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WASHINGTON (AP) — Fending off a U.S. default, the Senate gave final approval late Thursday to a debt ceiling and budget cuts package, grinding into the night to wrap up work on the bipartisan deal and send it to President Joe Biden’s desk to become law before the fast-approaching deadline.
The compromise package negotiated between Biden and House Speaker Kevin McCarthy leaves neither Republicans nor Democrats fully pleased with the outcome. But the result, after weeks of hard-fought budget negotiations, shelves the volatile debt ceiling issue that risked upending the U.S. and global economy until 2025 after the next presidential election.
Approval in the Senate on a bipartisan vote, 63-36, reflected the overwhelming House tally the day before, relying on centrists in both parties to pull the Biden-McCarthy package to passage.
Senate Majority Leader Chuck Schumer said the bill’s passage means “America can breathe a sigh of relief.”
He said, “We are avoiding default.”
Fast action was vital if Washington hoped to meet next Monday’s deadline, when Treasury has said the U.S. will start running short of cash to pay its bills, risking a devastating default. Raising the nation’s debt limit, now $31.4 trillion, would ensure Treasury could borrow to pay already incurred U.S. debts.
In the end, the debt ceiling showdown was a familiar high-stakes battle in Congress, a fight taken on by McCarthy and powered by a hard-right House Republican majority confronting the Democratic president with a new era of divided government in Washington.
Refusing a once routine vote to allow a the nation’s debt limit to be lifted without concessions, McCarthy brought Biden’s White House to the negotiating table to strike an agreement that forces spending cutbacks aimed at curbing the nation’s deficits.
It bolsters funds for defense and veterans, cuts back new money for Internal Revenue Service agents and rejects Biden’s call to roll back Trump-era tax breaks on corporations and the wealthy to help cover the nation’s deficits. It imposes automatic 1% cuts if Congress fails approve its annual spending bills.
After the House overwhelmingly approved the package late Wednesday, Senate Republican leader Mitch McConnell signaled he too wanted to waste no time ensuring it became law.
Touting its budget cuts, McConnell said Thursday, “The Senate has a chance to make that important progress a reality.”
Having remained largely on the sidelines during much of the Biden-McCarthy negotiations, several senators insisted on debate over their ideas to reshape the package. But making any changes at this stage would almost certainly derail the compromise and none were approved.
Instead, senators dragged through rounds of voting late into the night rejecting the various amendments, but making their preferences clear. Conservative Republican senators wanted to include further cut spending, while Democratic Sen. Tim Kaine of Virginia sought to remove the Mountain Valley Pipeline approval.
The energy pipeline is important to Sen. Joe Manchin, D-W.Va., and he defended the development running through his state, saying the country cannot run without the power of gas, coal, wind and all available energy sources.
But, offering an amendment to strip the pipeline from the package, Kaine argued it would not be fair for Congress to step into a controversial project that he said would also course through his state and scoop up lands in Appalachia that have been in families for generations.
Defense hawks led by Sen. Lindsey Graham of South Carolina complained strongly that military spending, though boosted in the deal, was not enough to keep pace with inflation — particularly as they eye supplemental spending that will be needed this summer to support Ukraine against the war waged by Russian President Vladimir Putin.
“Putin’s invasion is a defining moment of the 21st century,” Graham argued from the Senate floor. “What the House did is wrong.”
They secured an agreement from Schumer, which he read on the floor, stating that the debt ceiling deal “does nothing” to limit the Senate’s ability to approve other emergency supplemental funds for national security, including for Ukraine, or for disaster relief and other issues of national importance.
For weeks negotiators labored late into the night to strike the deal with the White House, and for days McCarthy had worked to build support among skeptics.
Tensions had run high in the House the night before as hard-right Republicans refused the deal. Ominously, the conservatives warned of possibly trying to oust McCarthy over the issue.
But Biden and McCarthy assembled a bipartisan coalition, with Democrats ensuring passage on a robust 314-117 vote. All told, 71 House Republicans broke with McCarthy to reject the deal.
“We did pretty dang good,” McCarthy, R-Calif., said afterward.
The White House immediately turned its attention to the Senate, its top staff phoning individual senators.
Democrats also had complaints, decrying the new work requirements for older Americans, those 50-54, in the food aid program, the changes to the landmark National Environmental Policy Act and approval of the controversial Mountain Valley Pipeline natural gas project they argue is unhelpful in fighting climate change.
The nonpartisan Congressional Budget Office said the spending restrictions in the package would reduce deficits by $1.5 trillion over the decade, a top goal for the Republicans trying to curb the debt load.
In a surprise that complicated Republicans’ support, however, the CBO said their drive to impose work requirements on older Americans receiving food stamps would end up boosting spending by $2.1 billion over the time period. That’s because the final deal exempts veterans and homeless people, expanding the food stamp rolls by 78,000 people monthly, the CBO said.
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AP White House Correspondent Zeke Miller contributed to this report.
NEW YORK (AP) — Racial bias built into a common medical test for lung function is likely leading to fewer Black patients getting care for breathing problems, a study published Thursday suggests.
As many as 40% more Black male patients in the study might have been diagnosed with breathing problems if current diagnosis-assisting computer software was changed, the study said.
Doctors have long discussed the potential problems caused by race-based assumptions that are built into diagnostic software. This study, published in JAMA Network Open, offers one of the first real-world examples of how the the issue may affect diagnosis and care for lung patients, said Dr. Darshali Vyas, a pulmonary care doctor at Massachusetts General Hospital.
The results are “exciting” to see published but it’s also “what we’d expect” from setting aside race-based calculations, said Vyas, who was an author of an influential 2020 New England Journal of Medicine article that catalogued examples of how race-based assumptions are used in making doctors’ decisions about patient care.
For centuries, some doctors and others have held beliefs that there are natural racial differences in health, including one that Black people’s lungs were innately worse than those of white people. That assumption ended up in modern guidelines and algorithms for assessing risk and deciding on further care. Test results were adjusted to account for — or “correct” for — a patient’s race or ethnicity.
One example beyond lung function is a heart failure risk-scoring system that categorizes Black patients as being at lower risk and less likely to need referral for special cardiac care. Another is an equation used in determining kidney function that creates estimates of higher kidney function in Black patients.
The new study focused on a test to determine how much and how quickly a person can inhale and exhale. It’s often done using a spirometer — a device with a mouthpiece connected to a small machine.
After the test, doctors get a report that has been run through computer software and scores the patient’s ability breathe. It helps indicate whether a patient has restrictions and needs further testing or care for things like asthma, chronic obstructive pulmonary disorder or lung scarring due to air pollutant exposure.
Algorithms that adjust for race raise the threshold for diagnosing a problem in Black patients and may make them less likely to get started on certain medications or to be referred for medical procedures or even lung transplants, Vyas said.
While physicians also look at symptoms, lab work, X-rays and family histories of breathing problems, the pulmonary function testing can be an important part of diagnoses, “especially when patients are borderline,” said Dr. Albert Rizzo, the chief medical officer at the American Lung Association.
The new study looked at more than 2,700 Black men and 5,700 white men tested by University of Pennsylvania Health System doctors between 2010 and 2020. The researchers looked at spirometry and lung volume measurements and assessed how many were deemed to have breathing impairments under the race-based algorithm as compared to under a new algorithm.
Researchers concluded there would be nearly 400 additional cases of lung obstruction or impairment in Black men with the new algorithm.
Earlier this year, the American Thoracic Society, which represents lung-care doctors, issued a statement recommending replacement of race-focused adjustments. But the organization also put a call out for more research, including into the best way to modify software and whether making a change might inadvertently lead to overdiagnosis of lung problems in some patients.
Vyas noted some other algorithms have already been changed to drop race-based assumptions, including one for pregnant women that predicts risks of vaginal delivery if the mom previously had a cesarean section.
Changing the lung-testing algorithm may take longer, Vyas said, especially if different hospitals use different versions of race-adjusting procedures and software.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
WASHINGTON (AP) — Vice President Kamala Harris said Thursday that federal agencies are taking new steps to stop racial discrimination in appraising home values by proposing a rule intended to ensure that the automated formulas used to price housing are fair.
“Everyone should be able to take full advantage of their aspiration and dream of owning a home,” Harris told reporters on a telephone call.
Announcement of the proposed rule comes a year after the administration laid out a plan to stop appraisers from systemically undervaluing the homes of Black people and other underrepresented groups. Low appraisals make it harder for these homeowners to build wealth and access home equity lines of credit, worsening racial inequality. Appraisers help to determine the value of a home so buyers can receive a mortgage.
The extent of the discrimination by appraisers can be massive, in some instances more than halving the value of a property. In Indianapolis, one Black homeowner found the appraised value of her home jumped to $259,000 from $125,000, after she declined to disclose her race on her application and removed all family photos and African American art in the home.
Because many financial institutions and mortgage companies use formulas to judge the value of a home, the proposed rule would set out new standards to prevent discrimination. Companies that rely on appraisals would need to adopt policies to improve the accuracy of their appraisals, stop data manipulation and avoid conflicts of interest.
The proposed rule would have a 60-day comment period.
The Biden administration is also having federal agencies make it easier for homebuyers to appeal racial bias in appraisals and is providing the public with more data in order to increase transparency. The administration is also seeking to make it easier for people in underrepresented groups to become appraisers.
In June 2021, President Joe Biden announced the formation of the Interagency Task Force on Property Appraisal and Valuation Equity, known as PAVE, to address the challenge of bias in appraisals.
