A 2013 Center for Public Integrity/ABC News investigation of the federal black lung benefits system, “Breathless and Burdened,” has won the Heywood Broun Award from The Newspaper Guild-Communications Workers of America.

The series, which also won the Pulitzer Prize and other national honors, exposed how some lawyers and doctors hired by the coal industry worked to deny benefits to ailing miners. The project prompted reforms within the Department of Labor and has triggered legislative proposals as well.

“Black lung? Wasn’t that something we first heard about decades ago and that public officials and the medical community have dealt with,” the four-member Broun judging panel wrote. “That was our belief — that is, until reading and viewing this report. Despite legislative reforms beginning in the late ‘60s and oversight by the Labor Department, it seems the coal industry giants have been gaming the system — not only using their hired legal specialists to prolong appeals in black lung benefit cases so that the process ‘outlives’ the victims, they actually co-opted one of our more prestigious hospitals [Johns Hopkins] to aid their scheme.”

Chris Hamby, now with BuzzFeed, was the reporter on the project, which was edited by former CPI staffer Ronnie Greene and Jim Morris, the Center’s managing editor for environment and labor. CPI staffer Chris Zubak-Skees produced the data-driven, interactive graphics.

The award is named for newspaper columnist Heywood Broun, who helped found The Newspaper Guild in 1933.

“We believe our winner truly reflects the Guild founder’s commitment to championing the underdog against the powerful, the uncaring, the corrupt,” the judges said.

The Sacramento Bee and the Washington Post won “Substantial Distinction” awards from the Guild — the Bee for a series about the busing of mentally ill patients out of Nevada and the Post for a series on the exploitation of desperate homeowners by lien buyers.

Watchdog organization Citizens for Responsibility and Ethics in Washington is asking the Internal Revenue Service to investigate the 60 Plus Association, a conservative advocacy group funded largely by the political network of billionaire industrialists David and Charles Koch.

In a complaint filed today, CREW asks the IRS to determine whether the 60 Plus Association "violated federal law by intentionally failing to disclose more than $11 million" it spent on political activity in 2010 and 2012.

During those elections, the 60 Plus Association told the Federal Election Commission that it spent millions of dollars on political ads that urged viewers to support or reject candidates.

But the group reported spending just $138,000 during the same period on "direct and indirect political campaign activities" on its annual tax returns. It appeared to classify millions of dollars in political-related expenditures as "educational awareness" and "educating seniors by influencing the election of political candidates."

These apparent discrepancies were first reported by the Center for Public Integrity on Wednesday.

It’s a felony to “willfully” file IRS tax returns containing fraudulent information.

Melanie Sloan, CREW's executive director, accused the 60 Plus Association of taking "outrageous liberties with the truth."

In the newly filed complaint, Sloan urged the IRS to refer the case to the Department of Justice for prosecution if the agency determines that the 60 Plus Association has made "false or incomplete statements" on its tax returns.

Gerry Scimeca, a spokesman for the 60 Plus Association, did not immediately respond to a request for comment.

The 60 Plus Association, founded in 1992, describes itself as nonpartisan, but it generally backs Republican candidates.

James L. Martin, a former journalist who served as chief of staff to a Republican senator during the 1960s, is the chairman of the 60 Plus Association. The group's president is Amy Noone Frederick, a political professional whose husband formerly served as the chairman of the Republican Party of Virginia. Singer Pat Boone serves as its national spokesman.

Officials with the IRS and DOJ declined to comment about the 60 Plus Association's reporting practices.

The Center for Public Integrity's "Toxic Clout" series on the chemical industry's questionable influence over science has won an award from the Society of Environmental Journalists.

The series won the Kevin Carmody Award for outstanding in-depth reporting from a small-market outlet.

"This year-long investigation convincingly revealed how chemical industry influence and regulatory malaise create uncertainty and delay, putting public health at risk," the judges said.

The series included a story on a prominent public-health scientist at the University of California, Berkeley, who quietly made millions of dollars working for chemical companies without disclosing conflicts. Another story uncovered how scientists with financial conflicts on an EPA peer-review panel delayed a scientific assessment of hexavalent chromium. The story prompted the the agency to reform its peer-review process.

The series also revealed how the American Chemistry Council, the industry's largest lobbying group, routinely seeks to relax regulations in states.  And it showed how Georgia Pacific hired scientists to publish articles that would help the company in litigation, a scheme that a New York appeals court concluded “could have been in furtherance of a fraud.”

The writers were David Heath, Ronnie Greene and Jim Morris.

The Society of Environmental Journalists received 313 entries for seven categories of awards. 

Other winners included the Seattle Times for a series on the acidification of the oceans, the Miami Herald and Chemical & Engineering News for beat reporting, Environmental Health News for feature reporting, the National Geographic for photography, and Dan Fagan for his book on a cancer cluster in Toms River, N.J.

Moneyed nonprofits and super PACs so often peddle political poison, sending sorties of negative advertisements straight at a preferredcandidate's opponent. The candidate's own campaign, in turn, stays positive.

But the script is flipped in Kansas, where groups attempting to save the political career of Republican Sen. Pat Roberts have invested big money in warm fuzzies designed to repel a primary challenge from tea party-backed upstart Milton Wolf.

Together, three political committees — sponsored by the American Hospital Association, American College of Radiology Association and National Rifle Association — have collectively spent $337,000 on ads and other messaging that promote Roberts, a Center for Public Integrity review of federal filings through Monday indicates.

Meanwhile, these groups, which are each headquartered in or near Washington, D.C., haven't spent a cent on messages that attack Wolf ahead of tonight'sprimaryvote.

Why? Success, perhaps. This positivity strategy mirrors one that worked perfectly for another embattled career politician —Sen. Thad Cochran, R-Miss., who edged tea party favorite Chris McDaniel in an otherwise nasty GOP primary runoff.

Super PACs and nonprofits backing Wolf, for their part, have been overwhelmingly nasty in their pitches to Kansans.

Of the $809,000 they've collectively spent, $588,000 of it — about 73 percent — has funded ads that expressly attack Roberts, federal records show.

Virginia-based Senate Conservatives Action, the super PAC arm of the Senate Conservatives Fund — a group founded by Heritage Foundation president and former U.S. Sen. Jim DeMint — accounts for about $499,000 worth of these negative ads, which paint Roberts as an out-of-touch back bencher. The Georgia-based Tea Party Patriots Citizens Fund accounts for the rest of the anti-Roberts ad spending.

The only negative ads to target Wolf are sponsored by the Roberts' campaign itself.

They include a recent television spot that pans Wolf, a radiologist by trade, for posting X-rays of his patients on Facebook and facing an investigation by Kansas' medical board. (The American College of Radiology has shunned Wolf in favor of Roberts, although that's probably more a function of Roberts' perch on the Senate's Health, Education, Labor, and Pensions Committee.)

"Unfit. Not trusted. Not right for Kansas," the ad's narrator declares.

Another ad chides Wolf for missing votes.

Roberts' own negative ad spending likely arises from his lack of air cover from super PACs and nonprofits: Outside groups supporting Roberts have spent about 41 cents for every dollar spent by groups supporting Wolf or bashing Roberts, federal records indicate.

But when the money the candidates themselves raised for their primary campaigns through mid-July is added to the money spent by supportive outside groups, the power of incumbency — and the cash that typically comes with it — is revealed.

Team Roberts controlled about $4.8 million, while Team Wolf controlled just $1.82 million.

Ben Wieder contributed to this report.

Susan Swithers is no stranger to food industry criticism.

In fact, the Purdue University professor anticipates a swift public relations blitz from trade groups representing diet- and low-calorie food companies every time she publishes a study about the health effects of artificial sweeteners.

“They reflexively put out a press release that spins it as, ‘Here’s what’s wrong with the study,’” says Swithers, a professor of behavioral neuroscience who has been researching artificial sweeteners for the past decade. “I’m sure I’m on somebody’s Google Alert at this point.”

Still, even Swithers was surprised by the way in which the diet food industry attacked a paper she published last summer that raised health concerns about popular sugar substitutes used in snack foods and diet drinks. In her widely publicized work, published as an opinion article in the journal Trends in Endocrinology and Metabolism, Swithers reviewed recent studies on artificial sweeteners and concluded that people who frequently consume sugar substitutes “may … be at increased risk of excessive weight gain, metabolic syndrome, type 2 diabetes, and cardiovascular disease.”

Seizing on the “opinion” tag, the food and beverage industry responded quickly. The American Beverage Association, for example, dismissed the paper’s findings, arguing that it was “not a scientific study.”

But perhaps the strongest, most wide-ranging attacks came from the Calorie Control Council, a lesser-known industry group with an innocuous-sounding name, a long history and a penchant for stealthy public relations tactics. The organization, which is run by an account executive with a global management and public relations firm, represents the low- and reduced-calorie food and beverage industry. But it functions more like an industry front group than a trade association.

In criticizing Swithers, the Council relied on industry-funded scientists, bloggers and dietitians — it even wrote a letter to the professor’s university demanding that the school stop promoting “biased science.”

“The intimidation tactics, going to somebody’s employer, it just seems to go beyond the realm of what’s reasonable,” says Swithers, who disputes the “opinion” critiques by noting that her paper was peer-reviewed and based on her assessment of recent scientific studies conducted about artificial sweeteners. “But I guess that’s par for the course in their world.”

Indeed, tracking the Calorie Control Council’s efforts to discredit Swithers’ paper on artificial sweeteners provides a lesson in how the food and beverage industry will go to great lengths — and often use questionable tactics — to protect its interests. With a brand new artificial sweetener about to hit the market, and with the science still unclear about the safety of sugar substitutes, industry’s efforts to discredit science unfavorable to their interests are unlikely to end anytime soon.

“This isn’t personal,” Swithers acknowledges. “This is about somebody’s bottom line."

Uncertain science

The global market for artificial sweeteners is expected to reach $2 billion by 2020. Fueled by weight-loss campaigns that promote low-calorie diets, sugar substitutes like aspartame (NutraSweet, Equal) and sucralose (Splenda) have become increasingly popular as consumers seek to shed calories without giving up sweet foods and beverages.

Artificial sweeteners are considered safe food additives by the U.S. Food and Drug Administration. To date, the federal agency has approved six “high-intensity” sweeteners to be used in products like soft drinks, baked goods and chewing gum. Advantame, a powerful sweetener 20,000 times sweeter than table sugar, was approved by the federal agency in May.

“All of the approved high-intensity sweeteners have been thoroughly studied and have a reasonable certainty of no harm to consumers under their approved conditions of use,” FDA spokeswoman Theresa Eisenman wrote in an emailed response to questions.

But while many studies — some funded by the food industry — have concluded that artificial sweeteners are safe additives that can help people lose weight, others have associated them with short- and long-term health problems, including weight gain, diabetes, cardiovascular disease — even cancer. The conflicting studies have sparked seemingly endless debate among scientists, health professionals and consumers.

Walter Willett, chair of the department of nutrition at Harvard School of Public Health, says artificial sweeteners should be used like a nicotine patch to help wean people off of sugary foods and beverages that are more clearly tied to weight gain and diabetes. But when it comes to long-term health effects, he says, “There is some element of unknown in most of the artificial sweeteners.”

“Industry will of course say, ‘This has been approved by the FDA and tested,’” says Willett, who was the target of industry criticism for a 2012 study he co-authored that raised the possibility that aspartame could be linked to cancer. “But I think the public needs to be aware that this is not absolute evidence of safety."

Industry attacks

If the public had any fears about the safety of the artificial sweeteners, Swithers’ paper only added to them. That’s probably why the Calorie Control Council acted so swiftly —and strongly — when the scientist’s conclusions made national headlines.

“Today an opinion article published in the journal Trends in Endocrinology & Metabolism claimed to review ‘surprising evidence on the negative impact of artificial sweeteners,’” Beth Hubrich, the Council’s executive director, wrote in a blog post on Council-run website TheSkinnyOnLowCal.org. “But what’s really surprising, especially for a scientific journal, was the lack of sound data to back up the author’s highly speculative assertions.”

Hubrich quoted from a Council press release citing John Fernstrom, a professor of psychiatry and pharmacology at the University of Pittsburgh School of Medicine, who expressed skepticism about Swithers’ conclusions.

“Dr. Swithers largely fails to point out that many intervention studies have been conducted over the past few decades, and uniformly show that when artificial sweeteners are introduced into the diet … fewer sugars and calories are ingested, and body fat content and body weight are reduced,” Fernstrom said. “So, artificial sweeteners by themselves do not make people fat (or diabetic).”

Not mentioned is that Fernstrom is a scientific consultant for Ajinomoto, a Japanese food and chemical company that makes aspartame. Nor did the Council’s press release mention that he and his wife, Madelyn Fernstrom, a professor of psychiatry, epidemiology and surgery at the University of Pittsburgh School of Medicine, have ties to industry groups. 

John Fernstrom is the scientific advisor to the Committee on Low-Calorie Sweeteners, whose members include Ajinomoto, Coca-Cola and PepsiCo. His wife, who is the diet and nutrition editor for the NBC Today show, is on the board of trustees for the International Food Information Council Foundation, which has been labeled an industry front group by public health advocates.

In May, Madelyn Fernstrom appeared on a Today show segment to talk about sugars and artificial sweeteners. During the segment, she noted that low-calorie sweeteners were recognized as safe by the FDA, and she cited a just-released study that found that drinking diet beverages containing artificial sweeteners might help people lose more weight than drinking water.

The Today show’s nutrition editor did not mention to viewers that the study was funded entirely by the American Beverage Association and that two of the study’s authors received consulting fees from Coca-Cola. She also did not mention her husband’s ties to the manufacturer of aspartame.

John Fernstrom told the Center for Public Integrity that his industry ties have “no impact on my work.” He says the most reliable scientific studies show that sugar substitutes are safe, and he notes that “some of the best research is done” by industry.

Fernstrom says companies have a strong incentive to thoroughly test their products to make sure they are safe. Otherwise, if they turn out to be harmful to consumers, “you’re out of business,” he says. “Industry is not the enemy.”

A University of Pittsburgh Medical Center spokeswoman for Madelyn Fernstrom did not respond to requests for comment by press time.

Megan Kopf, a spokeswoman for NBC, issued a statement: “We take disclosure issues seriously and are currently looking into this.  Madelyn has been a long-time contributor to NBC News and has always reported with integrity.”

Not only did the Council attack Swithers’ paper from the perspective of a scientist, but it also criticized it from the perspective of the everyday mom. Blogging at ILoveDietSoda.com, Council writer “Jenni PS” — a “busy woman” who gets through the day thanks to “the little things, like a can of diet soda” —lamented “another ridiculous opinion piece about the ‘downsides’ of low-calorie sweeteners.”

Council consultant Robyn Flipse, a dietitian who also represents food companies like Splenda, Coca-Cola and Kraft Foods, took to the comments section of an NPR story to critique Swithers’ paper. “Low calorie sweeteners are not making us fat or sick,” Flipse wrote in a lengthy comment. “Inactivity, excess calories and unbalanced food choices are.”

In an interview, Flipse told the Center that her ties to industry, including the Council, have no influence on her work. “I’m never told what to say,” she says, adding that she tries to help correct misinformation spread online and in the media about artificial sweeteners. Talking points “are not fed to me,” and she says the Council never tells her where or when to comment.

Perhaps the most brazen of all the Council’s attacks was its formal letter to Purdue University.

“The Council has serious concerns with the University’s actions in promoting Dr. Swithers’ opinion,” Council President Haley Curtis Stevens wrote to Purdue’s assistant vice president of marketing, noting that the paper “ignored decades of research affirming the safety of low-calorie sweeteners.”

“Promoting biased science, we feel, is not acting in the best interest of public health,” she wrote.

Amy Patterson Neubert, a Purdue spokeswoman, wrote in an email to the Center that the university has always supported Swithers' work. "Even a year after the publication of her peer-reviewed opinion piece," she wrote, "she still receives requests for interviews, which we help facilitate."

The Council's letter to Purdue was followed by more criticism from yet another industry ally. 

In response to the Purdue professor’s conclusions, two scientists from Baylor College of Medicine — Craig A. Johnston and John Foreyt — submitted a letter to Trends in Endocrinology and Metabolism, the journal that published Swithers’ paper.

In their letter published online, the authors called Swithers’ paper “highly selective, misleading, and biased” and noted that artificial sweeteners “are safe and provide individuals seeking to lose or maintain weight a healthy alternative to help to decrease caloric consumption.”

But the authors did not submit a conflict of interest statement with their letter. Only after the journal posted the letter online did editors learn that Foreyt had ties to industry. A spokeswoman for the journal confirmed that editors contacted the authors asking them to submit a disclosure statement to be published in the journal’s print edition.

“Dr. John P. Foreyt received grants, honoraria, donations, and consulting fees from numerous food, beverage, and pharmaceutical companies, as well as other commercial and nonprofit entities with interests in obesity,” the conflict of interest statement read. “He has served and is currently serving as a board member for multiple food, beverage, and pharmaceutical companies.”

Foreyt is listed on a Council website as an advisor to the trade group, but Dipali Pathak, a spokeswoman for Baylor College of Medicine, wrote in an email to the Center that “he has not worked with them for years.”

As for the authors’ omitted disclosure statement, she wrote, Foreyt and Johnston “were not asked to disclose any information on ties to the industry. Once the editor asked them to disclose this, they sent the information and the letter was republished with this information.”

Trade association or front group?

The Calorie Control Council, established in 1966, isn’t your typical trade association. For one thing, it’s run by Kellen Company, a global management and public relations firm. Stevens, the Council’s president, is an account executive at the PR firm.

Unlike other trade associations, including the International Sweeteners Association and the American Beverage Association, the Council does not publicly list its members. Nor does its website reveal its board of directors, which can be found on the trade group’s annual tax documents.

According to the Council’s 2012 tax filing, the board  includes officials from soda companies like Coca-Cola and PepsiCo, as well as artificial sweetener manufacturers like Ajinomoto and Merisant Company.

The Council orchestrated its first major public relations campaign in 1977. In response to an FDA proposal to ban the first artificial sweetener —saccharin — after studies linked it to cancer in rats, the industry group took out full-page advertisements in national newspapers discrediting the science behind the proposed ban. The ads encouraged readers to contact government officials and “let them know that you support postponement of a ban” until further studies on saccharin were completed.

The Council’s “media campaign was phenomenally effective at mobilizing consumers of artificial sweeteners for political action,” Carolyn de la Pena, a professor of American studies at the University of California at Davis, wrote in her 2010 book “Empty Pleasures: The Story of Artificial Sweeteners from Saccharin to Splenda.”

The ban on saccharin was never implemented, and the food additive remains on the market today.

Despite playing an integral role in helping save saccharin, de la Pena says the Calorie Control Council never became a household name. Nor did it become widely known during the debate over aspartame.

The Calorie Control Council was “the invisible force behind the approval of aspartame,” she says.

Today, most Americans have probably never heard of the Council, but they may have come across a website run by the trade group — without realizing that it’s controlled by industry.

The Council operates a number of industry-friendly websites, including aspartame.org, sucralose.org and saccharin.org. None of the sites disclose that the Council represents companies that make low-calorie, reduced-fat foods.

On the aspartame site, for example, the Calorie Control Council only describes itself — in small print at the bottom of the home page — as a “non-profit association” that “seeks to provide an objective channel of scientific-based communications about low-calorie foods and beverages, to assure that scientific and consumer research and information is made available to all interested parties.”

Government posts industry sites

Even the government has  fed into the impression that the Council is an independent source of information about artificial sweeteners. Type “FDA and artificial sweeteners” into Google, and the top search result is a webpage run by the U.S. Department of Agriculture. The page about sweeteners includes two links to Council-run webpages, including one called the “Aspartame Information Center.”

In an emailed statement, Stevens indicated that the Calorie Control Council clearly states on its “About” page on its CalorieControl.org website that the group represents “the low- and reduced-calorie food and beverage industry.”

But the description of the organization is not included on all of the other websites the Council runs.

In her statement, Stevens wrote that artificial sweeteners “can be important tools for people who wish to manage their carbohydrate and/or caloric intake.” Without directly mentioning Swithers, she also defended the Council’s response to the Purdue scientist’s paper.

“When studies do not meet certain acceptable scientific criteria, including peer review, reproducibility, and study design quality,” Stevens wrote, “the Council addresses those studies through thoughtful outreach to relevant parties.”

Public health advocates critical of food industry influence say the Calorie Control Council’s public relations strategy, as evidenced by its attempts to discredit Swithers’ paper, follows a well-established industry playbook: “Attack the science, recruit sympathetic scientists, do public relations, and then do everything possible behind the scenes to protect the industry,” says Marion Nestle, a professor of nutrition, food studies and public health at New York University.

Michele Simon, a public health lawyer who has written a guide to food industry front groups, says the Council operates “mostly under the radar, which is part of what makes them effective.”

But despite being relatively unknown, she adds, “the fact that they’ve been able to create confusion and doubt over the studies that question the safety of artificial sweeteners means they are highly effective."

A new federal study shows that many Medicare Advantage health plans routinely overbill the government for treating elderly patients — and have gotten away with doing it for years.

Analyzing government data never before made public, Department of Health and Human Services researchers found that many plans exaggerate how sick their patients are and how much they cost to treat. Medicare expects to pay the privately run plans — an alternative to traditional Medicare — some $160 billion this year.

The HHS study does not directly accuse any insurers of wrongdoing or name specific plans that were scrutinized. But the researchers offer the most comprehensive evidence to date that suspect billing practices have been common across much of the Medicare Advantage industry and are likely to get worse unless officials crack down.

“Further policy changes will likely be necessary,” the study concludes.

Congress created Medicare Advantage in 2003 to encourage private insurance companies to venture into the senior care market, and has remained supportive of the concept. The plans now insure some 16 million elderly and disabled people, nearly a third of those eligible for Medicare. They are popular with seniors because they often provide extra benefits, such as eyeglasses and dental care, and can cost less out-of-pocket than standard Medicare.

Medicare pays the Advantage health plans higher rates for sicker patients and less for healthy people using a complex formula called a “risk score.” But the HHS study spells out several ways health plans have inflated those scores, from reporting implausibly high levels of medical conditions such as alcohol or drug dependence to billing for an inordinately high number of patients with complications of diabetes.

Despite its broad implications for Medicare spending, the study by HHS researchers Richard Kronick and W. Pete Welch has attracted scant notice in Washington. It was quietly posted late last month on an online research site run by the Centers for Medicare and Medicaid Services, part of HHS.

Kronick directs the HHS Agency for Healthcare Research and Quality, whose mission is to improve health care delivery. Welch works for the HHS Office of the Assistant Secretary for Planning and Evaluation. The authors note that the study does not necessarily reflect HHS views, but both offices are influential in advising the government on policy matters.

CMS officials declined comment.  

“This is clearly impacting what taxpayers are paying for Medicare Advantage, I think, not in a good way,” said Dr. David Wennberg, a researcher at the Dartmouth Institute for Health Policy and Clinical Practice who has studied Medicare billing trends.

Health care fraud expert Malcolm Sparrow, a professor at Harvard’s Kennedy School of Government, said the problems with billings based on risk scores reveal how “financial incentives” can improperly influence how medicine is practiced.

“The problem seems significant,” he said.

The new study amplifies the findings of a Center for Public Integrity investigation published in June. The investigation found that Medicare made nearly $70 billion in “improper” payments — mostly overcharges from inflated risk scores — to Medicare Advantage plans from 2008 through 2013 alone. The Center’s investigation also found that risk scores rose much faster in some health plans than others and that federal officials repeatedly yielded to industry pressure to minimize efforts to recoup overpayments.

Medicare Advantage plans are paid a set monthly fee for each patient based on the risk scores and the government largely trusts the health plans to report the health status of people they enroll. About 70 medical conditions can boost payment rates.

Clare Krusing, a spokeswoman for America’s Health Insurance Plans, the industry’s trade group, said the higher billing resulted from health plans working with patients “to understand their specific health conditions, and consequently make sure they get the care they need.”

“What was not highlighted (in the study) is the fact that these programs have demonstrated improved quality in patients’ health,” she wrote in an email.

However, the study concludes that people who join Medicare Advantage plans are healthier than those who remain on standard Medicare, in which doctors and hospitals are paid individually for each service they provide. The study also says it’s “unlikely” that the higher payments health plans derive from diagnosing more medical conditions “are related to substantial health benefits.”

In short, the numbers of patients diagnosed with diseases which result in higher payments increased far faster at many Medicare Advantage health plans than among people on standard Medicare. Exaggerating the severity of a medical condition to jack up fees is known in medical circles as “upcoding.”

For instance, “drug and alcohol dependence” is as much as eight times more common in the highest coding Medicare Advantage plans than among patients in standard Medicare.

Even more striking, according to the study, is how much higher reported diabetes rates have been in certain health plans than others. The study tracked rapid rises in many medical conditions from 2004, when risk scoring began, up to last year, and made them public for the first time.

Overall, diabetes with serious complications, which pays higher rates, was reported as much as five times more often among some Medicare Advantage plans than among people on standard Medicare. Conditions such as major depression also were far more common in some plans than others.

Holly J. Cassano, a medical coding consultant in Florida, said that the government’s decision to make the billing data public was “an enormous leap … in the right direction for continued transparency in all areas of health care.”

 “The main issue, now that it has been revealed, is ‘upcoding’, which no one likes to discuss, but the data is in black and white and speaks volumes,” Cassano, CEO of Accucode Consulting, wrote in an email.

Medicare Advantage enjoys solid political backing on Capitol Hill and has successfully fought back efforts by the Obama administration to make substantial cuts to its payment rates. Lobbying by the insurance industry and the fear of angering seniors also has largely quieted concerns in Congress that Medicare Advantage plans can be a poor value for taxpayers.

Congress recognized problems with Medicare Advantage coding as far back as 2005, when lawmakers directed CMS to find ways to cut back on rising, and presumably unjustified, risk scores. But CMS didn’t act until 2010, when it adjusted risk scores downward. The Affordable Care Act theoretically requires further reductions, but the political storm over the planned cuts has made their ultimate fate uncertain.  

CMS has cut back payments levels for several diseases that appear to have prompted upcoding by Medicare Advantage plans. But the study’s authors noted that health plans are likely to find new conditions to replace lost revenue.

The study does not name any of the plans examined except to say that all had at least 10,000 members and that one plan among the highest billers had more than 200,000 members. The study does indicate that the longer patients stay in Medicare Advantage, the more their risk scores rose, suggesting that government’s failure to reel in coding has been costly.

The Center for Public Integrity has sought similar billing data from CMS for the past year as well as the names of Medicare Advantage plans that have been suspected of overbilling the government — and by how much. In late May, the Center sued the Department of Health and Human Services to make its Medicare Advantage audits and other related records public. The lawsuit is pending.

Last month, CMS published a draft regulation that would allow for “a formal process to recoup overpayments” made to the health plans. A final decision on the proposal is due by November 1.

Twelve million Americans would be killed outright and 60 million would be dead within a year. The federal government, with the exception of the vice president and perhaps one cabinet member, would be wiped out. Citizens would be dependent on bartering for up to a year. Widespread fires would destroy 169,000 square miles of land, a larger area than the state of California. A lethal blanket of radiation would cover up to half the nation for weeks.

There would be 41 million immediate deaths in the Soviet Union and more than 100 million people dead after one month. The Gross National Product in the USSR would be reduced by 75 percent, the government would be almost completely destroyed, there would be severe transportation problems, and medical supplies would be scarce. 

This was the official, predicted outcome of a nuclear war between the United States and Soviet Union in the late 1950s, at a time when the U.S. military already had more than 7,000 nuclear warheads and was busily expanding its arsenal at the pace of nearly 20 new bombs a day. The grim estimate, although briefed to President Eisenhower in 1958, was kept secret by the government for more than half a century. 

It was posted online in late July by the National Security Archive, a nonprofit historical research group affiliated with George Washington University, along with other previously classified documents about nuclear weapons briefings and communications involving top security officials. The Archive first requested release of some of the documents in 1993 and had to submit at least five appeals, according to William Burr, a senior analyst there who directs its nuclear history documentation project. 

Official estimates of how much death and destruction would result from a major nuclear conflict were prepared annually for the president from 1957 through 1963 by a group called the Net Evaluation Subcommittee, a panel attached to the White House National Security Council and composed mainly of top military and CIA officials. But the panel’s existence, as well as its product, was long kept secret. 

Notes on the 1961 briefing, one of the documents published online by the Archive, stated that “The President directed that no member in attendance at the meeting disclose even the subject of the meeting.” According to the president’s daily schedule for July 20, 1961, the briefing date, 44 people attended. There were, however, leaks about the meeting in the press, according to Burr. So the next year, according to a memorandum to the chairman of the subcommittee, only 11 people attended the briefing.

“They just wanted to keep it highly, highly secret, highly classified because they were really afraid of information about this getting out to the public,” Burr said. 

A majority of the group's reports expressed optimism that the United States would essentially "win" a nuclear war with the Soviets because fewer U.S. citizens would die and there would be less damage to its infrastructure.  

The 1958 report by the Net Evaluation Subcommittee, for example, predicted more than 50 million Americans would die, nearly a third of the population, while more than 100 million Soviet Union citizens would die, more than half of the population. It nonetheless tried to look on the bright side, suggesting that “the balance of strength would be on the side of the United States” after the nuclear war, and that “the survival of the United States as a nation appears highly probable.”

“The idea is who dies a little bit less than the other guy,” said Alex Wellerstein, a nuclear weapons historian at the Stevens Institute of Technology, the author of “Restricted Data: The Nuclear Secrecy Blog,” and a former instructor at Harvard and Georgetown universities. “It’s about comparative destruction, where ‘Okay, we lose this many people but don’t worry, they lose a lot more’ right? You should have seen the other guy. Which is such a weird way to think about the value of war in general. We might lose a third of our population but he’ll lose half of his. Great, we win.”

“This is the kind of analysis that was used at the time to justify a massive, massive, massive arsenal, this feeling of always being behind, or feeling like things could always be better for the U.S. if they had more than the Soviets," Wellerstein added.

In some respects, the reports overestimated the impact of a nuclear exchange based on an exaggerated notion of the size of the Soviet nuclear arsenal then. The 1958 subcommittee report predicted a 1961 attack would include the detonation of 234 warheads carried to American soil on Russian ballistic missiles, yet experts now say  the USSR had only 10 such missiles in 1961.

In any event, the panel’s final report in 1963, a year before it was disbanded, did not reaffirm its earlier optimism, or predict a relative victory for the United States. It said, “Neither the U.S. nor the USSR can emerge from a full nuclear exchange without suffering very severe damage and high casualties. This holds true whether the attack is initiated by the U.S. or the USSR.”

This analysis was a “more realistic assessment of the consequences of war at that time,” according to Martin Sherwin, a history professor at George Mason University who focuses on cold war politics and nuclear history.

The secretive subcommittee was disbanded in 1964, after Lyndon Johnson became president, when the process of estimating the consequences of a major nuclear exchange was removed from the White House and placed directly under Pentagon control. 

Defense Secretary Robert McNamara wrote in a Dec. 1964 memo to other senior officials that while the subcommittee’s annual reports were useful in 1958, “its contribution today is marginal when compared to the battery of specific studies which have become major functions of the [Joint Chiefs of Staff] and DOD during the intervening years.” 

If you ask anyone at the Center for Public Integrity, they'll tell you 2014 has so far been a busy year. Our staffcontinuesto grow, we received one of the biggest single grants in our history and our reporting was recognized with more awards than in any year before. This year also marks the 25th Anniversary since our founder Charles Lewis started the Center from his guest bedroom. 

But we still have a lot of work ahead. We have big investigations brewing on outside spending in state elections, the state of global nuclear security and municipal broadband. You can also expect more from our ongoing reporting on health effects of fracking, policy-making around at-risk youth and the many misleading ways special interests push an agenda in Washington. 

Until then, we wanted to review some of the top findings from our investigations so far this year. They reveal shortcomings in all three branches of government, on the federal and state level. 

1. Twelve universities took $100,000 or more in Koch foundation grants in 2012

Is your alma mater part of Koch Brothers Academy? Billionaire industrialists David and Charles Koch may rank among the nation’s biggest bankrollers of conservative causes and Republican campaign vehicles. But Koch ideals of government deregulation and pro-business civics have been increasingly targeted not just at creatures of Capitol Hill, or people watching TV in swing states, but at the hearts and minds of American college students, as well. Keep reading

2. When financial lobbyists disagree with tougher rules, they turn to these 11 lawmakers

Meet the Banking Caucus. They're all on the House Financial Services Committee, they get massive financial support from the industry and some have even been a part of the industry themselves — they're the financial industry’s proxy voices on Capitol Hill. Keep reading

3. Japan has no urgent plutonium needs, but a new plant will soon make more than 17,000 pounds of it each year

Starting this October, a Japanese nuclear fuel plant 22 years in the making will begin churning out a nuclear chemical that will eventually become an energy source for the country. But the key word there is, eventually. Japan can't currently convert the explosive nuclear component. With that kind of expected output, and a leak-detection system that is about 99 percent accurate, enough plutonium for 26 nuclear bombs could theoretically be removed without a trace.Keep reading

4. With no access to counsel, teens sent to jail for minor offenses like truancy, curfew violation, having tobacco

This is Judge Tim Irwin of Tennessee. As a juvenile court judge, he is admired for kind gestures like handing out stuffed animals to small children in court. Judge Irwin, however, doesn't allow pro bono lawyers to offer free representation to teens accused of committing non-criminal offenses. Because these minor status offenses aren't crimes, kids have no constitutional right to appointed legal counsel before they plead guilty. It's a technicality that has proved life-changing for some teens, especially when coupled with Tennessee's vigorous pattern of locking up status offenders immediately after proceedings. In one case, Judge Irwin abruptly detained a 15-year-old girl with crippling anxiety — for truancy. After her overnight lockup, her parents ignored orders to take her to school. She had become suicidal, and spent the following week in a psychiatric hospital. Keep reading

5. “I believe if you're anti-oil and gas, you're anti-Texas”

That's what Texas State Rep. Harvey Hilderbran had to say in reference to one of America's biggest energy booms, the Lone Star State's Eagle Ford Shale. But as wells are drilled at an unprecedented rate, local residents fear for their health — not from the water, but from the air they breathe. We wanted to know what, if anything, Texas was doing to monitor the potential health effects of residents who live near drilling sites. What did we find? Thousands of Texas oil and gas facilities are allowed to self-audit emissions without reporting to the state. Keep reading

6. About a third of all people on Medicare are covered by health plans that are susceptible to billing abuse

Americans 65 and older are either sicker than medical experts can explain, or health insurance plans are simply claiming they are. Our investigation into Medicare Advantage found that billions of tax dollars are wasted every year through leakage of a Medicare payment tool called a “risk score.” The formula is supposed to pay health plans more for sicker patients and less for healthy people, but often it pays too much. Some experts and researchers believe rising risk scores are more likely to reflect aggressive billing than a rapid deterioration in patients’ health. Keep reading

7. Manhattan just another island haven for dirty money

Thanks to lax U.S. rules and real estate industry’s no-questions-asked approach, Manhattan has become America’s own island haven for shady characters from overseas looking to funnel their wealth through New York’s luxury real estate. Keep reading

8. Sixteen high court judges ruled in 26 cases despite having a financial conflict

More than half of federal appellate judges, arbiters of the second-highest court in the U.S., reported owning stock in 2012. We wondered how judges were keeping track of their holdings when cases involved a company they'd invested in — some weren't keeping track. Four cases have been reopened in the time since this investigation was published. Keep reading

9. Only 12% of eligible households have signed up for Comcast's affordable Internet program

Back in 2011, Comcast wanted to ease federal approval of its merger with NBC Universal, so it promised to offer Internet access at a rate affordable to low-income families. The program, called "Internet Essentials," helped show regulators that Comcast's corporate deal was in the public interest (and it made for good public relations, too). Now Comcast wants to buy Time Warner, and this new merger begs the question — what happened to Internet Essentials? There are 7.2 million low-income people in Comcast's service area, of those, only 2.6 million have a child who is eligible for the federal school lunch program (one of the program's many requirements). Of those, only 300,000 participants have signed up for the program. Keep reading

10. Arsenic is 17 times more potent than the EPA reports, and they've known it since 2008

It's no secret that arsenic is bad for you. A person drinking the legal limit of arsenic daily (it occurs naturally in groundwater) has a much greater risk of developing cancer from arsenic than from any other toxin — 60 times greater, to be precise. So, why isn't the EPA's drinking-water standard for arsenic lower? For six years, the EPA has been prepared to say that arsenic is more carcinogenic than they currently report. The holdup comes from government backlog and industry sway, but ultimately, we connected the regulatory delay to a single paragraph inserted into a committee report by Idaho Rep. Mike Simpson. Keep reading

For years, the chemical industry has been winning a political battle to keep formaldehyde from being declared a known carcinogen.

The industry’s chief lobby group, the American Chemistry Council, has persuaded members of Congress that the findings of both the Environmental Protection Agency and the Department of Health and Human Services were wrong and should be reviewed by the National Academy of Sciences.

In 2011, the academy did indeed criticize the EPA’s report on formaldehyde for being unclear. The chemical industry then used that critique to delay dozens of other ongoing evaluations of potentially toxic chemicals.

But on Friday, the academy issued a second report, which found in effect that government scientists were right all along when they concluded that formaldehyde can cause three rare forms of cancer.

“We are perplexed as to why today’s report differs so greatly from the 2011” report, Cal Dooley, president and chief executive officer of the American Chemistry Council, said in a statement titled “The Safety of Formaldehyde is Well-Studied and Supported by Robust Science.”

Part of the disparity is that in the 2011 report, Congress asked the academy only to critique the EPA’s draft assessment rather than evaluate the dangers of formaldehyde itself. The panel concluded that the EPA’s report was too long, repetitive and lacked explanation.

But after reviewing the scientific evidence itself, the academy concluded on Friday that formaldehyde is indeed a known carcinogen.

Formaldehyde is widely used in wood products and clothing.

In a blog posting, Jennifer Sass, a scientist at the Natural Resources Defense Council, called the American Chemistry Council’s efforts “a vicious attack on government scientific assessments [meant] to distort and discredit any evidence linking toxic chemicals to diseases, disabilities or death.”

Using the academy to review any negative findings from the EPA has become common tactic of the chemical industry.

The Center for Public Integrity reported in June that Rep. Mike Simpson, a Republican from Idaho, got the EPA to turn its negative assessment of arsenic over to the academy. At the same time, Congress also insisted that the EPA redo all ongoing assessments to address the criticisms of the 2011 formaldehyde review. Forty-seven assessments are affected.

The American Chemistry Council said in its statement that the academy “misses an opportunity to advance the science.”

Richard Denison, a scientist at the Environmental Defense Fund, countered: “One can only hope that this sorry episode and waste of public resources will help to expose the narrow self-interest of the industry, which for years it has deceptively sought to wrap in the mantle of sound science.”

Among the many predictions of Obamacare-related catastrophe was that the law, by enabling millions to join the ranks of the insured, would force us all to wait longer to see a doctor and very possibly lead to a code blue for U.S. health care.

“Doctor shortage, increased demand could crash health care system,” A CNN report warned last October.

A few months earlier, a Forbes headline predicted that, “Thanks to Obamacare, a 20,000 Doctor Shortage Is Set to Quintuple.”

“America is suffering from a doctor shortage,” wrote Forbes blogger Sally Pipes, president of the Koch brothers-funded Pacific Research Institute, a think tank advocating “personal responsibility” and “free-market policy solutions.” “An influx of millions of new patients into the healthcare system will only exacerbate that shortage — driving up the demand for care without doing anything about its supply.”

Pipes cited numbers from a 2010 analysis conducted by the Association of American Medical Colleges. But unlike Pipes’ organization, which says the Affordable Care Act should be repealed, the AAMC called the law’s expansion of coverage “long overdue.” The doctor shortage would be alleviated, the AAMC says, if rather then repealing Obamacare, Congress would lift a freeze in Medicare’s support for physician-training positions that has been in effect since 1997.

It’s true that the number of doctors per capita in the U.S. likely will continue to decrease, especially in rural areas. But even though an estimated 13 million Americans have become newly insured since the first of this year, the predictions of the gloom-and-doomers have not panned out.

To find out if the critics’ were prescient or way off base, Kaiser Health News reporter Phil Galewitz went looking for problems. He didn’t find many. “Five months into the biggest expansion of health coverage in 50 years,” he wrote after interviewing officials from more than two dozen health centers and multi-group practices across the country, “there are few reports of patients facing major delays getting care.”

One reason the system has not been overwhelmed is that, although we might not have as many doctors as some think we should have, we do have a rapidly growing supply of mid-level medical providers — like physician assistants and nurse practitioners — who now treat many of our health problems. It probably won’t be long before most of us are treated — and treated just fine — by a well-trained professional who doesn’t have an M.D. after his or her name.

A couple of weeks ago, I sustained an injury that my wife felt was serious enough that I should either go to the ER or see my doctor. When I called my doctor’s office, I was told that while the doctor was on vacation, a nurse practitioner could see me right away. And she did. And I lived to tell about it.

I had no misgivings. When I was at Cigna, many of my colleagues and I were treated by one of the nurse practitioners who staffed the company clinic. I went years without going to a doctor. The nurse practititoner not only was able to take care of any problems I had, she also was able to prescribe medications.

Thousands of nurse practitioners and physician assistants are joining the medical work force every year. According to the Bureau of Labor Statistics, physician assistants — who can do anything from physical exams to ordering lab tests — are among the fastest-growing professions in the country. An estimated 90,000 PAs are already seeing patients, and that number is expected to increase 38 percent by 2022.

One of the reasons for this growth is the roles they are now playing as part of patient-centered medical homes and accountable care organizations, both encouraged by the Affordable Care Act, to help coordinate patient care more efficiently. They are becoming an accepted and welcome part of the medical team, even by physicians.

Other mid-levels are also joining those medical teams in growing numbers. According to a recent study by the Brookings Institution, workers with less than a bachelor’s degree now account for nearly half of the total health care workforce in the country’s 100 largest metro areas. They include licensed practical nurses, personal care aides, and even registered nurses, although most RNs now have bachelor’s degrees. The Department of Labor predicts that an additional 3 million pre-baccalaureate health care professionals will join the medical workforce by 2022.

In the not too distant future, expect to see mid-levels in your dentist’s office too. Three states—Alaska, Minnesota and Maine—are the first to license dental health care therapists, who can and will help make up for a growing shortage of dentists.

So while we might not be seeing our doctors and dentists as often as we did in the past, we will be finding out that we didn’t really need to see them so often anyway.

Russia’s largest privately held gas producer has turned to a Washington, D.C., public relations firm to lobby the administration and Congress after one of its largest shareholders, an associate of Russian president Vladimir Putin, was targeted for sanctions by the United States.

OAO Novatek, the Moscow-based gas company, in July hired QorvisMSL LLC, which assigned two of its lobbyists to the account, according to a lobbying disclosure statement filed Aug. 11 with the Senate. On its website, Qorvis says it “crafts stories that need to be heard, champions issues that need to be debated, and manages reputations for corporations, governments and individuals.” Among its other clients are Saudi Arabia, Venezuela, Sri Lanka and Bahrain. The news was first reported by the National Journal.

According to the filing, the lobbyists assigned to OAO Novatek’s account are Loretta Prencipe, a former contract communications analyst with the Department of Energy’s Office of Energy Efficiency and Renewable Energy, and Ayal Frank, who spent five years as a staffer for the House of Representatives, including on the House Armed Services Committee for former Rep. Jim Maloney, D-Conn. Prencipe did not comment after being contacted by the Center, while Frank would not respond to questions.

Qorvis did not immediately respond to requests for comment.

One of OAO Novatek’s largest shareholders is Gennady Timchenko, according to Reuters, whose longtime association with Putin goes back to their days as sparring partners in St. Petersburg’s Yawara-Neva judo club. The State Department has termed Timchenko a member of Putin’s “inner circle.” According to Forbes magazine, Timchenko is worth $14.5 billion.

The two lobbyists are targeting a White House executive order, issued March 20, that authorized the Treasury Department to put Timchenko and his companies on the sanctions list, according to the Qorvis filing. The lobbyists will also focus on a bill introduced by Sen. Bob Corker, R-Tenn., that would mandate more punitive measures against Russia and its assets, the filing said.

The U.S. imposed sanctions and other restrictions against Russia earlier this year for that country’s alleged role in the unrest in eastern Ukraine. Timchenko sold his stake in another firm, the Gunvor Group, one of the world’s largest energy traders, on March 19, one day before he was placed under sanctions. In April, fourteen of Timchenko’s other companies were sanctioned by the U.S. Treasury.

On July 17, the U.S. imposed more sanctions against Russian firms, including Timchenko’s Novatek, along with the oil giant Rosneft and one of Russia’s largest banks, Gazprombank.

Twenty months after the mass shooting at Sandy Hook Elementary School in Newtown, Connecticut, some would say little has changed when it comes to guns in America.

Others would say everything has.

Flurries of gun-related legislation and renewed national attention on the topic have not been enough to change federal gun laws. The National Rifle Association, still the most powerful entity in the war over guns in America, no longer has a monopoly on the debate.

A resurgence of the gun control movement is challenging the status quo, while groups to the right of the NRA are also growing. Nonprofit organizations on each side are battling like they haven’t in years, all trying to shape the country’s politics and win over the American people.

But in spite of the evolving landscape, no progress in either direction is certain.

The gun control movement was nearly $285 million behind the gun rights movement in 2012 revenue raised, before Sandy Hook. Today, it is playing catch-up to the money, membership and political savvy of its opponents as the NRA works to maintain its dominance.

Over the course of this year, News21 reporters, videographers and photojournalists traveled across the country to assess the state of the gun debate, its evolution and emerging issues.

With new groups, a revamped strategy, more money and unprecedented collaboration, the gun control movement has made headway. Organizations like Everytown for Gun Safety, the group backed by former New York City Mayor Michael Bloomberg, say they are moving the needle.

“Now, for the first time in our country’s history, there is a well-financed and formidable force positioned to take on the Washington gun lobby,” said Shannon Watts, founder of gun control group Moms Demand Action for Gun Sense in America, speaking at an Everytown event on Capitol Hill in May.

Whether that is possible remains to be seen.

The NRA is strong financially. Its budget has consistently hovered well above $200 million in revenue in recent years and it has cultivated a highly organized grassroots base for more than a century.

As the gun control movement organized in the wake of Sandy Hook, the gun rights movement’s membership boomed. Groups more conservative than the NRA, like the National Association for Gun Rights, are growing. State legislatures across the country passed laws expanding gun rights. The NRA has focused on broadening its appeal.

The NRA frequently targets Bloomberg, who donated $50 million to Everytown in April, though the amount is a quarter of what the NRA raises each year.

“Mr. Bloomberg, you’re an arrogant hypocrite,” said NRA Institute for Legislative Action Executive Director Chris Cox at the organization’s annual convention in April. “Stay out of our homes, stay out of our refrigerators and stay the hell out of our gun cabinets.”

With its near-mythical presence as a political lobby, the NRA is still the best-positioned player in the debate by far, bringing in and spending hundreds of millions of dollars on its broad range of programs. Though its grip on Congress has loosened somewhat, it still isn’t letting major federal legislation through or relinquishing its influence on state politics.

An amendment expanding background checks came to a vote in the Senate in April 2013, something gun control advocates saw as a victory. It didn’t get enough votes to pass.

The NRA began as a firearms education organization and sportsmen’s club in 1871 and didn’t become involved in politics until the 1970s. When it did, however, it had a built-in base of support. It has worked to build strong ties with members of Congress to back its lobbying and political efforts. Today, the NRA says it has 5 million members.

Around the same time the NRA entered politics, the group that would eventually become the Brady Campaign to Prevent Gun Violence was founded. It attained a high profile following the 1981 assassination attempt on President Ronald Reagan, in which Reagan press secretary James Brady was shot and partially paralyzed.

Its advocacy work in the ‘80s and ‘90s culminated in the passage of the Brady Act -- which mandated federal background checks on people buying firearms -- and the now-expired assault-weapons ban, both signed by President Bill Clinton in 1994.

In 1999, the Columbine High School shooting led to a resurgence of gun control advocacy. Like today’s movement, it had a billionaire benefactor in Monster.com’s Andrew J. McKelvey and a mother-led group, the Million Mom March. After a handful of state legislative victories, the movement fizzled.

This was the landscape when a spate of recent prominent mass shootings began: Virginia Tech in 2007; Tucson, Arizona, in 2011, in which then-Rep. Gabrielle Giffords, D-Ariz., was shot; the Aurora, Colorado, movie theater shooting in 2012; and then, Newtown.

The Sandy Hook shooting touched off for the gun control side what Everytown Director of Strategy and Partnerships Brina Milikowsky called a “once-in-a-generation moment of great transformation.”

The day after the shooting, Watts founded Moms Demand Action; a few weeks later, on the second anniversary of the Tucson shooting, Giffords and her husband, Mark Kelly, started Americans for Responsible Solutions.

In December 2013, Moms Demand Action formed a partnership with Mayors Against Illegal Guns, a group founded in 2006 by Bloomberg and former Boston Mayor Thomas Menino. In April, Everytown became an umbrella organization for the two other groups. Today, Everytown says it has 2 million members.

“Twenty years ago, Brady was the only game in town. And now there’s unprecedented resources and attention being focused on this issue, so we’re not a voice alone in the wilderness anymore,” said Dan Gross, president of the Brady Campaign.

In fact, there is a profusion of gun control groups, including many on the state level.

November’s congressional elections -- the first major election since Sandy Hook -- could provide a barometer for the political gun wars.

Some groups, like Moms Demand Action and the Brady Campaign, say they can now compete with the gun lobby. Others, like Giffords’ ARS, say they want to match the NRA but are still too new to have a comparable budget.

With new strategies, groups like the Coalition to Stop Gun Violence, founded in 1974, think they will “be a force for decades to come,” said Ladd Everitt, the group’s director of communications.

But tax filings show the top six national gun rights groups brought in close to $301 million in revenue in 2012, while six major national gun control nonprofits raised just more than $16 million.

The dollars are hard to track. The most recent tax filings available are from 2012, so they don’t reflect any changes that have occurred since Newtown, including Bloomberg’s $50 million donation to Everytown. Nonprofits are not required to disclose information about their donors.

Because Everytown, Moms Demand Action and Americans for Responsible Solutions are so new, their tax forms are not available yet.

However, when it comes to campaign spending, the political action committees on the two sides are neck-and-neck for 2014.

As of June 30, the NRA PAC had just more than $18 million in receipts and the ARS PAC had almost $17.5 million. ARS had spent nearly $8.5 million; the NRA had spent nearly $2.7 million, according to filings with the Federal Election Commission.

With some groups’ finances remaining a mystery, the numbers are inconclusive. In spite of their claims, gun control groups’ ability to compete financially remains questionable.

“We don’t have as much evidence as people sometimes think we do that you can sort of throw money at your cause and get your way,” said Matt Grossmann, a political science professor at Michigan State University. “In fact, that hardly ever works, especially for advocacy groups.”

Much of the NRA’s power is found in its passionate and faithful membership base.

“Their members are very highly trained in grassroots campaigning, so because of the emotional connection to guns, they are easily activated, and that is certainly a plus on their side,” said Karen Callaghan, a political science professor at Texas Southern University who is writing a book on the NRA.

Their members are loyal and, often, lifelong. For many, the organization offers a mark of identity.

“When the person’s a member of the NRA, most people know what that is. It speaks volumes of how they stand on issues, and it’s respected or hated by almost everybody,” said Brad Leeser, 58, a member of the NRA and Gun Owners of America in Moorhead, Minnesota.

Gun rights voters tend to be single-issue voters, meaning they prioritize gun rights over all other issues. Gun control supporters, on the other hand, tend to be less driven by the one issue.

“People on the other side of the debate, it’s a more diffused group, and so I think they’re disempowered for that reason,” said Kathy Kiely, managing editor of the Sunlight Foundation, a nonpartisan open-government nonprofit.

In July, the NRA started its 2014 “Trigger the Vote” campaign, an effort to get pro-gun voters to register before the November election. When Everytown was founded, it launched a “gun-sense voter” campaign, which aims to get “voters to consider gun-violence prevention as a number-one issue that they vote on,” said Jennifer Hoppe, program director for Moms Demand Action.

“The NRA and the gun lobby have done an amazing job over the last 30 years ... changing hearts and minds at every level up to the Supreme Court,” said Shaun Dakin, a volunteer who works with organizations including Moms Demand Action and the Brady Campaign. “Now the gun-violence-prevention movement has figured that out … Washington, D.C., will change when the culture changes and when they see people actually voting based on any particular issue.”

Building a grassroots effort is part of the gun control movement’s attempt to attract supporters and compete with the NRA.

That was Watts' goal in founding Moms Demand Action, which the Indiana mother of five modeled after Mothers Against Drunk Driving. It became a leading grassroots gun control organization and now has chapters in all 50 states.

“For the first time ever, there is a grassroots group that is going toe-to-toe with the gun lobby. That’s never been the case before,” Watts said in an interview in May.

Moms Demand Action’s strategy includes calling legislators, holding rallies -- like a June march across the Brooklyn Bridge -- and putting pressure on corporations and politicians through social media.

This type of organization is seen in the movement as a whole. The groups have begun to collaborate to move closer to a united front similar to that of the NRA membership base.

Each group plays a specific role, though almost all of them focus on political advocacy at the federal and state levels. The major national groups have a weekly conference call to discuss priorities and plans. Combined, the groups’ strategy covers legislation tracking, legal work, data collection and research, gun-safety education, work with survivors and more.

“There’s never been a point in history … where this movement’s been more unified,” Everitt, of the Coalition to Stop Gun Violence, said. “There’s a lot of mutual respect in our movement and even love.”

The newcomer groups are joined by more established organizations like the Law Center to Prevent Gun Violence, the Coalition to Stop Gun Violence, the National Gun Victims Action Council, the Brady Campaign and Brady Center.

There is no clear leader in the movement. Once the most powerful, the Brady Campaign sees itself as a gathering point for others now, but collaboration, not star power, is the key, Gross, president of the Brady Campaign, said.

Everytown, the newest player, has perhaps the biggest presence in the news and is the largest of the advocacy groups. Milikowsky says the group leads in research, investigation and thought, but it doesn’t view itself as the leader.

“The only way we’re going to overcome the corporate gun lobby, the only way we’re going to change deeply entrenched social norms, is not to be about any one organization but be about the American public,” Gross said.

Among the gun rights groups, the NRA overshadows other organizations, but many groups want better collaboration.

“We work together when possible, but we don’t always communicate as well as we probably should,” said Alan Gottlieb, chairman of the Citizens Committee for the Right to Keep and Bear Arms and the founder of the Second Amendment Foundation.

Luke Wagner, a grassroots activist who is now the board president of the Colorado Second Amendment Association, said he works to develop ties with other gun rights groups.

“We don't have to be intrinsically tied to one another. We don't have to take instructions from one another. But we do have to be able to talk to one another and at least be sure we're all on the same page,” Wagner said.

Though some groups want more collaboration, gun rights organizations positioning themselves as alternatives to the NRA have grown financially in recent years.

Groups like Gun Owners of America, which opposes all gun control measures unequivocally, and the National Association for Gun Rights, a newcomer that is blatantly anti-NRA, are trying to challenge the older organization.

NAGR’s revenue grew 16 times from 2009 to 2012, an increase unparalleled by fellow gun rights organizations. Gun Owners of America’s revenue grew from about $1.8 million in 2011 to $2.4 million in 2012.

“The NRA has taken gun owners’ money and more importantly, their trust and used it to support those who have a horrible record when it comes to gun rights,” according to one NAGR press release. The group did not respond to requests for comment for this story.

In May, the NRA called the tactics of another gun rights group, Open Carry Texas, “downright weird.” After protest from the group, which carries long guns in public to protest the Texas ban on the open carry of handguns, the NRA pulled the release from its website and replaced it with a message of unity.

The NRA did not respond to requests for comment.

For advocates like Nicki Kenyon, a writer for Jews for the Preservation of Firearm Ownership and a former editor of an NRA magazine, the gun rights movement’s theme is unity of mission, if not unity in tactics. 

“We may go about it in different ways. We may disagree on the tactics. But overall, we are an inclusive and we are a cohesive group of people whose only purpose is to protect our rights and freedoms,” she said.

But these groups are still small players compared to the NRA.

“The NRA is seen as the voice of gun owners. It doesn’t necessarily need much help,” said Grossmann, the Michigan State University professor.

Modern gun rights advocacy experienced a turning point after the Supreme Court ruled in District of Columbia v. Heller in 2008 that the right to bear arms is an individual right, not limited to those serving in a militia.

The decision overturned handgun bans on state and local levels, and groups like the Second Amendment Foundation followed it with their own lawsuits to reverse gun control measures in major cities like Chicago.

It brought a new sense of security to gun rights advocates.

“It’s having a huge impact, and the other side will ... deny it or try to spin it a certain way, but they know they’re losing,” said Philip Watson, director of special projects for the Second Amendment Foundation.

After Heller, the NRA began opening up to new demographics, said Callaghan, the Texas Southern University political science professor.

In the last few years, it has launched social media campaigns aimed at millennials, women and minorities. It recently debuted a show on its website hosted by a young black gun enthusiast and has six social media accounts aimed just at women.

Both sides of the debate want to reframe the conversation to use less loaded language and portray their stances as common sense.

Americans for Responsible Solutions is one of the groups trying to depoliticize the debate. Giffords and her husband, both gun owners, hoped to establish a presence that would counterbalance the NRA while welcoming gun owners, said Mark Prentice, the group’s press secretary.

“It’s about staking a place in the kind of moderate, reasonable middle where most people are on this issue,” Prentice said.

But what is described as common sense for one side is not common sense for the other.

For example, many gun rights advocates portray “stand your ground” laws, which allow people to use deadly force in self-defense instead of retreating, as common sense; gun control groups oppose it. Gun control groups say expanding background checks is common sense; gun rights groups disagree.

Mental health may be the one area that has the potential to be a meeting ground.

The NRA has supported mental health legislation in the past, like the 2007 law meant to improve state reporting to the National Instant Criminal Background Check System (NICS), which includes the reporting of mental health records. The Brady Campaign also worked to pass that bill.

In May, a combination mental health and domestic violence bill was introduced in the House by Democratic Reps. Mike Thompson of California and Elizabeth Esty of Connecticut, whose district includes Newtown. It is still in committee.

In the same month, an amendment to increase funding for NICS by $19.5 million in 2015 passed the House, but the Senate has not taken it up. The amendment’s passage was seen as a victory by the gun control movement – its single federal legislative success since Newtown – but NICS funding will not actually increase unless the bill passes the Senate.

The gun control movement also wants legislation addressing domestic abuse and background checks. Advocates still hope for expanded background checks that would include sales online and at gun shows. A bill like that failed in Congress last year.

Rep. Carolyn McCarthy, D-N.Y., whose husband was killed in a commuter train shooting in 1993, has been a vocal gun control advocate in Congress since the 1990s.

“So many members in the House and the Senate started to stand up and speak, so there’s so many more voices out there today than there was even 10 years ago,” McCarthy said at a February Moms Demand Action news conference on Capitol Hill.

“We went through at least a decade, if not more, where we were not political enough, where PACs we once had that were raising money ... folded. We didn’t have a financial presence in elections,” said Everitt of the Coalition to Stop Gun Violence. “We weren’t playing hardball.”

But given gridlock in Congress, both sides are fighting battles on other fronts, particularly in the states.

“We’ve shifted some of our priorities, and while we’re still leading the fight in Congress to strengthen our federal gun laws, we are doing more and more advocacy work at the state level and working to strengthen state gun laws,” said Everytown’s Milikowsky.

Six states passed laws this year to help remove firearms from domestic abusers. In Minnesota Everytown helped draft the bill.

Since the Heller ruling, the NRA has helped pass laws regarding concealed carry of guns, self-defense and “stand your ground,” often fighting multiple battles on the state level, said Callaghan, the political science professor. Grassroots gun rights groups often help or launch their own legislative campaigns.

Last year in Colorado, voters recalled some legislators who passed a package of gun control laws. The campaign was led by a citizen movement called the Basic Freedom Defense Fund.

The NRA eventually joined the campaign, but it was spearheaded by the grassroots activists, something that often happens at the state level.

As the political tug-of-war continues, an indicator of the future of guns in America is elusive. Many are looking to the 2014 elections for a hint.

The NRA’s Cox said on an NRA commentary show that the upcoming election is crucial.

“There’s no question that what we do between now and November is critical to the survival of the Second Amendment and the freedoms we all fight so hard to protect,” Cox said.

The NRA rates candidates and endorses them through its PAC. According to the fund, the rankings are based on voting records, public statements and responses to a questionnaire, the contents of which the NRA does not release publicly.

The association worked on 271 campaigns for Congress in 2008 and says it won 230 of the races, according to its website. Voters can print out “personal voting cards” from the website that list the candidates and mark which are supported by the NRA.

In July, Everytown sent out a questionnaire to every candidate for Congress. It is similar to the NRA’s, but unlike the NRA, Everytown released the questions to make its process transparent.  Milikowsky and other representatives would not say whether the group will make election endorsements, nor would they say what it will do with the survey results beyond publishing them.

Prentice, of Americans for Responsible Solutions, believes the issue of guns is going to be increasingly important in elections, and said his organization sees it as an obligation to highlight the issue and the candidates’ stances in campaigns around the country. The group doesn’t donate directly to candidates, but plans to channel money into ads supporting certain candidates.

“What’s most important is the people who have been champions on this issue already and (who) put their necks out there get to return to the U.S. Congress,” Prentice said.

“The election is going to be a bare-knuckles street fight,” said NRA Executive Vice President and CEO Wayne LaPierre at the organization’s convention. “They’re going after every House seat, every Senate seat, every governor’s chair, every statehouse that they can get their hands on.”

Jacob Byk contributed to this story. He is the News21 Dix/Oliver fellow.

In recent weeks, riders of Washington, D.C.’s metro system have seen a parade of posters inside trains that make shocking allegations about the nation’s best-known animal rights group, the Humane Society of the United States.

Featuring a baleful-looking caged dog, the ads accuse the Humane Society of giving only a tiny portion of its revenue to animal shelters and using donor money to pay employee pensions and the cost of a settling a racketeering case.

“That’s interesting, because you often hear about seemingly worthwhile organizations that are not,” said one rider on his morning commute, asked about the poster by a reporter. “I wonder who is putting up the ads and how factual they are?”

Good question — and a complicated answer. The ads direct readers to a website called “Humanewatch.org,” one of dozens connected to local public relations executive Rick Berman, once dubbed “Dr. Evil” in a segment of 60 Minutes. The site is the product of the Center for Consumer Freedom, managed by Berman and Co. and supported — according to the firm— by restaurants and food companies, who are sometimes targets of the Humane Society.

Humanewatch.org is vintage Berman. He pays his public relations firm with revenue from the various nonprofits he runs. He creates online “watchdogs” that attack enemies of business, like the Humane Society, health advocates, unions and even Mothers Against Drunk Drivers.

Berman doesn’t publicize his customers, but a Center for Public Integrity search of nonprofit files revealed a few. Clients include the International Dairy Foods Association, another Humane Society target; the Corn Refiners Association; and the Institute for Humane Studies, a think tank headed by activist billionaire Charles Koch.

The Center for Consumer Freedom was created in 2000 while Humanewatch.org debuted a decade later. Berman is listed as president and executive director of the Center for Consumer Freedom. Maintaining Humanewatch.org is expensive. The nonprofit spent $2.3 million on the project over its first three years, IRS reports show. The site regularly updates blog posts. The collection of advertisements has come at a steady pace, and gone beyond D.C. They are also active on Facebook and Twitter.

Berman did not return phone calls requesting comment for this story, but generally paints himself as a free-market advocate; others say he’s simply a hired gun for industry, and still others question the ethics of his business operations. The Berman firm’s website quotes a newspaper description: “Razor-Sharp wit and unconventional tactics.” The firm’s pitch says: “We don’t just change the debate. If necessary, we start the debate.” 

Enemy of my enemy

The Humanewatch.org site has gotten the attention of people like Carol Hamilton, a judge at dog shows,  an occasional dog breeder and a vociferous critic of the Humane Society. The Hacienda Heights, Calif., woman called the Center for Public Integrity, suggesting an investigation of the society and directing reporters to the Humanewatch.org website.

Hamilton calls the Humane Society “the biggest scam going. They’re collecting money galore.”

“My problem is they’re doing all this scamming for lobbying and not doing it for the animals,” she said.

Hamilton said she wasn’t aware of Humanewatch.org’s origins, but will continue to use it as a source of information.

 “If Humanewatch helps me get where I want to go then I want to utilize them,” she said.

Dog breeders, and especially the American Kennel Club, whose objective is to “advance the study, breeding, exhibiting, running and maintenance of purebred dogs,” are no fans of the Humane Society. One flashpoint in particular: a 13-page report the Humane Society released in July 2012 that accused the AKC of blocking laws that would crack down on “puppy mills.”

ABC News did a story on the report. In a statement released at the time, the AKC said it “supports legislation to strengthen enforcement and increase penalties for canine cruelty and neglect," but was concerned about USDA regulations that would treat a “hobby breeder who raises puppies in their home” the same as a “large scale commercial internet puppy seller.”

The American Kennel Club maintains it is not a Berman customer.  It has “never made financial contributions to HumaneWatch or the Center for Consumer Freedom, nor has it been a client of Richard Berman,” a club spokeswoman said in a prepared statement.

However, on Jan. 25 and 26, at the American Kennel Club’s 2014 Legislative Conference at its headquarters in Raleigh, N.C., one of the presenters was Sarah Longwell, a senior vice president of Berman and Co. She talked about Humanewatch.org and how to handle animal advocates. Her talk was entitled, “Taking Back the Conversation.”

When asked about how Longwell came to be present at the gathering or whether she was compensated, Kennel Club spokeswoman Hillary Prim sent an email message saying the organization would not be making any further statement. Longwell didn’t return calls seeking comment.

Accounts of Longwell’s speech laid out the Berman strategy. The Humane Society feeds off of perceived “moral authority,” she was quoted as saying in an AKC licensee’s newsletter. We must “remove that moral authority” in order to take back the conversation, she said.

Berman speaks — to pork council

Some of the issues Berman hits routinely involve pork. He has spoken at pork industry events and wrote an opinion piece for an industry publication. At “Iowa Swine Day” in 2013 he was voted the most effective speaker.

He specifically defends the use of “gestation crates” — tiny pens where pregnant pigs live before giving birth. The Humane Society caught the disturbing practice at farms owned by some of the nation’s biggest pork producers on hidden camera. It has lobbied hard to get companies to stop using them, and to urge restaurant chains not to buy pork from farms that do.

Berman urges pork producers to call them “maternity pens” instead.

One of Berman’s previous clients was Smithfield Foods, the U.S.’s largest pork producer, whose pens were featured in the film. The food giant hired Berman’s company to fend off efforts from its workers to unionize a plant in Tar Heel, N. C., according to a lawsuit, as reported in a Bloomberg News story. The suit was settled and workers voted to form a union, according to the story.

Unlike many public relations firms, Berman and Co. doesn’t identify scores of clients on its website. But the Center identified at least a few others:

• The International Dairy Foods Association which paid his firm nearly $250,000, according to its 2012 tax return, for a commercial and print ad. Dairy farming has also been a target of the Humane Society, which says “repeated reimpregnation, short calving intervals, overproduction of milk, restrictive housing systems, poor nutrition, and physical disorders impair the welfare of the animals in industrial dairy operations.”

• The Corn Refiners Association paid his company nearly $1.2 million for “communications” services in 2011, according to a tax document. The trade association is currently fighting criticism by health groups and the sugar industry of one of its most profitable products, high-fructose corn syrup.

• The Institute for Humane Studies paid the Berman firm nearly $300,000, according to a 2011 tax return. The libertarian think tank is housed at George Mason University. Its mission is to “support the achievement of a freer society.” Its board of directors is chaired by billionaire industrialist and conservative political donor Charles G. Koch.

Pacelle said the Humane Society goes after “institutionalized cruelty,” like factory farming and pharmaceutical testing, which makes it a target.

 “I could name 20 others that all hate the Humane Society,” he said.

Board connections

The Center for Consumer Freedom’s board members have deep connections to the food industry:

• Richard Verrecchia is a “26-year veteran of the restaurant industry,” according to his biography at Fintech, including stints with TGI Friday’s, Ground Round, Houlihan’s Restaurants, the Outback Steakhouse and others. Fintech processes payments for the alcoholic beverage industry.

• Lane Cardwell is president of Cardwell Hospital Advisory Inc. and is a 35-year restaurant industry veteran, having worked in management or on the boards of 40 different restaurant brands, according to a trade show bio.

• Joseph Kefauver was vice president of public affairs for Wal-Mart and served as the top lobbyist for Darden Restaurants, according to a biography from the Edgewater Group, a lobbying and consulting firm.

Berman is a former labor lawyer with the U.S. Chamber of Commerce. Berman and Co. was created in 1986, according to the company fact sheet. The Center for Consumer Freedom was created from an earlier group, the Guest Choice Network, which got its “seed money” from Philip Morris, the tobacco company, now known as Altria.

“The money funded a specific campaign related to smoking sections in restaurants — not smoking per se. BAC [Berman and Co.] spokespersons have never advocated for smoking or said it wasn’t harmful to peoples’ health,” the Berman fact sheet reads. “However, we have supported adults’ right to free choice when it comes to legal products.”

In the 1990s, Berman was president of Beverage Retailers Against Drunk Driving (BRADD), an organization formed in response to Mothers Against Drunk Driving.

As president, he argued for "tolerance of social drinking.” He was a lobbyist for the American Beverage Institute from 1999 through 2005, according to federal records.

Berman’s fact sheet says the Center for Consumer Freedom and other nonprofits he manages are not “shadowy front groups.”

“These organizations were founded to combat a tidal wave of anti-business, anti-free market Non-Governmental Organizations (NGOs) that advocate for a battery of laws, restrictions and regulations that attack personal freedom and entrepreneurialism,” it states.

Attacks on HSUS

Berman told the New York Times that the “Humane Society wants to force us all to be vegetarians — or vegans” and that it opposes the consumption of animals, regardless of how they are treated.

The Humanewatch.org ad currently running in Washington’s metro trains says that HSUS gives 1 percent of its budget to pet shelters and “spends millions on its offshore hedge fund investments and pension fund.” It also says dues go toward paying a more than $15 million federal racketeering settlement.

“The first thing is overall it’s just a false framing of the issue,” said HSUS spokesman Alan Heymann. “It’s never been the case that we’re some sort of grant-making association for local shelters — at the same time, the figure does not take into account all the other ways we support local shelters.”

As to the racketeering charge, the Humane Society was one of several animal rights activist groups that sued Feld Entertainment, the owner of Ringling Bros. Barnum & Bailey Circus, for mistreating its elephants. They lost the case, and a Feld employee worker was found to have been paid at least $190,000 by the animal rights groups to back their charges.

Feld filed a racketeering lawsuit seeking legal fees and won nearly $16 million in a settlement reached in a U.S. District Court in Washington. Heymann said its share of the settlement, which was not disclosed, will be paid from insurance.

“No HSUS donor dollars are being used to pay this,” he said.

Dog breeders contacted for this story don’t seem to be bothered by Berman’s reputation as a hired gun.

Darci Brown, owner of a car dealership in Greenfield, Mass., has bred dogs as a hobby for 30 years. She says the Humane Society would like to enforce spay and neuter laws to the point where there would be no pure bred dogs left.

She was present at the legislative presentation. The fact that Berman represents unnamed clients “concerns me a little, yes,” she said, but she feels the information he produces is factual.

“I think our people are focusing on the message they’re giving,” she said. “It just happens to be one we agree with.”

Chris Young contributed to this report.

In most of our country’s major institutions, we have little tolerance for cheating and lying. Whether it’s the court system, schools, businesses, even our sports teams, we impose stiff sanctions against those who deceive us to gain some advantage.

If convicted of lying on the witness stand, you’ll pay a fine and possibly wind up in jail. If caught cheating on a test, you’ll probably fail the course or worse. At the University of Virginia, a breach of the school’s honor code “has but a single penalty: immediate expulsion from the university.” 

In 2009, Bank of America agreed to pay a $33 million fine after the SEC accused it of lying. Just last month, a federal judge ordered that same bank to pay a $1.27 billion fine after a jury found it liable for bad loans that were part of a “fraudulent and reckless” mortgage-lending program.

Some of our most famous athletes have been stripped of their medals and banned for life from participating on sports teams for doping and lying about it.

Our religions condemn such deception. In Proverbs we are told that “a lying tongue” and “a false witness who pours out lies” are among the seven things that the Lord hates and considers detestable.

Yet there is one arena in which misleading the public not only is abided but is the norm: politics. In fact, much of what constitutes political discourse in this country is now built on a foundation of dishonesty. One of the most effective—and perfectly legal—ways to win votes and influence public policy these days is to pour millions of dollars into deception-based campaigns designed to manipulate public opinion.

The most recent evidence: a National Journal article about a new tactic used by the National Republican Congressional Committee to attack Democratic candidates. Earlier this year, the NRCC created several fake Democratic candidate websites. The organization’s latest effort is a brand new set of deceptive websites, this time designed to look like local news sources.

The NRCC has created about two dozen “faux news sites,” the National Journal reported, all of which feature articles that “begin in the impartial voice of a political fact-checking site, hoping to lure in readers.” After a few such paragraphs, the articles “gradually morph into more biting language.” 

With no hint of irony, the NRCC’s communications director was quoted as saying, "This is a new and effective way to disseminate information to voters who are interested in learning the truth about these Democratic candidates.” To the organization’s credit, there is a disclaimer at the bottom of the page noting that the NRCC paid for the site.

Late last month, The New York Times disclosed another deception-based scheme designed to influence voters. America’s Health Insurance Plans, the big lobbying and PR group for health insurers, secretly funneled $1.593 million to its longtime ally, the National Federation of Independent Business, to pay for a TV ad targeting Democratic senator Mark Pryor of Arkansas. The ad blames Pryor for making it harder for small businesses to make a profit as a result of his vote for “Obamacare.”

The ad didn’t mention that the funds to pay for it came from health insurers or that the spot was part of a continuing effort by AHIP to get Congress to eliminate a fee that was imposed on insurers to help offset the cost of expanding coverage to the uninsured.

The Times connected the dots after reviewing tax records filed by AHIP and the NFIB. An AHIP spokesman acknowledged to the newspaper that his organization had indeed provided the money for the ad.

The relationship between AHIP and the NFIB goes way back. When I worked in the insurance industry, I attended many meetings in Washington with NFIB staff during which we planned a campaign to make sure Congress did not pass a Patient’s Bill of Rights. Insurers worried that a provision of the bill holding insurers more accountable would lead to profit-threatening lawsuits against them. The big for-profit insurance companies contributed the lion’s share of the funding for the campaign, which included the operation of a front group called the Health Benefits Coalition. Not wanting to be too publicly associated with the campaign, we enlisted an NFIB executive as a spokesman for the group. 

Another organization insurers frequently call upon to front for them is the U.S. Chamber of Commerce. As the National Journal reported in 2012, AHIP funneled more than $100 million to the Chamber to finance it’s campaign to shape the health care reform debate in 2009 and 2010. As with the Times’ disclosure of the AHIP-NFIB alliance, the AHIP-Chamber of Commerce relationship was discovered only after a couple of reporters checked tax filings.

That’s the way the game is played in Washington, where ethical principles that apply elsewhere are blatantly flouted. And where the consequence of getting caught in a lie or deception is rarely more severe than a bad PR day.

Americans are more empowered than they have ever been by stand your ground or similar laws to use firearms to protect themselves and their property, though the laws are applied inconsistently across the country, a News21 analysis shows.

Since 2005, 31 states have adopted stronger self-defense laws, making it more difficult for police and prosecutors to prove a person breaks the law when acting in self-defense and making it more difficult to sue those people if they are found not guilty of a crime.

The laws have been invoked for everything from road rage that ended in gunfire to suspected thieves who were shot to death as they tried to flee.

In a recent Texas case, a woman is expected to claim self-defense for fatally shooting her neighbor through her locked front door because she thought he was trying to break in. The man she killed was an off-duty Houston firefighter who, for reasons unknown, was at the woman’s door following a day of drinking with friends on St. Patrick’s Day this year.

Almost all these laws came well before the highly publicized 2012 shooting death in Florida of 17-year-old Trayvon Martin by George Zimmerman. News21 found 28 attempts in state legislatures to scale back self-defense laws after Martin’s death, but all of them failed.

Some states have expanded the castle doctrine, which allows people greater leeway to act in self-defense in their homes. Texas and Louisiana, for example, passed laws that treat self-defense in workplaces and vehicles the same as if a person was at home.

Other states, including Hawaii and Idaho, approved laws to protect people from civil lawsuits if they are found innocent of criminal charges.

In many of the states, like North Carolina and Mississippi, a person in a public place does not have to retreat from a confrontation before shooting to kill in self-defense. The same states also placed a greater burden on prosecutors, requiring that they prove a person was not acting in self-defense to win a conviction.

“I think the reason most states have adopted this (no duty to retreat in public) is because the nature of homicidal violence in our country is normally manifested in the form of a firearm,” said legal expert Geoffrey Corn of South Texas College of Law. “Stand your ground is now the majority rule in the United States.”

However, News21 has found the likelihood of a person being charged with or convicted of a crime after a claim of self-defense involving a firearm may depend more on the state or region where the shooting occurred than the circumstances of the case.

Even cases in the same county produced disparate outcomes, News21 found, based on a review of 200 cases in Michigan, Kentucky, Florida, Louisiana, Texas and Arizona — six of 31 states to recently expand their laws.

The Duty to Retreat

Two cases in Arizona illustrate the contrasts.

John Chester Stuart and Thomas Orville Beasley hurled obscenities through the windows of their cars in the moments leading to Beasley’s shooting death around 9 p.m. at a Phoenix intersection in January 2008.

According to Beasley’s wife, Stuart illegally passed them moments before both cars stopped side by side at a red light and rolled their windows down. Beasley had been drinking.

After shouting profanities at each other, Beasley got out of his vehicle and approached Stuart, allegedly threatening him. From the inside of his truck, Stuart pulled out his .40-caliber handgun and shot the unarmed man in the face, later claiming that Beasley reached into his truck when he fired.

Three years later, and five miles away, David Ross Appleton and Paul Thomas Pearson were shouting at another Phoenix intersection, their windows rolled down. Appleton had finished eating dinner with friends. Pearson was talking on his cell phone with his cousin.

Appleton said he was upset because Pearson blocked him from turning left at a red light.

After the light turned green, Pearson followed Appleton for about two miles, telling his cousin over the phone that he saw Appleton run a red light. When Appleton pulled off the road and into a pharmacy parking lot, Pearson followed.

He got out of his vehicle and approached Appleton’s Toyota FJ Cruiser on foot, unarmed, cellphone in hand. Appleton said Pearson tried to choke him through the window of his SUV, so he fired his gun at Pearson, killing him.

Stuart is in prison. Appleton was never indicted.

Maricopa County Attorney Bill Montgomery, the prosecutor in the Arizona county where the two shootings took place, said the cases reached different outcomes because more evidence was available in Stuart’s case than in Appleton’s.  He believes Appleton, who had a history of road rage behavior, would have been convicted if he had been indicted.

“A grand jury made their decision, and I have to live with it,” Montgomery said.

In Arizona, there is no duty to retreat in public. State law forbids prosecutors from raising the issue to make their case.

“It means that a jury is never allowed to consider whether running away, whether retreat would have adequately protected the defendant,” said Corn, of the South Texas College of Law.

“You still have to be the victim of unlawful violence,” he said. “You still have to face an imminent threat, and you still have to use proportionate force."

Pursuing Criminals

In two states, Michigan and Texas, people can use lethal force to stop a fleeing criminal.

Luis Alonzo Guerrero was inside his Tacos El Indio truck shortly before 3 a.m. in a Houston industrial neighborhood when 24-year-old Benito Pantoja snatched away a tip jar from the truck and started to flee June 5, 2010.

He didn’t make it far.

The 50-year-old truck owner chased the thief with his .38-caliber revolver and shot twice, fatally wounding the Pantoja.

The tip jar contained $20.29.

Two years later in the same city, Troy Rector, who was mentally ill, entered a convenience store, stole a pack of beer around midnight, then tried to flee.

The 45-year-old didn’t make it very far either. A 19-year-old clerk confronted Rector outside the store and gunned him down.

Neither the clerk nor the taco truck driver were indicted by a grand jury because Texas law allows a person to use deadly force to regain stolen property from a criminal if the theft occurs at night.

Corn said the Texas law is a significant departure from traditional self-defense theory.

“The law always treated life as more valuable than property — even the life of a criminal.  So that’s why you couldn’t use deadly force just to protect property,” Corn said, “Because the harm you’re causing is legally greater than the harm you’re avoiding.”

“You’re trading a life for property. And so, in common law, homicide, homicidal force was never permitted just to protect property," he said.

In Monroe County, Michigan, near Temperance, Thomas Wallace was inside his mobile home when a man and his girlfriend robbed him at knifepoint.  The man cut Wallace with a knife and took off with his television.

As soon as the two left the trailer, Wallace grabbed his gun, ran outside and started shooting at the man who robbed him. The television thief was sitting inside his getaway vehicle when he was killed.

A grand jury indicted Wallace on a battery of charges that carried the possibility of life in prison. But Wallace accepted a plea offer to a misdemeanor weapons charge that came with 28 days in jail and probation.

In the same county 10 months earlier, two armed men tied up Robert Allen Goupill and his family with duct tape, then took off with the family’s cordless telephones, jewelry and marijuana plants.

After the men left, Goupill freed himself from the tape, grabbed his shotgun and chased after them in the snow for about 200 yards. One escaped. The other didn’t. Goupill shot him in the back as he was halfway inside the backseat of his car.

Goupill was later convicted of manslaughter and a marijuana charge, and is now in a Michigan prison serving a minimum of three-and-a-half years.

Jack Simms, assistant prosecutor for Monroe County, said the cases may have reached different outcomes because of the distance Goupill traveled in pursuit of his assailant, compared with Wallace’s case, which occurred right outside of his home.

Michigan is also one of 18 states with self-defense laws that give greater leeway to homeowners who shoot in self-defense if they believe they are being burglarized. 

“A prosecutor is going to be less likely now to file a criminal charge against a person who exercises self-defense — say in the home or when they’re being attacked — but it’s not a get-out-of-jail-free card,” said William Maze, president of Criminal Defense Attorneys of Michigan.

Louisiana is one of those 18 states. So when Merritt Landry heard his dogs barking early in the morning, he grabbed his .45-caliber handgun and stepped out the door and into the gated courtyard of his New Orleans home. The neighborhood where Landry lived had experienced multiple crimes recently, the police report said.

As he  stepped into his courtyard, Landry spotted a shadowy figure crouching 30 feet away. It was Marshall Coulter, a 14-year-old boy who had been in and out of jail. When Coulter made a sudden movement, Landry reacted, firing his gun and hitting the teen in the back of the head.

The shot did not kill him. Landry never went to trial.  A grand jury refused all charges.

In Michigan, Theodore Wafer told officers he woke up to violent banging on his door in the middle of the night last November at his Detroit-area home. On the other side of the door stood a drunk 19-year-old female, who had crashed her vehicle into a nearby tree   hours earlier.

Claiming both that he feared for his life and that his shotgun went off accidentally, Wafer fired a fatal round into Renisha McBride’s face through the screen door that separated them.

"I was not going to cower. I didn't want to be a victim in my own house," Wafer said at his trial. 

But a jury rejected his self-defense claim. Wafer was convicted of second-degree murder and related charges Aug. 7 and is scheduled to be sentenced Aug. 20.

“We have a right to self-defense, but we also have a right of free speech and a right to do variety of other things,” Maze said. “If these things are not exercised reasonably, all of a sudden someone finds themselves in legal trouble, and it’s expensive to hire a lawyer, it’s risky to go to a trial, and as we saw in this case, a jury can convict.”

Tracking The Impact

In early August, the American Bar Association released a report following a national study on the impact of stand your ground laws. Among the findings were that stand your ground states experienced an increase in homicides and that the law was applied unpredictably and inconsistently across racial lines.

The study group recommended creating a national database to track cases and cautioned that the adverse effects of the law appear to outweigh its possible benefits, saying people who claimed self-defense were sufficiently protected before stand your ground laws were passed. Read the full report here.                 

News21 asked prosecutor's associations and bar associations across the country what they do to monitor the application of self-defense laws and found few appear to actively track the law’s effect.

Some states have tried.

In 2012, the Louisiana Legislature made it mandatory for law enforcement to conduct full investigations of all homicides involving a self-defense claim. This year, it directed the state’s law institute to study the law’s effects.

A similar bill in Texas would have made it mandatory for law enforcement to track and investigate all self-defense cases, but the measure died in committee.

In Arizona's Maricopa County, the county attorney’s office established a special review panel of senior prosecutors to consider “colorable” self-defense cases before charging.

Montgomery, the Maricopa County Attorney, said he got the idea from a similar panel that reviews officer-involved shootings. The decision was not tied to an increase in self-defense shootings, he said.

From 2011 through 2013, the board reviewed 63 cases and turned down 26, meaning about 41 percent of all cases reviewed were not charged because they were considered justified.

In 2011, about 58 percent of cases reviewed were charged, compared with 40 percent in 2013, records show.

“I think we’re seeing fewer instances in which people are claiming self-defense that really requires us to take a review of it,” Montgomery said.

One of the cases prosecuted by Maricopa County was that of Donald Jackson Taylor, who shot and killed an unarmed transient man with a shotgun from 18 feet away in 2012. The man allegedly trespassed on Taylor’s unfenced yard and would not follow Taylor’s orders to get off his property.

Taylor was charged with a weapons violation because he had a felony conviction on his record and was not allowed to carry a weapon. He pleaded guilty to the weapons charges and a got a maximum sentence of three years in prison, but was never charged with murder or manslaughter.

Jon LaFlamme is the News21 Weil Fellow.

Contributing are Sam Stites and Wade Millward. 

When Minnesota retiree Doug Morphew needed surgery last year, he expected his Humana Medicare Advantage plan to step up and pay the lion’s share of the bill.

Morphew said the health plan had told him over the phone he would owe just $450 for the two days he spent in a St. Paul hospital recovering from the operation to repair an aortic aneurysm.

Less than a month later, however, Humana hit him with a bill for $6,461.66, claiming the surgery was not covered because the hospital was “out of network,” according to an affidavit he filed with the Minnesota Attorney General’s Office last year.

“Considering that I was expecting a bill of $450, I was incredibly upset,” said Morphew, 68, who lives in Lonsdale, Minn., and works part time as a transportation industry consultant.

“I am insulted by Humana’s runaround. It seems as though Humana is denying my claims hoping that I will give up and pay the out-of-network bills,” he said in the sworn statement.

In an interview with the Center for Public Integrity, Morphew said that Humana paid the bill, but only after “several months of fighting” with him, and after he complained to state regulators.

“It was a nightmare,” he said.

In October 2013, Minnesota Attorney General Lori Swanson sent Morphew’s formal complaint, and about two dozen others, to Centers for Medicare and Medicaid Services (CMS) administrator Marilyn B. Tavenner. Swanson asked the federal official to “undertake an investigation of Humana’s practices and take appropriate remedial and punitive action.”

The letter sparked media coverage in the state. But nearly a year later, Swanson is not satisfied with the response.

“As far as I’m aware, there has been no formal enforcement action taken,” said Minnesota attorney general’s office spokesman Benjamin Wogsland. “We have very serious concerns that continue,” he said.

Citing patient confidentiality laws, Humana spokesman Tom Noland declined to comment on specific cases. But he said that Humana “has worked actively with CMS to resolve the matters outlined in the letter.” CMS said it is satisfied that Humana has largely fixed any problems.

Medicare pays the privately run health plans—an alternative to traditional Medicare— a set monthly rate for each patient. About 16 million Americans have signed up at an annual cost to taxpayers of more than $160 billion, about one third of the elderly and disabled people eligible for Medicare. A Center for Public Integrity investigation published in June found as much as $70 billion of improper payments to Medicare Advantage plans from 2008 through last year.

Many health plans also collect monthly fees directly from patients and may charge co-payments for medical services, such as $10 for a doctor’s office visit. The plans also can limit care to doctors and hospitals in their networks, so long as patients are advised of these restrictions.

Humana has pitched its plans in Minnesota through radio and television ads, telemarketing and the mail. It also has set up booths at some retail stores, such as Walmart, and sends sales agents to peoples’ homes—typically telling seniors it offers more benefits than standard Medicare and will cost them less out of pocket.

But Humana “sometimes denies claims for services that are covered under original Medicare,” overcharges for copayments, “misrepresents” which doctors and hospitals patients can go to and hides behind “red tape and delay” to avoid paying claims, according to Swanson’s letter.

Swanson turned to CMS because state regulators lack the legal authority to impose sanctions on Medicare Advantage carriers. When Congress created the Medicare Advantage option in 2003, it gave CMS that power, thus preempting state laws and oversight.

Minnesota officials don’t believe CMS should have a “monopoly” on oversight. “We think states should have authority over improper determinations by Medicare Advantage plans,” Wogsland said. “If they (CMS officials) don’t take action, there’s no other remedy.”

Other state officials also have been frustrated by the limits on their authority. In October, Connecticut Attorney General George Jepsen called for federal officials to “aggressively scrutinize” UnitedHealthcare’s decision to drop a large number of doctors from its Medicare Advantage plans, a move that had caused an uproar from patients and medical groups.

“As you know, my office lacks the authority to resolve these important issues regarding a federally administered program,” Jepson wrote.

Medicare regulations state that CMS can inspect “or otherwise evaluate the quality, appropriateness and timeliness of services” offered by Medicare Advantage plans.

But the agency has reported its own difficulties keeping tabs on the fast-growing program.

In a little noticed proposal in March, CMS officials said they were “constrained in the number of program audits we can conduct each year, due to limited resources.” The agency is only able to audit about 30 Medicare Advantage companies a year—about one in ten—of the 300 operating.

CMS proposed that health plans conduct and pay for self-audits with the goal that each organization would be looked over at least every three years. But in May CMS backed off in the face of industry protests.

 “Ensuring that Medicare beneficiaries receive high quality care and timely services while enrolled in a Medicare Advantage plan is a top priority for CMS, an agency spokesman wrote in an email.  He said the agency “may finalize this proposal at a future date.”

Some consumer advocates worry that the agency yielded to pressure from industry to back away from the proposal to increase audits —at least for now.

“We were disappointed to see it rolled back,” said David Lipschutz, a senior policy attorney with the Center for Medicare Advocacy. He said the proposal “begged the question” of how often plans are audited.

“We have concerns across the board,” Lipschutz said. “It’s unfortunate that we have public dollars going toward a privatized program with relatively little oversight.”

CMS officials point out that they have taken enforcement action against health plans that fail to pay bills or provide necessary care for their patients.

The agency posts these actions on its website, though patients aren’t likely to spot them without considerable hunting around. Even if they do, the sanctions often are written in language that gives little clue to the actual infractions other than they pose a “serious threat to the health and safety” of patients.

From November of 2009 to August of this year, the agency levied 68 fines against Medicare Advantage plans for a total of about $9.8 million, a review of the CMS website shows.

In that time, CMS terminated four health plans, two of them because they had become insolvent. On 21 occasions, CMS suspended enrollment in health plans, usually after discovering that sales agents misrepresented the benefits to potential customers.

In the case of Humana’s performance in Minnesota, CMS officials said they had “not seen increases in complaints or other concerns” since receiving Swanson’s letter.

They said Humana “appears to have made significant progress addressing these issues, and we have been satisfied with Humana’s responses to date.”

Humana has “taken a number of other steps to improve their customer service and address issues that surfaced,” CMS said.  

But Minnesota official Wogsland called it “disappointing” that CMS had taken no formal action. His office continues to get complaints from patients, hospitals and other health care providers about unpaid bills. “That’s a problem,” he said.

He noted that some seniors in Minnesota have told regulators they were threatened with bills they could not afford, despite making every effort to play by the company’s rules.

Darlene Tucker, 75, of Bloomington, who said she got by on monthly Social security income of $1,271, is one.

In an affidavit, she said the Humana agent sold her a plan that was supposed pay the full cost of radiation therapy for breast cancer. But she said she was stuck with co-payments of $994.22, which she couldn’t afford.

The health plan never did pay, according to her affidavit. The center that performed the radiation treatments eventually wrote off the bill.

“My fight with cancer was enough for me to deal with at the time. I do not think I should have had to fight Humana for insurance coverage it promised to provide,” she said.

The nation’s second-largest school district — Los Angeles Unified — is unveiling a sweeping new agreement today to curb police involvement in minor school discipline and campus problems.

The agreement, more than two years in the making, is at the cutting edge of a national movement to stop sending students into courts for minor infractions at school.

In 2012, the Center for Public integrity began publishing a series of reports documenting how L.A. Unified’s police — the nation’s largest school police department — were giving out more than 10,000 court citations a year to kids mostly for minor infractions.

Nearly half the kids ticketed, often for tardiness or fights, were 14 or younger; almost all were black or Latino and from lower-income areas, the Center found.

A 12-year-old boy was handcuffed and arrested in reaction to a first-ever fight with a friend during a basketball game — his parents were not called first — and two first graders were issued citations for disturbing the peace after a scuffle, the Center found.

The new protocol “is a significant step forward to ensuring that student behavior is not inappropriately criminalized but rather met with interventions that will address the root causes of a student’s behavior,” said Ruth Cusick, Los Angeles-based education rights attorney with Public Counsel, the nation’s largest pro bono law group.

“Taking school fights out of the courtroom and instead teaching students about conflict resolution will keep more students in school on a path to success,” Cusick she continued.

About 20 percent of all student arrests are related to fights. The new protocol sets out requirements for how students must instead be referred to counseling at school or at community sites known as YouthSource Centers.

Students accused of other misbehavior that has resulted in police issuing them court citations must now be referred back to school for counseling on a campus or at a YouthSource Center. These infractions can include minor use of alcohol, tobacco, marijuana possession or minor damage or theft of school property.

Public Counsel worked on the policy along with juvenile court judges, school administrators, police officials and the Community Rights Campaign, an L.A.-based group that has represented students in court.

The Community Rights Campaign was instrumental in proving that police were concentrating their efforts to nab tardy students in lower-income areas, even handcuffing some kids if they arrived minutes late.   

Manuel Criollo, director of organizing for the Community Rights Campaign, said school playgrounds had become “minefields” of criminalization and that the protocol will help reverse the trend.

Los Angeles Juvenile Court Judge Donna Groman also hailed the new protocol in a press statement. Juvenile court, she said, “should be the last resort for youth who commit minor school-based offenses.” She said that she hopes that L.A. Unified’s policy “is shared both nationally and statewide as a model response.”

L.A. Unified Police Chief Steve Zipperman said, according to a press release, that the protocol “contains clear guidelines regarding the roles and responsibilities of …campus police officers and establishes criteria to assist officers in properly distinguishing school discipline responses to student conduct from criminal responses.”  

Last year, Zipperman announced that officers would no longer issue court citations to students 12 or younger unless there were extraordinary reasons for such an action.

In their press release announcing the new protocol, community groups said: “National reports show that police contact with young people is a strong predictor of whether a student will fail to finish school, will have to repeat a year, or will end up in the juvenile justice system or criminal justice system,” community groups that negotiated the police protocols said in a press release.

“In fact,” the groups said, “just one arrest doubles a child’s chance of dropping out of school.”

As Alaskans vote today to decide the Republican Party’s challenger to incumbent Democratic Sen. Mark Begich, outside forces are dominating the contentious race — the outcome of which could determine control of the U.S. Senate.

More than 90 percent of the 16,000-plus ads aired so far this cycle by political action committees, super PACs and nonprofits have come from groups based outside Alaska or that receive the bulk of their funding from non-Alaskans, according to a Center for Public Integrity review of advertising data provided by Kantar Media/CMAG.

That’s more than the roughly 15,000 ads that candidates themselves have collectively aired in a state that's home to just 740,000 people and, in Anchorage, the nation's 145th largest media market.

Both Republicans and Democrats are benefiting from the money from “outside,” as many Alaskans call the Lower 48.

For instance, half a dozen Washington, D.C., powerhouses have together aired more than 6,500 ads attacking Begich or touting the Republican frontrunner, Dan Sullivan.

Three of these groups — Americans for Prosperity, Freedom Partners and the American Energy Alliance —  fall within conservative billionaires Charles and David Koch's political network. Super PAC American Crossroads and nonprofit outfit Crossroads GPS are tied to GOP strategist Karl Rove. And the U.S. Chamber of Commerce is headquartered across the street from the White House.

Meanwhile, a pro-Begich super PAC called Put Alaska First has aired more than 6,000 ads promoting Begich and attacking his would-be Republican rivals, according to Kantar Media/CMAG, which tracks ads that both overtly call for the election or defeat of candidates as well as "issue ads" that simply mention candidates.

When Put Alaska First launched, its leader, longtime Alaska-based political consultant Jim Lottsfeldt, declared that “Alaskans, not outsiders, should pick our elected officials.”

But Federal Election Commission records show that about 95 percent of the $5.1 million Put Alaska First raised through July 31 came from Washington, D.C.-based Senate Majority PAC. This Democratic super PAC counts New York City mayor Michael Bloomberg, media mogul Fred Eychaner of Chicago and environmentalist Tom Steyer of San Francisco among its top donors.

Put Alaska First’s spending spree has augmented Begich's robust financial advantage.

As of July 30, the date of the most recent campaign finance reports filed by the candidates in Alaska’s Senate race, Begich had raised about $8.4 million and had more than $2 million still in the bank.

Sullivan, the state’s former attorney general and commissioner of the Department of Natural Resources, meanwhile, raised more than $4 million and had about $1 million cash on hand.

Sullivan’s main Republican rivals — former lieutenant governor Mead Treadwell and attorney Joe Miller — raised about $1.2 million and $760,000, respectively.

Notably, about 10 percent of Sullivan’s fundraising haul has come from people and political action committees associated with the securities and investment industry, according to the Center for Responsive Politics. That’s more than any other industry.

Employees of one hedge fund alone — Elliott Management, which is led by GOP mega-donor Paul Singer — have given Sullivan's campaign about $119,000.

Sullivan has also been aided by a super PAC called Alaska’s Energy America’s Values, which has raised $460,000 — the bulk of which has come from three relatives who live in Ohio.

Begich’s largest funder has been the legal industry, according to the Center for Responsive Politics, whose employees and PACs have given about $670,000, or 8 percent of his total haul.

As one of the Senate’s most endangered incumbents, Begich has also collected about $400,000 from the leadership PACs of his Democratic colleagues.

Republicans must pick up six seats in November to regain control of the U.S. Senate.

Number of states that prohibited concealed carry in 1981: 19

States that prohibit it today: 0

Number of states that do not require a concealed carry permit: 5

An open-carry permit : 25

WICKENBURG, Ariz. — More Americans can carry guns in more places than ever before. In the majority of states, law-abiding gun owners can walk into bars, restaurants and churches with their guns without fear of legal ramifications, a News21 review of all 50 states found.

“It’s a situation just like getting up in the morning and putting your shoes on or your boots on. For me it’s putting (my gun) onto my side,” said Lee Bird, owner of Twin Birds Saddlery in Wickenburg, Arizona, 60 miles northwest of Phoenix. Bird openly carries a .38 Smith & Wesson Special revolver on his hip everyday.

“People look at you, but I ignore it,” Bird said. “I’m not carrying it for attention. I’m carrying it because I want people to know that if there is an incident somewhere, that I am there to defend myself or my family.”

Although Bird prefers to openly carry, sometimes he keeps his gun concealed in his briefcase or pocket. Arizona has some of the strongest gun rights laws in the country. It is one of seven states that do not require gun owners to get a permit to carry a concealed gun.

Thirty years ago, Bird wouldn’t have been able to carry his gun concealed at all. Historically many states heavily restricted who could own a handgun or banned the concealed carry of handguns altogether.

“People have come to think of the Second Amendment as protecting the individual right to keep and bear arms,” said Joseph Blocher, a law professor at Duke University specializing in constitutional law. “Also, I think people have come to oppose strong handgun laws and things like that which have in the past found favor.”

Number of states that allow concealed carry in churches: 25

In schools: 28

Number of states that ban concealed carry in bars: 16

In restaurants: 0

Guns are increasingly common in public spaces.

Georgia’s Legislature recently passed the Georgia Safe Carry Protection Act, which significantly expanded where gun owners could take their firearms. It allows licensed gun owners to bring their firearms in to churches, schools, bars and restaurants. Critics of the bill have called it the “Guns Everywhere Bill.”

“I open my front door and walk in public spaces in Georgia,” said Kathryn Grant, co-founder of the Georgia Gun Sense Coalition. “Most people don’t think about the potential of violence erupting because it’s not a reference point, it’s not a part of their experience yet.”

For some, the acceptability of guns and the number of people who could potentially be carrying is terrifying.

“If I thought about the possibility of the increased number of guns now that are being carried in places, it would have a paralyzing effect, and I won't let that happen,” Grant said.

But Georgia Carry, an influential gun-rights group, pushed the Safe Carry Protection Act through the Legislature to reinforce its members’ Second Amendment rights.

“If the criminal isn’t going to abide by the law, then I should have more places to carry,” Georgia Carry Executive Director Jerry Henry said. “Or it’s the responsibility of the place that denies my right to carry to protect me.”

Georgia Carry aims to educate the public about gun owners’ carry rights in the state and to ensure that people understand that guns are an acceptable part of society, Henry said.

The expansion of gun rights into the public sphere is a relatively new phenomenon, although not unique to Georgia.

In the 1960s, legislators responded to race riots and rising violent crime by passing restrictive gun laws. However, recent gun violence has spurred legislators in some states to strip away restrictions on where people can carry guns outside the home.

In 2013, following the Newtown school shooting, 63 laws in 26 states were enacted that made it easier to carry in public, according to an analysis by Mother Jones magazine. Only two laws were enacted in two states that made it harder to carry.

“It’s now just a sort of empirical social fact in most of this country that when you go to the shopping mall or the ballet or wherever, some of the people in the crowd of the few thousand around you, there’s going to be a percentage carrying guns,” said Dave Kopel, adjunct law professor at Denver University who specializes in Second Amendment law.

Blood-alcohol content under which an individual in Nevada can legally drive a car: 0.08

can legally carry a gun: 0.10

Number of drunken-driving-related deaths in Nevada in 2011: 70

firearm-related deaths in 2011: 376

“The best states have strong permitting standards to make sure that people who have a history of alcohol abuse or of violent arrests are not carrying guns in public,” said Brina Milikowsky, a spokeswoman at Everytown for Gun Safety.

Gun owners making legal purchases are required to pass a federal background-check and in most states must meet certain standards to obtain carry permits, such as age and training.

“I have been through all the safety courses that are necessary,” said Bird, who calls himself a “middle-of-the-road” gun owner. He has no problem with background checks and gun laws for legitimate gun buyers, as long as they are not too restrictive, he said. Bird grew up hunting and target-shooting with his father and has been using guns since he was 4.

Gun laws regulating where people could carry used to fall along rural and urban boundaries. But the advent of pre-emption laws, which prevent municipalities from passing their own firearms ordinances, has polarized the issue of public carry.

States began passing firearms preemption laws in the 1980s. Prior to that it was illegal to carry a gun inside city limits in many places.

“You could have one outside because it was more rural, not as much of a police presence so you might need one to defend yourself,” said Blocher, the Duke law professor. “But in the city, people drew a different public-safety balance. That has changed a lot, especially in the last 30 years.”

In the majority of states, the cities and counties cannot make their own firearms ordinances but must abide by state law. However, pre-emption laws are not uniform across the country, and in some states, municipalities may have more-stringent firearm controls than the state.

Age that a person can purchase a shotgun or handgun in Vermont: 16

An R-rated movie ticket: 17

Number of firearm homicides in Vermont in 2012: 3

Firearm suicides: 52

“We’re a country that has more access to guns than any industrialized country,” said Grant, from the Georgia Gun Sense Coalition. “It’s important to stop this epidemic of gun violence. As a public safety issue it’s incredibly important.”

“All of the legislation points to more guns in more spaces being a good idea," Grant said. "The research isn’t out there. It’s fundamentally flawed logic.”

Laura Cutilletta, senior staff attorney for the Law Center to Prevent Gun Violence, says that open carry can still be jarring to some.

“The public tends to not like seeing people carrying guns openly in public places and they call the police, usually not realizing that it’s actually legal in most places,” Cutilletta said. “If they knew that people were carrying and they just can’t see it, they would be equally disturbed by that.”

The majority of gun owners have guns for personal safety, not to make a political statement, surveys have found. Despite the increased attention on open-carry rallies at state capitals or chain stores like Target, only 5 percent of gun owners said they carry to reaffirm their Second Amendment right, according to a 2013 Gallup poll.

“In my lifetime, I hope I never have to draw down on a person,” Bird said. “It’s there for my protection. If I need it, it’s a tool and that's all it’s used for.”

Many law-abiding gun owners feel that gun control advocates wrongly associate guns with crime. Brett Pucillo, president of Ohio Carry, said he started the group to advocate for general firearms rights through community outreach.

“Our goal is to spread that awareness and show people not only what they’re legally able to do and how to do it safely, but also to show them that good guys have guns, too,” Pucillo said. “So it’s not just the bad guys, like they see in movies.”

Kristen Hwang is a Donald W. Reynolds Foundation Business Journalism News21 Fellow.

Since the 2001 anthrax letter attacks that killed five people and raised the specter of bioterrorism in the United States, the number of high-level biosafety labs operated by governments, universities and others to study potentially lethal pathogens has been expanding rapidly. According to a 2013 report to Congress, the number of these labs grew by almost 10 percent, from 1,362 to 1,495, between 2008 and 2010 alone.

The construction of hundreds of new labs designed for working with dangerous organisms has occurred without any central oversight or clear strategy for expansion, congressional analysts and others say. The expansion has raised concerns that many of these labs may not be needed and that their sheer number raises the risk of exposure to the public from the germs they study.

The FBI’s chief suspect in the 2001 attack, who committed suicide in 2008 before he could be charged in the case, was a biologist at the Army’s biodefense lab at Fort Detrick, Maryland.

Despite the concerns, Los Alamos National Laboratory is pushing forward a 2001 plan to build labs to work with disease germs like anthrax and tuberculosis, even though Los Alamos has not adequately explained what the facility would be used for or why it is needed, according to a report released last week by Department of Energy Inspector General Gregory Friedman.

Friedman wrote that the $9.5 million proposal had been made without fully assessing the need for and cost effectiveness of the project, and that the DOE’s National Nuclear Security Administration, which runs Los Alamos and other energy labs, “needs to fully reassess its need for biological research facilities.”

Friedman’s criticism comes just a month after officials at the Food and Drug Administration in Bethesda found 12 boxes containing vials of smallpox, dengue fever and influenza viruses — among other potentially deadly disease agents — squirreled away in cold storage.

It also comes after Congress in January created an independent commission to consider consolidating or downsizing the Energy Department’s 17 research labs, which cost $10 billion annually, in part to reduce duplication of efforts. At their first meeting in July, Secretary of Energy Ernest Moniz said he hoped the panel would come up with a “strategic” view of the laboratories in the 21st century. Its findings aren’t expected until next year.

Today there are more than 450 research centers operating as many as 1,500 labs capable of conducting research on biological agents such as Ebola and anthrax, said Richard Ebright, a professor of chemical biology at Rutgers University and a laboratory director at the university’s Waksman Institute of Microbiology. Ebright said more than 12,000 individuals are authorized to work with these lethal pathogens.

The major concern, he said, is that the sheer number of biosafety labs could raise the risk that dangerous pathogens will accidentally or deliberately be released into the wild.

“It would be funny if it were not so unfortunate,” Ebright said. “The response to the problem magnified the problem, at enormous cost as well.”

Biosafety labs are broken into four categories, with BSL-1 for the lowest-risk pathogens and BSL-4 labs dealing with lethal agents like Ebola that have no vaccine or treatment. The Los Alamos expansion would include BSL-3 labs, which study agents like anthrax, Rift Valley fever, malaria and West Nile virus that can cause possibly lethal infections, as well as a BSL-2 facility, where scientists will study less dangerous agents.

Ebright said the DOE in particular has “no mission that is relevant in any way, shape or form, directly or indirectly, to biological weapons agents. It has no need, directly or indirectly” for a BSL-3 lab.

Ebright told a congressional hearing on biolab safety in July that the number of BSL-3 and BSL-4 labs should be cut by a factor of 20 to 40. He told the Center for Public Integrity the labs should be restricted to just 22 sites — all of which would have BSL-3 labs and eight of which would also have BSL-4 labs. Concentrating these organisms at fewer laboratories would make it easier to keep them secure, according to advocates for limiting their number.

Smallpox, which was eradicated in the wild, is supposed to be held in only two places on Earth: at a secure facility at the Centers for Disease Control and Prevention in Atlanta and a virology institute in Novosibirsk, Siberia.

Nancy Kingsbury, the managing director for applied research and methods at the Government Accountability Office, said federal biosafety labs have been constructed by multiple government agencies, each of which assessed their own needs without regard for what other agencies were doing.

“Each agency has its own mission, each agency has its own relatively narrow focus on their part of the problem, and so each agency has gone to Congress and gotten funding to do x, y and z,” Kingsbury told the Center. “There are not good cross-agency mechanisms for looking at these issues and deciding who should be in charge.”

To add to the confusion, Kingsbury said there are multiple committees within Congress that have oversight of the agencies that have laboratories or want them, meaning that both operation and oversight is fragmented. She called it “a tough nut to crack.”

BSL-3 and BSL-4 labs are operated by the CDC, the National Institutes of Health, the departments of Energy, Defense and Homeland Security, as well as a number of universities and private companies.

Concerns about the proliferation of these labs date back to shortly after the expansion began in the early 2000s. A September 2009 GAO report called for a national strategy for oversight of the labs, saying that it was impossible to say how many there were because only those working with select agents needed to register.

“As a consequence, no federal agency can determine whether high-containment laboratory capacity may now be less than, meet, or exceed the national need or is at a level that can be operated safely,” the 2009 report said.

In addition to the discovery of the vials of smallpox and other deadly agents in Bethesda last month, employees at the CDC’s Atlanta headquarters were accidentally exposed to anthrax in June. During the July hearing on these incidents, before a House Energy and Commerce subcommittee, Chairman Tim Murphy, R-Pa., said the incidents represented “a pattern of reoccurring issues, of complacency, and a lax culture of safety. This is not sound science, and this will not be tolerated. These practices put the health of the American public at risk. It is sloppy, and it is inexcusable.”

Marian Downing, president-elect of the American Biological Safety Association, who previously worked in BSL-2 and BSL-3 labs with Abbott Laboratories in Illinois, said there are institutions that have BSL-3 facilities that don’t need them.

 But she said the majority of these labs follow the CDC’s guidelines, Biosafety in Microbiological and Biomedical Laboratories, as if they were strict standards.

“For people to say there are no standards, it makes the public think it’s out of control,” but, she said, that’s not the case. “There are these guidelines, they’re basically mandatory if you’re working on select agents or toxins.”

 While most of the expansion of the nation’s biolabs occurred during the Bush administration, the Obama White House has defended the trend.

According to the 2013 GAO report, officials with the White House Office of Science and Technology Policy said they did not agree with the GAO’s recommendation that a single agency should conduct a government-wide strategic evaluation of high-level biolabs. Nor did the office agree that expanding the number of labs increased the risk to the public. A spokeswoman for the office did not respond to requests for comment.

Kingsbury told the Center that the labs are generally safe and run by experienced scientists, but that the sheer number of these facilities increases risk.

“You can’t say the risk is zero,” she said. “So if the risk in a given lab is not zero — and these recent episodes were largely human-error driven — if the risk is not zero, then the more labs you have, the bigger the risk there is.”

Los Alamos completed an environmental assessment in 2002 of plans to build two BSL-3 labs. The facility to house them was constructed a year later. The project was delayed for years, however, because of a lawsuit by two advocacy groups, Nuclear Watch New Mexico and Tri-Valley CAREs, located in Livermore, California.

In the environmental assessment, Los Alamos’ management said that research into disease organisms was not outside the scope of its mission, nor inconsistent with existing work at Los Alamos.

The assessment said that additional BSL-3 labs were required due to the increasing concern that biological agents could pose a national security threat. Similar labs elsewhere, it said, were often booked for other projects and using them added risks in handling the agents.

“In order to more effectively utilize and capitalize on existing onsite facilities and capabilities … NNSA needs BSL-3 laboratory capability within the boundaries of the national lab,” the assessment said.

In his July report, DOE Inspector General Friedman wrote that the Los Alamos project would nearly double the NNSA’s BSL-3 lab space. Yet the NNSA doesn’t track or coordinate its biological research facilities across its sites and laboratories, Friedman wrote.

Friedman also wrote that Los Alamos didn’t consider whether it would duplicate capacity at other places, including at Lawrence Livermore National Laboratory, which has three BSL-3 labs.

Most of the work would come from other federal agencies rather than the Department of Energy, the IG report said, while the demand for work from these agencies is less certain than Los Alamos claimed.

IG spokeswoman Felicia Jones said they spoke with two prospective clients named by Los Alamos, the Department of Defense and the Department of Homeland Security. According to the report, both agencies told the IG they had no specific plans for conducting research at a BSL-3 lab at Los Alamos. The report said officials at one of the agencies said it was planning to build its own BSL-3 facility in the next two years. It did not say which one.

When asked for comment about the Inspector General’s report, representatives from both Los Alamos and the NNSA referred the Center to the official management response included in the report. They did not respond to requests for further comment.

In the response, NNSA Administrator Frank Klotz wrote that his agency would develop metrics to measure the use of biosafety labs and would use that data to make decisions on facilities. Klotz wrote that the proposed work at Los Alamos could not be conducted at Lawrence Livermore laboratory, though he did not explain why.

Klotz also wrote that his agency would re-evaluate the analysis of the proposed BSL-3 facility at Los Alamos and “more formally document” the mission, need and potential customers.