On May 13, 2022, John Fetterman, lt. governor of Pennsylvania and the Democratic candidate for Pennsylvania’s open US Senate seat, suffered a stroke. Since then Fetterman has been fighting to recover, fighting to win the Senate seat and fighting non-stop ableism.

The candidate’s stroke was due to a blood clot caused by atrial fibrillation – an irregular heart rhythm – with which Fetterman was first diagnosed in 2017. He was hospitalized for 10 days, during which time he had a pacemaker combined with a defibrillator implanted. He was then sent home to recuperate. His cardiologist, Dr. Ramesh Chandra, said Fetterman suffered no cognitive damage and should “be fine” if he took his medication, ate well and exercised.

At the time, Fetterman released a statement to the press corps in which he said, “The good news is I’m feeling much better, and the doctors tell me I didn’t suffer any cognitive damage.”

READ MORE: Philadelphia Inquirer editorial board endorses Fetterman for Congress: Oz 'wholly unprepared to be US senator'

Fetterman’s opponent is world-renowned cardiothoracic surgeon and celebrity TV doctor, Mehmet Oz. Rather than wish him well and confirm what doctors said, Oz began a campaign of ableist and medically inaccurate innuendo about Fetterman. Oz’s campaign said that if “Fetterman had ever eaten a vegetable in his life, then maybe he wouldn’t have had a major stroke.”

On Labor Day, Oz held a presser in Philadelphia after Fetterman, who had been campaigning throughout the state, declined to debate at that time. Oz told reporters that, “John Fetterman is either healthy and he’s dodging the debate because he does not want to answer for his radical left positions or he’s too sick to participate in the debate.”

Since then, Fetterman agreed to a debate with captions and has given a series of interviews, including an in-depth interview with journalist Rebecca Traister for the October cover for New York.

On Oct. 12, Rebecca Traister tweeted, “Fetterman speaks about what it’s like to have a doctor (Oz) mock his recovery — a gross irony, yes. Also ironic is news media clamoring for transparency, then themselves offering distortion: implying challenges are cognitive when they’re not, failing to contextualize accommodations.”

READ MORE: Tucker Carlson’s latest attack against John Fetterman quickly comes back to haunt him

Traister was responding to an on-air interview with NBC News reporter Dasha Burns that had turned into a national furor over ableism and accommodations for disability, which have been law since 1990’s passage of the Americans with Disabilities Act.

Fetterman requested that interview questioned be captioned because he has, like many stroke victims (and also the 40 million Americans who are hard of hearing), auditory processing issues. These are expected to fully resolve in the coming months.

The interview went well. Fetterman had a minor hiccup over a word – “empathetic” – and used it to explain his recovery. The interview was peak transparency. Yet in Burns’ commentary to anchor Lester Holt, she suggested that Fetterman was unable to follow “small talk” without captions and that when the captioning device was off, “it wasn’t clear he was understanding our conversation.”

The GOP, which has portrayed the progressive Fetterman as a radical leftist who’s soft on crime, pounced on the comments and conflated them with the entire interview. Townhall and the Daily Caller used Burns’ comments to bolster Oz. Some pundits and reporters across the political spectrum began questioning Fetterman’s fitness.

Reporter and podcaster Kara Swisher, who had a stroke herself in 2011, was prompted to respond, noting on Twitter that, “This is just nonsense. Maybe this reporter is just bad at small talk.”

Swisher, who has called the ableist attacks on Fetterman “appalling,” had herself done an interview with Fetterman for her podcast. She reposted it on Twitter and said that, “I was really quite impressed with how well he’s doing. Everyone can judge for themselves.”

The blowback via disability rights groups and progressives like Swisher and Traister was swift, prompting her to defend herself. “We were happy to accommodate closed captioning. Our reporting did not and should not comment on fitness for office. This is for voters to decide. What we do push for as reporters is transparency. It’s our job. Fetterman sat down and answered our questions. That’s his job.”

Burns has not tweeted since Oct. 12, the day after the interview.

While Fetterman has continued to campaign throughout the state to large crowds, his wife Gisele has called on NBC News to apologize for comments she called a “shocking.” In an Oct. 17 interview with Eric Michael Garcia of The Independent, Gisele Fetterman said, "I would love to see an apology toward the disability community from

Dasha Burns and NBC News for the damage they have caused."

Two Democratic United States senators, Maryland’s Chris Van Hollen, 61, and New Mexico’s Ben Ray Luján, 50, have had strokes this year. They recovered and returned to the Senate.

There are 61 million disabled Americans – the largest minority group in the US. Yet ableism – attacks by non-disabled people on people with disabilities – is still a socially acceptable form of bigotry. As I wrote last month, ableism is behind the constant and consistent efforts to restrict mail-in ballots in Pennsylvania and other states.

In February, the Public Interest Law Center (PILC) filed a brief with the Pennsylvania Supreme Court supporting the right to choose to mail-in voting. As was proven in 2020, access to mail-in voting increases participation, especially for those with disabilities. A higher percentage of Americans – 67 percent – voted in 2020 than in any election in US history – despite or because of the covid pandemic.

The case against Fetterman points dramatically to how consequence-free it is to dismiss disabled Americans – even those with power. As the PILC brief asserts that, “Voters with disabilities face an especially increased risk of disenfranchisement.” It’s unvarnished suppression against a large but vulnerable population.

What NBC News and others did is unethical and unconscionable. In conflating the use of language-assistive devices with intellectual and cognitive disability, Fetterman has been portrayed as incompetent.

Oz, a doctor, has used his credibility to imply that Fetterman is sicker than he claims. The weaponizing of disability is the ugliest of ploys, portraying the 6'9" Fetterman into a weak and mentally challenged.

With the election weeks away, voters will, as Burns asserted, have to decide. But the ableist stink remains. It impacted not just Fetterman, his family and Pennsylvanians, but also 61 million Americans.

READ MORE: 'Ableist propaganda': Media condemned for criticizing John Fetterman's use of closed captioning

On Sunday’s 60 Minutes, Joe Biden declared the covid pandemic was over. He said, “The pandemic is over. We still have a problem with covid. We’re still doing a lot of work on it. But the pandemic is over.”

That pronouncement was news to the president’s healthcare staff who scrambled for explanations after Biden's comments went viral on social media and prompted a hashtag #TheCovidIsNotOver.

A half dozen unnamed officials told the Post the next day that Biden’s unequivocal statement undermines his own rollout of a new covid booster campaign and also damages coming efforts to get the Congress to authorize $22 billion in pandemic response funding.

READ MORE: 'MAGA violence' and 'domestic terrorism' are driving 'dual citizenships' among America's wealthy: report

But why do it if the pandemic is over?

Biden’s statement also contravened fact.

On the previous Friday, 107,066 cases of the covid were reported. That number does not include people who took a covid test at home and never reported their cases to local public health departments. So there are tens of thousands of unreported cases as well.

Between 400 and 500 Americans are dying each day from the covid – more than 3,000 a week. On Sept. 21, there were 419. There are about 30,000 hospitalizations daily. Among those, about 10 percent land in ICU. One in five covid cases results in the mysterious and disabling syndrome, long covid, which is, apart from the human toll, costing the economy billions in lost wages and unfilled jobs.

READ MORE: 'Never again': Progressive lawmakers observe 9/11 with calls to 'do better and learn from our mistakes'

As disturbing as these numbers are, Biden is right in that January 2022 saw an average of 800,000 cases per day. From that vantage, it does look like the pandemic has ceased to peak.

But we know from three years of pandemic data that covid cases ebb in the summer and surge in the winter when people are more likely to be indoors and confined in unventilated spaces, unmasked.

The numbers rarely discussed are the vaccination numbers. Set aside for now (a story for another time) the uniformly terrible way the Centers for Disease Control has handled the pandemic.

The shift from the Trump administration to the Biden administration was barely noticeable. Major mistakes have been made by CDC Director Rochelle Walensky – so much so that she investigated the CDC herself and found it, but not her, wanting.

The area of biggest failure is vaccines.

By never clarifying that boosters were not boosters at all, but a third and essential shot to have full immunity, CDC botched their rollout.

The CDC also never stipulated that vaccinations were essential public health tools for schools and workplaces, and should not be viewed as arbitrary. Vaccines, already politicized by the MAGA right as a “woke” trend to “take away personal freedoms,” became even more politicized without the agency tasked with teaching the public.

As a consequence, the vocal phalanx of anti-vaccine protesters grew louder and even those who were not vaccine hesitant simply never bothered with the third “booster.” So while poor nations remain desperate for vaccines, Americans are hand-waving their necessity.

While the CDC website states that 79 percent of Americans age 5 and over have at least one shot, it also states that only 34.9 percent of Americans are fully vaccinated with two shots and a booster.

That’s not just redhat Magaland failing to get vaccinated. That’s also a lot of liberals, Democrats and progressives. Only 24.2 million Americans – that’s 7.2 percent – have had the second shot.

Biden’s dismissal of a pandemic that has killed over 1.1 million and disabled another 25 million with long covid unintentionally polarized the country on the issue of vaccines. People who call themselves not anti-vaxxers but “pro-vaccine choice,” “pro-safe vaccine” or “vaccine skeptical” feed off the administration’s convoluted messaging.

Still, if the only issue were vaccine hesitancy, it could be somewhat manageable – at least until the next eventual surge. But it isn’t.

Anti-vaxxers – people who oppose vaccinations for a range of reasons from religious proscriptions to QAnon to Big Pharma conspiracy theories – are in the forefront of a growing political divide over vaccinations and its implications for public health.

Anti-vaxxers are also making us sicker.

The failure to immunize has resulted in more mutations and more – and more dangerous – variants of the coronavirus.

Anti-vaxxers have also brought back measles, mumps and now polio. As Rolling Stone reported in “Polio Is Making a Comeback. Thanks, Anti-Vaxxers!”: “If it seems like infectious diseases are coming at us faster, spreading more widely and persisting longer than they have in generations, it’s because they are, health experts say.”

"There are some more conservative states where we are likely to see other non-covid vaccine mandates under attack, and it is very worrisome," Marcus Plescia of the Association of State and Territorial Health Officials told Newsweek. "If we have some of these pediatric infectious diseases come back, it will be horrific."

And coming back they are – in outbreaks of measles, mumps, whooping cough and tuberculosis.

The CDC’s own database bears this out.

There are fewer vaccinations among under-50 people nationwide, but those numbers are lowest in red states. The reappearance of polio and other diseases in wastewater underscores Plescia’s view that Gen X parents refusing to vaccinate their kids is a trend.

The World Health Organization (WHO) released a report in July with the alarming statistic that the the covid-19 pandemic had fueled the largest continued backslide in [childhood] vaccinations in three decades. In 2019, just before the pandemic hit, WHO listed growing vaccine hesitancy as one of its top 10 threats to global health, citing an “infodemic” on social media and internet websites creating distrust of vaccines and urging it be addressed.

While Biden was making his declaration, Anthony Fauci, the chief medical advisor to the president, was sounding the alarm over vaccines. In a Sept. 18 interview in Financial Times, Fauci said, “I’m concerned the acceleration of an anti-vaxxer attitude in certain segments of the population … might spill over into that kind of a negative attitude towards childhood vaccinations.”

A few days earlier, Fauci had commandeered the Twitter account of HHS to discuss this issue. The longtime head of the National Institute of Allergy and Infectious Diseases and world-renowned infectious disease specialist said, “If you fall back on vaccines against common vaccine-preventable childhood diseases, that’s where you wind up getting avoidable and unnecessary outbreaks.”

And deaths.

The covid was the leading cause of death among US law enforcement in 2020 and 2021 due to vaccine resistance. For the second year in a row, the covid was the third leading cause of death in all age groups in the US in 2020 and 2021 and in line to be so in 2022 as well.

Misinformation and disinformation related to covid vaccines fomented by Fox, celebrities and conspiracy theories have caused this dramatic uptick in parents refusing to vaccinate children against diseases that only a few decades ago killed kids on a regular basis.

That these parents are often, as one Times report showed, literal rocket scientists who have still been caught up in these disinformation campaigns and who were themselves vaccinated as children is concerning to pediatricians nationwide.

Kate Williamson, a pediatrician, said she’d seen a rise in vaccine resistance. She told the Times, “I have this worry in the back of my mind — that we’re up against something that we have never seen before. To have something that could be anti-science as part of a political identity and culture is very concerning.”

Peter Hotez, of the Baylor College of Medicine and contributor to CNN and MSNBC, said, “The anti-vaccine movement is so strong, so well organized, so well-funded, I doubt it will stop at covid-19 vaccines.” In August, Hotez published a research paper in Nature on the damage done by this movement. He was unequivocal:

“I think it’s going to extend to childhood vaccinations.”

Vaccines have been settled science since the 18th century when British physician Edward Jenner discovered the smallpox vaccine, saving the world from a ravaging disease that had killed more than 20 percent of the world population. George Washington had a vaccine mandate for his troops at Valley Forge.

The monkeypox outbreak, with its painful and disfiguring pustules similar to smallpox, gave people a glimpse into what might happen if long-dormant diseases resurge.

Smallpox was eradicated in the US in 1949, globally in 1980. Polio was eradicated in the US in 1979, measles in 2000, whooping cough in 1945, mumps in 2003 – all due to vaccine protocols. But in recent years, outbreaks of each of these debilitating and sometimes fatal diseases have reappeared due to failures to vaccinate.

Initially, these outbreaks were local to religious communities, but then spread into suburban communities where families fell prey to internet misinformation about links between vaccines and autism.

Some of that misinformation was spread by celebrity parents of children with autism like Robert DeNiro and Jenny McCarthy.

The most prominent anti-vaxxer is Robert F. Kennedy Jr. Kennedy’s own family has disavowed his stance. He has written an anti-vax book published by Simon & Schuster. He established an anti-vax foundation, Children's Health Defense (CHD). In August, it was kicked off Instagram and Facebook for misinformation. The group had a half million followers at the time. Kennedy was kicked off Instagram in 2021 but has an active account on Facebook and CHD is on Twitter.

Regardless of the source of vaccine misinformation, the result could be catastrophic if the 22 diseases children are vaccinated against prior to their fourth birthday begin a comeback.

The herd immunity that eradicates diseases is created when more than 80 percent of a population is vaccinated. Lower that number even marginally and outbreaks turn into full-blown pandemics.

Hotez told the Times that the anti-vaxxer movement is incalculably dangerous. “This is a deadly movement,” Hotez said. “With things like terrorism and nuclear proliferation, we have lots of infrastructure.

“For this, we don’t have anything.”

READ MORE: 'No exit': Signs are pointing to 'a civilization in terminal decline'

Queen Elizabeth II is dead at 96. The rule of succession means her eldest son, Charles, for decades known as the Prince of Wales, became King Charles III the moment she drew her last breath.

Now’s a good time to revisit the damage done by the legacy of colonialism over which Elizabeth reigned for seven decades.

Having ascended to the throne in 1952, at 25, Elizabeth was the longest reigning monarch in British history and the second-longest reigning monarch, after Louis XIV of France, in world history.

READ MORE: Historian blows up on MSNBC's Velshi for bringing up British colonialism

At the age of 10 she became the heir apparent. At 19, Princess Elizabeth joined the war effort against the Nazis, serving in the Auxiliary Territorial Service (ATS). She trained as a driver and mechanic and eventually attained the position of junior commander (equivalent to the rank of captain). At the time of her death, she was the sole surviving world leader to have fought in World War II.

When Elizabeth ascended the throne, Harry Truman was president. At her death, 14 presidents later, it was Joe Biden. She was queen to 15 prime ministers, beginning with Winston Churchill, through Margaret Thatcher and Tony Blair, to Boris Johnson and Liz Truss.

The queen lived a life of service to country, which celebrated her Platinum Jubilee in June. In a gracious note to her supporters – her subjects – posted June 5, she said, “I have been humbled and deeply touched that so many people have taken to the streets to celebrate my Platinum Jubilee,” and pledged to “remain committed to serving you to the best of my ability, supported by my family.”

Elizabeth’s final official act as monarch was formally appointing the new prime minister, the Tory Liz Truss, on September 6, at Balmoral Castle in Scotland, just days before her death.

READ MORE: Queen Elizabeth II has a secret speech ready if World War 3 breaks out

World leaders, including Presidents Biden and Emmanuel Macron and Prime Minister Justin Trudeau (Canada is still a constitutional monarchy of the British commonwealth), paid their respects.

Sirs Paul McCartney, Elton John and Mick Jagger, Janet Jackson and Whoopi Goldberg, Helen Mirren, who won an Academy Award for her portrayal of Elizabeth in 2006’s "The Queen,” and myriad others took to social media to express their condolences and to remark on her extraordinary service and the perceived stability she evoked for Britons, 80 percent of whom were born during her reign.

But there is another side – an unaddressed side – to the monarchy that reflects a brutal and unforgiving legacy. While some declared themselves proud Elizabethans, others saw, on the queen’s passing, a far different vantage point on her years as Britain’s monarch.

Some posts, including those of a Black professor at Carnegie Mellon, were removed from Twitter for violating its rules of service. Both #BlackTwitter and #IrishTwitter were sent trending, groups holding her to task for colonization and oppression throughout her reign.

An article by the Irish Times’ Patrick Freyne circulated. He wrote that “having a monarchy next door is a little like having a neighbor who’s really into clowns and has daubed their house with clown murals, displays clown dolls in each window and has an insatiable desire to hear about and discuss clown-related news stories. More specifically, for the Irish, it’s like having a neighbor who’s really into clowns and, also, your grandfather was murdered by a clown.”

Elizabeth’s role in putting down – or attempting to put down – insurrections against the royal crown in the British colonies has rarely been mentioned. Yet the 1950s, 1960s and 1970s were fraught with such actions, largely throughout the African continent.

In 2015, Elizabeth surpassed her great-grandmother, Queen Victoria, who reigned for 63 years, as the longest reigning British monarch.

The Post detailed the change since her coronation. “When Elizabeth was crowned in 1952, Britain still had a real empire, with more than 70 overseas territories. Even then, however, it was clear that the situation could not last. India, often declared ‘the jewel in the crown’ for the Empire, had won its independence just five years before. In 1952, British troops were fighting independence movements in Egypt and Kenya. They would go on to lose both, and many others.”

The Post added that “in 1921, at the empire's peak, the British ruled around a quarter of the land on Earth. However, there is a small silver lining for Queen Elizabeth: She remains the monarch in 15 commonwealth nations in addition to Britain.” As a matter of fact, Britain still retains 14 colonies, though they are now called British Overseas Territories. The term "colonies" is no longer used.

India achieved independence in 1947, Israel, Myanmar and Sri Lanka in 1948, Libya in 1951. Ghana became Britain's first African colony to reach independence in 1957. By 1967, more than 20 territories were independent, including Kenya, Sierra Leone, Sudan, Uganda, Zambia and Zanzibar. All of these exits came with immense bloodshed.

In Northern Ireland, “The Troubles” raged from 1968 through 1998. Betty Williams and Mairead Maguire received the Nobel Peace Prize in 1977 for their efforts to peacefully resolve the violent conflict in Northern Ireland. Yet 20 years later the Nobel Peace Prize 1998 was awarded jointly to John Hume and David Trimble "for their efforts to find a peaceful solution to the conflict in Northern Ireland."

These histories are long and brutal.

At the core of each is the British monarchy.

When one looks at a list of the colonies once controlled by the British Empire and considers the plundering of their natural resources as well as the subjugation of the mostly Black and brown populations, control of waterways and air spaces and economic deprivation, it is or should be easy to see and feel the rage of those once colonized.

The brutality with which Britain responded to independence movements cannot be ignored. Nor can the plundering over generations and the sense of entitlement that accompanied it.

A simple walk through the British Museum tells the tale of all that the British Empire stole as it ravaged the Middle East, Asia, Africa and other parts of Europe. The Grecian Elgin Marbles and the statues of Ramses are all there, as is the greatest collection of cuneiform.

And then there is the human toll.

Muthoni Mathenge was part of Kenya’s Mau Mau rebellion in 1952 – a rebellion that was put down brutally by British troops. At the time of the Queen’s Jubilee, Germany’s DW News posted a video of Mathenge describing her torture and detention by British troops, and her request for direct compensation from the queen for her suffering.

Is Queen Elizabeth II to blame for the mayhem wrought in the colonies throughout her reign? Well, the monarchy has become more ceremonial than active. The British monarch is mainly a figurehead abjured from intervention in political matters. In these terms, no.

But as head of state, Elizabeth retained constitutional powers, such as formally investing each prime minister, as she did with Truss.

The American colonies divested of the monarchy early, in 1776, with the Declaration of Independence. The authors of the Declaration and the Federalist Papers made it clear there would be no king nor any divine rights. It was a sound decision. The UK should consider now.

What is the role of the monarchy in 2022, other than a reminder of its long legacy of theft and dominion and enslavement?

For 70 years, Elizabeth’s white face has been on every stamp and pound note and in every photograph in her many trips throughout the commonwealth. When the Irish, Black Americans, Africans, Afro-Caribbeans and West Indians push back against the lauding of the queen, and the erasure of the bloody impact of colonialism and imperialism, is this not a message that should be heeded?

In Jamaica – among those countries still overseen by the monarchy – officials have revealed a plan to become a republic and seek $10 billion in reparations from Britain for the slave trade.

Wasn’t the imperiling nature of the monarchy exposed by Charles’s first wife, Princess Diana, and then again recently by Prince Harry’s wife, Meghan Markle, Duchess of Sussex, who was made suicidal during her first pregnancy by the overt racism within the family?

In the revisionism taking hold over Elizabeth’s story, she’s become the monarch who attempted to heal a nation riven by the tragic death of Diana, rather than what she was: the petty mother-in-law who refused to lower the flags and waited to visit the huge memorial of flowers and other mementos the grieving populace had left at the gates of Buckingham Palace in memoriam to their favorite royal.

At her husband, Prince Philip’s memorial service, the queen chose to be escorted by her disgraced son, Prince Andrew, accused of sexual assault by Virginia Giuffre, who was a minor at the time of the alleged assault. Andrew had just settled with Giuffre for an undisclosed amount prior to the service. While royalty watchers said it was a choice that bespoke the queen’s fealty to family, many were aghast at the tone-deafness and perceived slap at victims of sexual assault.

Seventy years is long time for mistakes to be made. But as Elizabeth is laid to rest and the whitewashing of her legacy begins in earnest, isn’t it time to ask why the monarchy should continue, why British subjects should pay for it and when recompense will be made to the victims of colonialism, with its legacy of racism and deprivations and incidents like that experienced by Muthoni Mathenge?

While one can claim the monarchy is politically neutral, it is not.

Never addressed in the 2020 primary was the extent of medical debt, despite a presidential race in the middle of a once-a-century pandemic hospitalizing people for days, weeks and months. The cost was astronomical. Medical debt has accrued exponentially since.

Every candidate had a plan to revamp our broken healthcare system during the 2020 Democratic primary. They ranged from Medicare for All (Bernie Sanders) to expanding the Affordable Care Act (Joe Biden).

Elizabeth Warren said a significant number of Americans got their health insurance from their employers. Pandemic lockdowns meant millions lost it. Kamala Harris touted a variation of Medicare for All. Amy Klobuchar pushed for lowering the age for Medicare to 50.

The debate suggested whoever won the general would dedicate to fixing the system many have tried restructuring – including Hillary Clinton, who attempted in 1993 to institute a universal healthcare initiative – until the GOP ended the possibility of passage.

In 2010, Speaker Nancy Pelosi shepherded the Affordable Care Act into law – which then-Vice President Biden called a “big fucking deal” after President Obama signed it. What the ACA did – Sarah Palin dubbed Obamacare – was set up a healthcare marketplace to buy insurance plans with different levels of coverage and affordability.

The ACA also expanded Medicaid to the working poor. It allowed dependent children to stay on their parents plans until they were 26. It forced insurance companies to charge men and women the same rates, instead of overcharging women for being female. The ACA addressed preexisting health conditions, forbidding companies from rejecting applicants on the basis of their prior health status.

The ACA was the most sweeping healthcare initiative since Lyndon Johnson signed Medicare and Medicaid into law in 1965. Thus Democrats did not expect pushback from Republicans on a law allowing millions of uninsured Americans to buy coverage.

Republican governors rejected Medicaid expansion. Some sued to deny adoption in their states. This meant millions of Americans in those states remained uninsured and vulnerable to medical debt.

Never addressed in the 2020 primary was the extent of medical debt, despite a presidential race in the middle of a once-a-century pandemic hospitalizing people for days, weeks and months.

The cost was astronomical.

Medical debt has accrued exponentially since.

A new study finds that healthcare is now the country’s largest source of debt. One in 10 Americans carry medical debt ranging from $250 – more than a week’s wages for a minimum wage worker – to $10,000.

That latter number is most common. According to healthcare.gov, a three-day hospital stay – the average – costs more than $30,000.

These medical debts are largest in states run by Republican governors who refused to expand Medicaid under the Affordable Care Act.

Moreover, many households can’t pay cost-sharing in private health plans. That means they’re unable to pay for deductibles, copays and coinsurance like prescription plans. This makes it less likely for people to buy health insurance, even from the healthcare marketplace.

An investigation conducted and published by the Journal of the American Medical Association found that “an estimated 17.8 percent of individuals in the US had medical debt in collections in June 2020.”

That’s well above what was previously thought.

The JAMA investigation was conducted before the true costs of the pandemic had been accrued and analyzed. Yet even without those numbers, the amount of medical debt was staggering at $140 billion.

To put that in perspective, the total 2020 US State Department budget – including USAID – was $52 billion. The total US Department of Justice budget was $35 billion. Medical debt is nearly twice that.

Members of Congress, among them the House Progressive Caucus, frequently take to Twitter to call for student loan debt relief.

But what about medical debt?

According to a new study from the American Journal of Public Health, crowdfunding isn’t an answer. Researchers found that the funding acquired was “highly unequal, and success was low, especially in 2020.” A mere 12 percent of campaigns met their fundraising goals.

Moreover, crowdfunding raised far less money throughout 2020 in states that had more medical debt, higher uninsured rates and lower incomes – notably states controlled by Republican governors.

These states also have the highest percentage of people of color who are significantly more likely to have medical debt than their white peers and who were disproportionately impacted by the covid.

At a GOP debate in Pennsylvania on April 25 for what is arguably the most-watched Senate, five candidates railed against “lockdowns” and “mandates.” Mehmet Oz, a cardiothoracic surgeon and celebrity medical TV personality, was the most strident. He claimed his son was being forced in medical school to wear a mask against his will.

No one discussed the impact of the pandemic on the healthcare system nor on the debt being carried by average Americans.

Who will pay for their care? How do we end medical debt?

With the 2024 presidential election looming, it’s a question future candidates on both sides of the aisle must prepare to address.

While many are aware of Florida’s “Don’t Say Gay” law signed by GOP Governor Ron DeSantis on March 28, few are aware of how many similar bills have been signed or proposed in state legislatures.

The rightwing has turned Disney’s backlash against DeSantis’s law into a full-fledged fight. There are already T-shirts with the Disney logo and “Disney groomers” available for sale. On the back: “bring ammo.”

The GOP and MAGAs like Jack Posobiec – who was suspended from Twitter briefly for posting an image of the T-shirt and for linking Disney, LGBTQ-plus people and pedophiles – have turned violent.

Utah, Oklahoma and Alabama have passed similar anti-LGBTQ-plus laws. 2022 is on track to set a record for anti-LGBTQ-plus legislation. Since January, 238 such bills have been proposed, a rate of more than three a day. Limiting the rights of trans youth to medical care, limiting access in schools to basics like bathroom use, and limiting who gets to participate in sports – are the focus of about half the bills.

According to an NBC News analysis, about 670 anti-LGBTQ-plus bills have been filed since 2018. The number has increased each year. According to NBC, there were 41 bills in 2018, slightly more than 60 in 2019, nearly 150 in 2020, 191 in 2021 and 238 bills this year.

As Florida's “Don’t Say Gay” law suggests, silencing discourse of any kind about sexual orientation or gender identity is the goal.

The GOP theory seems to be that if kids don’t hear about queer and trans people, they won’t become queer or trans. That these identities are likely embedded from birth (or before) is a concept the purveyors of “Parental Rights” bills don’t want to grapple with.

Ask any gay, lesbian, non-binary or trans person about their identity. Most will say they always knew. Most will say they were who they are, even if they didn’t yet have a name for it. Books and other materials allowing LGBTQ-plus youth to feel comfortable in their identities and most importantly, not isolated, are key to safe, healthy adolescence.

A national survey from The Trevor Project, an LGBTQ-plus youth suicide prevention and intervention group, found that 42 percent of LGBTQ-plus youth seriously considered attempting suicide last year.

“LGBTQ youth are not inherently prone to suicide risk because of their sexual orientation or gender identity but rather placed at higher risk because of how they are mistreated and stigmatized in society.”

During the off-year election in November 2021, the push to ban LGBTQ-plus-themed books began in earnest. Glenn Youngkin, now governor of Virginia, campaigned on getting “offensive” books out of schools. Top of list: books dealing with race and LGBTQ-plus issues.

In 2022, school boards are debating books allowable in classrooms. Texas, Mississippi, Arizona and Tennessee have passed laws ostensibly banning books with LGBTQ-plus content. These include the classic works of James Baldwin, Walt Whitman and Stephen Sondheim. Among other books banned are Alice Walker’s Pulitzer Prize-winning The Color Purple and Harper Lee’s classic To Kill a Mockingbird.

In Texas, GOP Governor Greg Abbott proffered a “Parental Bill of Rights” so parents decide what their children are taught. In November, he declared a “war on pornography” in schools, which, while unspecific, seemed to include all – and solely – LGBTQ-plus books.

Texas state Rep. Matt Krause, who chairs the Texas House’s General Investigating Committee, queried the Texas Education Agency over his concerns that books in Texas schools were allowing subversive discourse on race, sexuality and gender identity. Attached to his letter to the TEA was a 16-page list of 850 book titles published from 1969 to 2021 that deal with issues of race, gender identity and sexuality.

The Dallas Morning News revealed that “of the first 100 titles listed, 97 were written by women, people of color or LGBTQ authors.”

In January, Mayor Gene McGee of Ridgeland, Mississippi, withheld $110,000 in funding from the Madison County Library System, the first-quarter funds the city owes the county’s library program. McGee is opposed to what he calls “homosexual materials” in the local library and said he would not release the funds until they were removed.

Those who argue this is “just” a red state phenomenon aren’t paying attention. Suburban school boards in blue states are focusing on “parental rights.” On April 5, Pennsylvania, with a critical Senate and gubernatorial race, voted an anti-LGBTQ-plus bill out of committee. It will soon come before the legislature where it’s expected to pass.

During confirmation hearings, the Republicans interrogated Judge Ketanji Brown Jackson repeatedly about LGBTQ-plus issues. Senator Marsha Blackburn, attempting a gotcha on trans issues, asked Jackson to define the term woman. Jackson declined, saying “I can’t.”

“You can’t?”

“Not in this context. I’m not a biologist.”

That exchange became a focal point for the right.

The next day US Rep. Bob Good addressed House Speaker Nancy Pelosi as "Person Speaker" rather than “Madam Speaker,” as she is customarily known. Good said it was in deference to Judge Jackson.

A week earlier, Charlie Kirk, a right-wing activist, was suspended from Twitter for saying Assistant Secretary of Health and Human Services Rachel Levine, a trans woman, as a man, to his 1.7 million followers.

These aggressive actions, like Blackburn’s interrogation and Kirk’s attacks on Levine, as well as the many laws and policies being pushed by the GOP, have a ripple effect on LGBTQ-plus people.

Especially youth.

Chasten Buttigieg, spouse of US Secretary of Transportation Pete Buttigieg asked “what kind of state are you building [in Florida], where you're essentially pushing kids back in the closet? … You're saying, 'We can't talk about you. We can't even talk about your families.'"

Buttigieg’s point is a salient one.

Most families have at least one LGBTQ-plus person. Most books, TV series and movies marketed to children refer repeatedly to heterosexuality and its many manifestations as well as to gender.

Yet the GOP would have you believe mentioning one’s gay, lesbian or trans family member in the classroom is “grooming” them in a nefarious sexualized plot while the prevalence of heterosexual imagery is manifold. Does anyone really believe Encanto is grooming kids?

The midterms will determine who runs the Congress next year.

If the GOP wins, harm to LGBTQ-plus Americans will be incalculable.