Fewer than half of the states meet recommended cybersecurity goals
State Court Report: 2024’s most significant state constitutional cases
There has been growing public interest in the potential of state courts and constitutions to provide greater protections to people within their borders than what’s offered under the federal Constitution. In 2024, multiple high-profile cases wound through state judiciaries, addressing reproductive rights, democracy, criminal justice, and much more.
Against this backdrop, we asked some the country’s leading legal thinkers to weigh in on the question: What is a state constitutional case you think our readers should know about from this past year, and why? Their responses painted a complex but often hopeful picture for the future of civil rights.
One more note: The year isn’t over yet and we expect to see state supreme courts continue to issue decisions in the waning days of December. Case in point: on Wednesday the Montana Supreme Court ruled in Held v. Montana that the state constitution’s right to a clean and healthful environment includes a guarantee of a “stable climate system,” striking down a law that barred agencies from considering greenhouse gas emissions as part of their environmental impact assessments.
Expanding Abortion Rights
Leah Litman, professor at the University of Michigan Law School and cohost of the Strict Scrutiny podcast
In Kaul v. Urmanski, the Wisconsin Supreme Court will decide whether Wisconsin’s near total abortion ban will go into effect. The ban was originally enacted in 1849.
Oral arguments were in October, just about two years and two months after the Supreme Court heard oral arguments in Dobbs v. Jackson Women’s Health Organization, the case that ultimately overruled Roe v. Wade.
The tenor of the two arguments could not have been more different.
In Dobbs, the U.S. Supreme Court gave barely any attention (aside from some questions from two Democratic nominees) to the life-or-death consequences of restrictive abortion bans. (Since Dobbs was decided, ProPublica has reported five known cases in which women have died because abortion restrictions delayed their medical care.) In Kaul, by contrast, Justice Jill Karofsky pointedly told the lawyer arguing for the revived abortion ban that the law would be “signing the death warrant” for women, children, and families. In Dobbs, Justice Amy Coney Barrett drew an analogy between the consequences that an abortion ban had on liberty to the consequences that a vaccine requirement had on liberty.
In Kaul, Justice Rebecca Dallet expressed concern about confining the court’s analysis to the 1840s, when the only “people who had rights” were “white men” who “owned property.” In Dobbs, of course, the Supreme Court leaned into the supposed history and tradition of restricting women’s bodily autonomy.
The Wisconsin Supreme Court will release its decision in Kaul next year. So while it’s not a 2024 decision, the oral arguments highlighted an essential element of 2024: the (potential) divergence between the U.S. Supreme Court and state supreme courts.
Whether the Wisconsin Supreme Court continues to take a different tack than the U.S. Supreme Court, however, will be decided by an election next year — the April 2025 race to determine control of Wisconsin’s high court.
Why Kaiser bet on Greensboro, N.C.’s Cone Health for its Tar Heel State expansion |
A recent Saturday night at the Moses Cone Memorial Hospital Emergency Department felt different. It didn’t reflect the madhouse triage atmosphere of past years, when a standing-room-only crowd of patients might wait hours to be seen. “We were worried about what it might be like on a Saturday,” said Claire Hampton, who brought her young son in with an asthma-related breathing problem a little after 9 p.m. “But they got us right through. It’s really gotten a lot better. We’ve noticed that.” One factor driving that change: Cone Health’s expanded network of urgent care facilities, including locations near the main hospital on Greensboro’s N. Church Street and Elmsley Court, as well as in Winston-Salem, Burlington, and Asheboro. Those locations have helped keep less serious cases—small accidents, non-lethal allergic reactions—out of the main E.R., which can both lower patient costs and free up capacity for treating life-threatening emergencies. Cone is doing what other systems across the state have, planting its brand’s flag in smaller locations in the Piedmont to reach more patients. In the past decade, large hospital systems across North Carolina like Duke, UNC Health, and Atrium have been growing and building urgent care facilities, freestanding emergency departments, and clinics outside their traditional service areas. That’s made them more powerful and better able to drive harder bargains with insurance companies. UNC Health has acquired a handful of troubled rural hospitals, their finances buoyed by the more profitable businesses at the flagship in Chapel Hill and Rex Hospital in Raleigh. Atrium—which is restricted from purchasing distant hospitals within North Carolina by its status as a county hospital authority—has instead “partnered” with Wake Forest Baptist while also acquiring hospitals in Georgia and South Carolina. Now merged with Advocate Health, Atrium has become one of the 10 largest health systems in the country, providing care at 69 hospitals across six states. North Carolina Health News, The Assembly Fewer than half the states meet recommended cybersecurity goals Cyber attacks are a huge concern for state and local governments. Falling victim can mean downed services, compromised sensitive information, stolen money, and costly response and recovery work. Cybersecurity tops state chief information officers’ priority lists for 2025, according to the National Association of State Chief Information Officers. The Nationwide Cybersecurity Review (NCSR) aims to provide that kind of information. The NCSR is a voluntary self-assessment that helps state, local, tribal and territorial governments, as well as state agencies and local departments, understand how well they're prepared to deter and respond to cyber attacks. It’s sponsored by the Department of Homeland Security and the Multi-State Information Sharing and Analysis Center and offered at no cost. Louisiana forbids public health workers from promoting COVID, flu and mpox shots A group of high-level managers at the Louisiana Department of Health walked into a Nov. 14 meeting in Baton Rouge expecting to talk about outreach and community events. Instead, they were told by an assistant secretary in the department and another official that department leadership had a new policy: Advertising or otherwise promoting the COVID, influenza or mpox vaccines, an established practice there — and at most other public health entities in the U.S. — must stop. NPR has confirmed the policy was discussed at this meeting, and at two other meetings held within the department’s Office of Public Health, on Oct. 3 and Nov. 21, through interviews with four employees at the Department of Health, which employs more than 6,500 people and is the state’s largest agency. According to the employees, who spoke on the condition of anonymity because they fear losing their jobs or other forms of retaliation, the policy would be implemented quietly and would not be put in writing. Staffers were also told that it applies to every aspect of the health department’s work: Employees could not send out press releases, give interviews, hold vaccine events, give presentations or create social media posts encouraging the public to get the vaccines. They also could not put up signs at the department’s clinics that COVID, flu or mpox vaccines were available on site. The new policy in Louisiana was implemented as some politicians have promoted false information about vaccines and as President-elect Donald Trump seeks to have anti-vaccine activist Robert F. Kennedy Jr lead the U.S. Department of Health and Human Services. And some public health experts are concerned that if other states follow Louisiana, the U.S. could face rising levels of disease and further erosion of trust in the nation’s public health infrastructure. At a Dec. 16 news conference, Trump addressed ongoing concerns about Kennedy’s nomination, and whether it could lead to significant changes in national vaccine policy. Trump said that Kennedy will be “much less radical than you would think” and that he has “a very open mind.” Trump also called himself a “big believer” in the polio vaccine and said “you’re not going to lose the polio vaccine.” |
A blow to public health practice
Staff at Louisiana’s health department fear the new policy undermines their efforts to protect the public, and violates the fundamental mission of public health: to prevent illness and disease by following the science.
“I mean, do they want to dismantle public health?” one employee at the health department said.
Bill to charge public for police video sits on Ohio governor’s desk
Ohio Gov. Mike DeWine is evaluating whether he wants to sign a bill into law that could charge the public hundreds of dollars for footage from law enforcement agencies, including body cameras. In the wee hours of Wednesday morning, lawmakers passed H.B. 315, a massive, roughly 450-page omnibus bill. In it was a provision that would cost people money to get access to video from police and jails. Law enforcement could charge people for the “estimated cost” of processing the video — and you would have to pay before the footage is released. Governments could charge up to $75 an hour for work, with a fee cap of $750 per request. Legal experts say this could affect access to video from dash and body cameras, as well as surveillance video from inside jails — which are public records in Ohio. Supporters say this would help cover the cost of reviewing and redacting video. “It only applies if you want the public office to make a copy of a video record, and only if it relates to law enforcement, and only if the public office opts to charge,” bill sponsor Bill Seitz (R-Cincinnati) texted us. “There is a cap of $750 max charge, but you can inspect the records for free and make your own video of the video with your own phone or camera.” Case Western Reserve University Law Professor Jonathan Entin said he worries this could prevent people in the general public from pursuing a question or complaint against a law enforcement agency. “People are talking about how it’s hard to afford groceries these days, or clothing or the car or your medicines, right?” Entin told News 5 anchor and reporter Tessa DiTirro. “If you’ve got all those things, having to pay $75 an hour for video — even for one hour — might bust your budget and therefore, you might not ask.” Now, opponents are asking for Gov. Mike DeWine to line-item veto this provision. The policy was not public, nor had a hearing, prior to being snuck into the legislation. We brought transparency concerns to the governor on Friday. “These requests certainly should be honored, and we want them to be honored. We want them to be honored in a swift way that’s very, very important,” DeWine responded. “We also, though — if you have, for example, a small police department — very small police department — and they get a request like that, that could take one person a significant period of time.” Mississippi’s health department budget request prioritizes training doctors, increasing health insurance coverage New programs to train early-career doctors and help Mississippians enroll in health insurance are at the top of the state Department of Health’s budget wish list this year. The agency tasked with overseeing public health in the state is asking for $4.8 million in additional state funding, a 4% increase over last year’s budget appropriation. The department hopes to use funding increases to start three new medical residency programs across the state. The programs will be located in south central Mississippi, Meridian and the Delta and focus on internal and family medicine, obstetric care and rural training. The Office of Mississippi Physician Workforce, which the Legislature moved from UMMC to the State Department of Health last year, will oversee the programs. The office was created by the Legislature in 2012 and has assisted with the creation or supported 19 accredited graduate medical education programs in Mississippi, said health department spokesperson Greg Flynn. A $1 million dollar appropriation requested by the department will fund a patient navigation program to help people access health services in their communities and apply for health insurance coverage. People will access these services at community-based health departments, said Flynn. Patient navigators will help patients apply for coverage through Medicaid or the Health Insurance Marketplace, said Health Department Senior Deputy Kris Adcock at the Joint Legislative Budget Committee meeting on Sept. 26. “We want to increase the number of people who have access to health care coverage and therefore have access to health care,” she said. The Health Insurance Marketplace is a federally-operated service that helps people enroll in health insurance programs. Enrollees can access premium tax credits, which lower the cost of health insurance, through the Marketplace. The department received its largest appropriation from the state’s general fund in nearly a decade last year, illustrating a slow but steady rebound from drastic budget cuts in 2017 that forced the agency to shutter county health clinics and lay off staff. Racial turnout gap grew again in Georgia Over the past 15 years, the racial turnout gap in the United States has grown dramatically. A good deal of the widening gap — but by no means all of it — can be attributed to restrictive state voting policies, such as Georgia’s Senate Bill 202, following the Supreme Court’s 2013 decision in Shelby County v. Holder, which hollowed out key protections against racially discriminatory voting rules. Perhaps just as important as formal laws and policies making voting more difficult are features in our democratic systems that leave many Americans of color underrepresented, which leads to disengagement from political participation. Campaign finance laws make it more difficult for low-income Americans to raise the money they need to run for office, the Electoral College reduces the value of most Americans’ presidential votes, and gerrymandered maps keep one party in power. To be sure, there were other reasons voters stayed home this year, like anger over inflation, that can’t be directly tied back to features of our democracy. To fully explore these dynamics, we’ll need to wait until the national voter file becomes available next summer, along with large postelection surveys. But in Georgia, an important swing state, we already know exactly who cast a ballot in last month’s election, and the trends are somewhat concerning. (Georgia is the first state to release its voter history file, and the other states will follow.) We underscore that these results are preliminary, and it is not clear to what extent they might be true in other states. Nevertheless, understanding what happened in Georgia is important in its own right. One takeaway is that the gap in turnout rates between white and Black voters in Georgia grew by 3 percentage points between 2020 and 2024 (for a discussion on how we calculated the number of eligible voters in Georgia in 2024, see the methodological note at the end of this piece). That’s roughly equal to how much the turnout gap grew between 2016 and 2020, but looking only at the change in the gap can be misleading. Between 2016 and 2020, turnout among both white and Black voters increased, but it increased more for white voters; that’s what drove up the turnout gap. This year, white turnout went up again in Georgia, but Black turnout declined by 0.6 points. That said, the total number of ballots cast by white and Black voters increased — from 3.16 million to 3.3 million for white voters and from 1.44 million to 1.52 million for Black voters — but the increase among Black voters did not keep up with population increases. All told, Black Georgians would have cast an additional 400,000 ballots if their turnout rate matched that of white Georgians. While we cannot know who these voters would have supported, this number is far larger than President-elect Trump’s winning margin of about 115,000 votes. Helene impacts an already fragile child care system in Western North Carolina Three weeks after Helene hit Western North Carolina, Marcia Whitney thought she was close to a breakthrough. The president of Verner Center for Early Learning was desperate to reopen and help their families and children return to at least some of their routines. Through her involvement in the Rotary Club of Asheville, Whitney secured a donated water filtration system, capable of filtering up to 20,000 gallons per day. Locals with water engineering experience had set it up, and it was ready to go. But the NC Department of Public Health’s Environmental Health Specialists wouldn’t approve use of this water for the Verner Center’s two facilities. The reason? Though the water tested as clean, the filtration system didn’t have a chlorine residual — a detectable level of chlorine required in the public water supplies by the EPA — to add to the water. “We couldn’t have used it as potable water in our child care centers,” Whitney explained. “I went to the Director of the [North Carolina Department] Division of Health and Human Services for the state. I had state senators involved.” Though the daycare couldn’t use the water from the Rotary’s filtration system inside its buildings for handwashing, cooking or drinking, the program could send it home with kids. And they did—many families brought the filtered water home, as did the staff and faculty. That particular decision is “going past the realm of logic,” Whitney said. The kids’ “formula can be made with that water at home [but] it can’t be used to wash their hands here.” |
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