Son of first woman on U.S. Supreme Court reflects on O’Connor’s journey

BY:&nbsp;<a href="https://kansasreflector.com/author/tim-carpenter/">TIM CARPENTER</a> <a href="https://kansasreflector.com/">Kansas Reflector</a>

LAWRENCE — The late Sandra Day O’Connor overcame stifling 1950s-era gender barriers widely imposed on law school graduates to build a career culminating with appointment as the first woman to serve on the U.S. Supreme Court.

The list of rejections received by the Stanford University graduate included the influential California firm of Gibson, Dunn and Crutcher that employed William French Smith, who decades later became U.S. attorney general under President Ronald Reagan. One of Reagan’s campaign promises was to appoint a woman to the Supreme Court.

Ironically, it was Smith who dispatched a Justice Department attorney, Ken Starr, to conduct the pre-nomination interview with O’Connor in the living room of her Arizona home in 1981.

“Smith’s law firm in Los Angeles that he left to become attorney general was one of the firms that turned mom down, but offered her a job as a legal secretary,” said Scott O’Connor, the late justice’s eldest son. “So, during the interview she got to really twist the knife.”

Reagan nominated O’Connor and, despite conservative backlash tied to abortion politics and gender bias, she won unanimous confirmation in the U.S. Senate. She served on the nation’s highest court for 24 years, wrote more than 600 opinions and was viewed as a swing vote on a divided court. She retired in 2006 and passed away in December 2023.

On Thursday, the Robert Dole Institute of Politics at the University of Kansas presented the late justice with the $25,000 Dole Leadership Prize. It’s a bipartisan award presented to individuals or nonprofits engaged in public service that demonstrated the importance of engaging in political and civic affairs. She was the Dole Institute’s first posthumous recipient.

Other recipients include Presidents George H.W. Bush and Bill Clinton, civil rights leader and U.S. Rep. John Lewis, Secretary of State James Baker, U.S. Sen. Nancy Kassebaum and professor Temple Grandin.

In terms of Justice O’Connor, the award honored her service in all three branches of Arizona government, her prominent role on the U.S. Supreme Court and her dedication in retirement to the nonprofit organization iCivics. It’s an educational program offering millions of students annually the opportunity to engage in civics.

“She was the quintessential American,” said Scott O’Connor, who accepted the prize on behalf of his mother. “She understood our country. What it could be. She respected its institutions and felt it was our obligation to do all we could do to make them function better, not to tear them apart.”

He said her selection by Reagan demonstrated that anyone could reach the highest echelon of U.S. government if qualified and passionate for the work. She grew up on a family cattle ranch about 9 miles from the nearest paved road in a home without running water until she was age 7. She enrolled at Stanford at 16 and earned a law degree by 21.

Her legal career began in San Mateo, California, where she served as a county attorney without a salary. She shared a desk with a receptionist. Her husband, attorney John Jay O’Connor, was drafted and both worked for the military in Germany for three years before returning to the United States and moving to Maricopa County, Arizona.

She left private practice in the late 1960s to become an assistant attorney general in Arizona. For a portion of that time, O’Connor and another woman in the office worked three-fourths time for one-half pay while raising young children.

O’Connor was subsequently appointed to a vacancy in the Arizona Senate and over two-plus terms became the first woman to serve as a Senate majority leader of any state.

“She enjoyed the work,” Scott O’Connor said. “It was extremely challenging, but she soon realized the typical state legislator wasn’t necessarily the most ethical, the most high-minded person you might want to spend the rest of your career with.”

The Republican chose not to seek reelection to the state Senate. She served for four years on the Maricopa County Superior Court prior to appointment by the governor to the Arizona Court of Appeals. She was on the state appellate bench until nominated by Reagan in 1981.

“All of that happened to a little ranch girl from the middle of nowhere,” Scott O’Connor said. “It was just astonishing. It gave our family great hope for America — that it works.”

Scott O’Connor said the life experiences of his mother — a childhood on a cattle ranch, breaking gender barriers, serving in the three branches of government — offered an awareness of American life not shared enough by modern appointees to the federal judiciary. He said too many federal judges “come through a cloistered existence.”

“They don’t know what it’s like to pass a bill that is controversial,” he said. “They don’t know what it’s like to run for public office. They don’t know necessarily what it’s like to represent the poorest indigent clients in a strip-mall law office.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2024/10/1730039502163.png" alt="Scott O’Connor, eldest son of the late U.S. Supreme Court Justice Sandra Day O’Connor, accepted the Dole Leadership Prize from the Dole Institute at University of Kansas. It honors individuals and nonprofits dedicated to inspiring discourse in political or civic life. A bust of the late U.S. Sen. Robert Dole sits over his left shoulder. (Kansas Reflector screen capture from Dole Institute)" />
 <figcaption>Scott O’Connor, eldest son of the late U.S. Supreme Court Justice Sandra Day O’Connor, accepted the Dole Leadership Prize from the Dole Institute at University of Kansas. It honors individuals and nonprofits dedicated to inspiring discourse in political or civic life. A bust of the late U.S. Sen. Robert Dole sits over his left shoulder. (Kansas Reflector screen capture from Dole Institute)</figcaption>
 </figure><h2>Son of first woman on U.S. Supreme Court reflects on O’Connor’s journey</h2>BY:&nbsp;<a href="https://kansasreflector.com/author/tim-carpenter/">TIM CARPENTER</a> <a href="https://kansasreflector.com/">Kansas Reflector</a>LAWRENCE — The late Sandra Day O’Connor overcame stifling 1950s-era gender barriers widely imposed on law school graduates to build a career culminating with appointment as the first woman to serve on the U.S. Supreme Court.The list of rejections received by the Stanford University graduate included the influential California firm of Gibson, Dunn and Crutcher that employed William French Smith, who decades later became U.S. attorney general under President Ronald Reagan. One of Reagan’s campaign promises was to appoint a woman to the Supreme Court.Ironically, it was Smith who dispatched a Justice Department attorney, Ken Starr, to conduct the pre-nomination interview with O’Connor in the living room of her Arizona home in 1981.“Smith’s law firm in Los Angeles that he left to become attorney general was one of the firms that turned mom down, but offered her a job as a legal secretary,” said Scott O’Connor, the late justice’s eldest son. “So, during the interview she got to really twist the knife.”Reagan nominated O’Connor and, despite conservative backlash tied to abortion politics and gender bias, she won unanimous confirmation in the U.S. Senate. She served on the nation’s highest court for 24 years, wrote more than 600 opinions and was viewed as a swing vote on a divided court. She retired in 2006 and passed away in December 2023.On Thursday, the Robert Dole Institute of Politics at the University of Kansas presented the late justice with the $25,000 Dole Leadership Prize. It’s a bipartisan award presented to individuals or nonprofits engaged in public service that demonstrated the importance of engaging in political and civic affairs. She was the Dole Institute’s first posthumous recipient.Other recipients include Presidents George H.W. Bush and Bill Clinton, civil rights leader and U.S. Rep. John Lewis, Secretary of State James Baker, U.S. Sen. Nancy Kassebaum and professor Temple Grandin.In terms of Justice O’Connor, the award honored her service in all three branches of Arizona government, her prominent role on the U.S. Supreme Court and her dedication in retirement to the nonprofit organization iCivics. It’s an educational program offering millions of students annually the opportunity to engage in civics.“She was the quintessential American,” said Scott O’Connor, who accepted the prize on behalf of his mother. “She understood our country. What it could be. She respected its institutions and felt it was our obligation to do all we could do to make them function better, not to tear them apart.”He said her selection by Reagan demonstrated that anyone could reach the highest echelon of U.S. government if qualified and passionate for the work. She grew up on a family cattle ranch about 9 miles from the nearest paved road in a home without running water until she was age 7. She enrolled at Stanford at 16 and earned a law degree by 21.Her legal career began in San Mateo, California, where she served as a county attorney without a salary. She shared a desk with a receptionist. Her husband, attorney John Jay O’Connor, was drafted and both worked for the military in Germany for three years before returning to the United States and moving to Maricopa County, Arizona.She left private practice in the late 1960s to become an assistant attorney general in Arizona. For a portion of that time, O’Connor and another woman in the office worked three-fourths time for one-half pay while raising young children.O’Connor was subsequently appointed to a vacancy in the Arizona Senate and over two-plus terms became the first woman to serve as a Senate majority leader of any state.“She enjoyed the work,” Scott O’Connor said. “It was extremely challenging, but she soon realized the typical state legislator wasn’t necessarily the most ethical, the most high-minded person you might want to spend the rest of your career with.”The Republican chose not to seek reelection to the state Senate. She served for four years on the Maricopa County Superior Court prior to appointment by the governor to the Arizona Court of Appeals. She was on the state appellate bench until nominated by Reagan in 1981.“All of that happened to a little ranch girl from the middle of nowhere,” Scott O’Connor said. “It was just astonishing. It gave our family great hope for America — that it works.”Scott O’Connor said the life experiences of his mother — a childhood on a cattle ranch, breaking gender barriers, serving in the three branches of government — offered an awareness of American life not shared enough by modern appointees to the federal judiciary. He said too many federal judges “come through a cloistered existence.”“They don’t know what it’s like to pass a bill that is controversial,” he said. “They don’t know what it’s like to run for public office. They don’t know necessarily what it’s like to represent the poorest indigent clients in a strip-mall law office.”

Dole leadership prize honors life of the late Sandra Day O’Connor, a ‘quintessential American’

Experts worry older patients could be exposed to ‘catastrophic’ costs and interrupted access to care.

BY:&nbsp;<a href="https://stateline.org/author/avollers/">ANNA CLAIRE VOLLERS</a> <a href="https://stateline.org/">Stateline</a>

HUNTSVILLE, Ala. — Libby and Andrew Potter usually ignore the avalanche of Medicare Advantage ads that land in the mailbox at their home in Huntsville, Alabama, each fall as Medicare’s open enrollment period begins.

Libby, a retired middle school librarian, has what she considers good health insurance through the state employee health plan. Andrew has insurance through his job as a university professor and plans to join Libby’s insurance when he retires next year.

But this year, a few days before open enrollment began, a letter arrived from UnitedHealthcare, informing the Potters that the region’s largest hospital system would no longer be considered in-network for Libby’s Medicare Advantage plan.

The Potters spent the next couple of weeks worried and unsure what to do. It seemed incredible that 14 area hospitals, including the area’s only Level 1 trauma center, could suddenly become much, much more expensive.

“We were being very careful in how we go up and down stairs,” Libby joked.

Medicare is the federal health insurance program for people over 65 and those with certain disabilities. Medicare Advantage is a version of Medicare run by private insurance companies that contract with the government. These plans typically offer extra benefits, such as dental, vision and prescription drug coverage, that aren’t included with traditional Medicare.&nbsp;<a href="https://www.medpac.gov/wp-content/uploads/2024/03/Mar24_Ch12_MedPAC_Report_To_Congress_SEC.pdf" target="_blank">More than half</a>&nbsp;of eligible Medicare beneficiaries now get their coverage through private Medicare Advantage plans.

But this year, as Medicare’s open enrollment season kicks off, more than 1 million patients will have to shop for new health insurance. Facing financial and federal regulatory pressures, many insurers are pulling their Medicare Advantage plans from counties and states they’ve deemed unprofitable. Meanwhile, large health systems in states including Alabama, Minnesota and Vermont have cut ties with some Medicare Advantage plans.

It’s a situation that’s alarmed state insurance regulators, who are fielding questions from older adults concerned about their hospitals and doctors withdrawing from their Medicare Advantage plans. Last month, the National Association of Insurance Commissioners sent&nbsp;<a href="https://content.naic.org/sites/default/files/inline-files/FINAL%20MA%20SEP%20CMS%20Letter%20Sept%202024.pdf" target="_blank">a letter</a>&nbsp;to the federal Centers for Medicare &amp; Medicaid Services asking for guidance.

“Beneficiaries are faced with either paying the increased out-of-network costs or rescheduling their necessary medical services with another provider who may not have prompt availability,” the insurance commissioners’ group wrote. “A delay in access to medically necessary services is likely to result in harm.”

The Potters eventually learned that Libby’s copayments at the hospital would remain the same whether or not the hospital was in-network for the state educators’ Medicare Advantage plan. But those with other UnitedHealthcare Medicare Advantage plans will have to pay more — or find another plan.

“When a contract leaves the market, that can threaten continuity of care and access to care,” said Dr. Amal Trivedi, professor of health services, policy and practice at the Brown University School of Public Health. “The beneficiary will have to choose a new plan, and each of these plans is going to have a different benefit structure, different provider network, different prior authorization policies and different [prescription drug] formularies.

“The worry is that’s going to affect their out-of-pocket costs, expose them to catastrophic spending, or compromise their access to care.”

Insurance giants such as UnitedHealthcare have been aggressively pushing enrollment in their Medicaid Advantage plans for the past several years, luring customers with perks and bonuses not available through traditional Medicare. These plans tend to have low or even no monthly premiums and offer extra benefits such as vision and dental coverage, gym memberships, transportation to medical appointments, and even debit cards for medical supplies.

And they’re simple: They provide all of a person’s coverage in one plan, unlike traditional Medicare, under which people must get separate prescription drug coverage and supplemental coverage.

But there are trade-offs. Medicare Advantage plans often have a limited network of hospitals and physicians. And while the premiums are typically low, enrollees could end up&nbsp;<a href="https://www.ncoa.org/article/what-is-the-difference-between-medicare-advantage-and-medigap/#:~:text=You%20could%20end,with%20Original%20Medicare)." target="_blank">paying more in the long run</a>&nbsp;in copays and deductibles if they develop a serious illness.

Medicare Advantage programs also are&nbsp;<a href="https://www.kff.org/medicare/issue-brief/use-of-prior-authorization-in-medicare-advantage-exceeded-46-million-requests-in-2022/#:~:text=Virtually%20all%20enrollees%20in%20Medicare%20Advantage%20(99%25)%20are%20required%20to%20obtain%20prior%20authorization%20for%20some%20services%20%E2%80%93%20most%20commonly%2C%20higher%20cost%20services%2C%20such%20as%20inpatient%20hospital%20stays%2C%20skilled%20nursing%20facility%20stays%2C%20and%20chemotherapy.%20This%20contrasts%20with%20traditional%20Medicare" target="_blank">more likely than traditional Medicare</a>&nbsp;to require prior authorization for hospital stays and other high-cost services. The plans’ prior authorization requirements have&nbsp;<a href="https://www.nytimes.com/2024/05/25/science/medicare-seniors-authorization.html" target="_blank">prompted increased scrutiny</a>&nbsp;in recent years. A congressional investigation by Democratic Senate staff released this month, for example, found the nation’s largest Medicare Advantage insurers&nbsp;<a href="https://www.hsgac.senate.gov/wp-content/uploads/2024.10.17-PSI-Majority-Staff-Report-on-Medicare-Advantage.pdf" target="_blank">denied a quarter of all prior authorization requests</a>&nbsp;for post-acute care in nursing homes, rehab hospitals and long-term care.

Medicare Advantage is popular among large employers, many of which are&nbsp;<a href="https://www.kff.org/medicare/issue-brief/10-reasons-why-medicare-advantage-enrollment-is-growing-and-why-it-matters/#:~:text=A%20growing%20share%20of%20large%20employers%20are%20shifting%20their%20Medicare%2Dage%20retirees%20into%20Medicare%20Advantage%20plans%20for%20both%20Medicare%20and%20supplemental%20benefits" target="_blank">shifting their Medicare-age retirees</a>&nbsp;into these plans. And&nbsp;<a href="https://www.kff.org/medicare/issue-brief/in-2024-a-majority-of-states-offer-medicare-advantage-plans-to-their-state-retirees-with-13-offering-medicare-advantage-exclusively/" target="_blank">most states</a>&nbsp;offer Medicare Advantage plans to retired state employees; in 13 states, it’s the only option. In some of those 13 states, retirees forfeit their health benefits in perpetuity if they choose coverage under traditional Medicare.

North Carolina Treasurer Dale Folwell, whose office administers the state health plan, said its Medicare Advantage plan is popular.

“What we hear from our retirees, is that they are grateful and happy to have such a great offering as a result of their retirement benefit,” the Republican said. “That’s why nearly 89% of our retirees over age 65 have availed themselves of the [Medicare Advantage] product we offer them.”

This year, the handful of insurance giants that dominate the Medicare Advantage market have said they’re scaling back or eliminating plans, to shed members and boost sagging profits. They&nbsp;<a href="https://s2.q4cdn.com/447711729/files/doc_financials/2024/q1/CVS-1Q24-Earnings-Transcript.pdf" target="_blank">blame</a>&nbsp;new federal changes to their reimbursements, including&nbsp;<a href="https://www.axios.com/2024/04/02/medicare-advantage-insurer-pay" target="_blank">a small cut to their base payments</a>, and say patients are using more medical services and benefits than they anticipated.

Though most companies haven’t released data on specific counties where they’re making cuts, plans are reportedly shuttering in states such as&nbsp;<a href="https://pfsinsurance.com/news/wellcare-080524" target="_blank">Alabama</a>,&nbsp;<a href="https://pfsinsurance.com/news/wellcare-080524" target="_blank">Massachusetts</a>,&nbsp;<a href="https://www.beckerspayer.com/payer/bcbs-kansas-city-exiting-medicare-advantage-market.html" target="_blank">Missouri</a>,&nbsp;<a href="https://www.concordmonitor.com/harvard-pilgrim-medicare-new-hampshire-57353658" target="_blank">New Hampshire</a>,&nbsp;<a href="https://pfsinsurance.com/news/wellcare-080524" target="_blank">New Mexico</a>,&nbsp;<a href="https://www.dmagazine.com/healthcare-business/2024/09/southwestern-health-resources-to-sunset-medicare-advantage-health-plan-amid-layoffs/" target="_blank">Texas</a>&nbsp;and&nbsp;<a href="https://vtdigger.org/2024/10/03/2-medicare-advantage-plans-will-no-longer-be-available-in-vermont-in-2025/" target="_blank">Vermont</a>, affecting hundreds of thousands of older adults. Experts say the reasons why a company might find certain markets unprofitable are complex, but can include demographics, availability of providers and plans that are already in the market.

“[T]he industry broadly is going to be trimming benefits and in some cases significantly, and exiting from certain counties that aren’t profitable,” Aetna’s former President Brian Kane&nbsp;<a href="https://s2.q4cdn.com/447711729/files/doc_financials/2024/q1/CVS-1Q24-Earnings-Transcript.pdf" target="_blank">told shareholders</a>&nbsp;on an earnings call in May, before he left his position. Aetna, a subsidiary of CVS Health, is the third-largest Medicare Advantage insurer in the nation. “I think that’s an industry issue and I think it’s clearly an Aetna focus as well.”

Executives at CVS Health, Aetna’s parent company, told shareholders the priority for its Medicare Advantage program would be improving profit margins rather than increasing the number of enrollees.

They have not announced publicly which counties will lose Medicare Advantage plans, but noted their changes could&nbsp;<a href="https://www.statnews.com/2024/05/14/cvs-aetna-medicare-advantage-cut-benefits/?utm_campaign=health_care_inc&amp;utm_medium=email&amp;_hsenc=p2ANqtz-_KG6jNdcCYt_b2-JXr0SMQbogbV_XDMgmCvnUjnWW5m_UsBvalMlvUPozxIsPXvn9C126pFPAlA2qO2jZszULKf47ccg&amp;_hsmi=307746331&amp;utm_content=307746331&amp;utm_source=hs_email" target="_blank">push out 10% of their membership</a>, meaning up to 420,000 patients could be forced to shop for a different plan.

Even with the decline in the number of plans available next year, “there are still a lot of plans and people have a lot of options,” said Jeannie Fuglesten Biniek, associate director of the Medicare policy program at KFF, a health policy research organization. Next year, the average Medicare beneficiary will have access to 34 Medicare Advantage plans that include drug coverage, down from 36 this year, she said.

But that average masks wide variation across states and even counties in how many plans are available.

“There are a handful of counties, more than in previous years, where all Medicare Advantage plans exited and those look to be predominantly rural counties,” said Fuglesten Biniek. “We’re talking fortyish counties out of 3,000. For those people in those counties, that matters, but overall, it’s a smaller number.”

Experts say there isn’t enough data available yet to know whether the plan exits are concentrated in certain states or counties.

But research has shown that Medicare Advantage plans that enroll higher shares of Black beneficiaries are&nbsp;<a href="https://jamanetwork.com/journals/jama-health-forum/fullarticle/2797677#:~:text=enrolled%20a%20greater%20proportion%20of%20Black%20(21.9%25%20vs%2014.3%25%2C%20P%E2%80%89%3C%E2%80%89.001)%20beneficiaries" target="_blank">more likely to be terminated</a>, said Trivedi, of Brown University. Black enrollees have&nbsp;<a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/1475-6773.13977" target="_blank">more lower-quality Medicare Advantage plans</a>&nbsp;available in their counties of residence than white enrollees, research shows; terminated contracts tend to&nbsp;<a href="https://jamanetwork.com/journals/jama-health-forum/fullarticle/2797677#:~:text=Terminated%20contracts%20tended%20to%20have%20lower%20quality" target="_blank">have lower-quality ratings</a>.

“The consequence is that contract terminations in Medicare Advantage seem to have a disproportionate effect on Black beneficiaries because their contracts are more likely to be terminated,” Trivedi said.

A&nbsp;<a href="https://www.kff.org/medicare/report/disparities-in-health-measures-by-race-and-ethnicity-among-beneficiaries-in-medicare-advantage-a-review-of-the-literature/" target="_blank">disproportionate share</a>&nbsp;of Medicare Advantage beneficiaries are Black, Hispanic, and Asian and Pacific Islander. These patients&nbsp;<a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9923792/#:~:text=African%20American%20and%20Hispanic%20Medicare%20beneficiaries%20tend%20to%20have%20lower,et%20al.%2C%202019)." target="_blank">tend to have lower incomes</a>&nbsp;than white beneficiaries, and may by drawn by the lower upfront costs of Medicare Advantage plans.

“[Insurers] like to frame it as, ‘People are choosing us because we’re awesome,’” said Brandon Novick, program outreach assistant at the Center for Economic and Policy Research. “But it’s because financially it makes more sense in the short term” for people with limited incomes.

Meanwhile,&nbsp;<a href="https://www.beckershospitalreview.com/finance/15-health-systems-dropping-medicare-advantage-plans-2024.html" target="_blank">at least 28 health systems</a>&nbsp;in 21 states have stopped accepting some Medicare Advantage plans this year, according to an analysis from Becker’s Hospital Review, an industry publication.

Health systems have cited delayed reimbursements, cumbersome prior authorization requirements and high rates of patient claim denials for their decisions to drop Medicare Advantage plans. Nearly 1 in 5 health systems&nbsp;<a href="https://www.hfma.org/wp-content/uploads/2024/03/Overview-2024-CFO-Pain-Points-Study.pdf" target="_blank">stopped accepting one or more Medicare Advantage plan</a>s last year, according to a report by the Healthcare Financial Management Association.

For retirees like Libby and Andrew Potter, losing access to trusted doctors and hospitals can mean going longer without needed medical care. Finding a new doctor and getting an appointment can take months, particularly for specialists. And for older adults living in rural areas, losing an in-network hospital or physician can mean choosing between a long drive for care or high out-of-pocket costs.

“There are really important access-to-care issues when providers no longer contract with your Medicare Advantage plan,” Trivedi said.

He said the sheer number of plans and differences in benefits might be overwhelming for older adults.

“To sort through all of that when somebody also may have frailty or cognitive impairment, that’s a really tough ask,” Trivedi said. “I study health policy for a living and it’d be hard for me to sort through 40 different options.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2024/10/1729516122048.jpeg" alt="Andrew and Libby Potter look over the letter they received in October, telling them that their region’s largest hospital system would no longer be considered in-network for Libby’s Medicare Advantage policy. The Potters live in Huntsville, Ala., where Libby is a retired middle school librarian and Andrew is a professor at a state university. Anna Claire Vollers/Stateline" />
 <figcaption>Andrew and Libby Potter look over the letter they received in October, telling them that their region’s largest hospital system would no longer be considered in-network for Libby’s Medicare Advantage policy. The Potters live in Huntsville, Ala., where Libby is a retired middle school librarian and Andrew is a professor at a state university. Anna Claire Vollers/Stateline</figcaption>
 </figure><h2>Experts worry older patients could be exposed to ‘catastrophic’ costs and interrupted access to care.</h2>BY:&nbsp;<a href="https://stateline.org/author/avollers/">ANNA CLAIRE VOLLERS</a> <a href="https://stateline.org/">Stateline</a> HUNTSVILLE, Ala. — Libby and Andrew Potter usually ignore the avalanche of Medicare Advantage ads that land in the mailbox at their home in Huntsville, Alabama, each fall as Medicare’s open enrollment period begins.Libby, a retired middle school librarian, has what she considers good health insurance through the state employee health plan. Andrew has insurance through his job as a university professor and plans to join Libby’s insurance when he retires next year.But this year, a few days before open enrollment began, a letter arrived from UnitedHealthcare, informing the Potters that the region’s largest hospital system would no longer be considered in-network for Libby’s Medicare Advantage plan.The Potters spent the next couple of weeks worried and unsure what to do. It seemed incredible that 14 area hospitals, including the area’s only Level 1 trauma center, could suddenly become much, much more expensive.“We were being very careful in how we go up and down stairs,” Libby joked.Medicare is the federal health insurance program for people over 65 and those with certain disabilities. Medicare Advantage is a version of Medicare run by private insurance companies that contract with the government. These plans typically offer extra benefits, such as dental, vision and prescription drug coverage, that aren’t included with traditional Medicare.&nbsp;<a href="https://www.medpac.gov/wp-content/uploads/2024/03/Mar24_Ch12_MedPAC_Report_To_Congress_SEC.pdf" target="_blank">More than half</a>&nbsp;of eligible Medicare beneficiaries now get their coverage through private Medicare Advantage plans.But this year, as Medicare’s open enrollment season kicks off, more than 1 million patients will have to shop for new health insurance. Facing financial and federal regulatory pressures, many insurers are pulling their Medicare Advantage plans from counties and states they’ve deemed unprofitable. Meanwhile, large health systems in states including Alabama, Minnesota and Vermont have cut ties with some Medicare Advantage plans.It’s a situation that’s alarmed state insurance regulators, who are fielding questions from older adults concerned about their hospitals and doctors withdrawing from their Medicare Advantage plans. Last month, the National Association of Insurance Commissioners sent&nbsp;<a href="https://content.naic.org/sites/default/files/inline-files/FINAL%20MA%20SEP%20CMS%20Letter%20Sept%202024.pdf" target="_blank">a letter</a>&nbsp;to the federal Centers for Medicare &amp; Medicaid Services asking for guidance.“Beneficiaries are faced with either paying the increased out-of-network costs or rescheduling their necessary medical services with another provider who may not have prompt availability,” the insurance commissioners’ group wrote. “A delay in access to medically necessary services is likely to result in harm.”The Potters eventually learned that Libby’s copayments at the hospital would remain the same whether or not the hospital was in-network for the state educators’ Medicare Advantage plan. But those with other UnitedHealthcare Medicare Advantage plans will have to pay more — or find another plan.“When a contract leaves the market, that can threaten continuity of care and access to care,” said Dr. Amal Trivedi, professor of health services, policy and practice at the Brown University School of Public Health. “The beneficiary will have to choose a new plan, and each of these plans is going to have a different benefit structure, different provider network, different prior authorization policies and different [prescription drug] formularies.“The worry is that’s going to affect their out-of-pocket costs, expose them to catastrophic spending, or compromise their access to care.”<h2>How we got here</h2>Insurance giants such as UnitedHealthcare have been aggressively pushing enrollment in their Medicaid Advantage plans for the past several years, luring customers with perks and bonuses not available through traditional Medicare. These plans tend to have low or even no monthly premiums and offer extra benefits such as vision and dental coverage, gym memberships, transportation to medical appointments, and even debit cards for medical supplies.And they’re simple: They provide all of a person’s coverage in one plan, unlike traditional Medicare, under which people must get separate prescription drug coverage and supplemental coverage.But there are trade-offs. Medicare Advantage plans often have a limited network of hospitals and physicians. And while the premiums are typically low, enrollees could end up&nbsp;<a href="https://www.ncoa.org/article/what-is-the-difference-between-medicare-advantage-and-medigap/#:~:text=You%20could%20end,with%20Original%20Medicare)." target="_blank">paying more in the long run</a>&nbsp;in copays and deductibles if they develop a serious illness.Medicare Advantage programs also are&nbsp;<a href="https://www.kff.org/medicare/issue-brief/use-of-prior-authorization-in-medicare-advantage-exceeded-46-million-requests-in-2022/#:~:text=Virtually%20all%20enrollees%20in%20Medicare%20Advantage%20(99%25)%20are%20required%20to%20obtain%20prior%20authorization%20for%20some%20services%20%E2%80%93%20most%20commonly%2C%20higher%20cost%20services%2C%20such%20as%20inpatient%20hospital%20stays%2C%20skilled%20nursing%20facility%20stays%2C%20and%20chemotherapy.%20This%20contrasts%20with%20traditional%20Medicare" target="_blank">more likely than traditional Medicare</a>&nbsp;to require prior authorization for hospital stays and other high-cost services. The plans’ prior authorization requirements have&nbsp;<a href="https://www.nytimes.com/2024/05/25/science/medicare-seniors-authorization.html" target="_blank">prompted increased scrutiny</a>&nbsp;in recent years. A congressional investigation by Democratic Senate staff released this month, for example, found the nation’s largest Medicare Advantage insurers&nbsp;<a href="https://www.hsgac.senate.gov/wp-content/uploads/2024.10.17-PSI-Majority-Staff-Report-on-Medicare-Advantage.pdf" target="_blank">denied a quarter of all prior authorization requests</a>&nbsp;for post-acute care in nursing homes, rehab hospitals and long-term care.Medicare Advantage is popular among large employers, many of which are&nbsp;<a href="https://www.kff.org/medicare/issue-brief/10-reasons-why-medicare-advantage-enrollment-is-growing-and-why-it-matters/#:~:text=A%20growing%20share%20of%20large%20employers%20are%20shifting%20their%20Medicare%2Dage%20retirees%20into%20Medicare%20Advantage%20plans%20for%20both%20Medicare%20and%20supplemental%20benefits" target="_blank">shifting their Medicare-age retirees</a>&nbsp;into these plans. And&nbsp;<a href="https://www.kff.org/medicare/issue-brief/in-2024-a-majority-of-states-offer-medicare-advantage-plans-to-their-state-retirees-with-13-offering-medicare-advantage-exclusively/" target="_blank">most states</a>&nbsp;offer Medicare Advantage plans to retired state employees; in 13 states, it’s the only option. In some of those 13 states, retirees forfeit their health benefits in perpetuity if they choose coverage under traditional Medicare.North Carolina Treasurer Dale Folwell, whose office administers the state health plan, said its Medicare Advantage plan is popular.“What we hear from our retirees, is that they are grateful and happy to have such a great offering as a result of their retirement benefit,” the Republican said. “That’s why nearly 89% of our retirees over age 65 have availed themselves of the [Medicare Advantage] product we offer them.”<h2>Insurers retreat</h2>This year, the handful of insurance giants that dominate the Medicare Advantage market have said they’re scaling back or eliminating plans, to shed members and boost sagging profits. They&nbsp;<a href="https://s2.q4cdn.com/447711729/files/doc_financials/2024/q1/CVS-1Q24-Earnings-Transcript.pdf" target="_blank">blame</a>&nbsp;new federal changes to their reimbursements, including&nbsp;<a href="https://www.axios.com/2024/04/02/medicare-advantage-insurer-pay" target="_blank">a small cut to their base payments</a>, and say patients are using more medical services and benefits than they anticipated.Though most companies haven’t released data on specific counties where they’re making cuts, plans are reportedly shuttering in states such as&nbsp;<a href="https://pfsinsurance.com/news/wellcare-080524" target="_blank">Alabama</a>,&nbsp;<a href="https://pfsinsurance.com/news/wellcare-080524" target="_blank">Massachusetts</a>,&nbsp;<a href="https://www.beckerspayer.com/payer/bcbs-kansas-city-exiting-medicare-advantage-market.html" target="_blank">Missouri</a>,&nbsp;<a href="https://www.concordmonitor.com/harvard-pilgrim-medicare-new-hampshire-57353658" target="_blank">New Hampshire</a>,&nbsp;<a href="https://pfsinsurance.com/news/wellcare-080524" target="_blank">New Mexico</a>,&nbsp;<a href="https://www.dmagazine.com/healthcare-business/2024/09/southwestern-health-resources-to-sunset-medicare-advantage-health-plan-amid-layoffs/" target="_blank">Texas</a>&nbsp;and&nbsp;<a href="https://vtdigger.org/2024/10/03/2-medicare-advantage-plans-will-no-longer-be-available-in-vermont-in-2025/" target="_blank">Vermont</a>, affecting hundreds of thousands of older adults. Experts say the reasons why a company might find certain markets unprofitable are complex, but can include demographics, availability of providers and plans that are already in the market.“[T]he industry broadly is going to be trimming benefits and in some cases significantly, and exiting from certain counties that aren’t profitable,” Aetna’s former President Brian Kane&nbsp;<a href="https://s2.q4cdn.com/447711729/files/doc_financials/2024/q1/CVS-1Q24-Earnings-Transcript.pdf" target="_blank">told shareholders</a>&nbsp;on an earnings call in May, before he left his position. Aetna, a subsidiary of CVS Health, is the third-largest Medicare Advantage insurer in the nation. “I think that’s an industry issue and I think it’s clearly an Aetna focus as well.”Executives at CVS Health, Aetna’s parent company, told shareholders the priority for its Medicare Advantage program would be improving profit margins rather than increasing the number of enrollees.They have not announced publicly which counties will lose Medicare Advantage plans, but noted their changes could&nbsp;<a href="https://www.statnews.com/2024/05/14/cvs-aetna-medicare-advantage-cut-benefits/?utm_campaign=health_care_inc&amp;utm_medium=email&amp;_hsenc=p2ANqtz-_KG6jNdcCYt_b2-JXr0SMQbogbV_XDMgmCvnUjnWW5m_UsBvalMlvUPozxIsPXvn9C126pFPAlA2qO2jZszULKf47ccg&amp;_hsmi=307746331&amp;utm_content=307746331&amp;utm_source=hs_email" target="_blank">push out 10% of their membership</a>, meaning up to 420,000 patients could be forced to shop for a different plan.<h2>Canceled plans</h2>Even with the decline in the number of plans available next year, “there are still a lot of plans and people have a lot of options,” said Jeannie Fuglesten Biniek, associate director of the Medicare policy program at KFF, a health policy research organization. Next year, the average Medicare beneficiary will have access to 34 Medicare Advantage plans that include drug coverage, down from 36 this year, she said.But that average masks wide variation across states and even counties in how many plans are available.“There are a handful of counties, more than in previous years, where all Medicare Advantage plans exited and those look to be predominantly rural counties,” said Fuglesten Biniek. “We’re talking fortyish counties out of 3,000. For those people in those counties, that matters, but overall, it’s a smaller number.”Experts say there isn’t enough data available yet to know whether the plan exits are concentrated in certain states or counties.But research has shown that Medicare Advantage plans that enroll higher shares of Black beneficiaries are&nbsp;<a href="https://jamanetwork.com/journals/jama-health-forum/fullarticle/2797677#:~:text=enrolled%20a%20greater%20proportion%20of%20Black%20(21.9%25%20vs%2014.3%25%2C%20P%E2%80%89%3C%E2%80%89.001)%20beneficiaries" target="_blank">more likely to be terminated</a>, said Trivedi, of Brown University. Black enrollees have&nbsp;<a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/1475-6773.13977" target="_blank">more lower-quality Medicare Advantage plans</a>&nbsp;available in their counties of residence than white enrollees, research shows; terminated contracts tend to&nbsp;<a href="https://jamanetwork.com/journals/jama-health-forum/fullarticle/2797677#:~:text=Terminated%20contracts%20tended%20to%20have%20lower%20quality" target="_blank">have lower-quality ratings</a>.“The consequence is that contract terminations in Medicare Advantage seem to have a disproportionate effect on Black beneficiaries because their contracts are more likely to be terminated,” Trivedi said.A&nbsp;<a href="https://www.kff.org/medicare/report/disparities-in-health-measures-by-race-and-ethnicity-among-beneficiaries-in-medicare-advantage-a-review-of-the-literature/" target="_blank">disproportionate share</a>&nbsp;of Medicare Advantage beneficiaries are Black, Hispanic, and Asian and Pacific Islander. These patients&nbsp;<a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9923792/#:~:text=African%20American%20and%20Hispanic%20Medicare%20beneficiaries%20tend%20to%20have%20lower,et%20al.%2C%202019)." target="_blank">tend to have lower incomes</a>&nbsp;than white beneficiaries, and may by drawn by the lower upfront costs of Medicare Advantage plans.“[Insurers] like to frame it as, ‘People are choosing us because we’re awesome,’” said Brandon Novick, program outreach assistant at the Center for Economic and Policy Research. “But it’s because financially it makes more sense in the short term” for people with limited incomes.Meanwhile,&nbsp;<a href="https://www.beckershospitalreview.com/finance/15-health-systems-dropping-medicare-advantage-plans-2024.html" target="_blank">at least 28 health systems</a>&nbsp;in 21 states have stopped accepting some Medicare Advantage plans this year, according to an analysis from Becker’s Hospital Review, an industry publication.Health systems have cited delayed reimbursements, cumbersome prior authorization requirements and high rates of patient claim denials for their decisions to drop Medicare Advantage plans. Nearly 1 in 5 health systems&nbsp;<a href="https://www.hfma.org/wp-content/uploads/2024/03/Overview-2024-CFO-Pain-Points-Study.pdf" target="_blank">stopped accepting one or more Medicare Advantage plan</a>s last year, according to a report by the Healthcare Financial Management Association.<h2>‘A tough ask’</h2>For retirees like Libby and Andrew Potter, losing access to trusted doctors and hospitals can mean going longer without needed medical care. Finding a new doctor and getting an appointment can take months, particularly for specialists. And for older adults living in rural areas, losing an in-network hospital or physician can mean choosing between a long drive for care or high out-of-pocket costs.“There are really important access-to-care issues when providers no longer contract with your Medicare Advantage plan,” Trivedi said.He said the sheer number of plans and differences in benefits might be overwhelming for older adults.“To sort through all of that when somebody also may have frailty or cognitive impairment, that’s a really tough ask,” Trivedi said. “I study health policy for a living and it’d be hard for me to sort through 40 different options.”

1 million+ patients lose coverage as insurers, hospitals drop Medicare Advantage

KANSAS CITY —&nbsp;&nbsp;Law enforcement continue working to identify a suspect in a bank robbery that occurred Oct. 21 at the Hawthorn Bank,&nbsp;17430 E. 39th Street in Independence, Missouri, according to the Federal Bureau of Investigation.

The suspect entered the bank, approached the teller, made a verbal demand for cash, and brandished a firearm. The suspect fled the bank with an undisclosed amount of cash on a blue sports bike

According to reports, the suspect is described as older white male, approximately 5-foot-6 to 5-foot-9 tall,&nbsp; short grey hair, black leather jacket with patches, dark pants, grey sneakers dark head covering, Blue surgical mask.

Anyone with info can report a tip online at&nbsp;<a href="https://t.co/49eEgggFOb" target="_blank">http://tips.fbi.gov</a>.

<figure>
 <img src="https://media.eaglewebservices.com/public/2024/10/1730033811704.png" alt="Photo FBI Kansas City" />
 <figcaption>Photo FBI Kansas City</figcaption>
 </figure>KANSAS CITY —&nbsp;&nbsp;Law enforcement continue working to identify a suspect in a bank robbery that occurred Oct. 21 at the Hawthorn Bank,&nbsp;17430 E. 39th Street in Independence, Missouri, according to the Federal Bureau of Investigation.The suspect entered the bank, approached the teller, made a verbal demand for cash, and brandished a firearm. The suspect fled the bank with an undisclosed amount of cash on a blue sports bikeAccording to reports, the suspect is described as older white male, approximately 5-foot-6 to 5-foot-9 tall,&nbsp; short grey hair, black leather jacket with patches, dark pants, grey sneakers dark head covering, Blue surgical mask.Anyone with info can report a tip online at&nbsp;<a href="https://t.co/49eEgggFOb" target="_blank">http://tips.fbi.gov</a>.

Search continues for suspect who fled KC bank robbery on sports bike

JOHNSON COUNTY—A Kansas man is going to prison for violent child sex crimes.

This week, Judge T. Kelly Ryan sentenced 36-year-old Timothy Ryan Hugo to Life without the possibility of parole for 25-years for aggravated indecent liberties, rape of a child under 14 and aggravated criminal sodomy, according to the Johnson County District Attorney's office. The crimes were committed in 2019, according to online jail records.

In July, a jury found Hugo guilty of two counts of aggravated indecent liberties, two counts of rape of a child under 14 and aggravated sodomy. He has in the Johnson County Detention Center since October 2021, according to online jail records.&nbsp;

<figure>
 <img src="https://media.eaglewebservices.com/public/2024/7/1722275116463.png" alt="Hugo-photo Johnson Co." />
 <figcaption>Hugo-photo Johnson Co.</figcaption>
 </figure>JOHNSON COUNTY—A Kansas man is going to prison for violent child sex crimes.This week, Judge T. Kelly Ryan sentenced 36-year-old Timothy Ryan Hugo to Life without the possibility of parole for 25-years for aggravated indecent liberties, rape of a child under 14 and aggravated criminal sodomy, according to the Johnson County District Attorney's office. The crimes were committed in 2019, according to online jail records.He registered a sex offender this week.In July, a jury found Hugo guilty of two counts of aggravated indecent liberties, two counts of rape of a child under 14 and aggravated sodomy. He has in the Johnson County Detention Center since October 2021, according to online jail records.&nbsp;

Kansas man going to prison for violent child sex crimes

GRANT COUNTY, Nebraska —Law enforcement are investigating a Kansas man on drug allegations after a traffic stop.

Just after 5:30 p.m. October 24, while working traffic North of Hyannis on Hwy 61, a Grant County Deputy stopped a Kansas registered vehicle traveling south bound doing 75 mph in a 60 mph zone, according to a media release.

An investigation revealed a 38- year old man from Wichita was in possession of suspected large quantities of cocaine, methamphetamines, marijuana, cash and paraphernalia.

With the assistance of Nebraska State Patrol and Box Butte County Sheriff's Office, the man was arrested for multiple drug charges and transported to the Box Butte County Jail without incident.

<figure>
 <img src="https://media.eaglewebservices.com/public/2024/10/1729785025424.jpeg" alt="Photos Grant Co. Sheriff" />
 <figcaption>Photos Grant Co. Sheriff</figcaption>
 </figure>GRANT COUNTY, Nebraska —Law enforcement are investigating a Kansas man on drug allegations after a traffic stop.<figure>
 <img src="https://media.eaglewebservices.com/public/2024/10/1729785041197.jpeg" alt="" />
 <figcaption></figcaption>
 </figure>Just after 5:30 p.m. October 24, while working traffic North of Hyannis on Hwy 61, a Grant County Deputy stopped a Kansas registered vehicle traveling south bound doing 75 mph in a 60 mph zone, according to a media release.<figure>
 <img src="https://media.eaglewebservices.com/public/2024/10/1729785056243.jpeg" alt="" />
 <figcaption></figcaption>
 </figure>An investigation revealed a 38- year old man from Wichita was in possession of suspected large quantities of cocaine, methamphetamines, marijuana, cash and paraphernalia.With the assistance of Nebraska State Patrol and Box Butte County Sheriff's Office, the man was arrested for multiple drug charges and transported to the Box Butte County Jail without incident.

Kan. man, driving 75mph in a 60,  caught with large quantities of cocaine

JASPER COUNTY —One person died in an accident just after 2:30a.m. Saturday in Jasper County.

The Missouri State Highway Patrol reported a 2003 GMC Sierra driven by Ronnie D. Gillmore, 23, Reeds, was westbound on MO 96 one half mile east of Carthage.

The pickup crossed the center line and struck an eastbound 2022 Freightliner semi driven by Kevin W. Fields, 58, Marionville.

After impact Gillmore was ejected from the vehicle and pronounced dead at the scene. Fields was not injured. Gillmore was not wearing a seat belt, according to the MSHP.

JASPER COUNTY —One person died in an accident just after 2:30a.m. Saturday in Jasper County.The Missouri State Highway Patrol reported a 2003 GMC Sierra driven by Ronnie D. Gillmore, 23, Reeds, was westbound on MO 96 one half mile east of Carthage.The pickup crossed the center line and struck an eastbound 2022 Freightliner semi driven by Kevin W. Fields, 58, Marionville.After impact Gillmore was ejected from the vehicle and pronounced dead at the scene. Fields was not injured. Gillmore was not wearing a seat belt, according to the MSHP.

Missouri man dies after pickup, semi crash

TOPEKA —A Kansas man pleaded guilty this week to preparing and filing false income tax returns on behalf of his clients, according to the United State's Attorney.

According to court documents and statements made in court, Hophine Bwosinde, of Lenexa, operated Ambroseli Professional Services, a tax preparation business. From 2018 through 2022, Bwosinde prepared and filed false tax returns on behalf of his clients by either inflating legitimate business expenses or by claiming losses related to fake businesses. In addition, Bwosinde falsely reported negative income on clients’ returns. These false items caused his clients to significantly underreport their income to the IRS, which reduced the amount of taxes the clients owed and generated refunds for many to which they were not entitled.

In total, Bwosinde caused a total tax loss exceeding $1.5 million.

A sentencing hearing will take place on Feb. 18, 2025. Bwosinde faces a maximum penalty of three years in prison. He also faces a period of supervised release, restitution and monetary penalties. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

TOPEKA —A Kansas man pleaded guilty this week to preparing and filing false income tax returns on behalf of his clients, according to the United State's Attorney.According to court documents and statements made in court, Hophine Bwosinde, of Lenexa, operated Ambroseli Professional Services, a tax preparation business. From 2018 through 2022, Bwosinde prepared and filed false tax returns on behalf of his clients by either inflating legitimate business expenses or by claiming losses related to fake businesses. In addition, Bwosinde falsely reported negative income on clients’ returns. These false items caused his clients to significantly underreport their income to the IRS, which reduced the amount of taxes the clients owed and generated refunds for many to which they were not entitled.In total, Bwosinde caused a total tax loss exceeding $1.5 million.A sentencing hearing will take place on Feb. 18, 2025. Bwosinde faces a maximum penalty of three years in prison. He also faces a period of supervised release, restitution and monetary penalties. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

Kan. tax preparer faces prison time for filing false returns for clients

BAGHDAD –&nbsp;During the early morning of Oct. 22, Iraqi Security Forces (ISF), enabled by Coalition Forces as part of Combined Joint Task Force-Operation Inherent Resolve (CJTF-OIR), conducted strikes and follow raids on multiple ISIS locations in Central Iraq, targeting several senior ISIS leaders and killing at least seven ISIS operatives, according to a media release from the U.S. Central Command.

 During the Iraqi-led operation, two U.S. military personnel were wounded while assisting Iraqi forces with site exploitation. They are in stable condition.&nbsp; U.S. officials have released no additional details on them.

 Also as previously released, Iraqi Security Forces, enabled by&nbsp;Combined Joint Task Force-Operation Inherent Resolve, conducted precision airstrikes in Northeastern Iraq, Oct. 14-15, that killed four members of ISIS, including an ISIS senior leader. Both Iraqi-led strikes were conducted to disrupt and degrade ISIS attack networks in Iraq.&nbsp;

Also in the past week, U.S. Central Command (CENTCOM) forces successfully destroyed 15 drones, Land Attack Cruise Missiles and Surface-to-Air Missiles in the CENTCOM area of responsibility (AOR). T

These Iranian-supplied weapons, launched episodically by the Houthis and Iranian-Aligned Militia Groups (IAMGs) over several days during the week, posed a significant risk to United States, allies, and partner forces, as well as civilians in the region. The weapons systems were downed by a combination of U.S. Air Force and U.S. Navy assets deployed to the region.

<figure>
 <img src="https://media.eaglewebservices.com/public/2024/2/1707001115180.png" alt="File photo U.S. Central Command&nbsp;" />
 <figcaption>File photo U.S. Central Command&nbsp;</figcaption>
 </figure>BAGHDAD –&nbsp;During the early morning of Oct. 22, Iraqi Security Forces (ISF), enabled by Coalition Forces as part of Combined Joint Task Force-Operation Inherent Resolve (CJTF-OIR), conducted strikes and follow raids on multiple ISIS locations in Central Iraq, targeting several senior ISIS leaders and killing at least seven ISIS operatives, according to a media release from the U.S. Central Command. During the Iraqi-led operation, two U.S. military personnel were wounded while assisting Iraqi forces with site exploitation. They are in stable condition.&nbsp; U.S. officials have released no additional details on them. Also as previously released, Iraqi Security Forces, enabled by&nbsp;Combined Joint Task Force-Operation Inherent Resolve, conducted precision airstrikes in Northeastern Iraq, Oct. 14-15, that killed four members of ISIS, including an ISIS senior leader. Both Iraqi-led strikes were conducted to disrupt and degrade ISIS attack networks in Iraq.&nbsp;Also in the past week, U.S. Central Command (CENTCOM) forces successfully destroyed 15 drones, Land Attack Cruise Missiles and Surface-to-Air Missiles in the CENTCOM area of responsibility (AOR). TThese Iranian-supplied weapons, launched episodically by the Houthis and Iranian-Aligned Militia Groups (IAMGs) over several days during the week, posed a significant risk to United States, allies, and partner forces, as well as civilians in the region. The weapons systems were downed by a combination of U.S. Air Force and U.S. Navy assets deployed to the region.

U.S. military personnel injured during raid in Iraq continue recovery

Republican Denny Hoskins sees hand counting as a tool to prevent digital interference and cut costs, while local election officials and Democrat Barbara Phifer predict delayed and error-prone results

BY:&nbsp;&nbsp;<a href="https://missouriindependent.com/author/rudi-keller/">RUDI KELLER</a> <a href="https://missouriindependent.com/briefs/missouri-senate-committee-advances-bill-to-ban-texting-while-driving/">Missouri Independent</a>

In April 2023, Osage County Clerk Nicci Kammerich agreed to an experiment — she would tally municipal election results by hand, a move urged by residents who argued it would be cheaper, quicker and more secure.

The results, Kammerich&nbsp;<a href="https://anewscafe.com/wp-content/uploads/2023/06/OsageCountyApril2023.docx" target="_blank">wrote after the election</a>, were the opposite.&nbsp;

The vote count finished three hours later than the previous year, it cost more and the results were less reliable, she wrote.The people she hired as election judges, she wrote, said they would quit if hand counting continued.

“After considering all factors of this election and comparing it to other elections that are similar, I fear that if we were to continue hand counting it would cost us more in time, money, losing volunteers and accuracy of votes,” Kammerich wrote.

Kammerich resigned this summer — saying it was due to “threats, harassment, and bullying my staff and I have received since April 2023,” in her resignation letter, the&nbsp;<a href="https://www.unterrifieddemocrat.com/stories/county-clerk-cites-threats-harassment-and-bullying-as-reason-for-resignation,130550" target="_blank">Linn Unterrified Democrat</a>&nbsp;reported.

In this year’s secretary of state race, state Sen. Denny Hoskins, the Republican nominee, wants to&nbsp;<a href="https://x.com/DLHoskins/status/1818505270982574453" target="_blank">mandate hand-counting for all elections</a>. Like the residents of Osage County who urged it on Kammerich, he said in an interview with The Independent that he distrusts counting machines, believes it will make elections cheaper overall and that it should not delay reporting results.

“I know that the left is trying to make hand counting ballots into some big boogie man, but we did that for hundreds of years before we had the electronic election machines,” Hoskins said. “So it’s not something that has never been done.”

The Democratic nominee, state Rep. Barbara Phifer, said she sees no reason to change the current process where most ballots are counted by scanning machines certified for accuracy by state and federal officials.

“It is an attempt to sow distrust and chaos and he just makes up stuff,” Phifer said.

Hoskins and Phifer are vying to replace Jay Ashcroft, who ran in the Republican primary for governor rather than seek a third term as Missouri’s chief elections officer. Carl Herman Freese is the Libertarian candidate and Jerome Bauer is the Green Party nominee.

Hoskins is an accountant from Warrensburg who has been a lawmaker since 2009, when he became a member of the Missouri House. He was elected to the Senate in 2016.

Phifer, from Kirkwood, has been a representative since 2021. She is a retired United Methodist pastor, working as a religious leader for more than 40 years.

The biggest issue in the race is Hoskins’ call for hand-counted ballots.

Voting machines have been in use in some locations for nearly 150 years. Like a secret ballot, the machines were part of efforts to improve elections and protect their integrity.&nbsp;

When Missouri became a state, votes were cast out loud on Election Day. Paper ballots were first printed lists, distributed by political parties and colored to reveal each voters’ preference. A plain paper ballot with all candidates’ names was&nbsp;<a href="https://cdm16795.contentdm.oclc.org/digital/collection/p16795coll26/id/9363/rec/14" target="_blank">mandated in Missouri by a law passed in 1875</a>.

Vote counting with&nbsp;<a href="https://www.csg.org/2023/11/08/election-technology-through-the-years/" target="_blank">lever-style machines began in 1892</a>&nbsp;in some locations in the United States and computerized vote counting was introduced in the 1960s.&nbsp;

Today, Missouri mandates a paper ballot counted by machines certified for accuracy by federal and state officials,&nbsp;<a href="https://revisor.mo.gov/main/OneSection.aspx?section=115.225&amp;bid=51440&amp;hl=" target="_blank">including the secretary of state’s office</a>.

County clerks have the option to use hand-counting at any election.

The machines are trustworthy and deliver results in the timely manner demanded by the public, said Cape Girardeau County Clerk Kara Clark Summers, a Republican.

“When there’s so many races and so many things on the ballot, and then you’re trying to literally hand count every ballot and every race and every question on the ballot, it’s too overwhelming,” Summers said. “There’s too much room for human error and also for fraud to take place.”

With 56,000 registered voters, she said, the task of counting ballots could take days, if not weeks, after Election Day. And because the law mandates bipartisan teams of election judges, she said, finding people just to work the polls can be difficult, so finding counters would multiply the difficulty.

“That’s the problem with a lot of these legislators that want to make these changes, they’ve never performed the job,” Summers said.

Boone County Clerk Brianna Lennon said her ballot has 29 items for every voter this year, from the presidential race at the top to judicial retention votes and state ballot issues at the end.&nbsp;

In 2020, 91,837 ballots were cast in Boone County. That many ballots with 29 contests on each results in 2.7 million tallies that must be recorded.

“Elections are a human-run process, and anything that we are asking humans to do is going to have an error rate assigned to it,” she said. “And if you ask them to hand count, in this case, upwards of 90,000 ballots with 29 issues on each ballot, it is asking for errors.”&nbsp;

And because the tallies must be accurate, it has to be done at least twice in every precinct for verification, Lennon said.

“I’d probably need three times the number of election judges that I have, because I have to have extra people there to relieve others that have been there all day,” she said. “So, for example, this election, I need about 650 judges, so I’d be closer to 2,000, almost.”

Lennon was deputy director of elections under Secretary of State Jason Kander.&nbsp;

While Hoskins would need to turn to the legislature if he wants to mandate hand counting ballots, Lennon said he could try to force the issue by refusing to certify new tabulators.&nbsp;

“I don’t see anywhere in that law where it requires the secretary of state’s office to certify any machine at all,” Lennon said. “So if they choose not to, then there just won’t be certified machines.”

Hoskins said the estimates of additional workers and time are exaggerated. Taiwan conducts its elections with&nbsp;<a href="https://www.reuters.com/world/asia-pacific/factbox-how-does-taiwan-election-work-2024-01-11/" target="_blank">hand-counted ballots</a>, he said, and voting machines used in Puerto Rico’s June primary&nbsp;<a href="https://apnews.com/article/puerto-rico-primaries-discrepancies-voting-problems-machines-8019db17829c7b1fbae5fb3fde623a4b" target="_blank">didn’t produce accurate results</a>.&nbsp;

Missouri requires 5% of precincts to be counted by hand after an election to verify the results. If Missouri keeps using machines, Hoskins said, that won’t be enough.

“We need to at least double that percentage,” he said.

The only way to get rid of vote tabulating machines is by legislative action. Hoskins said he will not refuse to certify voting machines to force hand counting.

And he will ask the legislature to provide funding to pay for hand counting, he said.

“Most certainly we could help pay for those election costs through the secretary of state’s budget,” he said. “However, if you don’t have the election machines, or you don’t have as many election machines, I think there will actually be a net savings.”

The cost will be huge because the job will be enormous, Phifer said. While Boone County would have to make 2.7 million tallies, St. Louis County would have 24.3 million, she said.

Officials have estimated that “in order to get it done within four hours, which has been one of the proposed laws, they would have had to hire 44,000 people to do it,” Phifer said. “It just gets absurd after a while.”

The contest between Hoskins and Phifer hasn’t attracted much money, and most of the attention has centered on Hoskins’ ballot-counting proposal. Phifer outraised Hoskins during September, reports filed earlier this month show, but her total for the campaign, $222,670, hasn’t allowed for much advertising.

Using digital messaging, she said she is targeting younger women voters most likely to also be supporting Amendment 3, which would enshrine abortion rights in the Missouri Constitution.

The courts rewrote the ballot language Ashcroft crafted for Amendment 3, and then rewrote his&nbsp;<a href="https://missouriindependent.com/2024/09/05/judge-rules-ashcrofts-abortion-amendment-unfair-misleading/">“fair ballot language,”</a>&nbsp;calling it “unfair, inaccurate, insufficient and misleading.”

It is not the job of the secretary of state to impose political views on ballot measure language, she said.&nbsp;

“We have to have an umpire,” she said. “And when you have an umpire, you don’t want somebody who is actually rooting for the Cardinals or actually rooting for the Royals.”

Hoskins, who won an eight-way primary with 24.4% of the vote, has raised $191,565 for his campaign since the start of 2023, and an affiliated committee, Old Drum Conservative PAC, has taken in $223,725. His latest reports show he has only spent $4,592 since the primary, while Phifer has spent $114,000.&nbsp;

Hoskins has been a factional figure in the Senate, a member of the Freedom Caucus and its earlier iteration, the Conservative Caucus, that sought to disrupt legislation pushed by GOP leadership.

He sees the office as a place to set a policy agenda.&nbsp;

Along with hand-counting ballots, Hoskins is promising to follow up on Ashcroft’s efforts to target&nbsp;<a href="https://www.gartner.com/en/finance/glossary/environmental-social-and-governance-esg-#:~:text=Environmental%2C%20social%20and%20governance%20(ESG)%20refers%20to%20a%20collection,its%20environmental%20and%20social%20impacts." target="_blank">environmental, social and governance</a>, or ESG, investing. Ashcroft wrote a rule requiring brokers and investment advisers to obtain annual, written consent to recommend an investment, or actually place any client funds in account that “incorporates a social objective or other non financial objective” for a reason “not solely focused on maximizing a financial return.”

The rule was&nbsp;<a href="https://bankingjournal.aba.com/2024/09/missouri-federal-court-grants-summary-judgment-permanent-injunction-to-block-missouri-anti-esg-rules/" target="_blank">blocked by a federal court</a>&nbsp;in August, and after initially appealing, Ashcroft dropped his challenge to the ruling in a motion filed early this month.

He will try to write rules that survive a court challenge, Hoskins said.

“The shareholders need to understand that before they invest in those companies,” he said. “And so it needs to be fully disclosed and write big bold letters.”

The issues Hoskins is talking about are not big concerns for voters, Phifer said.

“They are this little group in the Freedom Caucus, and they just talk to each other,” she said. “And they think this is what people in Missouri want. But they don’t.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2024/10/1729946995826.png" alt="Republican Denny Hoskins, left, and Democrat Barbara Phifer face off in the race for Missouri Secretary of State (photos submitted)." />
 <figcaption>Republican Denny Hoskins, left, and Democrat Barbara Phifer face off in the race for Missouri Secretary of State (photos submitted).</figcaption>
 </figure><h2>Republican Denny Hoskins sees hand counting as a tool to prevent digital interference and cut costs, while local election officials and Democrat Barbara Phifer predict delayed and error-prone results</h2>BY:&nbsp;&nbsp;<a href="https://missouriindependent.com/author/rudi-keller/">RUDI KELLER</a> <a href="https://missouriindependent.com/briefs/missouri-senate-committee-advances-bill-to-ban-texting-while-driving/">Missouri Independent</a>In April 2023, Osage County Clerk Nicci Kammerich agreed to an experiment — she would tally municipal election results by hand, a move urged by residents who argued it would be cheaper, quicker and more secure.The results, Kammerich&nbsp;<a href="https://anewscafe.com/wp-content/uploads/2023/06/OsageCountyApril2023.docx" target="_blank">wrote after the election</a>, were the opposite.&nbsp;The vote count finished three hours later than the previous year, it cost more and the results were less reliable, she wrote.The people she hired as election judges, she wrote, said they would quit if hand counting continued.“After considering all factors of this election and comparing it to other elections that are similar, I fear that if we were to continue hand counting it would cost us more in time, money, losing volunteers and accuracy of votes,” Kammerich wrote.Kammerich resigned this summer — saying it was due to “threats, harassment, and bullying my staff and I have received since April 2023,” in her resignation letter, the&nbsp;<a href="https://www.unterrifieddemocrat.com/stories/county-clerk-cites-threats-harassment-and-bullying-as-reason-for-resignation,130550" target="_blank">Linn Unterrified Democrat</a>&nbsp;reported.In this year’s secretary of state race, state Sen. Denny Hoskins, the Republican nominee, wants to&nbsp;<a href="https://x.com/DLHoskins/status/1818505270982574453" target="_blank">mandate hand-counting for all elections</a>. Like the residents of Osage County who urged it on Kammerich, he said in an interview with The Independent that he distrusts counting machines, believes it will make elections cheaper overall and that it should not delay reporting results.“I know that the left is trying to make hand counting ballots into some big boogie man, but we did that for hundreds of years before we had the electronic election machines,” Hoskins said. “So it’s not something that has never been done.”The Democratic nominee, state Rep. Barbara Phifer, said she sees no reason to change the current process where most ballots are counted by scanning machines certified for accuracy by state and federal officials.“It is an attempt to sow distrust and chaos and he just makes up stuff,” Phifer said.Hoskins and Phifer are vying to replace Jay Ashcroft, who ran in the Republican primary for governor rather than seek a third term as Missouri’s chief elections officer. Carl Herman Freese is the Libertarian candidate and Jerome Bauer is the Green Party nominee.Hoskins is an accountant from Warrensburg who has been a lawmaker since 2009, when he became a member of the Missouri House. He was elected to the Senate in 2016.Phifer, from Kirkwood, has been a representative since 2021. She is a retired United Methodist pastor, working as a religious leader for more than 40 years.<h2>Key difference</h2>The biggest issue in the race is Hoskins’ call for hand-counted ballots.Voting machines have been in use in some locations for nearly 150 years. Like a secret ballot, the machines were part of efforts to improve elections and protect their integrity.&nbsp;When Missouri became a state, votes were cast out loud on Election Day. Paper ballots were first printed lists, distributed by political parties and colored to reveal each voters’ preference. A plain paper ballot with all candidates’ names was&nbsp;<a href="https://cdm16795.contentdm.oclc.org/digital/collection/p16795coll26/id/9363/rec/14" target="_blank">mandated in Missouri by a law passed in 1875</a>.Vote counting with&nbsp;<a href="https://www.csg.org/2023/11/08/election-technology-through-the-years/" target="_blank">lever-style machines began in 1892</a>&nbsp;in some locations in the United States and computerized vote counting was introduced in the 1960s.&nbsp;Today, Missouri mandates a paper ballot counted by machines certified for accuracy by federal and state officials,&nbsp;<a href="https://revisor.mo.gov/main/OneSection.aspx?section=115.225&amp;bid=51440&amp;hl=" target="_blank">including the secretary of state’s office</a>.County clerks have the option to use hand-counting at any election.The machines are trustworthy and deliver results in the timely manner demanded by the public, said Cape Girardeau County Clerk Kara Clark Summers, a Republican.“When there’s so many races and so many things on the ballot, and then you’re trying to literally hand count every ballot and every race and every question on the ballot, it’s too overwhelming,” Summers said. “There’s too much room for human error and also for fraud to take place.”With 56,000 registered voters, she said, the task of counting ballots could take days, if not weeks, after Election Day. And because the law mandates bipartisan teams of election judges, she said, finding people just to work the polls can be difficult, so finding counters would multiply the difficulty.“That’s the problem with a lot of these legislators that want to make these changes, they’ve never performed the job,” Summers said.Boone County Clerk Brianna Lennon said her ballot has 29 items for every voter this year, from the presidential race at the top to judicial retention votes and state ballot issues at the end.&nbsp;In 2020, 91,837 ballots were cast in Boone County. That many ballots with 29 contests on each results in 2.7 million tallies that must be recorded.“Elections are a human-run process, and anything that we are asking humans to do is going to have an error rate assigned to it,” she said. “And if you ask them to hand count, in this case, upwards of 90,000 ballots with 29 issues on each ballot, it is asking for errors.”&nbsp;And because the tallies must be accurate, it has to be done at least twice in every precinct for verification, Lennon said.“I’d probably need three times the number of election judges that I have, because I have to have extra people there to relieve others that have been there all day,” she said. “So, for example, this election, I need about 650 judges, so I’d be closer to 2,000, almost.”Lennon was deputy director of elections under Secretary of State Jason Kander.&nbsp;While Hoskins would need to turn to the legislature if he wants to mandate hand counting ballots, Lennon said he could try to force the issue by refusing to certify new tabulators.&nbsp;“I don’t see anywhere in that law where it requires the secretary of state’s office to certify any machine at all,” Lennon said. “So if they choose not to, then there just won’t be certified machines.”Hoskins said the estimates of additional workers and time are exaggerated. Taiwan conducts its elections with&nbsp;<a href="https://www.reuters.com/world/asia-pacific/factbox-how-does-taiwan-election-work-2024-01-11/" target="_blank">hand-counted ballots</a>, he said, and voting machines used in Puerto Rico’s June primary&nbsp;<a href="https://apnews.com/article/puerto-rico-primaries-discrepancies-voting-problems-machines-8019db17829c7b1fbae5fb3fde623a4b" target="_blank">didn’t produce accurate results</a>.&nbsp;Missouri requires 5% of precincts to be counted by hand after an election to verify the results. If Missouri keeps using machines, Hoskins said, that won’t be enough.“We need to at least double that percentage,” he said.The only way to get rid of vote tabulating machines is by legislative action. Hoskins said he will not refuse to certify voting machines to force hand counting.And he will ask the legislature to provide funding to pay for hand counting, he said.“Most certainly we could help pay for those election costs through the secretary of state’s budget,” he said. “However, if you don’t have the election machines, or you don’t have as many election machines, I think there will actually be a net savings.”The cost will be huge because the job will be enormous, Phifer said. While Boone County would have to make 2.7 million tallies, St. Louis County would have 24.3 million, she said.Officials have estimated that “in order to get it done within four hours, which has been one of the proposed laws, they would have had to hire 44,000 people to do it,” Phifer said. “It just gets absurd after a while.”<h2>Low-key contest</h2>The contest between Hoskins and Phifer hasn’t attracted much money, and most of the attention has centered on Hoskins’ ballot-counting proposal. Phifer outraised Hoskins during September, reports filed earlier this month show, but her total for the campaign, $222,670, hasn’t allowed for much advertising.Using digital messaging, she said she is targeting younger women voters most likely to also be supporting Amendment 3, which would enshrine abortion rights in the Missouri Constitution.The courts rewrote the ballot language Ashcroft crafted for Amendment 3, and then rewrote his&nbsp;<a href="https://missouriindependent.com/2024/09/05/judge-rules-ashcrofts-abortion-amendment-unfair-misleading/">“fair ballot language,”</a>&nbsp;calling it “unfair, inaccurate, insufficient and misleading.”It is not the job of the secretary of state to impose political views on ballot measure language, she said.&nbsp;“We have to have an umpire,” she said. “And when you have an umpire, you don’t want somebody who is actually rooting for the Cardinals or actually rooting for the Royals.”Hoskins, who won an eight-way primary with 24.4% of the vote, has raised $191,565 for his campaign since the start of 2023, and an affiliated committee, Old Drum Conservative PAC, has taken in $223,725. His latest reports show he has only spent $4,592 since the primary, while Phifer has spent $114,000.&nbsp;Hoskins has been a factional figure in the Senate, a member of the Freedom Caucus and its earlier iteration, the Conservative Caucus, that sought to disrupt legislation pushed by GOP leadership.He sees the office as a place to set a policy agenda.&nbsp;Along with hand-counting ballots, Hoskins is promising to follow up on Ashcroft’s efforts to target&nbsp;<a href="https://www.gartner.com/en/finance/glossary/environmental-social-and-governance-esg-#:~:text=Environmental%2C%20social%20and%20governance%20(ESG)%20refers%20to%20a%20collection,its%20environmental%20and%20social%20impacts." target="_blank">environmental, social and governance</a>, or ESG, investing. Ashcroft wrote a rule requiring brokers and investment advisers to obtain annual, written consent to recommend an investment, or actually place any client funds in account that “incorporates a social objective or other non financial objective” for a reason “not solely focused on maximizing a financial return.”The rule was&nbsp;<a href="https://bankingjournal.aba.com/2024/09/missouri-federal-court-grants-summary-judgment-permanent-injunction-to-block-missouri-anti-esg-rules/" target="_blank">blocked by a federal court</a>&nbsp;in August, and after initially appealing, Ashcroft dropped his challenge to the ruling in a motion filed early this month.He will try to write rules that survive a court challenge, Hoskins said.“The shareholders need to understand that before they invest in those companies,” he said. “And so it needs to be fully disclosed and write big bold letters.”The issues Hoskins is talking about are not big concerns for voters, Phifer said.“They are this little group in the Freedom Caucus, and they just talk to each other,” she said. “And they think this is what people in Missouri want. But they don’t.”

Push for hand counting ballots a key divide in race for Missouri Secretary of State

KANSAS CITY —Law enforcement are investigating another homicide in Kansas City.

Just after 8p.m. Thursday, police were dispatched to the intersection of E. 34th Street and Garfield Avenue on a reported shot spotter, a gunshot detection system activation, according to KCPD&nbsp;Officer Alayna Gonzalez.

 While officers were enroute to the original call for service an additional call came in of a reported shooting in the same area. Officers located EMS personnel assisting a woman, later identified as 44-year-old Ebony Davis out of a vehicle who was suffering from apparent gunshot trauma.&nbsp; She was immediately transferred to an area where she succumbed to her injuries and was declared deceased, according to Gonzalez.

Preliminary investigation indicates the gunshots came from outside of the vehicle, striking the woman who was inside of a vehicle.

Police do not have a person of interest identified and no one is in custody. Homicide detectives and crime scene personnel responded to the scene to begin collecting evidence and gather witness statements. 

<figure>
 <img src="https://media.eaglewebservices.com/public/2024/10/1729882663816.png" alt="On Friday afternoon, detectives returned to scene homicide to canvass for additional evidence.-photo Sheriff Daryl Forte'" />
 <figcaption>On Friday afternoon, detectives returned to scene homicide to canvass for additional evidence.-photo Sheriff Daryl Forte'</figcaption>
 </figure>KANSAS CITY —Law enforcement are investigating another homicide in Kansas City.Just after 8p.m. Thursday, police were dispatched to the intersection of E. 34th Street and Garfield Avenue on a reported shot spotter, a gunshot detection system activation, according to KCPD&nbsp;Officer Alayna Gonzalez. While officers were enroute to the original call for service an additional call came in of a reported shooting in the same area. Officers located EMS personnel assisting a woman, later identified as 44-year-old Ebony Davis out of a vehicle who was suffering from apparent gunshot trauma.&nbsp; She was immediately transferred to an area where she succumbed to her injuries and was declared deceased, according to Gonzalez.Preliminary investigation indicates the gunshots came from outside of the vehicle, striking the woman who was inside of a vehicle.Police do not have a person of interest identified and no one is in custody. Homicide detectives and crime scene personnel responded to the scene to begin collecting evidence and gather witness statements.

Gunshot detection system alerted KCPD to woman's killing 

JOHNSON COUNTY — Emporia State University placed a professor on administrative leave following an arrest for alleged child sex crimes.

On Wednesday Howard Pitler, 72, was booked into the Johnson County jail on requested charges of&nbsp; electronic solicitation of a child under 14 years old, according to online jail records. He met the requirements of a $25,000 bond and is no longer in&nbsp; custody.

According to Emporia State, "Upon being made aware of the arrest of Howard Pitler, the university responded immediately and placed Pitler on administrative leave. With our rich tradition as a premier Teachers College, the care and safety of students of all ages is of the utmost importance. Pitler taught fully online master’s level courses as an associate professor of School Leadership, Middle &amp; Secondary Teacher Education in The Teachers College. He has been at ESU since 2018. Emporia State will cooperate fully with authorities. We cannot comment further on an ongoing investigation."

Pitler is scheduled to return to court October 31, according to online jail records.&nbsp;

<figure>
 <img src="https://media.eaglewebservices.com/public/2024/10/1729898976418.png" alt="Pitler photo Johnson County" />
 <figcaption>Pitler photo Johnson County</figcaption>
 </figure>JOHNSON COUNTY — Emporia State University placed a professor on administrative leave following an arrest for alleged child sex crimes.On Wednesday Howard Pitler, 72, was booked into the Johnson County jail on requested charges of&nbsp; electronic solicitation of a child under 14 years old, according to online jail records. He met the requirements of a $25,000 bond and is no longer in&nbsp; custody.According to Emporia State, "Upon being made aware of the arrest of Howard Pitler, the university responded immediately and placed Pitler on administrative leave. With our rich tradition as a premier Teachers College, the care and safety of students of all ages is of the utmost importance. Pitler taught fully online master’s level courses as an associate professor of School Leadership, Middle &amp; Secondary Teacher Education in The Teachers College. He has been at ESU since 2018. Emporia State will cooperate fully with authorities. We cannot comment further on an ongoing investigation."Pitler is scheduled to return to court October 31, according to online jail records.&nbsp;

Emporia State University professor accused of child sex crime

WASHINGTON, D.C.&nbsp;– U.S. Senator Jerry Moran, ranking member of the Senate Veterans’ Affairs Committee – was alerted by the Department of Veterans Affairs (VA) of a problem with an electronic fax system that resulted in 875 files sent to the VA Eastern Kansas Health Care System from community care providers to go missing, according to a media release from Moran's office.

These files dated as far back as June 11, 2024, and contained medical documentation, care referrals, authorizations for care and other information needed for the coordination of veteran health care.

“I have asked VA to quickly review every file and take all appropriate actions to mitigate patient harm that has or may result from this system failure,”&nbsp;said Sen. Moran.&nbsp;“I have also asked VA to quickly review each of the other 27 health care systems across the Veterans Health Administration that use this same electronic fax system in order to identify similar issues and assist any patients whose care has been negatively impacted. My office will remain in contact with VA until the full scope of this problem is known and all necessary corrective actions are taken.”

Any veteran concerned this issue may have caused a delay in their care should contact their VA care team. If a veteran needs further assistance, they should reach out to Sen. Moran’s office&nbsp;<a href="https://www.moran.senate.gov/public/index.cfm/federal-agency-assistance">and Click Here</a>.

WASHINGTON, D.C.&nbsp;– U.S. Senator Jerry Moran, ranking member of the Senate Veterans’ Affairs Committee – was alerted by the Department of Veterans Affairs (VA) of a problem with an electronic fax system that resulted in 875 files sent to the VA Eastern Kansas Health Care System from community care providers to go missing, according to a media release from Moran's office.These files dated as far back as June 11, 2024, and contained medical documentation, care referrals, authorizations for care and other information needed for the coordination of veteran health care.“I have asked VA to quickly review every file and take all appropriate actions to mitigate patient harm that has or may result from this system failure,”&nbsp;said Sen. Moran.&nbsp;“I have also asked VA to quickly review each of the other 27 health care systems across the Veterans Health Administration that use this same electronic fax system in order to identify similar issues and assist any patients whose care has been negatively impacted. My office will remain in contact with VA until the full scope of this problem is known and all necessary corrective actions are taken.”Any veteran concerned this issue may have caused a delay in their care should contact their VA care team. If a veteran needs further assistance, they should reach out to Sen. Moran’s office&nbsp;<a href="https://www.moran.senate.gov/public/index.cfm/federal-agency-assistance">and Click Here</a>.

Moran alerts veterans to system failure at VA in Kansas

CAMDEN COUNTY —At the request of the Camden County Sheriff’s Office, the Missouri State Highway Patrol’s Division of Drug and Crime Control is investigating an officer involved shooting which occurred in Camdenton, Missouri.

The preliminary investigation revealed, at 2:30a.m.&nbsp; Friday, the Camdenton Police Department and Camden County Sheriff's Office responded to 95 Third Street, in Camdenton, in response to a 911 call indicating a deceased body was located at the residence, according to a media release from the MSHP.

 Law enforcement arrived at the scene and Matthew D. MacDonald, 28, Camdenton, exited the residence armed with a rifle. Deputies attempted to negotiate with MacDonald and gave verbal commands to drop the firearm. 

MacDonald failed to comply, and a Camden County deputy fired his duty rifle, striking MacDonald. MacDonald was taken into custody and medical treatment was provided on scene. 

Emergency medical services personnel transported MacDonald to an area hospital for further medical treatment. No other injuries were reported, and it was determined that there was not a deceased body at the scene as initially reported.

The investigation is ongoing by criminal investigators with the Missouri State Highway Patrol’s Division of Drug and Crime Control. Upon completion of the investigation, the reports will be forwarded to the Camden County Prosecuting Attorney for review.

CAMDEN COUNTY —At the request of the Camden County Sheriff’s Office, the Missouri State Highway Patrol’s Division of Drug and Crime Control is investigating an officer involved shooting which occurred in Camdenton, Missouri.The preliminary investigation revealed, at 2:30a.m.&nbsp; Friday, the Camdenton Police Department and Camden County Sheriff's Office responded to 95 Third Street, in Camdenton, in response to a 911 call indicating a deceased body was located at the residence, according to a media release from the MSHP. Law enforcement arrived at the scene and Matthew D. MacDonald, 28, Camdenton, exited the residence armed with a rifle. Deputies attempted to negotiate with MacDonald and gave verbal commands to drop the firearm. MacDonald failed to comply, and a Camden County deputy fired his duty rifle, striking MacDonald. MacDonald was taken into custody and medical treatment was provided on scene. Emergency medical services personnel transported MacDonald to an area hospital for further medical treatment. No other injuries were reported, and it was determined that there was not a deceased body at the scene as initially reported.The investigation is ongoing by criminal investigators with the Missouri State Highway Patrol’s Division of Drug and Crime Control. Upon completion of the investigation, the reports will be forwarded to the Camden County Prosecuting Attorney for review.

Patol: Man wounded in Missouri deputy shooting 

BY:&nbsp;<a href="https://missouriindependent.com/author/jennifer-shutt/">JENNIFER SHUTT</a>

WASHINGTON — Nearly 30 million Americans by Thursday had cast their ballots ahead of Election Day, with 13 million choosing to vote in person at early voting centers and another 17 million submitting mail-in ballots, according to data from the University of Florida’s election lab.

The total number of early votes is expected to increase significantly in the days leading up to Election Day on Nov. 5.

Voters will determine whether Democratic presidential nominee Kamala Harris or Republican candidate Donald Trump occupies the Oval Office for the next four years. On the national level, they’ll also decide which political party controls the U.S. House and U.S. Senate for the next two years.

The nonpartisan Larry Sabato’s Crystal Ball at the University of Virginia Center for Politics say the presidential race is still very much up for grabs, rating the battleground states of Arizona, Georgia, Michigan, Nevada, North Carolina, Pennsylvania and Wisconsin as toss-ups.

Early voting is higher in several of those purple states than some of their counterparts, according to&nbsp;<a href="https://election.lab.ufl.edu/early-vote/2024-early-voting/" target="_blank">data</a>&nbsp;from the University of Florida’s election lab.

Michigan, Ohio, Pennsylvania and Virginia have each received at least 1.2 million early ballots, while California, Florida, Georgia, North Carolina and Texas have all received at least 2 million early votes.

The University of Florida data shows that among states that disclose party breakdowns, Democrats have cast nearly 42% of ballots while Republicans have submitted 35% and other voters have sent in about 23%.

Sabato’s Crystal Ball projects that Republicans are at least slightly favored to win 212 House seats, with Democrats holding onto at least 209 seats in that chamber. Another 14 races are rated as toss-ups, meaning control of the chamber is still far from decided.

“Overall, our ratings show just 7 Republican-held Toss-ups and 7 Democratic-held Toss-ups, for 14 total,” Managing Editor Kyle Kondik and Associate Editor J. Miles Coleman&nbsp;<a href="https://centerforpolitics.org/crystalball/rating-changes-pushing-house-toss-ups-nebraska-senate-to-leans-republican/" target="_blank">wrote in the latest update</a>, released Thursday morning.

“Splitting the Toss-ups down the middle would produce a 219-216 Republican House, so the ratings technically have the Republicans very narrowly ahead—but neither side is favored in the race for the House majority, even at this late stage,” they wrote.

Democratic Congressional Campaign Committee Chairwoman Suzan DelBene of Washington state told reporters Thursday the organization has several voter protection efforts underway to ensure Americans who want to vote have an opportunity to do so.

Those efforts won’t stop when the polls close on Election Day, but will continue as absentee ballots are counted, she said in a virtual meeting with the Regional Reporters Association.

“So this is obviously a priority for us, and some of these races are very, very close, so we want to make sure we’re there to help make sure ballots are counted across the country,” DelBene said.

Control of the House might not be announced on election night, or for several days afterward. It took more than a week after the 2022 midterm elections before The<a href="https://apnews.com/article/2022-midterm-elections-house-control-79475a4fc11e4375cd0dded651b9eede" target="_blank">&nbsp;Associated Press called control&nbsp;</a>for the GOP.

The Senate is leaning slightly toward Republican control, with GOP candidates on track to pick up seats in West Virginia and Montana.

Sabato’s has, however, moved Nebraska’s rating from likely Republican to leans Republican, “as the Republican cavalry has had to ride in to help” incumbent GOP Sen. Deb Fischer maintain her seat against independent challenger Dan Osborn.

“Unlike Sens. Ted Cruz (R-TX) and Rick Scott (R-FL), the only other two GOP incumbents in races that we rate as something other than Safe Republican, Fischer has, arguably, never had to run in a legitimately competitive statewide general election,” Kondik and Coleman wrote.

<figure>
 <img src="https://media.eaglewebservices.com/public/2024/10/1729870329996.png" alt="Voters in line this week in Sedgwick County-photos courtesy KWCH" />
 <figcaption>Voters in line this week in Sedgwick County-photos courtesy KWCH</figcaption>
 </figure>BY:&nbsp;<a href="https://missouriindependent.com/author/jennifer-shutt/">JENNIFER SHUTT</a>WASHINGTON — Nearly 30 million Americans by Thursday had cast their ballots ahead of Election Day, with 13 million choosing to vote in person at early voting centers and another 17 million submitting mail-in ballots, according to data from the University of Florida’s election lab.The total number of early votes is expected to increase significantly in the days leading up to Election Day on Nov. 5.Voters will determine whether Democratic presidential nominee Kamala Harris or Republican candidate Donald Trump occupies the Oval Office for the next four years. On the national level, they’ll also decide which political party controls the U.S. House and U.S. Senate for the next two years.The nonpartisan Larry Sabato’s Crystal Ball at the University of Virginia Center for Politics say the presidential race is still very much up for grabs, rating the battleground states of Arizona, Georgia, Michigan, Nevada, North Carolina, Pennsylvania and Wisconsin as toss-ups.Early voting is higher in several of those purple states than some of their counterparts, according to&nbsp;<a href="https://election.lab.ufl.edu/early-vote/2024-early-voting/" target="_blank">data</a>&nbsp;from the University of Florida’s election lab.<figure>
 <img src="https://media.eaglewebservices.com/public/2024/10/1729870269518.png" alt="Photo courtesy KWCH" />
 <figcaption>Photo courtesy KWCH</figcaption>
 </figure>Michigan, Ohio, Pennsylvania and Virginia have each received at least 1.2 million early ballots, while California, Florida, Georgia, North Carolina and Texas have all received at least 2 million early votes.The University of Florida data shows that among states that disclose party breakdowns, Democrats have cast nearly 42% of ballots while Republicans have submitted 35% and other voters have sent in about 23%.<h2>U.S. House control up in the air</h2>Sabato’s Crystal Ball projects that Republicans are at least slightly favored to win 212 House seats, with Democrats holding onto at least 209 seats in that chamber. Another 14 races are rated as toss-ups, meaning control of the chamber is still far from decided.“Overall, our ratings show just 7 Republican-held Toss-ups and 7 Democratic-held Toss-ups, for 14 total,” Managing Editor Kyle Kondik and Associate Editor J. Miles Coleman&nbsp;<a href="https://centerforpolitics.org/crystalball/rating-changes-pushing-house-toss-ups-nebraska-senate-to-leans-republican/" target="_blank">wrote in the latest update</a>, released Thursday morning.“Splitting the Toss-ups down the middle would produce a 219-216 Republican House, so the ratings technically have the Republicans very narrowly ahead—but neither side is favored in the race for the House majority, even at this late stage,” they wrote.Democratic Congressional Campaign Committee Chairwoman Suzan DelBene of Washington state told reporters Thursday the organization has several voter protection efforts underway to ensure Americans who want to vote have an opportunity to do so.Those efforts won’t stop when the polls close on Election Day, but will continue as absentee ballots are counted, she said in a virtual meeting with the Regional Reporters Association.“So this is obviously a priority for us, and some of these races are very, very close, so we want to make sure we’re there to help make sure ballots are counted across the country,” DelBene said.Control of the House might not be announced on election night, or for several days afterward. It took more than a week after the 2022 midterm elections before The<a href="https://apnews.com/article/2022-midterm-elections-house-control-79475a4fc11e4375cd0dded651b9eede" target="_blank">&nbsp;Associated Press called control&nbsp;</a>for the GOP.<h2>U.S. Senate tilts toward GOP</h2>The Senate is leaning slightly toward Republican control, with GOP candidates on track to pick up seats in West Virginia and Montana.Sabato’s has, however, moved Nebraska’s rating from likely Republican to leans Republican, “as the Republican cavalry has had to ride in to help” incumbent GOP Sen. Deb Fischer maintain her seat against independent challenger Dan Osborn.“Unlike Sens. Ted Cruz (R-TX) and Rick Scott (R-FL), the only other two GOP incumbents in races that we rate as something other than Safe Republican, Fischer has, arguably, never had to run in a legitimately competitive statewide general election,” Kondik and Coleman wrote.<a href="https://vote.gov/guide-to-voting#earlyvoting" target="_blank">Early in-person voting</a>&nbsp;as well as&nbsp;<a href="https://vote.gov/guide-to-voting#mail-absentee" target="_blank">who is eligible for mail-in ballots</a>&nbsp;is determined by each state, meaning when and where voters can cast early ballots varies considerably.All states are required to host in-person voting on Election Day, scheduled for Nov. 5. More information about voting can be found&nbsp;<a href="https://www.vote.gov/" target="_blank">here</a>.