(NEW YORK) — Jennifer Crumbley, the mother of Michigan school shooter Ethan Crumbley, testified she and her husband often argued with their son about missing school assignments and said her husband struggled to keep a job as her manslaughter trial continued Thursday with her taking the stand in her own defense.
Jennifer Crumbley and her husband, James Crumbley, are each facing four counts of involuntary manslaughter in connection with the school shooting, which was carried out by their then-15-year-old son Ethan. James Crumbley is being tried in a separate trial in March.
Ethan Crumbley has been sentenced to life in prison without parole for killing four students and injuring seven others in November 2021.
One day after Brian Meloche, the man with whom Jennifer was having an affair, took the stand, she admitted to the relationship in her own testimony.
She told the jury that Meloche was a long-time friend who was also a part of the horse community; Jennifer was a regular rider, with her texts to her husband from the horse farm featuring earlier in testimony. She said she saw Meloche an average of once a week and the affair lasted about six months.
Jennifer Crumbley testified that she believes the affair did not cause her to neglect her son in any way, saying the two met in the mornings while her son was at school.
She testified Thursday that she cared about her job and said she enjoyed her work.
Earlier, prosecutors and her defense attorney, Shannon Smith, clashed over admitting evidence Smith previously sought to suppress.
The two sides were at odds over admitting excepts from Ethan Crumbley’s journal, including information about him torturing birds.
The evidence was presented during testimony from Oakland County Sheriff’s Detective Lt. Timothy Willis about what police found in Crumbley’s backpack after the shooting. The journal was found in his backpack, along with roughly 90 loose papers with school assignments, 50 of which the shooter had drawn guns on.
Willis testified there were 22 pages of written information in the journal, all of which referenced a school shooting.
Ethan Crumbley wrote in an entry apparently from before the shooting that he planned to shoot up his school the next day.
“I want to shoot up the school so f—— badly,” one of the excerpts said. “Soon I am going to buy a 9 mm pistol.”
“I’m about to shoot up the school and spend the rest of my life in prison,” the shooter wrote in another excerpt.
In other excerpts, the shooter appeared to be writing about wanting help.
“I want help but my parents don’t listen to me so I can’t get any help,” the shooter wrote.
Police also had concerns on the day of the shooting that there were secondary devices or bombs at other locations around the school, Willis testified.
(NEW YORK) — Washington state is experiencing its first known outbreak of a potentially deadly fungus, according to public health officials.
Four patients in the last month have tested positive for Candida auris, or C. auris, Public Health – Seattle & King County said in a release.
The first case occurred in a patient who had recently been admitted to Kindred Hospital Seattle, which was identified through a proactive screening program.
Additional screenings found two new cases, as well as a case with links to Kindred, who had originally tested negative for C. auris when first admitted, the health department said.
It’s currently unclear what the initial source of the infection is and officials said the investigation is ongoing.
A case of C. auris was identified in July in a patient who was transferred to Kindred from St. Joseph’s Hospital in Pierce County. It’s believed to be the first locally acquired case in Washington state, according to the department.
Health officials said they have been working with the hospital for many months “with the expectation that C. auris would eventually be found in Washington State.”
“Public Health continues to work together with Kindred to help limit spread,” the release said. “This includes keeping patients who test positive for C. auris away from other patients to reduce risk of spread and using specific disinfecting cleaning products effective for C. auris.”
The health department said the hospital is also notifying facilities that received Kindred patients and advising that they screen for the fungus.
Kindred did not immediately reply to ABC News’ request for comment.
C. auris Is a type of yeast that can lead to serious illnesses and spreads easily among patients in health care facilities, according to the Centers for Disease Control and Prevention (CDC).
It’s a relatively new type of fungus, first identified in Japan in 2009, according to the CDC. However, studies conducted since then have found samples of C. auris can be dated back to South Korea in 1996.
C. auris can spread either from person-to-person transmission or by people coming into contact with contaminated surfaces.
Most healthy people do not need to worry about C. auris infections, according to the CDC.
However, those with weakened immune systems or who are immunocompromised, are at risk of hard-to-treat infections as well as elderly patients or hospital patients who have had lines or tubes in their body.
There are strains of C. auris that are drug-resistant, meaning infections caused by the yeast will not respond to multiple antifungal drugs commonly used to treat Candida infections.
Despite this, there is a class of antifungal drugs called echinocandins that can be used and are given intravenously. Echinocandins prevent a key enzyme needed to maintain the cell wall of the fungus, according to the National Institutes of Health. In some cases, multiple high doses may be required, according to the CDC.
More than one in three patients with invasive C. auris infection, meaning it affects the blood, heart, or brain, die, according to the CDC.
To prevent spread, the CDC recommends family members and close contacts of C. auris patients properly sanitize their hands. Health care personnel and laboratory staff are reminded to do the same as well as disinfect a patient room and report cases quickly to public health departments.
(ATLANTA) — Police in Atlanta said they are searching for three suspects who chased down and opened fire on an 11-year-old boy, injuring him.
Atlanta police released surveillance footage on Wednesday that captured the incident while asking for the public’s help in identifying the three male suspects.
The incident occurred on Jan. 14. Officers responded to a report of a person shot around 6:18 p.m. local time, Atlanta police said.
Surveillance footage showed the victim running from the three suspects and then hiding near a laundromat. The assailants found him and all three discharged firearms, striking the victim twice, police said. The victim was struck in the left foot and left fibula, according to the police incident report.
The officers found a dozen shell casings at the scene and a pair of sneakers, according to the incident report.
The victim’s family told police that he made it back to his nearby home after the shooting and “fell down,” the report stated. He was transported to an area hospital via an ambulance, police said.
The victim has since been released from the hospital, his mother told Atlanta ABC affiliate WSB-TV.
Two suspects were seen in the surveillance footage wearing all black, while a third was wearing white shoes, black pants and a gray or white hoodie with a black jacket, police said.
The incident remains under investigation. No additional information is being released at this time, a police spokesperson told ABC News.
Police are offering a reward of up to $2,000 for information on the case.
(NEW YORK) — More than 100 days since Hamas terrorists invaded Israel on Oct. 7, the Israeli military continues its bombardment of the neighboring Gaza Strip.
The conflict, now the deadliest between the warring sides since Israel’s founding in 1948, shows no signs of letting up soon and the brief cease-fire that allowed for over 100 hostages to be freed from Gaza remains a distant memory.
Here’s how the news is developing. All times Eastern:
Feb 01, 1:26 PM
Some Gazans say they’re forced to use bird feed in place of flour
The possibility of a “full-fledged famine” looms large across the entire Gaza Strip, humanitarian groups have warned — especially in northern Gaza, where some people there say they’re using bird feed in place of flour to stave off starvation.
Northern Gaza has been largely cut off for months now, according to the United Nations, and aid trucks carrying flour arrive sporadically and are swarmed by hundreds of hungry people.
United Nations Relief and Works Agency for Palestine Refugees in the Near East officials also say Israel provides too few authorizations to make deliveries into some areas and that heavy fighting often makes it too dangerous for aid workers to operate. The aid arriving in northern Gaza has been particularly restricted, the U.N. says. Israel disputes the criticisms.
“For more than two months, we have not received flour due to the difficulty of aid entering and the scarcity of flour in the area,” Sami Abu Sweilem, a 55-year-old father who is sheltering in a UNRWA school in northern Gaza, told ABC News.
“Children almost died of hunger, so we thought of a way to save our children from death,” he said, explaining how he’s been using bird feed and animal fodder in place of precious flour.
Feb 01, 12:00 PM
Executive order targets four Israeli settlers involved in attacks on Palestinians in West Bank
President Joe Biden is expected to sign an executive order Thursday to sanction four Israeli settlers involved in attacks against Palestinians in the West Bank, according to the State Department. The sanctions will prohibit them from accessing the U.S. financial system and property in the U.S. and will block them from receiving financial transactions from U.S. citizens.
The move escalates U.S. posture against the hardline elements in Israeli society amid the ongoing war between Israel and Hamas in the Gaza Strip. In December, the U.S. imposed a visa ban on Israelis linked to violence and unrest in the West Bank that impacted “dozens” of settlers in the Israeli-occupied territory, according to the State Department.
Feb 01, 11:05 AM
Biden to sign executive order targeting Israeli settlers involved in attacks on Palestinians
President Joe Biden is expected to sign an executive order to sanction Israeli settlers involved in attacks against Palestinians in the West Bank, two sources familiar with the plans confirmed to ABC News. The news was first reported by Axios.
The move would escalate U.S. posture against the hardline elements in Israeli society amid the ongoing war between Israel and Hamas in the Gaza Strip.
It was not immediately clear how many Israelis would be targeted by the administration’s actions. In December, the U.S. imposed a visa ban on Israelis linked to violence and unrest in the West Bank that impacted “dozens” of settlers in the Israeli-occupied territory, according to the State Department.
Feb 01, 7:40 AM
UNRWA warns operations will be shut down by end of February without funding
The United Nations Relief and Works Agency for Palestine Refugees in the Near East warned Thursday that it “will most likely be forced to shut down” its operations in the war-torn Gaza Strip and the wider region “by the end of February” if funding does not resume.
Sixteen donor countries, including the United States, have suspended financial support to the U.N. agency over Israel’s allegations that 13 UNRWA staff members were involved in the Hamas-led Oct. 7 terror attack. UNRWA said it is investigating the accusations and that “full accountability and transparency are expected out of this process, should the allegations be substantiated.”
“As the war in Gaza is being pursued unabated, and at the time the International Court of Justice calls for more humanitarian assistance, it is the time to reinforce and not to weaken UNRWA. The Agency remains the largest aid organization in one of the most severe and complex humanitarian crises in the world,” UNRWA Commissioner-General Philippe Lazzarini said in a statement Thursday. “I echo the call of the U.N. Secretary General Antonio Guterres to resume funding to UNRWA. If the funding remains suspended, we will most likely be forced to shut down our operations by end of February not only in Gaza but also across the region.”
Feb 01, 6:21 AM
What we know about the conflict
The latest outbreak of war between Israel and Hamas, the Palestinian militant group that governs the Gaza Strip, has reached the three-month mark.
In the Gaza Strip, at least 27,019 people have been killed and 66,139 others have been wounded by Israeli forces since Oct. 7, according to Gaza’s Hamas-controlled Ministry of Health.
In Israel, at least 1,200 people have been killed and 6,900 others have been injured by Hamas and other Palestinian militants since Oct. 7, according to the Israel Defense Forces.
There has also been a surge in violence in the Israeli-occupied West Bank. Israeli forces have killed at least 297 people in the territory since Oct. 7, according to the Palestinian Ministry of Health.
The ongoing war began after Hamas-led militants launched an unprecedented incursion into southern Israel from neighboring Gaza via land, sea and air. Scores of people were killed while more than 200 others were taken hostage, according to Israeli authorities. The Israeli military subsequently launched retaliatory airstrikes followed by a ground invasion of Gaza, a 140-square-mile territory where more than two million Palestinians have lived under a blockade imposed by Israel and supported by Egypt since Hamas came to power in 2007. Gaza, unlike Israel, has no air raid sirens or bomb shelters.
(LONDON) — The possibility of a “full-fledged famine” looms large across the entire Gaza Strip amid the Israel-Hamas war, humanitarian groups have warned — but especially in northern Gaza, where some people there say they’re using bird feed in place of flour to stave off starvation.
Northern Gaza has been largely cut off for months now, according to the United Nations, and aid trucks carrying flour arrive sporadically and are swarmed by hundreds of hungry people.
United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) officials also say Israel provides too few authorizations to make deliveries into some areas and that heavy fighting often makes it too dangerous for aid workers to operate. The aid arriving in northern Gaza has been particularly restricted, the U.N. says. Israel disputes the criticisms.
“For more than two months, we have not received flour due to the difficulty of aid entering and the scarcity of flour in the area,” Sami Abu Sweilem, a 55-year-old father who is sheltering in a UNRWA school in northern Gaza, told ABC News.
“Children almost died of hunger, so we thought of a way to save our children from death,” he said, explaining how he’s been using bird feed and animal fodder in place of precious flour.
“I saw one of the displaced people in an area neighboring us with a bag of corn from a store and he told me that he wanted to grind it to make bread. I thought it was a good idea and we tried it,” Abu Sweilem said.
Soon others followed suit, he said, and now it’s even difficult to find animal feed to grind.
Almost all Gazans are now reliant on food aid for sustenance, according to the United Nations. The World Food Programme estimates that 26% of the population in Gaza is now facing starvation. Roughly two-thirds of Gazans relied on food aid before the start of the war, the WFP has said.
“If things continue as they are, or if things worsen, we are looking at a full-fledged famine within the next six months,” Arif Husain, the chief economist for the WFP, told ABC News.
“We were searching for flour and constantly waiting for aid,” Salwa Diab told ABC News on the phone from her refuge at the Gaza Training College in Gaza City. But when the aid never came, she said she was forced to turn her bird feed into bread.
“When I made this bread for the first time, my children thought it was like a normal loaf of bread. They were very happy with it and ate it and were forced to accept its taste,” she said, adding: “When the bread is cold, it becomes so bad that we cannot eat it, unfortunately, but when the children are hungry, they are forced to eat it in order to silence their hunger. For more than a month, I have been making this bread when we have available fodder.”
“The aid that comes very rarely, we know about it through the news,” 42-year-old Khaled Nabhan told ABC News in a phone call from Gaza City.
“People come out onto the streets, either on the coast road or Salah al-Din Street, waiting for the aid to enter,” he said, estimating that the crowds can reach the thousands and adding that people have been injured due to stampeding and gunfire.
“The question now is, when these fodders run out, how will we get flour,” Nabhan asked. “This war has been a quest to escape death, either from bombing or from hunger,” he added.
Israeli officials, who control the routes into Gaza, say they send 200 trucks of food and aid a day into the Gaza Strip. Before the war, 500 trucks were being sent to Gaza, according to UNRWA.
Israeli officials denied accusations they’re not letting enough food into Gaza and blamed the Hamas terrorist group for stealing aid. They said they conduct necessary inspections on the trucks, and also blamed the U.N. and other aid agencies for creating logistical bottlenecks.
The U.N. has disputed the Israeli officials’ claims, saying, on average, far less than 200 trucks are entering Gaza most days. U.N. officials have said excessive Israeli inspections, as well as arbitrary rejections of some aid, frequently hold up deliveries.
“We are getting the average of trucks near 80, 80 trucks per day,” UNRWA spokesman Adnan Abu Hasna told ABC News.
UNRWA has come under fire over the last week, as a dossier from the Israeli military recently revealed new allegations against some UNRWA employees who are accused of being involved in the Oct. 7 Hamas attack on Israel. The report obtained by ABC News alleges that 13 UNRWA employees participated in the Oct. 7 attack, including six employees who allegedly infiltrated Israel.
The U.N. condemned the alleged actions and said nine of those workers were fired. Two of the accused workers are reportedly dead and one has not immediately been identified, the U.N. said.
Not long after the allegations were announced Friday, several nations and other organizations, including the U.S. State Department, announced they would pause funding to UNRWA as the investigation continues.
On Monday, a coalition of 20 nongovernmental organizations, including Save the Children, sent out a letter condemning the funding pause, saying innocent Gazans will be left to suffer without aid from UNRWA.
“We are shocked by the reckless decision to cut a lifeline for an entire population by some of the very countries that had called for aid in Gaza to be stepped up and for humanitarians to be protected while doing their job,” the statement read.
UNRWA, which is the primary aid provider in Gaza and shelters about 1.4 million people, has warned that the funding suspension could impact its operations within weeks.
“If funding remains suspended, we will most likely be forced to shut down our operations by end of February,” UNRWA Commissioner-General Philippe Lazzarini wrote Thursday on X, formerly known as Twitter.
More than 27,000 people have been killed in Gaza and over 65,000 others injured since Oct. 7, according to the Hamas-run Gaza Health Ministry. Since then, in Israel, at least 1,200 people have been killed and 6,900 others injured, according to the Israeli prime minister’s office. Israeli officials say 556 Israel Defense Forces soldiers have been killed, including 221 since the ground operations in Gaza began.
(NEW YORK) — More than 100 days since Hamas terrorists invaded Israel on Oct. 7, the Israeli military continues its bombardment of the neighboring Gaza Strip.
The conflict, now the deadliest between the warring sides since Israel’s founding in 1948, shows no signs of letting up soon and the brief cease-fire that allowed for over 100 hostages to be freed from Gaza remains a distant memory.
Here’s how the news is developing. All times Eastern:
Feb 01, 12:00 PM
Executive order targets four Israeli settlers involved in attacks on Palestinians in West Bank
President Joe Biden is expected to sign an executive order Thursday to sanction four Israeli settlers involved in attacks against Palestinians in the West Bank, according to the State Department. The sanctions will prohibit them from accessing the U.S. financial system and property in the U.S. and will block them from receiving financial transactions from U.S. citizens.
The move escalates U.S. posture against the hardline elements in Israeli society amid the ongoing war between Israel and Hamas in the Gaza Strip. In December, the U.S. imposed a visa ban on Israelis linked to violence and unrest in the West Bank that impacted “dozens” of settlers in the Israeli-occupied territory, according to the State Department.
Feb 01, 11:05 AM
Biden to sign executive order targeting Israeli settlers involved in attacks on Palestinians
President Joe Biden is expected to sign an executive order to sanction Israeli settlers involved in attacks against Palestinians in the West Bank, two sources familiar with the plans confirmed to ABC News. The news was first reported by Axios.
The move would escalate U.S. posture against the hardline elements in Israeli society amid the ongoing war between Israel and Hamas in the Gaza Strip.
It was not immediately clear how many Israelis would be targeted by the administration’s actions. In December, the U.S. imposed a visa ban on Israelis linked to violence and unrest in the West Bank that impacted “dozens” of settlers in the Israeli-occupied territory, according to the State Department.
Feb 01, 7:40 AM
UNRWA warns operations will be shut down by end of February without funding
The United Nations Relief and Works Agency for Palestine Refugees in the Near East warned Thursday that it “will most likely be forced to shut down” its operations in the war-torn Gaza Strip and the wider region “by the end of February” if funding does not resume.
Sixteen donor countries, including the United States, have suspended financial support to the U.N. agency over Israel’s allegations that 13 UNRWA staff members were involved in the Hamas-led Oct. 7 terror attack. UNRWA said it is investigating the accusations and that “full accountability and transparency are expected out of this process, should the allegations be substantiated.”
“As the war in Gaza is being pursued unabated, and at the time the International Court of Justice calls for more humanitarian assistance, it is the time to reinforce and not to weaken UNRWA. The Agency remains the largest aid organization in one of the most severe and complex humanitarian crises in the world,” UNRWA Commissioner-General Philippe Lazzarini said in a statement Thursday. “I echo the call of the U.N. Secretary General Antonio Guterres to resume funding to UNRWA. If the funding remains suspended, we will most likely be forced to shut down our operations by end of February not only in Gaza but also across the region.”
Feb 01, 6:21 AM
What we know about the conflict
The latest outbreak of war between Israel and Hamas, the Palestinian militant group that governs the Gaza Strip, has reached the three-month mark.
In the Gaza Strip, at least 27,019 people have been killed and 66,139 others have been wounded by Israeli forces since Oct. 7, according to Gaza’s Hamas-controlled Ministry of Health.
In Israel, at least 1,200 people have been killed and 6,900 others have been injured by Hamas and other Palestinian militants since Oct. 7, according to the Israel Defense Forces.
There has also been a surge in violence in the Israeli-occupied West Bank. Israeli forces have killed at least 297 people in the territory since Oct. 7, according to the Palestinian Ministry of Health.
The ongoing war began after Hamas-led militants launched an unprecedented incursion into southern Israel from neighboring Gaza via land, sea and air. Scores of people were killed while more than 200 others were taken hostage, according to Israeli authorities. The Israeli military subsequently launched retaliatory airstrikes followed by a ground invasion of Gaza, a 140-square-mile territory where more than two million Palestinians have lived under a blockade imposed by Israel and supported by Egypt since Hamas came to power in 2007. Gaza, unlike Israel, has no air raid sirens or bomb shelters.
U.S. Secretary of Defense Lloyd Austin meets with the U.K. Secretary of State for Defense Grant Shapps at the Pentagon on Jan. 31, 2024 in Arlington, Virginia. (Samuel Corum/Getty Images)
(WASHINGTON) — Defense Secretary Lloyd Austin is holding a press conference at the Pentagon podium, his first media briefing since his surgery and subsequent hospitalization — both of which were kept secret from the public and White House.
“We did not handle this right. I did not handle this right,” Austin said.
“I should have told the president about my cancer diagnosis, and should also have told my team and the American public,” he continued. “I take full responsibility. I apologize to my teammates and to the American people.”
It is also the first time the public is seeing him standing. He continues to undergo physical therapy.
The defense secretary underwent a minimally invasive surgical procedure for prostate cancer Dec. 22, which led to a urinary tract infection and serious intestinal complications. He was hospitalized again on Jan. 1, but the White House didn’t learn of it for three days.
The delay in informing President Joe Biden and top administration officials of his hospitalization prompted intense scrutiny and is under investigation by lawmakers and the Pentagon.
Austin said he never “directed anyone” to keep his Jan. 1 hospitalization from the White House, and also denied creating a “culture of secrecy.”
Austin also said he directly apologized to Biden, and told him he was “deeply sorry” for not letting him know of his diagnosis immediately.
Austin spoke frankly about his first response after learning about his cancer diagnosis.
“The news shook me, as I know that it shakes so many others, especially in the Black community. It was a gut punch,” he said. “And frankly, my first instinct was to keep it private. I don’t think it’s news that I’m a pretty private guy. I never like burdening others with my problems. It’s just not my way.”
“But I’ve learned from this experience,” he continued. “Taking this kind of job means losing some of the privacy that most of us expect. The American people have a right to know if their leaders are facing health challenges that might affect their ability to perform their duties — even temporarily. So a wider circle should have been notified, especially the president.”
On Jan. 12, Biden publicly faulted Austin for not informing him earlier that he was hospitalized for complications from cancer treatment.
When a reporter asked Biden whether it was “a lapse in judgment for him not to tell you earlier,” Biden replied, “Yes.”
At the same time, when asked by a reporter if he still had confidence in Austin, Biden replied he did.
(CHICAGO) — One teenager was killed and two were injured in an apparent targeted shooting in broad daylight a few blocks from their Chicago school, according to police.
The three teens were walking Wednesday afternoon when a car pulled up, and several people got out and fired shots toward the victims, Chicago Police Superintendent Larry Snelling said at a news conference.
One teen was killed, one is in critical condition and the other is in stable condition with a gunshot wound to the leg, Snelling said.
“We do believe that the three individuals were targeted,” Snelling said.
The victims, all Nicholas Senn High School students, are ages 15 and 16, Snelling said.
“A loss of life is horrific under all circumstances, but it is especially harsh when our young people are targeted,” Chicago Mayor Brandon Johnson said. “We do everything in our power to keep our children safe. So this hurts, and I know our city is hurting.”
The mayor and police chief vowed to bring the shooters to justice.
“The individuals who are responsible for this kind of violence, it has to end,” Johnson said. “Whatever conflict, whatever pain you are expressing — this is not the way to do it. The loss of life is tearing at the fabric of this city.”
“We have to push back against this type of violence, this type of brazenness,” Snelling said. “We will hold violent criminals accountable — I can promise you that.”
(NEW YORK) — More than a decade after the Affordable Care Act was passed, more than 600,000 adults in North Carolina are now eligible to receive benefits through an expansion of Medicaid that the state, like 10 others, long resisted.
The change in policy was bipartisan, since North Carolina, a perpetual battleground state, has a government divided between Democrats and Republicans.
And while North Carolina is the most recent state to adopt the Medicaid expansion that became possible under the ACA starting in 2014, it’s potentially not the last: Republican officials in other holdout states like Alabama and South Carolina have signaled openness to the possibility.
“Medicaid expansion is not going anywhere. So why should we turn down the federal tax money that we’ve already paid in Washington? Why should we prevent North Carolinians from benefiting from that?” the state’s governor, Roy Cooper, a Democrat, told ABC News in an interview.
The expansion was signed into law in March 2023 — with nearly two-thirds of the state House’s Republicans and even more state Senate Republicans backing it — and went into effect in December, making North Carolina the 40th state to opt into the program.
The newly qualified residents are adults from 19 to 64 years old who earn too much money to receive traditional Medicaid but generally not enough to afford public subsidies available for private health insurance.
Under the new guidelines, coverage expands to adults ages 19 through 64 who earn up to 138% of the federal poverty line, which means a single person earning about $20,000 or a family of three earning about $34,000 annually can now qualify for routine check-ups, prescription medication and other medical services without out-of-pocket expenses.
A 2022 report from the National Center for Health Statistics estimated that 17.6% of the state’s 10.7 million residents were uninsured. The Medicaid expansion will cover about 5.6% of North Carolinians.
After years of debate, here’s how North Carolina agreed on expanding Medicaid:
A change of heart over time
Cooper had advocated for providing more Medicaid coverage since he took office in 2017, despite facing what he called “stiff resistance” from Republican state leaders.
Those conservatives had long said they were not in favor of expanding Medicaid, citing concerns over government-funded insurance and the possibility that Congress could cut the financial contribution through the ACA that initially made the expansion possible. Under the ACA, the federal government pays for 90% of the cost of the expansion; individual states pay for 10%.
But if Congress one day ended the federal payments, critics said, state governments could be suddenly saddled with unworkable new bills.
Then, in 2022, the federal government offered a new financial incentive — a nearly $1.8 billion bonus over two years to any of the remaining states who decided to expand Medicaid.
There are no restrictions on how the additional money can be spent, allowing state lawmakers to decide how it should be allocated.
Cooper told ABC News that Republican legislators in North Carolina and across the country also warmed up to the idea of expansion when they realized that the ACA, also known as “Obamacare,” would not be repealed.
North Carolina state Sen. Phil Berger, a leading Republican in the chamber, echoed that in a local op-ed column published in 2023.
“Since it was enacted, every attempt in Congress and by the courts to reverse the ACA and Medicaid expansion has failed,” he wrote then. “When Donald Trump was president and Republicans controlled Congress, they did not repeal or significantly alter the ACA. It’s not going away, and refusing to accept that reality hurts North Carolinians and the state’s finances.”
The ACA did not have majority approval from the public in the first years after it was passed, but that changed after 2016, according to Gallup polling.
There is still skepticism about expanding Medicaid in the remaining 10, largely Republican-led states, however.
Georgia Gov. Brian Kemp has linked it to “failed one-size-fit-none policies” and Mississippi Gov. Tate Reeves, who narrowly won reelection in the fall after a race that turned in part on the issue of Medicaid, has suggested he thinks it will be bad for the state’s workforce if Medicaid expands and “able-bodied Mississippians [are added] to the welfare rolls.”
Cooper said he hopes that other state leaders will see North Carolina as an example for change.
“This is the same self-examination that should occur in Texas and Florida and Alabama, and these places that need health insurance for their people,” he told ABC News.
In Kansas, Democratic Gov. Laura Kelly is renewing her push for lawmakers to expand Medicaid to provide health care to about 150,000 low-income residents, and she has proposed adding a work requirement to the program.
Building unlikely alliances
North Carolina Department of Health and Human Services Secretary Kody Kinsley, a native of Wilmington, played a key role in advocating for Medicaid expansion in the state.
Kinsley met with leaders in the health care industry while collaborating with Republican and Democratic legislators to plan town halls on improving access to mental health resources.
He previously worked in the Obama White House during the implementation of the ACA, which was both historic — in how it overhauled the health insurance system — and divisive, sparking fierce criticism from Republicans. In the years since, however, public attitudes have changed and softened on the ACA, as Gallup found.
Kinsley said he made it his “mission” for Medicaid expansion in his home state to become a reality.
“I grew up without health insurance,” he told ABC News. “And so getting to today has been a personal mission for me and something I’m really proud of, to pay it forward.”
“My parents got health insurance for the first time in their lives,” he continued. “Right now we know we’ve got folks that are getting health insurance for the first time in their lives here in North Carolina.”
Through his years of advocacy work, he created alliances in unlikely places.
Kinsley, a Democrat and the state’s first openly gay Cabinet member, said he spent years “working across the aisle” with numerous leaders in the health care industry, fellow Democrats and Republican legislators to find common ground on health-related issues.
“We’ve traveled all across the state,” Kinsley said. “We’re committed to trying to find a way in areas where we do agree, charting a path forward to make a difference for the people of North Carolina.”
Kinsley built key relationships like with state Rep. Donny Lambeth, one of the primary sponsors of the bill last year that expanded Medicaid. The pair bonded over their shared commitment to improving mental health care in North Carolina.
“Secretary Kinsley has been an exceptional partner in supporting legislators in our policy work,” Lambeth told ABC News in a statement. “He was a valuable resource to me during my work on Medicaid Expansion. I, along with my primary bill sponsors, would seek his advice on timing of implementation particularly and details about the federal waiver process.”
“He was our link to the federal staff on key issues that we incorporated in the Bill such as the jobs training program,” Lambeth added. “He always made himself available to us as we needed his assistance.”
A ‘positive impact in rural North Carolina’
The Medicaid expansion looks set to provide a particular boost for the state’s rural areas, where many residents fell in the insurance coverage gap, Kinsley said.
North Carolina has the second largest rural population in the country, according to census data. According to the state health department, the majority of adults 19 to 64 years old who are newly insured under the Medicaid expansion live in rural areas live in rural areas.
“I’m particularly happy that we’re seeing a disproportionately positive impact in rural North Carolina,” Kinsley said. “To see some of our rural communities where people have had historic lack of access to health care be some of the biggest gainers proportionately in the number of covered folks is such an important investment in their health and in the health system in those communities.”
Rural residents like Carrie McBane say they have been making ends meet for years while navigating the challenges that can come without health insurance.
McBane, 50, lives in the small town of Sylva along the ridges of the Plott Balsam Mountains. She worked as a restaurant server for several years and said she earned too much to qualify for traditional Medicaid but not enough to afford private insurance.
“In small towns, it’s a lot of restaurants and construction,” McBane said. “So the pay rate, the wages per hour are very low. The cost of living now is very high. It’s a struggle.”
McBane said she was working long hours, at times 10-to-12-hour shifts, to support herself until she suddenly became very ill.
“I knew that something was wrong,” she recalled. “I had very bad dry mouth, my hair started falling out, my vision changed backward … this just kind of hit me all at once.”
After visiting several doctors who could not identify her illness and paying for those visits out of pocket, she was ultimately diagnosed with Type 2 diabetes, she said. Without insurance, she struggled to pay for insulin and other life-saving medications.
“When you’re really sick, and you don’t know what to do — I can’t afford it, so basically I’m robbing Peter to pay Paul,” she said.
“I was just exhausted,” she added. “I just felt like nobody was listening to me.”
Her health journey inspired her to become an advocate and help spread awareness about health coverage options in her community. She said she did not qualify for traditional Medicaid because her monthly income was about $100 too high, thus placing her in the insurance coverage gap like many other families in her town.
“When you don’t have health care coverage, the struggle is real and it is dire,” she said. “We want the recognition you know, we’re not second-class citizens because we live in the mountains.”
But now, McBane says she hopes that expanded Medicaid coverage will help aid others like her who faced the same barriers to health care access, including limited resources and costly medical expenses.
“The advocacy work is getting the information out there, trying to help people understand what’s required, trying to not be afraid of the system and just to give support,” she said. “Our next steps are they’re just going to have to be fluid. It’s a broken system. Winning big steps to get this work done — it will happen.”
People displaced by the conflict in Sudan walk with their belonging along a road in Wad Madani, the capital of al-Jazirah state, on Dec. 16, 2023. (AFP via Getty Images)
(LONDON) — Nearly eight million people have been displaced by the war in Sudan as the conflict enters its 10th month, the United Nation has announced.
The conflict, which erupted on April 15, 2023, between the Rapid Support Forces Paramilitary group (RSF) and the Sudanese Army (SAF) after weeks of tensions linked to planned civilian rule, has killed at least 12,000 people according to the U.N.
Local groups, however, say the true toll is likely much higher than that.
“I heard stories of heartbreaking loss of family, friends, homes and livelihoods in the midst of this despair,” said U.N. High Commissioner for Refugees, Filippo Grandi, speaking as he concluded his three-day visit to Ethiopia. “Without further donor support, it will be extremely difficult to deliver much-needed help to those who need it most.”
Since April 2023, over 1.5 million people have fled to neighboring nations, with more than 500,000 fleeing into the border country of Chad, says the U.N. — 86% of whom are women and children.
A further 100,000 people have crossed into Ethiopia and, in South Sudan, an estimated 1,500 refugees flow into it daily.
Aid organizations tell ABC News the situation is “dire,” with nearly 25 million people — almost 50% of Sudan’s total population — in need of humanitarian aid as humanitarian access remains a “major issue” and health systems “near collapse.”
U.N. Chief Fillipo Grandi has called on further “urgent” and “additional” support to meet their needs.
As the war continues, International Criminal Court (ICC) Prosecutor Karim Khan this week announced the ICC had “grounds to believe” war crimes under the Rome Statute are being committed in Darfur by both the RSF and SAF.
“I can confirm to the council that we are collecting a very significant body of material, information and evidence that is relevant to those particular crimes,” Khan said speaking at the United Nations Security Council (UNSC). “The situation is dire by any metric.”
The impact of the war has been devastating as “profound” damage has ravaged “nearly every sector” of the northeast African nation. Many civilian homes continued to be occupied by militia groups, while civilian jewelry, cars and other items have been looted and often smuggled into neighboring countries.
As international demands for a cessation of hostilities continue, senior leaders from the SAF and RSF are reported to have met three times this month in Bahrain, attended by officials from Egypt and the United Arab Emirates.
“We want to see both parties return to the negotiating table, we want to see a ceasefire that is actually adhered to and we want to see both parties to this conflict stop their brutal attacks on civilians and actually take actions that are in the interests of the people of Sudan,” said U.S. State Department Spokesperson Matthew Miller.
