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The Senate voted 88 to 9 to approve a stopgap spending bill to fund the federal government through Nov. 17, narrowly averting a shutdown by a midnight deadline. The bill now heads to President Biden’s desk for his signature.

The legislation also includes $16 billion in emergency disaster assistance requested by the White House and extends authorization for the Federal Aviation Administration through the end of the year. It does not include any additional aid to Ukraine, despite widespread bipartisan support for that funding in the Senate.

Biden praised the legislation and called for Congress to move quickly to address the lack of funding for Ukraine.

“We cannot under any circumstances allow American support for Ukraine to be interrupted,” Biden said in a statement. “I fully expect the Speaker will keep his commitment to the people of Ukraine and secure passage of the support needed to help Ukraine at this critical moment.”

The sudden agreement in Congress on spending was a major reversal after House Republicans remained at an impasse for weeks. House Speaker Kevin McCarthy, R-Calif., unveiled the bill Saturday morning after a closed-door meeting with House Republicans.

The vote came after an hours-long delay led in part by Sen. Michael Bennet, D-Colo., who demanded a firm commitment from leaders in both parties on the Ukraine aid.

“I think it’s really important for us to send a message that the dysfunction that we have, in terms of this immediate question about opening or closing the government, doesn’t reflect on our bipartisan commitment to make sure that the United States stays in this battle and that we continue to support the Ukrainian people in their fight,” Bennet told reporters outside the Capitol.

The Senate vote capped a day of dramatic swings in Congress ahead of the shutdown deadline.

Earlier in the day the House voted 335 to 91 to approve the extension. McCarthy has refused for weeks to consider any spending bill that would require the support of Democrats. But facing the potential for a politically and economically harmful shutdown, McCarthy reversed course, specifically calling on Democrats for help passing the bill.

“What I am asking, Republicans and Democrats alike, put your partisanship away, focus on the American public,” McCarthy told reporters before the vote.

In the final vote, more Democrats than Republicans supported the measure, 209 to 126.

No funding for for Ukraine

The White House, congressional Democrats and many Senate Republicans have insisted on including financial support for Ukraine, because current funding is set to run out at the beginning of October. However, a bloc of House Republicans strongly oppose more funding for Ukraine, and lawmakers abandoned those plans in order to pass a deal on spending.

Senate Democrats lamented the lack of Ukraine funding but said there is a bipartisan commitment to find a path for funding. House Republicans have suggested the only way to do that is to pair the funding with money to address illegal immigration at the U.S. border with Mexico. Sen. Chris Murphy, D-Conn., rejected that idea.

“I just think it’s much better for all of us, much better for the world if we separate the question of Ukraine from any other political question,” Murphy told reporters in the Capitol.

He said lawmakers are “going back to the drawing board” to figure out what would go in a Ukraine assistance package but “that can’t happen overnight.”

Many Republicans in the House and some in the Senate oppose new funding for Ukraine without further accounting of how the previous funds have been spent.

“We’re going to have a really, really tough conversation about whether and how we’re going to fund Ukraine,” said Sen. J.D. Vance, R-Ohio. “I think this is a victory for those of us who are skeptical of indefinite funding for Ukraine. But there’s going to be another fight, whether it’s next week or three weeks from now.”

McCarthy’s reversal

The sudden rush of action came after House Republicans huddled in the basement of the Capitol to discuss strategy.

Some McCarthy allies, like Rep. Dusty Johnson, R-S.D., argued a temporary fix to funding the government was needed so House Republicans can continue to push for conservative spending policy without the threat of a shutdown. Leaders stressed that with continued resistance from a group of conservative GOP members, there was no way to move a bill with just Republicans. McCarthy holds a narrow majority and can’t lose any more than four votes.

Johnson pointed to the 21 far-right Republican members who blocked a GOP bill on Friday as the reason why the speaker moved to this new plan. Those members “put us in a position to unfortunately pass something a little less conservative. Now the good news is this is still a pathway to get the kind of conservative wins we need through the appropriations process.”

House Republican leaders canceled the planned district recess for the beginning of October and said the House will continue to move their own spending bills — they passed four of the 12 that fund federal agencies.

Conservatives pushed back against the stopgap bill. Rep. Bob Good, R-Va., told reporters he would vote no against a continuing resolution. “There’s no such thing as a clean CR.” He argued if one passed he didn’t believe the House would continue taking up the rest of the annual spending bills.

The threat to McCarthy’s leadership

McCarthy’s move opens him up to a challenge for his gavel. Florida GOP Rep. Matt Gaetz has been hinting for days he was planning to file a resolution to oust the speaker. Under rules McCarthy agreed to in January when he was elected, only one lawmaker is needed to file a “motion to vacate” — a resolution that calls for a vote of confidence in the speaker.

Asked by reporters if he was worried about his job, the speaker said, “you know what, if somebody wants to remove because I want to be the adult in the room, go ahead and try.”

Democrats join with McCarthy’s plan

There was drama early in the day as House Democrats attempted to stall progress on the House bill in order to give the Senate time to vote first on their own version of the legislation that would have provided roughly $6 billion for Ukraine.

As senators crept toward their own vote, across the Capitol, the House Appropriations Committee’s Democratic staff members released an analysis criticizing the bill for not including money for Ukraine.

But it quickly became clear that Senate Republicans were on board with McCarthy’s plan and House Democrats relented.

Rep. Jim McGovern, D-Mass., the top Democrat on the Rules Committee, said he was disappointed with the decision to remove Ukraine aid, but Congress needed to move ahead with the deal they could reach.

“There’s bipartisan consensus on [Ukraine], we’ve had overwhelming votes on this, so I think we will work that out,” McGovern told reporters. “But right now this is a bill — I mean I would have written the bill a little bit better, but this is a bill that Democrats can support and I think we won some important victories.”

NPR’s Deepa Shivaram contributed to this report.

Copyright 2023 NPR. To see more, visit https://www.npr.org.

Emily Gebel was trying to figure out why she was having trouble breastfeeding. That’s when she felt a lump.

Gebel, a mother of two children, went to her primary care doctor in Juneau, Alaska, who referred her for testing, she said.

Her 9-month-old was asleep in her arms when she got the results.

“I got the call from my primary care nurse telling me it was cancer. And I remember I just sat there for probably at least another half an hour or so and cried,” Gebel said.

Juneau, the state capital, has about 31,700 residents, who are served by the city-owned Bartlett Regional Hospital. But Gebel said she has several friends who have also had cancer, all of whom recommended she seek treatment out of town because they felt bigger cities would have better care.

She opted for treatment in Seattle, the closest major American city to Alaska. She underwent surgery at Virginia Mason Medical Center in September 2022. In January, she began chemotherapy at Lifespring Cancer Treatment Center, a stand-alone clinic that she said she selected because it offers a lower-dose chemotherapy.

During chemo, she learned she had stage 4 breast cancer, she said.

Commuting to Seattle for chemo every week — nonstop flights last as long as two hours and 45 minutes — became tiring. So Gebel began treatment at Bartlett Regional Hospital after her Seattle doctor taught hospital staffers there how to administer her chemo regimen.

Then the bill came.

The patient: Emily Gebel, 37, insured through her husband’s employer by Premera Blue Cross. She was previously covered by Moda Health.

Medical service: One round of metronomic chemotherapy, which involves regular infusions at lower but more frequent doses and over a longer period than traditional chemotherapy.

Service provider: Bartlett Regional Hospital and Lifespring Cancer Treatment Center. The hospital is a tax-exempt facility owned by the city and borough of Juneau, though most of its revenue comes from the services it provides, according to hospital officials. Lifespring is a stand-alone, doctor-owned cancer clinic in Seattle.

Total bill: The prices for Emily’s chemo infusions at Bartlett Regional Hospital varied week to week. A hospital bill showed one infusion in July was listed at $5,077.28 — more than three times the price for a similar mix of drugs at the Seattle clinic, $1,611.24.

What gives: In the United States, the price for the same medical service can vary based on where it is received. And for those living in remote areas like Alaska, the price difference can put care further out of reach.

Emily’s firsthand experience with this disparity began after her husband, Jered, requested a cost estimate from Bartlett Regional Hospital. It said Emily’s chemo would cost around $7,500 per weekly infusion, more than 4½ times what she had been charged in Seattle.

“The email came through with the bill estimate, and it’s like, ‘Oh my goodness, this has to be wrong,'” Jered said.

Jered said Emily had met her annual out-of-pocket maximum, meaning her insurance would cover the costs of her treatment, but from the start, the disparity just bothered him.

When Emily received a bill for a few rounds of her weekly chemo treatments, it showed that the hospital charged more than triple what the Seattle clinic did for a round of chemo, asking higher prices for every related service and medication she received that week.

The hospital charged about $1,000 for the first hour of chemo infusion, which is more than twice the rate at the Seattle clinic. One of Emily’s drugs cost $714, more than three times the price at the clinic.

It was even the tiniest things: The hospital charged $19.15 for Benadryl, about 22 times the clinic’s price of 87 cents.

Staff at Lifespring Cancer Treatment Center, the Seattle clinic, did not reply to requests for comment.

Sam Muse, the hospital’s former chief financial officer who no longer works there, said Bartlett Regional Hospital officials determined prices by looking at average wholesale prices and what other facilities in the region charge. Muse said the hospital had to account for high operating costs.

“Anything that we charge certainly has to take into consideration … the cost of just supplying healthcare in a rural setting like Juneau,” Muse said. “We’re not accessible by road at all, only ferry or plane.”

Juneau’s isolated geography makes reaching many resources a challenge. The city is part of the Alaska Panhandle, a narrow, island-speckled sliver of the state wedged between Canada, the Pacific Ocean, and Glacier Bay National Park & Preserve. Neither Anchorage nor Vancouver, its nearest major cities, is close by.

The hospital — the only one in the city and largest in the panhandle — treats a small number of cancer patients, at least a few hundred last year, Muse said. Its two oncologists live outside the city and fly into Juneau six times a month, said Erin Hardin, a hospital spokesperson.

Bartlett spent nearly $11 million last year to pay and fly in nurses, doctors, and other staffers who live outside the city, Muse said.

We’re “trying to find that happy medium between keeping care here and keeping costs down and how do we do that in a sustainable way for the long term,” Muse said.

Even though research shows Alaskans seek emergency care and are admitted to the hospital less often than many Americans, they had the third-highest health care expenditures per capita in 2020.

“Alaska is special in that it’s small, it’s remote, therefore it’s more expensive,” said Mouhcine Guettabi, an associate professor of economics at the University of North Carolina-Wilmington who studied health care costs in Alaska when he taught there.

Guettabi said hospitals often need to offer higher wages to recruit doctors and nurses willing to live in Alaska, which has a higher cost of living than most states.

Towns or entire regions may have few specialists and only one hospital, creating a dearth of competition that may drive up costs, Guettabi said. It’s also more expensive to ship items there, including medical supplies.

But Alaska’s costs are higher even when taking all those factors into account, Guettabi said. In Anchorage, for instance, prices for medical items increased nearly three times faster from 1991 through 2017 than prices overall.

Alaska also has a unique policy that may be increasing prices. Its “80th percentile rule” was enacted in 2004 to limit the amount of money patients pay when treated by providers outside their health insurers’ network. But like many experiments meant to rein in costs, the rule has instead been increasing health care spending, according to a study by Guettabi.

“Critics think the rule may be adding to that soaring spending, partly because over time providers could increase their charges — and insurance payments would have to keep pace,” the study noted.

The resolution: Emily received a bill from the hospital in September, more than five months after beginning treatment there.

It said Emily owed about $3,100 even though a previous explanation of benefits said she’d met her out-of-pocket limit.

Jered said he contacted hospital billing officials, who discovered that a medicine had been incorrectly coded and told Jered that Emily’s charge was zero.

“We know how hard it is to pay these ridiculous medical bills,” Jered said. “If I’m able to push back a little bit against this massive system, well, hey, maybe other people can, too. And who knows, maybe eventually health care prices can come down.”

Emily said she’s glad Jered knows how to handle the financial aspects of her care. Like many Americans, she could have just paid or ignored the incorrect bills, risking being sent to collections.

“I can’t imagine the amount of time I would have to spend on it while juggling parenting and also dealing with completing treatment, going through the sickness that goes along with that, and just generally feeling very run down,” she said.

The takeaway: Alaska government officials, nonprofits, and experts have suggested methods to lower the cost of health care. The state is considering repealing the 80^th percentile rule and implementing value-based care, which emphasizes paying providers based on health outcomes.

But what should Alaskans and other patients do in the meantime? If you live in a high-cost state, you might check out prices at a health care system in a state next door.

In any case, get ready to advocate for yourself.

Jered learned about medical billing by following the Bill of the Month series and reading “Never Pay the First Bill,” a book by Marshall Allen, a former ProPublica reporter.

Request itemized bills and make sure the codes match the services you received, Jered said. Note any prices that seem outrageous. If you have concerns, arrange an in-person meeting with an official in the provider’s finance department. If that’s not possible, a phone call is better than email. Make sure to document all conversations, so you have a record.

Come prepared with your documents and evidence, including the rate paid by Medicare, the federal insurance system for those 65 and older. Ask the official to explain the reasons for the codes and pricing before contesting anything. You can sometimes negotiate high-priced services down. And remember that the person you’re speaking with isn’t to blame for your health care costs.

“Don’t come at them angry, don’t come at them as viewing them as the enemy — because they’re not,” Jered said. “They are working within the same broken system.”

Emmarie Huetteman of KFF Health News edited the digital story, and Taunya English of KFF Health News edited the audio story. NPR’s Will Stone edited the audio and digital story.

KFF Health News, formerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

Copyright 2023 KFF Health News. To see more, visit KFF Health News.

For the first time since 2019, congressional gridlock is poised to at least temporarily shut down big parts of the federal government — including many health programs.

If it happens, some government functions would stop completely and some in part, while others wouldn’t be immediately affected — including Medicare, Medicaid and health plans sold under the Affordable Care Act. But a shutdown would complicate the lives of everyone who interacts with any federal health program, as well as the people who work at the agencies administering them.

Here are five things to know about the potential impact to health programs:

1. Not all federal health spending is the same.

“Mandatory” spending programs, like Medicare, have permanent funding and don’t need Congress to act periodically to keep them running. But the Department of Health and Human Services is full of “discretionary” programs — including at the National Institutes of Health, Centers for Disease Control and Prevention, community health centers and HIV/AIDS initiatives — that must be specifically funded by Congress through annual appropriations bills.

The appropriations bills (there are 12 of them, each covering various departments and agencies) are supposed to be passed by both chambers of Congress and signed by the president before the start of the federal fiscal year, Oct. 1. This almost never happens. In fact, according to the Pew Research Center, Congress has passed all the appropriations bills in time for the start of the fiscal year only four times since the modern budget process was adopted in the 1970s; the last time was in 1997.

Congress usually keeps the lights on for the government by passing short-term funding bills, known as “continuing resolutions,” or CRs, until lawmakers can resolve their differences on longer-term spending.

This year, however, a handful of conservative Republicans in the House have said they won’t vote for any CR, in an attempt to force deeper spending cuts than those agreed to this spring in a bipartisan bill to raise the nation’s borrowing authority. House Speaker Kevin McCarthy and his allies could join with Democrats to keep the government running, but that would almost certainly cost McCarthy his speakership. Several of the rebellious conservatives are already threatening to force a vote to oust him.

2. The Biden administration decides what stays open.

The White House Office of Management and Budget is responsible for drawing up contingency plans in case of a government shutdown and publishes one for each federal department. The plan for Health and Human Services estimates that 42 percent of its staff would be furloughed in a shutdown and 58 percent retained.

The general rule is that two types of activities may continue absent annual spending authority from Congress. One is activities needed “for safety of human life or the protection of property.” At HHS, that would include caring for patients at the hospital on the campus of the National Institutes of Health — though new patients generally would not be admitted — as well as the agency’s laboratory animals, and CDC investigations of disease outbreaks.

Other activities that may continue are those with funding sources that aren’t dependent on annual appropriations. Medicare and Social Security, for example, are entitlements funded by taxes and premiums. Drug approvals at the Food and Drug Administration are largely funded by user fees paid by drugmakers, so approvals in process can continue but there are questions about whether new approval processes could start.

Also unaffected are programs that have been funded in advance by Congress. For example, the Indian Health Service is already funded through the 2024 fiscal year.

3. What happens to enrollment in Medicare and Affordable Care Act plans?

It depends on how long the shutdown lasts. In the short term, mandatory spending programs would be mostly, but not completely, unaffected by a government shutdown. Benefits would continue under programs like Medicare, Medicaid and the Affordable Care Act, and doctors and hospitals could continue to submit bills and get paid. But federal staff not considered “essential” would be furloughed.

That means initial Medicare enrollment could be temporarily stopped. According to the Committee for a Responsible Federal Budget, an independent group that tracks federal spending, during the 1995-96 federal shutdown, “more than 10,000 Medicare applicants were temporarily turned away every day of the shutdown.”

A shutdown shouldn’t much affect Medicare’s annual open enrollment period, which starts Oct. 15 and allows current beneficiaries to join or change private Medicare Advantage or prescription drug plans. That’s because much of the funding to help seniors and other beneficiaries choose or change Medicare health plans has already been allocated.

Rebecca Kinney, who runs the HHS office that oversees the federal program that counsels Medicare beneficiaries about their myriad choices, said Friday that funding for both the 1-800-MEDICARE hotline and federally funded state counseling agencies has already been distributed for this year, so neither would be affected, at least in the short run.

The same is true for Affordable Care Act plans, which open for enrollment on Nov. 1. The HHS contingency documents say the Centers for Medicare & Medicaid Services, which oversees the federal health exchange, HealthCare.gov, “will continue Federal Exchange activities, such as eligibility verification,” using fees paid by insurers left over from the previous year.

Still, about half of CMS staff would be furloughed in a shutdown. That could complicate a lot of other activities there, starting with drug price negotiations set to begin Oct. 1. HHS Secretary Xavier Becerra told reporters at the White House last week that a shutdown would likely push back the timeline for negotiations.

A shutdown would also threaten HHS oversight of the Medicaid “unwinding” process, as states reevaluate the eligibility of those enrolled in the program for low-income people. State workers would be unaffected, according to the Georgetown University Center for Children and Families, so eligibility reviews will continue regardless. But because of federal furloughs, “technical assistance to help states address unwinding problems and adopt mitigation strategies could cease,” wrote the center’s Kelly Whitener and Edwin Park. “Efforts to determine if there are further renewal processes that are out of compliance with federal requirements could be limited or ended.”

4. What if the shutdown is prolonged?

More programs could be affected. For example, the HHS shutdown contingency document says that “CMS will have sufficient funding for Medicaid to fund the first quarter” of fiscal year 2024. The government has never been shut down long enough to know what would happen after that. The 2013 shutdown, which included HHS, lasted just over two weeks. Most of the agency wasn’t affected by the 2018-19 shutdown because its annual appropriations bill had already been signed into law. (The FDA is funded under the appropriations bill that covers the Agriculture Department rather than the one that funds HHS.)

5. Do federal employees get paid during a shutdown?

It depends. Employees whose programs are funded continue to work and be paid. Those considered “essential” but whose programs are not funded would continue to work, but they wouldn’t get paid until after the shutdown ends. A 2019 law now requires federal workers to get back pay when funding resumes, which was not always the case. However, federal contractors, including those who work in food service or maintenance jobs, have no such guarantee.

KFF Health News, formerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

A little-known provision of the U.S. Constitution is at the center of a growing debate about former President Donald Trump’s eligibility for the 2024 election, with a number of Trump opponents claiming it should prevent him from appearing on ballots next year.

The 14th Amendment was ratified in 1868, following the Civil War, and its Section 3 essentially disqualifies from office anyone who engaged in “insurrection or rebellion” against the U.S.

It was designed to prevent former Confederate leaders from serving in Congress, and got the most use in the decade or so after the war, says James Gardner, a professor at the University at Buffalo School of Law who specializes in constitutional and election law.

It’s rarely been discussed — let alone invoked — since.

“Until recently, nobody would have said that there was even a real chance of a sort of a rebellion or insurrection against the United States of the kinds the amendment would deal with,” Gardner tells NPR. “Now is certainly the most important context to which the provision is relevant since the 1870s.”

That’s because of Trump’s efforts to overturn his 2020 election loss, and the events of Jan. 6, 2021, when Trump supporters stormed the U.S. Capitol to try to stop Congress from certifying the results.

Liberal groups have since tried unsuccessfully to apply the amendment to block several well-known Republican members of Congress from running for reelection over their involvement in Jan. 6.

While the activists said they intended to eventually target Trump if he sought the presidency again, and have laid the legal groundwork to do so, actually keeping him off the ballot is likely a longshot.

That’s despite the House panel that investigated the Jan. 6 attack last year blaming Trump as its “central cause,” and a grand jury indictment on four federal counts related to efforts to overturn the 2020 election.

The special counsel’s probe is one of several criminal cases facing now-candidate Trump, who continues to dominate the Republican primary race.

And in recent weeks, a growing chorus of legal scholars and voters’ rights groups have argued that the clause should disqualify him from the ballot.

“I think there is consensus in the legal field that it is worth looking into,” Gardner says. “The questions that are difficult are exactly how that would happen.”

Because the presidential election happens nationwide yet is so decentralized, individual state officials could theoretically make their own determinations about whether Trump should be on the ballot, based on their state statutes.

Election administrators in several states, including Michigan, New Hampshire and Georgia, have already said Trump’s name will be on the ballot unless a court rules otherwise.

Gardner — who personally would like to see Trump disqualified from ballots nationwide — says the issue would ideally settled by the U.S. Supreme Court in time for the upcoming election cycle.

“I think that the situation that would be most fraught is if the state courts in New York and California throw him off, but the state courts in Alabama and Georgia keep him on,” he explains. “So then you’d have a disagreement among perfectly well-authorized judicial systems. … It needs to be decided by the Supreme Court for everybody.”

People disagree about whether it would be worse to ignore or confront the question, Gardner says. He believes any decision will be fateful for the U.S. as a civic society, especially in the broader context of the democratic backsliding happening here and elsewhere around the world.

Here’s what else to know about the clause — how it’s been used before, why it’s so divisive and what might happen next.

What does the clause say?

Section 3 of the 14th Amendment reads:

“No person shall be a Senator or Representative in Congress, or elector of President and Vice-President, or hold any office, civil or military, under the United States, or under any State, who, having previously taken an oath, as a member of Congress, or as an officer of the United States, or as a member of any State legislature, or as an executive or judicial officer of any State, to support the Constitution of the United States, shall have engaged in insurrection or rebellion against the same, or given aid or comfort to the enemies thereof.”

The wording of the clause opens it up to a slew of definitional questions, including the meaning of insurrection, what constitutes engagement and “aid or comfort,” and whether the presidency is really an “office.”

For his part, Gardner argues Jan. 6 was clearly a violent insurrection against the U.S., citing the loss of life and destruction of property.

The degree of Trump’s involvement is a question that people view as more murky, he says, pointing to examples like Trump’s rousing speech beforehand and the Jan. 6 committee’s revelation that he wanted to go to the Capitol himself.

Trump has not been charged with or convicted of insurrection, which some legal experts say weakens the case for using the provision to disqualify him. Others, like Gardner, argue a conviction isn’t a prerequisite.

Gardner says Trump’s March 2024 election interference trial tackles different legal issues — namely, whether he violated particular criminal statutes, not whether he violated a provision of the Constitution.

“It may be that in those trials, evidence would be produced which would be relevant to the constitutional question,” he explains. “But they’re really not connected.”

When has it been used before?

The clause has never been invoked against a presidential candidate. It got what Gardner calls “the biggest workout” in the period immediately following the Civil War.

“What happened was Southern states, once they were readmitted, began trying to send ex-Confederate leaders to Congress,” he says. “And there was a long period where Congress was refusing to seat those people.”

Fast forward a century and half later to 2022, when a county official in New Mexico was removed from office because of his involvement in Jan. 6.

A judge ruled that Otero County Commissioner Couy Griffin, a Trump supporter, was disqualified from holding public office — because he violated Section 3 of the 14th Amendment — after he was convicted of entering a restricted area of the U.S. Capitol.

The liberal-leaning Citizens for Responsibility and Ethics in Washington (CREW), which sued on residents’ behalf, said Griffin’s was the only successful case to be brought under Section 3 since 1869. (Congress also excluded a House member after World War I, before his conviction was overturned and he was seated after winning election again.)

Another liberal group, Free Speech For People, sought to disqualify additional Trump allies, including Reps. Marjorie Taylor Greene of Georgia and Madison Cawthorn of North Carolina.

Greene remained on Georgia’s ballot — and eventually won reelection — after a state administrative judge said the plaintiffs failed to prove she engaged in insurrection. And while Cawthorn lost his primary race after a string of scandals, an appeals court ruled as part of that case that participants in an insurrection against the U.S. can be barred from holding office.

Who is talking about it?

The idea to use this clause to bar Trump from the presidential ballot started gaining new traction in August, largely but not exclusively in liberal circles.

Former federal Judge J. Michael Luttig, a prominent conservative, and liberal constitutional scholar Laurence Tribe made their case in a joint opinion piece for The Atlantic. Two conservative law professors who studied the question for a year endorsed the theory in a recent New York Times interview (another scholar quoted favorably has since changed his mind).

And voters’ rights organizations in two states filed lawsuits to that effect in as many weeks.

CREW is seeking to ban Trump from the ballot in Colorado, alleging he violated his oath of office by “recruiting, inciting and encouraging a violent mob that attacked the Capitol” (Trump denounced those leading the effort as “deranged … slime balls”). Free Speech For People filed a separate, similar lawsuit in Minnesota shortly after.

And a federal judge recently rejected one such challenge by a tax attorney in Florida, saying he lacked legal standing.

One of Trump’s most outspokenly critical primary challengers, former Arkansas Gov. Asa Hutchinson, said in August that Trump’s actions on Jan. 6 likely violated the amendment, adding, “I’m not even sure that he’s qualified under our Constitution.”

Trump himself has spoken out against it. He posted on social media that the amendment has “no legal basis or standing” related to the election, and told conservative radio host Dan Bongino that “this is like a banana republic.”

“What they’re doing is, it’s called election interference,” he said. “Now the 14th Amendment is just a continuation of that. It’s nonsense.”

What are the arguments for and against?

The main argument for using the clause to bar Trump from reelection, legal scholar Gardner says, is “a consequence of application of the plain language of the Constitution to his behavior.”

He says there are two main arguments against doing so. One is a set of technical legal arguments and factual questions that explain why his behavior might not be covered. The other is a set of concerns about what barring Trump would mean for civic peace.

“Trump supporters have now a long history of personally, viciously attacking electoral officials who do things that they don’t want them to do, and this is a decision that’s going to be controversial even among reasonable people,” Gardner says. “So yeah, it’s full of risk. And you’d have to be a pretty brave person to decide that the law requires you to disqualify Trump and then go ahead and do it.”

Kim Wehle, a constitutional law scholar at the University of Baltimore who raised the 14th Amendment question in a Politico piece last year, acknowledges such a move could cause “tremendous civil unrest.”

But, as she told Morning Edition in September, there is a “textual commitment in the Constitution” that should be reckoned with now, given the stakes if Trump is reelected.

“That would be, in my mind, the end of American democracy, given his stated plans for what he will do to the federal government with a cadre of loyalists making very clear that they’re not willing to adhere to the electoral process in the Constitution with fidelity in the way that federal officials have to date,” Wehle added.

David Frum, a former speechwriter for President George W. Bush who now writes for The Atlantic, argues that using the 14th Amendment would just perpetuate existing problems — like making it harder for secretaries of state to safeguard elections or for the public to accept their results.

“It’s a reckless project, and it distracts people from the real work they have to do, which is to make sure that you are signed up to drive your friends and neighbors to the polls to save your country from a threat to democracy that isn’t going to be stopped by magic words,” Frum told Morning Edition.

Gardner says it boils down to this: Do we put the issue aside because the potential consequences could be so divisive and disruptive for democracy, or do we confront it because democracy means applying the rule of law to everyone, even the president?

His answer: “I wouldn’t want to be a secretary of state right now making any decisions any more than I’d want to be a justice on the U.S. Supreme Court.”

What might happen next?

Secretaries of state are starting to get questions — and pressure — from voters, leading some to affirm publicly that they plan to keep Trump’s name on the ballot unless a court says otherwise.

In New Hampshire, for example, a group of GOP lawmakers wrote to Secretary of State David Scanlan, also a Republican, countering the 14th Amendment argument and asking him to ensure Trump will be on the ballot.

“Now it is time for the great leaders of the Granite State to ensure that their constituents have access to a free and fair primary election by standing against the misinterpretation and politicization of our Constitution,” they wrote in the Sept. 12 letter.

The following day, Scanlan — whose state is just months away from its traditional early presidential primary — held a press conference to dismiss claims that he has the power to take Trump’s name off the ballot. Doing so on a state-by-state basis would bring “chaos, confusion, anger and frustration,” he said, adding that the proper venue to decide that question is the U.S. Supreme Court.

Gardner, like many, expects the issue to be resolved in court.

He says the “procedurally more solid way” to get it there would be for an election administrator to say Trump is disqualified, which would likely spark an immediate lawsuit — either from Trump, his campaign or his supporters in that particular state.

And he says it’s hard to predict how the Supreme Court might rule, even with its conservative supermajority.

There is precedent for it acting quickly in an election dispute, as it did during Bush v. Gore in 2000 — but its reputation took a hit after it was perceived as meddling in the outcome. And, he adds, it could decline to intervene at all, as it did in several cases related to election procedures ahead of 2020.

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The White House on Wednesday unveiled a new climate jobs training program that it says could put 20,000 people to work in its first year on projects like restoring land, improving communities’ resilience to natural disasters and deploying clean energy.

The American Climate Corps is modeled after a program that put millions to work during the Great Depression. President Biden’s climate policy adviser Ali Zaidi told reporters that the program has broader goals beyond addressing the climate crisis.

“We’re opening up pathways to good-paying careers, lifetimes of being involved in the work of making our communities more fair, more sustainable, more resilient,” Zaidi said.

The program will pay participants, and most positions will not require previous experience. The administration is also proposing new regulations aimed at making it easier for participants to enter the federal public service after the program.

The announcement has been in the works for some time

Biden first called for the government to find a way to establish a “civilian climate corps” in an executive order during his first week in office. The president said that he hoped the corps would “mobilize the next generation of conservation and resilience workers and maximize the creation of accessible training opportunities and good jobs.”

The idea of a climate corps began with progressive environmental activist groups, including the youth-led Sunrise Movement.

“We need millions of people, especially young people, employed to do the essential work of averting climate catastrophe and building a fair and equitable new economy,” said Varshini Prakash, the group’s executive director, who has advised the White House on climate issues.

“I am thrilled to say that the White House has been responsive to our generation’s demand for a Climate Corps and that President Biden acknowledges that this is just the beginning of building the climate workforce of the future,” Prakash told reporters.

Biden has been criticized by young climate activists

When he took office, Biden named tackling climate change as one of his top four priorities, and announced a goal of slashing U.S. greenhouse gas emissions to half of 2005 levels by the end of the decade.

His 2022 Inflation Reduction Act — some $369 billion in climate incentives and spending — is expected to get the country close to that goal.

But Biden has faced intense criticism from some factions of the environmental movement, particularly after he approved a large-scale drilling project known as Willow in northern Alaska. That decision directly contradicted a campaign pledge to bar all new drilling on federal lands, and polling showed a decline in his approval ratings on climate.

Since then, Biden been barred federal drilling on millions of acres of federal property, a measure aimed at wooing back the young, climate-conscious voters who played an important role in his electoral coalition.

The Climate Corps is more modest than some had hoped

Democratic lawmakers including Rep. Alexandria Ocasio-Cortez, D-N.Y., and Sen. Ed Markey, D-M.A., had pushed for more funding for the climate corps program, but that did not transpire, meaning the program is likely to be smaller in scope than early proposals.

It’s also much smaller than its predecessor: the Civilian Conservation Corps, a New Deal-era program that ran for ten years and employed millions restoring public lands and building infrastructure for the country’s national parks.

There is another key difference, too. While the Conservation Corps primarily employed young, white men, the White House says that the American Climate Corps is designed to attract participants from disadvantaged communities disproportionately impacted by the changing climate.

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Catastrophic floods in eastern Libya killed at least 5,100 people, according to local authorities. The disaster comes after a string of deadly floods around the world this month, from China to Brazil to Greece. In every case, extremely heavy rain was to blame.

The enormous loss of life on multiple continents reinforces the profound danger posed by climate-driven rain storms, and the need for better warning systems and infrastructure to protect the most vulnerable populations.

Climate change makes heavy rain more common, even in arid places where the total amount of precipitation is small. That’s because a hotter atmosphere can hold more moisture. Everyday rainstorms, as well as bigger storms such as hurricanes, are increasingly dangerous as a result.

In Libya, a storm called Daniel swept in from the Mediterranean over the weekend and resulted in a jaw-dropping 16 inches of rain in just 24 hours, according to the World Meteorological Organization. That is far too much water for the ground to absorb, especially in an arid climate where the soil is dry and is less able to suck up water quickly.

The massive amount of rain caused widespread flash flooding, and overwhelmed at least one dam near the coastal city of Derna. That unleashed torrents of water powerful enough to sweep away entire neighborhoods.

While it was clear to global meteorologists that the storm was powerful and was headed for the Libyan coast, it’s not clear that residents of Derna were warned about the severity of the potential flooding. Libya is governed by two rival governments, and years of war means dams and other infrastructure haven’t been well-maintained.

Before it got to Libya, the storm called Daniel also devastated Greece and Turkey with enormous amounts of rain. Some parts of Greece received more than two feet of rain in a three hour period last week, according to local authorities. And in Hong Kong last week, a record-breaking 6 inches of rain fell in one day. That caused flash flooding in the dense, hilly city, carrying away cars and flooding underground rail stations.

In Brazil, flooding from a cyclone last week killed more than 20 people and left a swath of southern Brazil underwater.

Cities around the world are scrambling to upgrade their infrastructure to handle increasingly common deluges.

The disasters in the last two weeks also underscore the vulnerability to climate change of people who are not wealthy or who live in places that are at war. While extreme rain has caused floods around the world recently, the death toll is significantly higher in places where there isn’t money or political will to maintain infrastructure and adequate weather warning systems.

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