More than 1 million people in the European Union died from avoidable causes in 2022, according to new data from a Eurostats report. Of these, over 386,000 deaths were attributed to diseases treatable with quality healthcare, while at least 725,000 could have been prevented through effective public health interventions.
The conditions cited include heart disease, COVID-19, and several cancers – such as colon, breast, and lung cancer – that experts have long said could be more effectively addressed with proper investment in screening and treatment. Despite these warnings, European authorities continue to slash funding for health and care services while committing record sums to military spending.
More than 1 million people in the European Union died from avoidable causes in 2022, according to new data from a Eurostats report. Of these, over 386,000 deaths were attributed to diseases treatable with quality healthcare, while at least 725,000 could have been prevented through effective public health interventions.
The conditions cited include heart disease, COVID-19, and several cancers – such as colon, breast, and lung cancer – that experts have long said could be more effectively addressed with proper investment in screening and treatment. Despite these warnings, European authorities continue to slash funding for health and care services while committing record sums to military spending.
Republican Congressman Robert Bresnahan of Pennsylvania got publicly shamed by many of his congressional colleagues on Thursday after it was revealed he unloaded a Medicaid-related stock before voting for a massive budget package that enacted historically devastating cuts to the program. Quiver Quantitative, an investment data platform that tracks stock trades made by politicians and other…
The last time a Republican-controlled Congress and President Donald Trump moved to slash Medicaid spending, in 2017, a key political force stood in their way: GOP governors. Now, as Congress steamrolls toward passing historic Medicaid cuts of about $1 trillion over 10 years through Trump’s tax and spending legislation, red-state governors are saying little publicly about what it does to…
“Medicaid! “Saves Lives!” health-care workers chanted in call-and- response outside New York-Presbyterian Hospital in Washington Heights June 23. The overhead passageway between two buildings provided a bit of shade but no protection from the 93-degree heat. “Keep the hospitals open,” called out a woman with “Healthcare Hero” on the back of her shirt, despite the oppressive temps.
The rally, a rotating cast of dozens of people in purple 1199SEIU T-shirts, maroon scrubs, and navy-blue mechanics’ gear, and environmental-services workers in sky-blue hair coverings, was one of 11 street actions the union organized in New York City, Long Island, and the Hudson Valley to protest congressional plans to cut close to $1 trillion from Medicaid in next year’s federal budget.
Senate Republicans voted Tuesday to advance Donald Trump’s massive spending and tax bill, which will now go back to the House of Representatives for final approval. President Trump has publicly pushed his party to get the bill on his desk to sign by July 4. Dozens of peaceful protestors, including disabled people in wheelchairs, were arrested last Wednesday, June 25, in Washington, DC, while protesting Trump’s so-called “One Big Beautiful Bill,” which will slash taxes, dramatically increase funding for war and immigration enforcement, and make devastating cuts to vital, popular programs like Medicaid and the Supplemental Nutrition Assistance Program (SNAP). TRNN Editor-in-Chief Maximillian Alvarez speaks with Lorraine Chavez, an educator, researcher, and community leader based in Chicago, and Christine Rodriguez, a legal assistant from Pasadena, California, both of whom traveled to DC with the Debt Collective and were arrested for participating in the peaceful act of civil disobedience.
Guests:
Lorraine Chavez is an educator, researcher, and community leader based in Chicago. She is also a student debtor and traveled to the Washington, DC, protest with the Debt Collective.
Christine Rodriguez is a legal assistant and student debtor from Pasadena, California, who also traveled to the Washington, DC, protest with the Debt Collective.
Credits
Studio Production / Post-Production: David Hebden
Transcript
The following is a rushed transcript and may contain errors. A proofread version will be made available as soon as possible.
Maximillian Alvarez:
Senate Republicans voted Tuesday to advance Donald Trump’s massive spending and tax Bill three Republican Senators, Susan Collins of Maine, Tom Tillis of North Carolina and Rand Paul of Kentucky joined all Democrats in voting against the bill. But with Vice President JD Vance casting the tie-breaking vote, the bill will now go back to the House of Representatives for final approval and Trump has publicly pushed his party to get the bill on his desk to sign by July 4th. Now, dozens of peaceful protesters, including disabled people in wheelchairs were arrested last Wednesday in Washington DC while protesting President Trump’s so-called one big beautiful bill, which will slash taxes and includes devastating cuts to vital, popular and lifesaving programs like Medicaid and the Supplemental Nutrition Assistance Program or snap.
Dr. Richelle Brooks:
These cuts are death sentences. Trump is proposing 1.4 trillion in cuts, 793 billion from Medicaid alone and 293 billion from a CA. This would result in 10.9 million people immediately losing their health insurance. If this bill is passed and its rules are codified, this will cause mass loss of insurance for many people in need for years to come. It’s not just going to affect us now. It’s going to affect us later. This bill doesn’t just remove care from those in need and who need access to it most. It adds barriers to access for everyone. They’re intentionally attacking Medicaid and benefits like Snap Pell grants and programs like public service loan forgiveness because they are the last remaining examples of what access to Repairative public goods can look like in this country. They don’t want us to think that we have a right to healthcare. They don’t want us to believe that we have a right to public goods. They want us to believe that we need to earn the access for our basic needs to be met with our labor, with our compliance, and with our silence.
Maximillian Alvarez:
Speaking to Republican colleagues who were worried about the public blowback to these deeply unpopular cuts, former Senate majority leader Mitch McConnell reportedly said, I know a lot of us are hearing from people back home about Medicaid, but they’ll get over it now. These massive cuts to public programs like Medicaid and food stamps are part of a systematic overhaul that would place the biggest financial burden on poor and working people to pay for Trump’s staggering increases to war and immigration enforcement spending and to make permanent his tax cuts from 2017, which overwhelmingly benefit corporations and the rich as part of Trump’s plan to remove undocumented immigrants from the country. The Guardian reports Immigration and customs Enforcement will receive 45 billion for detention facilities, $14 billion for deportation operations and billions of dollars more to hire an additional 10,000 new agents by 2029. And more than $50 billion is allocated for the construction of new border fortifications, which will probably include a wall along the border with Mexico.
Now, the Senate version of the bill also includes over 150 billion in new military spending and decade after decade, Republican tax cuts have eroded the US tax base and enriched the wealthiest households all while funding for war policing and surveillance has continued to rise. Trump’s one big beautiful bill would reportedly increase the national debt by $3.3 trillion and someone has to pay for that. And Trump and the GOP think that that someone should be working people like you among other things. The so-called big beautiful Bill also includes a provision to bar states from imposing any new regulations on artificial intelligence or AI over the next 10 years. A move that critics say is both a massive violation of states’ rights and a dangerous relinquishing of government oversight on big tech and AI when oversight is most needed. The bill would also restructure the student loan and debt system imposing stricter limits on new borrowers who hope to attend college and much harsher repayment plans for current debtors.
The fact that so many millions of Americans will be directly impacted by this bill is exactly what brought so many different groups out to Washington DC last week to protest it, including popular Democracy in Action, the Service Employees, international Union, planned Parenthood, Federation of America, the Debt Collective Standup, Alaska Action, North Carolina, Arkansas Community Organizations and American Disabled for Attendant Programs Today, or Adapt. Now, I spoke with Lorraine Chavez, an educator, researcher, and community leader based in Chicago, as well as Christine Rodriguez, a legal assistant from Pasadena, California, both of whom were arrested in DC last week for participating in the Peaceful Act of Civil Disobedience and both of whom are student debtors themselves and traveled to DC with the Debt Collective. A union of debtors
Lorraine Chavez:
I came to DC having followed the Debt Collective for a number of years, and I came because I personally have student loan debt that I have no capacity to pay. I’m a single mother. I put my two kids who are twins both 33 through college, and they did not receive any financial assistance at all from their college professor, father, so it was all on me. So I have no capacity to pay back my own debt, and I know others have all kinds of medical debt. I know there are all kinds of cutbacks coming to the disabled community of which I had been a part of and an advocate for in Chicago. So I didn’t mind getting arrested. I was really thrilled to be with all these other advocates from all over the country.
Christine Rodriguez:
So all these things that are just interconnected. And then on top of this, all these tax cuts are going to basically allocate for funding for increased military defense, which I live near Los Angeles. I’ve definitely seen a lot heavier military presence along with our police, but specifically federal military, the Marines coming into Los Angeles, all these tax cuts, that’s just where our money is going to go to armed people who want to just lock us up and silence us. I came in for student loan forgiveness, but just in that introduction round, I had now become a part of other folks who were fighting for Medicaid, fighting for to reduce, to not cut the spending for the SNAP program or for the food stamp program.
Lorraine Chavez:
It just speaks to the crisis that we have around all debt on all levels and these really horrific policies that are about to or will be passed. And some of the banners that people had, which I fully support, said that people are going to die if these policies are put in place. How are Medicaid recipients going to get medical care? We are in a deep, profound crisis of health in the country, and these cutbacks will drastically increase the death rate for sure of millions of Americans who will be denied access to healthcare.
Christine Rodriguez:
And when we get to the Rotunda area, there’s already a lot of police presence there. I guess they got word because there’s so many of us at the hearing, they even tried to tell us like, you guys cannot, woo. You guys can’t chant. You can’t be too loud. You could only clap. So kind of in that moment at the press hearing, we could already see they’re trying to keep us quiet in a sense. The Capitol police were really almost waiting for us at the rotunda, definitely at the second floor where we wanted to do our banner drop at the rotunda at the time, we could already hear that the demonstration was going on. As we’re trying to drop our banner, we could already kind of hear that the plan of people are going to have a die-in at the bottom. They’re going to have a banner shush over us. And I think from the videos that I’ve seen already, when people were lying on the floor, banners were being taken away and people were already getting arrested just from, they could see their association with the Diane. So people were just getting arrested. We say arrest is really, it’s a dramatic citation. It is what happened because they let us go for $50. But again, it’s why does this need to be so dramatic of us advocating our First Amendment rights to express how much we don’t want the government to go through with this big disastrous plan?
Lorraine Chavez:
We were a peaceful group of demonstrators, totally peaceful, exercising our first amendment rights, and even within the holding center where we were, no air conditioning, it looked like a gigantic empty garage. There were fans, but it was excruciatingly hot the whole time. And I counted how many police men and women. There were about 30 of us there, and there were about 25 policemen and women. I mean, it was it absurd. And to see dozens and dozens and dozens of police, men and women swarming the Senate building as well. There must have been a police man or woman for every single one of us that was there. It was ridiculous, quite frankly, and also terrifying because we were just there exercising our First Amendment rights about issues that impact all of us. And there was an enormous crowd, enormous group of protestors in wheelchairs and amongst the disabled, their hands were tied in front or in back of them. It was a really dangerous situation. I actually had bruises on my wrist until the next day because of the plastic ties were just gripped around my wrists, and I wasn’t even allowed really to drink water. I mean, it was a dangerous situation given the heat and given the fact there was no air conditioning virtually in the police fans, there was no air conditioning at all in the holding center.
And here we were simply exercising our first amendment rights for free speech and to protest, which we are allowed to do under the Constitution. So it was really terrifying, honestly, to observe all of that going on around us
Christine Rodriguez:
And let the record show that I do not want my student loan forgiveness money to be funding ice my community in Pasadena. Just last week, two weeks ago, we experienced two raids within a week, and these raids were within walking distance of my apartment That’s happening right in my backyard. And as we saw with our action that we did earlier this week, there’s a lot of people who are going to suffer if these funding cuts happen. Unfortunately, it’s the opposite. That’s what should be happening. We should be giving more money to Medicaid. We should be giving more money to food stamps. People are barely getting by and this is their one lifeline that could be cut.
Lorraine Chavez:
I personally feel in such kind of a desperate state about all of this that I said, I don’t care if I get arrested. I mean, what else are we going to do? But unfortunately, put our bodies on the line. I don’t know. Of course, I’ve written 500 emails to my representatives. I’ve been an advocate myself for the fight for 15 in 2013, marching on the streets of Chicago for blocks and blocks. So I’ve done this before, but I just feel this incredible feeling of desperation right now.
Christine Rodriguez:
Are you tired of seeing the system fall in front of you? Are you tired of seeing injustice? Step number one, talk to your neighbors, right? We have to be our own kind of networks, and a lot of that takes just talking to strangers, but neighbors, but also strangers. Lorraine was a stranger a week ago, and now we’re buddies for life because we had this amazing experience. Say, definitely visit your local city council, city, town hall, any local thing, try to get tapped in because there’s a lot of information and drama there that’s not advertised, and it could cause a little change in your community and it could really push you to be more involved.
As Senate Republicans rushed to pass a massive budget package known as the “big, beautiful bill,” the political consequences of pushing for the deepest cuts in decades to Medicaid and other safety net programs serving millions of people are already becoming clear. After working overnight to vote on a number of amendments and pass the package ahead of an entirely symbolic July 4 deadline imposed by…
Before states banned abortion, one of the gravest outcomes of early miscarriage could easily be avoided: Doctors could offer a dilation and curettage procedure, which quickly empties the uterus and allows it to close, protecting against a life-threatening hemorrhage. But because the procedures, known as D&Cs, are also used to end pregnancies, they have gotten tangled up in state legislation…
Sen. Bernie Sanders condemned the Republican budget reconciliation package in stark terms during a floor speech late Sunday, calling the measure “the most dangerous piece of legislation in the modern history of our country” and warning that its massive cuts to Medicaid, federal nutrition assistance, and other programs would have deadly consequences nationwide. “Over 50,000…
It’s been three years since Dobbs v. Jackson Women’s Health Organization, an odious Supreme Court ruling that has unleashed a veritable crisis of rights, health, and safety for people who can become pregnant.
Since the Supreme Court overturned Roe v. Wade in 2022 and sent abortion’s legality back to the states, abortion bans have spread widely across much of the U.S. As of June 2025, 16 states have enacted a total or near-total abortion ban, rendering the entire Southeast a legal abortion desert. Other states, like North Carolina, Nebraska, and Utah, have banned abortion at 12 or 18 weeks, which would have been unconstitutional under Roe just a few short years ago. In 2023 alone, the first full year after Dobbs, 171,000 people were forced to travel out of state to access abortion care in the U.S.
Traveling, especially out of state, isn’t just a logistical burden; it also means added cost. Plane tickets, lodging, gas money, child care, food — so much is needed to make abortion accessible when someone is forced to travel for care. The Brigid Alliance, which provides financial and logistical assistance to people forced to travel for abortion care, estimates that the average cost per abortion travel itinerary now exceeds $2,300, despite the fact that a first trimester procedure costs only a quarter of that.
Dobbs doesn’t just hurt people seeking abortion care. If a pregnant person in a state with an abortion ban has a different outcome other than a live birth, including a miscarriage or stillbirth, they can face serious prison time. People like Serena Maria Chandler-Scott of Georgia, who miscarried at 19 weeks, and Brittany Watts of Ohio, who miscarried at 22 weeks, have been charged under their respective states’ restrictive anti-abortion laws. And the net of criminalization also extends beyond pregnant people to providers and doctors, creating a network of fear for pregnant people, their families, and the health care providers they entrust to care for them.
That’s bad enough and a crisis in its own right. But the ramifications of Dobbs are far broader than hindering abortion access.
Dobbs is, quite literally, killing people.
Doctors are afraid to provide basic care to pregnant folks in states where abortion bans are in effect, unsure if they will be charged with murder.
At least two Black women in Georgia, Amber Nicole Thurman and Candi Miller, died because of the ramifications of Dobbs. Georgia has a strict, six-week abortion ban. Thurman died after being denied basic care because she was pregnant and past the six-week point in her pregnancy in 2022: she had an infection related to fetal tissue that hadn’t been fully expelled from her body, but the hospital delayed performing a routine dilation and curettage due to Georgia’s restrictive laws. Miller, afraid of possible prosecution, refused to go to the hospital after complications from a self-managed abortion in the fall of 2022. Thurman and Miller were, essentially, killed by the state instead of receiving the basic, life-saving care to which they were constitutionally entitled just a few months before.
And then there’s the abhorrent case of Adriana Smith, a Black woman diagnosed with brain death who has been forcibly kept alive by the State of Georgia — against her family’s wishes — because she was nine weeks pregnant. She was taken off life support on June 17 this year after her fetus was delivered via C-section. That the state can force a Black woman’s body to be used as a literal incubator is a direct result of the Dobbs decision.
Because of Dobbs, to be pregnant in a state with an abortion ban, even if it isn’t an outright total abortion ban, is to risk your life.
But Dobbs has also wrought a different shift, one unexpected to just about everyone: It made abortion rights politically popular.
Abortion has won in nearly every election in which it’s been on the ballot since the Dobbs decision came down in June 2022, including conservative states like Ohio, Montana, and Kansas. Even when the ballot initiative failed, like in Florida, it was only because the state required a 60 percent threshold. (The initiative was approved by 57 percent of voters.) Support for abortion rights is a winning issue, and it is currently more politically popular than it has been since Roe v. Wade was decided in 1973.
Unfortunately, that popularity doesn’t automatically translate into legality, and legality doesn’t translate into access. For example, in November 2023, Missouri voted to enshrine the right to reproductive freedom into the state constitution, which should override the state’s total abortion ban and make abortion legal to Missourians once again. However, the Missouri Supreme Court has, so far, refused to allow the change to take effect. Before Dobbs, Missouri only had a single clinic left, and it’s been shuttered for three years. If the state ever does allow abortion to become legal, reopening a clinic will require a significant expense and effort.
One of the most important lessons that the tragedy of Dobbs can teach us is that a right is hard to retrieve once it’s lost. It’s not impossible, and we cannot afford to stop this fight because it isn’t just about abortion. Trans rights, immigrant justice, freedom for Palestinians — all of these are about our most sacred and fundamental rights.
Bodily autonomy isn’t an empty catch phrase; it’s a worldview, one predicated on everyone’s shared humanity. Dobbs, like many egregious Supreme Court rulings that came before it, is a great injustice, done by the state to the people. To undo that injustice, we cannot simply wait for the state to change hands. Instead, we must do it ourselves.
This article is licensed under Creative Commons (CC BY-NC-ND 4.0), and you are free to share and republish under the terms of the license.
Senate Republicans are under mounting pressure from doctors and medical associations to reject massive cuts to health care and food assistance as they rush to complete a draft of the budget reconciliation bill designed to implement President Donald Trump’s agenda. Despite an ongoing debate over deep cuts to Medicaid — cuts experts say would devastate already underfunded health systems.
Congressional Republicans, looking for ways to offset their proposed tax cuts, are seeking to mandate that millions of Americans work in order to receive federally subsidized health insurance. The GOP tax and budget bill passed the House in May, and Senate Republicans are working feverishly to advance their draft of federal spending cuts in the coming days.
Georgia, the only state with a Medicaid work mandate, started experimenting with the requirement on July 1, 2023. As the Medicaid program’s two-year anniversary approaches, Georgia has enrolled just a fraction of those eligible, a result health policy researchers largely attribute to bureaucratic hurdles in the state’s work verification system. As of May 2025, approximately 7,500 of the nearly 250,000 eligible Georgians were enrolled, even though state statistics show 64% of that group is working.
South Carolina can block Planned Parenthood clinics from receiving Medicaid funds, the Supreme Court ruled in a 6-3 decision on Thursday — a major step toward the longtime conservative goal of “defunding” the nation’s largest family planning provider. The case, Medina v. Planned Parenthood South Carolina, concerns a 2018 order from the state’s Republican governor that barred any clinic…
Activists on May 31 made bold demands, refusing to believe the wealthiest country should have a separate healthcare system for the poor, or that we should wait until we are 65 to access a public healthcare system into which we pay all our working lives. On May 31, activists demanded an end to a system where health insurance CEOs, who worry more about “disappointing investors” than patients, control our health. On May 31, we demanded the end of a system where insurance companies get to make trillions of dollars in earnings and spend millions on federal lobbying to influence government officials who write the laws to benefit the owners and not the people who suffer under it.
Republican efforts to restrict taxes on hospitals, health plans, and other providers that states use to help fund their Medicaid programs could strip them of tens of billions of dollars. The move could shrink access to health care for some of the nation’s poorest and most vulnerable people, warn analysts, patient advocates, and Democratic political leaders. No state has more to lose than…
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In 2022, three Food and Drug Administration inspectors headed to India to investigate a massive Sun Pharma plant that produces dozens of generic drugs for Americans. Over two weeks, they found dangerous breakdowns in the way critical medications were made, and the FDA ultimately placed the factory on an import ban — prohibiting the company from shipping drugs to the United States.
The agency, however, quietly gave the global manufacturer a special pass to continue sending more than a dozen drugs to Americans even though they were made at the same substandard factory that was officially banned from the U.S. market.
It wasn’t the first time. Here are the key takeaways from ProPublica’s 14-month investigation into the FDA’s oversight of foreign drugmakers:
Over a dozen years, the agency entrusted to protect America’s drug supply gave similar exemptions to some of the most troubled foreign drugmakers in India, allowing factories banned from the U.S. market to continue shipping medications to an unsuspecting American public.
A secretive group inside the FDA exempted the medications from import bans, ostensibly to prevent drug shortages. With each pass, the agency dismissed warnings from its own inspectors about dangerous breaches in drug quality on factory floors. All told, the FDA allowed into the United States at least 150 drugs or their ingredients from banned factories found to have mold, foul water, dirty labs or fraudulent testing protocols. Nearly all came from factories in India.
The FDA did not regularly test the drugs exempted from import bans to see if they were safe or actively monitor reports about potential harm among patients. And as the drugs circulated in the United States, the agency kept the practice largely hidden from the public. The FDA said it put protective measures in place, such as requiring third-party oversight of factories to ensure the exempted drugs were safe.
Some of the exempted drugs were recalled — just before or just after they were exempted — because of contaminants or other defects that could cause health problems. And a ProPublica analysis identified more than 600 complaints in the FDA’s files about the exempted drugs at three factories alone, each flagging concerns in the months or years after the medications were excluded from import bans. The reports cite about 70 hospitalizations and nine deaths.
Janet Woodcock, who for more than two decades led the FDA’s Center for Drug Evaluation and Research, said she didn’t see a need to inform the public about the drugs from banned factories because the agency believed they were safe and that such information would create “some kind of frenzy” among consumers who might seek to change their prescriptions. “We had to kind of deal with the hand we were dealt,” she said, noting she supported the exemptions to deal with chronic drug shortages.
Decisions made by the FDA decades ago gave rise to the use of exemptions. In the 2000s, as the cost of brand-name drugs soared, the FDA approved hundreds of generic drug applications for foreign manufacturers that had been in trouble before, companies well-known to the inspectors working to stamp out safety and quality breakdowns.
The exempted drugs that have come to the United States include antibiotics, chemotherapy treatment, antidepressants, sedatives and epilepsy medication.
Sun Pharma did not respond to multiple requests for comment. When the FDA imposed the ban, the company said it would “undertake all necessary steps to resolve these issues and to ensure that the regulator is completely satisfied with the company’s remedial action. Sun Pharma remains committed to being … compliant and in supplying high-quality products to its customers and patients globally.”
Patricia Callahan and Vidya Krishnan contributed reporting. Alice Crites contributed research.
ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.
Joe DeMayo always knew his healthy years could end abruptly, bound to the lifespan of a transplanted kidney about the size of a small fist. But as the father of a toddler, he had hoped to have more time.
When he was 33, his wife had donated her kidney to him, a milestone that changed the course of DeMayo’s life. The relentless fatigue, nose bleeds and itchy skin brought on by his own poorly functioning kidneys vanished, and he felt good enough to leave home in Philadelphia for a new beginning in the foothills of northern California.
Over long afternoons, DeMayo would hike in the mountains with his wife and their black-and-white mutt, Fausto. When his son was born, he’d imagined himself coaching baseball games, clad in Phillies gear.
But his donated kidney started to fail in early 2023, much earlier than expected. The decline came as a surprise to DeMayo, who had been faithfully taking his medications, including tacrolimus, an essential immunosuppression drug that helps stave off organ rejection.
Joe DeMayo, his wife and son at Christmas in 2022. About a year later he would have a second kidney transplant.
(Courtesy of Joe DeMayo)
DeMayo didn’t know at the time that the capsules he swallowed twice a day precisely 12 hours apart could have left him vulnerable — or that one of the most formidable drug regulators in the world may have failed to protect him.
As he grew weaker, his kidney unable to cleanse his body of excess fluid and waste, investigators from the Food and Drug Administration headed to western India to inspect the factory that manufactured DeMayo’s tacrolimus and other generic drugs for American consumers.
It was at least the eighth time since 2015 that the FDA had been there, and each of those visits had uncovered problems in the way the drugs were made, government records show.
During the inspection in the spring of 2023, investigators discovered the Intas Pharmaceuticals factory had, among other things, manipulated drug-testing records to cover up the presence of particulate matter — which could include glass, fiber or other contaminants — in the company’s drugs.
Unaware of the inspection, DeMayo continued taking his tacrolimus capsules. He fought exhaustion and struggled to hold onto his job behind a deli counter.
“Daddy needs a new kidney,” he recalled telling his 5-year-old son at the time.
DeMayo’s tacrolimus medication
(George Etheredge, special to ProPublica)
That November, the FDA barred the Intas factory from exporting drugs to the United States. But under a long-standing practice uncovered by ProPublica, the agency excluded certain medications from the factory-wide ban, including tacrolimus, allowing the drugs to continue flowing to the U.S.
In a statement to ProPublica, Intas, whose U.S. subsidiary is Accord Healthcare, said that the company could not comment on the cases of individual patients but that its tacrolimus is safe and effective. The company said it immediately responded to the FDA’s inspection findings, launching a program focused on quality and investing millions of dollars in upgrades and new hires. Intas also said that some exempted drugs were never shipped to the United States but would not provide details.
“Intas is well on its way towards full remediation of all manufacturing sites,” the company said.
ProPublica’s investigation found the FDA has allowed more than 150 drugs or their ingredients from banned factories into the country over the past dozen years, ostensibly to prevent drug shortages.
The agency did not routinely test the drugs or actively look for signs of sudden or unexplained reactions among patients. And the exemptions were largely kept hidden from Congress and the public, including patients like DeMayo, who counted on his medication to keep him alive.
DeMayo filled another prescription for tacrolimus only days before the FDA exempted it from the Intas import ban and continued taking the capsules until just before his second transplant surgery at Temple University Hospital in January 2024.
“I’m trying to do the right thing, take all my medicine,” said DeMayo, 45, who took Intas tacrolimus for two years. “If I’m doing all that, shouldn’t somebody be doing their due diligence?”
In a statement, the FDA said drugmakers that receive a pass from import bans are required to conduct additional safety and quality testing and hire third-party experts to assess the results before shipping medication to the United States. Current and former FDA officials said those measures are faulty. Many of the companies have been cited before for testing protocols that were ineffective or prone to fraud.
DeMayo, now recovered from his second transplant surgery, gave ProPublica two bottles of his unused Intas tacrolimus capsules. ProPublica had them tested at Valisure, an independent, accredited lab in Connecticut.
The Testing Process
I. Preparation
Valisure conducted three separate tests on DeMayo’s medication. For two of the analyses, technicians emptied the material inside the capsules onto a scale so precise that it protects samples from the movement of air. The material was then put into a solution for testing.
II. Assessment for Dosage
For the first assessment, technicians used a machine to separate, identify and quantify compounds in the solution.
The liquid was poured into tiny vials and then assessed for physical and chemical properties. The analysis revealed how much of the medication’s key ingredient was present and whether it matched the dosage levels described on the label.
III. Testing for Contaminants
Valisure also tested the drug for the presence of toxic elements, including lead, arsenic and mercury. The liquid was put into a machine that breaks down chemicals into atoms using plasma that is 18,000 degrees — hotter than the surface of the sun.
IV. Testing for Dissolution
In the third assessment, a technician prepared a liquid that simulates stomach acid.
Then, the technician placed the pills into small metal cages and dropped them into the liquid.
The testing machine measured how fast the drug dissolved and whether the capsules provided the right amount of medication at the right time.
(Photography by George Etheredge, special to ProPublica)
In their first test, the scientists at Valisure found that some of DeMayo’s pills contained an adequate amount of the key ingredient but others contained a lower amount than the minimum level set by U.S. regulation. Pharmacists, doctors and other experts said underdosing can leave patients vulnerable to organ rejection.
Valisure did not find any substantive contamination in DeMayo’s medication.
But the scientists found another potential problem. The capsules dissolved quickly — up to three times faster than the name brand. Rapid dissolution can introduce too much of the drug too quickly, experts said, potentially causing tremors, headaches and kidney failure.
Note: Data was modeled by Valisure using the Weibull model. The chart depicts modeled data for 1 mg capsules.
(Lucas Waldron/ProPublica)
ProPublica did not test tacrolimus made by any other manufacturer. In its statement, Intas said that the findings are “unrelated to the [FDA’s] inspections” and that the FDA had determined the drug was equivalent to the brand-name version when it was first approved for the U.S. market.
Valisure previously tested Intas’ tacrolimus for the Department of Defense, which is conducting safety and quality testing on more than three dozen drugs commonly used by U.S. service members and their families. Those tests, too, showed the capsules dissolved too quickly.
“This is an alarming signal of other quality issues that can be affecting patient care,” said retired Army Col. Vic Suarez, who helped launch the Defense Department effort and is assisting on the project.
The FDA conducted its own studies of Intas’ tacrolimus in recent years and reported a similar result on its website. The agency noted there was no apparent risk of organ rejection but said the Intas generic could create toxins in the body, which can cause kidney damage. The FDA said the capsules may not provide the same therapeutic effect as the brand-name version.
The findings were made public in September 2023. Weeks later, the agency went on to excuse the drug from the Intas import ban, allowing the company to continue shipping tacrolimus to the United States.
Janet Woodcock, who for years led the FDA’s Center for Drug Evaluation and Research, said in an interview that the results of the testing are concerning and that the agency should quickly “try to sort them out.”
“This obviously was a quality problem,” she said.
Woodcock did not say why the FDA exempted the drug from the import ban imposed on the Intas factory. Though Woodcock approved exemptions for years, she had left the center and was serving as the FDA’s principal deputy commissioner when the exemptions for tacrolimus and other Intas drugs were made.
DeMayo said he’ll never know whether the medication contributed to the loss of his donated kidney. Organ rejection, which can happen quickly or over years, is among the most common causes of kidney failure in transplant patients, but kidneys can fail for other reasons, too, said Joseph Vassalotti, chief medical officer at the National Kidney Foundation.
In DeMayo’s case, he was hospitalized with a stomach virus and dehydration the same year his kidney function started to decline. Still, he questions the drug that was supposed to protect him and worries that other transplant patients who have taken Intas tacrolimus could be at risk.
One and a half years after the FDA banned the factory from shipping drugs to the United States, tacrolimus is still excluded. A customer service agent for the company said Intas recently stopped distributing the drug, but the company did not respond to a request for comment.
“The people who oversee the pills are failing and the people who are making the pills are failing,” DeMayo said. “How did it get so bad?”
In January, one year after his second kidney transplant, DeMayo went to Temple University Hospital for a follow-up appointment.
(First and third photos: Hannah Yoon for ProPublica. Second photo: George Etheredge, special to ProPublica.)
When it comes to vaccines, there are two kinds of parents coming into Dr. Megan Prior’s office in Washington, D.C., these days. One set are parents who pepper the pediatrician with increasingly panicked questions about the future availability of vaccines and whether their children can get any shots early. Then there are the parents who feel vindicated in their decision not to vaccinate their…
On a sweltering morning in western India in 2022, three U.S. inspectors showed up unannounced at a massive pharmaceutical plant surrounded by barricades and barbed wire and demanded to be let inside. For two weeks, they scrutinized humming production lines and laboratories spread across the dense industrial campus, peering over the shoulders of workers at the tablet presses…
We are still reporting. If you are a current or former FDA employee or someone in the industry with information about the agency, the safety of generic drugs, or the manufacturers that make them, our team wants to hear from you. Megan Rose can be reached on Signal or WhatsApp at 202-805-4865. Debbie Cenziper can be reached on Signal or WhatsApp at 301-222-3133. You can also email us at FDA@propublica.org.
ProPublica has sued the U.S. Food and Drug Administration in federal court in New York, accusing the agency of withholding information about the safety and availability of generic drugs critical to millions of Americans.
For years, Congress, watchdog groups, doctors and others have questioned the quality of generic drugs made in factories overseas. To better understand how the FDA regulates the industry and protects consumers, ProPublica submitted four records requests last year under the Freedom of Information Act.
The FDA declined to quickly release the documents, including records that would identify drugs made at some of the most troubled factories in India. Inspection reports that describe unsafe manufacturing conditions are public, but the FDA redacts the names of the medications made in those factories.
“Americans (including pharmacists, doctors, hospital systems, policy makers) cannot see for themselves which drugs may have been made in unsafe facilities,” the lawsuit said.
ProPublica requested the records as part of an ongoing investigation into the safety of America’s generic drug supply. ProPublica has reported that the FDA allowed some manufacturers to continue shipping their drugs to Americans even after the factories that made them were found in violation of quality standards and banned from the U.S. market. More than 150 drugs or their ingredients were given these little-known exemptions over the past dozen years.
In its response to ProPublica’s initial records request, the FDA said the news organization had not demonstrated “a compelling need” to expedite the release of documents. Since the lawsuit was filed in November, the agency has begun to turn over some of the requested records. The case is still active in federal court in New York.
ProPublica has argued the records will help inform American consumers, who increasingly rely on generic drugs made overseas. Quality concerns have dogged the industry for years: In 2023, four people died after using tainted eye drops made in India, and others had to have their eyeballs surgically removed.
“Every single one of us relies on the FDA to ensure that the medicines we take and give our loved ones are safe,” said ProPublica’s outside counsel, Jack Browning, a partner at Davis Wright Tremaine. “With the increasing prevalence of offshore manufacturing, it is imperative for organizations like ProPublica to ensure that safety violations are not being swept under the rug.”
The Department of Health and Human Services, which oversees the FDA, declined to comment on the case, citing the ongoing litigation.
This is the second time ProPublica has sued the FDA in recent years.
In 2023, the news outlet and the Pittsburgh Post-Gazette filed a lawsuit against the agency for withholding records related to the massive recall of breathing machines made by Philips Respironics. The agency ultimately provided the documents.
Dailey and Nguyen are with Northwestern University’s Medill Investigative Lab in Washington, D.C.
Senate Republicans on Monday proposed cutting Medicaid even more aggressively than their House colleagues to help offset the cost of trillions of dollars in tax breaks that would disproportionately benefit the wealthiest Americans. The legislative text unveiled by the GOP-controlled Senate Finance Committee is a central component of the sprawling reconciliation package that Republicans are…
We are still reporting. If you are a current or former FDA employee or someone in the industry with information about the agency, the safety of generic drugs, or the manufacturers that make them, our team wants to hear from you. Megan Rose can be reached on Signal or WhatsApp at 202-805-4865. Debbie Cenziper can be reached on Signal or WhatsApp at 301-222-3133. You can also email us at FDA@propublica.org.
On a sweltering morning in western India in 2022, three U.S. inspectors showed up unannounced at a massive pharmaceutical plant surrounded by barricades and barbed wire and demanded to be let inside.
For two weeks, they scrutinized humming production lines and laboratories spread across the dense industrial campus, peering over the shoulders of workers at the tablet presses, mixers and filling machines that produce dozens of generic drugs for Americans.
Much of the factory was supposed to be as sterile as an operating room. But the inspectors discovered what appeared to be metal shavings on drugmaking equipment, and records that showed vials of medication that were “blackish” from contamination had been sent to the United States. Quality testing in some cases had been put off for more than six months, according to their report, and raw materials tainted with unknown “extraneous matter” were used anyway, mixed into batches of drugs.
Sun Pharma’s transgressions were so egregious that the Food and Drug Administration imposed one of the government’s harshest penalties: banning the factory from exporting drugs to the United States.
But the agency, worried about medication shortages, immediately undercut its mission to ensure the safety of America’s drug supply.
A secretive group inside the FDA gave the global manufacturer a special pass to continue shipping more than a dozen drugs to the United States even though they were made at the same substandard factory that the agency had officially sanctioned. Pills and injectable medications that otherwise would have been banned went to unsuspecting patients across the country, including those with cancer and epilepsy.
The FDA didn’t routinely test the medications for quality problems or use its vast repository of drug-related complaints to proactively track whether they were harming the people who relied on them.
And the agency kept the exemptions largely hidden from the public and from Congress. Even others inside the FDA were unaware of the details.
In the hands of consumers, according to the FDA’s longtime head of drug safety, the information would have caused “some kind of frenzy.”
“We felt we didn’t have to make it a public thing,” said Janet Woodcock, who spent nearly four decades at the agency.
The exemptions for Sun weren’t a one-time concession. A ProPublica investigation found that over a dozen years, the same small cadre at the FDA granted similar exemptions to more than 20 other factories that had violated critical standards in drugmaking, nearly all in India. All told, the group allowed into the United States at least 150 medications or their ingredients from factories with mold, foul water, dirty labs or fraudulent testing protocols.
The FDA inspection report of the Sun Pharma factory in India warned of leaks that could allow dirty water into a sterile area where drugs were made.
(Obtained by ProPublica. Highlighted by ProPublica.)
Some of the drugs were recalled — just before or just after they were exempted — because of contaminants or other defects that could cause health problems, government records show. And a ProPublica analysis identified more than 600 complaints in the FDA’s files about exempted drugs at three of those factories alone, each flagging concerns in the months or years after they were excluded from import bans in 2022 and 2023.
The “adverse event” reports about drugs from the Sun plant and two others run by Indian drugmaker Intas Pharmaceuticals described medication with an abnormal taste, odor or residue or patients who had experienced sudden or unexplained health problems.
The reports cite about 70 hospitalizations and nine deaths. And those numbers are conservative. ProPublica limited its count to reports that linked problems to a single drug. However, the total number of complaints to the FDA that mention exempted drugs is in the thousands.
“Abdominal pain … stomach was acting very crazy,” one report said about a woman using a seizure drug from Sun Pharma. The FDA received the complaint in 2023, nine months after it excluded the medication from the import ban.
“Feeling really hot, breaking out with hives, hard to breathe, had confusion, glucose level was high, heart rate went up and head, arms and hands got numb,” noted another report about a patient taking a sedative from Intas. The complaint was sent to the FDA in June 2023, the same month the agency exempted the medication.
The outcomes described in the complaints may have no connection to the drug or could be unexpected side effects. In some cases, the FDA received complaints about the same drugs made by other manufacturers.
Still, the seriousness of the reports involving exempted drugs did not galvanize the agency to investigate, leaving the public and the government with no way of knowing whether people were being harmed and, if so, how many.
Those unknowns have done little to slow the exemptions. In 2022, FDA inspectors described a “cascade of failure” at one of the Intas plants, finding workers had destroyed testing records, in one case pouring acid on some that had been stuffed in a trash bag. At the second Intas factory, inspectors said in their report that records were “routinely manipulated” to cover up the presence of particulate matter — which could include glass, fiber or other contaminants — in the company’s drugs.
A 2022 FDA inspection report described “a cascade of failure” at one of the Intas plants, noting that employees were observed destroying records “by tearing it into pieces.”
(Obtained by ProPublica. Highlighted by ProPublica.)
The FDA barred both plants in 2023 from shipping drugs to the U.S. Then the agency simultaneously granted more than 50 exemptions to those banned factories — the broadest use of exclusions in ProPublica’s analysis.
Intas, whose U.S. subsidiary is Accord Healthcare, said in a statement that the company has invested millions of dollars in upgrades and new hires and launched a companywide program focused on quality. Exempted drugs were sent to the United States in a “phased manner,” the company said, with third-party oversight and safety testing. Intas also said that some exempted drugs were never shipped to the United States because the FDA found other suppliers. The company would not provide details.
“Intas is well on its way towards full remediation of all manufacturing sites,” the company said.
Sun did not respond to multiple requests for comment. When the FDA imposed the ban, the company said it would “undertake all necessary steps to resolve these issues and to ensure that the regulator is completely satisfied with the company’s remedial action. Sun Pharma remains committed to being … compliant and in supplying high-quality products to its customers and patients globally.”
“We’re supposed to have the best medicine in the world,” said Joe DeMayo, a kidney transplant patient in Philadelphia who took an immunosuppression medication made by Intas until December 2023, unaware that a month earlier the FDA had excused the drug from an import ban. “Why are we buying from people who aren’t making it right?”
Joe DeMayo, a father and grocery store worker, had no idea the capsules he took every day to protect his transplanted kidney were coming from a factory in India that the FDA had banned from the U.S. market.
(Hannah Yoon for ProPublica)
An excerpt from an FDA inspection of an Intas factory about its manufacturing of sterile drugs
(Animation by Lisa Larson-Walker/ProPublica)
How the United States wound up here — playing a game of chance with risky drugs made thousands of miles away — is the story of an agency that has relentlessly pressed to keep the supply of low-cost generics flowing even as its own inspectors warned that some of those drugs posed a potentially lethal threat to the American public.
The vast majority of the prescriptions filled in the country are for generic drugs, from penicillin to blood thinners to emergency contraception, and many of those come from overseas, including India and China. For years, the FDA has vouched for the quality of generics, assuring the public in press releases, speeches and social media campaigns that they are just as safe and effective as brand-name drugs.
That guarantee came under serious question in 2019 when journalist Katherine Eban published a breakthrough book, “Bottle of Lies,” that exposed rampant fraud and manufacturing violations in Indian factories and the FDA’s reluctance to aggressively investigate.
ProPublica identified another alarming level of entrenched failure: Even when the agency did investigate and single out factories that were among the worst in India, it still gave them access to American consumers. All the while, patients took their medicine without question, trusting an agency that has long been considered the gold standard in drug regulation.
While specialized business publications have sometimes reported on exemptions when they happen, they’ve offered little context and few specifics.
The FDA in many ways put itself in this untenable position, forced to decide between not having enough drugs or accepting potentially dangerous ones, interviews and government records show.
For years, the agency gave companies with a history of manufacturing breakdowns approval to produce an increasingly larger share of generic drugs, allowing them to become a dominant force in American medicine with the power to disrupt lives if production lines were shuttered.
“It’s our own fault,” said former FDA inspector Peter Baker, who reported a litany of failures during inspections in India and China from 2012 to 2018. “We allowed all these players into the market who never should have been there in the first place. They grew to be monsters and now we can’t go back.”
The decisions to weaken penalties and allow banned factories to continue sending drugs to the United States were approved by Woodcock, one of the agency’s most powerful administrators. For more than two decades, she led the Center for Drug Evaluation and Research, the arm of the FDA that serves as the country’s gatekeeper for new and generic drugs.
In a series of interviews with ProPublica, Woodcock said she supported the use of exemptions “as a practical approach.”
“We had to kind of deal with the hand we were dealt,” she said.
Janet Woodcock, who served for years as the country’s top drug regulator, said she believed the drugs coming into the United States from banned factories were safe. The FDA did not routinely test the drugs for quality problems.
(Jason Andrew for ProPublica)
Woodcock said she didn’t see a need to inform the public because the agency believed the drugs were safe. She said she mentioned the practice periodically in closed-door meetings with congressional staffers, but she did not provide specifics about those conversations.
After Woodcock left her post in 2020 to help lead the agency’s response to the COVID-19 pandemic, the exemptions — including those for Sun and Intas — continued under her successor, Patrizia Cavazzoni. Cavazzoni, who left the agency earlier this year and rejoined Pfizer, declined to comment.
Former FDA Commissioner Robert Califf, who led the agency when Sun and Intas received exemptions, told ProPublica that tough calls had to be made and the practice did not worry him.
The FDA did not respond to questions about who made those decisions or how the drugs were evaluated, and it declined requests for interviews with officials who currently oversee drug regulation. In an email, the agency said the exemptions are “thoroughly evaluated through a multi-disciplinary approach.”
Years after the FDA started granting exemptions, some current and former officials say they wrestle with a lingering fear that bad drugs are circulating in the United States.
“It’s not even a hypothetical,” said one senior FDA employee familiar with the exemptions, who, like others, spoke on the condition of anonymity because they were not authorized to speak publicly. “It’s not a question of if — it’s a question of how much.”
“It Was Rotten Eggs”
Although the FDA has been giving companies a way around import bans since at least 2013, the internal process was so secretive that many current and former FDA officials said they have no idea how many exemptions have been granted or for what drugs. In an email, the agency said it did not maintain a comprehensive list.
Even two high-level FDA staff members who worked on drug shortage challenges for the agency said in interviews they had never heard of the exemptions.
Congress required the FDA in 2012 to provide specific information every year about how and when the agency relaxed its rules for errant drugmakers to prevent shortages. But the FDA did not mention exemptions to import bans until 2024 — and only then in a single footnote of its 25-page report to Congress.
ProPublica uncovered the frequent use of exemptions by searching for the “import alert” list published on the FDA’s website that names factories banned from the U.S. marketplace. Because the agency publishes only a current list and doesn’t make the old ones public, the news organization used internet archives and FDA documents maintained by the data analytics company Redica Systems, ultimately compiling import alerts dating back more than a decade. The lists identify the drugs exempted from bans but provide few other details.
ProPublica reviewed scores of inspection reports and corporate documents for overseas factories and interviewed more than 200 people, including current and former officials of the FDA, to understand the little-known practice and the ongoing threat posed by the agency’s decisions.
The investigation revealed not only how many drugs received exemptions from import bans, but also how long the FDA allowed those exemptions to stay in place — in some cases for years.
The agency has removed exemptions when there is no longer a shortage concern. In those cases, the drugs are then banned along with the others at the factory. Both Sun and Intas have had drugs that lost their exemptions.
Two and a half years after the Sun factory was banned, five drugs are still exempted. Intas, whose factories were banned in 2023, currently has 24 drugs on the list. The bans themselves are removed only after companies fix the problems.
Earlier this month, the FDA went back to the Sun Pharma factory for a surprise inspection and found ongoing problems, according to a Sun filing with the Indian stock exchange and Indian media reports. The concerns focused on the way sterile drugs were made, including some of the exempted drugs still being sent to the United States, according to a person familiar with the situation who did not want to be named because they were not authorized to speak publicly.
The FDA said it put protections in place for exempted drugs: Manufacturers are required to conduct additional quality checks before they are sent to the United States. That has included extra drug-safety testing, in some cases at an independent lab, and bringing on third-party consultants to verify the results.
The agency did not provide ProPublica with the names of the third-party consultants hired by Sun and Intas. Intas declined to name its consultants.
“The odds of these drugs actually not being safe or effective is tiny because of the safeguards,” said one former FDA official involved in the exemptions who declined to be named because he still works in the industry and fears professional retribution. “Even though the facility sucks, it’s getting tested more often and it’s having independent eyes on it.”
But current and former FDA inspectors said those safety measures require trusting the vigilance of companies that were banned, at least in part, for providing unreliable or deceptive test results to the government or failing to investigate reports about drugs with contaminants or other quality concerns.
The FDA has granted exemptions from import bans to more than 20 foreign factories despite serious quality issues. In this 2019 inspection of a factory in south-central India, inspectors found cross-contamination on drugmaking equipment.
(Obtained by ProPublica. Highlighted by ProPublica.)
The FDA could have done its own routine testing of the exempted drugs but chose not to. The agency said in an email that it tests the drugs using a “risk-based approach” but would not provide ProPublica with any information about which drugs have been tested and what the results were.
Woodcock said testing was expensive and budgets were tight. She acknowledged that regularly assessing the exempted drugs for quality or safety concerns “would have enhanced our confidence … and made everyone more comfortable.”
The European Union, by contrast, requires drugs made in India and China to be checked for quality on EU soil. And the U.S. Department of Defense is conducting its own testing of more than three dozen generic medications and has already identified potency and other quality issues.
“If you don’t know about the quality of the product, why are you letting it in?” said Murray Lumpkin, the FDA’s former deputy commissioner for international programs, who left the agency in 2014 before most of the exemptions were granted.
Beyond the lack of testing, the FDA didn’t actively look for patterns of harm among the exempted drugs in its adverse event database, Woodcock and others said.
ProPublica’s analysis of that data found thousands of reports both before and after the factories were given a pass to sidestep import bans. The reports described unexpected cases of cardiac arrest, blurred vision, choking, vertigo and kidney injuries, among other issues — and in some instances identified specific concerns about how the drugs were made.
Photos from an FDA inspection show discarded and shredded records. Drugmakers are supposed to retain records like these for inspectors to review to prove that drugs going to American consumers are safe and effective.
(Obtained by ProPublica)
One person who took Intas’ clonazepam, a sedative and epilepsy drug, reported getting “brain zaps” and bright blue teeth from the coating of dye on the drug. The FDA received the complaint the same month the agency exempted the drug from the import ban.
Even before the FDA exempted Intas’ antidepressant bupropion, consumers reported that it made them sick, wasn’t always effective and had an abnormal odor, which pharmacists and others say can happen when an inactive ingredient breaks down.
“It was rotten eggs,” Nari Miller, a geologist in California who took the pills in 2022 and had severe stomach pain, told ProPublica. “I opened it and smelled it when I got home and it was awful.”
Intas said it could not respond to specific complaints and that all drugs have side effects. “Intas and Accord pay attention to each and every adverse event report,” the company said, adding, “Accord and Intas are committed to continuing to bring safe and effective medicines to patients.”
In its statement, the FDA said the database is monitored weekly for new reports in general. Woodcock, however, acknowledged the reports about exempted drugs, ideally, “would be under much more scrutiny.”
Excerpt from an FDA inspection of the Sun Pharma factory that led to an import ban
(Animation by Lisa Larson-Walker/ProPublica)
Decisions made by the FDA decades ago gave rise to the use of exemptions and the risks that now confront the American public.
When new brand-name drugs come to market, they are protected by patents and exclusive sales rights that make them generally expensive. When patents expire, generic drug companies rush in to make their own versions, which are supposed to be equivalent to the brand. Generics are often far cheaper, and insurance companies typically insist that patients use them.
In the 2000s, as the cost of brand-name drugs soared, the FDA began to approve large numbers of generics. The agency, however, gave hundreds of those approvals to foreign manufacturers that had been in trouble before, companies well known to the inspectors working to stamp out safety and quality breakdowns at overseas factories, ProPublica found.
The FDA granted Sun Pharma alone more than 250 approvals for generic drugs since the late 2000s, when the company started amassing violations, records show. The agency’s decisions helped to transform the company from a local provider in India to one of the leading exporters of medications to the United States, with nearly $2 billion in annual U.S. sales.
The approvals kept coming as inspectors continued to raise concerns about manufacturing practices at the company’s factories in India, government records show.
More problems were found at a factory that Sun had acquired in Detroit, where the diabetes drug metformin was contaminated with metal scrapings. The violations were so significant that federal marshals in 2009 raided the plant and seized drugs. The company eventually shuttered the factory.
The rapid expansion of Sun and other foreign drugmakers set off new alarms among inspectors, their supervisors and advisers to Woodcock.
“In a rational system, you would have said, ‘This company is not producing properly, so let’s not approve any more of their drugs,” said William Hubbard, former FDA deputy commissioner for policy, planning and legislation. “The agency in a sense kind of let this happen.”
Ajaz Hussain, the former deputy director of an FDA office that oversaw pharmaceutical science, said that after leaving the agency and becoming a consultant, he made his concerns known in meetings with Woodcock and others.
“They can’t manufacture it. Why do you keep approving it?” Hussain recalled in an interview with ProPublica. “I said, ‘Wake up.’ … But they didn’t listen.”
Hussain in 2012 went to work for Wockhardt, one of the largest pharmaceutical companies in India, but quit eight months later after he said he told his superiors about manufacturing failures in the company’s factories.
Although FDA inspectors had reported lapses after multiple visits to Wockhardt plants between 2004 and 2012, the agency cleared the way for the company to export sedatives, antibiotics, beta blockers, painkillers and other generics to the United States, records show. Wockhardt received exemptions from import bans in 2013. The company did not respond to repeated requests for comment, but at the time, the company said it was going to quickly address the FDA’s concerns.
The FDA could have denied generic drug applications — nothing in the law prohibits the agency from saying no to companies with spotty track records. In an email, the FDA said it considers a company’s history and conducts inspections in some cases before issuing approvals.
Woodcock said the agency knew which factories were poor performers but feared being sued by companies blocked from introducing new drugs based on past behavior. Instead, she said that she tried to convince drugmakers to invest in equipment and practices that would turn out higher-quality drugs.
“We had many meetings about this, and we agonized about all these problems,” she said.
But little changed.
Shortages vs. Quality
In 2008, dozens of Americans were killed by contaminated blood thinner from China. So when Margaret Hamburg was appointed commissioner of the FDA in the aftermath of the crisis, she pressed the agency to crack down on overseas drugmakers.
Her efforts ran headlong into what would become the worst drug shortage in modern history. By 2010, cancer drugs were scarce. So were the drugs on hospital crash carts. In all, more than 200 critical medications were in short supply.
Razor-thin profit margins had limited the number of companies that were willing to make generic drugs. And the FDA’s enforcement overseas had forced some manufacturing lines to temporarily shut down, which exacerbated the problem.
LeRoy Hubley, whose wife and son died after taking a tainted generic blood thinner from China, testified before Congress in 2008. The crisis helped prompt the FDA, under Commissioner Margaret Hamburg, to ramp up inspections of overseas drugmakers.
(Brendan Smialowski/Bloomberg News)
Congress lambasted the FDA for the shortages and started requiring the agency to prove every year how it was combatting the problem.
At the time, the FDA had a small team focused on shortages that operated on the edges of Woodcock’s 4,000-person Center for Drug Evaluation and Research. With the pressure on, Woodcock elevated the team in 2010 to report directly to her deputy, a move that gave those staff members a commanding voice at the highest levels of the agency, several former staffers told ProPublica.
After 16 years in top leadership roles, Woodcock was formidable enough to force a culture change. Standing 5’2” in FDA conference rooms where she had often been disregarded as the lone woman, Woodcock had fought for her status — sometimes, she said, pushed nearly to tears with frustration. The board-certified internist asserted her authority by wielding data, what she called “brute force” and the soft persuasion of an occasional gift of an orchid, picked from her garden in suburban Maryland.
Woodcock, an avid gardener, retired from the FDA last year.
(Jason Andrew for ProPublica)
By 2010, Woodcock had marshalled the center into a powerhouse with great independence — in many ways, outside the reach of the political whims of the commissioners who came and went. Those who worked with her over the years said despite her approachable manner, she fiercely guarded her territory.
In the conference room next to Woodcock’s office, the drug shortage staff began to weigh in whenever the FDA’s compliance team moved to penalize wayward drugmakers because of bad inspections, according to several former FDA officials involved in the deliberations.
Sometimes the small group would decide that a factory could no longer ship drugs to the United States and would try to get other manufacturers to make more. And other times, the group determined that exemptions from import bans were the only course.
Discussions could be tense and often lasted for weeks. A former employee on the compliance team told ProPublica that they repeatedly argued to impose a total import ban on a foreign factory because they feared the drugs couldn’t be trusted. They were left feeling uncomfortable about an exemption granted anyway — for a product that they would not use themselves.
Without exemptions, Woodcock told ProPublica, the FDA might have been forced to source the drugs from a “totally unknown manufacturer, say, from China or somewhere.”
Current and former FDA officials said the concessions became a yearslong practice rather than a stopgap measure and that the protections put in place by the agency were not sufficient. They question why Woodcock and her successor didn’t do more to raise alarms with Congress or the public about the decision to rely on inadequate factories for critical drugs.
Woodcock said she thought the exemptions were a symptom of larger issues involving the drug supply that the FDA had no control over — the agency, for example, can’t force companies concerned about slim profit margins to produce generic drugs.
Two former FDA commissioners told ProPublica they knew about the practice but were not included in the decision-making.
Hamburg, who spent six years at the agency under the Obama administration, said the extent of the practice surprised her. “Had I known that it was sort of an open-ended policy, I would have been disturbed,” she said.
One of her successors, Stephen Hahn, appointed during President Donald Trump’s first term, said more people should have been involved in the decisions.
“You’re talking about a drug of questionable quality being brought into the country,” he said.
Woodcock said she did not believe she needed their input. “I didn’t think in the individual circumstances it was necessary to elevate,” she said, “because what could they do?”
Excerpt from an FDA inspection of the Sun Pharma factory that led to an import ban
(Animation by Lisa Larson-Walker/ProPublica)
In 2020, the billionaire founder of Sun Pharma joined a pivotal conference call with FDA compliance and investigative staff.
Dilip Shanghvi, whose father had run a wholesale drug business in Kolkata, India, started the company in the 1980s and ultimately turned Sun Pharma into one of the largest suppliers of generic drugs in the United States. On the call, Shanghvi spoke about improvements at Sun’s enormous plant in the Indian city of Halol, according to an FDA official who attended the meeting.
Among other drugs, the plant produced at least 16 sterile injectables for the U.S. market, according to a Sun email to the FDA obtained by ProPublica. Injectables are particularly dangerous if contaminated because the medication is injected directly into the body, unlike a pill that goes through the filtering of the digestive tract.
The company also had to recall more than 135,000 vials of vecuronium bromide, a muscle relaxer used during surgery, after reports that the medication contained glass particles. Sun said the defect could cause life-threatening blood clots.
On the call with the FDA, according to the agency official, Shanghvi assured the government that the Halol plant was turning out high-quality products.
Yet, when the three investigators went back to the factory that scorching morning in 2022 for the surprise inspection, it was clear within days that the FDA would have to take swift action.
Splitting up to check different parts of the plant, the inspectors quizzed workers about cleaning procedures and looked at disassembled equipment to see if it was contaminated with residue from old drugs. At one point, they spotted water leaking near areas where sterile drugs were made, an alarming observation because water can introduce contaminants capable of causing infections or even death.
Digging through company records and test results, they found more evidence of quality problems, including how managers hadn’t properly investigated a series of complaints about foreign material, specks, spots and stains in tablets.
The 2022 FDA inspection report of Sun’s Halol plant described metal particles in vials of injectable medication.
(Obtained by ProPublica. Highlighted by ProPublica.)
Several FDA employees familiar with the inspection report — 23 pages of detailed violations — said they had no idea why the agency went on to exclude so many of Sun’s drugs from the subsequent import ban.
“We know what was found,” said the FDA official who attended the meeting with Shanghvi. “How could you trust [those] drugs?”
Sun did not respond to questions about the recalls or its regulatory history with the FDA. In its 2023-24 annual report, the company said, “We have a relentless focus on 24×7 compliance to ensure continuity of supplies to our customers and patients worldwide.”
The specific findings of the FDA’s latest inspection of the Sun plant conducted this month have not yet been made public, and the company did not respond to a request for comment.
To some current and former FDA officials and other experts, plugging a supply shortage with drugs that may be contaminated or ineffective is no solution at all.
“That might be helping a shortage but might be creating a new problem,” said Lumpkin, the former deputy commissioner.
Last summer, a pair of FDA investigators arrived at another manufacturing plant in India that had a bustling production line. After more than a week at the Viatris factory, they left with a familiar list of safety and quality violations.
The inspectors found that equipment wasn’t clean and managers failed to thoroughly investigate unexplained discrepancies in test results.
In a statement to ProPublica, Viatris said it immediately worked to resolve the FDA’s concerns. “Patient safety remains our primary and unwavering focus,” the company said.
Just before Christmas, the FDA banned the facility from exporting drugs.
Then the agency gave the factory a pass, and four of its drugs are still bound for the United States.
Patricia Callahan and Vidya Krishnan contributed reporting, and Alice Crites contributed research.
Medill Investigative Lab students Haajrah Gilani, Emma McNamee, Julian Andreone, Isabela Lisco, Aidan Johnstone, Megija Medne, Yiqing Wang, Phillip Powell, Gideon Pardo, Casey He, Lindsey Byman, Josh Sukoff, Kunjal Bastola, Shae Lake, Alyce Brown, Zhiyu Solstice Luo, Jessie Nguyen, Sinyi Au, Kate McQuarrie and Katherine Dailey contributed reporting.
We are still reporting. If you are a current or former FDA employee or someone in the industry with information about the agency, the safety of generic drugs, or the manufacturers that make them, our team wants to hear from you. Megan Rose can be reached on Signal or WhatsApp at 202-805-4865. Debbie Cenziper can be reached on Signal or WhatsApp at 301-222-3133. You can also email us at FDA@propublica.org.
It’s been 17 years since tainted blood thinner from China injured or killed hundreds of people in the United States, and since then, contaminants and other defects have appeared in a cross section of America’s generic drugs.
The investigation exposed how the FDA, without warning the public, allowed more than 150 drugs or their ingredients into the United States over the past dozen years even though they were made at factories banned from shipping products here. The agency did not routinely test the drugs as they were circulating in the United States or actively track whether consumers had been harmed.
The FDA and several former agency officials told ProPublica they believed the medications that were exempted from import bans were safe. They said the agency required generic drugmakers to conduct additional quality checks before the drugs were sent to the United States, including extra drug-safety testing and bringing on third-party consultants to verify the results.
To conduct its analysis, Propublica used Redica Systems, a quality and regulatory intelligence company with a vast collection of agency documents, as well as the Internet Archive’s Wayback Machine, to find hundreds of “import alert” lists published by the FDA over more than 15 years. The lists identified factories barred from shipping drugs to the United States because the FDA found manufacturing violations.
In examining those lists, reporters discovered references to drugs or raw ingredients that the FDA had excluded from the bans. The exemptions were mentioned with almost no explanation, scattered throughout the often lengthy alerts.
Because the FDA does not keep a comprehensive list of drugs that have been exempted from bans over the years, ProPublica had to build one. Reporters employed two distinct methods to do this. First, ProPublica wrote code that used keyword search and pattern matching to pull drug names and manufacturing locations from the FDA alerts. Second, ProPublica used artificial intelligence to extract the same information. Results from each analysis were cross-checked, and reporters verified each of the results.
In finalizing its analysis, ProPublica counted all drugs that were exempted from each banned factory. Sometimes, the same drug was exempted from multiple factories and was added to each factory’s total. In a handful of cases, the FDA exempted different formulations of the same drug, such as a tablet, capsule or injectable. ProPublica counted those different forms as distinct drugs.
ProPublica’s list of drugs exempted from import bans could be an undercount; there is no way to know for sure without a full accounting from the FDA.
The reporting team interviewed more than 200 people, including former FDA inspectors who repeatedly reported breakdowns in drugmaking overseas and top administrators directly involved in drug safety. ProPublica also obtained troves of government and corporate documents in the United States and India and filed suit against the FDA in November after the agency said it would take as long as two years to turn over public records related to drug safety. The FDA has since begun to provide some of the requested records; the case is active in federal court in New York.
ProPublica paid Redica for access to FDA inspection records and ultimately reviewed reports spanning more than two decades.
To gauge what the FDA knew about the drugs before and after they were exempted from import bans, ProPublica drew on reports from the agency’s Adverse Event Reporting System. The reports are submitted to the FDA by consumers, health care professionals, drug companies and others and used by the agency to detect safety concerns and potential patterns of harm. Each contains information about conditions or reactions linked to drugs and, in some cases, complaints about product quality.
ProPublica identified more than 8,000 reports about the drugs excused from factorywide import bans both before and after the bans were put in place. ProPublica’s analysis included reports from 2010 to early 2025.
The FDA has cautioned that information in the reports is not verified and there may be no “causal relationship” between the drug and the adverse event. Multiple drugs are sometimes listed in a single adverse event report. ProPublica limited its analysis to cases that listed only one primary suspect drug.
Some reports don’t list specific concerns but instead reference academic studies; ProPublica excluded those reports.
To examine the FDA’s role in the growth of foreign drugmakers, ProPublica used the agency’s Orange Book, a register of drugs considered safe and effective by the FDA. The list includes approvals for both brand name and generic drugs, the dates the drugs were approved and the names of the companies that submitted the applications. ProPublica’s analysis showed that companies with troubled regulatory histories received scores of approvals to introduce generic drugs in the United States — and some went on to receive exemptions from import bans.
Journalists have been uncovering problems with generic drugs for years. Katherine Eban’s bestselling 2019 book, “Bottle of Lies,” exposed how Indian drugmakers failed to follow basic quality and safety standards and often knowingly sent shoddy drugs abroad. In 2023, a Bloomberg investigation revealed, among other things, how poisoned cough syrup made in India spread around the world. And the independent watchdog The People’s Pharmacy has raised repeated concerns about the quality of some generic drugs.
ProPublica collaborated with journalism students from Northwestern University’s Medill Investigative Lab in Washington, D.C. Haajrah Gilani, Emma McNamee, Julian Andreone, Isabela Lisco, Aidan Johnstone, Megija Medne, Yiqing Wang, Phillip Powell, Gideon Pardo, Casey He, Lindsey Byman, Josh Sukoff, Kunjal Bastola, Shae Lake, Alyce Brown, Zhiyu Solstice Luo, Jessie Nguyen, Sinyi Au, Kate McQuarrie and Katherine Dailey contributed to this report.
If the budget reconciliation package before the U.S. Senate becomes law in the coming weeks, reproductive health advocates say the provision that would cut federal funding to Planned Parenthood clinics could serve as a backdoor nationwide abortion ban, eliminating access to 1 in 4 abortion providers. The Republican-led bill, which already passed the House by a slim margin, is more than 1,000…
From voting rights to health care to workplace equality, the U.S. Supreme Court will weigh in on a number of issues this summer that could have major implications for Black Americans.
“In America, for Black people, we’ve had a long season where our rights were generally respected,” said Andrea Young, executive director of the ACLU, who has been closely following the Trump administration’s legal moves. “We have Black elected officials … Black leaders in corporate America, we have extreme poverty, but we also have thriving middle class communities. We have many areas where we have lots of highly educated black people. All of those things rest on a legal framework that allows those rights to be protected.”
The D-Day anniversary on June 6 is a pretty irresistible date for scheduling a protest related to veterans benefits. Eighty-one years ago, American soldiers and their allies stormed ashore in Normandy, establishing a critical beachhead in the military campaign to defeat Adolph Hitler and Nazism.
In World War II‘s aftermath, hundreds of thousands of injured veterans were treated back home in a nationwide network of hospitals run by the federal government. Since then, the VA healthcare system has greatly expanded, and now through the Veterans Health Administration (VHA) provides high-quality care to nine million veterans. The majority of those veterans want to see the VHA improved and even expanded.
On June 6, thousands of veterans, union members, VA hospital nurses, elected officials, and more gathered on the National Mall in Washington D.C. at the “Unite for Veterans, Unite for America rally” to protest the Trump administration’s attacks on veteran jobs, benefits, and healthcare. In this on-the-ground edition of Working People, we report from Friday’s rally and speak with veterans and VA nurses about how Trump’s policies are affecting them now and how to fix the longstanding issues with the VA.
Speakers:
Peter Pocock, Vietnam War veteran (Navy) and retired union organizer
Lelaina Brandt, veteran (National Guard), 2SLGBTQIA+ advocate, and part-time illustrator and graphic designer.
Eric Farmer, Navy submarine veteran
Irma Westmoreland, registered VA nurse in Augusta, GA, secretary-treasurer of National Nurses United, chair of National Nurses United Organizing Committee/NNU-VA
Andrea Johnson, registered VA nurse in San Diego, CA, medical surgical unit and the NNOC/NNU director of VA Medical Center- San Diego
Justin Wooden, registered VA nurse in the intensive care unit (ICU) at James A. Haley Veterans’ Hospital in Tampa, FL
The following is a rushed transcript and may contain errors. A proofread version will be made available as soon as possible.
Maximillian Alvarez:
Alright. Welcome everyone to another on-the-ground edition of Working People, a podcast about the lives, jobs, dreams, and struggles of the working class Today. Working People is a proud member of the Labor Radio Podcast Network and is brought to you in partnership within these Times Magazine and the Real News Network. The show is produced by Jules Taylor and made possible by the support of listeners like you. My name is Maximillian Alvarez and I am here on the National Mall in Washington, DC at the Unite for Veterans Unite for America rally, where thousands of veterans from all military branches and age groups, union members, VA hospital nurses, elected officials, and more have gathered to send a message to the Trump administration. This is a critical follow-up episode to our recent interview with VA nurses and national nurses, United Union reps, where we talked about the devastating impact that President Trump’s cuts to federal agencies and attacks on federal workers are causing for VA healthcare workers and the veteran patients that they serve as national nurses.
United describes in their press release about today’s rally on Friday, June 6th, the anniversary of D-Day, dozens of registered nurses from National Nurses Organizing Committee slash National Nurses United will join Senator Tammy Duckworth, veterans federal workers, military families and allies in Washington DC for the Unite for Veterans, unite for America rally organized by the Unite for Veterans Coalition. This rally is modeled after the 1932 Bonus Armies march on Washington DC and will spotlight attacks on veteran benefits, call out attempts to privatize the VA and rally the veteran community to defend the institutions that serve them. So I am here on the ground talking to folks about why they’re here, why it’s important, and what message they want to send to the administration and to their fellow workers around the country.
Peter Pocock:
I’m Peter Pocock. I’m out on the mall here in DC with a whole bunch of other veterans. I’m an old timer. I’m pushing 80. I’ll be 80 this year. I was in the Vietnam era and happily for me and intentionally for me, I was in the Navy because you were more likely to avoid bullets in the Navy. Yeah, we’re out here on the mall today because the Veterans Administration, which takes care of a lot of us, myself included, I’m 90% disabled and we can go into that later, but we’re here because certain parties who are in the government are really trying to cut the hell out of what we have supposedly earned by our service over the years. Yeah, Gary from the podium, we’re here to fight back. First of all, there’s a whole lot of vets that actually are losing their jobs, particularly government jobs.
We got a preference. That was one of our benefits of being in the service. We got a little bit of a preference for jobs coming out and especi people who have been working for the government for 10, 20, 30 years who are being basically told, we don’t need you anymore. Thank you very much. Actually, no, thank you very much. Let’s just go away. Not happy about that. I tend to do only family friendly language and interviews, but there’s a whole lot of words I could use to describe what the Trump administration is trying to do to labor. That’s something that the right wing has been after for what decades, maybe more, and I’ve been fighting. I was in the labor movement my whole working life after the Navy and been fighting it that whole time. Even in retirement. Keep on showing up is the way that you win every time.
We’re not going to storm the capitol. We’re not going to surround the White House and take prisoners and things like that. What we’re going to do is keep on showing up everywhere in the country, every opportunity we have, every chance to have a conversation with somebody about it, talk to ’em about what’s going on, talk to ’em about the fact that people’s livelihoods are being taken away. Things that people have worked for their whole lives are being taken away. That’s not just veterans, that people with jobs. You got a job, you want somebody to take it away from you for no good reason except to send a little more money to some folks that have no need of more money. Thank you very much. I came back in 1970 to an environment that was not particularly friendly to veterans
And I kept showing up. I kept telling people I never held it against somebody that they thought that I was at fault for this war. I was against the war myself. Well, another thing that has got me out here is I’m 90% disabled according to the Veteran’s Administration, and it’s because I’ve got Parkinson’s disease. See, there’s what I got is Parkinson’s Disease, and it’s generally attributed to the fact that I was exposed through Agent Orange during my service. My bet is that basically any of the folks that were in Southeast Asia in the late sixties and the early seventies all have been exposed to Agent Orange and many of them will if they haven’t already be displaying all kinds of symptoms because of it. In my case, Parkinson’s.
I’m lucky that it didn’t show up until late so that I’m still, I’m going to make it to 80. Anyhow, a lot of my people have, the VA takes care of people like me. The VA takes care of people who are in wheelchairs because of their service for laying flat on their backs in a hospital bed because of their service, and that’s where they’re going to be. The VA’s taking care of them. That’s not waste, that’s not fraud, that’s not abuse. That’s what they have earned is that care and that’s what everybody in this whole country earns just by being citizens is care. How come we are not taking care of our people? We had all kinds of very interesting things going on in the Navy, in the army. I got friends that were doing some really good anti-war stuff that endangered them. So when I came back, that’s what I started doing and I mean doing it ever since. I wasn’t in a labor movement at the beginning. I was in left wing politics, anti-war politics, and from there being in the labor movement was just a natural. As soon as I got the kind of a job that actually had that kind of stuff going on in it, we don’t need to go into it too much, but I was a real hippie organizer in Politico. I was not in a position to be in anything but the IWW. So yeah, but I spent 30 years in the labor movement and I’m still with it.
Everett Kelley:
My name is Everett Kelley. I’m a proud Army veteran and I have the pleasure as the National President of the American Federation of Government Employees A FGE. First and foremost, I want to thank the Union Veteran Council for inviting me to speak and for putting on this necessary undue event. Now I want to welcome all of you who came here today from out of town. Your commitment is aspiring and I want to thank you for being here today. We’re here to unite on behalf of all veterans and to bring awareness and attention to this unprecedented and un-American attack on veterans jobs, benefits, healthcare and union rights. What do you say? Well, it doesn’t matter what branch you serve in, right? We’ve all made a huge sacrifice for our country and all of you are my family. Now though we all come from different backgrounds and different races have different religious beliefs and political views.
We all have similar stories as veterans. My story starts in good water, Alabama, where at 18 years old I joined the United States Army and went on to serve in the Army Reserve for another eight years. After my three year tour, like many of you, after I my military services, I wanted to continue to serve my country. So I became a federal employee working at Anderson Army Depot with my fellow veterans while we continued supporting the mission. You see, just because the job change doesn’t mean your service is complete. Our mission has not changed. Our mission is protect and to serve, to support and defend, and that has not changed. But now what has changed, however, is the government’s promise to be there for us when we get home that changed the promise to care for our families, our caregivers, and our survivors. For years, politicians on both sides of the aisle have campaigned on their support of veterans, but once they get in the office, they cut our benefits on the fund, our services and take every opportunity to privatize our healthcare.
What do you say about that? No, and guess what? Brothers and sisters, we are tired of it. Veterans are tired of being celebrated on Veterans Day remembered on Memorial Day and forgotten about after election day. What do you say about that? Are you tired? We’re tired of being thankful. Our service in the public and stabbed in our back in the private. We are tired now. This S ring no true than today. In January, the VA presented employees, what a fuck in the road. Wow. They encouraged members to end federal services in February, VA recklessly terminated more than 1500 probationary employees resulted in chaos and confusion within the department. In March, the VA announced plan to cut 83,000 jobs for no rhyme or reason whatsoever under disguise of efficiency. I say it’s not efficiency, it’s fraud and a FG been fighting sensely because we know what the big ass will do, don’t we?
Right? And if you don’t know what the big enough plan for Americans veterans is, let me share it with you. The big enough plans for Americans, veterans, it’s a privatized veteran healthcare. In order to make themselves wealthier, they want to make a quick buck offer the sacrifices of the pain and the scars of all those of us who have served this country. They want to take away our VA medical centers claiming that private healthcare is better. However, study after study showed that vegetable prayer to get their care to be VA because it was created for us. Now, the VA is a place my brothers and sisters to go too far camaraderie and for exchanging stories where we are treated with respect and honor because nearly 30% of the employees are veterans too, and they understand who we are. They understand the sacrifices that we’ve made.
They understand the specialties that’s needed. They understand a person that has PTSD. They know it’s not a sham. They know it’s for real. The VA plays for veterans by veterans and for veterans. However, these master reorganization plans that stand before us today is the targeted attack on veterans job, on healthcare, on benefits and union rights. The layoff plans aren’t just figments of our imagination. They are here. We’ve already seen thousands of employees being fired, but brothers and sisters, lemme tell you this, I got to leave you, but before I go, I want you to know that you have doctors, nurses, housekeepers, es, chiropractors, pharmacists, social worker, benefit specialists, police officers, janitors, engineers, painters, electricians, psychiatrists, cooks, greeters at the front door at the va.
Terri Henry:
I’m Terri Henry. I live in Alexandria, Virginia. I’m here in Washington DC today to protest the Trump administration’s treatment of veterans. I am a veteran. I’m married to a Vietnam veteran. My father is a veteran. My brother is a veteran. I believe in veterans. My husband and I had nowhere to go after high school graduation. We weren’t born with a silver spoon like Donald Trump. So we joined the military and his two brothers joined as well, and we got our educations through the va. So we are all college educated people who were able to improve our lives by virtue of our military service. That would not have been a path open to me. Only marriage and children would’ve been open to me. I had no education and no way to earn a living. The military taught me skills and I used those skills and I believe in America.
The other thing that happened is my husband got agent orange cancer for his Vietnam service. So we rely on the VA for his cancer treatment. If it had not been for the va, I tell you, I would’ve had just a complete breakdown. But they were wonderful. They took him in, they gave him chemo. We never had to worry about a bill. Every American that gets cancer in America has to worry about how they’re going to pay for their treatments in the military. We never worried about that. We went to the doctor when we needed to go to the doctor and they gave us what we needed and they promised us that that care would continue after we left the military. And in my husband’s case it has. But now in the Trump administration that care is threatened, these veterans are threatened. We’ve got new veterans, young veterans, Afghanistan, veterans, Iraqi veterans, Vietnam veterans still alive.
We need that care. You promised that care. Donald Trump is a draft dodger 1968. He refused to take the cough. In fact, he got his father to pay for a bone spurs excuse. That’s not courage. That’s not courage. And that man is insisting that we the veterans or the active duty military march in front of him like puppets and he is a draft dodger and a felon. The irony, the insult, it is such an insult to the American military to make them parade for him. This is not Hollywood. This is real life. And those federal workers that you’re un employing, they actually take a military member out of a combat seat. Why? Because the federal workers do the things behind the scenes that allow the military to deploy forward. Every federal worker you fire, you’re taking someone out of combat and you should know that you’re harming the mission and they don’t have time to do your petty tasks.
Like this parade on the, what is it, 14th of June, which by the way, that parade is not a birthday parade for Donald Trump. It’s not a birthday parade for the army. What it is is a show of force, a show of force as was conducted in 1939 at another birthday parade in another nation where that dictator showed the world, his military and what they had to be afraid of. That’s what this parade is about. He’s using the US army to threaten the rest of the world with our military might. We’re very proud of our military. We have a great military, but they are already overt, tasked and now he’s cutting them as is Pete Heg said. Now Trump’s priority is real estate. What he wants to do is put Gaza puts the French Riviera in Gaza. He wants to own Greenland. All he sees when he sees other nations is real estate opportunities, opportunities to make money.
That is not what the government does. The government is here for. We the people, they only exist to serve. We the people just as a church passes a collection plate. The government passes the tax plate, we put the money in with the intent that’ll be spent on our needs, not on his. And there’s quite the difference between the two. So I say to you, don’t believe Donald Trump, he is lying every day. He has a network that does that Cox News. He’s cutting down on journalism like N-P-R-P-B-S so that you will never hear the truth. And now voice of America as well. So this is a very dangerous time in our nation and it is time for us to stand up and say, no, no, Donald Trump, we see you. We’ve seen this before, but it’s not going to happen here in America.
Ellen Barfield:
My name’s Ellen Barfield. I’m a nearly 30-year-old Baltimore aunt originally from, did a lot of my life in Texas and I did four years in the Army, 77, 81. I’m the co-founder of the Baltimore Chapter of Veterans for Peace, and I’m back on the national board.
Maximillian Alvarez:
Well, it’s so great to chat you and yeah, Baltimore out here representing, we are literally sitting on the National Mall right now at the Unite for Veterans Unite for America rally. I wanted to just ask if you could say a little more about yourself, about why you’re out here and what the message today really is.
Ellen Barfield:
Well, the main messages stop trashing veterans and stop taking away our benefits and firing. So many of us disproportionately veterans are employed in the federal government. They do get a little bit of a point for being veterans and they come from that kind of mindset. So they want to keep serving, if you will. So the threats to our VA healthcare and the firings of so many veterans, those have got to be stopped and reversed. And that’s why we’re here now. A lot of the folks here are a good bit more politically conservative than veterans for peaces, but that’s okay. We have to get together to defend the promises this country made to its veterans to take care of us in exchange for our possibly being sacrificed. I personally think war is the enemy and humanity better unlearn war. It’s going to finish us. So I don’t glorify wars, but it is something nations have done for a long time. It’s had militaries. And part of the deal is you potentially risk your life in exchange for benefits afterward. That’s the promise. And they’re taking that away and we got to hang together here. Even if we don’t politically agree to say hell no, we’re not going to let you do that.
Maximillian Alvarez:
And can I just ask, as a veteran yourself as an organizer with Veterans for Peace, have we been fulfilling that promise to our veterans? And I guess that’s a two part question. How have we been treating our veterans in the aggregate before 2025 and what are these new attacks from the Trump administration doing to our veterans on top of that?
Ellen Barfield:
Yeah, thank you. Because that’s exactly right. The VA has essentially never been fully funded. It was already down about 60 or 70,000 staff around the country before Trump even got back into office. And now there’s threats of about 85 or 90,000 more cuts and they’re talking about, oh, we’ll keep the essentials doctors and nurses, excuse me, if the floor is a wash and trash and the toilet won’t flush and all of the staff is important, it’s not just the professionals. So give me a damn break.
Maximillian Alvarez:
Brian and I literally just interviewed multiple VA nurses to say like, look, when you cut our support staff, who do you think has to pick up the work us? Which we can’t tend to
Ellen Barfield:
Our patients take care of the patients, exactly. We got to have medical tests and we got to have clean bathrooms and all of that. I wear this shirt the same, our VA shirt when I go to the VA and talk to some of the staff. And some of them are very grateful to see it and some of them are kind of puzzled amazingly, this one guy who’s been doing the check-in for me, the blood pressure and whatnot before I see my endocrinologist have a thyroid condition. And this was before Trump got back in, but that’s exactly what I was talking to him about. The staff is way, way down across the nation. I’m sure y’all are tight here. And he said, yeah, as a matter of fact, you’re right, we are. So it was interesting that I was helping him understand, and you’re absolutely right, it was far from perfect for a long, long time, but it was a lot better than we’re looking at and being fearing right now. So yeah, it’s chipping away at something that was already far from the strength that needed to be.
Maximillian Alvarez:
And I guess, I know there’s a broad question, but we got a lot of folks who listen to the show who are not veterans, right? They’re workers union and non-union. I’m sure they’re curious if you had to give a general sort of overview, how is this country treating its veterans?
Ellen Barfield:
Well, how is this country treating anybody who isn’t a massively wealthy person? And I have said for a long time that VA healthcare, if fully funded and staffed is the way everybody’s healthcare should be. Single payer, everybody in, nobody out. And sadly, the VA has never been everybody in. They don’t cover everybody and they really should. It depends on timing, depends on a lot of things as to whether they will take you or not. But a large chunk at least of veterans, but it is a single system where your records are all together, your care is all in one place. They understand the specifics of you being a veteran. And there are lots of other categories of people that need particular attention paid. Everybody should have single payer get rid of the 30% insurance premium that the civilian world pays for their healthcare.
Then we could afford to make sure everybody had primary care, everybody had preventive care. It wouldn’t be showing up at the emergency room at the last minute when you’re catastrophically sick and if they’re going to save you, they’re going to have to spend a lot of time and money, preventive, preliminary, that’s what everybody needs. The VA at least theoretically and to a large extent in fact is damn good. It’s a unified system where it’s all together and they take care of it all. It’s so much easier than having to ferry records across town because you have to go to a specialist who’s never seen you before. Everybody should have it. So yeah, the nation’s not being kind to veterans, but it’s not being kind to anybody that isn’t filthy rich.
Maximillian Alvarez:
Listen, truer words never spoken. And you mentioned something at the beginning of our interview here where you said there are a lot of conservative folks out here. There are folks more on the left, but this moment of crisis is bringing those folks together here as one crowd on the National Mall. Things are getting so bad that it is forcing a lot of folks to come together in common struggle. And I wanted to kind of end on that note from the veteran side of things. What possibilities, possi, do you think this moment presents and what do people need to do to seize on that moment and fight for our rights, fight for our future before they’re all gone?
Ellen Barfield:
Well, I have really avoided the thought that things have to bottom out to energize people, but it’s obviously happening sadly. People are terrified as they have reason to be here. And are we going to lose our Medicaid? Are we going to lose our healthcare? Are we going to lose our social security? And then what the hell are we going to do? Yeah, there is reason to be terrified and we have to unify across our differences and across our skin color and our religion and all those things that they are using. It is what imperialists fascists always do is to divide and conquer, to teach you that somebody who’s on the same level as you is threatening you. When that’s bullshit. Immigrants don’t threaten us. Black folks or white folks or brown folks don’t threaten each other. Pretty much all of us in the same boat now, there was a middle class, it’s pretty much gone.
So we don’t have any damn choice and it is pulling people together. I’m glad of that, but I’m horrified that it had to get so bad. But here we are, veterans for Peace is 40 years old this year. We’re fixing to have our first face-to-face conference in a while because of COVID and other things. We are small. We’re only about 3000. We got up about 10,000 in the earlier Iraq years, but we’re small, but we speak out about challenging all war and there’s got to be a better way that the imperialists of Europe and the US have got to figure out they need to be just part of the world like the rest of it. We got to, there’s struggle in the United Nations and other international forum to recognize that the climate is going to kill us if we don’t stop pumping crap into it. And we have to work together to solve that. And the ridge world owes the global south a huge amount of funds to help them take care of it. And we got to do it here too. And that’s totally the direction we’re not going right now. We can’t possibly, as human beings expect it continue if we don’t come together. And sadly, when it gets this bad, it kind of knocks people upside the head and they understand it a little better.
Lindsay Church:
Good afternoon. My name is Lindsay Church. I’m a Navy veteran, the executive director of Minority Veterans of America, and someone who still holds tightly to a belief that this nation is worth fighting for, not with weapons or wars, but with truth, with compassion, and with conviction that we all deserve to belong. We stand here today not just in protests but in protection one another of our shared future of the Soul of public service itself. Because what we are witnessing is not theoretical, it is not slow moving. It is here, it is deliberate, and it is already doing harm. Today marks the beginning of what history will remember as a purge of transgender service members, an unconscionable order from Secretary of Defense, Pete Hexes that puts thousands of service members across the country and around the world in the crosshairs of their own government. Troops who serve with integrity and distinction are being told that their presence is a problem, that their identities are incompatible with patriotism, that they must choose, walk away from the careers that they’ve built or stand and stay to be persecuted. This week I walked to the halls of Congress beside some of them. Brave, steady, remarkable people who are carrying the weight of betrayal was grace that shouldn’t be required of them. I watched as they told their stories calmly, powerfully, beautifully. And I watched members of Congress and their staff move from polite interest to a deeper knowing. Those weren’t statistics in front of them, they were patriots. And no matter what, some want to believe they belong.
But Secretary Hex says is not the only one making these decisions. At the Department of Veterans Affairs secretary Doug Collins has announced his goal to eliminate 83,000 jobs. Jobs failed by the very people who care for us. When the wars are over, people who process disability claims answer crisis lines, help veterans find housing and walk alongside us through recovery. Many of them veterans themselves, many of them survivors of the very systems now being dismantled. This isn’t reform, it’s abandonment, and it’s not isolated to VA today. The cuts, the job cuts are there, but they’re already spreading the workforces. Its social security, FEMA education, those pillars of community stability are already being slashed. Public servants across the country are being demoralized, discarded, and erased. Not because they failed in their duties, but because they dared to serve the people that those in power find inconvenient. This is not about cost saving, this is about consolidation of power, of control, of the very definition of who gets to be counted as an American. This week, the Navy quietly announced that it will rename the USS Harvey Milk.
A name meant to honor courage, authenticity, and sacrifice stripped from our national memory. Without ceremony, without justification and without shame, the Harvey Milk story is not one they can erase. And neither are the stories of Harriet Tubman or Medgar Evers or Ruth Bader Ginsburg or John Lewis. All namesakes of navy ships, these aren’t just names, they’re the scaffolding of American progress. They remind us who we’ve been and they point to us towards who we could become. When we erase them, we do not become stronger, we become smaller. And while these symbolic erasers continue, the real world harm accelerates. Just weeks ago, the VA rescinded protections that in turn, the transgender non-binary veterans like me could access medically necessary care. Care that is affirming care, that is evidence-based and care that saves lives. This isn’t about budget, it’s not about medicine, it’s about cruelty, cloaked in bureaucracy.
And while the spotlight is aimed at transgender people benefits for others, women, people of color, disabled veterans are being quietly dismantled in the shadows. Let me be clear, we are the canary in the coal mine. What they do to us in the headlines they will do to you in silence. I’ve stood besides veterans as we slept on the steps of the capitol to pass the Pact Act because our sick and dying friends deserved better. I’ve traveled to Ukraine with fellow veterans to stand with our allies in their fight for freedom. I’ve stood my life in the military and far beyond it answering the call to serve. Because to me, service isn’t defined by the uniform. It is defined by what we choose to protect, by who we choose to stand up for. Whether we leave behind a world that is more just more compassionate and more free. So I say this to secretaries, he Collins, and to every person who believes that they can quietly erase us from this country’s fabric. We are not going anywhere. We are your neighbors, your coworkers, your classmates, your family. We’re veterans, we’re public servants, we’re Americans, and we’re still here. We will not be erased. We’ll not be silenced, and we’ll not stop fighting, not just for ourselves, but for the America we know is still possible. Thank you.
Leilana Brandt:
So my name is Leilana Brandt. I am a veteran of the Army, national Guard, served from 1996 to 2002 in the 36 50th maintenance company in Colorado.
Eric Farmer:
My name is Eric Farmer. I served from 1999 to 2020 in the Navy. Did most of my time on submarines, also did a tour to Iraq and I come from Texas.
Maximillian Alvarez:
Well, thank you both so much for chatting with me. We are standing here on the National Mall to unite for veterans, unite for America rally. I was wondering if we could just hear a bit more about you all your time in the service and what the hell’s going on right now that is bringing so many folks out here to the mall?
Leilana Brandt:
Well, I am a transgender person and I also was in the military during Don’t ask, don’t tell last time. So I was completely closeted for my own safety, not just in the military, but in my life in general. And it took me a very long time to have the courage to do what some of the service members now are doing, which is being themselves while being in the military. And each and every one of us have taken an oath to the constitution just like every other service member and veteran. And I feel that them being stripped away from the military right now, not only losing their livelihoods but also their homes, their friends, they’re just being stripped from their lives completely just because of how they were born. And I think it is appalling and insulting to all of us.
Maximillian Alvarez:
And can I just ask on that note, could you remind folks who maybe forgotten what the hell it was like in the Don’t ask Don’t Tell era? It felt like we made quite a bit of progress in a short amount of time and now we’re just yanking it right back.
Leilana Brandt:
While for anyone in the two s LGBTQI plus community, they were expected to not speak of it, to not have any hints of who they were. And so they basically had to hide themselves in order to serve. And there were many that were separated through no fault of their own, but because they were outed by other people. And then there were just folks that used that as an opportunity to shirk deployments and stuff like that by falsely claiming it. So it’s not anything that makes sense as far as readiness goes. And also Hertz enlistment because there are many folks in the queer community that want to serve or that need to serve because that is the best way for them to make a livelihood for themselves in a country that discriminates against them already. And the military has long been a place that started to be more diverse before the public sector was. And so I believe that that’s something, or sorry, before the private sector was. So I believe that that’s something that should continue, that it should be at the front of the pack as far as allowing everyone who wants to serve to do so.
Eric Farmer:
My time in the Navy, like I said, was mostly on submarines. When I first started out, it was strictly men, it was strictly men. When I first started out in the submarine community, it wasn’t until about 2006 that they started allowing females to serve on submarines and that was started out as officers. My last submarine that I was on that I did a deployment on was integrated with enlisted females as well. And they stepped up. They stepped up and did the job that all the other men said that they wouldn’t be able to do. And so I have a feeling that what’s about to happen is that they’re going to try to do away with females in the submarine community and it’s not going to make us ready. The jobs are being filled by females right now, and if you take all those females out, we’re not going to be capable of deploying our submarines.
Now what’s bringing out the veterans here is the fact that they are trying to take away the jobs of the veterans. They’re saying that that’s going to help the veteran community with the va. And I’m telling you that we’re about to find out that you can’t do more with less. I have had three to four phone calls where I’m trying to get community care on the phone so that way they can send something to the VA so I can get my work done. And they’re, they’re not picking up the phone. I’ve been on three or four phone calls where it’s been 30 plus minutes and no one’s picking up and it just cuts off and I have to call back. And so I’m waiting. I’m already waiting. And the cuts have just begun.
Maximillian Alvarez:
One, it really gives a grim meaning to that phrase, right? We are doing more with less, but it’s not what people think. You have more plane crashes around the country when you have fewer air traffic controllers. You have more wait times for veterans like yourselves when you have less healthcare staff at the va, right? That’s the kind of more we’re getting for less, which is nuts. But I wanted to ask you if you could both touch on that a bit more. Since your time in the service, what has your experience been like as veterans? How have we been doing as a country in caring for our veterans before the new Trump administration? And then we’ll talk about what the hell’s going on right now.
Leilana Brandt:
Well, I think that what I have seen, I never used the VA because I was never overseas, but my father was Lifetime and had multiple deployments and he has been someone who used the VA and he has always had complaints. He has always had complaints, and it is mostly about the understaffing. It’s not that there is waste happening as far as personnel goes, and that’s the place where they’re trying to make cuts is personnel. That’s the thing they need more of, not less. So if they need to find ways to make it more efficient, that’s great, but personnel is not the place to start with that.
Eric Farmer:
So when I first got out in 2020, I was scared about to go into the VA because I’ve heard all the horror stories. And for me, when I first got out, it was actually pretty good. Not very long wait time to get ahold of somebody. No wait time to get in. It wasn’t until recently that the wait times have become longer and longer and I’m not getting the care that I feel like I need. In fact, I go Wednesday to have a surgery on my shoulder from an injury from the Navy that I re-injured, but I’m not going through the va. I’m having to use my personal insurance. I’m going through TRICARE because the VA wants you to go through physical therapies before they do anything, and I have a tear in my labrum that needs to be fixed.
Maximillian Alvarez:
There’s been so much going on in the past three months alone, it’s hard to even know where to start. But like you said, the cuts to federal agencies across the board, including Veterans Affairs, and I just interviewed some of the nurses at VA hospitals, so they’re feeling it. Folks here in DC are feeling it on the administrative side. It’s going to take a while for us to really wrap our hands around the impact of all this. But I think one silver lining of the terrible moment we’re in is that it’s bringing so many folks out of complacency to gatherings like this. Even people who don’t normally agree on stuff, people who maybe aren’t down with L-G-B-T-Q rights, but who are saying, fuck it, we’re all getting destroyed right now. If we don’t start learning how to work together, we’re all going to fall like dominoes. So I wanted to kind of end on that note because things are obviously pretty grim right now, but what do you think it signifies that so many folks have come out to the mall, that there’s so many diverse groups of veterans, there’s union folks, non-union folks, older folks, younger folks. What message does that send and what do you think it’s going to take for us to really stand together as working people to fight this?
Leilana Brandt:
Well, I think that the military needs to continue to lead that way in diversity as it always has. Every person I ever served with, regardless of what their personal political views, religious views, anything like that, they didn’t give a shit what their buddy in the foxhole believed or where they came from or anything like that, as long as they had their six. And that’s something that we need to remember is that we need to have each other six. We need to be there for each other knowing that we all have a common goal and we have a common enemy, and that is anyone who is an enemy to the constitution that we took an oath to support and defend, and if any of us are under attack, then we all come together to fight that.
Eric Farmer:
I think the silver lining of having the diverse group to show up today is sending a message. It’s going to send a message that the oath that we took does not end, that it’s going to continue until we eradicate the fascism that is trying to implement our country. My grandfather fought in World War II against this, and never in my mind did I think that we would have to fight this, but taking it to the front lines today, to the front steps, to the front door of the capitol, as long as someone, even if they support a certain person, just listens to some facts from today, that might change their mind and go, you know what? I have that oath. I need to defend the constitution because I’ve asked people, well, what are you going to do whenever the constitution starts getting taken away? And they told me that they would fight, but they’re not here. They’re not protesting
Leilana Brandt:
Because they’d be here today if they
Eric Farmer:
Actually recognized it was already happening. They don’t go to any protests. They sit idly by and we can’t do that as veterans with the support of non-veterans. This is what it’s going to take. Non-veterans supporting the veterans, the veterans coming up and being the bonus army that this is about bonus Army of 2025.
Irma Westmoreland:
Well, good afternoon you guys. My name is Irma Westmoreland and I’m a registered nurse in Augusta, Georgia for the va. I’m also secretary treasurer for National Nurses United and chair of our VA division. While I’ve worked for the VA for 34 years as a nurse, some of my earliest memories are going to the VA in Augusta, Georgia to work with the veterans on bingo nights or dance parties. When I got older with my mother who spent 50 years as a VA volunteer, I know. Pretty cool, huh? Also, my husband is a retired SFC Army veteran of 21 years of service who has disabilities from its service. So the VA is deeply personal to me. Our servicemen and women were told, if you need us, we’ll be there for you. It’s a promise. Now, secretary Collins and the administration want to take that promise away and we’re not going to allow it. That’s why it deeply pains me to see these attacks on the va. When we have a contract for the VA care, the nurses and the doctors are going to be caring for these patients. When the administration says they won’t cuts, we say, no, we need to live up to what we told and promised our veterans. We told them that we would be there for them and we need to do that. They stood for you and me and I ask you now to stand for them. No cuts to the va.
Maybe some of you know someone or love someone ill from burn pit smoke or from Agent Orange or lost a limb from an IED exposure or died or suffered from PTSD, military sexual trauma or other chronic illnesses. We know the VA is the best place to get care for these ailments and more. The VA is the only healthcare system centered around the special needs of service members. 30% of our employees are veterans themselves, but it’s more than that. It’s also the only healthcare system in the country that’s fully integrated will help with veterans in poverty, with homelessness, offers, clothing, allowances, and much, much more. I’ve seen magic happen at the VA friendships form fast and it’s not unusual to see veterans helping veterans, whether it’s pushing a wheelchair or walking them down the hall to an office. These veterans share a deep sense of camaraderie and a sense of belonging. That goes a long way in making a person feel better and stronger. Now, if you ask, is the VA perfect? No, it’s not. I can’t tell you that it is, but let me tell you, we’re light years better than the private sector.
That’s why I will not stop fighting to see the VA improved and not destroyed. As you all know, secretary Collins is now looking to cut tens of thousands up to 80,000 jobs from the va eight. Yeah. These decisions are being made at the atmospheric level. The staff that do the work know best where things can be improved and streamlined. And I say ask them. He says, no mission critical positions will be cut. But let me tell you that all positions in the VA are mission critical. It’s important for every person to keep their job from the engineering staff to the housekeeper, to the dietary staff, secretarial staff, and many, many more. When cuts are made, who will be there to have to pick up the work that needs to be done? The nursing staff and the medical staff that are left when supply folks are cut. I heard that operations were being postponed so nurses could run, get clinical surprise. Let me explain that for you. In one place, a nurse had to go and to the warehouse in the VA to get supplies for surgery needed in the OR for a patient who was waiting. That’s not right. That’s right. But that veteran finally got their surgery. It was delayed, but it was done. But it was because the nurses stood for that veteran.
When housekeeping was cut, I heard delays in veterans getting into beds because there was no one to clean the rooms. This causes delays for our patients getting needed treatments started, and in some cases it may need to lead for a more elevated critical need of treatment. It’s common sense cutting 80,000 jobs will cause delays in veteran care. So we say absolutely no cuts. That’s right. We know. We know we are. What we’re witnessing is an effort to push the VA past its breaking point. The ultimate goal is to privatize the VA and pour billions of taxpayer dollars into giant healthcare corporations and the pockets of billionaires instead of the veterans who served our country.
Don’t sell us out because what they do, they know the VA and the federal government. It’s going to pay them on time every time. That’s why they want our care, but they don’t know our care. They don’t know how to provide our care. They don’t know that the VA does it better than anybody. The nurses and the doctors are specifically trained to do it. We’ve been training for years since the VA was incepted and while right now we are not going to go away for sale, we are not for sale. That’s exactly right. It is the nurses and the government workers who are standing up to block this privatization effort. It is because of our unwillingness to back down that nurses and other unions are filling the retribution that came down on March 27th with an executive order designed to strip us of our union rights. It is union busting and intimidation, plain and simple, but we’re fighting back national nurses united along with other federal workers, labor unions, and other veterans groups. We sued the administration over this outreach of executive power. This is not about us, it’s about our patients. We must have collective bargaining protections that allow us to advocate for our veterans and to speak up about issues in our facilities that cause us concerns for our patient safety. One example is we’ve had shortages of IV normal saline to mix medications. How stupid is that?
With that being said, you all understand the VA is not a contract. The union’s not a contract. The unions are nurses. We represent, the union says, and I say no cuts. Keep the VA strong so that we can care for every veteran. NNU knows that an injury to one is an injury to all. So we say when we fight, we win. When we fight, we win and we will prevail. The VA will stand strong for our veterans. Thank you.
Andrea Johnson:
My name is Andrea Johnson and I’m a registered nurse. I work with veterans in San Diego.
Justin Wooden:
And I’m Justin Wooden. I am a registered nurse in the ICU and I work in Tampa, Florida.
Maximillian Alvarez:
Well, Andrea, Justin, thank you both so much for chatting with me today. We are of course standing out here on the National Mall at the Unite for Veterans, unite for America rally. You all with National Nurses United have shown up in full force because of course, these cuts that the administration is doing to the federal agencies across the board are impacting workers, including workers at the VA and across the board across the country. So I wanted to ask if you could just say a little more about who you guys are, the work that you do, and what it’s like to work where you work under the conditions we’re under right now.
Andrea Johnson:
So we’re a special breed, and I say that because we care for patients that are not typical patients. Veterans went overseas, they fought wars. They’ve done many things that affect them morally and mentally. And because of those actions and the things that they had to choose to do in wars, they come back broken. And that’s what is unique about the VA system and VA nurses and healthcare providers in general, is that we have that knowledge and experience to care for the veteran in their entirety, right? Outside public hospital systems don’t have that knowledge or experience working with veterans and the special, unique needs that they come back after serving their country with. So as BA nurses we’re there, we’re taking care of that whole veteran. We’re taking care of their medications, we’re taking care of their home life. We’re coordinating with social workers to make sure that they have all the resources that they need. It’s not just passing medications. We’re caring for that whole veteran. And I think that’s what’s special about being nurses
Justin Wooden:
And our veteran population that we care for is also different than the fact that I’ve worked private sector before and I’ve worked the va, the veterans, they’re not like the average person when it comes to their care. They want it straight, don’t beat around the bush. They want to know what’s going on, cut to the chase, just tell me what is going on. They don’t want sugarcoated. They want direct answers and we offer that.
Andrea Johnson:
That’s right. And I think the other thing that makes veterans unique is that they come from a system where they’ve been told what they can wear, how they can act, what they can say, what they can do. And soner, VA nurses and healthcare providers in general struggle sort of with this authority in a way where we educate and try to teach our veterans better ways to care for themselves.
But we have that sort of roadblock because they put up a wall, it feels like we’re telling them what to do, and that’s never what we are trying to do. So we always have to find unique ways with each veteran. Each veteran is unique in how they receive and retain information. So I think that’s what makes us unique too than outside hospitals, is that veterans are a very special population and taking away the care that the VA provides them is despicable. And like I said, no outside hospital system could take on the number of patients that the VA system cares for or the special needs that the veterans have.
Justin Wooden:
And veterans, they have a little camaraderie. If you’re in the army, you’re army strong. If you’re in the Marines, you’re strong. So every branch kind of has a little internal battle with each other, but when it comes to it, they’re all a brotherhood. They will stand behind each other. A lot of our veterans in Tampa where I go, they come to the VA hospital just to be around veterans. So it’s a community to them. It’s not just a place to get healthcare, but they go there because they feel the camaraderie, they feel the brotherhood. So while they have appointments, they come early just to talk with other veterans that they know from places or they just feel more secure. And a lot of military veterans don’t like to talk about their time and their service, but at the va, we encourage it, it therapeutic, it’s cathartic, and they feel free to tell stories there that they haven’t told their families.
I mean, we have patients who are towards the end of their life and they have all these things that they haven’t said that they finally want to say, and they feel comfortable with the nursing staff, with the doctors at the VA to have those conversations and tell the things that they were so afraid to talk about before. So I love working for the va. I think it’s a phenomenal thing and a wonderful place to work. But the current administration is causing a lot of rifts and making it a lot more difficult in a lot of ways.
Andrea Johnson:
These actions by the government are creating anxiety and fear for healthcare workers coming to the va. That’s not stopping us from coming to the va. We’re dedicated to our mission and we show up day in and day out to deliver that care despite what’s happening. But that’s why we’re here today, right? We’re fighting for what we know the vets earned and what they deserve.
Maximillian Alvarez:
Could you guys say a little more about what has been going on inside the VA over the past three months? I mean, how have these policies from the Trump administration affected you all in your day-to-day work? Right. I mean, there’s the current attack on the collective bargaining rights of federal employees, over a million federal employees, including nurses at National Nurses United work for the va, right? There’s like the voluntary resignations, staff cuts that are impacting agencies across the board in different ways. Could you just give listeners a little on the ground view of how has this been affecting you all and the work you do over the past few months?
Andrea Johnson:
Well, like I mentioned earlier, nurses, at least the nurses I’ve been speaking to in San Diego, and I’m hearing from my colleagues across other VA facilities as well, is that there’s a decrease in morale. People are feeling fearful and anxious coming to work because we don’t know what’s next. We don’t know if tomorrow when I go into work, I’m going to lose my job. So we’re dealing with those fears, but we’re still coming in, right? It’s not stopping us from coming in. It’s not making me want to quit my job and go find a job somewhere else. I know what I do at the VA is important, and I know that the veterans appreciate the care that they receive there. And I think the government and the people making these decisions need to actually come and spend some time with these people to better understand where they’re coming from, making these decisions without any of their, in my opinion, without any of the veterans in mind, any of the federal workers really, or the American people for that matter. But specifically for today, they’re making these decisions, not considering what the veterans want.
Justin Wooden:
So I work in the ICU at the bedside, and it affects me in ways because sometimes they send us to areas because they’re short staffed, that we are going to areas and covering areas that we’re not familiar with or used to working in these areas. And a lot of people are like, oh, well, you’re a nurse, you can work anywhere. Well, and I like to is like, would you go to a podiatrist to get your teeth done? They’re both doctors, but it’s similar. We have different specialties. And also as a leader in the union at my facility, I round the hospital and talk with all the nurses and all the units to see what their concerns are. And a lot of ’em come to me. They’re like, well, we’re told there’s no union. There is a union,
Andrea Johnson:
Andrea, Andrea. It’s really confusion.
Justin Wooden:
There’s a lot of animosity every day. You don’t know what’s going on. It’s just very tense. I guess that’s a good way to put it. But going around the hospital, a lot of the nurses that I work with are saying they feel that there’s more focus being put on numbers and metrics as opposed to the care of veterans or the staff. They’re putting numbers over the patients. And ever since I’ve been at the va, which is, I’ve always had a wonderful time, but recently it’s becoming very, like you said, very anxious. It becomes very nerve wracking like you’re walking on eggshells just because you don’t know what’s next.
Andrea Johnson:
Yeah. We just don’t have any clue. But I think, and Justin made a good point, that a lot of our nurses are concerned about the union because of these executive orders and attacks on union unions and the federal government in general. But as union leaders, we remind them that the contract our CBA, our contract is not the Union National Nurses United. Yes, we are the union. I’m not the union. It’s every single one of our nurses that are on the floor, right, collectively, so they can try to take us down, but they’re only going to succeed if we let them. And so I’m using that as sort of a motivator to keep my nurses motivated and encouraged to continue to fight the good.
Justin Wooden:
Because right now the current administration is, they’re doing union busting tactics. So being a federal government agency, they took away union dues being done through a direct deposit through your paycheck. So essentially we lost every member we had, and now we have to start from the ground up getting everyone to reset up. So essentially it’s like a grassroots project starting from the ground
Andrea Johnson:
Up. It’s very grassroots right now. Yeah.
Maximillian Alvarez:
Can I just ask a blunt question? What does eliminating collective bargaining rights and changing the structure of how union dues are paid, how does that serve the American people? How is that? Are you creating efficiency or cutting waste?
Andrea Johnson:
It has absolutely nothing to do with government efficiency and cutting waste. If anything, especially federal agency unions provide protections to the employees that they represent to speak out about fraud, waste, and abuse. We provide that layer of protection for VA nurses to speak out about patient safety issues when there’s not enough staff or if we have broken equipment, our collective bargaining agreement provides, in a way, it’s a bubble. It sort of insulates us from retaliation from being targeted by management. So I think that’s the importance of our collective bargaining agreement.
Justin Wooden:
And I worked in private sector, so I can see. So in the private sector, say you’re an employee and you’ve done something. So I call you into the office, say, Hey Max, you did this. Can’t be doing that. Here’s a writeup, right? If you are opposed to that or don’t agree with it, that’s your opinion and you have no say in a union, you have a union backing, you have union rights. You can have a representative there to say, Hey, I don’t think this is right. And we can investigate it and say, Hey, I don’t think this is just what you’re doing. So we stand up for our members.
That’s just one scenario. We also ensure, like Andrea said, safe working additions. We make sure the veterans are safe, making sure that if they change any policies that, or any changes in working conditions that it’s safe for the staff or things like that. So there’s a lot of things the agency does to help protect workers, not just, it’s not saving money. I mean, yes, the union does fight for, we look at locality pay and we look at all the area hospitals, how much are they making? Why is our pay not equal or similar to the surrounding areas? We do those things as well. We also help our employees who have problems with hr. A lot of our time at my facility is spent because HR payroll hasn’t done what they’re supposed to do or bonuses weren’t given or a lot of unjust things are being done by HR because this is the federal government. It’s not just we don’t have our own HR department. We have to go through multiple steps to get things done. So we have a lot of resources that we use to get to the people so we can help our employees.
Andrea Johnson:
Yeah, yeah. Just to kind of last little thoughts on that, like I said, the collective bargaining agreement, and I hate to describe it this way, but it’s sort of an insurance policy for some people because like I said, there’s sometimes fear to speak out about safety issues and when something is being done incorrectly because of that fear of retaliation or being singled out and like I said, that collective bargaining agreement provides that protective layer. It makes people feel safe and comfortable to be able to speak out. And that’s why those are important. It holds management accountable. They can’t just decide to do whatever they want because if it’s written in a contract, they have to follow that
Justin Wooden:
Essentially having union is having a democracy. There’s due process and checks and balances in the private sector, it’s more authoritarian. This is what I say, do it
Maximillian Alvarez:
Well. And that’s always been my retort when I hear folks say they want government to be run a business. And I was like, well, as someone who interviews workers at businesses across the country, I can tell you you’re saying you want our government to be run like a dictatorship. How most businesses are run. I could talk to you guys for hours, but I know I got to let you go here, but I wanted to just pick up on something that you were saying both of y’all. But we’ve interviewed a lot of healthcare workers on this show over the years
And through those interviews from folks who work at private Catholic hospitals to public hospitals, university hospitals, certain common like horrifying trends have become apparent in terms of what’s going on in healthcare. The crisis that we have been facing with more work being piled onto fewer workers, patient care, the quality of patient care going down as patients are increasingly treated like commodities to come in, get their care and get kicked out. This whole sort of McDonald’s model of healthcare is something that I’ve heard described from different healthcare workers around the country. I wanted to ask how much the VA has sort of been going the same way or how things are different within the va. I guess maybe to end on that note, what do you all in the VA deal with on a day-to-day basis that is indicative not only of problems that need to be fixed at the va, but problems that we’re facing in our healthcare industry across the board right now?
Justin Wooden:
I can speak to that first.
Andrea Johnson:
I’m going to let you go ahead
Justin Wooden:
Because working in private sector
Before coming to the va, I’ve seen both sides. So I know everything is about billing. In private sector, it’s about getting money. Because they’re for profit, they need to make money. So every procedure that’s done has to be documented so they can bill for it to get money. At the va, it’s not like that at the va. So you were describing healthcare as like a fast food restaurant. So drive through, get what you need, and then at the VA we care about the veteran whole. So when they come in, we’re worried about discharge planning when they come in. So are there anything you need at home? Do you need shower bars? So we’re working on the discharge to make sure when they do leave, when it’s time for them to go, they have the appropriate things. Do they have problems with any meals? We’re going to get every resource.
Mental health, we schedule their appointments before they leave. Where in private sector, they don’t do that. So before you’re discharged from the va, any follow up appointments, we we make sure they’re scheduled before you walk out the door and we print out a calendar of here’s all your upcoming appointments so you know what you have to have done and all your medications are listed, all these things are there. We don’t want to set up for failure. We want them to know their health course, know what they need to do and follow up with those treatments. We have social workers who call after they leave to make sure, hey, it’s been a week since you’ve been home, is everything okay? So those are the things that I see the biggest difference. I think that’s the biggest strength the VA has. So for them to do cuts and try and eliminate that system, I think is the worst thing we can do.
Andrea Johnson:
And to sort of piggyback off of what Justin was saying is, I mean you made a good point, max. Our people are talking across the country about our healthcare system and how broken it is. And so taking 9 million veterans who receive care in a system, that one has significantly higher standards than any hospital outside of a federal agency. Were held to a higher standard when we screw up. That’s in the news. When local hospitals make a mistake that’s not in the news because they’re smaller, it’s more central. But the VA is a federal agency where across the entire country. So if the VA does make a mistake, it’s known. But what we do very well isn’t necessarily spoken about in the public as much, but the VA does a lot of things very well for our veterans
Justin Wooden:
And veterans choose to come to the VA
Andrea Johnson:
That outside hospital systems cannot, cannot do. And if we eliminate the va, if we try to continue to push veterans into the community with a system who already or that already cannot serve the citizens that they’re set out to serve and we add 9 million more people to that system, what’s going to happen? We’re going to have a very sick America that is unhealthy, that can’t happen
Justin Wooden:
Paying through the nose
Andrea Johnson:
And paying through the nose. And
Justin Wooden:
The PAC Act added 400,000 more veterans that can get care and then they want to cut 80,000 plus jobs. So who’s going to care for those veterans, those newly signed veterans? You’re offering more services for veterans, but now you have less people to provide those services.
Andrea Johnson:
Right. And we know studies show our experience and our knowledge knows that the more staff you have on hand to care for people, the better healthcare outcomes there are. And that’s just, you can’t make that up. It’s documented, very well documented. And we should be looking at not dismantling one healthcare system that serves 9 million people, but looking at the healthcare system as a whole on how we can make it better. Not taking one away and throwing it into this other one that’s already a disaster. We need to be looking at trying to make our outside hospital systems more like the VA as far as standards and things like that go. I think we’d be better off in America if more outside hospital systems followed in the va, which is why we need to keep the VA in place.
Maximillian Alvarez:
Well, and just a final question on that note to everyone who’s out there listening right now, whether they’re in a union or not, whether they’re veterans or not, why should they care about this and what can they do to help? How can they stand in solidarity with you all at National Nurses United and what can they do to join this fight to save the va?
Andrea Johnson:
Okay. I think this fight, whether you’re Democrat or Republican, you are union or non-union. I think that this is an important issue because we’re dealing with our veterans. These are people who risk their lives, gave up time from their families, were injured, witnessed some atrocious things. And if we’re not supporting them and receiving healthcare, then there’s something wrong. And I think that we need to be focusing on making sure that the veterans continue to receive the care that they have earned and that they receive. And because this is just me, but what they’re doing to the veterans, this is just one step. They could easily turn that to people who are not in the union, to people who are not veterans, to just regular old Americans. And then what are we going to do when our already broken healthcare system is even worse? So I think that healthcare in general should be a human issue no matter what side of the aisle you fall on.
Justin Wooden:
And my point I always like to say is every one of us has family member. If your family member is sick and in the hospital and they hit their call bill because they need help, you want somebody to be there to respond with the way the current healthcare system is going. We’re being put spread more places, so it’s taking us longer to respond to those calls. We as humans, as you said, our job as nurses, we want to care for our patients. We don’t want do any harm to our patients. We want to be there. So we are just fighting and want people to know that we’re here fighting for your family members, for your loved ones and for our veterans because that’s our job. That’s our oath that we’ve taken as nurses. So we just want to be able to have the supplies, the tools and the resources we need to give the best care we can to our veterans and patients.
Cecil E. Roberts:
My name is not just Cecil Roberts, president of United Mine Workers of America. I used to be Sergeant Cecil e Roberts in Vietnam in 1 96, like infantry brigade.
When I first got to Vietnam, I want you to listen to this. Some people tell me I was never scared when I went over there. You’re looking at a guy that was scared to death.
I tell the truth, that’s the truth. I was scared when I first got here. It appeared that nobody liked me. These people with 15 months, 10 months, eight months counting the days, they looked at us new guys as like, that guy’s going to get me killed when they hurt my accent. Oh no. Another hill belly from West Virginia. That’s what they thought. They looked at me, these veterans, they said, how you going to act? I didn’t understand the question. How you going to act? I want you to remember that because I’m going to ask you how are we going to act moving forward from this place? That’s right.
And then bullets go right by your nose. They look at me and say, don’t mean nothing, man. I’m thinking bullshit and say something to me and I want you to think about that. You get immune to this and I saw so many wonderful people with kids at home, mom and dad’s at home, wives at home, and all kinds of friends at home. Not make it. When I first got there, somebody with 30 days got killed, had a daughter he never met. Somewhere in this United States of America, there’s a 57-year-old woman, had never met her father. Now, how many veterans we have here? By show of hands, you’re going to get a test right now. How many of you met a million there in Vietnam or where you are stationed? How many of you met a millionaire? There’s a good reason millionaires don’t defend a country. They take advantage of the country, and if there’s people listening to this live broadcast, you could be mad. Your feelings could be hurt and I don’t care.
The other thing I want to ask you, when you got back home, how many people patted you on the back, particularly if you was a Vietnam veteran? Didn’t happen. Didn’t happen. But I want to thank everybody, every veteran because we’ve been embraced for the last 20 years and that means so much to me. Thank God for you. It isn’t, isn’t enough to come here and rally. This is a great first step. Abraham Lincoln said, this is a country of the people by the people and for the people it has turned in to a country for the rich people who don’t care about the rest of us, I’m going to tell you what we should be planning on doing. We should demand that every person who worked for the federal government and lost their union rights be restored. Right now, I was in the army and I’m glad people recognized the service of people who were in the army, but we shouldn’t be having a parade.
We shouldn’t be having to parade until every veteran has the healthcare they deserve and we shouldn’t be having a tax plan send to the rich who don’t need money. Here’s another tax cut for you. Until every American who has a job, doesn’t have a job, has a job until every homeless person has a home, we should make, I’m going to close with something. First of all, I’m calling on Congress. I’m calling on everybody that’s elected. I’m calling on every American, how are you going to act? Because this is terrible what’s happening to this country, and that’s why we’re here today.
You do know, this is my last quote, okay? On map next to last, Dr. King was assassinated. One month before I left Vietnam and I watched these African-American soldiers so desperate, so frustrated, so hurt, pick up their rifles, pick up their M sixties, and went out into those rice patties and defended the United States. When the United States didn’t defend them, that was wrong. This one will really challenge you. Dr. King in the middle of the civil rights movement said this to those who were being bitten by dogs. He said, listen to this. If you don’t have something, not somebody, not your wife, not your daughter, got your mom, not your dad, something that you would die for, you don’t have a life worth living. Think about that.
This is the last one. It’s strange that I jumped from Dr. King to Mother Jones. My great grandmother and Mother Jones were friends, two great radicals, and I’m so proud of our heritage. You may not know this history, but when you leave here today, read it. How many of you heard La Lulo at Ludlow? The gun thugs came off the hill after taking the machine gun and firing into the tent calling all day long. Sometime in the middle of the day, they cut a 12-year-old boy In two later in the day, they murdered the leader of that tent colony, and then they set those tents on fire and burned 13 women and children alive. That happened. That’s part of our history. Mother Jones did not quit. She called for a rally in Trinidad about 15 miles from the Ludlow site. She looked out on a crowd probably twice this size, and she looked at them, take this W when you go home. She said, sure, you lost. Sure you lost. But they had bayonets and all you had was the Constitution of the United States of America. And then she posed. Lemme assure you, any confrontation between a bayonet and a constitution, the bayonet will win every time. But you must fight. You must Fight and win. You must fight and lose, but you must fight. What must you do? You must fight. You must fight. You must fight.
Maximillian Alvarez:
All right, gang, that’s going to wrap things up for us this week, and I want to thank you for listening and I want to thank you for caring. We’ll see you all back here next week for another episode of Working People. And if you can’t wait that long, then go explore all the great work we’re doing at the Real News Network where we do grassroots journalism that lifts up the voices and stories from the front lines of struggle. And we need to hear those voices now more than ever. Sign up for the Real News Newsletter so you never miss a story. And help us do more work like this by going to the real news.com/donate and becoming a supporter today. I promise you it really makes a difference. I’m Maximilian Alvarez. Take care of yourselves. Take care of each other. Solidarity forever.
When Immigration and Customs Enforcement took José into its custody at Otay Mesa Detention Center in San Diego in January, he told medical staff at the facility that he had colon cancer. Since then, his symptoms have worsened, he said, and he has begged them for treatment — to no avail. “They have ignored me,” José said in Spanish. “They’ve ignored all the times I’ve been bleeding.”…
A growing number of states are considering legislation to set up protections for patients who might be drug tested when they give birth.
Three of the bills were introduced following an investigative series by The Marshall Project and Reveal that exposed the harms of drug testing at childbirth—including how many patients are often reported to child welfare authorities over false positive or misinterpreted test results and how women have faced child welfare investigations and removals over medications the hospitals themselves administered.
In New York, a bill that would require hospitals to obtain consent from patients before drug testing has been advancing. Two proposed bills in Arizona and Tennessee failed to make it out of their legislative sessions.
“We know when there’s secret drug testing, families are often torn apart,” said New York state Rep. Linda Rosenthal, a Democrat from Manhattan, who noted cases of women who were reported to child welfare over positive tests caused by poppy seeds and prescribed medications. “This is not some theoretical discussion we’re having here. This is really something that occurs.”
The New York bill, versions of which were first introduced by Rosenthal beginning in 2019, has faced years of resistance from lawmakers. Similar efforts in Minnesota, Maryland, and California also failed in prior legislative sessions. But in New York, The Marshall Project’s reporting on hospital drug testing helped convince more lawmakers to get on board, according to activists who lobbied for the legislation.
Poppy seeds, used in bagels, salads, and other foods, can yield positive results for opiates in urine tests. Credit: Andria Lo for The Marshall Project
If passed, the law would permit hospitals to drug test birthing patients and their newborns only if medically necessary. It would also require them to obtain informed consent from patients before drug testing them, which would include disclosing the potential legal consequences of a positive test result.
Similar bills were introduced this year in Tennessee by both a Democrat and Republican. Sen. Janice Bowling, a Republican from Tullahoma who frequently advocates for parental rights, was first approached about the issue by a progressive advocacy group and quickly saw the bipartisan appeal. She said she was shocked to learn that women had been tested and reported over false positive tests caused by poppy seeds, the heartburn drug Zantac, and other legal substances.
“Can you imagine if someone took the baby from you out of your arms or never even let you hold your child?” she said. “Taking children from families because a state entity says they have the authority to determine whether or not you’re a fit parent, that’s a slippery slope.”
After a particularly contentious legislative session, the bill failed to make it out of committee. Bowling said she plans to take up the bill again in 2026.
In Arizona, lobbyists and activists said they plan to pursue a similar informed consent bill in the next legislative session, in addition to continuing to pursue a more far-reaching bill that was introduced but failed to advance this year.
The Pro-Choice Arizona Action Fund and reproductive advocacy group Patient Forward began pursuing the legislation following a Reveal and New York Times Magazine investigation in 2023 that detailed the story of an Arizona woman whose baby was placed in foster care after she was reported to child welfare authorities for taking prescribed Suboxone during her pregnancy. Current state law requires health care providers to contact child welfare anytime a baby is born exposed to controlled substances, including legal medications such as Suboxone and methadone.
“We were like, how does this happen? What are the mechanisms in place that allow this to happen?” said Garin Marschall, co-founder of Patient Forward. “We wanted to understand what we could do to make sure that it didn’t happen again.”
The proposed legislation would have revised Arizona law to bar positive drug tests alone as a reason for a child welfare report or investigation. If health care providers have no concerns about abuse or neglect, the law would require hospitals to notify the health department instead of child welfare authorities. Other states, such as Massachusetts and New Mexico, have passed similar laws, while hospitals around the country have also made changes to their drug testing policies.
In New York, advocates said their bill has historically faced resistance from lawmakers who worry that asking patients for consent to test them for drugs will lead more women to decline such tests. But health care providers interviewed by The Marshall Project have said it’s rare for patients to decline a drug test, and even so, drug tests rarely provide useful medical information. Doctors don’t typically need drug tests to identify or treat babies exposed to substances in the womb, and a positive test does not prove that a parent has an addiction, the experts said.
Instead, studies have found that screening questionnaires, which collect certain information from patients, such as their partner’s history of drug use, are effective at identifying someone with an addiction without putting them at risk of needless child welfare intervention. Doctors have found that maintaining open communication with patients is also the best way to help them, whereas studies show more punitive policies lead women to avoid prenatal care altogether.
“If the trust between a doctor and patient is broken, that will lead to much more severe consequences for the child and the mother,” Rosenthal said. “Everyone does better if that doesn’t happen.”
Disabled people hold immense expertise in navigating both chronic illnesses and moments of crisis. And yet, despite all the public reflections on “lessons learned” at the five-year anniversary of the onset of the COVID-19 pandemic — from which hundreds of people in the U.S. are still dying each week — disabled people find themselves under increasing attack by the Trump administration.