With just days to go before Election Day, political coverage is everywhere. At ProPublica, we avoid horse race reporting and focus on telling stories about deeper issues and trends affecting the country.
Here are some stories from the last year about issues that are important to voters.
Abortion
When the U.S. Supreme Court in 2022 overturned Roe v. Wade, the 1970s-era ruling that guaranteed access to abortion throughout the country, states quickly enacted a patchwork of laws restricting the procedure. In all, 13 states now have a total ban on abortion.
ProPublica has thoroughly examined the impact of those laws over the last two years. Doctors have told ProPublica that confusion and fear about the potential for legal repercussions are changing the way their colleagues treat pregnant patients who have complications.
- In Tennessee, we followed one mother, Mayron Hollis, for a year after she was denied an abortion because of the state’s newly enacted ban. She had become addicted to drugs at 12, and the state had already taken away several of her children. Doctors were concerned that this latest pregnancy, which had implanted in scar tissue from a recent cesarean section, could kill her. The story and visual narrative follows Hollis’ struggles to get care following the birth of her daughter.
- In Georgia, Amber Thurman took abortion medication to end a pregnancy but died of an infection after her body failed to expel all of the fetal tissue, a rare complication that the suburban Atlanta hospital she went to was readily equipped to treat. But earlier that summer, the state had made abortion a felony, and with Thurman’s infection spreading, doctors waited nearly 20 hours before operating. When they finally did, it was too late. Thurman was the mother of a 6-year-old son. U.S. senators are examining whether the hospital broke federal law by failing to intervene sooner, and an official state committee concluded that her death was preventable.
Doctors and a nurse involved in Thurman’s care declined to explain their thinking and did not respond to questions from ProPublica. Communications staff from the hospital did not respond to multiple requests for comment. Georgia’s Department of Public Health, which oversees the state maternal mortality review committee, said it cannot comment on ProPublica’s reporting because the committee’s cases are confidential and protected by federal law.
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- Most abortions in the U.S. take place in the early weeks of pregnancy, and roughly 63% are done using medication. We recently examined how abortion pills work and answered common questions about them.
- In Texas, Josseli Barnica is one of at least two pregnant women who died after doctors delayed emergency care. She’d told her husband that the medical team said it couldn’t act until the fetal heartbeat stopped. The doctors involved in Barnica’s care at HCA Houston Healthcare Northwest did not respond to multiple requests for comment on her case. In a statement, HCA Healthcare said, “Our responsibility is to be in compliance with applicable state and federal laws and regulations,” and said that physicians exercise their independent judgment. The company did not respond to a detailed list of questions about Barnica’s care.
- In a second Texas case, 18-year-old Nevaeh Crain, who was six months pregnant, visited two emergency rooms a total of three times after experiencing abdominal cramps and other troubling symptoms. The first hospital diagnosed her with strep throat without evaluating her pregnancy. At the second, she screened positive for sepsis, a life-threatening and fast-moving reaction to an infection, medical records show. But doctors said her fetus had a heartbeat and that Crain was fine to leave. On Crain’s third hospital visit, an obstetrician insisted on two ultrasounds to “confirm fetal demise,” a nurse wrote, before offering a procedure called a dilation and curettage to remove the fetus. Hours later, Crain was dead.
Doctors involved in Crain’s care did not respond to several requests for comment. The two hospitals, Baptist Hospitals of Southeast Texas and Christus Southeast Texas St. Elizabeth, declined to answer detailed lists of questions about her treatment.
Immigration
As the number of migrant encounters at the U.S. border has surged under the Biden administration, immigration has become a top issue for voters. ProPublica has recently explored how this increase differs in key ways from past surges. In recent years, more of the people crossing the border have been turning themselves in and claiming asylum rather than trying to avoid arrest.
- The U.S. faces a shortage of skilled workers, and immigrants have helped fill that gap. Even areas critical to national security, such as Navy shipbuilding, are struggling to find enough qualified workers. So undocumented workers have stepped in as contractors, but that means they get fewer protections if something goes wrong on the job.
- Cities and towns far from the southern border are facing new challenges with the arrival of significant numbers of immigrants. In the small town of Whitewater, Wisconsin, several hundred immigrants from Nicaragua have arrived — mostly looking for low-paying jobs in factories and farms. Police say the biggest challenge has been strained resources and immigrants driving without licenses — not a wave of crime, as falsely claimed by former President Donald Trump.
- For decades, lobbyists from the business community shaped immigration legislation and moderated the contours of the debate. But in the Trump era, businesses see far more risk in advocating for these policies, a change that’s made it even harder to get to consensus on immigration reforms, even as businesses in a variety of sectors say they need more immigrant workers.
Economy
The condition of the U.S. economy is the top concern for voters, according to multiple polls. Across the world, inflation — the rate at which prices increase — surged beginning in 2020 with the COVID-19 pandemic, brought on by supply chain disruptions, surges in demand for goods and services, and the war in Ukraine.
- Last year, ProPublica looked at inflation through the lens of the humble automobile tire, tracing the raw materials from a rubber plantation in Southeast Asia to a repair shop in Mississippi to try to answer the question: Why are prices so high?
- For a time in 2022, a cadre of ocean carriers were charging exorbitant, potentially illegal, fees on shipping containers stuck because of congestion at ports, another reason the price of goods rose so quickly. That congestion has now eased considerably.
- Surveys also suggest housing costs are a primary concern to many Americans. While most economists agree that the lack of housing supply and a decade of low interest rates have fueled increases in housing prices and rents, there may be another factor at work: the use of algorithms to determine the price of your rent through the company RealPage.
- Democrats, including Ohio’s Sen. Sherrod Brown and Rep. Marcy Kaptur, face tough reelection fights in states that have shifted swiftly toward Trump, despite investments from the Biden administration in reviving manufacturing through the Inflation Reduction and CHIPS acts. National Democrats often overlook how important the place you live can be: Even if your own finances are secure, if you look out your window and see your city or town struggling, you believe you are, too. Some academics have referred to this as a sense of “shared fate,” and it could be a powerful force in this election, especially in small cities in the industrial Midwest.
Health Care
Fourteen years after the Affordable Care Act passed, more Americans have health care coverage, but the system itself remains as broken and fractured as ever. ProPublica has investigated various players in the health care system, from doctors accused of wrongdoing to insurers refusing to cover lifesaving treatments. We’ve also extensively explored mental health treatment this year and how, despite rising needs, America’s health care infrastructure can’t provide meaningful support.
- When companies such as Aetna or UnitedHealthcare want to rein in costs, they turn to EviCore, whose business model depends on turning down payments for care recommended by doctors for their patients. EviCore counters that it develops its guidelines for approvals with the input of peer-reviewed medical studies and professional societies, and that they are routinely updated to stay current with the latest evidence-backed practices. It said its decisions are based solely on the guidelines and are not interpreted differently for different clients.
- For Americans searching for mental health providers, many of the lists compiled by insurance companies are misleading or outdated. It’s a “ghost network” that leaves patients frustrated and unable to get timely care.
- Health insurer Cigna tracks every minute that its staff doctors spend deciding whether to pay for health care. One doctor who used to work for the company, Debby Day, said her bosses cared more about being fast than being right: “Deny, deny, deny. That’s how you hit your numbers,” Day said. In written responses, Cigna has said its medical directors are not allowed to “rubber stamp” a nurse’s recommendation for denial. In all cases, the company wrote, it expects its doctors to “perform thorough, objective, independent and accurate reviews in accordance with our coverage policies.”
In 2023, ProPublica revealed how Cigna rejects claims from patients without even reading them. In written responses about this program, Cigna said the reporting by ProPublica and The Capitol Forum was “biased and incomplete.” Cigna said its review system was created to “accelerate payment of claims for certain routine screenings,” Cigna wrote. “This allows us to automatically approve claims when they are submitted with correct diagnosis codes.”
Education
Few issues ignite as much passion as educating America’s schoolchildren. School boards and districts are facing battles over school vouchers, book bans and COVID-19 — conflict that is slowly changing how the U.S. educates kids, leaving them on different and unequal paths at school.
Many states led by conservative legislators and governors have pushed a rapid expansion of school voucher programs that promise to allow students and their parents to put state money toward the school — private or public — of their choice.
- The model for voucher programs in the country has been Arizona, which now offers vouchers to all students. But the state has spent so much money paying private schoolers’ tuition that it’s now facing hundreds of millions in budget cuts to critical state programs and projects.
- A ProPublica analysis shows that low-income families are using the system far less than wealthier families, in part because the location of private schools and the additional costs for transportation, tuition and meals makes using the vouchers more difficult.
- School choice advocates are intent on expanding the availability of vouchers to fund private education at the expense of public schools, but they’re facing a surprising pocket of resistance: Some conservative, rural residents are fighting the program, fearing their tax dollars will flow from the only public school in their area to benefit people in cities.
- Texas, however, remains one of the biggest holdouts against a school voucher program in which state tax dollars could be used to pay for private schools. Gov. Greg Abbott aggressively campaigned against members of his own party who did not support voucher programs. This fall, Abbott may finally get the votes needed to pass a bill, fulfilling a decadeslong wish of conservative donors in the state.
- We told the story of Courtney Gore, a Texas school board candidate who won her seat after claiming on the campaign trail that children were being indoctrinated. She later disavowed her party’s far-right platform after finding no evidence of such efforts.
- After COVID-19 school closures ended, absenteeism nearly doubled. With state and federal governments largely abdicating any role in getting kids back into classrooms, some schools have turned to private companies for a reimagined version of the truant officer.
Foreign Policy
The now yearlong war between Israel and Hamas has left tens of thousands dead, and Gaza is facing massive shortages of food, water and medical care. The war has sparked infighting in the Democratic Party and debates within the State Department over how best to manage the situation given the U.S.’s longtime trade and military ties to Israel. Both Trump and Vice President Kamala Harris have signaled their desire to end the war soon, though what will get both sides to agree isn’t entirely clear.
- The U.S. has long supported Israel with weapons. In January, U.S. Ambassador to Israel Jack Lew urged Washington to give thousands more bombs to the Israelis because they have a “decades-long proven track record” of avoiding killing civilians, a request that came, at the time, amid the deaths of at least 25,000 Palestinians in the war.
- The U.S. government’s two foremost authorities on humanitarian assistance concluded this spring that Israel had deliberately blocked deliveries of food and medicine into Gaza. But Secretary of State Antony Blinken and the administration of President Joe Biden did not accept either finding.
