White House Abortion Fight, Debt Ceiling Proposal, Children's Vaccines
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With new threats to abortion access, the White House is rallying support to protect reproductive rights. And Vice President Kamala Harris is the leading voice. We have to have a counter movement. We'll hear more on how the administration is focusing on the issue. I'm Ian Martinez, that's Michelle Martin, and this is Up First from NPR News.

House Speaker Kevin McCarthy unveiled his plan to raise the debt ceiling, but it comes with major strings attached. He proposed huge cuts to important programs that millions of Americans count on. President Biden is not on board, but since they're running out of time, can they compromise? And 67 million children worldwide missed their usual vaccines because of the COVID pandemic. That's according to a new report. We'll talk about what it could mean for outbreaks of some of the most contagious diseases. Stay with us. We'll tell you the news you need to start your day.

The Supreme Court has extended a temporary freeze in the abortion pill case until Friday at midnight. At stake is access to an FDA-approved medication used in abortions and to help manage miscarriages. The White House says it is prepared to fight regardless of the outcome.

NPR White House correspondent Asma Khalid has been looking into the White House strategy on defending Mipha Pristone. And she's with us now to tell us more. Good morning, Asma. Good morning. So abortion access for the moment seems to be largely in the hands of the courts or the states. So what's the White House trying to do?

Michelle, the administration can't do a whole lot, it seems, on the policy front. It can fight this in the courts. That's what it's been doing. That's what it's going to continue to do. And I interviewed the White House Chief of Staff, Jeff Zients, yesterday. He also made it clear that the administration is going to continue to use the power of the bully pulpit. Vice President Harris is leading the charge for our administration with urgency and determination. We've been clear. She's been clear. We're prepared for any outcome.

And we're going to continue to fight. And the court needs to do the right thing here. How is the White House doing that? How is it trying to draw focus to the issue? Well, the vice president has been traveling around the country. She's been meeting with local lawmakers, activists, students, health care providers. Her staff tells me she's been to 18 states so far. And, you know, she talks about, I will say, a woman's body, a woman's choice with a degree, I think, of authenticity. Activists tell me that Biden cannot necessarily do that.

You know, for example, the other day she was out on the streets of L.A. rallying the crowd at a women's march, and then she went on to Reno, Nevada, where she was applauding efforts to enshrine abortion rights into that state's constitution. But she was also criticizing Republicans for efforts nationwide to try to restrict abortion. We have to have a counter-movement to what they are attempting to do, which is to create a national ban.

So Asma, you've told us what the vice president is doing. What's the president doing? Well, you know, to be clear here, whatever the administration is doing is essentially the president's agenda, but he's not as visible on the issue. Some Democrats say that Biden is not as comfortable speaking about abortion. You know, he has expressed reservations in the past because of his Catholic faith.

And I want to be clear here that his position has certainly evolved. Democrats say the debate has shifted so far to the right with six-week bans and this medication abortion case that it's easier for people to pick a side.

I was speaking the other day with Linnea Erickson. She's with this centrist Democratic group called Third Way, and she had this sharp analysis of what exactly Biden's job is. I think that his role is to help frame just how extreme the Republican policies are. He is much more comfortable talking about the kind of edges of this debate and where it has moved.

Biden's main role has been to set the direction of his administration, you know, make it clear that reproductive rights are a priority. He's also called on Congress to pass a law that would restore Roe versus Wade. But he's not out there rallying the troops. You know, he's framing abortion more broadly as a threat to democracy in the context of how extreme Republicans have become and also raising alarms about politics interfering in medical decisions made, you know, for example, by the FDA.

Let's talk for a minute about the politics. It would seem that this would be a huge focus as we head into next year's presidential elections. I'm just thinking even just about the role that it played in more recent state or midterm elections. That's right. And I will say that, you know, so far, reproductive rights have seemed to be a real winning issue for Democrats. You also see that in polls. You know, banning medication abortion and putting really restrictive conditions on abortions are just not where public opinion is.

I will also say that there are political benefits for this all, also for the vice president. You know, there has been a lot of reporting that has criticized Harris for the way that she has done her job as VP. And this issue of abortion isn't like some of the other trickier things in her portfolio, like the root causes of migration, right, the situation at the border.

He or she is spending time on an issue where Democrats are seen to have the upper hand, and that could raise her political profile and quiet some of the criticism ahead of the re-election campaign. That is NPR's Asma Khalid. Asma, thank you. My pleasure.

You may have been hearing a lot recently about the debt ceiling. Yeah, that's the limit on the total amount of government borrowing. The U.S. hit its limit in January. The Treasury Department is using extraordinary measures to avoid the first ever U.S. debt default, but those are on track to run out this summer.

There's growing anxiety on Capitol Hill with the looming deadline, and House Speaker Kevin McCarthy and President Biden have been at an impasse on the issue for several months. Yesterday, McCarthy laid out the House Republicans' legislative demands to stop a default from happening. NPR congressional reporter Barbara Sprunt is with us now to tell us more about it. Good morning, Barbara. Good morning. All right, so let's start with the bill itself. What's in it?

The bill does what McCarthy has long signaled he wants to see happen, increasing the debt limit done in tandem with federal spending cuts. The bill would increase the country's borrowing limit by $1.5 trillion or through March of next year, whichever comes first. It would roll back federal spending levels to those from two years ago, limit the growth of spending going forward to 1% annually, and it would try to unwind some of Democrats' signature legislative accomplishments.

repealing parts of the Inflation Reduction Act, which funded energy and climate change programs, and prevent the administration from enacting its student loan forgiveness plan, which I should note is still tied up in the courts. And another thing that's getting a lot of attention about this bill are work requirements for adults without dependents who are enrolled in federal assistance programs. By restoring these common sense measures, we can help more Americans earn a paycheck,

learn new skills, reduce childhood poverty, and rebuild the workforce. The bill would also target the $80 billion aimed at improving the Internal Revenue Service, which Democrats approved last year as part of the Inflation Reduction Act, and that's aimed at easing up the agency's backlog.

And it's worth noting that the nonpartisan Congressional Budget Office has estimated that that $80 billion allocated over 10 years for the IRS would increase revenues and that repealing the measure would actually contribute to the deficit. And Barbara, you know, Democrats have been calling on McCarthy to release the details of this proposal that he's been promising for some time now.

What are they saying now that he's finally done it? Democrats say a lot of these ideas, particularly the work requirement provision we just discussed, are non-starters. Yesterday, Biden cast McCarthy's plan as something that benefits Wall Street and the wealthy. He said the threat of defaulting on the nation's debt would destroy the economy. Instead, I'm making threats of default if I don't go along with what they want, which would be catastrophic to the country.

If we don't do it, they say they're going to let default take place. Take default off the table and let's have a real serious, detailed conversation about how to grow the economy, lower costs and reduce the deficit. Barbara, before you go, it doesn't sound like the president is eager to engage with McCarthy on this. So can you just tell us what's the thinking from the speaker's side? It doesn't seem like this bill is going to go very far in the Democratic-controlled situation.

Senate. So what's the logic of this here? That's exactly right. The first hurdle for McCarthy is making sure he has the votes in his own conference. He has a very narrow majority in the House. He can only afford to lose a few Republican members and still pass this thing without any Democratic support.

Yesterday, as he was leaving the floor after the speech, he told our colleague Deirdre Walsh he feels confident he does have the votes he needs. But as you said, yes, this would be dead on arrival in the Senate. But the thinking is that if Republicans can pass this in the House, it could put some political pressure on Biden to come back to the negotiating table. That's NPR congressional reporter Barbara Sprunt. Barbara, thank you. Thank you.

The COVID-19 pandemic disrupted routine health care services for millions of us. A new report by UNICEF finds those disruptions caused the biggest drop in childhood vaccinations in decades, and countries across the world are seeing the consequences of those missed vaccines. Here to tell us more about those findings is NPR's health correspondent, Ritu Chatterjee. Ritu, good morning.

Good morning, Michelle. So tell us more about the report and what it found. How many kids missed their vaccines? So, you know, this is a report that UNICEF puts out every year. And this latest one finds that between 2019 and 2021, a total of 67 million children did not receive all or some of their routine vaccines like measles, polio, hepatitis B, diphtheria, etc.,

And 48 million kids got zero doses. And these kids, you know, are already three years old or nearing that age by when they have received all their shots.

And I spoke with Lily Caprani, the chief of global advocacy at UNICEF. And here's what she told me about what these numbers say. We've seen the largest sustained decline in the number of children reached with their basic childhood immunizations, more than a generation's worth of progress. And the consequences of that will be measured in children's lives. And when she says a generation's worth of progress, what does she mean?

So, you know, the world has had made so much progress in recent decades in controlling these dangerous childhood diseases with vaccines. And in just a matter of three years, so much of that work has just been undone. This is so important. Ritu, does this mean that these diseases that the vaccines protected kids against are coming back?

Yeah, there's been a rise in cases of tetanus and diarrheal diseases, for example, and countries are seeing large and disruptive outbreaks of one of the most contagious diseases, measles. Just last year, 33 countries saw major measles outbreaks, including India, Somalia, Nigeria, Afghanistan, Ethiopia, and

Polio cases are rising too. Brian Keeley is the editor-in-chief of this report, and he told me that the number of children paralysed by polio have jumped eightfold during this time. Here's Keeley. It really does show that we can't be complacent with something like polio. For my generation, we thought this was over. You know, we thought it was dealt with. It isn't. If we don't keep up these efforts to really vaccinate every child, this will come back.

And so will, you know, all these other diseases that kids are vaccinated for. So before we let you go, what are countries doing to make up for the lost time and to catch up on these truly important childhood vaccines? So the good news here is that many countries have already vaccinated

been working really hard to catch up on these missed shots. And many have succeeded in getting to kids that had missed these vaccines. For example, the Philippines has been doing a lot of community outreach and using some innovative approaches like doing vaccination campaigns in commercial places like malls to vaccinate kids.

So, you know, to get to people where they are, and they've caught up quite a bit, according to a UNICEF official based in Manila. And India, which had nearly 3 million kids with zero vaccine doses, has really turned things around with very targeted campaigns in the most affected communities. But, you know, the poorer countries and those that are conflict-ridden have really a long way to go to reach every child. That is NPR's Ritu Chatterjee. Ritu, thank you. My pleasure.

And that's Up First for Thursday, April 20th. I'm Michelle Martin. And I'm Ian Martinez. Up First is produced by Taylor Haney and David West. Our editors are Amra Pasich and Alice Wolfley. Our technical director is Zach Coleman. And start your day here with us tomorrow. If you like our mix of the top stories each day, not to mention plenty of analysis and some fun too, then you should check out our new daily thing. It's NPR's all-in-one Up First newsletter. Sign up at npr.org slash upfirstnewsletter.

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