties with the Heritage Foundation and its founder, Forbes reported. According to CNN, more than 140 former Trump administration officials were involved in its creation.


Blake Kernen, a spokeswoman for Hogan’s campaign, did not answer Raw Story’s questions about donations from individuals whose employers were cited as being involved with Project 2025.

“Governor Hogan’s only ‘role’ in Project 2025 is being the leading Republican in America to oppose it, and he is fully committed to fighting against it in Congress,” Kernen told Raw Story via email.

Kernen did not respond to Raw Story’s questions about Trump megadonors contributing to fundraising committees benefitting Hogan’s campaign.

Trump billionaire donors support Hogan

Maryland’s Future, a super PAC supporting Hogan, has received donations of more than $100,000 – and as much as $10 million — from 12 wealthy Republican donors, some of whom support Trump, according to The Washington Post.

The PAC is spending $18.3 million on TV ads during the last six weeks of the Hogan-Alsobrooks race, according to The Washington Post.

According to a Raw Story review of records from the Federal Election Commission, at least three of the top 26 billionaire donors to Trump (as reported by Forbes) have also contributed to Hogan’s campaign.

Republican megadonor Kenneth Griffin, CEO of the hedge fund Citadel, donated the most to Maryland's Future PAC: $10 million. According to Federal Election Commission filings, he also contributed $6,600 to Hogan for Maryland, Hogan's principal campaign committee.

Fortune reported that Griffin has not donated to Trump’s campaign but reportedly met with him in July about financing his presidential campaign.


Blackstone CEO Stephen Schwarzman and his wife, Christine Schwarzman, donated $2 million to Maryland's Future and $6,600 each to Hogan for Maryland. Schwarzman contributed $419,600 to a joint fundraising committee supporting Trump, according to The Washington Post.

Warren Stephens, CEO of the private investment bank Stephens, Inc., gave $1 million to Maryland's Future and $6,600 to Hogan for Maryland, according to the Federal Election Commission. He also donated $2 million to the Make America Great Again Inc. super PAC and $250,000 to another pro-Trump fundraising committee, according to The Washington Post.

As for other Trump megadonors, Linda McMahon, the wife of Vince McMahon, the World Wrestling Entertainment mogul under investigation for sex trafficking, has donated $16 million to Trump campaign committees, according to Forbes.


According to Federal Election Commission records, she also donated $6,600 to Hogan for Maryland.


McMahon is chair of the board and chair of the Center for the American Worker for the America First Policy Institute, a conservative nonprofit think tank founded in 2021 to promote Trump's public policy agenda.


Carla Sands, former Trump administration ambassador to Denmark, is also involved with the America First Policy Institute as vice chair for the Center for Energy and Environment. Sands is credited with contributing to Project 2025, noting her affiliation with the America First Policy Institute.



Screen grab from Project 2025 document crediting Carla Sands and Justin Schwab (https://static.project2025.org/2025_MandateForLead...)


Marc Lotter, chief communications officer for the America First Policy Institute, told Raw Story via email that the nonprofit “does not endorse any candidates” and is “not in any way affiliated with Project 2025.”


“Ambassador Sands' work occurred in her personal capacity and should have been reflected as such. At no time was AFPI aware of her participation, nor was she authorized to use her AFPI affiliation," Lotter said.

Lotter added, “Ms. McMahon was not aware nor involved in Ambassador Sands's personal work. The use of her AFPI affiliation was not authorized.”

Kelsy Warren, CEO of oil company Energy Transfer Partners, has donated nearly $6 million to Trump’s campaign, according to Forbes. He has also donated $6,600 to Hogan for Maryland, according to the Federal Election Commission.

Steve Wynn, a real estate developer who created notable Las Vegas casinos and hotels but stepped down due to sexual assault allegations he denies, has given Trump campaign groups $1.1 million, according to Forbes. He and his wife, Andrea Wynn, each gave $6,600 to Hogan for Maryland, according to the Federal Election Commission.
Project 2025 questions

While Hogan maintains his condemnation of Project 2025, he previously appointed Robert Moffit, a senior fellow in the Heritage Foundation's Center for Health Policy Studies, as chairman of the Maryland Health Care Commission while serving as governor of Maryland.

Kernen did not respond to Raw Story’s questions about whether Hogan stands by Moffit’s 2017 appointment.

In the 900-page Project 2025 document, two individuals who worked with CGCN, an all-Republican lobbying firm, and its separate law firm, are credited as contributors: Aaron Szabo, now a government and regulatory affairs attorney with Faegre Drinker, and Justin Schwab, founder of CGCN law.

According to his candidate financial disclosure filed with the U.S. Senate in April, Hogan worked with CGCN as a consultant. His campaign manager, David Weinman, was also a former senior vice president with CGCN.


Hogan’s involvement with CGCN was “limited to consulting in support of President Biden’s cancer moonshot initiative,” Kernen told Raw Story. Weinman did not work on Project 2025, according to the campaign.

Hogan did not work with Szabo or Schwab and CGCN Law, according to the Hogan campaign.

Szabo and Schwab did not respond to Raw Story’s request for comment.

Shane Jackson, president of Jackson Healthcare and board member for the Foundation for Government Accountability, gave Hogan for Maryland, $3,300. The Foundation for Government Accountability, a conservative public policy think tank, is credited as being part of the advisory board for Project 2025.

The Foundation for Government Accountability and Jackson did not respond to Raw Story’s request for comment.


Two executive committee members of the Middle East Forum each contributed to the Hogan for Maryland committee. The Middle East Forum, a conservative nonprofit think tank focused on promoting "American interests in the Middle East" and protecting "the West from Middle Eastern threats," is credited as part of the advisory board on the Project 2025 website.

Executive committee member Nordahl Brue contributed $2,000 to Hogan for Maryland, and another committee member, Joshua Katzen, contributed $500.

“As a nonprofit organization, the Middle East Forum does not endorse political candidates or campaigns. Our policies and operations are guided by our mission, not by the personal political activities of individuals associated with our organization,” Gregg Roman, chief operating officer for the Middle East Forum, told Raw Story via email.



Screen grab of Project 2025 advisory board website page showing Middle East Forum credited (https://www.project2025.org/about/advisory-board/)


Roman referred questions about “individual donations or personal involvement in political projects” to the specific individuals. Brue and Katzen could not be reached for comment.

Roman did not respond to Raw Story's questions about the nature of the Middle East Forum's involvement with Project 2025.

Alexandria Jacobson is a Chicago-based investigative reporter at Raw Story, focusing on money in politics, government accountability and electoral politics. Prior to joining Raw Story in 2023, Alex reported extensively on social justice, business and tech issues for several news outlets, including ABC News, the Chicago Sun-Times and the Chicago Tribune. She can be reached at alexandria@rawstory.com. More about Alexandria Jacobson.

 

FOR PROFIT HEALTHCARE U$A

Study finds minorities more likely to have ‘free’ preventive healthcare denied by insurers

UMass Amherst researcher also shows providers charge disadvantaged groups a higher amount for preventive services

University of Massachusetts Amherst

 

image: 

Co-author Michal Horný is an assistant professor of health policy and management in the UMass Amherst School of Public Health and Health Sciences. 

view more 

Credit: UMass Amherst

Although the Affordable Care Act (ACA) made preventive healthcare free for most Americans, claims for these services nonetheless get denied for various reasons by insurance plans, leaving patients with unexpected bills or without access to important health screenings and other recommended preventive care. 

A new study published in JAMA Network Open by a team of scientists, including a University of Massachusetts Amherst health services researcher, also shows that insurers are more likely to deny claims from racial and ethnic minorities, as well as other marginalized groups, for such preventive care as cancer, diabetes, cholesterol and depression screenings, as well as contraception administration and wellness visits.

In addition, when claims were denied, healthcare providers charged a higher amount for preventive services to disadvantaged groups, the study found. 

“Preventive care provides a lot of value to patients and healthcare systems and population health overall,” says co-author Michal Horný, assistant professor of health policy and management in the UMass Amherst School of Public Health and Health Sciences, who collaborated with lead author Alex Hoagland, a health economist at the University of Toronto, to examine claims from 2.5 million preventive care visits by 1.5 million patients between 2017 and 2020. “That’s why the Affordable Care Act mandated health insurers to provide recommended preventive services to their beneficiaries at no cost. What we document is that there are inequities at the starting line.”

For example, Asian, Hispanic and non-Hispanic Black patients were about twice as likely as non-Hispanic white patients to have claims denied, and low-income patients were 43% more likely than high-income patients to have their claims denied. 

The inequitable pattern continued when researchers looked at the amount healthcare providers billed to patients for denied claims. For example, the median charge for a denied claim for patients with a household income of under $30,000 was $412, compared to a $354 median charge for patients with a household income of between $50,000 and $74,000 and a $365 charge for patients with an income over $100,000. 

Non-Hispanic white patients were charged less than any other ethnic group when preventive service claims were denied. “These findings suggest that experiences of patients seeking free preventive care differ on the basis of their demographics, leading to inequities in accessing basic preventive care,” the paper concludes. 

A second, related study published in the American Journal of Preventive Medicine

found that privately insured patients faced charges in 40% of preventive care visits that should have been fully covered for free. These unexpected out-of-pocket costs may deter patients from pursuing preventive care services in the future, Horný says.

For both studies, the team looked at national claims data for seven preventive services recommended by the U.S. Preventive Services Task Force, which triggers the ACA requirement for Marketplace insurance, as well as private health plans, to cover them fully, at no cost to the patient: wellness visits, contraception administration and screenings for breast cancer, colorectal cancer, cholesterol, depression and diabetes. 

In addition, the researchers had access to demographic details of the patients. “It’s a highly novel and innovative data set because it combines the richness of the claims data that span the entire nation, and also includes the demographic information which is typically lacking in these data sources,” Horný says.

In the study about patients’ shared expenses, the research team found the “likelihood and size of [out-of-pocket] costs for preventive care varied considerably by patient demographics; this may contribute to inequitable access to high-value care.” 

For example, lower-educated patients had 9.4% higher odds of incurring out-of-pocket costs than patients with college degrees. On the other hand, patients with a lower household income ($49,999 or less) had 10.7% lower odds of being charged than high-income patients. However, when incurring costs, lower educated patients paid $15 less than higher educated patients, and low-income patients paid $12 more than high-income patients.

“Some protections for individuals with lower incomes seem to be kicking in, so they do not get billed for preventive care as often as those with higher incomes,” Horný says. He hypothesizes that lower income people incurred higher expenses when they are billed because of multiple cracks in a complex healthcare system.

Both studies highlight how the lack of both uniform coverage of preventive care by insurers and standardized billing practices for physicians contribute to inequitable access to preventive healthcare in the U.S., the researchers note.

“We want to prevent preventable diseases,” Horný says. “It saves money down the road if we don’t have to treat the diseases that could have been prevented in the first place. And the key reason is we want to have a healthy population.”

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Journal

JAMA Network Open

DOI

10.1001/jamanetworkopen.2024.33316 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Social Determinants of Health and Insurance Claim Denials for Preventive Care

 

Do MPH programs prepare graduates for employment in today's market? Mostly yes, but who is hiring may be surprising

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Columbia University's Mailman School of Public Health

Public health degree programs provide key competencies demanded by employers, but graduate employability could be improved by using more real-time data from employer job postings, according to a new study at Columbia University Mailman School of Public Health. This could help public health schools and programs ensure that graduates obtain specific technical skills listed in job postings, meet current employer needs, and prepare graduates for the demands of today’s labor market. The findings are published in the American Journal of Public Health.

The competencies required for the MPH curriculum are established by the Council on Education in Public Health (CEPH). Competencies are generally in alignment with current employer needs.

This the first study to use real-time data from a large-scale data set of job postings to analyze the top skills, certifications and software in demand by current employers seeking to hire Master of Public Health graduates, while comparing them with the competencies required by the accreditation body, CEPH.

“Our research revealed labor market competition for public health degree graduates, as well as certain technical skills desired by today’s employers, while showing that the CEPH competencies do, in large part, match current employer demands,” noted Heather Krasna, PhD, EdM, associate dean of Career and Professional Development at Columbia Mailman School.

Using a dataset of 70,343 job postings for MPH graduates from Lightcast, which collects, and analyzes millions of job postings per year, the researchers contrasted skills from the postings with CEPH competencies. They used real-time job postings data, to validate whether required competencies match employer needs, and to illustrate ongoing labor market competition for public health graduates.

Lightcast uses machine learning and natural language processing tools to deduplicate job postings, to code the job postings by occupation type, job title, company name, industry, and  skills, and to provide a list of salary ranges. Lightcast assesses job postings for “sequences of words that indicate skills,” and matches them to a “comprehensive taxonomy of over 32,000 skills collected from hundreds of millions of job postings, resumes, and online profiles,” to categorize skills.

Employers currently seeking to hire MPH graduates are predominantly in for-profit industry, followed by academia/research, and healthcare. Only 12% of unique job postings were in government agencies, illustrating ongoing labor market competition for public health graduates from other sectors, especially from higher-paying industries like consulting, insurance and pharmaceuticals. “The job market for MPH graduates seems to continue moving towards for-profit companies such as insurance firms and healthcare, which is in alignment with other research on employment outcomes of public health graduates,” said Krasna. “Public health graduates’ skills are in demand in many sectors where they can make a positive impact on the public’s health.”

Noteworthy is that job postings from employers seeking to hire MPH graduates did not appear to prioritize diversity and inclusion, health equity, policy, advocacy, and other related skills which are required competencies by CEPH. According to Krasna there are several possible explanations for this. “It is possible that the large proportion of job postings in for-profit corporations (26%), healthcare/hospitals (14%), and academia/research (26%) and the relative scarcity of job postings in government or nonprofits (12%) as well as the skewing of job titles towards analytical, technical and epidemiological roles meant that technical and statistical skills were more in-demand than skills in community partnerships and diversity.”

Even if health equity skills are not listed as the top requirements in job postings, graduates with training in health equity will bring these skills to the employers seeking a public health perspective in their workplace. “Since health equity is at the center of the Essential Public Health Services, ensuring public health graduates receive these skills is crucial, regardless of where graduates find jobs,” said Krasna.

The most common titles from Lightcast Job postings collected July 2022-Feb. 2023 were Epidemiologists at 1,344 and biostatisticians at 1,323, followed by Environmental Health and Safety Specialists at 1,185.

Competencies in communications and management and applied leadership skills were considered critically important for communicating public health content.

“We believe our study is a thorough analysis on first-destination employment outcomes of public health graduates and offers valuable insights into the alignment between academic training and industry needs and complements articles on labor market competition for public health graduates,” said Krasna.

Columbia University Mailman School of Public Health

Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the fourth largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master’s and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu.

 

 

 

 

 

 

 

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Journal

American Journal of Public Health

DOI

10.2105/AJPH.2024.307834) 

Article Title

Employer Demand and Desired Skills for Public Health Graduates: Evidence From Job Postings

 

Water fluoridation less effective now than in past

The dental health benefits of adding fluoride to drinking water may be smaller now than before fluoride toothpaste was widely available, an updated Cochrane review has found.

Cochrane

The dental health benefits of adding fluoride to drinking water may be smaller now than before fluoride toothpaste was widely available, an updated Cochrane review has found.

The team of researchers from the Universities of Manchester, Dundee and Aberdeen reviewed the evidence from 157 studies which compared communities that had fluoride added to their water supplies with communities that had no additional fluoride in their water. They found that the benefit of fluoridation has declined since the 1970s, when fluoride toothpaste became more widely available.

The contemporary studies were conducted in high-income countries. The impact of community water fluoridation in low- and middle-income countries is less clear, due to the absence of recent research.

Fluoride, used in many commercially available toothpastes and varnishes, is known to reduce tooth decay. Governments in many countries have added fluoride to the drinking water supply to improve population oral health, although there are polarized views on whether this is the right action to take.

“When interpreting the evidence, it is important to think about the wider context and how society and health have changed over time,” says co-author Anne-Marie Glenny, Professor of Health Sciences Research at the University of Manchester. “Most of the studies on water fluoridation are over 50 years old, before the availability of fluoride toothpaste. Contemporary studies give us a more relevant picture of what the benefits are now.”

Results from studies conducted after 1975 suggest that the initiation of water fluoridation schemes may lead to slightly less tooth decay in children’s baby teeth. Analysis of these studies, covering a total of 2,908 children in the UK and Australia, estimates that fluoridation may lead to an average of 0.24 fewer decayed baby teeth per child. However, the estimate of effect comes with uncertainty, meaning it’s possible that the more recent schemes have no benefit. By comparison, an analysis of studies with 5,708 children conducted in 1975 or earlier estimated that fluoridation reduced the number of decayed baby teeth, on average by 2.1 per child.

The same contemporary studies (conducted after 1975) also looked at the number of children with no decay in their baby teeth. The analysis found that fluoridation may increase the number of children with no tooth decay by 3 percentage points, again with the possibility of no benefit.

The review was only able to draw conclusions about the impact on children’s teeth, with similar findings across both baby and permanent teeth. There were no studies with adults that met the review’s criteria.

“The evidence suggests that water fluoridation may slightly reduce tooth decay in children,” says co-author Dr Lucy O’Malley, Senior Lecturer in Health Services Research at the University of Manchester. “Given that the benefit has reduced over time, before introducing a new fluoridation scheme, careful thought needs to be given to costs, acceptability, feasibility and ongoing monitoring.”

Advocates have suggested that one of the key benefits of water fluoridation is that it reduces oral health inequalities. This updated review sought to examine this question and did not find enough evidence to support this claim, although this doesn’t necessarily mean there is no effect.

The review’s findings accord with recent observational studies including the LOTUS study, which compared anonymised dental health records with water fluoridation status for 6.4 million adults and adolescents in England between 2010 and 2020. People in fluoridated areas needed slightly fewer invasive dental treatments, with no significant impact on inequalities.

“Contemporary evidence using different research methodologies suggest that the benefits of fluoridating water have declined in recent decades,” says Tanya Walsh, Professor of Healthcare Evaluation at the University of Manchester, co-author on both the Cochrane review and the LOTUS study. “Oral health inequalities are an urgent public health issue that demands action. Water fluoridation is only one option and not necessarily the most appropriate for all populations.”

“Whilst water fluoridation can lead to small improvements in oral health, it does not address the underlying issues such as high sugar consumption and inadequate oral health behaviours,” says co-author Janet Clarkson, Professor of Clinical Effectiveness, University of Dundee. “It is likely that any oral health preventive programme needs to take a multi-faceted, multi-agency approach.”

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Journal

Cochrane Database of Systematic Reviews

DOI

10.1002/14651858.CD010856.pub3 

Method of Research

Systematic review

Subject of Research

People

Article Title

Water fluoridation for the prevention of dental caries

Article Publication Date

3-Oct-2024

COI Statement

The authors' interests as declared in the review are as follows: ZIE has declared that they have no confl ict of interest. TW is a co-author on Goodwin 2022 and Co-Director (since July 2023) of the Colgate-Palmolive Dental Health Unit based at The University of Manchester. She has been Statistical Editor for Cochrane Oral Health. TW did not participate in the assessment of Goodwin 2022. SL is a former Deputy Co-ordinating Editor for the Bone, Joint and Muscle Trauma group; she has had no role inthe editorial process for the review. PR is Deputy Co-ordinating Editor for Cochrane Oral Health; he has had no role in the editorial process for this review. DB has declared that they have no conflict of interest. JC is Joint Co-ordinating Editor for Cochrane Oral Health; she has had no role in the editorial process for thisreview. HW was previously Joint Co-ordinating Editor for Cochrane Oral Health/Statistical Editor; she has had no role in the editorial process for this review. AMG is Joint Co-ordinating Editor for Cochrane Oral Health; she has had no role in the editorial process for this review. LO'M has declared that they have no conflict of interest.

 

Bridging the gap: how pragmatic trials can better serve healthcare systems

Harvard Pilgrim Health Care Institute

Boston, MA – A new thought piece led by the Harvard Pilgrim Health Care Institute with collaborators from Duke University and Kaiser Permanente Washington Health Research Institute highlights the challenges facing healthcare researchers and decision makers in the quest to improve population health in a constantly evolving healthcare landscape. The authors offer strategies to enhance the effectiveness of pragmatic clinical trials and increase their impact on real-world healthcare settings.

The Viewpoint appears October 2 in JAMA.

Pragmatic clinical trials, designed to inform health care decision-makers about the comparative benefits, burdens, and risks of health interventions, have seen a significant increase in interest over the past decade. Since 2012, the NIH Pragmatic Trials Collaboratory has supported 32 such trials, addressing critical issues like suicide prevention, opioid prescribing, and infection control.

Pragmatic clinical trials compare treatments in everyday clinical settings, rather than under ideal conditions. However, the authors note that the adoption of trial findings by healthcare systems has been inconsistent.

“Our goal is to ensure that the findings from these trials are not only scientifically sound but also readily implementable in diverse healthcare settings,” says lead author Richard Platt, Harvard Medical School distinguished professor of population medicine at the Harvard Pilgrim Health Care Institute. “Pragmatic clinical trials are designed to bridge the gap between research and care, and we believe this bridge can be built even more efficiently.”

The authors identify key challenges and propose solutions to align trial goals with healthcare system needs, including:

• Identifying relevant outcomes: Collaborate with healthcare leaders to determine the clinical or cost-saving outcomes that would motivate adoption.
• Shortening trial duration: Designing trials to span 2-3 years to match the decision-making timelines of healthcare systems.
• Conducting interim assessments: Utilizing interim analyses to provide timely information and potentially stop or modify trials early.
• Considering costs: Understanding and planning for associated costs to ensuring interventions are sustainable post-trial.

“By accommodating the priorities of healthcare leaders and introducing adaptive trial designs, we can generate actionable evidence that truly improves patient care,” adds Dr. Platt.

 

 

About the Harvard Pilgrim Health Care Institute’s Department of Population Medicine
The Harvard Pilgrim Health Care Institute's Department of Population Medicine is a unique collaboration between Harvard Pilgrim Health Care and Harvard Medical School. Created in 1992, it is the first appointing medical school department in the United States based in a health plan. The Institute focuses on improving health care delivery and population health through innovative research and education, in partnership with health plans, delivery systems, and public health agencies. Point32Health is the parent company of Harvard Pilgrim Health Care and Tufts Health Plan. Follow us on X and LinkedIn.

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Journal

JAMA

Article Title

Making Pragmatic Clinical Trials More Pragmatic

Article Publication Date

2-Oct-2024

Opinion

"Pro-life" identity politics: GOP's sudden support of abortion shows it was never about policy

Amanda Marcotte
Thu, October 3, 2024 
SALON

JD Vance Chip Somodevilla/Getty Images


Before Dobbs v. Jackson Women's Health, the Supreme Court decision that ended abortion rights, it was a truism in the Beltway press that Americans were "bitterly divided" on abortion. Driven by polls that mostly asked people if they are "pro-life" or "pro-choice," journalists portrayed Republican voters as strongly opposed to abortion for moral and religious reasons. So it's quite the shocker to see recent polls show that a plurality — and in many cases, the majority — of Republicans plan to vote for abortion rights in various state ballot initiatives this November.

Polls show "GOP support for abortion rights measures outpacing states that had similar ballot measures in recent years," Aaron Blake of the Washington Post wrote Monday. Just a couple of years ago, state polls showed Republicans only backing abortion rights by 14-18%, he reports. Now "2024 ballot measures show Republican support between 28 and 54 percent" supporting abortion rights.

It turns out that "pro-life" conviction was only an inch deep.


What's going on here isn't especially confusing. Prior to Dobbs, calling yourself "pro-life" was a low-cost way for Republican voters to tell a story where they are morally upright heroes while casting feminists, urban liberals, college kids, and racial minorities as oversexed heathens. When abortion is legal, it's easy to condemn other people's abortions as a matter of "convenience" or say they're "using it for birth control" or employ other euphemisms for promiscuity, while quietly believing the abortions you and your friends get are justified.

We saw this shell game in action during Tuesday night's vice presidential debate, when Donald Trump's running mate, Sen. JD Vance of Ohio, talked about a friend who had an abortion. "She felt like if she hadn't had that abortion, that it would have destroyed her life because she was in an abusive relationship," he said, falsely implying that he is fine with keeping these kinds of abortions legal. In reality, as the fact-checkers lamely noted, both current and proposed abortion bans, which Vance has backed wholeheartedly, do not make exceptions based on the reason a patient seeks an abortion.

Want more Amanda Marcotte on politics? Subscribe to her newsletter Standing Room Only.

It was an outrageous lie by insinuation, but why he lied is not mysterious. Vance understands that his voters want to hear a pretty story where people like themselves will get to have abortions, but those other people — imagined to be "sluts" and "welfare queens" — will not. The problem for him and Trump, as this polling shows, is that the cold, hard reality of abortion bans is hard to ignore, now that they're law and not just an abstraction. Post-Dobbs, "abortion" isn't just a way for MAGA voters to gloat about their self-defined moral superiority. Instead, they realize that the bans apply to MAGA and non-MAGA alike. It's shifted from cheap identity politics to real-world impacts. As these polling changes demonstrate, their actual policy preference has started to eclipse what used to move them, which was culture war nonsense.

Republican politicians win by keeping their base voters focused on phantasms and symbolic, ego-driven identity politics, rather than real world issues. It's why Trump and Vance are laser-focused on immigration. It's not just that it has no material impact on their base voters, but because it doesn't. For the average MAGA voter, stories about Haitian immigrants eating cats feel like a low-stakes way to wallow in a sense of racial superiority. Many of them don't even pause to consider how these ego-fluffing lies harm real people. To them, "Haitians" are a largely imaginary group — like the "sluts" of anti-abortion mythology — that they can feel safe hating, without considering the consequences. But suppose Trump is successful in deporting millions of people from the workforce, which economists believe would trigger an economic depression. It's safe to say these voters would not enjoy that outcome.

We can see this tension playing out in the battle over union endorsements. Regarding the brass tacks of policy, the difference between Democrats and Republicans is vast. President Joe Biden has been regarded by experts as the most pro-worker president since FDR. He's aggressively defended unions, made organizing much easier, and sent law enforcement after companies for union-busting and other shady tactics. Trump, on the other, can barely conceal his contempt for workers, and especially for unions. He praised Elon Musk for firing workers for going on strike, which is illegal. He bragged about cheating workers out of overtime pay, which is also illegal. This is why United Auto Workers endorsed the Democratic ticket, with the president Shawn Fain calling Trump a "scab."

But while UAW did the right thing, the same cannot be said of the Teamsters, who refused to endorse this election. The Teamsters are whiter and more male than other unions, and subsequently 60% of their members are voting for Trump instead of Vice President Kamala Harris. It's easy for white, male union workers to live in the world of fantasy politics, where they're more focused on protecting their ego against admitting a Black woman could be president, rather than the real world, where the white male candidate is coming for their job protections. They are, in the internet parlance, in the "effing around" period. But if Trump gets elected and unleashes Project 2025's plans to dismantle organized labor in the U.S., it will be a finding-out season. But, as Republican women learned after the Dobbs decision, by the time you get there, it's too late to stop it.

Democrats are often accused by the pundits of being the ones who practice "identity politics," usually when they note the real world impacts of sexism, racism, and homophobia on real people. But what Republicans do is pure identity politics, a politics about ego and identity that is disconnected from material implications. Their propaganda apparatus encourages white people to wallow in sick urban legends about cat-eating immigrants, which creates the temporary thrill of feeling superior without doing anything substantive to improve their lives. Or to complain about imaginary "loose" women who use abortions as "birth control." Or to get mad about "cancel culture" or make-believe slights from liberals.

As long as they aren't feeling palpable consequences for their votes, it is more fun and satisfying for some voters to live in the constant ego-reinforcement chamber of GOP propaganda. It's a cheap thrill, to be told you're morally, intellectually, and physically superior to various "others," simply by being part of the MAGA tribe. On abortion, reality has eclipsed fantasy, as the polls show. Unfortunately, Trump's neck-in-neck race with Harris shows that far too many Republican voters have not yet received their wake-up call.


Why Some People Will Vote for Abortion Rights—and Trump

Melissa Gira Grant
Wed, October 2, 2024 

NEW REPUBLIC



Ever since voters in red states like Kansas and Ohio turned out in droves in 2022 and 2023 to protect abortion rights in their states, some in the Democratic Party have hoped abortion ballot measures in swing states might increase turnout and shift the course of this year’s election. Ten states have abortion measures on the ballot this year—including swing states like Florida and Arizona. But last month, a New York Times/Siena College poll from Arizona disrupted this narrative: Likely voters’ support for Harris, at 45 percent, seemed to be trailing support for the state’s abortion rights ballot measure, at 58 percent. These numbers may seem surprising to those who hoped ballot measures would boost Democratic turnout, but they reflect a broader reality: Legal abortion is more popular than Democrats are.

For those who research and run ballot measure campaigns, the Arizona polling is not an unusual finding. Since 2021, Benjamin Case has led ballot initiative research at the Center for Work and Democracy, a labor-funded research center at Arizona State University. “Pretty consistently, we see results where people will vote differently when they’re allowed to vote on a policy versus when they have to vote for a politician as a proxy for all their views on different policies,” said Case. “The conventional wisdom was that abortion was this polarizing issue that splits the country down the middle,” said Case. But “one of the things that allowed that misperception to survive was the fact that voters weren’t really asked very often directly.”

Kansas broke this dynamic open when anti-abortion groups working alongside the Republican-led state legislature rushed a ballot measure ending abortion rights in front of voters, months after Dobbs. Kansas voters rejected it firmly; and in some counties that Trump had won in 2020, though the ballot measure lost, the margins were much closer than Trump’s margin. Then came Ohio in 2023: Voters passed, 57 to 43 percent, a constitutional amendment to protect legal abortion. “The scope of the victory for the Yes side suggests that a significant number of Republicans voted in favor,” according to an AP analysis. It wasn’t universal: 44 counties Trump had won by 70 percent or more in 2020 voted against protecting abortion rights. But nine out of the 10 counties where Trump won by 60 percent or less in 2020 voted “yes” on the abortion rights measure. It appeared that some Trump voters were “flipping.”

Such results helped fuel the notion that abortion rights ballot measures were good for Democrats: They might increase Democratic turnout, benefiting not only the presidential race but downballot Democrats. The numbers looked strong after Ohio and heading into the 2024 election. “The abortion rights position has over-performed Democrats’ presidential vote share by an average of nine points since 1970,” noted a Washington Post story on a recent Ballotpedia analysis. “But in 5 of 7 cases post-Roe, it has over-performed by double digits.” Another way of looking at those figures is that abortion rights were more popular than some Democratic candidates for president.

“The very existence of my organization,” said Kelly Hall, executive director of the Fairness Project, “is evidence that there is a gap between people’s partisan affiliations and how they are willing to vote on specific issues when they’re brought to them as ballot measures.” The group is nonpartisan, and provides strategy and communications support to state-based ballot measure campaigns. Given what they have seen, Hall said she’s “pretty dubious of those turnout arguments” about the measures boosting Democrats. Those arguments get a lot of attention because the press focuses on the Republican and Democrat horse race, Hall said. “They try to fit everything in the political landscape into that box.”

The Arizona poll showing Harris at 45 percent and the state’s abortion rights ballot measure at 58 percent, while a good reality check, isn’t necessarily a reason for Harris supporters to panic: To start, the poll has a margin of error of 4.4 percent, meaning the Harris support might be nearer to the 50 percent support for Trump. It’s also just one poll; a new one released this week puts Harris just two points behind Trump in the state.

The Arizona case is particularly complex, and not easy to capture in polls. Overall, two-thirds of the state’s women voters say they support abortion until presumed fetal viability, as the ballot measure proposes, according to a KFF poll of women voters published in June. That includes 68 percent of independents in a state where voters who list no party affiliation have at times outnumbered those registered Republican or Democrat. Six in 10 Democratic women voters said they would be more motivated to vote with an abortion rights measure on the ballot, along with 52 percent of independent women voters—indicating some potential impact on turnout.

It’s not just independents; there’s substantial support for the ballot initiative among Republicans. About four in 10 Republican women voters in Arizona said they support the ballot initiative—perhaps not that surprising, since nationwide, about half of Republican women voters believe abortion should be legal in all or most cases. (The Harris campaign has also been courting Republicans, for example sending surrogates out to “Republicans for Harris” campaign events in Arizona, specifically on the issue of abortion rights.) What this reflects is that when voters are asked directly to vote on a policy, their votes don’t necessarily align with those of the politicians they also vote for.

But what should we make of the four in 10 women voters in Arizona who said they would vote for Kari Lake for Senate and yet also support the ballot measure? Lake has backed laws banning abortion over the course of her political career, has praised a near-total abortion ban, and still denies that she and Trump lost their last elections. At first, these numbers can seem shocking, or lend themselves to hopes that those Lake voters could be flipped if only they had the “right” information.

“The shocking thing to me,” Kelly Hall said, “is the number of Arizona voters who believe that Joe Biden was to blame for the fall of Roe, because it happened on his watch—the number of folks who do not pay attention to this for a living, who don’t fundamentally understand that there is a major difference between the parties on this issue.” In Arizona, according to a May 2024 Times/Siena poll, around 16 percent of registered voters said that Biden bears a lot or some responsibility “for the Supreme Court ending the constitutional right to abortion.” (Fifty-six percent said it was Trump’s responsibility.) On this question, the Arizona voters were in line with those in other swing states, where on average, 17 percent of voters blamed Biden for the end of Roe, including 12 percent of Democrats.

“There is actually not as deep and well-worn a connection between ‘Democrats are good on this issue and agree with me, and Republicans are not’ as folks in D.C. and the coast would like to believe,” Hall continued. And some Republican candidates, including Donald Trump, who claims he merely “returned abortion to the states,” are working to muddy that distinction. “It is the job of the Democratic Party, if they want to take it on, to draw that distinction,” Hall said.

The problem of voter information goes deeper than just what voters know or don’t know about where candidates stand on abortion, though. In a state like Arizona, where the legality of abortion has remained in flux—bans came into effect, and were blocked—many voters this year may not know if abortion is legal or not. (It is—up to 15 weeks.) Another KFF survey, conducted this spring, found that among women of reproductive age, only 21 percent knew that in their state abortion was legal, but only earlier in pregnancy. In light of this, the ballot measure campaigns might also serve as political education, and in a way that electoral campaigns do not. Abortion ballot measure campaigns are a way to let people know what the status quo is, and what would change if the measure passes.

Mobilizing voters for abortion rights is a different project from electing Democrats. In fact, ballot measures give voters an opportunity to divorce their vote for abortion rights from their votes for any particular candidate; that opportunity may be precisely what motivates them to turn out and vote in an election where they aren’t enthusiastic about their candidate options. Having both approaches open to voters—the ability both to elect candidates they hope will do right by them, and also the ability to directly vote for the policies they want—Hall said, is “a net positive—a very good thing.”


Your guide to the presidential candidates' views on abortion

Seema Mehta
Thu, October 3, 2024
LOS ANGELES TIMES

Abortion rights have become a crucial election issue since the Supreme Court overturned Roe vs. Wade two years ago. (Patrick Semansky / Associated Press)


Abortion rights, always a polarizing issue in American politics, became an electoral tinderbox in 2022 after the Supreme Court overturned Roe vs. Wade, the landmark decision to create a federal right to abortion access. Democrats have seized upon the issue of women’s bodily autonomy, notably in the 2024 presidential election, in part because it could motivate the critical bloc of suburban women voters in swing states.

The prospect of women not having access to abortion was theoretical in many voters' minds until the Supreme Court's decision in Dobbs vs. Jackson Women's Health Organization, which set in motion a domino effect of widely varying laws about abortion in the states. As of June, 14 states had enacted total bans on the medical procedure, according to the Guttmacher Institute, a nonprofit research organization that supports abortion access.

Read more: What's on the November ballot in California?

Other states have enacted restrictions at various stages in pregnancy. The end result of all of the laws is many American women traveling to receive reproductive care, more than 171,000 in 2023, according to the institute. ProPublica reported on Sept. 16 that two Georgia women died after being unable to access legal abortion and timely medical care there, including a 28-year-old single mother who traveled to another state to obtain a prescription for a medical abortion, but then had rare complications because the fetal tissue was not fully expelled from her body.

Care that is routinely provided in such situations was significantly delayed, resulting in Amber Nicole Thurman getting a sepsis infection that caused her blood pressure to plummet and her organs to fail, according to the ProPublica report. Twenty hours later, after doctors decided to operate, her heart stopped. A state committee focused on pregnancy-related fatalities concluded that her death was "preventable."

Democratic presidential nominee Kamala Harris weighed in the day after the report was published, saying that such tragedies are the direct result of former President Trump's Supreme Court appointees who voted to strike down Roe.

“This young mother should be alive, raising her son, and pursuing her dream of attending nursing school," the vice president said in a statement. "In more than 20 states, Trump Abortion Bans are preventing doctors from providing basic medical care. Women are bleeding out in parking lots, turned away from emergency rooms, losing their ability to ever have children again. Survivors of rape and incest are being told they cannot make decisions about what happens next to their bodies. And now women are dying. These are the consequences of Donald Trump’s actions."

There have also been multiple reports of woman suffering miscarriages and other medical emergencies who struggled to get care.
The 'execution' of babies

Republicans, including Trump, have claimed that Harris and running mate Tim Walz support allowing babies to be killed after they are born. Trump repeated that false assertion during the September presidential debate.

“It’s an execution,” Trump said, claiming that Democrats support allowing babies to be killed in the final months of pregnancy and after they are born.

Read more: Abortion quickly emerges as a flashpoint between Harris and Trump

It is illegal to kill babies after they are born in every state, and extremely rare late-term abortions typically occur because the baby's health is severely compromised and the baby is not viable, or because of threats to the health of the woman.

Abortions after 21 weeks, considered late-term pregnancies, account for less than 1% of abortions, according to the Centers for Disease Control and Prevention. More than 80% of abortions occur in the first nine weeks of pregnancy, and 6% occur during the second trimester.
A federal abortion ban

In the aftermath of the Supreme Court's Dobbs decision, questions immediately arose about whether Congress would enact legislation protecting abortion access across the nation or a federal measure prohibiting such rights.

Trump has vacillated on whether or not he would sign a federal abortion ban, but he has said that he would support a federal prohibition after a certain length of pregnancy. The former president has also stated that Americans broadly support the issue being decided by the states, which is decisively refuted by all reliable public polling.

“Look, this is an issue that’s torn our country apart for 52 years,” Trump said during the debate. “Every legal scholar, every Democrat, every Republican ... they all wanted this issue to be brought back to the states where the people could vote, and that’s what happened.

“Each individual state is voting. It’s the vote of the people,” Trump said.

Read more: Trump would veto legislation establishing a federal abortion ban, Vance says

Harris argues that Trump is untrustworthy on the issue, and she vocally supports federal legislation allowing abortions until a fetus could survive outside the uterus, and later if required for medical reasons. The first White House official to visit an abortion clinic, Harris has called Trump's actions on abortion “unconscionable.”

“It’s insulting to the women of America,” Harris said. “Understand what has been happening under Donald Trump’s abortion bans. Couples who pray and dream of having a family are being denied IVF treatments. What is happening in our country, working people, working women who are working one or two jobs who can barely afford child care as it is, have to travel to another state, to get on a plane, sitting next to strangers to go and get the healthcare she needs.”
The importance of Supreme Court appointees

A president's power to reshape the Supreme Court took on greater importance when Trump narrowly defeated Hillary Clinton in 2016. Senate Republicans refused to even consider President Obama's nomination of Merrick Garland to fill the seat of conservative Justice Antonin Scalia after Scalia died in February 2016 — nine months before the election.

That set the stage for Trump to fill Scalia's seat and two others — the last of his picks, Amy Coney Barrett, was confirmed just a week before the 2020 election — paving the path to Roe being overturned, which the former president frequently boasts about.

"Now it’s not tied up in the federal government,” Trump said. “I did a great service in doing it. It took courage to do it, and the Supreme Court had great courage in doing it, and I give tremendous credit to those six justices" who voted to overturn the landmark abortion ruling.

Read more: In her own words: Amy Coney Barrett on faith, precedent, abortion

Harris has lashed out at Trump for appointing the justices who supported overturning federal protection for abortion rights.

“Donald Trump hand-selected three members of the Supreme Court with the intention that they would undo the protections of Roe vs. Wade — and they did exactly as he intended,” she said.


TRUMP LIES!

Donald Trump Claims He Would Veto National Abortion Ban If Elected

Alanna Vagianos
Updated Wed, October 2, 2024 

Donald Trump said Tuesday that he would veto a federal abortion ban, after months of dodging questions on his abortion stance.

“Everyone knows I would not support a federal abortion ban, under any circumstances, and would, in fact, veto it, because it is up to the states to decide based on the will of their voters (the will of the people!),” Trump wrote in an all-caps post on social media.

This is the first time the GOP presidential nominee has fully and directly answered the question of whether he would support a national abortion ban since the Supreme Court repealed Roe v. Wade in 2022. During the presidential debate last month, Trump refused to say whether he would support a national ban despite being pressed several times by moderators and Vice President Kamala Harris.

In the social media post, Trump reiterated his support for exceptions to abortion bans including for rape, incest and life of the mother. He added that he does not support “the Democrats radical position of late term abortions” including in the “7th, 8th, or 9th month” and “the possibility of execution of the baby after birth.” Trump has repeated the false rhetoric that Democrats support murdering newborns; homicide is illegal in all 50 states and no Democrats are calling for that to change.

The former president posted the message as his running mate, Sen. JD Vance (R-Ohio), was asked about his stance on reproductive rights during the vice presidential debate Tuesday night. Vance straight-up lied about his record on abortion, telling moderators that he never supported a federal abortion ban, although he did as recently as 2022.

It’s hard to take Trump at his word when he has such a long history of extreme comments on abortion care. It was reported earlier this year that Trump would not support a total national abortion ban, but possibly a 16-week national abortion ban. He later denied the report and told a group of reporters that he would not sign a federal abortion ban.

But Trump has repeatedly boasted about his role in reversing federal abortion protections after nominating three of the conservative justices who were critical in overturning the historic 1973 Roe decision. The former president also once endorsed punishing women who get abortions with jail time. He’s surrounded himself with some of the most extreme anti-abortion advocates in politics, including Vance who has called for federal restrictions on traveling for abortion care and advocated for the surveillance of women’s menstrual cycles to prevent them from getting abortions.

“Donald Trump is scrambling to try and clean up his disastrous debate performance, when he refused three times in front of 67 million viewers to commit to vetoing a national abortion ban,” Sarafina Chitika, a spokesperson for the Harris-Walz campaign, said in a press statement.

“Trump clearly knows his record of ripping away women’s freedoms and his Project 2025 plans to ban abortion nationwide will cost him this November ― now he’s trying to rewrite his record, words and actions. It won’t work,” Chitika continued. “Women are living the consequences of the nightmare Trump created ― and too many are losing their lives to extreme Trump bans. They will hold him accountable this November.”

Project 2025, an extreme policy agenda for a possible second Trump term, includes several draconian anti-abortion policy proposals including enacting the Comstock Act, a 150-year-old anti-obscenity law that if enforced would criminalize sending abortion pills by mail and effectively create a backdoor national abortion ban. Although Trump has attempted to distance himself from the plan, many of his longtime allies are responsible for the 900-page document.