This story was originally published by Grist and is reproduced here as part of the Climate Desk collaboration.

It’s November and it’s unseasonably warm as John John Brown, a Muscogee elder, works to replant peach saplings. “I haven’t had much luck growing them from seed,” he says. The reason, he thinks, is because peaches need lower temperatures. 

Around him, tiny peach trees the size of pencils stand above the browning grass underneath their parent tree. Brown harvested around 200 peaches this year from his small orchard—enough for his family and neighbors—but he had competition: A fox has been poking around. “The animals know when the peaches are ripe quicker than I do,” Brown laughs. “They start coming in and stealing my peaches.”

Brown’s peaches aren’t your everyday peaches, they’re heirlooms: direct descendants of peach seeds brought across the continent on the Trail of Tears. Brown calls them “Indian peaches” while other Muscogees call them “Trail of Tears peaches.” There has been little research on this particular variety, and it’s unknown just how many genes they share with commercial peaches. While grocery store peaches are soft and fleshy, Indian peaches don’t get much bigger than a lemon and are extremely firm but sweet.

The Indian peach is threatened by climate change. Where hurricanes, flooding, and higher temperatures have massive impacts on crops, including peaches, around the nation, heirloom varieties, like the Indian peach, are also threatened. This fruit, that crossed a planet, carried by traders and travelers, and eventually by a few Muscogees along The Trail before they found a new home outside Sapulpa, Oklahoma, is a connection to another time and place. 

“One of the greatest gifts Creator gave me is these peaches and the ability to share these trees with our community and everyone,” Brown said. 

There are only 50 Indian peach trees on the Muscogee reservation that Brown knows of—some grow in some peoples’ backyards, and some at a local daycare—and between climate-driven changes to growing cycles and high temperatures, they face a difficult future. Luckily, they have people like Brown working to protect them.

Peach cultivation is thought to have begun around 8,000 years ago in the Yangtze Valley in China. One of the first mentions of peaches in literature appears in the fictional novel Journey to the West, written in 1592, that describes peaches as a fruit that could grant longevity and “make a man’s age equal to that of Heaven and Earth, the sun and the moon.”

From China, peaches made their way to Europe, then to the Americas in the 1600s on Spanish ships—the beginning of a kind of crop exchange between the continents: potatoes and tomatoes from South and Central America went to Europe while peaches made their way to the Georgia coast, and quickly, into Indigenous diets. 

“Indigenous people were already caring for and managing forests and other kinds of tree foods,” said Jacob Holland-Lulewicz at Pennsylvania State University, who studies archaeology and ethnohistory. “That would have allowed them to adopt peaches super quickly and know really well how to create healthy peaches.”

Within a few decades, and with the help of a vast network of trade routes, peaches made their way across the continent, as far as the Southwest, where tribes like the Navajo sun-dried and stewed them. 

Around 1780, thousands of peach trees tended by the Seneca and Cayuga tribes along the Finger Lakes in western New York State were destroyed by President George Washington, in an attempt to ethnically cleanse Indigenous peoples from the region. Washington wrote in a letter to one of his generals that the goal was “to lay waste all the settlements.” He added, “It will be essential to ruin their crops now in the ground and prevent their planting more.”

In 1830, President Andrew Jackson signed into law the Indian Removal Act that led to the Trail of Tears—a death march that forced around 60,000 Indigenous people to leave their homes and move west, across the Mississippi River, to Oklahoma. 

Vernon Courtwright grew up eating Indian peaches. Now 75 years old, the Muscogee elder and veteran says his family brought Indian peach seeds and planted them when they were done walking The Trail. “That was the beginning of our life and the peaches’ life in Oklahoma,” he said. When he was a child, his grandmother, Emma Bruner, was the one who taught him about how to grow and tend to the fruit. “We grew up eating these peaches.”

Courtwright says in the 1970s, he began to see Indian peaches disappear. With each passing year, there was less on the landscape. “I just knew that our orchard had to be taken care of,” he said. When his grandparents passed, he took on the work of caring for the trees, and eventually, met John John Brown, who helped cultivate seeds and saplings to give out to other Muscogees.

“It’s our legacy,” said Courtwright. “It’s my family’s legacy to the tribe.”

Georgia, the Peach State, produces nearly 25,000 tons of peaches every year, but falls far behind California, which produces nearly 475,000 tons each year. Globally, nearly 24 million tons of peaches are grown each year, with most coming from China.

Climate change is having a big impact on those numbers, though. One of the biggest threats to the peach industry is rising temperatures. Peaches need “peach chill”—a certain amount of time in temperatures that are under 45 degrees Fahrenheit. Without adequate peach chill, peach trees won’t produce, and with rising temperatures, blooms will sprout too early.

In 2017, around 70 percent of peach losses could be attributed to lack of peach chill. “Lack of chill is something that we think is going to be the biggest issue for us and our industry,” said Dario Chavez, a peach geneticist at the University of Georgia. “If you are in a northern climate, you don’t worry too much about the chill. But I think they’re starting to see the physiological responses to issues with chill.”

Then there are extreme weather events supercharged by climate change that can inflict immediate, wide-spread damage. This year, Hurricane Helene killed at least 226 people. It also devastated Georgia’s agricultural economy to the tune of nearly $6.5 billion dollars.

But Helene’s path was only the beginning. Hurricanes bring flooding, which is especially bad for peaches—peach trees don’t like to be too wet and can prematurely drop fruit if under water. They’re also susceptible to diseases like brown rot, which can be triggered after heavy storms.

For the Indian peach, peach chill and extreme weather aren’t as big a threat as they are in the South. However, Oklahoma is expected to become around two and a half degrees hotter in the next 20 years. Even though the peach is a resilient plant, peach chill will become an issue. Natural disasters like floods become more of a threat to the lives and livelihoods of tribal members—tribal lands in Oklahoma are the most prone to flooding in the state. 

But to protect Indian peaches, and a little part of tribal history, John John Brown has been giving out saplings for the better part of a decade to anyone interested in growing them.

Brown regularly travels to Georgia and Alabama to visit the proposed Ocmulgee Mounds National Park and Preserve—located on Muscogee homelands. On his drives, he often passes peach orchards filled with the variety most Americans are used to. “You don’t think they would be able to produce peaches,” he says as he eyes the tightly-pruned rows. “They cut ’em back real small.” 

He goes down to the homelands to remind settlers in the area that the Muscogee survived despite the United States attempts at genocide and demos making canoes and bows the traditional way out of local wood during the annual Ocmulgee Indigenous Celebration. To Brown the peaches are a symbol of resilience. 

“When our ancestors brought these peaches up from the South you think about how devastating it was, to lose loved ones, and not know if the seeds will sprout,” he said. “I do this to honor them, and their strength.”

A growing number of law enforcement authorities and Democratic leaders across the country are speaking out about their plans to thwart one of President-elect Donald Trump’s top immigration priorities: Mass deportation. Taking lessons from the first four years of the Trump era, many have vowed to stand their ground and refuse to cooperate with federal law enforcement in arresting undocumented immigrants. They are also preparing counter-lawsuits to have ready to take the incoming administration to court as soon as officials attempt to begin deportations, which they’ve promised to kick off on day one.

In interviews with Politico published Saturday, prosecutors in six Democratic-led states described their plans to pursue legal challenges against actions Trump may take to carry out his immigration agenda.

These include the potential deployment of the US military domestically to find undocumented people, violations of immigrants’ rights to due process, the withholding of funds from s0-called sanctuary cities, and attempts to deputize the National Guard from red states to carry out arrests and detentions in blue ones.

These prosecutors said they’re also preparing to fight scenarios where the administration tries to send immigration agents into schools and hospitals, or where they withhold federal funds from local law enforcement to force them into compliance with deportation plans.

Earlier this week, Trump reaffirmed his plans to declare a national emergency in order to use federal troops to round-up targets for deportation.

“If he’s going to want to achieve that type of scale, the largest deportation in US history, as he says, by definition he’s going to have to target people who are lawfully here and … go after American citizens,” Matthew Platkin, New Jersey’s attorney general told Politico, likely referring to the fact that millions of undocumented people live with US citizens, including those whose children were born on American soil. Those children would have to leave the country with deported parents in order for families to stay together. “We’re not going to stand for that,” Platkin added. The goal of top prosecutors across blue states, the president of the Democratic Attorneys General Association Sean Rankin told ABC News, is to put up a “unified front” against Trump’s immigration agenda.

The Trump administration will inevitably face not only legal but logistical obstacles if they attempt to deliver on the promise of conducting an unprecedented mass deportation campaign. As Dara Lind with the American Immigration Council recently wrote in the New York Times, deporting one million undocumented immigrants per year—a fraction of the estimated 11 million living in the country—would cost an annual $88 billion. The limited number of detention beds and immigration courts’ years-long backlog will also inhibit a massive crackdown.

Still, Tom Homan, Trump’s new “border czar,” who won’t require Senate confirmation, has indicated the administration will push hard against jurisdictions that get in their way. “If we can’t get assistance from New York City,” Homan told Fox News recently, “we may have to double the number of agents we send to New York City. Because we’re going to do the job. We’re going to do the job without you or with you.” And in fact, Homan has a history of pushing forward extreme immigration policies: As a US Immigration and Customs Enforcement (ICE) official during Trump’s first term, he was the architect of the “zero tolerance” policy that separated thousands of parents from their children at the border. To this day, many have not been reunited.

Several Democratic leaders have publicly said they won’t go along with mass deportation efforts. Massachusetts Gov. Maura Healey, who sued the Trump administration 100 times as attorney general, said they would use “every tool in the toolbox” to protect the state’s population. In a statement, a spokesperson for the Rhode Island State Police said while they cooperate with ICE, “they are not immigration officers and will not expend any time and resources to support mass deportation efforts.”

Top prosecutors in states like Massachusetts are also trying to dispel the unsupported claims, repeatedly reinforced by Trump, that immigrants are more prone to committing crimes. Instead, according to Politico‘s reporting, they hope to make the case that mass deportation would be bad for the US economy. As I’ve previously reported, the mass deportation of undocumented workers would drastically reduce the GDP, make inflation rise, and even result in fewer jobs available for American citizens.

In the early 1990s, Justin Pourier was a maintenance man at Red Cloud Indian School, a Catholic school on the Pine Ridge Reservation in South Dakota. One day, he says he stumbled upon small graves in the school’s basement. For nearly 30 years, Pourier would be haunted by what he saw and told no one except his wife. 

“Those are Native children down there…hopefully their spirit was able to travel on to whatever is beyond this world,” Pourier says. In 2022, he urged school officials to search the basement for the graves.

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The hunt for unmarked graves of Native children isn’t happening just at Red Cloud, now called Maȟpíya Lúta. It’s one of more than 400 Indian boarding schools across the country that were part of a program designed by the federal government to “kill the Indian and save the man”—those were the actual words of one of the architects of the plan to destroy Native culture. In a historic first this fall, President Joe Biden apologized to Native Americans on behalf of the United States for the country’s past Indian boarding school policies.

This week on Reveal, in a two-part collaboration with ICT (formerly Indian Country Today), we expose the painful legacy of boarding schools for Native children with ICT reporter Mary Annette Pember, a citizen of the Red Cliff Band of Ojibwe. She’s been writing about these schools for more than two decades. 

This is a rebroadcast of an episode that originally aired in October 2022.

Continuing the string of MAGA loyalist picks to serve in his administration, President-elect Donald Trump on Friday evening tapped Russell Vought to serve as director of the Office of Management and Budget—again. Vought, a self-avowed Christian Nationalist and key contributor to the Heritage Foundation’s Project 2025 agenda for a conservative presidency, led OMB during Trump’s first term, transforming the powerful agency—charged with developing and executing the federal budget, and reviewing executive branch regulations—into a vehicle to deliver on the president’s wildest dreams.

In a recent appearance on Tucker Carlson’s show on X, in which the former Fox News host said he was “very likely to run OMB again,” Vought described the agency as the “nerve center of the federal government, particularly the executive branch.” He recounted having provided Trump with a plan to divert funding from the Department of Defense to fund his border wall without congressional approval, a move disavowed by the White House counsel and later ruled illegal. “Presidents use OMB to tame the bureaucracy, the administrative state,” Vought said, characterizing it as “the president’s most important tool to deal with the bureaucracy.”

Vought described what kind of person would be best suited to wield the power of this agency on behalf of President Trump. “What you need is people who are able to absorb political heat,” he told Carlson. “They don’t have a fear of conflict. They can execute under withering enemy fire. They are up to speed and they are no-nonsense in their own ability to know what must be done. And they’re unbelievably committed to the president and his agenda.” Vought also advocated for doing away with the notion of independent agencies, singling out the Department of Justice as a target.

Vought most recently led the conservative Center for Renewing America, which he has described as a “shadow” OMB outside the government. He is a big proponent of reviving an executive order from the final days of the first Trump administration that would upend the federal workforce in service of Trump’s goals. Known as Schedule F, the order would reclassify potentially thousands of career civil servants working in policy-related positions as at-will employees and strip them of job protections, making it easier for political appointees to fire them and fill the openings with candidates hand-picked to support MAGA priorities.

At OMB, Vought tried to reclassify almost 90 percent of the agency’s workforce as at-will employees, hoping to set an example for other government heads. As a former OMB worker and author of Trump and the Bureaucrats: The Fate of Neutral Competence put it to me, Vought’s first round leading the agency was nothing short of “traumatic.”

Inside the Trump administration, Vought came across as fiercely dedicated to the America First cause, even if it meant a colossal increase in the federal debt. Trump was prone to outbursts, but to Vought that aggression equaled power. Vought made it his mission to weaponize OMB on behalf of the president, who had long perceived the civil service bureaucracy as an obstacle to his haphazard rule. “We view ourselves as the president’s Swiss Army Knife,” he once said. “How do you come up with options that work and then talk through the pros and cons?” Vought interpreted his job as being inside Trump’s head—a “keeper of ‘commander’s intent.’”

And that appears to be the same approach Vought plans to take when restored to his old job next year. In previously undisclosed videos of 2023 and 2024 private speeches obtained by ProPublica, Vought talked about wanting the “bureaucrats to be traumatically affected,” adding they should “not want to go to work” when waking up in the morning. “We want to put them in trauma.”

He also suggested creating a “shadow Office of Legal Counsel” to enable a crackdown on anti-Trump dissent. “We want to be able to shut down the riots and not have the legal community or the defense community come in and say, ‘That’s an inappropriate use of what you’re trying to do.” A new Trump administration,” Vought declared, “must move quickly and decisively.”

This story was originally published by Yale E360 and is reproduced here as part of the Climate Desk collaboration.

In the fall of 2023, the Biden administration announced $7 billion in funding for seven hydrogen hubs, slated to be built across the country over the next eight to 12 years. If all goes as planned, one of those hubs, the Mid-Atlantic Clean Hydrogen Hub (MACH2)—a network of more than a dozen interconnected hydrogen production centers, storage facilities, pipelines, and new solar farms that will power these operations—will stretch from southeastern Pennsylvania and neighboring southern New Jersey into Delaware. Expected to receive $750 million in federal funding, MACH2 is projected to create roughly 20,800 jobs in the Delaware Valley region, of which 6,400 will be permanent.

The US Department of Energy (DOE) says that a sufficiently robust buildout of hydrogen production could power steelmaking, cement production, and other energy-intensive heavy industries, which account for more than a fifth of national carbon emissions and have been notoriously hard to decarbonize, as well as fueling ships, airplanes, and trucks. But some environmentalists and energy experts question whether investing so much money in hydrogen could siphon funding from more effective decarbonization strategies. Even a so-called “green” hub, which runs entirely on renewable energy, they say, might not provide the promised carbon-reduction benefits and could potentially even increase emissions.

And residents of potential host communities—particularly the hard-pressed city of Chester, Pennsylvania, where some of the MACH2 facilities are planned—are concerned that they will bear the brunt of the potential risks and health hazards that hydrogen production and transport could bring.

“Safety knowledge and best practices for the production and transportation of hydrogen are well-established and mature.”

Scientists discovered how to extract usable hydrogen from water molecules using electrolysis in the 1800s, and as far back as 1874, novelist Jules Verne predicted it would someday be “the coal of the future.” Hydrogen is, after all, the most abundant element on the planet, and it produces no carbon emissions when burned. The United States already produces 10 million metric tons of hydrogen a year—but most of it is derived from natural gas and is largely used in petroleum refining and in making ammonia for manufacturing fertilizer. Every ton of ammonia produced generates 2.6 tons of lifecycle greenhouse gas emissions, according to a report published in Green Chemistry.

Still, scaling up low- or zero-carbon hydrogen production wasn’t considered financially viable until passage of the Bipartisan Infrastructure Law in 2021 and the Inflation Reduction Act in 2022, which offer substantial tax credits to producers of clean hydrogen.

Today, some proposed hubs are planning on producing “blue” hydrogen—that is, hydrogen created using natural gas but with the resulting carbon emissions captured and stored underground. Representatives of the MACH2 hub say that 82 percent of their production will be “green,” meaning powered by solar and wind; 15 percent will be “pink”—powered by the Salem and Hope Creek nuclear plants, in southern New Jersey; and the remaining 3 percent will be “orange”—powered by biogas, which is produced when organic matter decomposes in an anaerobic environment.

Despite MACH2’s commitment to using green energy, some environmental advocates and local residents have reservations. Will the production facilities and pipelines pose threats to the environment and human health? Will the development process be transparent? Will jobs for community members materialize?

A year after the official announcement, the hub has shared few details with the public—locations of facilities, potential environmental impacts, how the project would benefit communities—saying plans have not yet been finalized pending permit approvals from the Pennsylvania Department of Environmental Protection (DEP), commitments from private investors, and contract negotiations between the DOE and the companies that will operate as part of the hub, who are expected to provide investments to match their government-awarded funds. More information will be released in the project’s next phase, expected to begin in the coming year.

The lack of specificity has unnerved environmental and community groups. The Delaware Riverkeeper Network, an environmental advocacy nonprofit, is alarmed by what it sees as a lack of proper safety precautions. Part of MACH2’s plan involves repurposing old fossil fuel infrastructure to carry hydrogen. Like many aspects of the project, what that means isn’t yet clear.

“These projects are often placed in areas that have less political power and representation. We should have the right of refusal.”

MACH2 officials are currently creating an inventory of underutilized infrastructure, according to Matt Krayton, the communications lead for the hub. He says the hub would likely repurpose existing pipeline rights of way—every pipeline needs approval from landowners whose property would be crossed—and possibly the pipelines themselves, which would be re-sleeved with a hydrogen-safe polymer to prevent leaks.

Some 1,600 miles of hydrogen pipelines are already operating across the US, and Nick Barilo, executive director of the Center for Hydrogen Safety at the American Institute of Chemical Engineers, noted that all combustible fuels carry a certain amount of risk, and hydrogen is no more dangerous than natural gas. “The US industry has been using hydrogen for over a century,” Barilo said. “Safety knowledge and best practices for the production and transportation of hydrogen are well-established and mature.”

In some potential host communities, like Chester, Pennsylvania, assurances like Barilo’s fall flat. Fifteen miles outside of Philadelphia, the city once bustled with manufacturing and heavy industry. But after World War II, plants began to shutter, and the city entered a long decline. By 2020, its population was half its 1950 peak.

Today, a third of Chester residents live in poverty, and the city, which declared bankruptcy in 2022, is host to 11 industries classified by the DEP as hazardous, including one of the largest incinerators in the nation. Chester’s asthma rate is double the state level, according to an analysis conducted by the Center of Excellence in Environmental Toxicology, at the University of Pennsylvania. “These [industries] assault us every day,” said Zulene Mayfield of Chester Residents Concerned for Quality Living. “And it is sanctioned by the state.”

“These projects are often placed in areas that have less political power and representation,” said Kearni Warren, a local outreach coordinator for the Clean Air Council, an environmental health advocacy organization. “We should have the right of refusal when it comes to projects that put our health and safety at risk.”

When MACH2 finalizes its arrangements with the DEP and formally begins Phase 1 of the project, which includes a community engagement plan and detailed plans for building sites, residents may start to see if their skepticism is warranted. But the industry still faces headwinds over its potential costs and benefits.

Although burning hydrogen produces no direct greenhouse gas emissions, hydrogen that leaks into the atmosphere, according to a 2022 research paper published in Atmospheric Chemistry and Physics, increases concentrations of other greenhouse gases, like methane, ozone, and water vapor. “Any time you’re handling [hydrogen], producing it, transporting it, storing it — [the molecule] is so small that the risk of leaks is significant,” said Talor Musil, a field manager at the Pennsylvania-based nonprofit Environmental Health Project.

And according to a recent report published by Energy Innovation Policy & Technology, an energy and climate policy think tank, making green hydrogen to power short-haul planes and heavy-duty vehicles—two sectors often touted as ripe for adopting hydrogen—is neither economical nor efficient. Roughly 20 to 30 percent of hydrogen’s energy value is lost in the process of splitting water molecules, the report said, and another 15 percent may be lost during compression and storage. The Energy Innovation report ranked the potential end uses for hydrogen by their long-term viability and determined that it made the most financial and environmental sense for refining oil and producing ammonia for fertilizer, while also having value in steelmaking and long-haul aviation and marine shipping.

Energy experts agree on these high-value uses for hydrogren, but the Inflation Reduction Act guarantees a tax credit for the fuel, no matter what its end use, for 10 years. Given rapid advances in battery technology, said the Energy Innovations report, it will be hard to justify hydrogen’s expense in industries like trucking—which can operate far more cheaply using electricity—when the credit ends.

A recent study by a group of Harvard researchers estimated that depending on what it’s ultimately used for, green hydrogen may wind up being even less cost effective at fighting climate change than direct air capture of CO2, which the International Energy Agency estimated would have an operating cost, when scaled up, of between $230 and $630 per metric ton of CO2 captured.

And then there’s the matter of impact. The seven hubs combined are projected to reduce annual greenhouse gas emissions by 25 million metric tons of CO2 a year (not counting the emissions linked with hydrogen production). The total tonnage is not significant, some experts say—it amounts to less than half of one percent of total US CO2 emissions—considering the $7 billion in taxpayer support. But the Energy Department considers the hubs a catalyst, a way to “kickstart a national network of clean hydrogen producers, consumers, and connective infrastructure”; presumably, costs of hydrogen production will drop as the industry develops.

Unless the federal government implements strict rules on carbon capture and the use of green energy for the hubs, the industry could actually increase overall emissions, according to the National Resources Defense Council (NRDC). Last November, Rachel Fakhry, the NRDC’s policy director for emerging technologies, testified before the House Environmental Resources and Energy Committee that, for hydrogen to be truly sustainable, green hubs would need to abide by three main tenets: buying electricity from newly built renewable energy sources, rather than pulling existing renewables from the grid (a requirement known as “additionality”); matching their hourly use with the availability of green energy, which prevents hubs from dipping into fossil fuels and buying clean energy credits after the fact; and using clean energy that’s produced close to the hubs, ensuring that its delivery doesn’t lead to increased emissions. Legislators and industry groups are already indicating they will challenge a proposed additionality requirement.

As the federal government works to finalize how it will regulate the hydrogen tax credits, energy experts continue to grapple with the potential significance, and value, of the proposed hubs. “One of the big challenges in the broader field of serious, big systems decarbonization is we’re sort of talking about various imaginaries,” said Danny Cullenward, a climate economist and senior fellow at University of Pennsylvania’s Kleinman Center for Energy Policy. “We’re throwing money at the hubs. We’re throwing money through this tax credit at the production of hydrogen. But there isn’t really anything resembling a coordinated strategy for what’s the right use of hydrogen,” he said. “It’s actually a really weird thing, if you think about it.”

Since winning the election, President-elect Donald Trump has seized headlines with a series of alarming appointments for his incoming administration. Many lack the basic qualifications for their respective posts; nearly all can be fairly characterized as MAGA loyalists.

Dr. Mehmet Oz, the former TV personality and failed Republican Senate candidate, is among the more heavily scrutinized picks—and for good reason. Oz is a celebrity doctor without any experience running a large federal bureaucracy, now tapped to lead the Centers for Medicare and Medicaid Services, a massive agency that administers Medicare, Medicaid, and the Affordable Care Act. Oz also boasts a long history of peddling dubious scientific theories and treatments.

But Oz’s remarkable lack of qualifications does not appear to have dimmed Republican excitement. In fact, they seem thrilled. Sen. Lindsey Graham said he was “very excited” about the nomination; Sen. Tommy Tuberville went as far as to call Oz an “all-star” candidate. Here’s what to know about Oz and why he could be the perfect vessel to help achieve the party’s long-sought goal of dramatically gutting safety net programs.

He Has a Long History of Peddling Pseudoscience

Trained as a heart surgeon, Oz rose to fame as a daytime TV personality. In the 2000s, he made frequent appearances on The Oprah Winfrey Show, where the eponymous TV host dubbed him “America’s Doctor.” He then moved on to his own show in 2009. Throughout his 13 years on air, Oz repeatedly came under fire for pushing questionable remedies, including sketchy weight-loss supplements that landed him in the hot seat with the US Senate.

“My show is about hope,” Oz told senators in 2014. “We’ve engaged millions in programs, including programs we did with the CDC, to get folks to realize there are different ways they can rethink their future.”

In 2011, Oz told viewers to stop drinking apple juice out of concern that it contained dangerous levels of arsenic. The FDA slammed the advice, calling it “irresponsible and misleading to” make such a suggestion.

Throughout the pandemic, Oz encouraged people to use hydroxychloroquine and chloroquine, malaria medication that then-President Donald Trump heralded as an effective treatment for Covid. (It is not.) In emails reported by the Washington Post, Oz even urged Jared Kushner to help expedite the medication to patients, writing, “We have a potential pandemic solution at our fingertips.”

Oz’s previous support for Joseph Mercola, an osteopath who’d eventually become one of the leading spreaders of Covid misinformation, was also condemned. As my colleague David Corn reported:

With his cheerleading for hydroxychloroquine, Oz helped distort the national public conversation about Covid. But his greater impact on the pandemic might be his previous support for Mercola. Advancing the career of the fellow who would become a top promoter of Covid misinformation—and whose efforts may have prompted many Americans to not become vaccinated and, thus, face terrible consequences—hardly meets the oath that Oz once swore: first, do no harm.

Oz Has Invested in Private Health Care Programs

One of the major concerns raised by Oz’s critics is whether he will cut funding to Medicare and Medicaid. As the Washington Post reported, Trump’s advisers are preparing to cut Medicaid, which currently serves about 80 million low-income people, in addition to a slew of other safety-net programs, to offset the cost of extending Trump’s 2017 tax cuts.

Oz does not appear to have taken any public positions concerning Medicaid. However, he has been a vocal supporter of the privatization of health care programs. In 2020, he wrote an op-ed supporting Medicare Advantage, a private coverage option supported by Trump and Project 2025.

As William Gavin at Quartz reported, Oz has previously disclosed owning at least $600,000 of stocks in companies that benefit from private Medicare services, raising serious concerns that, if confirmed, Oz could stand to finally benefit from the services his agency oversees.

Experts have long warned that privatizing Medicare is not a viable solution for cutting government waste, and will instead potentially make health care far more inaccessible for vulnerable communities.

But there is some reason to be hopeful. As my colleague Julia Métraux reported, existing laws will make it somewhat challenging for Oz to completely wreck Medicare.

His Peers Have Questioned His Ethics—A Lot

For nearly as long as Oz has been famous, peers have questioned his motives. In 2011, ABC News’ Richard Besser accused Oz of fearmongering, stating his apple juice claims reminded him of “screaming fire in a crowded theater.” In 2015, doctors wrote a letter calling for Columbia University to cut its ties to Oz, stating that Oz had “repeatedly shown disdain for science and for evidence-based medicine.” It didn’t work at the time. But seven years later, as Oz campaigned for Senate, the university finally severed its ties.

“It took Columbia far too long to remove Oz from its otherwise distinguished medical faculty,” Dr. Henry Miller, of the Pacific Research Institute, in California, told MedPage Today. Miller called Oz “an unethical grifter whose claims and pronouncements were not supported by science, and were injurious to consumers—in the interest of financial benefit to Oz himself.”

In 2017, academics wrote a paper titled The Case of Dr. Oz: Ethics, Evidence, and Does Professional Self-Regulation Work?, in which they called the media personality “a dangerous rogue unfit for the office of America’s doctor.”

His Failed Senate Campaign Was Rife With Ableism

While running for Senate, Oz’s campaign also took several ableist potshots at his competitor, Sen. John Fetterman. “If John Fetterman had ever eaten a vegetable in his life,” Oz’s senior communications officer told Business Insider after Fetterman poked fun at the infamous crudité video, “then maybe he wouldn’t have had a major stroke and wouldn’t be in the position of having to lie about it constantly.”

Oz’s campaign also mocked Fetterman in September 2022 by including the following line in a press release: “We will pay for any additional medical personnel he might need to have on standby.”

Flying during the Thanksgiving holiday is likely to be terrible—as usual. The lobbying group Airlines for America anticipates a record 31 million people will take to the air to visit family and friends for the holiday. But no matter how terrible the flying experience might be this season, it will probably be as good as it gets for a long time to come, as the second Trump administration plans to take a wrecking ball to commercial airline regulation.

Under Secretary Pete Buttigieg, the federal Department of Transportation has made a priority of tackling some of the biggest gripes Americans have had about air travel. To that end, the DOT has extracted nearly $4 billion in reimbursements and refunds owed to passengers since President Joe Biden took office, including forcing Southwest Airlines to refund more than $600 million to more than 2 million passengers who were stranded after it canceled 60 percent of its flights over two days during the December holidays in 2022. The DOT also fined the airline $140 million for a host of operational failures and consumer protection violations.

Under Biden, the DOT has forced most of the major airlines to guarantee free rebooking, meals, and even hotel accommodations when they cause a major delay. And it’s issued at least $225 million in penalties against airlines for violating consumer protection laws—a record. For example, in October, the DOT fined American Airlines $50 million for mistreating passengers with disabilities, including by breaking or losing thousands of wheelchairs.

Airlines destroying or breaking wheelchairs has been a chronic issue. In 2016, the Obama administration tried to remedy the problem with new regulations that would force airlines to track how often they broke or lost wheelchairs and mobility scooters. But as Mother Jones’ Russ Choma reported, the previous Trump administration, larded up with lobbyists from the industry, delayed the rule implementation almost immediately upon taking office. It finally took effect nearly two years later, and only after Sen. Tammy Duckworth (D-Ill.), a combat veteran and double amputee whose wheelchair had been lost by an airline, secured an amendment in Congress that forced the DOT’s hand.

The Biden DOT has also proposed rules to mandate disclosure of airline junk fees. This past spring, it issued a final rule requiring airlines to grant automatic cash refunds to people when the airlines cancel or cause significant delays to flights. The rule, which went into effect last month, spares travelers endless fights with airline bureaucracy to get their money back. And in August, the DOT proposed a rule to ban airlines from charging families extra fees to sit next to their children, a proposal that could save a family of four $200 on a round trip.

View this post on Instagram

A post shared by Secretary Pete Buttigieg (@secretarypete)

Unsurprisingly, the airlines hate all of this and long to return to the days when they could cancel your flight, keep your money, and force you to pay $50 so your toddler doesn’t have to sit next to a stranger on the plane. Delta Air Lines CEO Ed Bastian said this month that President-elect Donald Trump promised “to take a fresh look at the regulatory environment, the bureaucracy that exists in government, the level of overreach that we have seen over the last four years within our industry. I think that will be a breath of fresh air.” Trump promises to usher in that fresh air, as the authors of Project 2025 made clear in their blueprint for the new administration, writing, “Another problematic area is aviation consumer protection.”

Trump has signaled his intention to prioritize airline profits over passengers with his selection of former Wisconsin Rep. Sean Duffy as his transportation secretary. A former reality TV star and Fox News host, Duffy previously was a lobbyist for the airline industry, which has ferociously fought Biden’s consumer measures with both lawsuits and gobs of lobbying money.

Duffy will be charged with following through on all the plans laid out in Project 2025, which include moving parts of the air traffic control system out of Washington in the hopes that much of the staff would quit—the 21st-century version of the Reagan administration firing striking air traffic controllers. Project 2025 envisions a world with far fewer controllers and even fewer control towers, and it advocates axing funding for research and development, as well as subsidies for essential air service to small, rural airports. People who live in Altoona, Pennsylvania, or Beckley, West Virginia, can probably kiss their airports goodbye—but air taxis for rich people will be a high priority in the Trump DOT.

So enjoy your miserable airport journey to see grandma for Thanksgiving this year. Next year’s trip promises to be much, much worse.

This story was originally published by the Guardian and is reproduced here as part of the Climate Desk collaboration.

Oil and chemical companies who created a high-profile alliance to end plastic pollution have produced 1,000 times more new plastic in five years than the waste they diverted from the environment, according to new data obtained by Greenpeace.

The Alliance to End Plastic Waste (AEPW) was set up in 2019 by a group of companies which include ExxonMobil, Dow, Shell, TotalEnergies, and ChevronPhillips, some of the world’s biggest producers of plastic. They promised to divert 15 million metric tons of plastic waste from the environment in five years to the end of 2023, by improving collection and recycling, and creating a circular economy.

Documents from a PR company that were obtained by Greenpeace’s Unearthed team and shared with the Guardian, suggest a key aim of the AEPW was to “change the conversation” away from “simplistic bans of plastic” that were being proposed in 2019 amid an outcry over the scale of plastic pollution leaching into rivers and harming public health.

Early last year the alliance target of clearing 15 million metric tons of waste plastic was quietly scrapped as “just too ambitious”.

The new analysis by energy consultants Wood Mackenzie looked at the plastics output of the five alliance companies; chemical company Dow, which holds the AEPW’s chairmanship; the oil companies ExxonMobil, Shell, and TotalEnergies; and ChevronPhillips, a joint venture of the US oil giants Chevron and Phillips 66.

“It’s hard to imagine a clearer example of greenwashing in this world. The oil and gas industry…has been at this for decades.”

The data reveals the five companies alone produced 132 million metric tons of two types of plastic, polyethylene (PE) and polypropylene (PP), in five years—more than 1,000 times the weight of the waste plastic the alliance has removed from the environment in the same period. The waste plastic was diverted mostly by mechanical or chemical recycling, the use of landfill, or waste to fuel, AEPW documents state.

The amount of plastic produced is likely to be an underestimate as it only covers two of the most widely used polymers: polyethylene, which is used for plastic bottles and bags; and polypropylene, used for food packaging. It does not include other major plastics such as polystyrene.

The new data was revealed as delegates prepared to meet in Busan, South Korea, to hammer out the world’s first treaty to cut plastic pollution. The treaty has a mandate to agree on a legally binding global agreement to tackle plastic pollution across the entire plastics life cycle.

But the talks, which have been subject to heavy lobbying by the alliance and fossil fuel companies, are on a knife-edge in a row over whether caps to global plastic production will be included in the final treaty.

Will McCallum, a co-executive director at Greenpeace UK, said the revelations had stripped off the thin layer of greenwash hiding the growing mountain of plastic waste oil companies were producing.

“The recycling schemes they’re promoting can barely make a dent in all the plastic these companies are pumping out,” he said. “They’re letting the running tap flood the house while trying to scoop up the water with a teaspoon. The only solution is to cut the amount of plastic produced in the first place.”

Bill McKibben, a US environmentalist, said: “It’s hard to imagine a clearer example of greenwashing in this world. The oil and gas industry—which is pretty much the same thing as the plastics industry—has been at this for decades.”

In response to the allegations, a spokesperson for the AEPW said it “respectfully disagrees with the allegations and inferences, including that the organization’s purpose is to greenwash the reputation of its members…The alliance aims to accelerate innovation and channel capital into the development of effective scalable solutions to help end plastic waste and pollution.”

The AEPW has had a significant lobbying presence at the UN plastic waste talks, which entered their final stages on Monday. Its representatives have consistently argued that reductions in plastic production should not be included in the treaty.

The UK’s new Labour government has shifted the country’s stance and signed a ministerial declaration calling for the inclusion of reductions in production and consumption of primary plastic polymers to sustainable levels in the treaty. The United States under President Biden also shifted its position this summer to support caps on global production. It is not known yet the position of the incoming Trump administration.

A UK government source said: “The government supports an effective treaty which covers the full life cycle of plastics including reducing the production and consumption of plastics to sustainable levels.”

Flying during the Thanksgiving holiday is likely to be terrible—as usual. The lobbying group Airlines for America anticipates a record 31 million people will take to the air to visit family and friends for the holiday. But no matter how terrible the flying experience might be this season, it will probably be as good as it gets for a long time to come, as the second Trump administration plans to take a wrecking ball to commercial airline regulation.

Under Secretary Pete Buttigieg, the federal Department of Transportation has made a priority of tackling some of the biggest gripes Americans have had about air travel. To that end, the DOT has extracted nearly $4 billion in reimbursements and refunds owed to passengers since President Joe Biden took office, including forcing Southwest Airlines to refund more than $600 million to more than 2 million passengers who were stranded after it canceled 60 percent of its flights over two days during the December holidays in 2022. The DOT also fined the airline $140 million for a host of operational failures and consumer protection violations.

Under Biden, the DOT has forced most of the major airlines to guarantee free rebooking, meals, and even hotel accommodations when they cause a major delay. And it’s issued at least $225 million in penalties against airlines for violating consumer protection laws—a record. For example, in October, the DOT fined American Airlines $50 million for mistreating passengers with disabilities, including by breaking or losing thousands of wheelchairs.

Airlines destroying or breaking wheelchairs has been a chronic issue. In 2016, the Obama administration tried to remedy the problem with new regulations that would force airlines to track how often they broke or lost wheelchairs and mobility scooters. But as Mother Jones’ Russ Choma reported, the previous Trump administration, larded up with lobbyists from the industry, delayed the rule implementation almost immediately upon taking office. It finally took effect nearly two years later, and only after Sen. Tammy Duckworth (D-Ill.), a combat veteran and double amputee whose wheelchair had been lost by an airline, secured an amendment in Congress that forced the DOT’s hand.

The Biden DOT has also proposed rules to mandate disclosure of airline junk fees. This past spring, it issued a final rule requiring airlines to grant automatic cash refunds to people when the airlines cancel or cause significant delays to flights. The rule, which went into effect last month, spares travelers endless fights with airline bureaucracy to get their money back. And in August, the DOT proposed a rule to ban airlines from charging families extra fees to sit next to their children, a proposal that could save a family of four $200 on a round trip.

View this post on Instagram

A post shared by Secretary Pete Buttigieg (@secretarypete)

Unsurprisingly, the airlines hate all of this and long to return to the days when they could cancel your flight, keep your money, and force you to pay $50 so your toddler doesn’t have to sit next to a stranger on the plane. Delta Air Lines CEO Ed Bastian said this month that President-elect Donald Trump promised “to take a fresh look at the regulatory environment, the bureaucracy that exists in government, the level of overreach that we have seen over the last four years within our industry. I think that will be a breath of fresh air.” Trump promises to usher in that fresh air, as the authors of Project 2025 made clear in their blueprint for the new administration, writing, “Another problematic area is aviation consumer protection.”

Trump has signaled his intention to prioritize airline profits over passengers with his selection of former Wisconsin Rep. Sean Duffy as his transportation secretary. A former reality TV star and Fox News host, Duffy previously was a lobbyist for the airline industry, which has ferociously fought Biden’s consumer measures with both lawsuits and gobs of lobbying money.

Duffy will be charged with following through on all the plans laid out in Project 2025, which include moving parts of the air traffic control system out of Washington in the hopes that much of the staff would quit—the 21st-century version of the Reagan administration firing striking air traffic controllers. Project 2025 envisions a world with far fewer controllers and even fewer control towers, and it advocates axing funding for research and development, as well as subsidies for essential air service to small, rural airports. People who live in Altoona, Pennsylvania, or Beckley, West Virginia, can probably kiss their airports goodbye—but air taxis for rich people will be a high priority in the Trump DOT.

So enjoy your miserable airport journey to see grandma for Thanksgiving this year. Next year’s trip promises to be much, much worse.

This story was originally published by the Guardian and is reproduced here as part of the Climate Desk collaboration.

Oil and chemical companies who created a high-profile alliance to end plastic pollution have produced 1,000 times more new plastic in five years than the waste they diverted from the environment, according to new data obtained by Greenpeace.

The Alliance to End Plastic Waste (AEPW) was set up in 2019 by a group of companies which include ExxonMobil, Dow, Shell, TotalEnergies, and ChevronPhillips, some of the world’s biggest producers of plastic. They promised to divert 15 million metric tons of plastic waste from the environment in five years to the end of 2023, by improving collection and recycling, and creating a circular economy.

Documents from a PR company that were obtained by Greenpeace’s Unearthed team and shared with the Guardian, suggest a key aim of the AEPW was to “change the conversation” away from “simplistic bans of plastic” that were being proposed in 2019 amid an outcry over the scale of plastic pollution leaching into rivers and harming public health.

Early last year the alliance target of clearing 15 million metric tons of waste plastic was quietly scrapped as “just too ambitious”.

The new analysis by energy consultants Wood Mackenzie looked at the plastics output of the five alliance companies; chemical company Dow, which holds the AEPW’s chairmanship; the oil companies ExxonMobil, Shell, and TotalEnergies; and ChevronPhillips, a joint venture of the US oil giants Chevron and Phillips 66.

“It’s hard to imagine a clearer example of greenwashing in this world. The oil and gas industry…has been at this for decades.”

The data reveals the five companies alone produced 132 million metric tons of two types of plastic, polyethylene (PE) and polypropylene (PP), in five years—more than 1,000 times the weight of the waste plastic the alliance has removed from the environment in the same period. The waste plastic was diverted mostly by mechanical or chemical recycling, the use of landfill, or waste to fuel, AEPW documents state.

The amount of plastic produced is likely to be an underestimate as it only covers two of the most widely used polymers: polyethylene, which is used for plastic bottles and bags; and polypropylene, used for food packaging. It does not include other major plastics such as polystyrene.

The new data was revealed as delegates prepared to meet in Busan, South Korea, to hammer out the world’s first treaty to cut plastic pollution. The treaty has a mandate to agree on a legally binding global agreement to tackle plastic pollution across the entire plastics life cycle.

But the talks, which have been subject to heavy lobbying by the alliance and fossil fuel companies, are on a knife-edge in a row over whether caps to global plastic production will be included in the final treaty.

Will McCallum, a co-executive director at Greenpeace UK, said the revelations had stripped off the thin layer of greenwash hiding the growing mountain of plastic waste oil companies were producing.

“The recycling schemes they’re promoting can barely make a dent in all the plastic these companies are pumping out,” he said. “They’re letting the running tap flood the house while trying to scoop up the water with a teaspoon. The only solution is to cut the amount of plastic produced in the first place.”

Bill McKibben, a US environmentalist, said: “It’s hard to imagine a clearer example of greenwashing in this world. The oil and gas industry—which is pretty much the same thing as the plastics industry—has been at this for decades.”

In response to the allegations, a spokesperson for the AEPW said it “respectfully disagrees with the allegations and inferences, including that the organization’s purpose is to greenwash the reputation of its members…The alliance aims to accelerate innovation and channel capital into the development of effective scalable solutions to help end plastic waste and pollution.”

The AEPW has had a significant lobbying presence at the UN plastic waste talks, which entered their final stages on Monday. Its representatives have consistently argued that reductions in plastic production should not be included in the treaty.

The UK’s new Labour government has shifted the country’s stance and signed a ministerial declaration calling for the inclusion of reductions in production and consumption of primary plastic polymers to sustainable levels in the treaty. The United States under President Biden also shifted its position this summer to support caps on global production. It is not known yet the position of the incoming Trump administration.

A UK government source said: “The government supports an effective treaty which covers the full life cycle of plastics including reducing the production and consumption of plastics to sustainable levels.”

Some 15 percent of Americans are enrolled in Medicare Part D, which covers outpatient prescription drug costs for older adults and other qualifying individuals, providing nearly $140 billion a year in support to about 50 million people. But the program is administered by the Centers for Medicare and Medicaid Services—which President-elect Donald Trump has nominated celebrity physician Mehmet Oz to lead.

It’s questionable how a man infamous for promoting questionable supplements, who has commented that there’s no right to health for people who can’t afford it, will help lead and provide government health insurance in the United States. On his show, the cardiothoracic surgeon has mounted attacks on medications that Part D covers, such as antidepressants, claiming that they do not work for most patients (the evidence is against him).

Given his history, it makes sense that Oz would be part of Trump’s “Make America Healthy Again” cohort, which does seem fairly anti-science: Robert F. Kennedy Jr.’s attacks on vaccines, for instance, also conveniently ignore that measles and polio can cause lifelong health conditions. Medicare Part D currently covers the costs of all recommended vaccines.

But what kind of damage could Oz do from his new post? Will he be able to cut medications that actually help people manage chronic health conditions—conditions that people who qualify for Medicare are more likely to have? The short answer is no. At least not on his own.

Juliette Cubanski, deputy director of health nonprofit KFF‘s program on Medicare policy, explains that the range of medications covered by Medicare Part D is specified in the Social Security Act.

“Generally speaking, Medicare Part D covers drugs and vaccines that are approved by the Food and Drug Administration,” Cubanski told Mother Jones. “The law specifically excludes some types of drugs from coverage under Part D, including drugs used for weight loss or cosmetic purposes.” So dubious supplements that Oz promoted on his show could not readily be added to the list, nor could he easily remove actual medication.

“Congress would need to change the law in order to change what drugs Medicare Part D covers,” Cubanski said. “An agency official acting under their own authority can’t do that.”

There is still the possibility that some aspects of Medicare Part D could change through a regulatory process, says University of Pennsylvania health law and policy professor Allison Hoffman, but that too is a rigorous procedure—and attacking Medicare would also be a risky political move.

“Medicare Part D was passed during a Republican administration and with Republican control in Congress, with Democratic support,” Hoffman said. “Trump knows to tread carefully in this space because Medicare is a widely popular program and the Part D program has really created a lot of financial security for people.”

But if Republicans do, as they have pledged, go after the Inflation Reduction Act, which helped fund and improve Medicare affordability, Part D isn’t necessarily in the clear. The IRA instituted a new $2,000-a-year cap on out-of-pocket spending costs for prescriptions—still a lot for many older Medicare patients, and for qualifying younger disabled people, but an extremely short-lived protection if it’s immediately overturned by the GOP.

And while Oz on his own can’t screw up Medicare Part D too badly, there’s no guarantee he’ll let it work smoothly, either. In practice, the plans are administered by private insurance companies, which can choose which pharmacies to work with and even which medications to cover. Federal health reforms like the Affordable Care Act have focused in part on making it harder for insurers to weasel out of providing care—not a likely priority for Trump’s health officials. If someone on Medicare needs to start a new medication, they could meet with a rude awakening.

“That would require them to either switch to a different drug in the class, or switch plans during the next open enrollment period,” says Julie Donohue, chair of the University of Pittsburgh’s Department of Health Policy and Management.

Such limitations in Part D—and related programs, like private-insurer-run Medicare Advantage plans—illustrate the consistent failures of privatizing Medicare, something Oz nevertheless pushed for more of during his unsuccessful 2022 Senate campaign.

With the chaos and uncertainty that’s marked Trump’s White House nominations—like former Rep. Matt Gaetz withdrawing on Thursday from consideration to be his Attorney General—Hoffman also cautions us to “wait to see if people are confirmed,” rather than immediately panicking about “our imagination of what these policies might be.”

Update, November 21: Sen. Bob Casey conceded the Pennsylvania Senate race to Republican Dave McCormick.

Pennsylvania Sen. Bob Casey, a stalwart moderate who rose to power on the heels of his late father’s political legacy, seems likely to lose his reelection bid. Shortly after Election Day, the Associated Press called the race for his opponent, former hedge fund executive Dave McCormick, who had a narrow lead in returns. Even though McCormick has declared victory and was invited by Senate Majority Leader Chuck Schumer to the US Senate orientation, Casey has not conceded, citing thousands of uncounted ballots. 

The two candidates are engaged in ongoing legal battles over how counties are handling certain ballots, with the Pennsylvania Supreme Court recently ruling that undated or misdated mail-in ballots are not valid. There are still thousands of provisional ballots pending, some of which are subject to legal challenges, but it seems unlikely that enough will break for Casey. A recount is currently underway and should be completed by November 26—though this too is unlikely to significantly alter vote counts. On Thursday morning, McCormick was leading by just over 16,000 votes. 

After unsuccessful efforts by hardline MAGA Republicans like Dr. Mehmet Oz in the 2022 election, McCormick was a return to a more traditional Republican candidate. But he still managed to win over GOP voters and ride President-elect Donald Trump’s coattails. Casey’s campaign emphasized his moderate sensibilities and long-standing ties to the state—his father, Bob Casey Sr., was a popular two-term governor—but he ultimately underperformed Vice President Kamala Harris in crucial Democratic strongholds. 

In a cycle where Democrats lost up and down the ballot in Pennsylvania, 2024 was “like no race Casey had run before,” said Berwood Yost, a political science professor at Franklin & Marshall College. Casey was last up for reelection during a presidential cycle in 2012, when Barack Obama won Pennsylvania by five points.

“He needed Democrats to turn out to vote for him, and clearly, some people who voted for the top of the ticket abandoned him.”

“Casey had a difficult needle to thread because he had to distance himself from the policies of an unpopular president to be viable,” Yost said. “But at the same time, he needed Democrats to turn out to vote for him, and clearly, some people who voted for the top of the ticket abandoned him.”

On the day before Election Day, I watched Casey make his final appeal to voters in Bucks County, one of the closely watched suburban “collar counties” surrounding Philadelphia. Around 60 supporters—mostly white and almost all of them appearing to be of retirement age—gathered in the small town of Warrington. The mood was cautiously optimistic, despite polls showing a virtual tie. It seemed difficult to imagine that Casey, who had become an institution in Pennsylvania, was subject to the same shifting political waters that would decide the presidency for Trump.

In the summer, polls showed Casey with around a five-point lead over McCormick, but that gap narrowed as Election Day approached. When I asked rallygoers why it was so close, one man rubbed his fingers together—money. Around $283 million was spent on the race in total, according to a PennLive analysis, making the matchup among the most expensive Senate contests—likely second only to Ohio Sen. Sherrod Brown’s unsuccessful reelection bid. McCormick lagged behind Casey in fundraising and sunk at least $4 million of his own wealth into the race. But spending in support of McCormick mostly came from super-PACs and far outpaced Casey: The Senate Leadership Fund and Keystone Renewal PAC, whose largest donor is the CEO of the hedge fund Citadel, each spent about $50 million on McCormick’s behalf. WinSenate, a Democratic-aligned PAC, spent about $54 million on Casey’s behalf.

Casey first was elected to the US Senate in 2006, winning by 15 points and ousting tea party star Rick Santorum. Since then, Casey has enjoyed comfortable reelection margins, winning by 9 points in 2012 and 13 points in 2018. The senator grew up in an Irish Catholic family in Scranton and has an enduring homegrown appeal. At the Warrington rally, voters repeatedly told me that Casey was a “good man” and described him as a familiar presence—though they were vague on the particulars of his congressional accomplishments.  

Casey has a reputation for being understated—Pennsylvania’s junior senator, John Fetterman, calls Casey “Mild Thing”—which often has been considered an asset. He is seen as principled and dependable. But Casey has shown that he can move on issues when the political moment arises. He shifted his position on gun control after the 2012 Sandy Hook shooting and became an outspoken critic of the Trump administration’s family separation policies in 2017.

But the most notable change came regarding abortion. Casey has described himself as a “pro-life Democrat,” and his father was, at one time, a national face of the anti-abortion movement. As governor, Casey Sr. signed laws requiring a 24-hour waiting period for abortion and parental consent for minors. The legislation led to the 1992 Supreme Court case Planned Parenthood v. Casey. But in the wake of the overturning of Roe v. Wade, Casey Jr. voted for the Women’s Health Protection Act and has attacked Republicans for their extreme restrictions on abortion care.

Republicans used this evolution to create the narrative that Casey had become dangerously progressive. Even though his moderate image had won him crossover support in previous elections, he struggled this year with an association with the Biden administration—particularly on inflation and border security. He made fentanyl smuggling across the southern border a key issue and ran an ad claiming he had sided with Trump on fracking and trade. But as a longtime friend of President Joe Biden, a fellow Catholic, and a Scranton native, it was difficult to create any credible distance from his administration. 

McCormick was Casey’s strongest political challenger. A West Point graduate and Gulf War veteran, McCormick earned a PhD in international relations at Princeton. After a stint in George W. Bush’s administration, McCormick rose in the ranks at Bridgewater Associates, a Connecticut-based hedge fund giant, to become CEO. In 2022, he left Bridgewater to compete in the Republican primary to represent Pennsylvania in the US Senate. He was ultimately no match for Oz, the controversial physician and television personality, whose Pennsylvania residency was widely questioned (and whom President-elect Trump has recently named the head of the Centers for Medicare and Medicaid Services). After McCormick refused to say that the 2020 election was stolen, Trump all but sank his candidacy by endorsing Oz and dubbing McCormick “not MAGA.” Oz won the nomination by fewer than 1,000 votes, then lost to Fetterman by almost five points. 

During the 2024 campaign, McCormick leaned heavily into the more ruggedly patriotic aspects of his biography. His website is peppered with photos of him in military uniform, and the campaign’s most frequently used headshot features McCormick standing in front of a pastoral barn backdrop wearing a chore coat and a denim button-up. But Bridgewater is also presented as a point of pride, with his website describing it as “one of the largest, most successful investment firms in the world” that manages the pensions of “teachers, firefighters and law enforcement.” 

McCormick had the difficult task of triangulating within today’s Republican Party, where Trump remains the gravitational center of power. Though Trump acolytes have previously succeeded in Republican primaries in Pennsylvania’s statewide races, like Oz, they tended to fail in the general election. In the 2022 gubernatorial race, Trump loyalist and election denier Doug Mastriano also lost badly. McCormick distanced himself from the party on some issues: He is against a national abortion ban, for instance, and in favor of exceptions in the cases of rape, incest, and the life of the mother. 

But there was no path to victory without Trump, and, this time around, McCormick did his best to remain in the former president’s good graces. He spoke at Trump’s rally in Butler shortly before the attempted assassination, and he has amplified some of Trump’s favorite culture-war talking points. In early November, McCormick told a group of veterans that the country needs “a military that’s not woke and focusing on millions of hours of DEI training.”

“He just doesn’t draw the same type of animosity that more traditional Republicans receive from the populist element within the ranks.”

Christopher Borick, a political science professor at Muhlenberg College, called McCormick the “Goldilocks Republican”—occupying a comfortable middle in the party. “He just doesn’t draw the same type of animosity that more traditional Republicans receive from the populist element within the ranks,” Borick said. 

Casey’s campaign strove to paint McCormick as an out-of-touch “Connecticut mega-millionaire.” (McCormick grew up in Pennsylvania. He lived for many years in Connecticut and still has a home there.) Casey also tried to drive a wedge between McCormick and working-class voters by highlighting Bridgewater’s extensive investments in China and the fund’s bets against American-owned steel companies. But McCormick’s high-finance background ultimately didn’t alienate as many voters as Casey might have hoped. 

At the rally in Warrington, Casey’s remarks were narrowly focused on what he’s “delivered for the people of this county”: funding for public education and infrastructure. Wearing a navy gingham button-up and blue jeans, he was even-keeled and self-assured. In a political landscape dominated by whoever can shout the loudest, Casey wasn’t a remarkable orator or a natural showman—and he’d never had to be. After all, he was Pennsylvania’s native son. 

But that doesn’t seem to have been enough to put him over the top. Casey ended up winning fewer votes than Harris—current vote counts show him with about a 40,000 vote deficit—and the dropoff was particularly notable in traditionally Democratic areas like Philadelphia and its surrounding counties. Yost said that early analysis shows that Casey lagged four and a half points behind Harris in Philadelphia. In such a narrow race, those Harris-only voters could have made the difference not only for the incumbent but also for the balance of the Senate.

It looks as if Casey also lost many of the split-ticket voters who, in 2012, punched their ballots for both him and Republican presidential candidate Mitt Romney. In comparison, Montana Sen. Jon Tester and Ohio Sen. Brown both ran significantly ahead of Harris in states where Trump won by wide margins. (They both lost.) Tester and Brown are Democrats who were elected to the Senate the same year as Casey and similarly leaned on reputations as salt-of-the-earth moderates. 

Despite his familiarity with the state, it seems like Casey was unable to break out of the mold of a “generic Democrat,” as Brian Rosenwald, a scholar at the University of Pennsylvania, explained. “If anything, I think it was less about a moderating campaign,” he said, “and more about a lackluster campaign in general.”

It looks as if McCormick, with the help of Trump, had seized onto a more compelling narrative. In October, he went on Fox Business and described his “blessed” ascension from a small-town upbringing to West Point and through the ranks of the world’s largest hedge fund. “I’ve really lived the American dream,” McCormick said, “and I think that dream is slipping away.”

Pennsylvania voters appeared to agree.

On Monday night, Christian Pulisic, the star of the US men’s national soccer team, scored in a match against Jamaica and promptly jogged over to the corner flag. After a jumping fist pump, the red, white, and blue bedecked central midfielder did what’s become known as the “Trump Dance,” laughing as he wiggled his arms and hips.

This dance is more than just “fun.” It’s a symbol of shifts in power and policy.

In a post-game interview, Pulisic—a multi-millionaire who is a registered Republican—was questioned about his celebration, and disavowed that it carried any deeper meaning: “It’s not a political dance. It was just for fun.”

No matter what Pulisic intended, there’s no denying he’s part of a larger wave of athletes, from the NFL to the collegiate level, who in the wake of Trump’s 2024 win have been imitating the president-elect’s dance, which he is known to perform along to “YMCA.” 

In discussing the trend, Fox News liberal commentator Jessica Tarlov identified a hypocrisy in contrast to the national stick-to-sports outrages that followed political statements by stars like Colin Kaepernick and LeBron James: “I guess we’ve gotten to the portion of the Trump era where we have moved past shut up and dribble, and now it is fantastic for athletes to talk about their politics.”

There’s no doubt some athletes are doing the dance as a show of support for Trump and his agenda. Take San Francisco 49ers pass-rusher Nick Bosa, who, a week before the election, wore a “Make America Great Again” hat during a post-game appearance. He was eventually docked $11,255 for breaking rules barring displaying written messages on the field, but, as the Wall Street Journal reported, the NFL delayed the fine until after Election Day in hopes of avoiding controversy or retribution from Trump. The following Sunday, Bosa did Trump’s dance in celebration of a sack; a video went viral after being shared by Sean Hannity on social media.

Trump’s election win is visible beyond American athletes. Players from the English football club Barnsley F.C—founded in 1887 and now playing in the third tier of professional British soccer—celebrated a goal with the dance. The display was broadcast to the world by the team’s social media managers, who shared a video backed up by the sounds of YMCA. And this month’s attacks in Amsterdam on Israeli soccer fans were kicked off after at least one supporter of Maccabi Tel-Aviv, the visiting team, was photographed hoisting a Trump banner. 

As Trump’s win reverberates in American culture and across the world, his reelection has confirmed his status as a global right-wing figure. In that sense, symbols that are associated with him will always speak to shifts in power and policy. When they crop up in sports, it’s hard to argue they are simply “just for fun.”

It was clear from the outset that the Joint Resolutions of Disapproval from Sen. Bernie Sanders (I-Vt.) would not pass. The trio of bills, brought to a vote on Wednesday night, would have stopped $20 billion in weapons from being sent to Israel. Every single Republican in the Senate voted against Sanders, as expected. A majority of Democratic senators voted against the bills, too. 

But there has still been movement in favor of limiting military aid: About 40 percent of the Democrats present for the vote wanted to stop billions in arms sales to Israel, despite loud opposition from the White House, Senate Majority Leader Chuck Schumer, and the American Israel Public Affairs Committee (AIPAC).

Major figures in the Democratic Party—Sen. Elizabeth Warren (D-Mass.), Sen. Tim Kaine (D-Va.), Sen. Dick Durbin (D-Ill.), Sen. Raphael Warnock (D-Ga.)—voted for at least one of the resolutions. Nineteen senators backed at least a piece of Sanders’ call to limit aid, a historically high number showing explicit, public support for upholding American law as it applies to Israel.

Polls show that the majority of Americans support suspending offensive weapons to Israel until an end comes to the country’s yearlong bombardment of Gaza—in which, experts estimate, over 100,000 people have already been killed. But that majority view—endorsed even by some explicitly pro-Israel organizations, such as J Street—has not been reflected in the US government.

In fact, hours before Sanders brought his resolutions to the Senate floor, the United States vetoed another ceasefire resolution in the United Nations. It is the fourth such resolution since Israel’s war in Gaza—which United Nations agencies, independent experts, and several world governments have declared a genocide—began. (That resolution would have demanded the release of all hostages, and implemented Biden’s own ceasefire plan.)

On the Senate floor, Sanders spoke next to a large photo of a dead, emaciated Palestinian child. “Every member of the Senate who believes in the rule of law, that our government should obey the law, should vote for these resolutions,” he said. “The Foreign Assistance Act and the Arms Export Control Act are very clear. The United States cannot provide weapons to countries that violate internationally recognized human rights or block US humanitarian aid. That is not my opinion, that is what the law says.”

In mid-September, Biden administration leaders sent a letter to Netanyahu warning him of these specific provisions of US law, and saying Israel had 30 days to improve humanitarian conditions in Gaza or face cuts to military aid. But 30 days came and went, Palestinians continued to starve, and the Biden administration refused to enforce its own deadline.

Joint Resolutions of Disapproval are not unheard of—they’ve previously been levied against Saudi Arabia and Egypt, for example—but this is the first time that this type of weapons-trade-restricting measure has been brought against Israel, which is by a far larger recipient of US weapons, having been given about $310 billion in military aid from the US since its founding.

Sanders recounted anecdotes from doctors who saw civilians shot in the head in Gaza, explained that per satellite imagery two-thirds of the buildings in Gaza are flattened entirely, and told fellow congresspeople that reporting showed almost no one in Gaza has had consistent access to electricity or clean water for nearly 14 months. 

“Fundamentally, [President] Joe Biden will not uphold the law,” Matt Duss, a former Sanders aide now at the Center for International Policy, said of the White House pressure campaign to vote against Sanders. Instead, it’s “purely ideological: [Biden] just believes that Israel is entitled to absolute total wall-to-wall support, no matter how catastrophic the impact on Palestinians or Lebanese.” 

“A lot of people wrongly thought that it was because of political considerations,” Duss continued. “But no, even after the election, [the administration] remains completely committed to ignoring US law and keeping the flow of weapons running, even with the knowledge that these particular weapons will not reach Israel for over a year.”

The first bill to be voted on Wednesday night concerned exploding tank shells. Cat Knarr of the US Campaign for Palestinian Rights noted that these shells are thought to have killed 6-year-old Hind Rajab as she sat alone with the bodies of her family, pleading for help. Knarr’s group staged a protest the day before the vote at the Senate. “You’re either on the side of justice and stopping the weapons, or you’re on the side of arming a genocidal state, and you will go down in history for how you vote today,” she said. 

When opponents of the JRDs came to the floor, their talking points sounded like they were lifted directly from a White House memo circulated earlier that morning. As reported by Akbar Shahid Ahmed of the Huffington Post, the White House declared that those who would block weapons to Israel were aiding Hamas and prolonging the war.

Ted Budd (R-N.C.) and Lindsey Graham (R-S.C.) are among the senators who seemed to speak from that playbook. “If you love peace you have to destroy those who hate peace,” Graham said. 

No one argued against Sanders’ fundamental point—that sending weapons to a nation blocking humanitarian aid is illegal. Instead, they said Israel needed to defend itself against a region in which it is the only reliable ally for the West. Senator John Neely Kennedy (R-La.) spoke vaguely of a world of evil people: “They hate Americans. They want to kill us and drink our blood out of a boot.” 

But the closeness of Israel and the West is showing signs of cracking.

The next day, the International Criminal Court issued arrest warrants for Israeli Prime Minister Benjamin Netanyahu and former Minister of Defense Yoav Gallant for using starvation as a weapon of war as well as “murder, persecution, and other inhumane acts.” This marked the first time the ICC has ever indicted a pro-Western official on war crimes charges—which means the United States is certain to push back. After 14 months of unabated carnage, opposition to arming Israel even within the United States is looking less fringe.

Correction, November 22: The article has been updated to more accurately reflect who Sen. John Kennedy (R-La.) believes wants to kill Americans and “drink our blood out of a boot.”

Amid the escalating debate over whether to release a highly damaging report into allegations that he had sex with a minor, Matt Gaetz on Thursday announced that he was withdrawing from consideration to become President-elect Donald Trump’s attorney general.

“While the momentum was strong, it is clear that my confirmation was unfairly becoming a distraction to the critical work of the Trump/Vance Transition,” Gaetz wrote on social media. “There is no time to waste on a needlessly protracted Washington scuffle, thus I’ll be withdrawing my name from consideration to serve as Attorney General. Trump’s DOJ must be in place and ready on Day 1.”

The surprise announcement comes one day after the House Ethics Committee failed to agree to release the long-awaited results of the report surrounding Gaetz’s sexual relationships and payments to several women, including at least one minor. Trump shocked even close allies by tapping Gaetz for the role and was reportedly phoning members of Congress as recently as this week to rally support for the disgraced Florida Republican.

Those who have opposed the report’s release, including Republican House Speaker Mike Johnson, have argued that such a move would set a poor precedent since Gaetz, who resigned shortly after Trump announced his intention to appoint him, is technically no longer a sitting member of Congress.

“I remain fully committed to see that Donald J. Trump is the most successful President in history,” Gaetz continued. “I will forever be honored that President Trump nominated me to lead the Department of Justice and I’m certain he will Save America.”

The long, strange saga of the “nonprofit-killer bill” continues. The legislation—officially called HR 9495, or the “Stop Terror Financing and Tax Penalties on American Hostages Act”—would give the Secretary of the Treasury unilateral power to designate nonprofits as suspected “Terrorist Supporting Organizations,” taking away their tax-exempt status unless they are able to prove they are not terrorist supporting.

The bill was unable to meet the two-thirds majority vote it needed to make it through the House last week. But, today, with only a simple majority vote required, the legislation passed the House in a 219–184 vote. This time, it garnered far less Democratic support than it had only days ago.

In the bill’s original iteration, it was popular among both Republicans and Democrats, who saw it as an appealing way to police Palestinian rights organizations after protests last year. An earlier version, in April, passed the House easily, with only 11 votes against the bill. It didn’t make it through the Senate and was reintroduced in the House this fall.

One of those early no votes was Rep. Rashida Tlaib (D-Mich.), who said on the House floor today, “This is going to be my third time voting against this bill, because I don’t care who the president is. This is a dangerous and an unconstitutional bill that would allow unchecked power to target nonprofit organizations as political enemies and shut them down without due process.”

Meet HR 9495: The nonprofit killer. pic.twitter.com/kN6X5Sypwm

— Mother Jones (@MotherJones) November 20, 2024

When Tlaib was first voting against the bill, most Democrats disagreed with her. Since then, they have become concerned that a law they would have considered reasonable under a Harris administration would be dangerously applied under Trump.

This time, 183 Democrats and one Republican voted against the bill, and only 15 Democrats voted for it—down from 52 last week. Since then, there’s been a full-court-press civil society campaign to take down H.R. 9495. Nearly 300 organizations—including the ACLU, the Sierra Club, the AFL-CIO, Planned Parenthood, and the NAACP—have signed a letter pointing out that Trump is likely to use this bill to silence any of his enemies, not just Palestinians and their supporters. As Rep. Pramila Jayapal (D-Wash.) pointed out, that could also include nonprofit news outlets.

Rep. Lloyd Doggett (D-Texas) is one of the dozens of Democrats who flipped their vote on the bill since Trump’s election.

He gave a personal example of why. One of the organizations whose nonprofit status Trump wants to terminate, Doggett said, “has protested one of my speeches.”

“Protests are inconvenient,” he said. “The one I had was inconvenient.” Nonetheless, “America is stronger when we protect dissent in all its forms, as long as it is done in a proper way.” For Doggett, the bill itself is less of a concern than the man who could be utilizing it.

“There has been much made in this debate of the fact that some of us have been switching positions,” he said. “Well, we listen to our constituents.”

Of the many absurd things Robert F. Kennedy Jr. has said over the years—about vaccines, about 5G technology as a tool of mass surveillance, about Covid being an “ethnically targeted” bioweapon designed to spare Ashkenazi Jews and Chinese people—his claims about HIV and AIDS have been some of the most fact-free.

“He is entirely unqualified.”

Kennedy has suggested there are questions about whether HIV causes AIDS. (There are not, and it does.) His book The Real Anthony Fauci heavily quoted the work of Berkeley professor Peter Duesberg, an infamous first-wave AIDS denialist. Kennedy has also promoted the idea, debunked since the late 1980s, that the party drug poppers might cause AIDS. All of which has led experts to ask a simple question: what will become of the United States’ policies towards HIV/AIDS if Kennedy is confirmed as secretary of the Department of Health and Human Services? 

Donald Trump announced his plans to nominate Kennedy to lead HHS last week, generating immediate concern among scientists and public health experts. Given the extraordinary scope of HHS, one told Mother Jones, him taking charge of the agency would be “a genuine catastrophe.” In the case of HIV/AIDS, the damage could be global, if Kennedy’s previously-stated beliefs about the disease and its treatments still hold true.

Along with the State Department, HHS helps implement the President’s Plan for Emergency AIDS Relief, which was created by George W. Bush in 2003. The PEPFAR program has been an incredible success, spending about $100 billion to save millions of lives in the developing world, mostly in sub-Saharan Africa, by helping people access antiretroviral medication, testing, and prevention.

While AIDS denialism and revisionism take many different forms, one of the most common is suggesting that HIV may not be the true cause of AIDS. By that metric, Kennedy has engaged in overt denialism, writing in his Fauci book that he “takes no position” on whether HIV causes AIDS. In an video clip unearthed by the Twitter account Patriot Takes, he falsely told an audience that “a hundred percent of” the earliest AIDS deaths “were people who were addicted to poppers…people who were part of a gay lifestyle where they were burning the candle at both ends.” He went on to claim that some government scientists involved in early AIDS research believed the disease was environmental, but, RFK explained, “for Tony Fauci it was really important to call it a virus” because it “allowed him to take control of it.” 

The idea that AIDS is “environmental,” rather than being caused by a virus, is a clear reference to the roundly and repeatedly discredited Duesberg hypothesis. Duesberg—who was a biologist, but not an AIDS researcher—claimed that HIV was a harmless “passenger virus” and that the true cause of HIV/AIDS was drug use. In citing Duesberg, Kennedy took part in a small but noticeable resurgence of AIDS denialism, with people like Joe Rogan parroting Duesberg’s ideas, and NFL superstar Aaron Rodgers suggesting that Fauci used the AIDS crisis for personal gain and recklessly promoted the first-wave antiretroviral drug AZT. (Rogers wrongly suggested the drug was “killing people.”)

When I wrote about this resurgence in AIDS denialism earlier this year, Seth Kalichman, a professor of psychology at the University of Connecticut and the author of Denying AIDS: Conspiracy Theories, Pseudoscience, and Human Tragedy, expressed relief that nobody in a position of power in the US government had yet taken up the cause. 

Now, he says, “it’s hard to believe we’re having this conversation.” Kalichman predicts the danger of a Kennedy-controlled HHS is not that Kennedy will directly target AIDS studies, but that he’ll preside over a general reduction in science funding which will impact HIV research. Kennedy has already laid out a plan to radically reshape the National Institutes of Health, which is a division of HHS. Cuts to the NIH could mean, Kalichman says, that “the Office of AIDS Research, which is at the forefront of AIDS research globally, could easily go away.” 

“PEPFAR won’t be a priority,” in a new Trump administration, Kalichman adds, explaining that with Marco Rubio as the likely Secretary of State, he predicts “more isolationism” and “a real pulling-in of our resources across the board.”

“All of us would hope that any nominee will be committed to evidence-based decisionmaking.”

For Kalichman, Trump’s selection of Kennedy brings the United States closer to a “worst-case scenario” akin to what “they had in South Africa, where you now have AIDS denialism at the highest levels.” Thabo Mbeki, who became South Africa’s president in 1999, was persuaded by the denialist arguments of his health minister Manto Tshabalala-Msimang, as well as by American AIDS denialists who he hosted while he was in office. Tshabalala-Msimang argued that AIDS could be cured with beetroot and garlic while dismissing antiretroviral medications as toxic; her role was, Kalichman points out, “really the parallel position in government to the secretary of HHS.” 

Major AIDS research and philanthropy groups have made their opposition to a Kennedy nomination clear. The nonprofit amFAR, which has donated some $635 million to AIDS research over the years, released a statement citing “the many controversial and false statements made by RFK Jr in relation to HIV and AIDS.”

“Sadly, he repeats disproven and debunked theories. It is amfAR’s intent to refute these statements and to vigorously oppose his nomination to lead HHS—a position for which he is entirely unqualified,” it adds. (Kennedy could not be reached for comment. An email sent to his campaign press team bounced back; one sent to group set up to promote his Make America Healthy Again movement went unreturned.)

Emory professor of medicine Dr. Carlos del Rio is a widely recognized HIV and infectious disease expert who once chaired PEPFAR’s scientific advisory board. He declined to comment on what Kennedy might do at HHS, other than to say that “all of us would hope that any nominee will be committed to evidence-based decisionmaking.”

Rio also pointed out that Trump’s first term featured a surprisingly robust focus on AIDS. His 2019 State of the Union address called for more funding to end AIDS in the United States, although congressional Republicans subsequently attacked that allocation. “Say what you want,” del Rio says, “but he did good with PEPFAR.”

As one of the most effective public health interventions ever, del Rio says that Americans “should be very proud of PEPFAR.” If the program were to end, he points out, “30 million people currently in antiretroviral therapy would potentially die. Would you want to be the president who’s responsible for killing 30 million people globally?” 

“The one thing you don’t want to become, is the laughingstock of the world,” del Rio says. “I don’t think anybody in this administration would like that.” 

Some 15 percent of Americans are enrolled in Medicare Part D, which covers outpatient prescription drug costs for older adults and other qualifying individuals, providing nearly $140 billion a year in support to about 50 million people. But the program is administered by the Centers for Medicare and Medicaid Services—which President-elect Donald Trump has nominated celebrity physician Mehmet Oz to lead.

It’s questionable how a man infamous for promoting questionable supplements, who has commented that there’s no right to health for people who can’t afford it, will help lead and provide government health insurance in the United States. On his show, the cardiothoracic surgeon has mounted attacks on medications that Part D covers, such as antidepressants, claiming that they do not work for most patients (the evidence is against him).

Given his history, it makes sense that Oz would be part of Trump’s “Make America Healthy Again” cohort, which does seem fairly anti-science: Robert F. Kennedy Jr.’s attacks on vaccines, for instance, also conveniently ignore that measles and polio can cause lifelong health conditions. Medicare Part D currently covers the costs of all recommended vaccines.

But what kind of damage could Oz do from his new post? Will he be able to cut medications that actually help people manage chronic health conditions—conditions that people who qualify for Medicare are more likely to have? The short answer is no. At least not on his own.

Juliette Cubanski, deputy director of health nonprofit KFF‘s program on Medicare policy, explains that the range of medications covered by Medicare Part D is specified in the Social Security Act.

“Generally speaking, Medicare Part D covers drugs and vaccines that are approved by the Food and Drug Administration,” Cubanski told Mother Jones. “The law specifically excludes some types of drugs from coverage under Part D, including drugs used for weight loss or cosmetic purposes.” So dubious supplements that Oz promoted on his show could not readily be added to the list, nor could he easily remove actual medication.

“Congress would need to change the law in order to change what drugs Medicare Part D covers,” Cubanski said. “An agency official acting under their own authority can’t do that.”

There is still the possibility that some aspects of Medicare Part D could change through a regulatory process, says University of Pennsylvania health law and policy professor Allison Hoffman, but that too is a rigorous procedure—and attacking Medicare would also be a risky political move.

“Medicare Part D was passed during a Republican administration and with Republican control in Congress, with Democratic support,” Hoffman said. “Trump knows to tread carefully in this space because Medicare is a widely popular program and the Part D program has really created a lot of financial security for people.”

But if Republicans do, as they have pledged, go after the Inflation Reduction Act, which helped fund and improve Medicare affordability, Part D isn’t necessarily in the clear. The IRA instituted a new $2,000-a-year cap on out-of-pocket spending costs for prescriptions—still a lot for many older Medicare patients, and for qualifying younger disabled people, but an extremely short-lived protection if it’s immediately overturned by the GOP.

And while Oz on his own can’t screw up Medicare Part D too badly, there’s no guarantee he’ll let it work smoothly, either. In practice, the plans are administered by private insurance companies, which can choose which pharmacies to work with and even which medications to cover. Federal health reforms like the Affordable Care Act have focused in part on making it harder for insurers to weasel out of providing care—not a likely priority for Trump’s health officials. If someone on Medicare needs to start a new medication, they could meet with a rude awakening.

“That would require them to either switch to a different drug in the class, or switch plans during the next open enrollment period,” says Julie Donohue, chair of the University of Pittsburgh’s Department of Health Policy and Management.

Such limitations in Part D—and related programs, like private-insurer-run Medicare Advantage plans—illustrate the consistent failures of privatizing Medicare, something Oz nevertheless pushed for more of during his unsuccessful 2022 Senate campaign.

With the chaos and uncertainty that’s marked Trump’s White House nominations—like former Rep. Matt Gaetz withdrawing on Thursday from consideration to be his attorney general—Hoffman also cautions us to “wait to see if people are confirmed,” rather than immediately panicking about “our imagination of what these policies might be.”

Update, November 21: Sen. Bob Casey conceded the Pennsylvania Senate race to Republican Dave McCormick.

Pennsylvania Sen. Bob Casey, a stalwart moderate who rose to power on the heels of his late father’s political legacy, seems likely to lose his reelection bid. Shortly after Election Day, the Associated Press called the race for his opponent, former hedge fund executive Dave McCormick, who had a narrow lead in returns. Even though McCormick has declared victory and was invited by Senate Majority Leader Chuck Schumer to the US Senate orientation, Casey has not conceded, citing thousands of uncounted ballots. 

The two candidates are engaged in ongoing legal battles over how counties are handling certain ballots, with the Pennsylvania Supreme Court recently ruling that undated or misdated mail-in ballots are not valid. There are still thousands of provisional ballots pending, some of which are subject to legal challenges, but it seems unlikely that enough will break for Casey. A recount is currently underway and should be completed by November 26—though this too is unlikely to significantly alter vote counts. On Thursday morning, McCormick was leading by just over 16,000 votes. 

After unsuccessful efforts by hardline MAGA Republicans like Dr. Mehmet Oz in the 2022 election, McCormick was a return to a more traditional Republican candidate. But he still managed to win over GOP voters and ride President-elect Donald Trump’s coattails. Casey’s campaign emphasized his moderate sensibilities and long-standing ties to the state—his father, Bob Casey Sr., was a popular two-term governor—but he ultimately underperformed Vice President Kamala Harris in crucial Democratic strongholds. 

In a cycle where Democrats lost up and down the ballot in Pennsylvania, 2024 was “like no race Casey had run before,” said Berwood Yost, a political science professor at Franklin & Marshall College. Casey was last up for reelection during a presidential cycle in 2012, when Barack Obama won Pennsylvania by five points.

“He needed Democrats to turn out to vote for him, and clearly, some people who voted for the top of the ticket abandoned him.”

“Casey had a difficult needle to thread because he had to distance himself from the policies of an unpopular president to be viable,” Yost said. “But at the same time, he needed Democrats to turn out to vote for him, and clearly, some people who voted for the top of the ticket abandoned him.”

On the day before Election Day, I watched Casey make his final appeal to voters in Bucks County, one of the closely watched suburban “collar counties” surrounding Philadelphia. Around 60 supporters—mostly white and almost all of them appearing to be of retirement age—gathered in the small town of Warrington. The mood was cautiously optimistic, despite polls showing a virtual tie. It seemed difficult to imagine that Casey, who had become an institution in Pennsylvania, was subject to the same shifting political waters that would decide the presidency for Trump.

In the summer, polls showed Casey with around a five-point lead over McCormick, but that gap narrowed as Election Day approached. When I asked rallygoers why it was so close, one man rubbed his fingers together—money. Around $283 million was spent on the race in total, according to a PennLive analysis, making the matchup among the most expensive Senate contests—likely second only to Ohio Sen. Sherrod Brown’s unsuccessful reelection bid. McCormick lagged behind Casey in fundraising and sunk at least $4 million of his own wealth into the race. But spending in support of McCormick mostly came from super-PACs and far outpaced Casey: The Senate Leadership Fund and Keystone Renewal PAC, whose largest donor is the CEO of the hedge fund Citadel, each spent about $50 million on McCormick’s behalf. WinSenate, a Democratic-aligned PAC, spent about $54 million on Casey’s behalf.

Casey first was elected to the US Senate in 2006, winning by 15 points and ousting tea party star Rick Santorum. Since then, Casey has enjoyed comfortable reelection margins, winning by 9 points in 2012 and 13 points in 2018. The senator grew up in an Irish Catholic family in Scranton and has an enduring homegrown appeal. At the Warrington rally, voters repeatedly told me that Casey was a “good man” and described him as a familiar presence—though they were vague on the particulars of his congressional accomplishments.  

Casey has a reputation for being understated—Pennsylvania’s junior senator, John Fetterman, calls Casey “Mild Thing”—which often has been considered an asset. He is seen as principled and dependable. But Casey has shown that he can move on issues when the political moment arises. He shifted his position on gun control after the 2012 Sandy Hook shooting and became an outspoken critic of the Trump administration’s family separation policies in 2017.

But the most notable change came regarding abortion. Casey has described himself as a “pro-life Democrat,” and his father was, at one time, a national face of the anti-abortion movement. As governor, Casey Sr. signed laws requiring a 24-hour waiting period for abortion and parental consent for minors. The legislation led to the 1992 Supreme Court case Planned Parenthood v. Casey. But in the wake of the overturning of Roe v. Wade, Casey Jr. voted for the Women’s Health Protection Act and has attacked Republicans for their extreme restrictions on abortion care.

Republicans used this evolution to create the narrative that Casey had become dangerously progressive. Even though his moderate image had won him crossover support in previous elections, he struggled this year with an association with the Biden administration—particularly on inflation and border security. He made fentanyl smuggling across the southern border a key issue and ran an ad claiming he had sided with Trump on fracking and trade. But as a longtime friend of President Joe Biden, a fellow Catholic, and a Scranton native, it was difficult to create any credible distance from his administration. 

McCormick was Casey’s strongest political challenger. A West Point graduate and Gulf War veteran, McCormick earned a PhD in international relations at Princeton. After a stint in George W. Bush’s administration, McCormick rose in the ranks at Bridgewater Associates, a Connecticut-based hedge fund giant, to become CEO. In 2022, he left Bridgewater to compete in the Republican primary to represent Pennsylvania in the US Senate. He was ultimately no match for Oz, the controversial physician and television personality, whose Pennsylvania residency was widely questioned (and whom President-elect Trump has recently named the head of the Centers for Medicare and Medicaid Services). After McCormick refused to say that the 2020 election was stolen, Trump all but sank his candidacy by endorsing Oz and dubbing McCormick “not MAGA.” Oz won the nomination by fewer than 1,000 votes, then lost to Fetterman by almost five points. 

During the 2024 campaign, McCormick leaned heavily into the more ruggedly patriotic aspects of his biography. His website is peppered with photos of him in military uniform, and the campaign’s most frequently used headshot features McCormick standing in front of a pastoral barn backdrop wearing a chore coat and a denim button-up. But Bridgewater is also presented as a point of pride, with his website describing it as “one of the largest, most successful investment firms in the world” that manages the pensions of “teachers, firefighters and law enforcement.” 

McCormick had the difficult task of triangulating within today’s Republican Party, where Trump remains the gravitational center of power. Though Trump acolytes have previously succeeded in Republican primaries in Pennsylvania’s statewide races, like Oz, they tended to fail in the general election. In the 2022 gubernatorial race, Trump loyalist and election denier Doug Mastriano also lost badly. McCormick distanced himself from the party on some issues: He is against a national abortion ban, for instance, and in favor of exceptions in the cases of rape, incest, and the life of the mother. 

But there was no path to victory without Trump, and, this time around, McCormick did his best to remain in the former president’s good graces. He spoke at Trump’s rally in Butler shortly before the attempted assassination, and he has amplified some of Trump’s favorite culture-war talking points. In early November, McCormick told a group of veterans that the country needs “a military that’s not woke and focusing on millions of hours of DEI training.”

“He just doesn’t draw the same type of animosity that more traditional Republicans receive from the populist element within the ranks.”

Christopher Borick, a political science professor at Muhlenberg College, called McCormick the “Goldilocks Republican”—occupying a comfortable middle in the party. “He just doesn’t draw the same type of animosity that more traditional Republicans receive from the populist element within the ranks,” Borick said. 

Casey’s campaign strove to paint McCormick as an out-of-touch “Connecticut mega-millionaire.” (McCormick grew up in Pennsylvania. He lived for many years in Connecticut and still has a home there.) Casey also tried to drive a wedge between McCormick and working-class voters by highlighting Bridgewater’s extensive investments in China and the fund’s bets against American-owned steel companies. But McCormick’s high-finance background ultimately didn’t alienate as many voters as Casey might have hoped. 

At the rally in Warrington, Casey’s remarks were narrowly focused on what he’s “delivered for the people of this county”: funding for public education and infrastructure. Wearing a navy gingham button-up and blue jeans, he was even-keeled and self-assured. In a political landscape dominated by whoever can shout the loudest, Casey wasn’t a remarkable orator or a natural showman—and he’d never had to be. After all, he was Pennsylvania’s native son. 

But that doesn’t seem to have been enough to put him over the top. Casey ended up winning fewer votes than Harris—current vote counts show him with about a 40,000 vote deficit—and the dropoff was particularly notable in traditionally Democratic areas like Philadelphia and its surrounding counties. Yost said that early analysis shows that Casey lagged four and a half points behind Harris in Philadelphia. In such a narrow race, those Harris-only voters could have made the difference not only for the incumbent but also for the balance of the Senate.

It looks as if Casey also lost many of the split-ticket voters who, in 2012, punched their ballots for both him and Republican presidential candidate Mitt Romney. In comparison, Montana Sen. Jon Tester and Ohio Sen. Brown both ran significantly ahead of Harris in states where Trump won by wide margins. (They both lost.) Tester and Brown are Democrats who were elected to the Senate the same year as Casey and similarly leaned on reputations as salt-of-the-earth moderates. 

Despite his familiarity with the state, it seems like Casey was unable to break out of the mold of a “generic Democrat,” as Brian Rosenwald, a scholar at the University of Pennsylvania, explained. “If anything, I think it was less about a moderating campaign,” he said, “and more about a lackluster campaign in general.”

It looks as if McCormick, with the help of Trump, had seized onto a more compelling narrative. In October, he went on Fox Business and described his “blessed” ascension from a small-town upbringing to West Point and through the ranks of the world’s largest hedge fund. “I’ve really lived the American dream,” McCormick said, “and I think that dream is slipping away.”

Pennsylvania voters appeared to agree.