Scott Presler addressing Turning Point Action’s “People’s Convention” on June 16, 2024 in Detroit. (Photo by Jeff Kowalsky/AFP via Getty Images)
EVERY RIGHT-WING INFLUENCER needs a shtick. Scott Presler’s is that he registers tons and tons of new Republican voters. Whenever there’s a crucial election coming up, there’s a good chance Presler will be in the area, registering scads of new voters for the GOP—and posting about it. A lot.
Often, Presler advertises how he targets unique demographic groups, like truck drivers or the Amish. This has made him into a heroic figure on the right and earned him more than 2 million followers on X. Every time the RNC chair seat is open, Presler’s fanbase demands that he be appointed to run the party. The president’s daughter-in-law Lara Trump nearly did hire Presler to work for the RNC last year, until the resurfacing of an unsavory incident from Presler’s past in which he had sex in a Republican office, then posted the pictures on Craigslist. Presler is also gay, which made the incident a bit harder to land in GOP circles.
That colorful backstory hasn’t dimmed Presler’s star much, though. Last year, Elon Musk gave $1 million to Presler’s voter-registration PAC. Presler criss-crossed Wisconsin ahead of the state’s much-watched Supreme Court election in April, vowing that “the cavalry is on the way.”
But the cavalry failed to prevent a 10-point Republican defeat in that race. And since April, Presler has faced a growing chorus of Republican critics who say he is overstating the value of his voter-registration work, particularly in the battleground state of Pennsylvania.
Presler, contacted through his Early Vote Action PAC, didn’t respond to a request for comment.
Presler’s most prominent critic on the right has been Brandon Straka, a former friend of his who made his own name on the right as the head of the “WalkAway” movement, which encourages traditionally Democratic groups like LGBTQ people and racial minorities to “walk away” and become Republicans.
Presler and Straka have a lot in common. They’re both gay, they both have hairstyles that are unusually dramatic for operatives of the staid GOP, and they both claim to have brought new demographics into the Republican party.
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They were also both in Washington on January 6th. But while Presler spent the day hugging his fans on the streets of D.C., according to his social media posts, Straka egged on the mob at the Capitol and was sentenced to three years of probation for it.
Now the recipient of a presidential pardon, Straka has become an outspoken critic of Presler, claiming that he inflates his importance in a way that weakens Republican get-out-the-vote efforts. Straka calls it the “Scott Presler Early Vote Action delusion.”
“He has weaponized conservative apathy and told people, ‘Don’t worry about it, I have a magic wand and I’m going to come into your state, wave my magic wand, and turn it red,’” Straka said in an audio chat on X in May, adding, “If he could do it, why did he lose in Wisconsin in the Supreme Court election?”
THE CLASH BETWEEN PRESLER AND HIS CRITICS is bigger than personalities. It’s about the fevered world of right-wing influencers seeking to position themselves as key to the party’s future—and whether anyone beyond Trump can take credit for GOP victories.
The 2024 election had seemed to quiet these debates. But they’ve revved back up with remarkable speed after Musk’s failed attempt to influence the Wisconsin Supreme Court race by flooding money into it. It raised the question of how valuable high-profile voter registration efforts actually are—or, more importantly, whether it’s election tactics or just Trump himself being on the ballot that is key for the GOP’s success.
Straka told me he grew suspicious over Presler, whom he calls a former friend, when he compared what he considers negative press coverage of his own efforts with the general positive press Presler receives. As an example, Straka pointed to a March profile of Presler in the Wall Street Journal that included a discussion of his hair regimen. (Presler describes his chest-length hair as “the brand.”)
“We’re treated very differently, and that makes me go, ‘Hmm, might there be a reason why the left-wing media is not maligning him, ever?’” Straka told me.
Presler’s critics have other, less superficial, criticisms. They’ve laid out their evidence that his impact is overstated at Real$cottPresler.com, a website launched in April devoted to their gripes with him. Brian Ference, a conservative investigative reporter who has promoted the website, characterized it to me as proof that Presler has “inflated” his claims about “the Amish numbers and dozens of other things.”
“The Amish voting was completely inconsequential to the election results,” Ference told me.
Ference noted that while Presler has made much of the power of the Amish vote to deliver Pennsylvania for Trump, the state’s main Amish county, Lancaster County, saw Trump’s vote total increase by only 6,000 votes between 2020 and 2024.
In a state where Trump won by roughly 120,000 votes in 2024, that’s not nothing. There are other examples that critics trot out as evidence of Presler’s hype efforts. They note that he rejoiced in September after registered Republicans surpassed Democrats in Pennsylvania’s Luzerne County.
“This is monumental, earth-shattering, ground shaking news,” Presler wrote on X.
But as Presler’s detractors on the “Real$cottPresler” website point out, Trump won the county even when it had more registered Democrats—by 22,000 votes in 2020.
Presler’s critics also say Presler has been slow to debunk a popular claim circulated by his fans: that he registered 180,000 Amish voters in Pennsylvania. That’s a statistical impossibility: The total Amish population in the state is less than 100,000.
“There’s not one single photograph of that?” Straka said on an X Space in May. “There’s not one picture of a 6′ 7″ guy with hair down to the floor, transporting tens of thousands of Amish people to the polls? But people write it, over and over and over again. It’s literally insane.”
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LIKE MUCH IN THE MAGA MOVEMENT, tactical or even philosophical disagreements are often just cover for more catty disputes. And Straka has been clear that he has personal grievances with Presler.
He claims that Presler joined him as part of a coalition of influencers rallying voters ahead of the 2020 election, with the understanding that all of the personalities involved would repost each other’s content. Instead, Presler benefited from his collaborators’ shares but refused to boost everyone else’s videos in kind, according to Straka. The result was both that Presler seemed to have an outsized impact on voting efforts and that Straka was left aggrieved.
Worse, Straka claims Presler used their friendship to get a plum front-row seat at the Ellipse rally that preceded the January 6th riot, only to abandon Straka when the latter faced federal charges for his actions that day.
While Presler has kept mostly quiet in the face of the attacks, he seemed to allude to them in a late May post, arguing that his critics were out to undermine his efforts to turn Pennsylvania red because he represents a threat to the political establishment.
“A Lot of People Have Been Attacking Me and I Figured Out the Reason Why,” Presler wrote on X on May 28.
Perhaps the strangest part of this saga concerns Presler’s accent. In that May live chat with Straka on X, anti-voter fraud activist Mark Cook claimed that in a heated moment after he accused Presler of ignoring election fraud, Presler confronted him with a “very, very crazy deep accent that was not his normal voice.”
This may seem like a truly inconsequential element in a feud involving millions of dollars in GOP get-out-the-vote resources, but it has nevertheless become one more data point as to the distrust and fractious nature defining the world of MAGA influencers.
Straka even took to Rumble in May to post a video denouncing Presler, during which he pointed out that while his erstwhile friend grew up in Florida and Virginia, he sometimes puts on an exaggerated Midwest accent straight out of Fargo.
“What was even more off the wall—Scott was now speaking with a bizarre accent,” Straka said, playing the accent footage. “At first I thought he was kidding, but he wasn’t.”
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Nieraj Jain was puzzled by the patient sitting quietly in front of him. The woman, in her sixties, was losing her eyesight; that much was clear. Her vision was blurred, and she was having increasing difficulty seeing at night and in bright sunlight. Less obvious was the cause. A retinal specialist and surgeon at Emory University in Georgia, Jain pored over specialized scans of her eye and saw odd patches of pigment on her retina — patches that didn’t fit with any known diagnosis.
A fleeting memory pulled him up short; hadn’t he seen another patient a few months before with a similar finding? Combing through patient records, Jain dug up five more patients at Emory with the same puzzling retinal changes. All were going blind — and all happened to be taking Elmiron, a drug for a bladder condition called interstitial cystitis. In 2018, Jain and his colleagues published their findings about this new cause of blindness, dubbing it “pigmentary maculopathy.”
Meanwhile, gastroenterologists at Emory and other institutions were uncovering another troubling finding about Elmiron: some patients on the drug were being diagnosed with colitis, a chronic inflammatory bowel disease with potentially life-threatening complications.
According to a government database analyzed by the Lever and the McGraw Center for Business Journalism at CUNY’s Newmark Graduate School of Journalism, by the end of 2024, hundreds of patients on Elmiron had suffered vision loss or blindness. Others taking the drug were even more unlucky. Dozens of patient deaths associated with Elmiron were reported to the Food and Drug Administration (FDA), and 45 patients were hospitalized with severe colitis.
Another problem? There’s no good evidence that Elmiron works.
When the government approved Elmiron in 1996, the manufacturer provided close to zero data that the drug effectively treated interstitial cystitis. Regulators allowed Elmiron on the market only on the proviso that the company conduct a second study to determine if it worked. It would take eighteen years for the various companies that bought and sold the drug’s license to produce that study — and it proved to be a resounding bust. Patients who took Elmiron did no better than those given a sugar pill. (Janssen, which manufactures Elmiron, did not respond to repeated requests for comment.)
All of which raises a question: How could a drug with such serious side effects get on the market in the first place? And how could it stay on the market for nearly three decades, even after subsequent studies failed to show it was effective? The answer to both questions strikes at the heart of what ails the FDA today.
Elmiron is just one of hundreds of drugs that have been approved by the FDA over the last several decades on the basis of flimsy or nonexistent evidence. Drug companies have been allowed to market hundreds of prescription drugs to doctors and sell them to unsuspecting patients despite glaringly inadequate evidence that they offer any benefit and in many cases amid clear signs that they pose a risk of serious, often irreparable harm.
From January 2013 until December 31, 2022, the FDA approved 429 drugs, most of which were authorized on the basis of inadequate evidence that they worked, according to a database of government records created for this investigation. Based on an analysis of these records, the agency has allowed dozens of treatments, like Elmiron, to remain on the market even when subsequent studies failed to show they are effective. This investigation found that from 2013 through 2022:
Seventy-three percent of drugs approved by the FDA did not meet the agency’s four foundational standards required to show they work as expected.
More than half of drug approvals were based on preliminary data rather than sound evidence that patients had fewer symptoms, improved function, or lived longer.
Fifty-five of the 429 drugs approved met only one of the four standards needed to show that a drug is safe and effective; thirty-nine drugs met none of them.
Many of the issues with drug approvals uncovered in this investigation are particularly concerning with regard to cancer treatments.
Only 2.4 percent of the 123 cancer drugs approved from 2013 through 2022 met all four of the FDA’s scientific criteria. Twenty-nine drugs — 23 percent — met none.
Eighty-one percent of cancer drugs were approved based on preliminary evidence rather than data showing patients would live longer. Studies of cancer drugs approved on preliminary evidence have failed to show they improve survival in the vast majority of cases.
These statistics come after billions of dollars and years of lobbying by the pharmaceutical industry and patient advocacy groups pressuring Congress to loosen the FDA’s scientific standards.
The resulting seismic shift from proving drugs work before they are approved to showing they work only after approval — if ever — has been quietly accomplished with virtually no awareness by doctors or the public. Insurers and taxpayers effectively pay for research after drugs hit the market as pharmaceutical companies reap the profits. Patients serve as the unwitting guinea pigs — with very real consequences.
In the United States alone, an estimated 128,000 people are killed each year by side effects of prescription drugs that are properly prescribed. That number excludes opioid overdoses and is more than deaths from all illegal drugs combined. And the rate at which the agency approves unproven drugs has accelerated dramatically in the last ten years.
These are just some of the findings of a two-year investigation by the Lever and the McGraw Center into all 429 new drugs approved from 2013 through 2022. A team of four experts, three of whom are physicians and one a postdoctoral fellow at Harvard, evaluated the scientific studies cited by the agency in its approval decisions.
In addition, the authors used government reports, internal FDA documents, investigators’ notes, congressional testimony, court records, and interviews with more than one hundred researchers, legal scholars, current and former federal officials, patients, and their families.
A fourteen-member advisory committee including physicians, epidemiologists, biostatisticians, a patient advocate, an FDA insider, and an FDA advisor provided guidance for the investigation. Several of the advisors vetted the findings for accuracy.
These experts were shocked by some of this investigation’s findings.
“I’ve been discouraged about the FDA before, but the last few years have been the worst,” said one of those advisors, Diana Zuckerman, founder and president of the Washington, DC–based nonprofit National Center for Health Research. “The scientific bar is often so low it would be impossible to lower it much further.”
Examining the nation’s drug approval process has gained urgency in the wake of President Donald Trump’s executive orders demanding federal agencies deregulate numerous industries. And while Martin Makary, Trump’s pick for FDA commissioner, has written widely about medical error and the need for more rigorous medical science, Health and Human Services secretary Robert F. Kennedy Jr is known for his unsupported claims about medicines and vaccines.
Experts say the current political reality doesn’t bode well for a drug-approval process that’s already plagued by deficiencies.
“We need an agency that’s independent from the industry it regulates and that uses high-quality science to assess the safety and efficacy of new drugs,” says Reshma Ramachandran, a codirector of the Yale Collaboration for Regulatory Rigor, Integrity, and Transparency and an expert in analyzing clinical trials. “Without that, we might as well go back to the days of snake oil and patent medicines.”
Between drugs, food, dietary supplements, tobacco, and medical devices, the FDA regulates $3.9 trillion worth of products each year, roughly one-eighth of the entire US economy. With a budget of approximately $6.9 billion in 2024, hundreds of offices in the United States and abroad, and more than 19,000 full-time employees (prior to recent firings), the FDA’s resources and scope make it one of the most powerful agencies in the country and highly influential around the world.
Its reputation was built on hard-won scientific standards put into place by Congress in 1938 and 1962 after a string of medical tragedies. These new laws, sometimes called “super-statutes” because they are so far-reaching, authorized the agency to require drug companies to provide evidence that their drugs are safe and effective before they could go on the market.
Then came AIDS. By 1988, the epidemic was in full swing: 46,000 people had died, and another 37,000 were living in the US with the poorly understood condition. AIDS activist groups wanted access to new drugs — and fast. With news cameras rolling, activists blockaded the entrance to FDA headquarters in Rockville, Maryland, holding placards saying “Federal Death Administration,” and lying on the street holding cardboard tombstones that read “Killed by the FDA.”
Activists found ready partners in drugmakers, who were eager to get their products to market. Together the activists and companies argued before the FDA that the compassionate, lifesaving strategy would be to loosen scientific standards for establishing the efficacy of drugs.
Among those existing standards was the strong recommendation that companies submit two or more randomized, controlled clinical trials that show a drug is effective in order to win approval. That’s because any single study, no matter how well it’s conducted, will often yield results that can happen by chance alone and do not stand up to later scrutiny.
But these trials can be expensive and time-consuming to conduct and analyze. Between that and a shortage of FDA reviewers, new treatments for AIDS were flowing through the chronically underfunded agency at the speed of chilled molasses. It took an average of seven to twelve years to take a drug through the development pipeline, three of which could be taken up while a company’s data sat on an FDA reviewer’s desk.
Under pressure from patient groups and drugmakers, the FDA created an “accelerated pathway” in 1992, which allowed companies to provide preliminary evidence that their AIDS drugs were effective. The new rules let these companies conduct trials tracking unreliable patient outcomes known as “surrogates,” with the expectation that drugmakers would provide more substantive evidence of real patient benefit after the drugs were on the market.
Surrogate outcomes are laboratory tests, or imaging studies like CT scans, that don’t themselves track quality or quantity of life but are hypothesized to be reasonably likely to predict a so-called “clinical benefit.” Clinical outcomes are the ones that matter to patients, like feeling better and living longer, but relying on surrogate outcomes means that drug companies could gain approval based on shorter and cheaper studies.
The problem is that improvements in a surrogate outcome often fail to correlate with whether a drug actually improves patients’ lives. In addition, a surrogate outcome can’t reflect the harm that a drug can cause, a limitation that has been repeatedly confirmed.
Some external experts therefore expressed concern about approving drugs based on surrogate outcomes — and those worries were borne out by the AIDS drug AZT.
When AZT was approved in 1987, many expected it to be a raging success based on research that counted T-cells, disease-fighting cells that the AIDS virus attacks, and other studies that tracked early survival data. But less than two years later, researchers at the Claude Bernard Hospital in Paris published their findings on 365 AIDS patients treated with AZT, concluding the results were “disappointing.” The drug was toxic to blood cells, and after six months, patients “returned to their pretreatment levels [of T-cells] and several opportunistic infections, malignancies, and deaths occurred.’’ (AZT would prove beneficial in later years when used in lower doses as part of a triple cocktail of AIDS drugs.)
Still, the pharmaceutical industry actively promoted the treatment. With a list price of $21,000 a year per patient in 2025 dollars, AZT delivered $2 billion in profits to its drugmaker Burroughs Wellcome in 1989. Seeing the rewards to be reaped, companies began lobbying Congress to force the FDA to apply the looser AIDS standards to all sorts of drugs.
Big Pharma’s campaign contributions jumped from $1.9 million in 1990 to $3.6 million in 1992, according to the Federal Election Committee and OpenSecrets, an independent research group. That year, Congress passed the Prescription Drug User Fee Act, which explicitly directed the FDA to allow approvals based on lower standards.
Rep. Henry Waxman (D-CA) slammed the legislation, saying that while it “sounds good . . . it is a hoax to imply that it will do more than the FDA is already doing to bring effective AIDS drugs to the market.”
The act also required drug companies to pay “user fees,” which the agency used to hire nearly 600 new staff. But critics say such fees have led some senior agency officials to view the industry as “partners.” The agency would go on to launch multiple “public-private partnerships” with the companies it is tasked with regulating.
Subsequent laws directed the FDA to expedite drug approvals by further lowering standards of evidence.
“We opened Pandora’s Box, and pharma exploited it,” says Gregg Gonsalves, an AIDS activist and professor of epidemiology at the Yale School of Public Health. In 1993, he told an FDA advisory committee that with the best of intentions, and in the face of a terrifying health crisis, AIDS activists had helped “unleash drugs with well-documented toxicities onto the market, without obtaining rigorous data on their clinical efficacy.”
The result, said Gonsalves, is “we’ve arrived in hell.”
Today, hundreds of drugs intended to treat a wide range of diseases have been approved by the FDA without critical evidence demonstrating they work.
According to the database created for this investigation, nearly three-quarters — 311 — of the 429 drugs approved from 2013 through 2022 were put on the market despite inadequate evidence of their efficacy.
This analysis was based on the four essential criteria cited in the FDA’s own standards and case law for assessing whether drugs work and are safe:
Control group: Patients taking the drug were compared to a control group that was given a placebo or a comparator drug.
Replication: At least two “well-controlled” trials showed the drug was effective.
Blinding: Subjects in the studies and the doctors who cared for them don’t know which patients are on the drug and which are in the control group.
Clinical end point: The studies measured the drug’s effect on patients’ survival or function rather than a surrogate measure.
These criteria are by no means a complete list of sound scientific evidence. Instead, they comprise the minimum criteria needed to determine whether drugmakers have provided “substantial evidence” to support claims of effectiveness for new drugs.
Yet only 118 of the 429 drugs approved over that period, a mere 28 percent, met the four criteria. One hundred and twenty-three drugs (29 percent) met three of the criteria, while thirty-nine drugs, more than 9 percent of the total, failed to meet a single criterion. That doesn’t mean these drugs don’t work, but it does mean the FDA approved them without knowing whether they are more likely to help patients than hurt them.
More than a quarter of the drugs approved over the study period, 123, were for various forms of cancer. This might seem like good news for the war on cancer, but only three of those drugs met all four of the minimum criteria, and twenty-nine cancer drugs failed to meet a single criterion. In other words, one in four cancer drugs were approved based on studies with no comparison group, no blinding, no replication, and no clinical outcome.
The most common way drug companies get such cancer drugs approved is by using a surrogate outcome in their clinical trials, rather than measuring actual clinical benefit. Drug companies routinely study laboratory measures like how much a tumor shrinks in response to a drug, instead of mortality or symptom relief.
But experts say the FDA should have no illusions regarding the unreliability of such surrogate outcomes, especially since these outcomes fail to take into account the harms a drug may cause, such as liver failure and anemia. These criticisms were hammered home after the agency approved Avastin to treat metastatic breast cancer.
Originally approved for two other types of cancers, Avastin hit the market for breast cancer in 2008. At that time, women with metastatic breast cancer faced a dire prognosis: most would be dead within five years, even after multiple rounds of chemotherapy drugs. Avastin was hailed as a breakthrough because it doesn’t kill cancer cells the way chemotherapy does but instead inhibits the growth of blood vessels, which tumors need to grow.
Avastin was approved based on a surrogate outcome called “progression-free survival,” which doesn’t actually look at patient survival but instead measures how long a cancer drug keeps a tumor in check. But just because a tumor isn’t growing or even shrinks doesn’t mean the patient will live longer or enjoy a better quality of life.
In 2010, worldwide Avastin sales had hit $6.8 billion. The approval for breast cancer had come with the condition that the manufacturer, Genentech, conduct another study to determine whether the drug actually worked. Two years later, the company produced two studies that suggested the opposite: the drug did not help people live longer.
In total, the company had conducted five clinical trials, none of which demonstrated that Avastin helped breast cancer patients live longer or with less disability. The new studies also documented the drug’s more serious side effects, which included blood clots, perforated intestines, stroke, heart problems, and kidney malfunction. Genentech did not respond to repeated requests for comment.
But when the FDA proposed withdrawing approval for Avastin for breast cancer, Genentech and several patient advocacy groups fought back, sometimes viciously. At a two-day public hearing in 2011, one of the few patient advocates testifying in favor of the FDA’s decision came with a bodyguard after being threatened verbally by others who supported Avastin. FDA staff received violent threats, and police were posted outside the building.
The FDA ultimately withdrew its approval of Avastin for breast cancer, but the episode, still referred to as “Armageddon” by some staff, had a chilling effect. The agency would not demand another drug withdrawal in the face of company opposition for more than two decades.
Today progression-free survival, along with a half-dozen other surrogate outcomes, has become the norm for approving cancer drugs. This investigation found that 81 percent of the 123 cancer drugs approved from 2013 through 2022 were based on studies that did not track overall survival and instead reported on progression-free survival or another surrogate.
Such approvals have real consequences for patients. Take Copiktra, a cancer drug manufactured by Secura Bio Inc. that was approved by the FDA in 2018 based on improved progression-free survival and other surrogate outcomes. According to a Lever review of FDA records, two-thirds of leukemia and lymphoma patients taking the drug developed serious complications. Patients treated with Copiktra also died eleven months earlier than patients treated with the comparator drug.
In December 2021, the manufacturer announced it would stop marketing the drug for follicular lymphoma. Six months later, the FDA issued a warning about “possible increased risk of death and serious side effects.” But it wasn’t until July 2024 — six years after studies showed the drug cut months off the lives of patients — that the FDA announced that Copitra should not be used as first- or second-line treatment for certain types of leukemia and lymphoma “due to an increased risk of treatment-related mortality.”
A spokesperson for Copiktra’s manufacturer, Secura Bio, told the Lever that in May 2022, the company sent a “Dear Healthcare Professional” letter to physicians about the results of the postmarket studies “in accordance with FDA requirements.” The company said Copiktra can still be prescribed for certain conditions if two other drug treatments have failed.
Copiktra is hardly an exception. According to a 2015 study, only 14 percent of cancer drugs approved based on a surrogate outcome, such as progression-free survival, between 2008 and 2012 were later shown to improve real-world survival. In other words, 86 percent were not supported by evidence that they helped patients live longer. What the drugs did cause were numerous serious side effects, while costing patients, taxpayers, and insurers billions of dollars a year.
Another, more recent study found that between January 2006 and December 2023, 147 cancer drugs that had been approved on a surrogate outcome were later tested to determine if they improved overall survival. Approximately three-quarters failed to do so.
Even when cancer drugs do improve survival, the gains can be meager. A 2022 study by researchers at the National Cancer Institute found that the median survival time for 124 cancer medicines approved from 2003 through 2021 to treat solid tumors was just 2.8 months. The average cost of such drugs is more than $24,000 per month.
In other words, after patients and their families spend financially crippling sums and go through side effects ranging from nausea to death, their outcomes are hardly better — and could be worse — than no treatment at all.
That outcome is not what most cancer patients expect when their doctor writes a prescription. It’s also at odds with what doctors believe about the meaning of FDA drug approvals. In 2016, researchers published the results of a survey sent to physicians that included the following question: “For [the] FDA to approve a drug, must the studies show: a.) a clinically important result; b.) a statistically significant result; c.) both; d.) None of the above.” The correct answer was none of the above.
Only 6 percent of doctors got the answer right. Aaron Kesselheim, a researcher at Harvard Medical School and coauthor of the report, said the result was “disappointing, but not entirely surprising. Doctors aren’t taught about the approval process.”
Nothing about ProAmatine would suggest it would ever get on the market.
This investigation found that between 1990 and 1996, the FDA rejected the blood pressure drug four times. The agency told the company, Roberts Pharmaceutical, that its studies showing ProAmatine could treat low blood pressure when a patient stands up were “poorly conducted.” Nor were the “incremental” increases in blood pressure sufficient proof of benefit since they were surrogate measures, according to the agency, which wanted evidence that patients would feel or function better. The agency instructed the company to conduct randomized, double-blind, placebo-controlled studies.
Before the agency rejected the drug for the fourth time, in March 1996, FDA medical reviewer Maryann Gordon noted a striking incidence of severe high blood pressure among treated patients. She suggested that this side effect might account for at least some of the strokes, heart attacks, and congestive heart failure that had occurred among patients on ProAmatine. She concluded, “The mostly unexplored benefits of midodrine do not outweigh its real risks, thus making midodrine [ProAmatine] not approvable.”
But less than three months after the FDA’s fourth rejection of ProAmatine, the agency reversed course, saying that following a meeting with the company, it had “reconsidered” its prior rejection and would approve ProAmatine after all, under “21 Code of Federal Regulations Subpart H,” a provision in the regulations that the FDA interprets as giving the agency “flexibility” in its approval decisions.
One FDA insider who asked to remain anonymous told the Lever, “Subpart H was never meant to rescue failed drug development programs after trials had already failed to show direct benefit to patients.” Instead the provision was designed to allow the agency leeway in approving drugs that looked highly promising for life-threatening conditions for which there were few or no other treatments.
While the condition treated by ProAmatine is not life threatening, Roberts Pharmaceutical was able to use the regulation to get the drug on the market in 1996, agreeing to submit a follow-up study no later than 2000 to determine if the drug worked.
The year 2000 came and went. No study. In 2003, the drug patent expired. Still no study. The FDA tried to induce the company to conduct the promised postmarket study by granting a three-year patent exclusivity extension, allowing the company to maintain a monopoly on the drug and keep its prices high. In 2005, the company submitted two studies, but the FDA found them insufficient.
In 2013, researchers at the Mayo Clinic conducted a comprehensive review of all studies of the drug and found ProAmatine provided “no significant benefit” in blood pressure change on standing up. The drug also caused a higher incidence of adverse events, and the researchers concluded “there is insufficient and low-quality evidence” to support its use.
Yet the drug was allowed to remain on the market with no caution issued to patients or doctors until 2017. As of 2009, it had generated $257 million in sales; in 2023, the midodrine market was estimated to be $745 million. Twenty-nine years after the drug was approved, there is still no evidence that it works.
“I think rightly or wrongly, FDA managers have decided that completely bending their standards could still lead to good drugs,” says Matthew Herder, a legal scholar at the University of Dalhousie in Halifax, Canada. “They put a lot of faith in postmarket evidence.” But the history of ProAmatine demonstrates that once a drug has been approved on an expedited basis, a requirement for postmarket evidence can have little meaning.
According to a 2022 analysis by the US Department of Health and Human Services Office of Inspector General, more than one-third of drugs approved on an accelerated pathway have never seen a confirmatory trial. When they did conduct the studies, regulators found companies took anywhere from a few months to twelve years to do so. This investigation found that confirmatory trials can take even longer — up to thirty years — and may not be performed at all.
ProAmatine, no longer sold under its brand name, is currently manufactured by multiple companies under the generic name midodrine. Three generic manufacturers of midodrine failed to respond to requests for comment.
Even when postmarket studies are submitted, they often provide no new information. Bishal Gyawali, an oncologist and associate professor at Queen’s University in Kingston, Canada, and two Harvard colleagues looked at cancer drugs approved based on surrogate outcomes between December 1992 and May 2017. Twenty percent of the time, the company submitted a follow-up study that looked at the same surrogate it used to get the drug approved — even though the point of the additional study was to determine whether the drug offered an actual clinical benefit. In another 21 percent, the follow-up trial used a different surrogate end point, rather than clinical outcomes.
Such scenarios are so common that the agency has created a term, “dangling approvals,” for the status of drugs whose postmarket trials failed or weren’t conducted before their deadline. As of 2021, the FDA had allowed ten of thirty-five cancer treatments to remain on the market even after their follow-up studies failed. The manufacturers eventually withdrew eight of the ten treatments, but only after patients received ineffective treatments for years and companies reaped healthy financial rewards.
Among the drugs with dangling approvals was one that had generated controversy before: Avastin, the failed breast cancer drug. Avastin has been shown to improve survival for some cancers, and in 2009, the FDA authorized the drug for recurrent glioblastoma, a fatal brain cancer, based on progression-free survival. In 2017, after the requisite “confirmatory” trials, the agency granted it full approval — even though the follow-up studies failed to show it helped patients live any longer.
Avastin remains on the market for recurrent glioblastoma — at a cost of $153,000 per year. European regulators refused to approve the drug for that use, citing concerns about safety and efficacy. A spokesperson for Genentech said some patients could benefit, noting that 11 percent of patients were able to discontinue treatment with steroids.
Then there’s Keytruda, which is widely advertised on TV for a number of cancers. Granted expedited approval in 2017 to treat a certain type of gastric cancer, the drug subsequently failed its postmarket study. Keytruda was sold for this use for nearly four years before regulators withdrew its approval in 2021. It remains on the market for other cancers. Keytruda maker Merck did not respond to requests for comment.
While drug companies profit from the sales of unproven drugs, everyone else — patients, insurers, and the government — pays a heavy price. In just four years, from 2018 through 2021, the taxpayer-funded health insurance programs Medicare and Medicaid shelled out $18 billion for drugs approved on the condition that their manufacturers produce confirmatory trials that had yet to be delivered.
“Everybody from the [FDA] commissioner on down keeps telling us that approving these marginal drugs will lead to an accumulation of benefits to patients over time, but if a drug doesn’t work, it doesn’t work, and putting them all together doesn’t add up to an effective treatment,” says Fran Visco, a breast cancer survivor and president and cofounder of the National Breast Cancer Coalition. “The entire medical oncology treatment world is built on a shaky foundation of limited evidence and uncertain patient benefit, but rather than admit that, we keep tweaking it and building on top of it. And it’s not just that you are giving people things that don’t work; these drugs will harm them, and they are financially toxic.”
In defending dangling approvals, Richard Pazdur, a physician and the head of the cancer drug division at the FDA, wrote in 2021 that when a drug fails in a clinical trial, it “does not necessarily mean that the drug is ineffective.” In one sense, Pazdur is right. Not having convincing evidence that a drug works is not the same as knowing it does not work.
What the scenario does mean is no one knows if it works or not. This investigation’s database shows that hundreds of drugs are now being put on the market before anybody knows if they’re effective.
In the past, having a promising surrogate end point was used by drug companies to decide whether proceeding to a clinical trial was worth the investment. Now drugs are put on the market, sold to thousands if not millions of patients, and the evidence to determine if they actually work is allowed to come later, if it comes at all.
The arrangement can have devastating costs for people like Laura MacMillan.
Starting in 2001, Laura MacMillan was diagnosed with a series of puzzling medical conditions. First came interstitial cystitis. Two years later, when she was only forty-five, she developed severe abdominal pain and diarrhea that was diagnosed as colitis. “I could barely leave my house,” she says. “I had frequent accidents and could only go to stores where I knew there was a bathroom.”
Twelve years later, she began to see wavy lines as her vision progressively dimmed. One evening, she drove over a cement island in a parking lot, leaving her with a flat tire and $4,700 of damage to her car. Her ophthalmologist could find no known diagnosis for her eye condition and could offer no treatment. Between the colitis and progressing blindness, MacMillan’s world was closing in.
Finally, in 2021, MacMillan came across Nieraj Jain’s troubling findings of blindness linked to the interstitial cystitis drug Elmiron and instantly put two and two together. She had been on Elmiron for twenty years and had experienced the same retinal changes Jain uncovered. She stopped the drug, and within weeks, her colitis symptoms went away. A subsequent colonoscopy showed her gut had completely healed, but MacMillan’s vision loss is permanent.
“I can’t drive anymore,” she says. “I had to stop working thirteen years ago. When I get up in the morning, it can take about two hours for the blurriness to subside enough for me to see words on my tablet. Last summer, my husband and I drove [1,000 miles] to Toronto to see the Blue Jays play the Yankees. Even though we had good seats, I couldn’t see a damn thing. So we won’t ever be able to do that again.”
MacMillan is relatively lucky compared to the hundreds of others uncovered by this investigation who suffered serious injuries or died while taking the drug.
The FDA continues to approve medicines based on evidence as flimsy, contradictory, and inadequate as the data for Elmiron. Citing the need for “flexibility” and the importance of encouraging drug development when there are few treatment options, the agency has all but abandoned its hard-won standards for sound science, according to numerous experts.
Jerome Hoffman, professor emeritus of medicine at the University of California, Los Angeles, and the lead analyst of the database created for this investigation, says:
Most of us imagine that the primary goal of the FDA is to make sure that the drugs it approves are more likely to help people than to harm them. If so, the FDA would require drugmakers to submit rigorous studies. Instead, the agency seems to have forgotten about that goal and is more interested in promoting the interests of industry than protecting the public health.
In 2014, the Elmiron Study Group published their results of the long-awaited clinical trial that showed Elmiron was no better than a placebo. “I thought that the next day it would be over for Elmiron,” says Curtis Nickel, a urologist at Kingston Hospital in Ontario, Canada, who led the study group. “Doctors would stop prescribing it. The FDA would order it off the market.” But none of that happened.
Instead, after twenty-four years, Elmiron is still being sold, and doctors continue to prescribe it. Hundreds of thousands of patients have been exposed to the drug, and the American Urological Association lists it as the only FDA-approved medication for interstitial cystitis. The agency finally added a warning to the drug label in 2020, alerting doctors and patients to the risk of vision loss.
Nowhere is there any mention that studies have never shown Elmiron is effective.
Great Job Jeanne Lenzer & the Team @ Jacobin Source link for sharing this story.
Andrew Egger and Adrian Carrasquillo discuss Adrian’s story on a real family caught in the immigration system, where a sudden ICE raid tore their lives apart, leaving a wife behind to navigate fear, lawyers, and an uncertain future.
See the full report and what happened to the family here: Love in the Time of Self-Deportation
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Great Job Adrian Carrasquillo & the Team @ The Bulwark Source link for sharing this story.
You may think of Donald Trump as a reckless arsonist of federal bureaucracy, but you can’t say the big guy isn’t willing to spend some government dollars when it’s for a good cause. For instance, the Atlantic reports this morning that the Trump Department of Transportation allotted more than $2 million for celebrity defense attorney Alex Spiro to investigate whether DEI policies have been causing planes to crash. (The apparent answer: They haven’t been. But hey, at least now we know!) Happy Thursday.
An anti-Elon Musk poster on display during a press conference held by House Democrats at the U.S. Capitol on April 10, 2025. Photo by Kayla Bartkowski/Getty Images)
by William Kristol
In his eulogy for Julius Caesar, Shakespeare’s Mark Antony famously—and, of course, disingenuously—claims that he came “to bury Caesar, not to praise him.”
Is it time for Democrats to praise Elon Musk? Should the big-tent, anti-Trump coalition welcome him in? Should Democrats—who need allies where they can get them—be quoting Musk, even if disingenuously, as a reliable oracle on public policy?
No.
I understand that it’s hard to resist the temptation. Musk is out there attacking the Republican reconciliation bill as a “disgusting abomination.” He’s threatening to use his money to help “fire” Republicans who go along with it.
And so some Democrats are eager to welcome Musk to the fold. Rep. Ro Khanna (D-Calif.) previously toldThe Bulwark that he believes Democrats should bring Musk back into the tent. At the very least, Politico suggests, Musk’s heel turn against Trump is “complicating the Democratic party’s portrayal of him as a chainsaw-wielding, bureaucracy-breaking villain.”
The trouble is that Musk really is a chainsaw-wielding, bureaucracy-breaking villain. He’s done immeasurable damage to our government. He may be gone from Washington, but, to return to Mark Antony’s speech, the evil Musk has done lives on after him. And more broadly he’s a thoroughgoing enemy of liberal democracy, a backer and promoter of authoritarian parties ranging from Trump’s GOP to Germany’s AfD.
Send this newsletter to that one person you know who won’t stop talking about Elon Musk:
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One might forgive all this, at least temporarily, if Musk were a popular figure who could help move the public in the right direction at this important moment. But the American people don’t like Elon Musk. Polls show him with an average approval rating of 40 percent favorable to 54 percent unfavorable.
So why embrace him? It may well be enjoyable (if not productive) for Democrats to try and sow division within the MAGA ranks. Certainly, Musk’s opposition to the budget bill can be used politically in targeted ways to make life more difficult for some Republican senators and congressmen in their states and districts.
But Musk won’t help Democrats with swing voters in marginal districts or competitive states. And he’s little help as a national messenger.
For one thing, if you want to criticize the Republican bill because it increases the debt, you don’t need Musk. The nonpartisan Congressional Budget Office is directed by Phill Swagel, a respected economist who served in a Republican administration. The CBO released its analysis of the House bill yesterday. It shows that the Republican bill adds $2.4 trillion to the national debt over the next decade. And this is actual analysis, not a billionaire’s hissy fit.
I know voters may not care much about the CBO. But at least voters don’t actively dislike it.
And the budget bill’s increase to our debt isn’t the most important argument against it. The U.S. government currently has some $29 trillion in public debt. The CBO has forecast that, because of current policies and demographics, the debt will grow by another $20 trillion over the next decade. The Republican bill’s add-on of another $2.4 trillion isn’t good—but it’s not a big part of the problem.
What is big is that the CBO analysis also shows that the bill’s changes to Medicaid and the Affordable Care Act will result in nearly 11 million Americans losing their health insurance. That’s real, that’s tangible, and that’s well worth focusing on politically. And it’s also easy to explain that the Republican bill fits into a broader assault on Americans’ health care by the Trump administration, including the gutting of NIH and of biomedical research. Elon Musk has been part of that assault.
The reconciliation bill is a political opportunity for Democrats. But the allure of featuring Musk as a key voice in the fight is at best a distraction—at worst, it’s a trap.
Sometimes the enemy of your enemy can be a useful friend. But sometimes the enemy of your enemy is just another jackass.
by Adrian Carrasquillo
Reps. Dan Goldman and Bennie Thompson have written Kristi Noem and acting ICE director Todd Lyons, demanding explanations for recent actions of the Department of Homeland Security, including the decision to mask ICE agents.
“Over the past week, we have witnessed federal agents lying in wait outside courtrooms, detaining individuals as they leave their hearings upon the expectation that their immigration proceedings—often including asylum applications—have been dismissed upon the government’s request,” reads the letter, exclusively obtained by The Bulwark.
Signed by more than 85 Democrats, the letter asks what written guidance DHS has issued about agents wearing masks during enforcement operations; what specific guidance DHS has issued regarding the dismissal of ongoing court cases; how many individuals have been detained nationwide following court-case dismissals since May 1, 2025; whether detainees seeking asylum were receiving credible fear screenings; and whether immigration judges are being tracked for how they handle these cases.
The letter comes after Goldman reportedly confronted masked ICE agents in a Manhattan building where immigration hearings are held, a building shared by his office. Asked why they were wearing masks to detain immigrants, one agent told the congressman, “Because it’s cold.” The agent then walked away when Goldman asked him if he would testify to that under oath. Another agent admitted to wearing a mask “so that they are not caught on video.”
Goldman, who called the agents’ actions “Gestapo-like behavior,” told The Bulwark he coauthored the letter to the Trump administration in part because of his concerns over agents wearing masks.
“I was a federal prosecutor for ten years and worked with numerous immigration officers who have had to confront and arrest violent criminals—far more dangerous than immigrants showing up to routine court appearances,” he said. “None of them ever wore masks to hide their faces. These fear tactics aren’t about the safety of well-trained and armed federal law enforcement officers but are instead designed to intimidate and terrorize immigrants.”
The letter comes as White House senior aide Stephen Miller reportedly berated and threatened to fire senior ICE officials if they didn’t ramp up interior enforcement actions. Yesterday, ICE made more than 2,200 immigration arrests—the most ever in a single day—with hundreds detained at court hearings or scheduled check-in appointments.
These new tactics—using migrants’ compliance with the immigration system as a means of rounding them up more handily—recently led to an outcry after a Bronx high school student named Dylan was detained.
The letter from Goldman and Thompson, who is the ranking member of the House Homeland Security Committee, states that Dylan entered the United States lawfully in 2024, enrolled in public school, had employment authorization, and had no criminal record at the time of his detainment.
“It is clear that ICE is now targeting immigrants with no criminal history, many of whom are asylum seekers, parolees admitted through lawful processes, and students like Dylan—a 20-year-old Bronx high schooler who was detained after attending his court hearing alone and without a lawyer,” the letter said.
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What to Make of The Middle East… On Shield of the Republic, ELIOT COHEN and ERIC EDELMAN discuss the situation in Gaza and the difficulty of discerning a political objective in Israeli military operations. They also talk about Israeli policy in Syria, which may be self-defeating, and its potential impact on how Netanyahu responds to what may be a Trump Iran deal that looks an awful lot like President Obama’s.
How to Tyranny-Proof America’s Future… Now’s the time to start debating the reforms needed to prevent future presidential abuses like Trump’s, argues PATRICK EDDINGTON.
Slashing CISA Is a Gift to Our Adversaries… Trump is making America more vulnerable to cyberattack, explains GEN. MARK HERTLING.
MAGA is Imploding in Real Time… On The Next Level, TIM, SARAH, and JVL discuss the Musk/Trump breakup that’s ricocheting across MAGA, how the primaries for New Jersey governor and New York City mayor could shape the future of both parties, and Curtis Yarvin’s dangerous influence.
THROWBACK THURSDAY: CNN reports on President Trump’s decision last night to play a deep track for the real fans:
President Trump signed a proclamation Wednesday evening to ban travel from several countries to the US, citing security risks.
The ban will fully restrict entry of nationals from 12 countries: Afghanistan; Myanmar, also known as Burma; Chad; Republic of the Congo; Equatorial Guinea; Eritrea; Haiti; Iran; Libya; Somalia; Sudan; and Yemen. People from seven countries will have partial restriction: Burundi, Cuba, Laos, Sierra Leone, Togo, Turkmenistan and Venezuela.
The proclamation includes exceptions for lawful permanent residents, existing visa holders, certain visa categories and individuals whose entry serves US national interests.
Trump reportedly decided to move forward with the ban as a result of the antisemitic attack in Boulder, Colorado, this weekend—although the perpetrator is an Egyptian national, and Egypt is not on the list. Also notable: The Trump administration is restricting travel from Afghanistan on grounds that the country represents a national security threat at the same time it ends temporary protective status for Afghan nationals in the United States on grounds that they can return home because the country is no longer a national security threat.
In the early days of Trump’s first term, his OG travel ban targeting a number of Muslim-majority countries was one of the first “Wait, can he do that?” moments that helped us realize how far off the old map we were going to get. (After a few rebukes by the Supreme Court, he eventually got a modified travel ban in place.) Today, this wouldn’t crack the top ten of wild policy decisions since inauguration day. What’s that old saw about frogs in a pot?
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I’M SURE IT’S FINE: Per the Wall Street Journal, headlines that make you go hmmmm:
Some economists are beginning to question the accuracy of recent U.S. inflation data after the federal government said staffing shortages hampered its ability to conduct a massive monthly survey.
The Bureau of Labor Statistics, the office that publishes the inflation rate, told outside economists this week that a hiring freeze at the agency was forcing the survey to cut back on the number of businesses where it checks prices. In last month’s inflation report, which examined prices in April, government statisticians had to use a less precise method for guessing price changes more extensively than they did in the past.
The starve-the-government mentality behind both DOGE and the federal hiring freeze was simple: Just start turning things off and, if anything breaks, go back and fix it. Sometimes, however, things don’t break right away—they just get steadily worse and less reliable.
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Great Job William Kristol & the Team @ The Bulwark Source link for sharing this story.
While making his official exit from the White House, Elon Musk has repeatedly griped that he and his Department of Government Efficiency (DOGE) had been made the administration’s “whipping boy,” absorbing blame and outrage for just about everything the president and his team has done that people don’t like. The twist is, this is one of the rare times the Tesla billionaire is actually right about something.
For the past five months, Musk has been a useful punching bag for Democrats, the broad left, the press, and just about anyone looking to politically wound the second Trump administration. And who can blame them? His bizarre behavior, flagrant corruption, and general unlikability was tailor-made for clicks and shares, not to mention made him an easy target for Trump critics looking to tie the president to a sinking rock, which had real political consequences for the administration.
So it’s not surprising that even as the media pumps out pieces taking stock of Musk’s time in government, that coverage is peppered with insistences that Musk isn’t really leaving, and that he’ll continue to exert influence on the Trump White House from outside and thus be responsible for whatever it ends up doing next. This will no doubt be at least a little true, and the public certainly seems to agree. But trying to keep the spotlight on a departed Musk may not be as politically effective as critics hope, and it risks failing to understand what is actually going on in the Trump White House.
The reality is that while Musk was and still is a convenient political foil, even when he was in the thick of things at the White House he was still only doing the dirty, hands-on work of someone else: Russell Vought, the architect of Project 2025 and Trump’s Office of Management and Budget (OMB) director.
Anyone hoping to properly hold the Trump administration to account, not to mention understand what the people running it are trying to do, needs to shift their focus from the billionaire and onto Vought. If US politics was Kill Bill, Musk and his DOGE team would be the wacky, colorful henchman the Bride spends most of her time and energy dealing with, while the faceless Bill waits, untouched, and directs things from dark rooms far away from the action.
Shifting focus to Vought will be tricky because he has spent this first half-year of maximum outrage against the DOGE cuts working quietly and out of sight, is far less click- and ratings-friendly than the outrageous Musk, and is generally a less erratic, more media-trained figure who’s not likely to create the same cluster of political headaches for the White House. But besides the president himself, he is the driving force of the Trump agenda — and is now going to start acting like it.
The Wall Street Journal reported as early as a month ago that, with Musk on the outs, Vought will now become the official architect of Trump’s austerity program, working with Congress to make further cuts and get legislative sign-off for some of those already made under Musk, while also doing the media rounds to sell it to the public. This past Sunday, Vought was on CNN defending the cuts and other parts of the White House agenda.
But it’s not as if he was twiddling his thumbs before. Vought was, even before he was appointed to a government role, the one behind Trump’s disastrous January executive order pausing all federal grants, which the White House was forced to quickly rescind. The entire legal theory and approach underpinning DOGE — that the US president can simply refuse to spend the money Congress authorized for various agencies and programs, and can dismantle or wholesale eliminate them at will — comes from Vought, who has been closely involved in DOGE’s cuts from the moment they started. Trump’s second term has as a whole closely followed Project 2025, the policy blueprint Vought was so central to creating, and he admitted to undercover reporters last year that he would still be shaping Trump policy from outside government even if he wasn’t given a White House post.
Look at the budgets and policies Vought has written and called for while he worked in Congress or as an activist, you’ll quickly see that the cuts attributed to Musk would have happened one way or another as long as Vought was in the White House. Over the years Vought has favored privatizing the US Postal Service and repealing Obamacare, as well as cutting or eliminating the Department of Education, Medicaid, USAID, public broadcasting, the Centers for Disease Control and Prevention, the Federal Aviation Authority, and many more.
You will also see where the Trump administration is likely to go in the future. Vought has long had the big entitlements like Social Security (which he wants to privatize) and Medicare in his crosshairs, and he openly told an interviewer two years ago that his goal is to use this current spate of cuts to condition the public to the idea, so that somewhere down the line they can attack these big, previously “untouchable” programs.
But this is exactly why Vought could, in fact, become as much of a political liability for Trump as Musk was — it would just require substantive and well-targeted criticism that’s less well-catered to salacious headlines than Musk’s tenure. So far, that hasn’t happened.
The liberal press has tended to frame Vought as a scary “Christian nationalist,” a term that doesn’t mean much to the average person and might even sound appealing to a public that is still majority Christian and, like any population, thinks of its own national interest as its top priority. Meanwhile, in her Sunday interview with the OMB director, CNN’s Dana Bash spent a lot of time on the topic of Vought’s “impoundment” theory and its constitutionality, an important but arcane legal subject that isn’t likely to resonate with many.
What is both accurate and a more effective line of criticism is that Vought’s ideology — a militant anti-government zealotry that means he literally considers government investment in infrastructure completely illegitimate, and wants to eliminate or sell to the highest bidder just about every government program, from Medicaid to NASA — is alien and unappealing to most modern Americans, including Trump’s own working-class base, and will hurt them and their loved ones. A thirty-year record high majority of Americans now wants the government to do more to solve the country’s problems, not do less or barely exist, as Vought dreams of.
If you understand Vought’s history, then you know the entire course of his career is defined by the fact that his political goals have consistently proven so toxic with ordinary Americans, including Republican voters, that they have never been able to get democratically enacted. Vought’s big complaint is that every time he wrote out a budget that took away people’s health care and dissolved half the government (except for the Pentagon, of course), it would never pass, because Republican members of Congress who paid lip service to his anti-government ideology would get cold feet when they realized they would be savaged by their constituents if they ever dared put it into practice.
This is what eventually led Vought to Trump. Vought has openly said that both the US political consensus and mainstream legal opinion are so far from his anti-government vision, that the only way to make it reality is to take radical, unprecedented steps — like entrusting an all-powerful president to single-handedly dismantle the federal government and wage war on the other branches if they get in the way. This is astoundingly undemocratic, but it’s also undemocratic by necessity, because it is in the service of a political agenda that would be repellent to most Americans if they were properly informed about it.
In fact, it has already proven to be: just look at the furious public backlash to the Vought-authored grant pause, which forced GOP members of Congress to pressure the White House to undo it, or the anger Republicans are fielding in town halls over a Medicaid-decimating budget modeled on what Vought had plotted out.
Musk’s exit should be an opportunity to refocus scrutiny on Vought, who has been able to fly somewhat under the radar the past five months thanks to the Tesla billionaire’s attention-seeking. Vought may not be as colorful of a character, but if the public is accurately told what he believes and plans to do, they will be left just as disturbed by his influence in the White House.
Great Job Branko Marcetic & the Team @ Jacobin Source link for sharing this story.
Eric and Eliot discuss this week’s jackassery (Joni Ernst’s dismissive attitude towards Medicaid cuts, Trump’s obsessive posting on Truth Social and his disconnection from reality) before moving into a discussion of the Ukrainian drone attack on Russian Long-Range Aviation and the degree to which it represents an inflexion point in military affairs. How much will future wars in different parts of the world look like what we witnessed this past weekend? How will autonomy and AI combine to change the character of war? They also discuss the situation in Gaza, the difficulty of discerning a political objective in Israeli military operations, Israeli policy in Syria which may be self-defeating and its potential impact on how Bibi responds to what may be a Trump Iran deal that looks an awful lot like President Obama’s JCPOA.
Eliot’s Latest in The Atlantic: https://www.theatlantic.com/ideas/archive/2025/06/ghosts-haunt-strategy/683004/
Shield of the Republic is a Bulwark podcast co-sponsored by the Miller Center of Public Affairs at the University of Virginia.
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Shield of the Republic is a Bulwark podcast cosponsored by the Miller Center of Public Affairs at the University of Virginia.
Great Job Eric S. Edelman & the Team @ The Bulwark Source link for sharing this story.
COMPARED TO HIS PREDECESSORS, Donald Trump has moved faster and on a much larger scale to target individuals, categories of people, and organizations for reasons personal (think “revenge tour”) and political (think mass deportations, attacks on law firms). If a future Congress ever wants to prevent a repeat of these kinds of abuses, there are many specific reforms that should be enacted.
But it’s not enough to focus narrowly on Trump’s actions. The presidents who came before him set their own precedents and examples—often affirmed by Congress and the courts—that have also contributed to the present breakdown of our constitutional order. If Congress and the courts had not ceded so much raw, coercive power to the presidency, we might not now be facing a chief executive busily subverting the few remaining meaningful constitutional safeguards separating a republic from a tyranny.
To think more clearly about how Congress must act to provide independence to both law enforcement and the judiciary, let’s start with a turbo-speed history lesson.
In my new book, The Triumph of Fear, I catalogue a sixty-year period from William McKinley through Dwight Eisenhower in which, with perhaps the sole exception of Warren Harding, every man elected to the presidency misused the power handed to him to spy on and even politically persecute his political enemies—real or imagined.
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Following the exposure in the 1970s of many unconstitutional government-run surveillance and subversion programs, Congress passed multiple reforms to try to prevent future presidents from engaging in such abusive conduct. Unfortunately, every one of those 1970s-era reforms—be it the Foreign Intelligence Surveillance Act (FISA), the Inspector General Act, or the creation of the House and Senate intelligence committees—has failed to prevent presidential misconduct. The underlying assumption when they were adopted—that future presidents would find it difficult to work around or subvert them—was false.
Trump’s attacks on the federal judiciary stretch back to his first term in office and have only increased during the first months of his second term. His invocation of the two-century-old Alien Enemies Act (AEA) for lightning-fast, due process–free mass deportation operations is best thought of as a “proof of concept” of his playbook for authoritarian consolidation in the presidency at the expense of Congress, the courts, and ultimately the Constitution itself.
Trump’s ongoing defiance of court orders in the AEA cases is reinforced by the willingness—if not eagerness—of federal law enforcement agents of Immigration and Customs Enforcement (ICE), Homeland Security Investigations (HSI), the FBI, and even federally deputized state and local law enforcement officers to carry out his deportation orders despite multiple federal court rulings to the contrary.
Which brings to mind one area where Trump hasn’t yet abused his power—but he might.
Under current law, all federal law enforcement officers fall under the control of the executive branch, including the United States Marshals Service, which is charged by statute with protecting both court facilities and staff (especially judges). But what if Trump’s attorney general, Pam Bondi, elected to declare that statute unconstitutional? What if Bondi asserted that Trump could, at his discretion, order the marshals to leave their judicial-protection duties and instead join ICE, HSI, FBI, and other law enforcement on mass deportation operations?
An Office of Legal Counsel opinion, written during the Jimmy Carter administration and updated during the Obama administration, asserts that, “While there is no general privilege in the Executive to disregard laws that it deems inconsistent with the Constitution, in rare cases the Executive’s duty to the constitutional system may require action in defiance of a statute. In such a case, the Executive’s refusal to defend and enforce an unconstitutional statute is authorized and lawful.”
That OLC opinion, accepted by every one of Trump’s predecessors over the last forty-five years, could provide Trump and Bondi with at least a fig leaf of bipartisan political and legal cover to reduce or eliminate marshals protection for judges Trump deems “radical” or otherwise objectionable.
This threat has prompted some members of Congress to propose a solution designed to provide protection for judges that Trump or any of his successors could never remove.
Shortly before the Memorial Day holiday, Senators Cory Booker (D-N.J.), Chuck Schumer (D-N.Y.), Alex Padilla (D-Cal.), and Adam Schiff (D-Cal.), along with Representatives Eric Swalwell (D-Cal.), Jamie Raskin (D-Md.), and Hank Johnson (D-Ga.), introduced the MARSHALS Act, legislation that would move the Marshals Service out of the executive branch and place it under the control of the federal judiciary.
It’s a great idea that has zero chance of becoming law this session—but it demonstrates that at least some Senate and House members are willing to remove some of the armed, coercive law enforcement power currently under presidential control. That alone is a mental and political breakthrough that all those loyal to the constitutional republic should embrace.
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THE MARSHALS ACT IS JUST ONE example of the kind of legislative action that needs to be taken to prevent future presidential domestic political repression. Many other changes are needed as well; law professors, political activists, and commentators on constitutional matters are all likely to have their own lists of needful reforms—most of which will boil down to taking away the tools that make repression possible.
My preference, as someone who has closely studied the abuses arising from presidential control of law enforcement, would be for a constitutional amendment that would move all but two federal law enforcement organizations from the executive branch to the control of the federal judiciary. The Secret Service (which protects the president and vice president) and the Federal Protective Service (which secures most federal buildings) would remain in the executive branch, but all other federal law enforcement would come under the control of the federal judiciary . . . and thus outside the control of an inherently political branch of government.
Such a constitutional amendment should also modify current law to ensure that no president can call up a state’s National Guard units for “civil disturbance,” immigration enforcement, or any other domestic mission without the express written consent of the state’s governor. This would safeguard against a future president calling up National Guard troops to shoot political protesters, as Trump wanted to do in the summer of 2020 during the Black Lives Matter protests.
Such an amendment would go far to restore and preserve our constitutional republic. But it would unquestionably be a very heavy political lift, to put it mildly. In the meantime, advocates should start laying the groundwork—doing the necessary research and drafting legislative language—for congressional action on other reforms, such as strengthening search and seizure protections, setting national training standards for all law enforcement officers, and creating a meaningful private right of action for police misconduct.
Absent a dramatic (perhaps tragic) major political event, it’s all but impossible to imagine any of these proposals becoming law while Trump is still in office. But introducing them now is critical for building support for them so that once he’s out of office and a new Congress committed to preserving the constitutional order is in place, it can act quickly, while the memory of Trumpian abuses is fresh, to prevent a recurrence. We owe that to ourselves and to generations to come.
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Great Job Patrick Eddington & the Team @ The Bulwark Source link for sharing this story.
DURING MY TENURE as the commander of U.S. Army Europe, I visited Estonia and its fledgling Cyber Defense Centre in Tallinn. What I saw there in 2012 left a lasting impression. A small nation, Estonia aspired to be an entrepreneurial country using digital capabilities. But in 2007, The Russians took aim at those new capabilities, and Estonia experienced the world’s first full-scale cyberattack directed by a hostile state. After the nearly month-long digital onslaught, the Estonians learned, adapted, and built a stronger digital fortress to resist future attacks. What Estonia taught me nearly two decades ago remains true today: Cyber resilience is not a luxury for modern nations; it’s a strategic necessity.
Which makes President Trump’s recent decision to gut the U.S. Cybersecurity and Infrastructure Security Agency (CISA) even more dangerous. After a decade of our intelligence community ranking cyberwarfare among our top national security threats, dismantling the agency tasked with defending our digital homeland is reckless and shortsighted.
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Russia’s 2007 attack against Estonia was, at heart, a response to a political issue. The Estonian government had decided to relocate a Soviet-era World War II monument—known as the Bronze Soldier—from downtown Tallinn to a military cemetery. For non-Russian Estonians, the statue represented Soviet occupation. For the country’s Russian-speaking minority and the Kremlin, it was a symbol of victory over fascism. Moscow seized on Estonia’s decision, portraying it as an affront to Russian history, and mounted a diplomatic pressure campaign to prevent the relocation. Violent protests by ethnic Russians resulted in hundreds of injuries and arrests and many smashed shop windows and overturned cars.
But when the real assault finally arrived, it came across the internet.
The Russian cyberattack was coordinated, sweeping, and relentless. It began on April 27, 2007, the day the monument was moved, and proceeded in stages over three punishing weeks. First came the hits on government websites—those of the president, prime minister, parliament, and key ministries. Distributed denial-of-service (DDoS) attacks crippled official communications. Citizens couldn’t access public information. Government workers couldn’t rely on internal networks.
Soon, the attack spread to the media. Major newspapers like the Postimees and television broadcasters went dark online. For a population already rattled by protests and political tension, the loss of reliable information was deeply destabilizing. The digital blackout created an environment ripe for disinformation, fear, and confusion.
Then the banks were targeted. Estonia’s largest financial institutions, including SEB Eesti Ühispank and Hansapank, were overwhelmed. Online services were paralyzed. ATMs were rendered inoperable. People couldn’t pay bills, access salaries, or transfer funds. The economic pulse of the country faltered in real time.
In the final phase, the attackers turned to emergency responders and core infrastructure. Phone lines to emergency services were jammed. Legislative portals froze. Critical databases were either wiped or locked. The tiny country was on the edge of digital paralysis.
Estonia survived. But it had learned the hard way that in the twenty-first century, the front line isn’t always geographic. Sometimes it’s algorithmic.
WHEN I VISITED THE CYBER CENTER in Tallinn, all I could think of was what if this happened in the United States.
Imagine being in an emergency room with a family member. Suddenly, hospital systems crash. Doctors can’t access medical records. Prescriptions, allergies, previous diagnoses—all inaccessible. This isn’t speculative. In 2019, a ransomware attack forced numerous systems used by the Springhill Medical Center in Alabama offline. A newborn died during the outage because staff couldn’t access critical information in time.
Picture rush hour in Washington, D.C., or Los Angeles. Traffic lights fail. GPS systems malfunction. Subway control systems stall. In 2020, a technical problem briefly disrupted 911 emergency services across fourteen states; it’s not hard to imagine that outcome replicated deliberately by the agents of a hostile power. In recent years, hackers in China and Russia have breached transit computer systems in New York City and D.C.
Imagine finding your online bank account has vanished. Your retirement fund is frozen. Your paycheck hasn’t arrived. In 2016, North Korean hackers stole $81 million from Bangladesh Bank. It could just as easily have been Wells Fargo, JPMorgan Chase, or the Social Security Administration.
Now imagine all this happening during a national election.
Your polling location’s digital rolls are wiped. Machines jam or misreport. Your county’s election website—normally the trusted source of real-time results—is offline. And as chaos unfolds, disinformation floods your social media feed, engineered to deepen mistrust.
This is what CISA was created to prevent.
ESTABLISHED UNDER the Department of Homeland Security as the National Protection and Programs Directorate (NPPD) in 2007 and re-established by an act of Congress as an independent agency with its current name in 2018, CISA has become America’s nerve center for digital defense. It works with state governments to secure election infrastructure, warns utilities and hospitals of incoming threats, coordinates real-time responses to attacks on financial systems and energy grids, and builds partnerships between government and the private sector to harden areas of vulnerability. It is not just a tech agency—it is the digital equivalent of NORAD, or the hurricane warning center in the National Weather Service.
When Chris Krebs, then the director of CISA, publicly confirmed that the 2020 election was “the most secure in American history,” he was fired by President Trump. That was a warning sign. Now the proposed cuts in funding and personnel threaten to systematically dismantle CISA’s capacity to defend the nation’s infrastructure—physical, electoral, medical, financial.
This isn’t bureaucratic belt-tightening. It’s a strategic retreat in the middle of a war.
After the 2007 attack, the Estonians rebuilt based on the lessons they had learned. They digitized the government with blockchain technology, built a secure national ID system to protect citizens’ data, and backed up the entire state apparatus with encrypted servers in Luxembourg—a “data embassy” that ensures national continuity even in a digital blackout. They also organized a “Cyber Defense Unit,” an all-volunteer corps of engineers, IT professionals, and reservists trained to mobilize during digital emergencies. Cybersecurity in Estonia became a whole-of-society effort. And it worked.
Estonia became not only a model for other democracies, but a core contributor to NATO’s understanding of cyber conflict. Their center of excellence isn’t just a think tank—it’s a war college for digital defense. When I visited, I was struck by the seriousness with which they approached what many in the United States still considered a technical or marginal concern. They knew better, because they had lived it.
While the context of cyber conflict and security is technology, the core issue at play is trust. Society depends on a foundational level of trust to function. Trust that your vote counts. That your hospital can save your child. That your bank account is secure. That the lights turn on and the water is clean. Cyberattacks aim to break that trust—not just with damage, but with doubt.
If we undermine CISA, the agency responsible for safeguarding that trust, we don’t just weaken our defenses—we invite the next attack. And we won’t be able to claim we were caught off guard. The warnings have already come—loud and often. From SolarWinds to Colonial Pipeline, from the (largely pre-empted) attempts to interfere with the 2020 election to the continuous probing of our energy grid, we’ve seen the signs.
Cyber warfare is not a tomorrow problem. Estonia faced it in 2007 and responded with unity, innovation, and urgency. The United States now risks doing the opposite—dividing, defunding, and deflecting as threats continue to grow. Slashing CISA’s capabilities sends the worst possible message to adversaries like Russia, China, Iran, and North Korea: “Come on in. Our guard is down.”
As someone who has commanded American troops, advised NATO allies, and seen firsthand the consequences of digital vulnerability, I urge the Trump administration—and the American people—to reconsider. Because in this new battlespace, it’s not just about who has the most tanks, planes, or drones. It’s about who can protect their people, their institutions, and their way of life in a world where war is already being waged with ones and zeroes.
And right now, we’re pulling our sentries off the wall.
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When Thomas Fugate graduated from college last year with a degree in politics, he celebrated in a social media post about the exciting opportunities that lay beyond campus life in Texas. “Onward and upward!” he wrote, with an emoji of a rocket shooting into space.
His career blastoff came quickly. A year after graduation, the 22-year-old with no apparent national security expertise is now a Department of Homeland Security official overseeing the government’s main hub for terrorism prevention, including an $18 million grant program intended to help communities combat violent extremism.
The White House appointed Fugate, a former Trump campaign worker who interned at the hard-right Heritage Foundation, to a Homeland Security role that was expanded to include the Center for Prevention Programs and Partnerships. Known as CP3, the office has led nationwide efforts to prevent hate-fueled attacks, school shootings and other forms of targeted violence.
Fugate’s appointment is the latest shock for an office that has been decimated since President Donald Trump returned to the White House and began remaking national security to give it a laser focus on immigration.
News of the appointment has trickled out in recent weeks, raising alarm among counterterrorism researchers and nonprofit groups funded by CP3. Several said they turned to LinkedIn for intel on Fugate — an unknown in their field — and were stunned to see a photo of “a college kid” with a flag pin on his lapel posing with a sharply arched eyebrow. No threat prevention experience is listed in his employment history.
Fugate’s profile picture on LinkedIn
Credit:
Via Fugate’s LinkedIn page
Typically, people familiar with CP3 say, a candidate that green wouldn’t have gotten an interview for a junior position, much less be hired to run operations. According to LinkedIn, the bulk of Fugate’s leadership experience comes from having served as secretary general of a Model United Nations club.
“Maybe he’s a wunderkind. Maybe he’s Doogie Howser and has everything at 21 years old, or whatever he is, to lead the office. But that’s not likely the case,” said one counterterrorism researcher who has worked with CP3 officials for years. “It sounds like putting the intern in charge.”
In the past seven weeks, at least five high-profile targeted attacks have unfolded across the U.S., including a car bombing in California and the gunning down of two Israeli Embassy aides in Washington. Against this backdrop, current and former national security officials say, the Trump administration’s decision to shift counterterrorism resources to immigration and leave the violence-prevention portfolio to inexperienced appointees is “reckless.”
“We’re entering very dangerous territory,” one longtime U.S. counterterrorism official said.
The fate of CP3 is one example of the fallout from deep cuts that have eliminated public health and violence-prevention initiatives across federal agencies.
The once-bustling office of around 80 employees now has fewer than 20, former staffers say. Grant work stops, then restarts. One senior civil servant was reassigned to the Federal Emergency Management Agency via an email that arrived late on a Saturday.
The office’s mission has changed overnight, with a pivot away from focusing on domestic extremism, especially far-right movements. The “terrorism” category that framed the agency’s work for years was abruptly expanded to include drug cartels, part of what DHS staffers call an overarching message that border security is the only mission that matters. Meanwhile, the Trump administration has largely left terrorism prevention to the states.
ProPublica sent DHS a detailed list of questions about Fugate’s position, his lack of national security experience and the future of the department’s prevention work. A senior agency official replied with a statement saying only that Fugate’s CP3 duties were added to his role as an aide in an Immigration & Border Security office.
“Due to his success, he has been temporarily given additional leadership responsibilities in the Center for Prevention Programs and Partnerships office,” the official wrote in an email. “This is a credit to his work ethic and success on the job.”
ProPublica sought an interview with Fugate through DHS and the White House, but there was no response.
The Trump administration rejects claims of a retreat from terrorism prevention, noting partnerships with law enforcement agencies and swift investigations of recent attacks. “The notion that this single office is responsible for preventing terrorism is not only incorrect, it’s ignorant,” spokesperson Abigail Jackson wrote in an email.
Through intermediaries, ProPublica sought to speak with CP3 employees but received no reply. Talking is risky; tales abound of Homeland Security personnel undergoing lie-detector tests in leak investigations, as Secretary Kristi Noem pledged in March.
Accounts of Fugate’s arrival and the dismantling of CP3 come from current and former Homeland Security personnel, grant recipients and terrorism-prevention advocates who work closely with the office and have at times been confidants for distraught staffers. All spoke on condition of anonymity for fear of reprisal from the Trump administration.
In these circles, two main theories have emerged to explain Fugate’s unusual ascent. One is that the Trump administration rewarded a Gen Z campaign worker with a resume-boosting title that comes with little real power because the office is in shambles.
The other is that the White House installed Fugate to oversee a pivot away from traditional counterterrorism lanes and to steer resources toward MAGA-friendly sheriffs and border security projects before eventually shuttering operations. In this scenario, Fugate was described as “a minder” and “a babysitter.”
DHS did not address a ProPublica question about this characterization.
Rising MAGA Star
The CP3 homepage boasts about the office’s experts in disciplines including emergency management, counterterrorism, public health and social work.
Fugate brings a different qualification prized by the White House: loyalty to the president.
On Instagram, Fugate traced his political awakening to nine years ago, when as a 13-year-old “in a generation deprived of hope, opportunity, and happiness, I saw in one man the capacity for real and lasting change: Donald Trump.”
Fugate is a self-described “Trumplican” who interned for state lawmakers in Austin before graduating magna cum laude a year ago with a degree in politics and law from the University of Texas at San Antonio. Instagram photos and other public information from the past year chronicle his lightning-fast rise in Trump world.
Starting in May 2024, photos show a newly graduated Fugate at a Texas GOP gathering launching his first campaign, a bid for a delegate spot at the Republican National Convention in Milwaukee. He handed out gummy candy and a flier with a photo of him in a tuxedo at Trump’s Mar-a-Lago estate. Fugate won an alternate slot.
The next month, he was in Florida celebrating Trump’s 78th birthday with the Club 47 fan group in West Palm Beach. “I truly wish I could say more about what I’m doing, but more to come soon!” he wrote in a caption, with a smiley emoji in sunglasses.
Posts in the run-up to the election show Fugate spending several weeks in Washington, a time he called “surreal and invigorating.” In July, he attended the Republican convention, sporting the Texas delegation’s signature cowboy hat in photos with MAGA luminaries such as former Cabinet Secretary Ben Carson and then-Rep. Matt Gaetz (R-Fla.).
Fugate at the Republican National Convention
Credit:
Via Fugate’s Instagram account
By late summer, Fugate was posting from the campaign trail as part of Trump’s advance team, pictured at one stop standing behind the candidate in a crowd of young supporters. When Trump won the election, Fugate marked the moment with an emotional post about believing in him “from the very start, even to the scorn and contempt of my peers.”
“Working alongside a dedicated, driven group of folks, we faced every challenge head-on and, together, celebrated a victorious outcome,” Fugate wrote on Instagram.
In February, the White House appointed Fugate as a “special assistant” assigned to an immigration office at Homeland Security. He assumed leadership of CP3 last month to fill a vacancy left by previous Director Bill Braniff, an Army veteran with more than two decades of national security experience who resigned in March when the administration began cutting his staff.
In his final weeks as director, Braniff had publicly defended the office’s achievements, noting the dispersal of nearly $90 million since 2020 to help communities combat extremist violence. According to the office’s 2024 report to Congress, in recent years CP3 grant money was used in more than 1,100 efforts to identify violent extremism at the community level and interrupt the radicalization process.
“CP3 is the inheritor of the primary and founding mission of DHS — to prevent terrorism,” Braniff wrote on LinkedIn when he announced his resignation.
In conversations with colleagues, CP3 staffers have expressed shock at how little Fugate knows about the basics of his role and likened meetings with him to “career counseling.” DHS did not address questions about his level of experience.
One grant recipient called Fugate’s appointment “an insult” to Braniff and a setback in the move toward evidence-based approaches to terrorism prevention, a field still reckoning with post-9/11 work that was unscientific and stigmatizing to Muslims.
“They really started to shift the conversation and shift the public thinking. It was starting to get to the root of the problem,” the grantee said. “Now that’s all gone.”
Critics of Fugate’s appointment stress that their anger isn’t directed at an aspiring politico enjoying a whirlwind entry to Washington. The problem, they say, is the administration’s seemingly cavalier treatment of an office that was funding work on urgent national security concerns.
“The big story here is the undermining of democratic institutions,” a former Homeland Security official said. “Who’s going to volunteer to be the next civil servant if they think their supervisor is an apparatchik?”
Season of Attacks
Spring brought a burst of extremist violence, a trend analysts fear could extend into the summer given inflamed political tensions and the disarray of federal agencies tasked with monitoring threats.
In April, an arson attack targeted Pennsylvania Gov. Josh Shapiro, a Democrat, who blamed the breach on “security failures.” Four days later, a mass shooter stormed onto the Florida State University campus, killing two and wounding six others. The alleged attacker had espoused white supremacist views and used Hitler as a profile picture for a gaming account.
Attacks continued in May with the apparent car bombing of a fertility clinic in California. The suspected assailant, the only fatality, left a screed detailing violent beliefs against life and procreation. A few days later, on May 21, a gunman allegedly radicalized by the war in Gaza killed two Israeli Embassy aides outside a Jewish museum in Washington.
June opened with a firebombing attack in Colorado that wounded 12, including a Holocaust survivor, at a gathering calling for the release of Israeli hostages. The suspect’s charges include a federal hate crime.
If attacks continue at that pace, warn current and former national security officials, cracks will begin to appear in the nation’s pared-down counterterrorism sector.
“If you cut the staff and there are major attacks that lead to a reconsideration, you can’t scale up staff once they’re fired,” said the U.S. counterterrorism official, who opposes the administration’s shift away from prevention.
Contradictory signals are coming out of Homeland Security about the future of CP3 work, especially the grant program. Staffers have told partners in the advocacy world that Fugate plans to roll out another funding cycle soon. The CP3 website still touts the program as the only federal grant “solely dedicated to helping local communities develop and strengthen their capabilities” against terrorism and targeted violence.
But Homeland Security’s budget proposal to Congress for the next fiscal year suggests a bleaker future. The department recommended eliminating the threat-prevention grant program, explaining that it “does not align with DHS priorities.”
The former Homeland Security official said the decision “means that the department founded to prevent terrorism in the United States no longer prioritizes preventing terrorism in the United States.”
As the temperatures rose across Louisiana during Memorial Day weekend, the heat index, a measure of air temperature and humidity, approached triple digits. Bayou State residents seeking relief from the extreme temperatures turned up their fans and air conditioners, pushing an aging electrical grid to the breaking point. And by nightfall, more than 100,000 people had been plunged into darkness after a utility company cut off power for some Louisiana customers to keep a system that served 15 states from shutting down because of the demand.
Emergency preparedness advocates say the outage underscored how the threat of being left in the dark is increasingly likely for Black communities across the country this summer because of a confluence of forces, including record heat, a hyperactive hurricane season, and decrepit electrical grids. For Black Americans, researchers and activists say, the consequences of those conditions are magnified by long-standing inequities in housing, infrastructure, and access to resources. The Trump administration’s effort to reorganize the nation’s emergency response system is also threatening to upend vulnerable communities’ ability to prepare for, withstand, and recover from these events, advocates said.
With meteorologists tracking warmer-than-average ocean temperatures that could fuel intense storms, the National Oceanic and Atmospheric Administration is forecasting a summer of record-breaking heat and unusually strong hurricanes.
“The forecast is another very active hurricane season combined with these other climate disasters — and then we have these ongoing policy failures,” said Chrishelle Palay, a hurricane survivor and former director of the Houston Organizing Movement for Equity. “We get all of them coming towards each other on a collision course where the burden will continue to fall on Black and low-income families.”
Palay knows the personal toll of extreme weather events firsthand. In the aftermath of Hurricane Harvey in 2017, she attempted to help her great aunt, who had stage four chronic obstructive pulmonary disease, navigate the complicated application process for emergency federal assistance. The application was denied — even though her aunt’s home sustained extensive damage from water and mold. Three months later, her aunt died.
“I’m not a doctor, so we don’t know if that contributed to her quick decline, but the fact is, there are a lot more families that will lose loved ones in similar ways,” she said.
Hurricane season begins June 1 and ends Nov. 30. Historically, an average season features 14 named storms, including seven hurricanes and three major hurricanes.
This year, the federal government predicts 13 to 19 named storms, including six to 10 hurricanes. It expects three to five of those hurricanes to be major hurricanes of category 3, 4 or 5 strength, bringing winds of over 110 mph.
At the same time, President Donald Trump is planning to slash emergency assistance grants by $646 million, even as the agency is projected to run out of disaster relief money by this summer for the third consecutive year.
“The total number of storms is not truly what defines a hurricane season. It only takes one landfall to create a devastating season.” said Jonathan Porter, chief meteorologist for AccuWeather. “Thousands of families and small businesses across America are still struggling to recover from weather disasters over the past year.”
In response to a series of questions regarding FEMA’s plans to address this summer’s predicted storms, a spokesperson said in a statement, “FEMA is shifting from bloated, DC-centric dead weight to a lean, deployable disaster force that empowers state actors to provide relief for their citizens. The old processes are being replaced because they failed Americans in real emergencies for decades.”
“FEMA is fully activated in preparation for Hurricane Season,” the spokesperson added, and the agency is only cutting “wasteful and ineffective” programs that are “more concerned with climate change than helping Americans affected by natural disasters.”
These cuts, as Capital B has reported, included $1 billion meant to prepare Black and low-income communities for weather disasters.
“By removing these policies, the government is pretty much saying, ‘Yeah, we do not care about those people and their vulnerabilities,” said Anthony Rogers-Wright, director of environmental justice at New York Lawyers for the Public Interest. “And that is a profound proclamation.’”
Will FEMA still support victims?
As threats from extreme weather intensify, the federal government’s capacity to respond to disasters is being systematically taken apart. In addition to the billions of dollars in cuts, the agency has lost approximately 30% of its full-time workforce through layoffs and buyouts, including one-fifth of the officers who manage responses to large-scale disasters.
Trump’s executive order establishing a review council to “reimagine” FEMA signals a fundamental restructuring of the nation’s emergency response capabilities. With officials openly discussing renaming or eliminating the agency entirely, communities face the prospect of entering an active hurricane season with significantly reduced federal emergency management resources.
“FEMA really hasn’t behaved like a good actor for the Black community, but that doesn’t mean we haven’t depended on it,” said Rogers-Wright.
Last month, FEMA quietly ended one of its signature post-disaster programs — a door-to-door canvassing effort in damaged areas to meet survivors. For years, this practice had allowed the federal government to interact with survivors directly and help them register for federal aid.
A FEMA worker told a reporter with the technology magazine Wired that this new directive will “severely hamper our ability to reach vulnerable people.” The assistance, the worker said, “usually focused on the most impacted and the most vulnerable communities where there may be people who are elderly or with disabilities or lack of transportation and are unable to reach Disaster Recovery Centers.”
The directive also said FEMA will push for disaster-stricken areas to “emphasize assistance” from other partners like nonprofit organizations and state agencies rather than federal aid. The agency wants efforts to now rely on local and state-run recovery centers instead of federally directed initiatives, so the agency will no longer “need to establish FEMA Disaster Recovery Centers.”
Acting FEMA chief David Richardson recently reversed his earlier plan to introduce a new disaster response strategy for the 2025 hurricane season, instead telling staff that the agency will revert to last year’s operational procedures. This abrupt change does not change the agency’s plan to end its canvassing program and has caused confusion and concern among FEMA employees, especially given the workforce reductions and the cancellation of a larger four-year strategic plan.
“The bottom line is we’re not set up for success for whatever comes about this summer, when it comes to this hurricane season and heatwaves, even if it’s light,” Palay said.
What to know about hurricane season
Meteorologists are expressing heightened concern about the upcoming hurricane season, with particular emphasis on the increasing likelihood of storms undergoing dramatic strengthening just before making landfall. According to AccuWeather Lead Hurricane Expert Alex DaSilva, ocean temperatures both at the surface and extending hundreds of feet into the depths are above-average, creating ideal conditions for tropical systems to undergo explosive intensification.
Recent hurricane seasons have demonstrated that the destructive power of such storms extends far beyond traditional coastal boundaries. “As we witnessed last year with significant inland flooding from hurricanes Helene and Debby, the impacts of hurricanes can reach far beyond coastal communities,” said acting NOAA Administrator Laura Grimm.
Hurricane Beryl, which hit Houston last year, also exemplified this phenomenon, generating more than 60 tornadoes as it carved a destructive path spanning nearly 1,200 miles from the Texas coastline all the way to upstate New York. Similarly, Hurricane Helene showcased the multi-faceted nature of modern hurricane threats. After initially battering Florida with powerful winds and dangerous storm surge, the system continued inland, where it unleashed catastrophic flash flooding and destructive winds across the mountainous terrain of western North Carolina.
Over the past five years, water temperatures in the Atlantic Ocean, Caribbean Sea, and Gulf of Mexico have reached levels that surpass all previous measurements in recorded meteorological history. This excess thermal energy serves as a powerful catalyst that can transform relatively modest tropical storms into formidable hurricane systems.
Higher temperatures have become a particular source of concern for emergency management officials and meteorologists alike. When storms strengthen dramatically while approaching the coastline, communities find themselves with dramatically reduced timeframes for implementing safety measures and evacuation procedures. This compressed timeline creates more challenges for emergency response systems, complicating everything from the establishment of emergency shelters to the coordination of traffic along evacuation routes.
It brings into context the severity of the quickly changing situation at the federal level. Emergency management officials must now account for scenarios where storms can transform from manageable threats to life-threatening emergencies in a matter of hours, often with minimal advance warning for affected communities.
Extreme heat and what to expect this summer
The challenges facing America’s electrical infrastructure extend far beyond isolated incidents like Louisiana’s Memorial Day blackout. According to the North American Reliability Corporation’s latest assessment, several regions across the United States face elevated or high risk for resource adequacy shortfalls over the next decade. Most concerning is the Midcontinent Independent System Operator, which has less energy capacity than it had last year despite an anticipated rise in demand.
This electrical grid vulnerability comes at a particularly dangerous moment. NOAA’s updated summer 2025 forecast predicts that every state will experience warmer-than-normal temperatures, with the highest probability of extreme heat — ranging from 60% to 70% — concentrated across Texas, Nevada, Idaho, Utah, Colorado, Wyoming, Arizona, and New Mexico. The combination of record-breaking heat and an increasingly strained power grid creates a recipe for cascading failures that could leave millions without electricity during the most dangerous periods.
These converging crises will hit Black Americans hardest. Research consistently shows that Black households face significantly higher energy burdens, spending disproportionately more of their income on electricity bills even after controlling for income levels. In cities like New York, Black residents die from heat stress at double the rate of white residents, despite constituting only a quarter of the population.
The legacy of discriminatory housing policies has created urban heat islands in predominantly Black neighborhoods that can be up to 22 degrees hotter than surrounding areas. This drives nighttime temperatures even higher, robbing residents of relief after sunset. In these neighborhoods, air conditioning is often not a given; older housing stock, higher energy costs, and lower average incomes mean that staying cool can be a financial burden or simply out of reach. As energy bills climb in step with the thermometer, the risk of heat-related illness rises, especially for the elderly, children, and those with preexisting health conditions.
“If you shut off people’s electricity, it has to be understood, especially for Black people, that is basically akin to a cop kneeling on your neck or shooting you — it is killing us,” said Rogers-Wright.
The converging issues highlight the need for Black communities to build neighborhood-level networks, he added. Building real, community-rooted infrastructure where neighbors check on each other, share resources, and proactively plan for crises has become essential, because waiting for outside help can mean the difference between life and death.
To protect each other, we really need to center climate as a major issue for every facet of Black life,” he said. “From connecting it to economics, education, and social justice, emphasizing how to best handle these disasters will be necessary.”
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