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News Brief: Southern Border Crisis, Medicaid, Brexit Latest


The United States caught so many people at the border this week, the Department of Homeland Security says it hardly knows what to do.


Yeah. Officials spoke after two extraordinary days of apprehensions at the border. The annual flow of migrants to the U.S. remains well below historic highs, but it has been rising. On two separate days this week, federal agents apprehended more than 4,000 people crossing without authorization. That is the highest daily total in 15 years. CBP Commissioner, Kevin McAleenan, says it's part of a busy month.


KEVIN MCALEENAN: With 55,000 families - including 40,000 children - expected to enter the process this month, we are doing everything we can to simply avoid a tragedy in a CBP facility. But with these numbers, with the types of illnesses we're seeing at the border, I fear that it's just a matter of time.

INSKEEP: NPR's John Burnett is in San Antonio. He's covered the border for years.

John, good morning.


INSKEEP: We just gave a bunch of numbers. But what do those numbers feel like when you're near the border?

BURNETT: You know, I've covered immigration in the borderlands for a really long time, as you know. And I just never heard this kind of doom and gloom coming from officials. Right now, I'm at this gathering...

INSKEEP: John, I just want - John Burnett, I just want to mention something happened to your phone line. We're unable to hear anything that you're saying. If we can...

BURNETT: I'm sorry.

INSKEEP: ...Try that one more time. There we go.


INSKEEP: Go for it, John. What's happening? What's it feel like there?

BURNETT: So I've covered immigration in the borderlands for a long time, and I've never heard this kind of pessimism coming from officials. I'm at this gathering of immigration bigwigs. And they can't find enough superlatives to describe the situation at the border - the unabated crisis. We're overwhelmed. It's unsustainable. Kevin McAleenan, the commissioner who we just heard from, said the breaking point has arrived this week. And if current trends continue, now that the weather is warming up, their in-house forecast is looking at up to 150,000 migrants being arrested a month for the next three months.

INSKEEP: I want to follow up on a thing that we heard McAleenan say there. He said, we're doing everything we can to simply avoid a tragedy in a CBP facility. Do I understand him to say they don't have proper facilities to detain everyone, and they're going to end up in unhealthy or even deadly conditions?

BURNETT: Well, I mean, Steve, the Border Patrol stations were set up for single males, and so they're very Spartan. I mean, they've been described as dog kennels by some of those who've stayed in them. We've learned that some of these stations are two and three times over capacity. I mean, out of El Paso yesterday, we saw pictures. They were locking them up in holding pens outside under a bridge, waiting to process them. And in El Paso and up and down the border, they're ready - the Border Patrol's ready to release thousands of these immigrants directly to church-run shelters in the community. And if they don't have any room, they're going to be on the streets.

INSKEEP: OK. So that is one answer to this - to turn over some of the migrants to private organizations to the extent that they can. But is there any other way to help this situation?

BURNETT: Well, you know, this administration has been asking for help from the Pentagon since it came into office. There are National Guard down on the border, now there are active duty. And so the Border Patrol is making a request for assistance for even more help from the Pentagon, but this time, directly to help processing the immigrants. Remember; the Defense Department didn't want to have them - their soldiers in direct contact with immigrants. Now Customs and Border Protection is saying, hey, guys. We need help transporting and doing the paperwork for this crush of immigrants. We need your shoulders - we need your soldiers to pitch in directly.

INSKEEP: If there is no way to hold people, is it legal, in some cases, to simply load them on buses and ship them back to Mexico, where they seem to have come from?

BURNETT: They cannot do that. They cannot send them back into Mexico. They have to let them actually apply for asylum. And that's the frustrating thing for agents is that - even this, you know, this wall that this administration has been touting for so long, it doesn't make a difference. And I've been at this trade show with all of these immigration officials down here. And they - they're showing all these high-tech - this high-tech equipment like, you know, drones and pole-mounted cameras. And none of that would actually stop the immigrants from coming across because they're not trying to evade officers. They're crossing the river, and they're surrendering to Border Patrol officers. So it's a unique crisis they're facing down here.

INSKEEP: NPR's John Burnett. Thanks so much.

BURNETT: You bet, Steve.


INSKEEP: OK. Not for the first time, a federal judge has rejected an effort to put pressure on some of the poorest of the poor.

GREENE: Yeah. The judge rejected plans by two states to add a work requirement to Medicaid. That's the health insurance program for people near or below the poverty line. The Trump administration had encouraged states to approve a work requirement, but the judge blocked plans by Kentucky and Arkansas, which did that. In Arkansas alone, 18,000 recipients have lost health coverage since the state began the mandate last summer.

INSKEEP: NPR health policy correspondent Alison Kodjak has been covering this story.

Alison, good morning.

ALISON KODJAK, BYLINE: Good morning, Steve.

INSKEEP: What exactly were the work requirements?

KODJAK: So people who are adults who are considered, quote, "able-bodied" - which means not pregnant women, not disabled - would have to work 80 hours a month. And that work could be at an actual job, volunteer, go to school or job training. And in addition to actually doing the work, they would have to report in to the state exactly what they had done to meet those requirements.

INSKEEP: Some people listening will say, OK. Well, you ought to try to work to - as a requirement of having health insurance because other people work. What was the judge's response to that kind of reasoning?

KODJAK: Well, what the judge said is essentially Medicaid - the law that created Medicaid, its goal is only to provide health care to low-income people. It's not about making people work or an anti-poverty program. So when the Obama administration expanded Medicaid to more people, under the Affordable Care Act, they declined to allow states to require people to work. But as you mentioned earlier, the Trump administration has been saying, yes. We would like you to ask people to work in exchange for those benefits. This judge said that's not in the law. You can't condition health care on work.

INSKEEP: So there was this effort in at least two states to use Medicaid as a lever to get people into the workplace. Are there other states that could be affected by this ruling against that practice?

KODJAK: Yeah. There are 15 states who have either had a waiver - one of these requests to impose work requirements on Medicaid beneficiaries - approved, or it's pending. And because the Trump administration had, essentially, invited states to do this, even those pending ones seemed like they would get approved. Now that's all been tossed up in the air. Unless the Department of Health and Human Services in those states can come up with a rationale that says requiring work actually provides healthcare, it's unclear that they'll be able to go forward with these.

INSKEEP: The firmest solution would be an actual change in the law. Is that what you're saying?

KODJAK: Yeah. It would have to change the law that created the Medicaid program because that program, according to this judge, says the purpose of Medicaid is to provide health care not to lift people out of poverty, which is what the Trump administration has been saying they'd like it to do.

INSKEEP: Alison, thanks for the update.

KODJAK: Thanks, Steve.

INSKEEP: NPR health policy correspondent Alison Kodjak.


INSKEEP: Wow. An offer by British Prime Minister Theresa May suggests the bad feelings in Britain's parliament. Theresa May offered her colleagues an inducement. If they will just do what she wants one time, she promises to resign.

GREENE: Yeah. The incentive she offered is that if her Brexit deal is approved, she will let someone else take her job. Now, we should remember lawmakers have already rejected that plan two times. And in a series of votes last night, lawmakers also rejected every single other plan they could think of - 8 no votes in all. John Bercow, the Speaker of the House of Commons, read out the results.


JOHN BERCOW: So the noes have it. So the noes have it. So the noes have it.

INSKEEP: Frank Langfitt of NPR News, who's been covering this story - it sounds like the noes have it.

FRANK LANGFITT, BYLINE: It was the night of eight noes, yeah.

INSKEEP: (Laughter) My goodness. So is May likely to get out of this disaster by offering to quit?

LANGFITT: Not yet. She made progress, Steve. She picked up at least two dozen votes, as far as I can tell. The most significant one was Boris Johnson. He was one of the leaders of the 2016 Brexit referendum campaign. He'd been intense - he'd been an intense critic of her deal. He did a U-turn yesterday, said he could support it now. It's worth remembering; Boris Johnson is widely thought to want the prime minister's job, so her offer was particularly attractive to him. But the big problem for the prime minister still is the Democratic Unionist Party, they provide 10 crucial votes, which gives May's Conservative Party a majority in the Parliament. They still say they're not going to vote for her deal. By my count, roughly, it seems like she needs to flip 50 more votes, and she's not there yet.

INSKEEP: Let me just remember. Democratic Unionist Party - those are folks in Northern Ireland...

LANGFITT: In Northern Ireland.

INSKEEP: ...Who are especially affected by the way that Brexit turns out. I'm not sure that I understand what exactly happened yesterday. How did it come to pass that Parliament was voting on eight different plans, including just holding a second referendum on Brexit?

LANGFITT: Yeah. What they did is they seized control in the British political - British parliamentary system. The government, the prime minister, runs the agenda. The Parliament took control. And they had these eight different options. And I was surprised by this. I thought one was going to pass. They all went down to defeat. And the government saw this, like, as a bit of an opportunity to point out, you know, we gave you a chance to do this. You seized control. You failed. You really should take a closer look at our deal. And Stephen Barclay - he's the U.K.'s Brexit secretary. He laid it out to the - in the House of Commons last night like this.


STEPHEN BARCLAY: There is no simple way forward. The deal the government has negotiated is a compromise. The results of the process this house has gone through today strengthens our view that the deal the government has negotiated is the best option.

INSKEEP: Frank, isn't tomorrow a deadline for Parliament to do something?

LANGFITT: Very good memory - it is. They need to get her deal through. Otherwise, they have to come up with a new plan by April 12 or they will have to leave the EU with no deal, which most people think would be economically very damaging and, certainly, politically even more damaging to the United Kingdom.

INSKEEP: Oh, because the EU gave them until May if they pass something by tomorrow. But if they pass...

LANGFITT: Precisely.

INSKEEP: ...Nothing by tomorrow, they've only got, like, a couple of weeks. And they are out.

LANGFITT: Indeed. And so - and we still don't have any sense of how they're going to solve this. And we have one day left to get her deal through.

INSKEEP: OK, bit of suspense. Frank, thanks so much.

LANGFITT: Happy to do it, Steve.

INSKEEP: NPR's Frank Langfitt. Transcript provided by NPR, Copyright NPR.