April 8, 2019

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Trump Administration Kills Baseball Deal With Cuba

The Trump administration has canceled a deal between Major League Baseball and the Cuban Baseball Federation that would have allowed Cuban players to join professional teams in the U.S. and Canada.

Under the four-month-old agreement, a major league club seeking to sign certain Cuban players would have to pay a release fee – 25 percent over the player’s signing bonus – to the Federation. The player would also have to pay Cuban income taxes on foreign earnings.

The deal, which was initially negotiated under President Barack Obama, met with immediate opposition from the Trump administration.

Jose Abreu of the Chicago White Sox, seen in 2017, was one of the Cuban players who survived a risky, secret journey to the U.S. to play baseball.

Morry Gash/AP


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Morry Gash/AP

It was designed to end the often dangerous pattern of ambitious Cuban stars seeking to join the major leagues by defecting and arranging to smuggle themselves out of Cuba with the aid of human traffickers. Under the agreement, Cuban players may return to the island during the off-season, unlike those who defect.

A senior administration official, speaking on the condition of anonymity, said in a briefing that the agreement itself was a form of “human trafficking” by the Cuban government and that the Cuban Baseball Federation is a subsidiary of the Cuban government.

“We look forward to the day that Cuban baseball players can fully contract with Major League Baseball like players from every other country in the world and not as pawns of the Cuban dictatorship,” the official told reporters.

Major League Baseball defended the plan.

“We stand by the goal of the agreement, which is to end the human trafficking of baseball players from Cuba,” said league vice president Michael Teevan, in a terse e-mailed statement.

The administration blocked the baseball deal just a few days after the Cuban federation released the names of 34 players eligible to sign with MLB teams. Cuban players older than 25 years old and with six years of experience were eligible for the arrangement. Younger players were required to get the Cuban Baseball Federation’s blessing to play for MLB teams.

“The agreement with #MLB seeks to stop the trafficking of human beings, encourage cooperation and raise the level of baseball,” the Cuban Baseball Federation said in a message on Twitter as quoted by Reuters. “Any contrary idea is false news. Attacks with political motivation against the agreement achieved harm the athletes, their families and the fans.”

Some Florida lawmakers had opposed the baseball agreement for being an accommodation with the Cuban government. Republican Sen. Marco Rubio, in December, called the deal “both illegal and immoral.”

Among the Cuban-born players who have defected and struck it rich signing with MLB clubs in recent years are Jose Abreu of the Chicago White Sox, Yoenis Cespedes of the New York Mets and Yasiel Puig of the Cincinnati Reds.

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How HHS Secretary Alex Azar Reconciles Medicaid Cuts With Stopping The Spread Of HIV

HHS Secretary Alex Azar at a White House roundtable discussion of health care prices in January. Azar tells NPR his office is now in “active negotiations and discussion” with drugmakers on how to make HIV prevention medicines more available and “cost-effective.”

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In his State of the Union address this year, President Trump announced an initiative “to eliminate the HIV epidemic in the United States within 10 years.”

The man who pitched the president on this idea is Alex Azar, the Secretary of the Department of Health and Human Services.

“We have the data that tells us where we have to focus, we have the tools, we have the leadership — this is an historic opportunity,” Azar told NPR’s Ari Shapiro Monday. “I told the president about this, and he immediately grabbed onto this and saw the potential to alleviate suffering for hundreds of thousands of individuals in this country and is deeply passionate about making that happen.”

Trump’s push to end HIV in the U.S. has inspired a mix of enthusiasm and skepticism from public health officials and patient advocates. Enthusiasm, because the plan seems to be rooted in data and is led by officials who have strong credentials in regards to HIV/AIDS. Skepticism, because of the administration’s history of rolling back protections for LGBTQ people, many of whom the program will need to reach to be successful.

For instance, transgender people are three times more likely to contract HIV than the national average, according to the Centers for Disease Control and Prevention. Trump has banned transgender people from serving in the military and undone rules that allow transgender students access to bathrooms that fit their gender presentation.

Azar himself has strong Republican credentials — as a young man, he clerked for Justice Antonin Scalia. And yet he’s now touring the country promoting this plan to end HIV, which includes supporting needle exchange programs to reduce HIV infection among intravenous drug users.

“Syringe services programs aren’t necessarily the first thing that comes to mind when you think about a Republican health secretary,” Azar acknowledged at an HIV conference last month. “But we’re in a battle between sickness and health — between life and death.”

This interview has been edited for clarity and length.

This morning you toured facilities in East Boston, a neighborhood in one of 48 counties targeted in Trump’s plan. What did you learn there?

I was able to be at the East Boston Neighborhood Health Center and they have a remarkable program called Project Shine. What I was able to do is meet with the entire team that provides this type of holistic approach. It is very much what we’re going to try to do in the most impacted areas.

You find the individuals who may have HIV — get them diagnosed. Get those who are diagnosed on the HIV antiretroviral treatment — so that they have an undetectable viral load and can’t spread the disease to others, as well as live a long healthy life themselves. Get those who are most at risk of contracting HIV on a medicine called PrEP so that they dramatically reduce their chance of getting HIV. And then, finally, respond when you have clusters of outbreaks. So, just getting to see the the holistic approach there was extremely helpful for me.

Given that Medicaid is the single largest payer for medical care for people with HIV, do Republican efforts to block Medicaid expansion in high-infection states like Mississippi and Alabama undermine your efforts to get more people treatment?

The program that we have is based on the assumption that Medicaid remains as it is. …. And even were we to change Medicaid, along the lines of what the president has proposed in the budget …

Meaning the major reductions to Medicaid that are in the president’s budget?

Well, there are there are some reductions. But what it would do is actually give states tremendous flexibility. One of the challenges in the Affordable Care Act was that it prejudiced the Medicaid system very much in favor of able-bodied adults, away from the more traditional Medicaid populations of the aged, the disabled, pregnant women and children.

What we would do is restore a lot of flexibility of the states so that they could put those resources really where they’re needed. We would expect that those suffering from HIV/AIDS infection would be in the core demographic of people that you would want to make sure were covered. What we will do here, by stopping the epidemic of HIV, is have a dramatic reduction in cost for the Medicaid and Medicare programs in the future.

So one big part of your plan is expanding access to PrEP, the HIV prevention drug. Without insurance it can cost around $1,600 a month in the U.S. A generic version available overseas costs roughly $6 a month. AIDS activists say your department could ‘march in’ and break the patent that Gilead holds in order to make a generic version available to Americans. Is your agency going to pursue that?

I don’t know what you’re saying by breaking the patent. There’s no such thing as a legal right to break patents in the United States …

The Centers for Disease Control and Prevention also has a patent for PrEP, which Gilead disputes

Well, that’s very different than breaking a patent. That would be asserting patent rights held by the CDC. So the CDC has a patent on the product and Gilead has a patent on the product. We are actually in active negotiations and discussion with Gilead right now on how we can make PrEP more available and more cost effective for individuals as part of this ending the HIV epidemic program.

I recently went to Jackson, Miss., which has one of the highest rates of HIV infection in the country. I talked to Shawn Esco, a black gay man, who told me that stigma, homophobia, and racism prevent people from seeking care, and he has very little hope. What would you say to him?

That is exactly what the president and I want to solve. I want to give him that hope. So many of the infections are happening in areas of our country where there’s intense stigma against individuals — males who have sex with men; the African-American community, Latino community, American Indian, Alaska Native communities. What’s really made this is a historic opportunity right now is we have data that show us that 50 percent of new infections are happening in 48 counties as well as the District of Columbia and Puerto Rico, and so we can focus those efforts.

We want to learn from people on the ground, as I did this morning here in East Boston. How do we reduce stigma? How do we provide a holistic approach for Shawn and others? We can get them diagnosed and get them on treatment in ways that they find acceptable — or, as one of the individuals said to me this morning, meet people where they are.

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Government Watchdog Flips On Dollar Coin

A pile of newly minted one-dollar coins honoring former Thomas Jefferson are seen at the unveiling by the U.S. Mint in Washington, D.C., in 2007. In a turnaround, congressional analysts are no longer recommending a phaseout of paper dollars in favor a dollar coin.

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Jim Young/Reuters

Who says a dollar doesn’t go as far as it used to?

When it comes to dollar bills, a new report from the federal government says they’re lasting more than twice as long as they were at the beginning of the decade.

And that’s upending an old argument about replacing the dollar bill with a $1 coin.

Analysts have long argued the federal government could save money by making the switch because even though coins cost more to mint, they last much longer than paper money. In 2011, the Government Accountability Office estimated the savings at $5.5 billion over 30 years.

But a second look from the GAO flips that coin argument on its head. Analysts now say the government would lose between $611 million and $2.6 billion over 30 years by phasing out the dollar bill. The economics have shifted because dollar bills are lasting longer.

“When we last looked at this issue in 2011, the paper dollar was only lasting a little bit over three years,” said John Shumann, an assistant director at the GAO. “When we looked at this issue again this year, we found that the paper dollar is now lasting almost eight years long.”

Shumann said that’s partly because of changes in the way the Federal Reserve processes dollar bills. But it’s also a sign that in an increasingly cashless world, paper dollars aren’t getting around like they used to.

“They’re often showing less signs of wear and tear,” Shumann said.

As part of its research, the GAO surveyed lots of industries that might have a stake in the paper-versus-coin contest, and found most are not eagerly embracing the switch to $1 coins.

Even the Coin Laundry Association.

“You know, it’s right in our name,” said CEO Brian Wallace, whose group represents some 30,000 self-service laundries around the country.

Despite the name, only a handful of those businesses currently accept $1 coins. Meanwhile, alternative payment options have proliferated.

“You could still pay with a quarter,” Wallace said. “But you could also pay with a credit card or add value to a card. Or taking the Starbucks approach of just waving the phone at the washer and it starts.”

Other businesses long associated with coins have also moved on.

“Once upon a time, toll roads, along with transit systems and the post office itself were the largest coinage handlers in the country,” said Neil Gray, director of government affairs for the International Bridge, Tunnel and Turnpike Association.

Not anymore. Fewer than one in five toll-road users pay cash today.

“To the extent possible, we’ve had entire toll road systems eliminate cash completely,” Gray said.

Even slot machines have largely done away with coin slots.

(One exception is the gumball machine industry, which told the GAO it could offer higher-quality gum and toys if more people carried $1 coins.)

The new GAO report may discourage congressional efforts to phase out the dollar bill. In any case, $1 coins have proven stubbornly unpopular with the public. That’s why the Fed has more than a billion of the coins sitting unused, in storage.

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