“Are we going in?” she asked.

“Yes,” he said. “We are going in.”

His body had endured six years of chemotherapy and an additional five of experimental therapies. According to his medical record, he had responded “singularly impressively.” Two months earlier he had been running 5 miles a day, but since the latest round of chemo he had rapidly declined.

Lisa Warwick guided her husband up the stairs, dragged him to the car and raced to St. Peter’s Hospital in downtown Helena, Montana.

The emergency room doctor cited shortness of breath, fever and chills. He flagged that Warwick’s respiratory crisis could be the result of the chemotherapy. It had been restarted weeks before on the order of the oncologist who diagnosed him, the only doctor he’d consistently seen for more than a decade.

The next morning, a doctor named Randy Sasich arrived for his shift at St. Peter’s. An independent nonprofit with just under 100 beds, the hospital is the only acute-care facility for about 100 miles in any direction and has touched the lives of virtually every area resident going back generations. Helena, the state capital, remains a small vestige of the Old West, with just 34,000 residents, so luring doctors has always been a challenge. This was especially true in April 2020, at the onset of COVID-19, when Sasich signed a short-term contract.

A 47-year-old lung specialist, with degrees from Georgetown and Santa Clara University and experience at hospitals in major cities, Sasich was a rare get. The de facto director of the hospital’s intensive care unit, Sasich met with the morning shift’s coordinating doctor. Standing in the ICU, the two ran through patients, their needs, the usual, until Warwick.

We have a 51-year-old patient with metastatic lung cancer, diagnosed 11 years ago, Sasich remembered the doctor saying.

“There’s no way,” Sasich interrupted.

Well, he’s been treated for 11 years, the doctor explained.

“You don’t live 11 years after a Stage 4 lung cancer diagnosis,” Sasich said. “That doesn’t make any sense.”

Between patients, Sasich reviewed Warwick’s chart. Something must have been misread along a medical game of telephone, he reasoned, or he’d missed some great advancement in cancer treatment. He found the 2009 report that prompted the cancer diagnosis. A smoker at the time, Warwick had seen an ear, nose and throat doctor about a tiny lump on his neck. The ENT had sent a sample of cells from Warwick’s neck to the lab. A few days later he wrote in the file that they were “most likely consistent” with cancer.

That is not a cancer diagnosis, Sasich thought.

The records indicated that Warwick was referred to the hospital’s Cancer Treatment Center. Sasich’s curiosity graduated to shock: There was no biopsy. Yet Warwick was immediately placed on an aggressive chemotherapy regimen by the hospital’s sole oncologist, Dr. Thomas C. Weiner.

This is bad.

In his few months at St. Peter’s, Sasich had already questioned Weiner’s incomplete documentation and curious diagnoses and had taken his concerns to a veteran doctor for advice. To Sasich’s surprise, his colleague was fearful of challenging Weiner. According to Sasich, the doctor said: “I live here. My kids go to school here. I don’t want to move.”

Sasich scoured Warwick’s file, thinking someone must have ordered a lung tissue biopsy, which would capture more cells and target the suspected origin of the disease. Where was the lab report that confirmed cancer and ruled out everything else? From 2009 to 2019, he found none. Then, finally, there it was — in April 2020, just a few months earlier — a report on lung cells biopsied. Sasich read and reread the pathologist’s conclusion: no cancer.

“What the hell is going on here?” he whispered.

Despite the negative biopsy, Weiner had started Warwick on another round of chemotherapy, according to the medical records. Within two months, Warwick couldn’t walk upstairs, and now he was in the ICU while his wife and two children waited outside of the hospital because of COVID-19 protocols.

Sasich called the pathologist, who confirmed the finding. Sasich feared his own hypothesis. He worried what it would mean to Warwick and his family, but the “unbelievable conclusion” he had come to might save the patient’s life.

The next morning, Sasich entered the ICU where Warwick lay in the dark, oxygen pumping into his nose. Sasich pondered how to tell a man that everything he believed about himself for more than a decade was false.

Moments after Sasich left the room, Warwick called his wife. “He doesn’t know my history,” he told her. “He doesn’t know anything about me. He doesn’t know I’ve had this for 11 years. He doesn’t know anything. And this doctor’s telling me that I don’t have cancer? This guy’s an idiot.”

Sasich knew he had just challenged a powerful figure in Helena. He just had no idea how powerful.

While reporting on COVID-19’s toll in early 2022, I found myself in Helena, chatting over drinks with a handful of St. Peter’s medical staff. They wondered why I wasn’t asking about Tom Weiner. There was a deeper, haunting story, they told me, about the oncologist many inside the hospital suspected of hurting his patients. Despite those whispers, he was beloved by countless patients — “followers,” they called them. His nurses were wildly devoted to him — “a cult,” they said. The hospital administration feared him.

The rumors they shared, though vague, were disturbing and impossible to ignore. They portrayed a man whose ability to both inspire and intimidate had divided the town of Helena. It would take two years to unravel one doctor’s myth, a hospital’s complicity in creating it and the attempt to conceal a trail of suspicious deaths. One of them, I’d later learn, was of a 16-year-old girl.

Early in my reporting, I reached out to Weiner. Reluctant at first, he agreed to sit down with me. He was, he told me, the good guy in this story.

Weiner, 61, is guarded about his own life. He was raised Lutheran. His mother was a nurse, his father an FBI agent who urged him to be a lawyer. Weiner told me he was never much of “a research guy.” Rather, he wanted to bring a personal touch to medicine, to help people in their most vulnerable moments. He attended medical school at Hahnemann University, now Drexel, in Philadelphia. There, he met his wife, a devout Catholic, and he converted. An avid mountain climber and skier, Weiner felt that American westward pull and, after training in hospitals in Pennsylvania and Vermont, took the job at St. Peter’s in 1996.

He arrived as something of a savior. In an ad in the Great Falls Tribune, the hospital announced that it had hired a permanent oncologist to direct its new cancer treatment center, replacing a rotation of doctors who made often precarious commutes from Great Falls, Bozeman or Missoula. For most of the next 24 years, he was the only option for thousands of cancer patients. It’s not an overstatement to say anyone who had cancer or knew someone who had cancer in that time knew of Weiner.

He was instantly popular. Among his first patients was fashion designer Liz Claiborne, whose husband described Weiner as “a solid rock of a man, cheerfully youthful, robust, square-shouldered, handsome in a quiet way.” The Weiners became prominent members of the Cathedral of St. Helena and donated money to the Vatican.

In our talks, he was as Claiborne’s husband described, if weathered by a quarter century in the dry high country. He is fit, almost always wearing hiking shoes, a North Face T-shirt on warm days, a fleece in the cold. With sharp blue eyes, he smiles when he explains his medical judgment, projecting an absolute conviction in what he believes and has done.

Weiner’s stature rose with the cancer center’s. In late 2000, a news article reported that it was now treating about 250 patients a year. Three months later, the facility announced it would be adding six chemotherapy chairs, a library and a meditation center. An article in the Independent Record, the local paper, noted, “In the five years that Weiner has been with the cancer treatment center, he has seen an increase from 12 or 13 patients per day to 35 or 40 patients per day.”

Weiner told me, and records confirm, that he billed for as many as 70 patient contacts a day. That pace made him an obvious outlier in data tracked by federal insurance regulators, but no one inside or outside the hospital slowed him down. He spoke proudly of his workload. He was always on call, he told me, and many of his patients had his cellphone number. As business boomed, so did Weiner’s wealth.

Adding to a six-figure base salary, his pay was calculated by the number of relative value units, or RVUs, he billed on behalf of the hospital. The system compensates doctors using weighted values for certain types of visits or treatment. It works like this: A doctor might be paid $100 per RVU. A routine physical might be equal to 1 RVU, or $100; a more complicated and time-consuming procedure like radiation therapy might equal 8 RVUs, or $800. In other words, the more patient visits and treatments a doctor bills to insurance, the more that doctor and the hospital earn. Weiner described this system, which is common in American medicine, as “eat what you kill.”

In 2006, Weiner purchased a 3,400-square-foot home atop Mount Helena with a panoramic view of town. The next year, Weiner’s rising RVUs made him the hospital’s highest earner at $751,000, tax filings show. By 2010, Weiner was paid more than $1.3 million, more than three times the salary of hospital CEO John Solheim.

Around this time, according to court records, hospital administrators worried that Weiner’s pay could draw scrutiny from federal regulators for a violation of the Stark Law, which prohibits physicians who bill Medicare and Medicaid from referring patients in ways that enrich themselves. Those programs account for about 60% of St. Peter’s revenue. As questions about his pay intensified, Weiner responded by coordinating a staff rebellion, text messages show. A majority of St. Peter’s medical staff signed a letter of no confidence in Solheim, and Weiner was the lead signatory of a letter published in the Independent Record that charged the hospital with caring more about money than quality patient care. Not long after, Solheim resigned. He did not respond to my requests for comment. It’s unclear if the hospital at that time had its own concerns about the quality of Weiner’s care.

St. Peter’s had flourished since Weiner’s arrival, recording nearly 200,000 patient visits and bringing in more than $187 million in 2012. Weiner told me that most years his cancer care accounted for more than a quarter of the hospital’s revenue; St. Peter’s told me it was closer to 10%.

When negotiating his pay, emails show that Weiner leveraged his position as the region’s only oncologist, threatening to sue or quit, and he would prevail. With that power, he built a kingdom. In an unusual move, St. Peter’s allowed him to take over every facet of his patients’ care by naming himself their primary care physician. Because other options for cancer treatment were a long car ride or plane trip away, patients rarely sought a second opinion. Weiner protected his turf, resisting attempts to hire another oncologist or to transfer his patients to other doctors, court recordsshow. As a result, few colleagues were looking over his shoulder. Inside the hospital, some referred to what he created as “his closed system.” As one doctor put it to me, if you were Weiner’s patient, “he grabbed on to you. He stayed with you for life. No one else would see you until you die.”

Concerns about Weiner’s billing and patient load persisted. Solheim’s successor, Nate Olson, also questioned his compensation. Weiner again helped organize a vote of no confidence, records show. Olson, who did not respond to requests for comment, stepped down in May 2016.

In 2019, St. Peter’s current CEO, Wade Johnson, hired an expert on the federal False Claims Act and fraudulent billing practices to study Weiner’s pay. The consultant described Weiner’s RVUs as “exceedingly high” and his compensation “a significant outlier.” Weiner logged nearly four times the visits and treatments of the median oncologist in the United States, despite working in a sparsely populated region. The consultant said the billings could be defended but warned they presented a potential legal and financial liability for both the hospital and Weiner.

From 2009 to 2020, the period Scot Warwick was under his care, the hospital paid Weiner more than $20.1 million. In all our conversations, he never shirked questions about his income. The bottom line, he told me, was that without him, St. Peter’s had no cancer center. “You want me to keep seeing everyone?” he said. “Then you’re going to pay me more, because I’m doing more work.”

Each morning Warwick lay in the ICU, Weiner visited, still dressed in his gym clothes. Over a decade Warwick had come to see his doctor as a friend. In their talks, Weiner dismissed Sasich’s hypothesis, though he agreed with the decision to stop administering the chemotherapy drug gemcitabine. As Sasich spent more time with Warwick, his confidence only grew. Throughout his treatment, Warwick had shown few symptoms of lung cancer and had continued to backpack, camp and kayak with his kids.

In Warwick’s records, a medically coded tit for tat ensued between the hometown celebrity and the outsider. Sasich ordered a new biopsy and tests to look for infection in Warwick’s lungs. “Dr. Sasich,” Weiner responded, “is still skeptical of the diagnosis.”

Lisa Warwick first heard from Sasich on Aug. 9, a week into her husband’s hospitalization. He wanted to explain the need for another lung biopsy. A habitual note taker, she scribbled words her mind could not accept: “This doesn’t present to me like cancer,” he told her.

“Well, how could that be?” she remembered thinking. “All our lives sucked for 11 years. I can’t imagine that we went through all that and it not be real.”

Sasich agonized about what to do. Doctors rarely challenge one another’s work. But after talking with the Warwicks, he filed an official complaint, accusing Weiner of an egregious mistake. He sent a letter to the hospital’s peer review committee, an internal group of doctors tasked with examining concerns about patient care. In it, he wrote that Warwick “would be the longest living case in the medical literature.”

One of the tests Sasich ordered indicated a possible fungal infection in Warwick’s lungs — not uncommon for patients whose immune systems have been wrecked. He was treated with steroids and an antibiotic cocktail. Warwick improved and, on Aug. 13, was sent home with an oxygen tank. Three days later, Lisa Warwick found him suffocating. He left home again for St. Peter’s, this time in an ambulance.

After a week of tests, Sasich called Lisa Warwick to tell her that her husband was experiencing a rare and excruciating reaction to the antibiotic Bactrim. Called Stevens-Johnson syndrome, it causes the skin to blister and peel. He was intubated and flown to a specialized burn unit at the University of Utah’s Huntsman hospital. The next day, Warwick’s left lung collapsed. A doctor told her to rush down to Salt Lake City.

For three weeks, Lisa Warwick lived at Huntsman, unable to leave and reenter because of COVID-19. Inside, doctors expressed to her confusion about Warwick’s diagnosis and sparse medical record.

When his right lung neared collapse, a doctor asked about his dying wishes — his code status. Do not resuscitate, Lisa Warwick said, a DNR. When they could do no more, the lead doctor pulled her aside. According to court records, he asked if she wanted an autopsy. As he asked, the doctor nodded his head up and down. She said yes.

Scot Warwick’s final communication with his wife was a faint squeeze of her hand. He died just after midnight on Wednesday, Sept. 16, 2020.

About a month later, his widow heard from the medical examiner. This is how she recalled the conversation during court testimony:

“Mrs. Warwick, I’ve never had to make this call before,” he said. She began to take notes. “I’m sorry.”

“OK?”

“We did not find any cancer cells at all. We can’t find anywhere in his records that he had cancer and found no malignancy at all.” All signs indicated he died from lung failure caused by the drug gemcitabine. Chemotherapy killed him.

As the conversation closed, she asked: “What am I supposed to do with this? What do I do?”

“Get a lawyer,” he said.

After Warwick’s death, Sasich bumped into Dr. Robert LaClair, the hospital’s kidney specialist and chair of the peer review committee. “How the fuck did this go on for so long?” Sasich asked. He considered LaClair an excellent specialist and consulted him frequently. From LaClair’s face, Sasich worried he had offended him.

A former Air Force doctor, LaClair has a certain respect for bureaucratic channels, which Sasich admits is not his domain. LaClair had worked with Weiner for 11 years and over that time had choked down his concerns. As he would later tell me: “I was caught up in the culture. We all were.”

LaClair revealed to Sasich that for months he had been quietly building a case against Weiner. According to court testimony, he advised Sasich to lay low as any attempt to remove Weiner had to be done “by the book.” Weiner had the money to sue the hospital and had threatened to do so many times. It could become a circus. Sasich was relieved that something was happening but was outraged that no one had acted before his patient suffered an agonizing death.

What LaClair didn’t tell Sasich was that the problem was worse than he knew. The review had begun a year earlier, after LaClair and a colleague questioned Weiner about his practice of providing minimal, often indiscernible, notes in his patient files. This poor documentation complicated follow-up care and, according to LaClair, intentionally made it difficult for others to question Weiner’s treatment. Court records show LaClair and his colleague also told Weiner to stop admitting scores of patients to the hospital for stays unrelated to cancer — stays that financially benefited him.

By early 2020, doctors and nurses had submitted enough confidential complaints for peer review to make LaClair act. He sent a half dozen patient files to medical experts at the University of Utah, but the conclusions had been delayed by COVID-19.

After Warwick died, St. Peter’s added his file for review. The doctor examining it quickly responded, thinking there must have been a clerical error: The packet didn’t include a biopsy to support the 2009 diagnosis. On Oct. 9, St. Peter’s received his analysis: “If he had cancer, this course of many years would be truly remarkable.” It went on, “The long-term treatment with toxic medications in the absence of a confirmed diagnosis of cancer is not reasonable.”

External reviews typically lack forceful language, perhaps by design. Medicine is nuanced, messy and rife with decision points and diverging paths, so doctors grading other doctors can sound deferential, even perfunctory. The eight Utah reviews were different.

Looking at a 2018 incident involving a 62-year-old man whom Weiner had diagnosed with throat cancer, a reviewer described several decisions as potential “malpractice” that led to an unnecessary two-month hospitalization. As with Warwick, there was no biopsy in the file.

Another review criticized what Weiner didn’t do. A 67-year-old woman with breast cancer had received chemotherapy and undergone a mastectomy and breast reconstruction. In a June 2019 check-up, Weiner noted “no evidence of any recurrence.” But records show that he didn’t conduct a breast examination. (Records show that this was a common failing in his breast cancer treatment.) Months later, the patient found a lump. A biopsy ordered at another hospital confirmed the cancer had been back for some time, which led to a second breast tissue removal, radiation and chemo.

“I’ve never seen so many cases of what we sent out that was not meeting standard of care. I’ve never seen that before, and I hope I never see it again,” LaClair would testify.

LaClair later told me, “When the Utah reports came back, it was like: ‘Holy fucking shit. This is going to suck.’”

On Oct. 15, 2020, St. Peter’s suspended Weiner and revoked his privileges. Banished from the kingdom he’d built over a quarter century, Weiner told me he felt only “blank.”

The hospital hired The Greeley Company, a health care consultancy, to scrutinize the records of dozens of additional patients, many of them dead. Weiner would be given an opportunity to defend himself and regain his job at an internal “fair hearing.”

Word of Weiner’s suspension devastated the nurses at his cancer center, the core group of women who called themselves “Tom’s wives” or his “girls.” They were the envy of nurses in other departments for the prestige of working for Weiner and for the perks. From 2005 to 2020, records show that he gave them at least $140,000 of his own money in bonuses and jewelry. Upon retirement, nurses could expect diamond solitaire earrings worth about $1,500. He invited them to his home for dinners and holiday parties. They messaged him regularly, wishing him well on his extended trips to Italy.

In the weeks following his suspension, they delivered food and sent supportive notes. They vowed to resist the administration. Weiner told them not to lose their jobs for him.

“I love you. I’m here. I’m so sorry. I’m praying,” nurse Emily Burton texted him.

“You can tell the girls I will be fighting,” Weiner responded. “But it will probably get bloody.”

To others, like nurse Meghan Giovenco, he expressed anger: “They are going for the jugular. Scum.”

When Weiner heard that Sasich questioned his work in front of his nurses, he texted a hospital administrator, “FYI put a muzzle on Sasich or else.”

News of Weiner’s suspension spread through social media and Helena’s shops and diners. Patients formed a Facebook group called “We stand with Dr. Tom Weiner.” He saved their lives, their spouses’ lives, they said. He remembered the names of their children and grandchildren. He was kind, brilliant. Dozens more joined, then hundreds and hundreds.

To those inside St. Peter’s, it resembled the campaigns that forced out the previous CEOs — only worse. Soon, the first of what would be more than a hundred small rallies was held outside the hospital. By ousting the region’s only oncologist, they contended, patients had been abandoned, consigned to long waits and a rotation of travel doctors. One sign proclaimed, “I WANT MY DR. WEINER, NOT THE SECOND STRING.” Their message spread to yard signs, bumper stickers and T-shirts. Supporters caravaned along Helena’s downtown, honking horns.

The hospital fired Weiner on Nov. 17, 2020. Johnson, the CEO, convened a meeting with the cancer staff, telling them Warwick’s death was “the tip of the iceberg.” He barred attendees from recording the meeting, court documents show, and the hospital’s chief nurse paced the room, instructing employees to put their phones away. All of Weiner’s patients should seek second opinions, Johnson said.

Johnson also told the staff, “Don’t be surprised if black suits show up.” Weiner’s nurses understood this to mean that federal law enforcement or the Department of Health and Human Services would be investigating. “He explained it to be suits — there were going to be suits coming into the office and asking for things,” according to the testimony of nurse Andrea Thies, who, despite Johnson’s orders, took notes during the meeting.

“You walked out of there feeling like, ‘Was I killing people?’” nurse Fallon Melby would later testify.

Three weeks later, St. Peter’s posted an astonishing disclosure on its website: “The issues we have identified include the following: harm that was caused to patients by receiving treatments, including chemotherapy, that were not clinically indicated or necessary; failure to meet state and federal laws associated with the prescribing of narcotics; failure to refer patients to other specialists for appropriate treatments; and failure to meet requirements associated with clinical documentation.”

It’s unclear if the hospital referred any of these issues to the state’s medical board or to state and local law enforcement.

Days later, Weiner sued St. Peter’s and its executives for wrongful termination and defamation.

Early in 2021, Sasich was pulled aside by Shelly Harkins, the hospital’s chief medical officer. According to Sasich’s court testimony, she apologized for getting him caught up in this mess.

She next confided a story that rendered him “physically ill.” Hospital administrators had for years harbored suspicion about one case, a 16-year-old girl who died suddenly under Weiner’s care. Sasich remembered Harkins providing few details but saying Weiner was frustrated that another physician was treating his patient. Once he regained control of her treatment, the girl didn’t live long. “She told me that he gave her two doses of propofol,” Sasich testified, “and she died.”

Sasich hoped it was just a rumor, an exaggeration. But when he asked LaClair about it, the person who knew more than anyone about Weiner’s practice didn’t refute the story but for one correction. It wasn’t propofol.

“No,” LaClair told Sasich. “He uses phenobarbital.”

In the days after Weiner’s termination, dozens of his patients came into the hospital asking for refills of oxycodone, morphine and other opioids. The doctors taking over Weiner’s caseload couldn’t find the prescriptions in St. Peter’s electronic system, according to court records, and Weiner’s patient files were little help. So they turned to a state database that logs all pharmacy opioid sales and discovered he had been writing prescriptions by hand, which bypassed internal hospital controls. To their shock, they found that many of his patients had been on dangerous levels of narcotics for years. The state agency that oversees that drug registry did not respond to a request for comment.

Often the patients seeking painkillers didn’t have cancer and had no documented need for them. Weiner had ordered them as their primary care physician. Many were struggling with addiction. St. Peter’s created a document for doctors to track the crisis in real time. Their notes included: “nonsensical” and “one of the worst indications for opioids. I’m still piecing this together …” and “Many years on methadone. Not clear why.”

Weiner told me the hospital manufactured these allegations to justify firing him, and he denied writing prescriptions by hand.

St. Peter’s assembled a committee of pain management experts to review more than 2,000 patient files. Dr. Kyle Moore, an addiction specialist, led the effort to detoxify patients. He found that Weiner rarely accounted for what doctors call morphine equivalents; essentially, he didn’t do the math to ensure that when patients received drugs at different intervals and strengths they didn’t add up to a lethal dose. Weiner denied this. In the narcotics tracking memo, Moore is quoted as saying Weiner’s prescribing was “a greater danger to the community than coronavirus.”

The full scope of Weiner’s prescription practices may never be known. The hospital alerted the federal Drug Enforcement Administration, which began an investigation, a spokesperson told me. But court records show no attempt by St. Peter’s to quantify the problem beyond its initial scramble to detoxify patients. St. Peter’s would not tell me if it searched for patients in the community who overdosed or died, nor would it say whether it reported what it found to the state medical board.

While the front-line doctors taking over patients were horrified, court records show hospital administrators and the peer review committee had been warned more than a dozen times, since at least 2018, that Weiner was overprescribing. I learned that staff who raised concerns expected to be yelled at or intimidated by Weiner. In 2019, two nurses and a pharmacist questioned a Weiner order to apply a fentanyl patch on a 93-year-old woman who was already on opioids and bobbing in and out of consciousness. A nurse texted Weiner to ask whether he was sure. Weiner responded, “Tell them put it on or I will rip their lips off.” Weiner told me this was “an inside joke.”

Federal regulators also failed to address alarming trends. An analysis of Medicare drug data shows that, from 2013 to 2020, Weiner’s volume of opioid prescriptions ranked ninth among all cancer doctors who bill the program. When it came to morphine, Weiner consistently ranked among the top five. In 2017, he prescribed more morphine than any other cancer doctor. The Centers for Medicare and Medicaid Services did not respond to questions.

Before St. Peter’s fired Weiner, the hospital sent five pain management cases to The Greeley Company. All were deemed inappropriate. One case was Sharon Dibble, a 75-year-old with many health problems, including kidney failure and chronic obstructive pulmonary disease.

On March 6, 2018, for reasons that were unclear to the reviewers, Weiner doubled her extended-release morphine from 30 to 60 milligrams twice a day, on top of an oxycodone regimen. Four days later, Dibble’s daughter found her limp, blue in the face, not breathing. Paramedics rushed Dibble to St. Peter’s, where she was kept on life support for more than two weeks. She died on March 27.

St. Peter’s said the cause was acute respiratory failure — her body starved of oxygen and shut down. The family believed her mounting ailments overtook her. But that’s not what happened, according to the Greeley review. Weiner’s “excessively large increase” in morphine, it concluded, “led to respiratory arrest and the patient’s demise.”

When I raised the Greeley review with Weiner, he called it “ridiculous.” He told me that he swapped short-acting pain medicines for long-acting but that Dibble’s morphine equivalent was unchanged — a claim contradicted by medical records and the hospital’s review of her death. The Centers for Disease Control and Prevention cautions against exceeding the equivalent of 90 milligrams of morphine daily and warns anything above 120 risks overdose. Records show Dibble’s daily regimen equaled 195 milligrams of morphine.

St. Peter’s never told Dibble’s family what it knew.

Five years after Dibble’s death, I shared the report with her son and two daughters. During his mother’s last days, Tom Dibble made the decision to stop life-sustaining measures. It was, he thought, her time to go. Now, he feels duped.

“Not only did this individual cause her death,” he said, referring to Weiner, “but it’s pretty apparent that this whole thing was being covered up. We were never given any knowledge that this took place, and we have to live with this decision.”

Six months after Weiner’s firing, the hospital conducted its fair hearing. As in a trial, witnesses testify, attorneys cross-examine, but a fair hearing isn’t public, and the judges are doctors — in this case, a panel of three from St. Peter’s. Held in a hospital conference room, the hearing took six days. On the first night, LaClair spelled out the allegations — Warwick’s death, the numerous misdiagnoses, the narcotics and more.

But that wasn’t the worst of it. The hospital also accused Weiner of overriding his patient’s dying wishes. If a patient wants CPR or a machine to keep them breathing, they elect to be a “full code.” Weiner, the hospital said, had a pattern of altering, without consent, a patient’s status from full code to a DNR/DNI, do not resuscitate and do not intubate. The hospital would not tell me if it pursued a complete accounting of what the fair hearing panel determined to be “a serious violation of the standard of care and medical ethics.”

At the hearing, nurse Addie Weidow described two events in which she witnessed a patient’s code status being changed without permission, including one where a patient nearly died before an intervening doctor sent her to the ICU. In another instance, Weidow testified, the chart of a patient who was full code suddenly read DNR/DNI. Following hospital protocol, nurses tried to attach a purple wristband, signifying her wish to die without intervention. When the patient refused the band, Weidow said Weiner told them to “hang the band on the doorknob and leave it be.” In other words, if her heart stops, don’t enter the room. Weiner’s nurses called it “a slow code,” Weidow testified.

When Weiner left town, Dr. Ashley Coggins managed his patient load, giving her a rare view into his closed system. She testified that “many nurses have come to me in the last several years, telling me that that was a standard practice of his — to just change people’s code statuses once they were doing poorly.” She added: “He was basically using his own judgment as the judgment for people to live or die. It’s horrifying.”

During the hearing, a hospital attorney asked Dr. Kerry Hale about the 16-year-old girl, the rumor that now haunted Sasich. Hale couldn’t recall the girl’s name but remembered she had a Wilms tumor, a kidney cancer that affects mostly children, and was being treated on the pediatric floor. Then, out of nowhere, Weiner transferred her to his oncology floor “and then orders for DNR, and then three doses of phenobarbital were given, and the patient died, I believe, that evening.” Phenobarbital is a barbiturate commonly used to treat seizures during alcohol withdrawal. In large doses, it is lethal.

When Weiner’s turn came, his lawyer asked for his account. His answer was clinical and unflinching. “Mom wanted her comfortable,” he said. “So, I transferred her to the oncology floor, and I gave her pain meds, phenobarbital, and she died later.” Neither the hospital nor Weiner’s attorneys pressed him for more details.

“Comfort” was a word Weiner used often in our conversations. If a patient dies as a result of his treatment, he told me, it’s not unethical if his intent was to provide comfort. In medicine, this is called the principle of double effect. First developed by the Catholic saint and theologian Thomas Aquinas, it’s a set of criteria by which a person can morally justify ending someone’s life. It stipulates that a harmful consequence of a medical treatment, such as death, is permissible if it’s a secondary effect of beneficial treatment, such as alleviating pain with drugs. “It’s for their comfort,” Weiner told me. “It’s not that I euthanize them.”

At the fair hearing, Weiner denied the hospital’s accusations. “Part of my problem is I have a good memory,” he said, “so I just remember things, and I probably should put more in the chart.” It wasn’t odd that he prescribed high-dose opioids, he said. He’s an oncologist, and his patients were suffering. Why was he giving painkillers to people who didn’t have cancer? For most of his tenure, he said, St. Peter’s didn’t employ a pain specialist.

As for his end-of-life care, Weiner said he always discussed the options with patients — “tens of thousands,” he estimated — before altering their status.

The panel unanimously rejected Weiner’s appeal.

Despite being fired, Weiner maintained his medical license. The law only required St. Peter’s to report his suspension — not what it knew — to the state medical board and the National Practitioner Data Bank. The medical board would not comment on whether it conducted an investigation into Weiner.

Rather than go into private practice or retire, Weiner decided to sue St. Peter’s, spending, by his own account, millions of dollars. He told me that he expected the hospital to settle for as much as $20 million because “they can’t let out what they did.”

By suing, Weiner exposed himself and St. Peter’s to pretrial discovery. Over the next three years, thousands of documents — text messages, patient files, financial statements, the fair hearing transcripts — were entered in court as evidence. Hours of depositions by doctors, nurses, administrators and Weiner were recorded.

Although at odds in every other way, Weiner and St. Peter’s had one common interest: concealing the evidence. Both parties successfully petitioned the court to seal nearly all the discovery. I was able to obtain it.

If the residents of Helena had seen those files, they would know how Weiner built a high-volume business that billed as much as possible to public and private insurance, all the while sending numerous patients through a carousel of unnecessary and life-threatening treatments. They would have learned that the hospital had financial incentives to look away.

Evidence of that high-volume business was hiding in plain sight, in data published by CMS. An analysis of Medicare Part B billing data shows that, from 2013 to 2020, Weiner billed for 40,000 15-minute visits, more than any other doctor — of any specialty — in the nation. The publicly available data offers just a glimpse of what St. Peter’s knew was a much bigger problem. “He’d see 15 patients in 30 minutes,” LaClair told me. This made Weiner rich and apparently missed the gaze of insurance regulators.

If Weiner was such an outlier, why did he never come to the attention of CMS? I reached out to John Hargraves, a data expert at the Health Care Cost Institute in Washington. CMS investigators, he told me, are looking for obvious fraud, such as doctors billing for more expensive work than they delivered. Instead, Weiner crammed in an extraordinarily high number of less expensive patient visits into each day.

When I asked St. Peter’s about what I had found, the hospital refuted none of it. It would not answer questions about Scot Warwick or Sharon Dibble or any other patients despite being given health privacy waivers signed by the families. CEO Johnson turned down requests for an interview. Andrea Groom, the hospital spokesperson, emailed a statement that broadly declined to comment, citing ongoing litigation. “We believe this situation is isolated to a single, former physician, and we remain confident in the exceptional care provided by St. Peter’s medical staff,” it said.

In a follow-up email, Groom wrote: “Dr. Weiner was a highly productive physician, but this was not necessarily alarming, given that he was the only medical oncologist treating cancer patients for a large service area during much of his time with St. Peter’s Health.” Patient satisfaction ratings were high, she said, and complaints were rare. Groom added that “there was no reason at the time for St. Peter’s to believe that Dr. Weiner was providing substandard care.”

In a court filing, the hospital told a judge it expects to be sued by more Weiner patients.

What the hospital’s response ignores is that St. Peter’s enabled and protected Weiner. As LaClair said in his deposition, Weiner’s colleagues didn’t stop him earlier “because we were afraid of him.” In court filings, St. Peter’s admitted that for years it knew of “serious concerns of physician colleagues and staff members with several patient deaths.” When I asked Weiner why the hospital would publicly accuse him of various types of malpractice but withhold its concerns about his end-of-life care, he said it’s because administrators knew what he was doing and even encouraged it.

Fifteen months before he was fired, Weiner and his nurses took over the hospital’s end-of-life care. I found an August 2019 text message exchange between the hospital’s chief nurse, Kari Koehler, and Weiner that made it official: “Are you still okay if all end of life patients go to onc[ology] even if they aren’t yours? I just feel like those nurses do it best!”

Weiner responded: “I agree!!”

By the summer of 2021, the pro-Weiner Facebook group had about 4,000 members. The hospital CEO was “evil,” “a true devil” and “puke.” The group campaigned successfully to have Weiner named “Helena’s Best Physician” in the Independent Record and raised the money to rent billboards that read “WE STAND WITH DR. WEINER.” When I asked Weiner why the town was cleaved in two over him, he smiled and offered a correction. “I wouldn’t call it 50/50,” he said. “More like 80/20.”

For Lisa Warwick and her two children, each Weiner sign was a reminder to keep silent. “I was worried about violence against us,” she told me. That summer, the family sued St. Peter’s for Warwick’s wrongful death. In her deposition, the widow said: “My children lost their father. I lost my husband. It wasn’t quick. It was long. And it was torturous. And it was terrible. And I would never, ever wish that on anyone — ever.”

In his depositions, and later to me, Weiner maintained that Scot Warwick had Stage 4 lung cancer for 11 years. The April 2020 biopsy that didn’t show cancer? The pathologist missed the spot where the cancer was, he said. In our conversations, Weiner said that the cancer had passed back-and-forth between Warwick’s two lungs.

“He was pretty advanced, though?” I asked. “Don’t you think it would be hard to miss?”

“Well, you would think,” he said. “I agree with you. I was kind of pissed off.”

What about the doctor in Utah who performed the autopsy? He also missed the cancer, Weiner said.

The Warwicks and St. Peter’s eventually settled the case for an undisclosed amount. Weiner was not held liable because he was a hospital employee. Neither the family nor their attorney have solved the mystery of why three private health insurers paid for 11 years of Stage 4 lung cancer treatment. None of the companies responded when I asked.

When I shared Weiner’s claim that 80% of Helena residents stood behind him, Sasich didn’t disagree. He drove past the protesters on his way to work. In the hospital, Weiner’s nurses barely looked at him. The billboard gave him chills. He couldn’t understand why people weren’t demanding answers.

The mystery of the 16-year-old girl tore at him. He replayed the scenes in his head — Harkins, the chief medical officer, telling him that she may have been killed, LaClair confirming it. He asked a hospital attorney if they were investigating; “we’re aware of the case,” he was told. He took what he knew to Helena’s police chief. He had a brief meeting with a fraud investigator at the U.S. Department of Health and Human Services. No one seemed interested in pursuing it, Sasich told me.

Sasich’s inquiries came back to Weiner, who added him as a defendant in the lawsuit, accusing him of defamation. Sasich has denied the allegation.

Buried in the thousands of pages of medical records, correspondence and memos that build the hospital’s case against Weiner is a single sheet that summarizes the dying moments of seven people. In broken cursive, someone wrote in pen, “Phenobarbital cases.” Ranging in age from 53 to 77, they represent a small sample of those who died under Weiner’s care.

The memo tracks the final hours of a 62-year-old woman, admitted for stomach pain on Oct. 3, 2018. Four days later, at 6:01 p.m., she received 260 milligrams of phenobarbital for “terminal agitation.” Two hours passed. She received another 260 milligrams, then another at 10:58 p.m. — a total of 780 milligrams. She died just after midnight.

Unlike the narcotics and misdiagnosis cases, the hospital didn’t send these for outside review but rather enlisted its chief pharmacist, Starla Blank. During the fair hearing, Blank said the events were alarming because it wasn’t clear whether the patients were near death. “In most of the cases the patients were talking and visited with Dr. Weiner prior to their — prior to them getting the phenobarbital,” she said.

Still, St. Peter’s, which declined to comment on the phenobarbital cases, chose to ignore Blank’s assessment. In its final written account, the hospital concluded that the seven patients “were at end of life and that there were no remaining viable treatment options for them.”

One case is conspicuously missing from the phenobarbital memo.

There is no mention of the 16-year-old girl. In Harkins’ deposition, she recalled the case but not her name. LaClair’s testimony offered few details of an unnamed girl. Under oath, the hospital’s chief nursing officer referred to “a child” who had received so much phenobarbital as to arouse concern with nurses.

An online search of “Thomas Weiner” produces dozens of obituaries that express gratitude to the oncologist and his nurses for treating loved ones. One shows a photo of a thin girl with a big smile and blonde hair held back with barrettes. It speaks of hot air balloon rides in Arizona and beach trips in Oregon. She and her little brother built a play cabin in the woods and made pocket change selling lemonade. She loved camping and kayaking. At age 6, she was diagnosed with a Wilms tumor, but she didn’t let it rule her life. Her mother, who wrote the obituary, quotes her as saying, “Having cancer is no fun, but that doesn’t mean that you can’t have fun just because you have cancer.”

Her name was Nadine Long.

While I was reasonably sure this was the girl whose memory haunted the halls of St. Peter’s, I decided to knock on the door of the man who finally acted to stop Weiner but, by his own admission, had waited far too long.

To my surprise, Dr. Robert LaClair welcomed me into his home. Earlier that week in September 2023, a Montana judge had sided with St. Peter’s and thrown out Weiner’s lawsuit. The hospital had a right to enforce quality care under federal law, the judge ruled. In an addendum, the judge explained the hospital had not defamed the oncologist. Weiner vowed to file an appeal with the state Supreme Court. The judge did say, however, that Weiner’s defamation suit against Sasich could go forward. In LaClair’s study, we discussed Scot Warwick, the narcotics, the code status changes — cases he’d no longer have to recount in a trial. A weight seemed to be lifting from him, until I mentioned the name few knew. Taken aback at “Nadine,” his eyes welled. LaClair had read her file but had not sent it for outside review. He exhaled and after a long moment said: “Trust me, it’s so bad. You have no idea. She wasn’t terminal.”

By June 2024, Weiner and I had talked for many months. Sometimes, he’d offer an anecdote about an anonymous patient, unaware that I could identify their names and compare the stories with medical and court records. Invariably, he portrayed himself as a gifted and dedicated doctor. One was about a moribund young girl who needed him to intervene when a less capable doctor wasn’t keeping her comfortable. It was time to ask what happened to Nadine Long.

We sat at a long table in a hotel conference room in downtown Helena. Dressed in jeans and a short-sleeved polo shirt, he agreed to be recorded, attached a microphone to his lapel and talked first about a recent trip to Rome. Well into the interview, I presented him with a privacy waiver signed by Nadine’s family, and he told me his version of her final days.

It was March 2015. He was in New York, on Broadway, waiting with his wife for a matinee showing of “Les Misérables,” when Nadine’s mother called. She said her daughter was “in horrible pain. They won’t take care of her pain. Please come home.” After the show, he flew to Helena, arriving near midnight, and drove straight to St. Peter’s. Nadine was screaming and crying.

Weiner had treated Nadine since she was a child, when she was first diagnosed with cancer and when it recurred the following year. The cancer had now come a third time. Nadine had a pleural effusion — fluid built up between the lung and the chest cavity — that restricted her breathing. Her mother had talked with the oncologist filling in for Weiner, who was trying to transfer Nadine for further testing at St. Jude Children’s Hospital in Memphis, Tennessee. Weiner reviewed Nadine’s scans. “She was going down like a stone,” he told me. “She had hours to a day or two to live. There were no more cards to play.”

Hearing this, Nadine’s mother no longer wanted her transferred. “She just wanted her comfortable,” Weiner said. He gave Nadine a choice: a torrent of undignified treatments and pain with no promise of survival or “leave it up to God, and we’re just going to keep her comfortable.”

At that point, he moved Nadine to his oncology floor, to his nurses, “and she got some pain meds — I don’t remember how much phenobarbital — and she died later.”

His response mirrored what I had read in the fair hearing transcript. I had by then reviewed Nadine’s medical record, some of which I presented to him.

Weiner had examined Nadine less than a week earlier. In her file, he wrote, “she looks good … everything looks stable right now.” I asked how he could have missed what he claimed was an advanced and terminal disease.

“That’s how fast — the nature of that tumor when it comes back, it comes back with a vengeance,” Weiner said. “That fast.”

With her family’s consent, I had shared Nadine’s records with Dr. Sarah Friebert of Akron Children’s Hospital in Ohio. She specializes in pediatric oncology and founded and directs the hospital’s pediatric palliative care center. She wanted to be clear that she was not speaking for her employer.

I read aloud to Weiner some of her review.

“Here’s a girl who was skiing and then she’s dead a week later, and that’s — that’s concerning,” Friebert told me. “She ate 75% of her dinner on the night she died. Her vitals were not out of whack.” Nadine should have been sent to another hospital for testing, Friebert said, because nothing definitively showed she couldn’t have been treated. It’s not clear she was going to die, Friebert said.

Weiner determined she was dying based on a test of the fluid in her lungs, which was insufficient, she said. Neither Friebert nor I could find any evidence in Nadine’s file that Weiner ordered a biopsy that confirmed terminal cancer.

Friebert uses phenobarbital to calm children as they die of disease, but she told me Weiner “was escalating the phenobarbital in a way that is way out of proportion with what I would ever have done.” The intent, she said, could not have been comfort. “These doses were obscene,” she said. “He killed her with it.”

That a respected oncologist questioned his care didn’t seem to faze Weiner. She wasn’t there, he told me, and therefore can’t make such judgments. “I completely disagree,” he said. “This is a girl that’s got — her body is riddled with cancer, and she’s in horrible pain. Now did the phenobarbital hasten her death? Yeah, it did.”

In all our conversations, Weiner insisted his intent is always to provide comfort, never to hasten death, but here he equivocated.

“Could it have shortened her life?” Weiner asked. “Yes. Again, in most of these cases, could I not give phenobarbital, and would that patient live longer? The answer is yes.” Weiner paused. “But longer in, like, hours? I mean, is that worth being in misery for those hours?”

“My goal was not to kill Nadine,” he added. “My goal was to make her comfortable.”

I had shown him the “phenobarbital cases” memo, and we’d discussed the code status changes, Scot Warwick, the narcotics and now Nadine. Finally, I had to ask, “Are you killing your patients?”

“Well, uh, no. I’m not,” he responded.

“Why did you hesitate?” I asked.

“Well,” he said. “It depends on what you mean by killing them.”

Nadine’s parents live outside of Helena, at the end of a cattle road that curls around the peak where their daughter once played and her ashes now rest. Dan Beadle, her father, is an evidence technician for the county sheriff’s office. Her mother, Cheri Long, recently retired as an administrator at Carroll College in downtown Helena. They led me through the mudroom to the kitchen’s farmhouse table, where I asked them to recount the worst days of their lives.

While on a family vacation in New Hampshire in April 2005, Nadine was diagnosed with a Wilms tumor. She had her left kidney removed and received radiation. When the family returned to Montana, they met with Weiner, who directed her chemotherapy. During those treatments, Nadine bonded with his nurses, “the true loves of her life,” Long said. She appeared to be in remission. But a year later, the cancer reappeared in the spot where her kidney had been removed, Weiner told the family. Nadine received chemo and other treatments until about 2010, when Weiner said she was cancer free. She continued to see Weiner and his nurses for annual check-ups and more.

“Dr. Weiner always had a policy that once you’re his patient, he’s your primary physician,” Long said. “I don’t know if that’s normal.”

Nadine attended the same Catholic school as Weiner’s children. Her uniforms were hand-me-downs from his older daughter. The two families were friendly but not close. Nadine’s parents respected Weiner, although, as Long put it, he could be domineering.

Nadine also had bipolar disorder. When she was 14, a psychiatrist wrote that she struggled with information processing. He said her “insecurities, anxiety, and tendencies toward frustration when challenged dramatically interfered with her critical thinking skills.” But she was also “kind, compassionate, very empathic.”

In February 2015, Nadine’s parents noticed her hunching forward, struggling to breathe. She came to see Weiner on March 2. As with most of her visits, it lasted just a few minutes. “He listened to her lungs and said, ‘Everything’s good,’” her father recalled. “Then he tried to palpate a little bit, and she was extremely ticklish, so she started squirming around, and then at some point he goes, ‘I think we’re good to go.’”

Six days later, Nadine buckled and fell while skiing and was rushed to the St. Peter’s emergency room. Her parents were out of town when Nadine called to say: “Mommy, I’m in the hospital. My lung collapsed.” They raced to St. Peter’s, where they learned nurses had inserted a chest tube and drained her lungs of fluid, but no one would tell them more. Weiner was in New York City. For the next five days in the pediatric ward, Nadine vacillated between moments of calm and kicking and screaming, but her vitals were steady.

They felt they weren’t getting straight answers from Weiner’s backup oncologist. Long asked that Nadine be transferred to St. Jude. But as those arrangements were being made, Weiner appeared. “Finally,” Long remembered thinking, “We were like, ‘Someone who’s going to tell us the truth instead of tiptoeing around us.’”

She learned later that a St. Peter’s employee had phoned Weiner. His claim that he returned because Long called asking him to provide comfort to her daughter?

“That’s a flat-out lie,” she told me. “We did not ask for him to come home from his vacation.”

Weiner told her a large malignant mass was compressing Nadine’s lungs and would soon suffocate her. “How he described it was, ‘It’s doubling every day, and today it’s the size of a soccer ball,’” Long said.

Soon after, Weiner spoke with Nadine. “He spoke to our daughter, not to us,” Long said, “He told her, ‘You can choose the medical path or the God path.’” The conversation was “between the two of them. We were there, and he would check — he would look at us,” Long said. “Taking the God way was saying, ‘I fought my fight, and I’m ready to meet Jesus.’”

The teenager who struggled with processing information and critical thinking chose the God path. Her parents, terrified that she might needlessly suffer, didn’t object. On March 13, Nadine was changed from a full code to DNR/DNI, despite the day’s progress report that said, “She is alert and oriented, in no acute distress.” Weiner transferred her to the oncology floor.

Nadine had been heavily drugged since she’d arrived: Dilaudid, morphine, oxycodone, fentanyl. The next day, Nadine’s heart and respiratory rates elevated. She was panicking. “Saturday afternoon, she’s thrashing, she’s fighting, she can’t breathe,” Long said. Her father and a nurse couldn’t hold her down. They believed she was suffocating. The parents agreed to Weiner’s comfort measures.

Nadine’s medical file shows that he ordered a nurse to inject phenobarbital, which a computer tracked.

3:45 p.m. — 260 milligrams.

Nadine was still thrashing around. The nurse later said he was nervous about increasing the phenobarbital and called Weiner into the room. “He came in and stood there and oversaw,” Long said. “He just kept saying, ‘more, more.’”

5:26 p.m. — 390 milligrams.

It’s unclear when Nadine fell into sedation. After the initial doses, Weiner left the room.

7:47 p.m. — 390 milligrams.

Two of Weiner’s nurses who had doted on Nadine for years stayed late.

9:54 p.m. — 390 milligrams.

Relieved she was no longer in pain, her parents held on to her and each other.

1:45 a.m. — DISCHARGE.

Her heart stopped.

Nadine received 1,430 milligrams of a drug whose standard dosage for an adult is 260 milligrams. She weighed 100 pounds.

Nadine’s parents asked St. Peter’s to investigate the care she received. They wanted to know how Weiner could have missed a massive tumor a week before she died. Two months later, they met with the hospital’s director of risk management, who told them, Long said, “that he was reviewed and provided great care.”

For nine years, that answer had satisfied them. Believing Weiner had spared Nadine of pain in death, they put up a “We Stand With Doctor Weiner” sign in their yard. But now, having looked at Nadine’s medical file, they wanted to know if they had been manipulated, if she was actually terminal. Citing confidentiality laws, St. Peter’s has refused to provide the family the review, nor would it confirm to me that a review exists.

In August, Jesse Laslovich, the U.S. attorney for the District of Montana, and St. Peter’s announced a $10.8 million settlement for numerous violations of the False Claims Act: billing for unnecessary treatments, prescribing unneeded narcotics and more. The settlement, Laslovich said, “is not an indictment on the quality of care being provided by St. Peter’s Health as well as their doctors and their providers.”

The same day it announced the settlement, the U.S. attorney’s office sued Weiner. It accused him of getting rich by prescribing needless treatments, double billing, seeing patients more frequently than necessary and “upcoding” — billing for more expensive treatments than were delivered. The prosecutor pointed to Weiner’s enormous caseload as evidence that he had little regard for patient outcomes. Weiner’s attorney denied the allegations and has filed a motion to dismiss the case.

After the hospital reported Weiner’s narcotics practice to the DEA, the agency investigated, according to Steffan Tubbs with its Rocky Mountain field division. He told me investigators brought a potential criminal case to the U.S. attorney’s office but that prosecutors instead decided to pursue civil penalties against Weiner. A spokesperson for the U.S. attorney declined to comment.

In a press release, St. Peter’s commended itself for “acting with integrity” for alerting the DEA and laid blame on a rogue doctor. In settling, the hospital acknowledged that Weiner falsely billed multiple federal health care programs. But it did not acknowledge that his billing practices had been a constant problem and an obvious outlier for at least a decade. The prosecutor was silent on Weiner’s billing practices with private insurance.

The Montana State Supreme Court has yet to issue a ruling on Weiner’s appeal. His defamation suit against Sasich continues.

Weiner’s Montana medical license was renewed in 2023 and is set to expire in March. For now, he is free to practice medicine and prescribe drugs.

Neither the settlement nor the lawsuit against Weiner focus on the harm he exacted on countless patients. It’s unclear if any state or federal law enforcement agencies are looking into Weiner’s trail of suspicious deaths. Counting Scot Warwick, Sharon Dibble, Nadine Long and the seven documented phenobarbital cases, there are at least 10.

“We can simply choke off the money,” Trump said in a 2023 campaign video. “For 200 years under our system of government, it was undisputed that the president had the constitutional power to stop unnecessary spending.”

His plan, known as “impoundment,” threatens to provoke a major clash over the limits of the president’s control over the budget. The Constitution gives Congress the sole authority to appropriate the federal budget, while the role of the executive branch is to dole out the money effectively. But Trump and his advisers are asserting that a president can unilaterally ignore Congress’ spending decisions and “impound” funds if he opposes them or deems them wasteful.

Trump’s designs on the budget are part of his administration’s larger plan to consolidate as much power in the executive branch as possible. This month, he pressured the Senate to go into recess so he could appoint his cabinet without any oversight. (So far, Republicans who control the chamber have not agreed to do so.) His key advisers have spelled out plans to bring independent agencies, such as the Department of Justice, under political control.

If Trump were to assert a power to kill congressionally approved programs, it would almost certainly tee up a fight in the federal courts and Congress and, experts say, could fundamentally alter Congress’ bedrock power.

“It’s an effort to wrest the entire power of the purse away from Congress, and that is just not the constitutional design,” said Eloise Pasachoff, a Georgetown Law professor who has written about the federal budget and appropriations process. “The president doesn’t have the authority to go into the budget bit by bit and pull out the stuff he doesn’t like.”

Trump’s claim to have impoundment power contravenes a Nixon-era law that forbids presidents from blocking spending over policy disagreements as well as a string of federal court rulings that prevent presidents from refusing to spend money unless Congress grants them the flexibility.

In an op-ed published Wednesday, tech billionaire Elon Musk and former Republican presidential candidate Vivek Ramaswamy, who are overseeing the newly created, nongovernmental Department of Government Efficiency, wrote that they planned to slash federal spending and fire civil servants. Some of their efforts could offer Trump his first Supreme Court test of the post-Watergate Congressional Budget and Impoundment Control Act of 1974, which requires the president to spend the money Congress approves. The law allows exceptions, such as when the executive branch can achieve Congress’ goals by spending less, but not as a means for the president to kill programs he opposes.

Trump and his aides have been telegraphing his plans for a hostile takeover of the budgeting process for months. Trump has decried the 1974 law as “not a very good act” in his campaign video and said, “Bringing back impoundment will give us a crucial tool with which to obliterate the Deep State.”

Musk and Ramaswamy have seized that mantle, writing, “We believe the current Supreme Court would likely side with him on this question.”

The once-obscure debate over impoundment has come into vogue in MAGA circles thanks to veterans of Trump’s first administration who remain his close allies. Russell Vought, Trump’s former budget director, and Mark Paoletta, who served under Vought as the Office of Management and Budget general counsel, have worked to popularize the idea from the Trump-aligned think tank Vought founded, the Center for Renewing America.

On Friday, Trump announced he had picked Vought to lead OMB again. “Russ knows exactly how to dismantle the Deep State and end Weaponized Government, and he will help us return Self Governance to the People,” Trump said in a statement.

Vought was also a top architect of the controversial Project 2025. In private remarks to a gathering of MAGA luminaries uncovered by ProPublica, Vought boasted that he was assembling a “shadow” Office of Legal Counsel so that Trump is armed on day one with the legal rationalizations to realize his agenda.

“I don’t want President Trump having to lose a moment of time having fights in the Oval Office about whether something is legal or doable or moral,” Vought said.

Trump spokespeople and Vought did not respond to requests for comment.

The prospect of Trump seizing vast control over federal spending is not merely about reducing the size of the federal government, a long-standing conservative goal. It is also fueling new fears about his promises of vengeance.

A similar power grab led to his first impeachment. During his first term, Trump held up nearly $400 million in military aid to Ukraine while he pressured President Volodymyr Zelenskyy to open a corruption investigation into Joe Biden and his family. The U.S. Government Accountability Office later ruled his actions violated the Impoundment Control Act.

Pasachoff predicted that, when advantageous, the incoming Trump administration will attempt to achieve the goals of impoundment without picking such a high-profile fight.

Trump tested piecemeal ways beyond the Ukrainian arms imbroglio to withhold federal funding as a means to punish his perceived enemies, said Bobby Kogan, a former OMB adviser under Biden and the senior director of federal budget policy at the left-leaning think tank American Progress. After devastating wildfires in California and Washington, Trump delayed or refused to sign disaster declarations that would have unlocked federal relief aid because neither state had voted for him. He targeted so-called sanctuary cities by conditioning federal grants on local law enforcement’s willingness to cooperate with mass deportation efforts. The Biden administration eventually withdrew the policy.

Trump and his aides claim there is a long presidential history of impoundment dating back to Thomas Jefferson.

Most historical examples involve the military and cases where Congress had explicitly given presidents permission to use discretion, said Zachary Price, a professor at the University of California College of the Law, San Francisco. Jefferson, for example, decided not to spend money Congress had appropriated for gun boats — a decision the law, which appropriated money for “a number not exceeding fifteen gun boats” using “a sum not exceeding fifty thousand dollars,” authorized him to make.

President Richard Nixon took impoundment to a new extreme, wielding the concept to gut billions of dollars from programs he simply opposed, such as highway improvements, water treatment, drug rehabilitation and disaster relief for farmers. He faced overwhelming pushback both from Congress and in the courts. More than a half dozen federal judges and the Supreme Court ultimately ruled that the appropriations bills at issue did not give Nixon the flexibility to cut individual programs.

Vought and his allies argue the limits Congress placed in 1974 are unconstitutional, saying a clause in the Constitution obligating the president to “faithfully execute” the law also implies his power to forbid its enforcement. (Trump is fond of describing Article II, where this clause lives, as giving him “the right to do whatever I want as president.”)

The Supreme Court has never directly weighed in on whether impoundment is constitutional. But it threw water on that reasoning in an 1838 case, Kendall v. U.S., about a federal debt payment.

“To contend that the obligation imposed on the President to see the laws faithfully executed, implies a power to forbid their execution, is a novel construction of the constitution, and entirely inadmissible,” the justices wrote.

During his cutting spree, Nixon’s own Justice Department argued roughly the same.

“With respect to the suggestion that the President has a constitutional power to decline to spend appropriated funds,” William Rehnquist, the head of the Office of Legal Counsel whom Nixon later appointed to the Supreme Court, warned in a 1969 legal memo, “we must conclude that existence of such a broad power is supported by neither reason nor precedent.”

For years, it was a mystery: Seemingly out of the blue, therapists would feel like they’d tripped some invisible wire and become a target of UnitedHealth Group.

A company representative with the Orwellian title “care advocate” would call and grill them about why they’d seen a patient twice a week or weekly for six months.

In case after case, United would refuse to cover care, leaving patients to pay out-of-pocket or go without it. The severity of their issues seemed not to matter.

Around 2016, government officials began to pry open United’s black box. They found that the nation’s largest health insurance conglomerate had been using algorithms to identify providers it determined were giving too much therapy and patients it believed were receiving too much; then, the company scrutinized their cases and cut off reimbursements.

By the end of 2021, United’s algorithm program had been deemed illegal in three states.

But that has not stopped the company from continuing to police mental health care with arbitrary thresholds and cost-driven targets, ProPublica found, after reviewing what is effectively the company’s internal playbook for limiting and cutting therapy expenses. The insurer’s strategies are still very much alive, putting countless patients at risk of losing mental health care.

Optum, its subsidiary that manages its mental health coverage, is taking aim at those who give or get “unwarranted” treatment, flagging patients who receive more than 30 sessions in eight months. The insurer estimates its “outlier management” strategy will contribute to savings of up to $52 million, according to company documents.

The company’s ability to continue deploying its playbook lays bare a glaring flaw in the way American health insurance companies are overseen.

While the massive insurer — one of the 10 most profitable companies in the world — offers plans to people in every state, it answers to no single regulator.

The federal government oversees the biggest pool: most of the plans that employers sponsor for their workers.

States are responsible for plans that residents buy on the marketplace; they also regulate those funded by the government through Medicaid but run through private insurers.

In essence, more than 50 different state and federal regulatory entities each oversee a slice of United’s vast network.

So when a California regulator cited United for its algorithm-driven practice in 2018, its corrective plan applied only to market plans based in California.

When Massachusetts’ attorney general forced it to restrict the system in 2020 for one of the largest health plans there, the prosecutor’s power ended at the state line.

And when New York’s attorney general teamed up with the U.S. Department of Labor on one of the most expansive investigations in history of an insurer’s efforts to limit mental health care coverage — one in which they scored a landmark, multimillion-dollar victory against United — none of it made an ounce of difference to the millions whose plans fell outside their purview.

It didn’t matter that they were all scrutinizing the insurer for violating the same federal law, one that forbade companies from putting up barriers to mental health coverage that did not exist for physical health coverage.

For United’s practices to be curbed, mental health advocates told ProPublica, every single jurisdiction in which it operates would have to successfully bring a case against it.

“It’s like playing Whac-A-Mole all the time for regulators,” said Lauren Finke, senior director of policy at the mental health advocacy group The Kennedy Forum. The regulatory patchwork benefits insurance companies, she said, “because they can just move their scrutinized practices to other products in different locations.”

Now internal documents show that United, through its subsidiary Optum, is targeting plans in other jurisdictions, where its practices have not been curbed. The company is focused on reducing “overutilization” of services for patients covered through its privately contracted Medicaid plans that are overseen by states, according to the internal company records reviewed by ProPublica. These plans cover some of the nation’s poorest and most vulnerable patients.

United administers Medicaid plans or benefits in about two dozen states, and for more than 6 million people, according to the most recent federal data from 2022. The division responsible for the company’s Medicaid coverage took in $75 billion in revenue last year, a quarter of the total revenue of its health benefits business, UnitedHealthcare.

UnitedHealthcare told ProPublica that the company remains compliant with the terms of its settlement with the New York attorney general and federal regulators. Christine Hauser, a spokesperson for Optum Behavioral Health, said its process for managing health care claims is “an important part of making sure patients get access to safe, effective and affordable treatment.” Its programs are compliant with federal laws and ensure “people receive the care they need,” she said. One category of reviews is voluntary, she added; it allows providers to opt out and does not result in coverage denials.

ProPublica has spent months tracking the company’s efforts to limit mental health costs, reviewing hundreds of pages of internal documents and court records, and interviewing dozens of current and former employees as well as scores of providers in the company’s insurance networks.

One therapist in Virginia said she is reeling from the costly repercussions of her review by a care advocate. Another in Oklahoma said she faces ongoing pressure from United for seeing her high-risk patients twice a week.

“There’s no real clinical rationale behind this,” said Tim Clement, the vice president of federal government affairs at the nonprofit group Mental Health America. “This is pretty much a financial decision.”

Former care advocates for the company told ProPublica the same as they described steamrolling providers to boost cost savings.

One said he felt like “a cog in the wheel of insurance greed.”

Under ALERT

The year 2008 was supposed to mark a revolution in access to mental health care.

For decades, United and other insurers had been allowed to place hard caps on treatment, like the number of therapy sessions. But after Congress passed the Mental Health Parity and Addiction Equity Act, insurers could no longer set higher copays for behavioral services or more strictly limit how often patients could get them; insurers needed to offer the same access to mental health care as to physical care. The law applied to most plans, regardless of whether federal or state regulators enforced it.

As access to services increased, so did insurers’ costs. Company documents show United was keenly aware of this threat to its bottom line.

But there was a loophole: Insurers could still determine what care was medically necessary and appropriate.

Doing so case by case would be expensive and time-consuming. But United already had a tool that could make it easier to spot outliers.

Called ALERT, the algorithmic system was created years earlier to identify patients at risk of suicide or substance use. The company redeployed it to identify therapy overuse.

Company and court filings reveal that ALERT comprised a suite of algorithms — totaling more than 50 at one point — that analyzed clinical and claims data to catch what it considered unusual mental health treatment patterns, flagging up to 15% of the patients receiving outpatient care.

The algorithms could be triggered when care met the company's definition of overly frequent, such as when patients had therapy sessions twice a week for six weeks or more than 20 sessions in six months. Therapists drew scrutiny if they provided services for more than eight hours a day, used the same diagnosis code with most clients or worked on weekends or holidays — even though such work is often necessary with patients in crisis.

The system was originally designed to save lives, said Ed Jones, who co-developed the algorithm program when he worked as an executive at PacifiCare Behavioral Health, which later merged with United. Using ALERT to limit or deny care was “perverting a process that was really pretty good,” he told ProPublica.

Once patients or therapists were flagged, care advocates, who were licensed practitioners, would “alert” providers, using intervention scripts to assess whether care was medically necessary. The calls felt like interrogations, therapists told ProPublica, with the predetermined conclusion that their therapy was unnecessary or excessive.

ProPublica spoke with seven former employees from Optum who worked with the ALERT system from 2006 through 2021. They requested not to be named in order to speak freely, some citing fears of retaliation.

Even though the reviews were purportedly intended to identify cases where care was inappropriate or violated clinical standards, several former care advocates said these instances were rare. Instead, they questioned care if it passed an allotted number of sessions.

“It had to be really extreme to help the client be able to continue with the care,” said one former care advocate, who was troubled by the practice. “Not everyone with depression is going to be suicidal, but they still need therapy to support them.”

The advocates often overruled a provider’s expertise, a former team manager said. “There was always this feeling, ‘Why are we telling clinicians what to do?’” he said. “I didn’t think it was OK that we were making decisions like that for people.”

If the advocates found fault with therapists’ explanations — or couldn’t persuade them to cut back on care — they elevated the case to a peer-to-peer review, where a psychologist could decide to stop covering treatment.

According to court records, regulators alleged United doled out bonuses to care advocates based on productivity, such as the number of cases handled, and pushed workers to reduce care by modifying a therapist’s treatment or referring therapists to peer review in 20% of assigned cases.

At one point, care advocates were referring 40%, regulators alleged in court filings. Each peer review tended to last less than 12 minutes, offering providers little time to prove they had a “clear and compelling” reason to continue treatment.

Former advocates described feeling like parts of a machine that couldn’t stop churning. “Literally, we had to tell the company when we were going to the restroom,” one advocate said, “and so you would do that and come back and your manager would say, ‘Well, that was a little long.’”

The former workers told ProPublica they were pressured to keep calls brief; the rush added to the tension as therapists pushed back in anger.

“There was an expiration date on those jobs because there was such a pull on you emotionally,” one former care advocate said.

Three of them quit, they told ProPublica, citing damage to their own mental health.

New York and federal regulators started looking into the practice around 2016. A California regulator and the Massachusetts attorney general’s office soon followed.

All concluded that while United may not have set official caps on coverage, it had done so in practice by limiting mental health services more stringently than medical care. Therefore, it was breaking the federal parity law.

While California and Massachusetts got United to scale back its use of ALERT within their jurisdictions, New York was able to stretch its reach by teaming up with the U.S. Department of Labor to investigate and sue the insurer. Together, they found that from 2013 through 2020, United had denied claims for more than 34,000 therapy sessions in New York alone, amounting to $8 million in denied care.

By using ALERT to ration care, United calculated that it saved the company about $330 per member each time the program was used, the regulators said in court records. Cut off from therapy, some patients were hospitalized. The regulators did not specifically address in court filings whether the treatment denials met medical guidelines.

The company, which denied the allegations and did not have to admit liability or wrongdoing, agreed to pay more than $4 million in restitution and penalties in 2021. Notably, it also agreed to not use ALERT to limit or deny care.

The final terms of the settlement, however, only applied to plans under New York and federal regulators’ jurisdiction.

Rebranded Reviews

In the three years since the settlement, the company has quietly rebranded ALERT.

The Outpatient Care Engagement program continues to use claims and clinical data to identify patients with “higher-than-average intensity and/or frequency of services,” according to internal company documents, to ensure “that members are receiving the right level of care at the right time.”

Up to 10% of cases are flagged for scrutiny, public company documents show. If care advocates take issue with a case, they can elevate it to a peer review, which can result in a denial.

The advocates’ script is nearly the same as the one used for ALERT.

Care advocates are even calling therapists from the same phone number.

Overseen by the former director of ALERT, the team’s more than 50 care advocates are tasked with ensuring that “outpatient care follows clinical and coverage guidelines” and “reduces overutilization and benefit expense when appropriate,” according to company documents.

The team conducts thousands of reviews each month, targeting plans that are mostly regulated by states and fall outside of the jurisdictions of previous sanctions. Patients impacted include workers with fully insured plans and people covered by Medicaid.

Nearly 1 in 3 adults in the Medicaid program has a mental health condition, and a fifth of its members have a substance use disorder. “This is probably disproportionately sweeping up those that are most distressed, most ill and most in need of care,” Clement said.

Private insurers that manage Medicaid plans, also known as managed care organizations, are often paid a fixed amount per person, regardless of the frequency or intensity of services used. If they spend less than the state’s allotted payment, plans are typically allowed to keep some or all of what remains. Experts, senators and federal investigators have long raised concerns that this model may be incentivizing insurers to limit or deny care.

“They basically manage the benefits to maximize their short-term profit,” said David Lloyd, chief policy officer with the mental health advocacy group Inseparable and an expert on state-level mental health parity laws.

State regulators are supposed to be making sure private insurers that manage Medicaid plans are following the mental health parity laws. But this year, a federal audit found that they were failing to do so. “They are not well designed to essentially be watchdogs,” Lloyd said. “There’s very little accountability. Insurers can run roughshod over them.”

The internal records reviewed by ProPublica show the plans and geographic areas now scrutinized by the rebranded program. The team conducts two types of reviews, those considered “consultation” and those that question medical necessity.

For the first kind, the team flags members with high use (more than 30 sessions in eight months) or high frequency (twice-a-week sessions for six weeks or more) to engage their providers in “collaborative” conversations about the treatment plan.

Internal records indicate that the company uses this “consultation” model for about 20 state Medicaid programs, including Washington, Minnesota, Mississippi, Virginia and Tennessee. The company is also deploying the program with Medicaid plans in Massachusetts and, as of the fourth quarter of this year, New York, which are outside of the jurisdiction of the earlier state agreements.

While the Department of Labor does not have jurisdiction over Medicaid, a spokesperson said it “would be concerned about ‘consultation’ reviews that are conducted in a way that violates [the mental health parity act].” The department did not comment on whether it was investigating the insurer, as a matter of agency policy.

Company records show Optum is applying its more stringent review method, questioning medical necessity, to psychological testing services and a type of therapy to treat children with autism, known as applied behavior analysis, for people with Medicaid coverage in about 20 states. It is doing the same for routine therapy for its members with dual Medicare-Medicaid plans in about 18 states and Washington, D.C. Such plans are largely overseen by the Centers for Medicare & Medicaid Services, the federal agency responsible for overseeing both Medicare and Medicaid programs. While the dual plans are not subject to federal mental health parity laws, a CMS spokesperson said the agency was taking steps to “ensure that people enrolled in these plans have timely access to care.”

The internal company records reveal that Optum has continued to use quotas with its medical necessity reviews, setting productivity targets for how many cases its employees scrutinize. According to records from this year, the target was 160 reviews per employee, which the company exceeded with 180 reviews per employee.

Several state agencies that oversee Medicaid programs, including those in New York and Massachusetts, told ProPublica that they follow federal mental health parity laws and have strong monitoring practices to ensure that the private insurers that manage benefits are in compliance.

Katie Pope, a spokesperson for Washington’s Health Care Authority, told ProPublica that ALERT was discontinued three years ago but did not directly respond to questions about the current iteration of the program. Scott Peterson, a spokesperson for Minnesota’s Human Services Department, said that while United’s policies were compliant with federal parity laws, the company’s contract would expire at the end of the year. Last May, the state blocked for-profit insurers, like United, from participating in its Medicaid program.

Amy Lawrence, a spokesperson for Tennessee’s Medicaid program, said United’s outlier review practice entailed “voluntary collaborative conversations on best practices” and did not question the medical necessity of services nor result in denials of treatment. “There are no adverse consequences for providers who elect not to participate,” she said.

Mississippi’s, Louisiana’s and Virginia’s state Medicaid agencies did not respond to ProPublica’s questions. (Read all state responses.)

In response to ProPublica’s questions about its oversight of state Medicaid programs, a spokesperson for CMS said it was “actively engaged with states and other stakeholders to improve compliance and oversight of parity requirements.” (Read the full responses of federal agencies.)

Hauser, the spokesperson for Optum, told ProPublica that the company is committed to working with state Medicaid programs to ensure access to effective and necessary care. She said its new program was separate from ALERT, which she said had been discontinued. (She did not explain why the original ALERT program appears to be still operational in Louisiana, according to a recent company manual.) When the team conducts medical necessity reviews, she said, they are compliant with mental health parity law. (Read the company’s full response.)

Ringing Phones

Therapists who underwent the reviews told ProPublica that they felt the practice was intended to discourage them from providing necessary care, interfering with their ability to treat their patients.

This year, Oklahoma therapist Jordan Bracht received multiple calls from the team related to the care of two patients, who were both on United’s dual Medicare-Medicaid plan. “If we don’t hear back from you within a week,” a care advocate said in a voice message, “then the case will be forwarded to the peer review process to make a decision based upon the information available.”

Both of Bracht’s patients had diagnoses of dissociative identity disorder and required therapy twice a week. “Many of my clients are suicidal and would be hospitalized if I had to cut down the care,” Bracht told ProPublica.

Reviewers pushed for end dates for their therapy. “They really wanted me to nail down a discharge date,” she said. “We are really trying to keep this person alive, and it felt like they were applying their one-size-fits-all model. It doesn’t feel right.”

Virginia therapist Chanelle Henderson got a voice message in 2022 from the same number about her care of a patient with state Medicaid coverage. “We’d like to complete a clinical review,” the caller said. “We’ll follow up with one more call before the case is referred to the peer review process.”

When Henderson called back, a reviewer informed her that her practice had been flagged for providing longer sessions. Henderson tried to explain they were necessary to treat trauma, her practice’s specialty. “She had no trust in me as a clinician,” Henderson said of the reviewer.

The inquiry progressed to questions about other patients, including one who was being treated by a therapist under Henderson’s supervision. The reviewer said that the company did not cover sessions of supervised therapists at practices with less than 12 therapists. At the time, Henderson’s practice had eight.

The reviewer elevated her case, triggering an aggressive audit of the entire practice going back two years that threatened to shut it down.

Citing issues with supervision and longer sessions, United demanded the practice pay back about $20,000 for services it had already provided. Henderson and her business partner pushed back, hiring a biller to help submit hundreds of pages of additional notes and documentation. They also pointed out that during the audit, the company had even changed its policy to allow smaller practices to supervise therapists. United eventually decreased the penalty by half. Neither Optum, United nor Virginia’s Medicaid program directly responded to ProPublica’s questions about the case.

Bethany Lackey, who co-founded the practice with Henderson, said that the reviews felt like a pretext for additional scrutiny. “It’s all set up in order to catch someone doing something so that they can take back payments,” she said. “We all know that behind it is this more malicious intent of getting their money back.”

In a letter sent to the National Shooting Sports Foundation on Tuesday, Sen. Richard Blumenthal, D-Conn., questioned the legality of the “covert program” in which firearms manufacturers for years shared sensitive customer information with political operatives.

Blumenthal cited a ProPublica investigation that found some of America’s most iconic gunmakers secretly participated, even while the gun industry presented itself as a privacy protector and fought against government and corporate efforts to track firearms ownership.

At least 10 gun industry businesses, including Glock, Smith & Wesson and Remington, handed over hundreds of thousands of names, addresses and other private data — without customer knowledge or consent — to the NSSF, which then entered the details into what would become a massive database. The database was used to rally gun owners’ electoral support for the industry’s candidates running for the White House and Congress.

Blumenthal, who chairs a Senate subcommittees on privacy, gave the NSSF a Nov. 21 deadline to answer several questions. He wanted to know more about which companies contributed information to the database, the type of customer details shared and whether the data is still being used by the organization or by others.

The senator, who served as Connecticut’s attorney general for two decades and has consistently supported legislation to reduce gun violence, said he was also “disturbed” by “glaring discrepancies” between what ProPublica uncovered and the NSSF’s previous responses to his office.

In 2022, Blumenthal sent the NSSF a list of questions after reading leaked documents that made a passing reference to the database. In its response, the NSSF would not acknowledge the database’s existence.

“The secretive compilation and sharing of private information by NSSF and its partners seems to have violated federal consumer protection laws and created substantial data privacy and safety risks for lawful gun owners,” Blumenthal wrote.

The customer information initially came from decades of warranty cards filled out and returned to gun manufacturers for rebates and repair or replacement programs. A ProPublica review of dozens of warranty cards from the 1970s through today found that some promised customers their information would be kept strictly confidential. Others said some information could be shared with third parties for marketing and sales. None of the cards informed buyers their details would be used by lobbyists and consultants to win elections.

Violating a promise of strict confidentiality on warranty cards or failing to mention that consumer information could be given to the NSSF may qualify as a deceptive practice under the Federal Trade Commission Act, privacy and legal experts said. Under the law, companies must follow their privacy policies and be clear with consumers about how they will use their information.

The NSSF did not respond to messages seeking comment. Previously, the group defended the data collection, saying in a statement to ProPublica that any suggestion of “unethical or illegal behavior is entirely unfounded.” The statement said “these activities are, and always have been, entirely legal and within the terms and conditions of any individual manufacturer, company, data broker, or other entity.”

Glock and Smith & Wesson did not previously respond to ProPublica’s requests for comment. In the years since the data sharing program was launched, Remington has been split into two companies and sold. Remarms, which owns the old firearms division, said it was unaware of the company’s workings at the time. The other portion of the company is now owned by Remington Ammunition, which said it had “not provided personal information to the NSSF or any of its vendors.”

Founded in 1961 and currently based in Shelton, Connecticut, the NSSF represents thousands of firearms and ammunition manufacturers, distributors, retailers, publishers and shooting ranges. While not as well known as the chief lobbyist for gun owners, the National Rifle Association, the NSSF is respected and influential in business, political and gun-rights communities.

For two decades, the organization has raged against government and corporate attempts to amass information on gun buyers. As recently as this year, the NSSF pushed for laws that would prohibit credit card companies from creating special codes for firearms dealers, claiming the codes could be used to create a registry of gun purchasers.

As a group, gun owners are fiercely protective about their personal information. Many have good reasons. Their ranks include police officers, judges, domestic violence victims and others who have faced serious threats of harm.

The gun industry launched the data harvesting approximately 17 months before the 2000 election as it grappled with a cascade of financial, legal and political threats.

Within three years, the NSSF’s database — filled with warranty card information and supplemented with names from voter rolls and hunting licenses — contained at least 5.5 million people. The information was central to what NSSF called its voter education program, which involved sending letters, postcards and later emails to persuade gun buyers to vote for the firearms industry’s preferred political candidates.

Because privacy laws shield the names of firearm purchasers from public view, the data NSSF obtained gave it a unique ability to identify and contact large numbers of gun owners or shooting sports enthusiasts. The NSSF has credited its program for helping elect both George W. Bush and Donald Trump to the White House.

In April 2016, a contractor on NSSF’s voter education project delivered a large cache of data to Cambridge Analytica, a political consulting firm credited with playing a key role in Trump’s narrow victory that year, according to internal Cambridge emails and documents. The company later went out of business amid a global scandal over its handling of confidential consumer data.

The data given to Cambridge included 20 years of gun owners’ warranty card information as well as a separate database of customers from Cabela’s, a sporting goods retailer with approximately 70 stores in the U.S. and Canada.

Cambridge combined the NSSF data with a wide array of sensitive particulars obtained from commercial data brokers. It included people’s income, their debts, their religion, where they filled prescriptions, their children’s ages and purchases they made for their kids. For women, it revealed intimate elements such as whether the underwear and other clothes they purchased were plus size or petite.

The information was used to create psychological profiles of gun owners and assign scores to behavioral traits, such as neuroticism and agreeableness. With the NSSF supporting Trump and pro-gun congressional candidates, the profiles helped Cambridge tailor the NSSF’s political messages to voters based on their personalities.

Texas Democrats have long viewed the state’s growing Latino population as their ticket to eventually breaking through the Republican Party’s dominance. Tuesday night, however, showed that the GOP has made significant gains in peeling away those voters, and nowhere was that more apparent than along the border.

After years of losing the statewide Latino vote by double digits, Republicans set a high-water mark with Donald Trump capturing 55% of the critical voting bloc, besting Vice President Kamala Harris’ 44% share, according to exit polls.

In the traditionally Democratic strongholds along the border, Trump managed a near sweep.

He won 14 out of the 18 counties within 20 miles of the border, a number that doubled his attention-grabbing 2020 performance in the Latino-majority region. He carried all four counties in the Rio Grande Valley just eight years after drawing a mere 29% in the region — a feat that included delivering 97% Latino Starr County to Republicans for the first time since 1896. And, though he lost El Paso, one of the border’s most populous counties, he narrowed margins there in ways not seen in decades.

His gains along the border were the most for a Republican presidential candidate in at least 30 years, exceeding even the inroads made by native Texan George W. Bush in 2004.

Trump’s success in appealing to heavily Latino communities was evident throughout the country as he became the first Republican presidential candidate to win Miami-Dade County in more than three decades and nearly doubled his share of the Latino vote in Pennsylvania, even after a comedian at one of his rallies called Puerto Rico a “floating island of garbage.” But Trump’s performance is particularly striking in Texas, where Democrats have all but tied their fate to the idea that, as long as the state’s Latino electorate continued to grow and stayed reliably blue, Republicans would one day cease to win statewide elections.

In addition to dominating the presidential race, Republicans saw other gains along the border. U.S. Rep. Monica De La Cruz, a Republican from Edinburg, held onto a key GOP seat anchored in the Rio Grande Valley, and Republicans picked up a state Senate seat and two state House districts in South Texas that were previously held by Democrats. U.S. Sen. Ted Cruz, who won reelection by carrying a majority of Latino voters, said the results amounted to “generational change.”

Democrats saw their own bright spots. Eddie Morales Jr., a state representative for a sprawling border district that stretches from Eagle Pass to El Paso, held onto his seat on Tuesday, though he narrowly eked out a victory two years after winning by a more comfortable 12-point margin. U.S. Rep. Henry Cuellar, a Democrat from Laredo, also won by an unexpectedly narrow margin of about 5 percentage points against a GOP challenger whom he vastly outspent.

Joshua Blank, research director for the Texas Politics Project at the University of Texas at Austin, said it’s too early to tell if Republican gains will hold or extend beyond Trump himself. But, Blank said, Democrats would be wise to worry about the possibility that this shift endures.

Trump’s success among Latino voters seemed to stem from an understanding that, in places like Texas, many Latinos “think of themselves as multiracial” and have grown up in communities where race and ethnicity are not top of mind, Blank said. Trump targeted Hispanic men who rarely vote by appealing “to their pocketbooks, to their masculinity, to their place in culture and society, but not directly to an identity as a racial and ethnic minority.”

“Does that mean that these voters are going to stay in the Republican column? We don’t know. Does it mean that they’re going to support somebody who’s not named Donald Trump? Unclear,” Blank said. “But he has changed the terms of the debate in a way that I think Democrats are uncomfortable with.”

Not unlike his appeal among other constituencies, Trump won over Latino voters by hammering Harris on economic challenges that many of them — rightly and wrongly — blame on President Joe Biden.

University of Houston political science professor Jeronimo Cortina said Trump’s challenge now would be to deliver on his promises to improve voters’ economic fortunes. And he said he’d expect voters to hold Trump accountable if he doesn’t. Cortina noted that many Latinos supported Bush’s 2004 reelection, only to desert the Republican Party in favor of Democrat Barack Obama in 2008 amid a flailing economy.

“Realignments occur when there’s a sustainable change, and right now, it’s not clear we have that,” Cortina said.

He also said it would be premature to say whether Trump’s appeal — to say nothing of the Republican Party’s — was anything other than fleeting because, in local races, Latinos still tended to prefer Democrats.

One such example is the race for sheriff in Val Verde County, nearly three hours west of San Antonio.

In that race, Democrat Joe Frank Martinez held onto his seat, beating his Republican challenger after receiving 57% of the vote, even as Trump won the county with 63% of the vote.

According to Martinez, Project Red TX, a GOP-backed PAC, initially tried to get him to switch parties. When he declined, the PAC backed his opponent, who ran a campaign centered around the issue of immigration, even though that is not part of the sheriff’s job.

This year, the group supported more than 50 local candidates, primarily in border counties. The three candidates it backed in Val Verde County lost, though Wayne Hamilton, a veteran GOP operative who heads the group, noted that he also supported a number of local candidates who won their races with Trump carrying the county atop the ballot. One such case was in Jim Wells County, where Trump received 57% and the Democratic sheriff was narrowly ousted by a Republican challenger.

Hamilton said Latino voters living at or near the border flocked to Trump over what they see as the Biden administration’s “collapse in border enforcement and failing to do their job” by preventing more migrants from crossing into Texas.

Record numbers of arrivals overwhelmed border infrastructure in numerous communities. In Val Verde, some 20,000 mostly Haitian migrants arrived almost at once in 2021, forcing officials to shut the international port of entry while they figured out how to respond to the situation.

Public outcry was most acute, Hamilton said, in counties with high poverty rates where residents were more likely to feel that their community was “being overrun by people that are even poorer, with even greater needs.”

Hamilton celebrated that Trump flipped Starr by 16 points this year, a 76-point swing from his 60-point deficit there in 2016.

Down the ballot, though, Democrats, including the incumbent sheriff, managed to hold on to their positions despite aggressive campaigns on the Republican side. “All of those candidates that ran as Democrats, all won, so the Trump presidency is basically an isolated seat,” Starr County Democratic Chair Jessica Vera said.

Still, she said, if national and statewide Democrats want to keep the county blue, they need to work together with local leaders to connect with voters there.

Hamilton said some newly converted Trump voters might feel less inclined to vote against their local Democratic officials, especially in the smaller border counties, because they tend to be known in the community.

“The further down the ballot you go, it all becomes more personal,” Hamilton said. “It’s not a guy I see on TV, right? It’s the guy I go to Mass with.”

Local Democratic Party officials, including Sylvia Bruni in Webb County, a longtime Democratic stronghold, said they had warned their state and national headquarters about the advances Republicans were making in their districts. But she said she had gotten little support and instead had to rely almost entirely on whatever funds her group could raise on its own.

That’s not going to be good enough in the future, Bruni said. “We need help.”

The letter began by talking about fairness and following the law in elections. But it then suggested that election officials do something that courts have found to be illegal for over a century: treat the certification of election results as an option, not an obligation.

The large logo at the top of the email gave the impression that it was an official correspondence from the respected legal newspaper, though smaller print said it was sent on behalf of a public relations company. The missive was an advertisement from a new group with deep ties to activists who have challenged the legitimacy of recent American elections.

The group, Follow the Law, has placed ads in Pennsylvania and Wisconsin news outlets serving attorneys, judges and election administrators — individuals who could be involved in election disputes. In Georgia, it ran ads supporting the State Election Board as its majority, backed by former President Donald Trump, passed a rule that experts warned could have allowed county board members to exclude enough Democratic votes to impact the presidential election. (A judge later struck down the rule as “illegal, unconstitutional and void.”)

In making its arguments about certification, Follow the Law has mischaracterized election rules and directed readers to a website providing an incomplete and inaccurate description of how certification works and what the laws and rules are in various states, election experts and state officials said.

“Anyone relying on that website is being deceived, and whoever is responsible for its content is being dishonest,” said Mike Hassinger, public information officer for Georgia’s secretary of state.

Certification is the mandatory administrative process that officials undertake after they finish counting and adjudicating ballots. Official results need to be certified by tight deadlines, so they can be aggregated and certified at the state and federal levels. Other procedures like lawsuits and recounts exist to check or challenge election outcomes, but those typically cannot commence until certification occurs. If officials fail to meet those deadlines or exclude a subset of votes, courts could order them to certify, as they have done in the past. But experts have warned that, in a worst-case scenario, the transition of power could be thrown into chaos.

“These ads make it seem as if there's only one way for election officials to show that they're on the ball, and that is to delay or refuse to certify an election. And just simply put, that is not their role,” said Sarah Gonski, an Arizona elections attorney and senior policy adviser for the Institute for Responsive Government, a think tank working on election issues. “What this is, is political propaganda that’s dressed up in a fancy legal costume.”

The activities of Follow the Law, which have not been previously reported, represent a broader push by those aligned with Trump to leverage the mechanics of elections to their advantage. The combination of those strategies, including recruiting poll workers and removing people from voting rolls, could matter in an election that might be determined by a small number of votes.

Since Trump lost the 2020 election, at least 35 election board members in various states, who have been overwhelmingly Republican, have unsuccessfully tried to refuse to certify election results before being compelled to certify by courts or being outvoted by Democratic members. Last week, a county supervisor in Arizona pleaded guilty to a misdemeanor for failing to perform election duties when she voted to delay certifying the 2022 election. And last month, the American Civil Liberties Union sued an election board member in Michigan after he said he might not certify the 2024 results. He ultimately signed an affidavit acknowledging his legal obligation to certify, and the ACLU dismissed its case. Experts have warned that more could refuse to certify the 2024 election if Trump loses.

Follow the Law bills itself as a “group of lawyers committed to ensuring elections are free, fair and represent the true votes of all American citizens.” It’s led by Melody Clarke, a longtime conservative activist with stints at Heritage Action, a conservative advocacy organization, and the Election Integrity Network, headed by a lawyer who helped Trump try to overturn the 2020 election results in Georgia.

This summer, Clarke left a leadership position at EIN to join the Election Transparency Initiative, a group headed by Ken Cuccinelli, a former Trump administration official. The two groups work together, according to Cuccinelli and EIN’s 2024 handbook.

The banner ads that appeared in Georgia and Wisconsin outlets disclosed they were paid for by the American Principles Project Foundation. ETI is a subsidiary of a related nonprofit, the American Principles Project. Financial reports show that packaging magnate Richard Uihlein has contributed millions of dollars to the American Principles Project this year through a political action committee. Uihlein has funneled his fortune into supporting far-right candidates and election deniers, as ProPublica has reported.

Cuccinelli, Clarke and a lawyer for Uihlein did not respond to requests for comment or detailed lists of questions. Cuccinelli previously defended to ProPublica the legality of election officials exercising their discretion in certifying results. “The proposed rule will protect the foundational, one person-one vote principle underpinning our democratic elections and guard against certification of inaccurate or erroneous results,” Cuccinelli wrote in a letter to Georgia’s State Election Board.

The most recent ads appear to be an extension of a monthslong effort that started in Georgia to expand the discretion of county election officials ahead of the November contest.

In August and September, Follow the Law bought ads as Georgia’s election board passed controversial rules, including one that empowered county election board members to not certify votes they found suspicious. As ProPublica has reported, the rule was secretly pushed by the EIN, where Clarke worked as deputy director.

Certification “is not a ministerial function,” Cuccinelli said at the election board’s August meeting. The law, he argued, “clearly implies that that board is intended and expected to use its judgment to determine, on very short time frames, what is the most proper outcome of the vote count.”

However, a state judge made clear in an October ruling the dangers of giving county board members the power to conduct investigations and decide which votes are valid. If board members, who are often political appointees, were “free to play investigator, prosecutor, jury, and judge” and refuse to certify election results, “Georgia voters would be silenced,” he wrote, finding that this would be unconstitutional. The case is on appeal and will be heard after the election.

Despite that ruling, and another from a different judge also finding both certification rules unconstitutional, Follow the Law’s website section for Georgia still asserts that a State Election Board rule “makes crystal clear” that county board members’ duty is “more than a simple ministerial task” without mentioning either ruling. The state Republican party has appealed the second ruling.

In a Telegram channel created by a Fulton County, Georgia, commissioner, someone shared what they called a “dream checklist” for election officials this week that contains extensive “suggestions” for how they should fulfill their statutory duties. The unsigned 15-page document, which bears the same three icons that appear on Follow the Law’s website, concludes, “Resolve all discrepancies prior to certification.”

On the same day the Georgia judge ruled that county board members can’t refuse to certify votes, Follow the Law began running ads in Pennsylvania and Wisconsin legal publications. The communications argued that certification is a discretionary step officials should take only after performing an investigation to ensure an election’s accuracy, largely continuing the line of argument that Cuccinelli pushed to Georgia’s election board and that the lawyers took before the judge. “Uphold your oath to only certify an accurate election,” said banner ads that ran in WisPolitics, a political news outlet. Another read: “No rubber stamps!” WisPolitics did not respond to requests for comment.

In Pennsylvania, the ad claimed that “simply put, the role of election officials is not ‘ministerial’” and that election officials are by law “required to ensure (and investigate if necessary) that elections are free from ‘fraud, deceit, or abuse’ and that the results are accurate prior to certification.”

Follow the Law has also directly contacted at least one county official in Eureka County, Nevada, pointing him to the group’s website, according to a letter obtained by ProPublica and Wisconsin Watch.

Follow the Law’s ads and website overstate officials’ roles beyond what statutes allow, state officials in Georgia, Arizona, Pennsylvania and Wisconsin said.

The group’s Wisconsin page reads: “Canvassers must first ensure that all votes are legally cast and can only certify results after verifying this.” But officials tasked with certifying elections are scorekeepers, not referees, said Edgar Lin, Wisconsin policy strategist and attorney for Protect Democracy, a nonprofit that works to protect the integrity of American elections. Lin and other experts said officials ensure the accuracy of an election’s basic arithmetic, for example, by checking that the number of ballots matches the number of voters, but they are not empowered to undertake deeper investigations.

Gonski said that in addition to overstating certifiers’ responsibilities, Follow the Law’s messaging underplays the protections that already exist. “Our election system is chock-full of checks and balances,” Gonski said. “Thousands of individuals have roles to play, and all of them seamlessly work together using well-established procedures to ensure a safe, accurate and secure election. No single individual has unchecked power over any piece of the process."

Ads in the Wisconsin Law Journal and the Legal Intelligencer in Pennsylvania also presented the findings of a poll that Follow the Law said was conducted by Rasmussen Reports, a company whose credibility the ad emphasizes. But Rasmussen Reports did not conduct the poll. It was conducted by Scott Rasmussen, who founded the polling company but has not worked there in over a decade.

Both the company and pollster confirmed the misattribution but did not comment further. The Wisconsin Law Journal and ALM, which owns the Legal Intelligencer, declined to comment.

Sam Liebert, a former election clerk and the Wisconsin director for All Voting is Local, said he wants the state’s attorney general to issue an unequivocal directive reminding election officials of their legal duty to certify.

“Certifying elections is a mandatory, democratic duty of our election officials,” he said. “Each refusal to certify threatens to validate the broader election denier movement, while sowing disorder in our election administration processes.”

A key ally to former President Donald Trump detailed plans to deploy the military in response to domestic unrest, defund the Environmental Protection Agency and put career civil servants “in trauma” in a series of previously unreported speeches that provide a sweeping vision for a second Trump term.

In private speeches delivered in 2023 and 2024, Russell Vought, who served as Trump’s director of the Office of Management and Budget, described his work crafting legal justifications so that military leaders or government lawyers would not stop Trump’s executive actions.

He said the plans are a response to a “Marxist takeover” of the country; likened the moment to 1776 and 1860, when the country was at war or on the brink of it; and said the timing of Trump’s candidacy was a “gift of God.”

ProPublica and Documented obtained videos of the two speeches Vought delivered during events for the Center for Renewing America, a pro-Trump think tank led by Vought. The think tank’s employees or fellows include Jeffrey Clark, the former senior Justice Department lawyer who aided Trump’s attempts to overturn the 2020 election result; Ken Cuccinelli, a former acting deputy secretary in the Department of Homeland Security under Trump; and Mark Paoletta, a former senior budget official in the Trump administration. Other Trump allies such as former White House adviser Steve Bannon and U.S. Reps. Chip Roy and Scott Perry either spoke at the conferences or appeared on promotional materials for the events.

Vought does not hide his agenda or shy away from using extreme rhetoric in public. But the apocalyptic tone and hard-line policy prescriptions in the two private speeches go further than his earlier pronouncements. As OMB director, Vought sought to use Trump’s 2020 “Schedule F” executive order to strip away job protections for nonpartisan government workers. But he has never spoken in such pointed terms about demoralizing federal workers to the point that they don’t want to do their jobs. He has spoken in broad terms about undercutting independent agencies but never spelled out sweeping plans to defund the EPA and other federal agencies.

Vought’s plans track closely with Trump’s campaign rhetoric about using the military against domestic protesters or what Trump has called the “enemy within.” Trump’s desire to use the military on U.S. soil recently prompted his longest-serving chief of staff, retired Marine Gen. John Kelly, to speak out, saying Trump “certainly prefers the dictator approach to government.”

Other policies mentioned by Vought dovetail with Trump’s plans, such as embracing a wartime footing on the southern border and rolling back transgender rights. Agenda 47, the campaign’s policy blueprint, calls for revoking President Joe Biden’s order expanding gender-affirming care for transgender people; Vought uses even more extreme language, decrying the “transgender sewage that’s being pumped into our schools and institutions” and referring to gender-affirming care as “chemical castration.”

Since leaving government, Vought has reportedly remained a close ally of the former president. Speaking in July to undercover journalists posing as relatives of a potential donor, Vought said Trump had “blessed” the Center for Renewing America and was “very supportive of what we do,” CNN reported.

Vought did not respond to requests for comment.

"Since the Fall of 2023, President Trump’s campaign made it clear that only President Trump and the campaign, and NOT any other organization or former staff, represent policies for the second term,” Danielle Alvarez, a senior adviser to the Trump campaign, said in a statement. She did not directly address Vought’s statements.

Karoline Leavitt, his campaign’s national press secretary, added there have been no discussions on who would serve in a second Trump administration.

In addition to running his think tank, Vought was the policy director of the Republican National Committee’s official platform committee ahead of the nominating convention. He’s also an architect of Project 2025, the controversial coalition effort mapping out how a second Trump administration can quickly eliminate obstacles to rolling out a hard-right policy agenda.

As ProPublica and Documented reported, Project 2025 has launched a massive program to recruit, vet and train thousands of people to “be ready on day one” to serve in a future conservative administration. (Trump has repeatedly criticized Project 2025, and his top aides have said the effort has no connection to the official campaign despite the dozens of former Trump aides and advisers who contributed to Project 2025.)

Vought is widely expected to take a high-level government role if Trump wins a second term. His name has even been mentioned as a potential White House chief of staff. The videos obtained by ProPublica and Documented offer an unfiltered look at Vought’s worldview, his plans for a Trump administration and his fusing of MAGA ideology and Christian nationalism.

A Shadow Government in Waiting

In his 2024 speech, Vought said he was spending the majority of his time helping lead Project 2025 and drafting an agenda for a future Trump presidency. “We have detailed agency plans,” he said. “We are writing the actual executive orders. We are writing the actual regulations now, and we are sorting out the legal authorities for all of what President Trump is running on.”

Vought laid out how his think tank is crafting the legal rationale for invoking the Insurrection Act, a law that gives the president broad power to use the military for domestic law enforcement. The Washington Post previously reported the issue was at the top of the Center for Renewing America’s priorities.

“We want to be able to shut down the riots and not have the legal community or the defense community come in and say, ‘That’s an inappropriate use of what you’re trying to do,’” he said. Vought held up the summer 2020 unrest following George Floyd’s murder as an example of when Trump ought to have had the ability to deploy the armed forces but was stymied.

Vought’s preparations for a future Trump administration involve building a “shadow” Office of Legal Counsel, he told the gathered supporters in May 2023. That office, part of the Justice Department, advises the president on the scope of their powers. Vought made clear he wants the office to help Trump steamroll the kind of internal opposition he faced in his first term.

Historically, the OLC has operated with a degree of independence. “If, all of a sudden, the office is full of a bunch of loyalists whose only job is to rubber-stamp the White House’s latest policy directive, whose only goal is to justify the ends by whatever means, that would be quite dangerous,” said an attorney who worked in the office under a previous Republican administration and requested anonymity to speak freely.

Another priority, according to Vought, was to “defund” certain independent federal agencies and demonize career civil servants, which include scientists and subject matter experts. Project 2025’s plan to revive Schedule F, an attempt to make it easier to fire a large swath of government workers who currently have civil service protections, aligns with Vought’s vision.

“We want the bureaucrats to be traumatically affected,” he said. “When they wake up in the morning, we want them to not want to go to work because they are increasingly viewed as the villains. We want their funding to be shut down so that the EPA can't do all of the rules against our energy industry because they have no bandwidth financially to do so.

“We want to put them in trauma.”

Vought also revealed the extent of the Center for Renewing America’s role in whipping up right-wing panic ahead of the 2022 midterms over an increase in asylum-seekers crossing at the U.S.-Mexico border.

In February 2022, Arizona Attorney General Mark Brnovich released a legal opinion claiming the state was under “invasion” by violent cartels and could invoke war powers to deploy National Guard troops to its southern border. The legally dubious “invasion” theory became a potent Republican talking point.

Vought said in the 2023 speech that he and Cuccinelli, the former top Homeland Security official for Trump, personally lobbied Brnovich on the effort. “We said, ‘Look, you can write your own opinion, but here’s a draft opinion of what this should look like,’” Vought said.

The nonpartisan watchdog group American Oversight later obtained an email in which Vought pitched the “invasion” framework to Brnovich.

Brnovich wrote in an email to ProPublica that he recalled multiple discussions with Cuccinelli about border security. But he added that “the invasion opinion was the result of a formal request from a member of the Arizona legislature. And I can assure you it was drafted and written by hard working attorneys (including myself) in our office.”

In the event Trump loses, Vought called for Republican leaders of states such as Florida and Texas to “create red-state sanctuaries” by “kicking out all the feds as much as they possibly can.”

“Nothing Short of a Quiet Revolution”

The two speeches delivered by Vought, taken together, offer an unvarnished look at the animating ideology and political worldview of a key figure in the MAGA movement.

Over the last century, Vought said, the U.S. has “experienced nothing short of a quiet revolution” and abandoned what he saw as the true meaning and force of the Constitution. The country today, he argued, was a “post-constitutional regime,” one that no longer adhered to the separation of powers among the three branches of government as laid out by the framers.

He lamented that the conservative right and the nation writ large had become “too secular” and “too globalist.” He urged his allies to join his mission to “renew a consensus of America as a nation under God.”

And in one of his most dramatic flourishes, he likened the 2024 election to moments in America’s history when the country was facing all-out war.

“We are here in the year of 2024, a year that very well [could] — and I believe it will — rival 1776 and 1860 for the complexity and the uncertainty of the forces arrayed against us,” Vought told his audience, referring to years when the colonies declared independence from Britain and the first state seceded over President Abraham Lincoln’s election. “God put us here for such a time as this.”

Vought said that independent agencies and unelected bureaucrats and experts wield far too much power while the traditional legislative process is a sham. He extended that critique to agencies like the Department of Justice and the Federal Reserve, whose independence from the White House had long been protected by both political parties.

“The left in the U.S. doesn’t want an energetic president with the power to motivate the executive branch to the will of the American people consistent with the laws of the country,” he said in the 2024 speech. “They don’t want a vibrant Congress where great questions are debated and decided in front of the American people. They don’t want empowered members. They want discouraged and bored backbenchers.”

He added, “The all-empowered career expert like Tony Fauci is their model, wielding power behind the curtains.” Fauci was one of the top public health experts under Trump at the start of the COVID-19 pandemic and a key figure in coordinating the national response.

What sets Vought apart from most of his fellow conservative activists is that he accuses powerful organizations on the right of being complicit in the current system of government, singling out the Federalist Society for Law and Public Policy Studies, the conservative and libertarian legal network co-chaired by activist Leonard Leo. The society is widely seen as an instrumental force in cultivating young conservative lawyers and building a bench of future judges whose embrace of legal theories like originalism and textualism have led to decisions overturning abortion rights, environmental protections and social welfare policies.

Yet in his 2024 speech, Vought accused the Federalist Society and “originalist judges” of being a part of the problem, perpetuating the “post-constitutional structure” that Vought lamented by not ruling more aggressively to weaken or dismantle independent regulatory agencies that Vought and his allies view as illegitimate or unconstitutional.

It was “like being in a contract quietly revoked two decades ago, in which one party didn’t tell the other,” he said. “At some point, reality needs to set in. Instead, we have the vaunted so-called Federalist Society and originalist judges acting as a Praetorian Guard for this post-constitutional structure.”

Echoing Trump’s rhetoric, Vought implicitly endorsed the false claim of a stolen 2020 election and likened the media’s debunkings of that claim to Chinese Communist propaganda.

“In the aftermath of the election, we had all these people going around saying, ‘Well, I don’t see any evidence of voter fraud. The media’s not giving enough [of] a compelling case,’” he said. “Well, that compelling case has emerged. But does a Christian in China ask and come away saying, ‘You know, there’s no persecution, because I haven’t read about it in the state regime press?’ No, they don’t.”

Vought referred to the people detained for alleged crimes committed on Jan. 6, 2021, as “political prisoners” and defended the lawyers Jeffrey Clark and John Eastman, who have both faced criminal charges for their role in Trump’s attempts to overturn the 2020 election. Federal law enforcement agencies, he added, “are keeping political opponents in jail, and I think we need to be honest about that.”

The left, Vought continued, has the ultimate goal of ending representative democracy altogether. “The stark reality in America is that we are in the late stages of a complete Marxist takeover of the country,” he said, “in which our adversaries already hold the weapons of the government apparatus, and they have aimed it at us. And they are going to continue to aim it until they no longer have to win elections.”

When Democrats called Trump an “existential threat to democracy,” they were not merely calling for his defeat at the ballot box, he said, but were using “coded language the national security state uses overseas when they are overthrowing other governments” to discourage the military from putting down anti-Trump protests should he win.

“They’re making Trump out to be a would-be dictator or an authoritarian,” he said. “So they’re actively working now to ensure, on a number of levels, that the military will perceive this as dictatorial and therefore not respond to any orders to quell any violence.”

Trump, Vought insisted, has the credibility and the track record to defeat the “Marxist” left and bring about the changes that Vought and his MAGA allies seek. In his view, the Democratic Party’s agenda and its “quiet revolution” could be stopped only by a “radical constitutionalist,” someone in the mold of Thomas Jefferson or James Madison. For Vought, no one was in a better position to fill that role than Trump.

“We have in Donald Trump a man who is so uniquely positioned to serve this role, a man whose own interests perfectly align with the interests of the country,” Vought said. “He has seen what it has done to him, and he has seen what they are trying to do to the country.

“That,” he added, “is nothing more than a gift of God.”

Former President Donald Trump used a dubious accounting maneuver to claim improper tax breaks from his troubled Chicago tower, according to an IRS inquiry uncovered by ProPublica and The New York Times. Losing a yearslong audit battle over the claim could mean a tax bill of more than $100 million.

The 92-story, glass-sheathed skyscraper along the Chicago River is the tallest and, at least for now, the last major construction project by Trump. Through a combination of cost overruns and the bad luck of opening in the teeth of the Great Recession, it was also a vast money loser.

But when Trump sought to reap tax benefits from his losses, the IRS has argued, he went too far and in effect wrote off the same losses twice.

The first write-off came on Trump’s tax return for 2008. With sales lagging far behind projections, he claimed that his investment in the condo-hotel tower met the tax code definition of “worthless,” because his debt on the project meant he would never see a profit. That move resulted in Trump reporting losses as high as $651 million for the year, ProPublica and the Times found.

There is no indication the IRS challenged that initial claim, though that lack of scrutiny surprised tax experts consulted for this article. But in 2010, Trump and his tax advisers sought to extract further benefits from the Chicago project, executing a maneuver that would draw years of inquiry from the IRS. First, he shifted the company that owned the tower into a new partnership. Because he controlled both companies, it was like moving coins from one pocket to another. Then he used the shift as justification to declare $168 million in additional losses over the next decade.

The issues around Trump’s case were novel enough that, during his presidency, the IRS undertook a high-level legal review before pursuing it. ProPublica and the Times, in consultation with tax experts, calculated that the revision sought by the IRS would create a new tax bill of more than $100 million, plus interest and potential penalties.

Trump’s tax records have been a matter of intense speculation since the 2016 presidential campaign, when he defied decades of precedent and refused to release his returns, citing a long-running audit. A first, partial revelation of the substance of the audit came in 2020, when the Times reported that the IRS was disputing a $72.9 million tax refund that Trump had claimed starting in 2010. That refund, which appeared to be based on Trump’s reporting of vast losses from his long-failing casinos, equaled every dollar of federal income tax he had paid during his first flush of television riches, from 2005 through 2008, plus interest.

The reporting by ProPublica and the Times about the Chicago tower reveals a second component of Trump’s quarrel with the IRS. This account was pieced together from a collection of public documents, including filings from the New York attorney general’s suit against Trump in 2022, a passing reference to the audit in a congressional report that same year and an obscure 2019 IRS memorandum that explored the legitimacy of the accounting maneuver. The memorandum did not identify Trump, but the documents, along with tax records previously obtained by the Times and additional reporting, indicated that the former president was the focus of the inquiry.

It is unclear how the audit battle has progressed since December 2022, when it was mentioned in the congressional report. Audits often drag on for years, and taxpayers have a right to appeal the IRS’ conclusions. The case would typically become public only if Trump chose to challenge a ruling in court.

In response to questions for this article, Trump’s son Eric, executive vice president of the Trump Organization, said: “This matter was settled years ago, only to be brought back to life once my father ran for office. We are confident in our position, which is supported by opinion letters from various tax experts, including the former general counsel of the IRS.”

An IRS spokesperson said federal law prohibited the agency from discussing private taxpayer information.

The outcome of Trump’s dispute could set a precedent for wealthy people seeking tax benefits from the laws governing partnerships. Those laws are notoriously complex, riddled with uncertainty and under constant assault by lawyers pushing boundaries for their clients. The IRS has inadvertently further invited aggressive positions by rarely auditing partnership tax returns.

The audit represents yet another potential financial threat — albeit a more distant one — for Trump, the Republicans’ presumptive 2024 presidential nominee. In recent months, he has been ordered to pay $83.3 million in a defamation case and an additional $454 million in a civil fraud case brought by the New York attorney general, Letitia James. Trump has appealed both judgments. (He is also in the midst of a criminal trial in Manhattan, where he is accused of covering up a hush-money payment to a porn star in the weeks before the 2016 election.)

Beyond the two episodes under audit, reporting by the Times in recent years has found that, across his business career, Trump has often used what experts described as highly aggressive — and at times, legally suspect — accounting maneuvers to avoid paying taxes. To the six tax experts consulted for this article, Trump’s Chicago accounting maneuvers appeared to be questionable and unlikely to withstand scrutiny.

“I think he ripped off the tax system,” said Walter Schwidetzky, a law professor at the University of Baltimore and an expert on partnership taxation.

Trump struck a deal in 2001 to acquire land and a building that was then home to the Chicago Sun-Times newspaper. Two years later, after publicly toying with the idea of constructing the world’s tallest building there, he unveiled plans for a more modest tower, with 486 residences and 339 “hotel condominiums” that buyers could use for short stays and allow Trump’s company to rent out. He initially estimated that construction would last until 2007 and cost $650 million.

Trump placed the project at the center of the first season of “The Apprentice” in 2004, offering the winner a top job there under his tutelage. “It’ll be a mind-boggling job to manage,” Trump said during the season finale. “When it’s finished in 2007, the Trump International Hotel and Tower, Chicago, could have a value of $1.2 billion and will raise the standards of architectural excellence throughout the world.”

As his cost estimates increased, Trump arranged to borrow as much as $770 million for the project — $640 million from Deutsche Bank and $130 million from Fortress Investment Group, a hedge fund and private equity company. He personally guaranteed $40 million of the Deutsche loan. Both Deutsche and Fortress then sold off pieces of the loans to other institutions, spreading the risk and potential gain.

Trump planned to sell enough of the 825 units to pay off his loans when they came due in May 2008. But when that date came, he had sold only 133. At that point, he projected that construction would not be completed until mid-2009, at a revised cost of $859 million.

He asked his lenders for a six-month extension. A briefing document prepared for the lenders, obtained by the Times and ProPublica, said Trump would contribute $89 million of his own money, $25 million more than his initial plan. The lenders agreed.

But sales did not pick up that summer, with the nation plunged into the financial crisis that would become the Great Recession. When Trump asked for another extension in September, his lenders refused.

Two months later, Trump defaulted on his loans and sued his lenders, characterizing the financial crisis as the kind of catastrophe, like a flood or hurricane, covered by the “force majeure” clause of his loan agreement with Deutsche Bank. That, he said, entitled him to an indefinite delay in repaying his loans. Trump went so far as to blame the bank and its peers for “creating the current financial crisis.” He demanded $3 billion in damages.

At the time, Trump had paid down his loans with $99 million in sales but still needed more money to complete construction. At some point that year, he concluded that his investment in the tower was worthless, at least as the term is defined in partnership tax law.

Trump’s worthlessness claim meant only that his stake in 401 Mezz Venture, the LLC that held the tower, was without value because he expected that sales would never produce enough cash to pay off the mortgages, let alone turn a profit.

When he filed his 2008 tax return, he declared business losses of $697 million. Tax records do not fully show which businesses generated that figure. But working with tax experts, ProPublica and the Times calculated that the Chicago worthlessness deduction could have been as high as $651 million, the value of Trump’s stake in the partnership — about $94 million he had invested and the $557 million loan balance reported on his tax returns that year.

When business owners report losses greater than their income in any given year, they can retain the leftover negative amount as a credit to reduce their taxable income in future years. As it turned out, that tax-reducing power would be of increasing value to Trump. While many of his businesses continued to lose money, income from “The Apprentice” and licensing and endorsement agreements poured in: $33.3 million in 2009, $44.6 million in 2010 and $51.3 million in 2011.

Trump’s advisers girded for a potential audit of the worthlessness deduction from the moment they claimed it, according to the filings from the New York attorney general’s lawsuit. Starting in 2009 Trump’s team excluded the Chicago tower from the frothy annual “statements of financial condition” that Trump used to boast of his wealth, out of concern that assigning value to the building would conflict with its declared worthlessness, according to the attorney general’s filing. (Those omissions came even as Trump fraudulently inflated his net worth to qualify for low-interest loans, according to the ruling in the attorney general’s lawsuit.)

Trump had good reason to fear an audit of the deduction, according to the tax experts consulted for this article. They believe that Trump’s tax advisers pushed beyond what was defensible.

The worthlessness deduction serves as a way for a taxpayer to benefit from an expected total loss on an investment long before the final results are known. It occupies a fuzzy and counterintuitive slice of tax law. Three decades ago, a federal appeals court ruled that the judgment of a company’s worthlessness could be based in part on the opinion of its owner. After taking the deduction, the owner can keep the “worthless” company and its assets. Subsequent court decisions have only partly clarified the rules. Absent prescribed parameters, tax lawyers have been left to handicap the chances that a worthlessness deduction will withstand an IRS challenge.

There are several categories, with a declining likelihood of success, of money taxpayers can claim to have lost.

The tax experts consulted for this article universally assigned the highest level of certainty to cash spent to acquire an asset. The roughly $94 million that Trump’s tax returns show he invested in Chicago fell into this category.

Some gave a lower, though still probable, chance of a taxpayer prevailing in declaring a loss based on loans that a lender agreed to forgive. That’s because forgiven debt generally must be declared as income, which can offset that portion of the worthlessness deduction in the same year. A large portion of Trump’s worthlessness deduction fell in this category, though he did not begin reporting forgiven debt income until two years later, a delay that would have further reduced his chances of prevailing in an audit.

The tax experts gave the weakest chance of surviving a challenge for a worthlessness deduction based on borrowed money for which the outcome was not clear. It reflects a doubly irrational claim — that the taxpayer deserves a tax benefit for losing someone else’s money even before the money has been lost, and that those anticipated future losses can be used to offset real income from other sources. Most of the debt included in Trump’s worthlessness deduction was based on that risky position.

Including that debt in the deduction was “just not right,” said Monte Jackel, a veteran of the IRS and major accounting firms who often publishes analyses of partnership tax issues.

Trump continued to sell units at the Chicago tower, but still below his costs. Had he done nothing, his 2008 worthlessness deduction would have prevented him from claiming that shortfall as losses again. But in 2010, his lawyers attempted an end-run by merging the entity through which he owned the Chicago tower into another partnership, DJT Holdings LLC. In the following years, they piled other businesses, including several of his golf courses, into DJT Holdings.

Those changes had no apparent business purpose. But Trump’s tax advisers took the position that pooling the Chicago tower’s finances with other businesses entitled him to declare even more tax-reducing losses from his Chicago investment.

His financial problems there continued. More than 100 of the hotel condominiums never sold. Sales of all units totaled only $727 million, far below Trump’s budgeted costs of $859 million. And some 70,000 square feet of retail space remained vacant because it had been designed without access to foot or vehicle traffic. From 2011 through 2020, Trump reported $168 million in additional losses from the project.

Those additional write-offs helped Trump avoid tax liability for his continuing entertainment riches, as well as his unpaid debt from the tower. Starting in 2010, his lenders agreed to forgive about $270 million of those debts. But he was able to delay declaring that income until 2014 and spread it out over five years of tax returns, thanks to a provision in the Obama administration’s stimulus bill responding to the Great Recession. In 2018, Trump reported positive income for the first time in 11 years. But his income tax bill still amounted to only $1.9 million, even as he reported a $25 million gain from the sale of his late father’s assets.

It’s unclear when the IRS began to question the 2010 merger transaction, but the conflict escalated during Trump’s presidency.

The IRS explained its position in a Technical Advice Memorandum, released in 2019, that identified Trump only as “A.” Such memos, reserved for cases where the law is unclear, are rare and involve extensive review by senior IRS lawyers. The agency produced only two other such memos that year.

The memos are required to be publicly released with the taxpayer’s information removed, and this one was more heavily redacted than usual. Some partnership specialists wrote papers exploring its meaning and importance to other taxpayers, but none identified taxpayer “A” as the then-sitting president of the United States. ProPublica and the Times matched the facts of the memo to information from Trump’s tax returns and elsewhere.

The 20-page document is dense with footnotes, calculations and references to various statutes, but the core of the IRS’ position is that Trump’s 2010 merger violated a law meant to prevent double dipping on tax-reducing losses. If done properly, the merger would have accounted for the fact that Trump had already written off the full cost of the tower’s construction with his worthlessness deduction.

In the IRS memo, Trump’s lawyers vigorously disagreed with the agency’s conclusions, saying he had followed the law.

If the IRS prevails, Trump’s tax returns would look very different, especially those from 2011 to 2017. During those years, he reported $184 million in income from “The Apprentice” and agreements to license his name, along with $219 million from canceled debts. But he paid only $643,431 in income taxes thanks to huge losses on his businesses, including the Chicago tower. The revisions sought by the IRS would require amending his tax returns to remove $146 million in losses and add as much as $218 million in income from condominium sales. That shift of up to $364 million could swing those years out of the red and well into positive territory, creating a tax bill that could easily exceed $100 million.

The only public sign of the Chicago audit came in December 2022, when a congressional Joint Committee on Taxation report on IRS efforts to audit Trump made an unexplained reference to the section of tax law at issue in the Chicago case. It confirmed that the audit was still underway and could affect Trump’s tax returns from several years.

That the IRS did not initiate an audit of the 2008 worthlessness deduction puzzled the experts in partnership taxation. Many assumed the understaffed IRS simply had not realized what Trump had done until the deadline to investigate it had passed.

“I think the government recognized that they screwed up,” and then audited the merger transaction to make up for it, Jackel said.

The agency’s difficulty in keeping up with Trump’s maneuvers, experts said, showed that this gray area of tax law was too easy to exploit.

“Congress needs to radically change the rules for the worthlessness deduction,” Schwidetzky said.

The benefits have flowed from Trump’s businesses and campaign committees, according to a ProPublica analysis of public disclosures, court records and securities filings. One campaign aide had his average monthly pay double, from $26,000 to $53,500. Another employee got a $2 million severance package barring him from voluntarily cooperating with law enforcement. And one of the campaign’s top officials had her daughter hired onto the campaign staff, where she is now the fourth-highest-paid employee.

These pay increases and other benefits often came at delicate moments in the legal proceedings against Trump. One aide who was given a plum position on the board of Trump’s social media company, for example, got the seat after he was subpoenaed but before he testified.

Significant changes to a staffer’s work situation, such as bonuses, pay raises, firings or promotions, can be evidence of a crime if they come outside the normal course of business. To prove witness tampering, prosecutors would need to show that perks or punishments were intended to influence testimony.

White-collar defense lawyers say the situation Trump finds himself in — in the dual role of defendant and boss of many of the people who are the primary witnesses to his alleged crimes — is not uncommon. Their standard advice is not to provide any unusual benefits or penalties to such employees. Ideally, decisions about employees slated to give evidence should be made by an independent body such as a board, not the boss who is under investigation.

Even if the perks were not intended to influence witnesses, they could prove troublesome for Trump in any future trials. Prosecutors could point to the benefits to undermine the credibility of those aides on the witness stand.

“It feels very shady, especially as you detect a pattern. … I would worry about it having a corrupt influence,” Barbara McQuade, a former U.S. attorney for the Eastern District of Michigan, said after hearing from ProPublica about benefits provided to potential Trump witnesses.

But McQuade said these cases are difficult to prove, even if the intent were actually to influence testimony, because savvy defendants don’t explicitly attach strings to the benefits and would more likely be “all wink and a nod, ‘You’re a great, loyal employee, here’s a raise.’”

In response to questions from ProPublica, a Trump campaign official said that any raises or other benefits provided to witnesses were the result of their taking on more work due to the campaign or his legal cases heating up, or because they took on new duties.

The official added that Trump himself isn’t involved in determining how much campaign staffers are paid, and that compensation is entirely delegated to the campaign’s top leaders. “The president is not involved in the decision-making process,” the official said. “I would argue Trump doesn’t know what we’re paid.”

Campaign spokesperson Steven Cheung said in a statement that “the 2024 Trump campaign is the most well-run and professional operation in political history. Any false assertion that we’re engaging in any type of behavior that may be regarded as tampering is absurd and completely fake.”

Trump’s attorney, David Warrington, sent ProPublica a cease-and-desist letter demanding this article not be published. The letter warned that if the outlet and its reporters “continue their reckless campaign of defamation, President Trump will evaluate all legal remedies.”

It’s possible the benefits are more widespread. Payments from Trump campaign committees are disclosed publicly, but the finances of his businesses are mostly private, so raises, bonuses and other payments from those entities are not typically disclosed.

ProPublica did not find evidence that Trump personally approved the pay increases or other benefits. But Trump famously keeps close watch over his operations and prides himself on penny-pinching. One former aide compared working for the Trump Organization, his large company, to “a small family business” where every employee “in some sense reports to Mr. Trump.” Former aides have said Trump demands unwavering loyalty from subordinates, even when their duties require independence. After his Attorney General Jeff Sessions decided to recuse himself against then-President Trump’s wishes, paving the way for a special counsel to investigate his campaign’s ties to Russia, Trump fumed about being crossed. “Where’s my Roy Cohn?” Trump asked, referring to the notorious former aide to Sen. Joseph McCarthy who later served as Trump’s faithful fixer long before Trump became president.

In addition to the New York case in which Trump was convicted last week, stemming from hidden payments to a porn star, Trump is facing separate charges federally and in Georgia for election interference and in another federal case for mishandling classified documents.

Attempts to exert undue influence on witnesses have been a repeated theme of Trump-related investigations and criminal cases over the years.

Trump’s former campaign manager and former campaign adviser were convicted on federal witness tampering charges in 2018 and 2019. The campaign adviser had told a witness to “do a ‘Frank Pentangeli,’” referencing a character in “The Godfather Part II” who lies to a Senate committee investigating organized crime. Trump later pardoned both men in the waning days of his presidency. (He did not pardon a co-defendant of the campaign manager who had cooperated with the government.)

During the congressional investigation into the storming of the Capitol on Jan. 6, 2021, a former White House staffer testified that she got a call from a colleague the night before an interview with investigators. The colleague told her Trump’s chief of staff “wants me to let you know that he knows you’re loyal and he knows you’ll do the right thing tomorrow and that you’re going to protect him and the boss.” (A spokesperson for the chief of staff denied that he tried to influence testimony.)

Last year, Trump himself publicly discouraged a witness from testifying in the Georgia case. Trump posted on social media that he had read about a Georgia politician who “will be testifying before the Fulton County Grand Jury. He shouldn’t.”

One witness has said publicly that, when he quit working for Trump in the midst of the classified documents criminal investigation, he was offered golf tournament tickets, a lawyer paid for by Trump and a new job that would have come with a raise. The witness, a valet and manager at Mar-a-Lago, had direct knowledge of the handling of the government documents at the club, the focus of one of the criminal cases against the former president. “I’m sure the boss would love to see you,” the employee, Brian Butler, recalled Trump’s property manager telling him. (The episode was first reported by CNN.)

In an interview with ProPublica, Butler, who declined the offers, said he looked at them “innocently for a while.” But when he added up the benefits plus the timing, he thought “it could be them trying to get me back in the circle.”

One Trump aide who plays a key role in multiple cases is a lawyer named Boris Epshteyn, who became an important figure in Trump’s effort to overturn the results of the 2020 election.

A college classmate of one of Trump’s sons who worked on the 2016 campaign and briefly in the White House, Epshteyn was involved in assembling sets of false electors around the country after Trump lost the 2020 election, and Epshteyn’s emails and texts have come up repeatedly in investigations.

In 2022, he testified before the Georgia grand jury that later indicted Trump on charges related to attempts to overturn the election. The FBI seized his phone, and in April 2023 he was interviewed by the federal special counsel.

In early August 2023, the special counsel charged Trump with conspiracy to defraud the United States and conspiracy to obstruct an official proceeding as part of an effort to overturn the 2020 election. A couple weeks later, the Georgia grand jury handed down an indictment accusing Trump of racketeering as part of a plot to overturn the election results in the state. From November 2022 to August 2023, the Trump campaign had paid Epshteyn’s company an average of $26,000 per month. The month after the indictments, his pay hit a new high, $50,000, and climbed in October to $53,500 per month, where it has remained ever since.

Epshteyn is a contractor with the campaign and the payments go to his company, Georgetown Advisory, which is based at a residential home in New Jersey. The company does not appear to have an office or other employees. Campaign filings say the payments are for “communications & legal consulting.”

Kenneth Notter, an attorney at MoloLamken who specializes in white-collar defense, said that a defendant should have a good explanation for a major increase in pay like Epshteyn’s. “Any change in treatment of a witness is something that gets my heart rate up as a lawyer.”

Already in early 2023, months before the pay bump, a Trump campaign spokesperson described Epshteyn to The New York Times as “a deeply valued member of the team” who had “done a terrific job shepherding the legal efforts fighting” the investigations of Trump. The Times reported then that Epshteyn spoke to Trump multiple times per day.

Timothy Parlatore, an attorney who left Trump’s defense team last year citing infighting, found Epshteyn’s large raise baffling. He questioned Epshteyn’s fitness to handle high-stakes criminal defense given his scant experience in the area. “He tries to coordinate all the legal efforts, which is a role he’s uniquely unqualified for,” Parlatore said.

The Trump campaign official told ProPublica that Epshteyn got a pay raise because Trump’s legal cases intensified and, as a result, Epshteyn had more legal work to coordinate. The official declined to say if he started working more hours: “All of us are working 24/7, ... every second of the day.” Epshteyn declined to comment on the record.

Even after the major pay increase, Epshteyn has not devoted all of his working time to the Trump campaign. He has continued to consult for other campaigns in recent months, disclosure filings show. And in November, he got a new role as managing director of a financial services firm in New York called Kenmar Securities, regulatory filings show.

Other employees in Trump’s political orbit have followed a similar pattern — including his top aide.

Trump campaign head Susie Wiles, a Florida political consultant, was present when Trump allegedly went beyond improperly holding onto classified documents and showed them to people lacking proper security clearances.

When Trump was indicted on June 8, 2023, over his handling of the documents, the indictment described Wiles as a “PAC representative.” It described Trump allegedly showing her a classified map related to a military operation, acknowledging “that he should not be showing it” and warning her to “not get too close.”

That June, Right Coast Strategies, the political consulting firm Wiles founded, received its highest-ever monthly payment from the Trump campaign: $75,000, an amount the firm has equaled only once since.

Wiles had been a grand jury witness before the indictment. News reports indicated Wiles had told others that she continued to be loyal to Trump and only testified because she was forced to. (And, according to Wiles, Trump was told she was a witness sometime before the indictment’s June release.)

The Trump campaign official told ProPublica that the spike in payments was largely because Wiles was billing for previous months.

She also got a 20% raise that May, from $25,000 to $30,000 per month. “She went back and redid her contract,” the official said, adding that her role as a witness was not a factor in that raise.

A few months later, the Wiles family got more good news. Wiles’ daughter Caroline, who had done some work for Trump’s first campaign and in the White House, where she reportedly left one job because she didn’t pass a background check, was hired by his campaign. Her salary: $222,000, making her currently the fourth-highest-paid staffer. (The Trump campaign official said her salary included a monthly housing stipend.)

Susie Wiles said she and another campaign official were responsible for hiring her daughter, who she said has an expertise in logistics and was brought on to handle arrangements for surrogates taking Trump’s place at events he couldn’t attend. Wiles said Trump wasn’t involved in the hire.

Caroline Wiles told ProPublica her mother’s position in the campaign played no role in her getting a job, but she declined to describe the circumstances around the job offer. “How did I get the job? Because I have earned it,” she said. “I don’t think it has anything to do with Susie.”

The indictment suggests Susie Wiles herself has been aware of efforts to keep potential witnesses in the fold. Soon after the FBI found classified documents at Mar-a-Lago, a Trump employee was asked in a group text chat that included Wiles to confirm that the club’s property manager “was loyal.”

Wiles told ProPublica she couldn’t talk about the details of the case, but she called the text message exchange “a nothing.”

More generally, she said she was unaware of the need to ensure employees who are witnesses do not appear to be receiving special treatment. “It’s the first time I’ve heard that’s best practice,” she said. “I don’t mind telling you I conduct myself in such a way that I don’t worry about any of that.” Trump, she said, had never talked to her about her role as a witness.

Less powerful aides who are witnesses have also enjoyed career advances.

Margo Martin, a Trump aide who, like Wiles, allegedly witnessed Trump showing off what he described as a secret military document, got a significant raise not long after the classified documents case heated up with the search at Mar-a-Lago.

According to the indictment, Trump told Martin and others the military plan was “secret” and “highly confidential.” “As president I could have declassified it,” he allegedly told the group. “Now I can’t, you know, but this is still a secret.”

A few months before her grand jury appearance, she moved from the payroll of a Trump political committee to a job with the campaign as it was launching. Martin was given a roughly 20% pay raise, from $155,000 to $185,000 per year, according to the Trump campaign. Campaign finance filings show a much larger pay increase for Martin, but the Trump campaign said the filings are misleading because of a difference in how payroll taxes and withholdings are reported by the two committees.

Because of that quirk, it’s impossible to know who else got raises and how big they were. The campaign official said that at least one other witness also got a pay raise but did not provide details about how much and when.

Dan Scavino is a longtime communications aide who Trump once called the “most powerful man in politics” because he could post for Trump on the president’s social media accounts. Scavino was among the small group of staff who had an up-close view of Trump during the final weeks of his presidency — a focus of the congressional inquiry into the Jan. 6 insurrection and the criminal probe into election interference.

In August 2021, a month after the congressional investigation began, securities filings show that the parent company behind Truth Social, Trump’s social media company, gave Scavino a consulting deal that ultimately paid out $240,000 a year.

The next month, lawmakers issued a subpoena to Scavino to ask him what the White House knew about the potential for violence before the attacks and what actions Trump took to try to overturn the election results. The panel gave Scavino a half-dozen extensions while negotiating with him, but he ultimately refused to testify or turn over documents and was held in contempt.

In September 2022, Scavino received a subpoena to testify before the criminal grand jury in the federal election interference probe. This time, he wasn’t able to get out of it and was seen leaving the Washington, D.C., courthouse in May 2023.

Bits of Scavino’s testimony were reported by ABC News, citing unnamed sources. Though his recollections of Trump from Jan. 6 painted the former president unfavorably, his reported testimony didn’t include significant new information. He testified Trump was “very angry” that day, and, despite pleas from aides to calm the Capitol rioters, Trump for hours “was just not interested” in taking action to stop it. When the testimony was reported, Trump’s spokesperson said Scavino is one of the former president’s “most loyal allies, and his actual testimony shows just how strong President Trump is positioned in this case.”

Between getting the subpoena and testifying, Scavino was given a seat on the board of the Trump social media company.

Scavino was also granted a $600,000 retention bonus and a $4 million “executive promissory note” paid in shares, according to SEC filings. The company’s public filings do not make clear when these deals were put in place.

As one of the few aides who Trump was with on Jan. 6, Scavino is likely to be called if Trump’s election interference cases go to trial.

Reached by ProPublica, Scavino declined to answer questions about how he got the board seat and other benefits from the Trump media company. “It has nothing to do,” he said, “with any investigation.”

A Trump Media spokesperson declined to answer questions about who made the decision to give Scavino the benefits and why, but said, “It appears this article will comprise utterly false insinuations.”

When Atlanta attorney Jennifer Little was hired to represent Trump in his Georgia election interference case, it marked the high point of her career.

A former local prosecutor who started her own practice, she had previously taken on far more modest cases. Highlights on her website include a biker who fell because of a pothole, a child investigated for insensitive social media comments and drunk drivers with “DUI’s as high as .19.” Little had made headlines for some higher profile cases, like a candidate for lieutenant governor accused of sexual harassment, but everything on her resume paled in comparison to representing a former president accused of plotting to reverse the outcome of an election.

Then in May 2022, her job got even more complicated when Trump pulled her into his brewing showdown with the Justice Department over classified documents at Mar-a-Lago. Despite multiple requests, Trump had not returned all of the documents he had brought with him from the White House to his Florida club. The Justice Department had just elevated the matter by subpoenaing Trump for the records, and Trump wanted her advice.

Little told him, according to news reports, that unlike the government’s prior requests, a subpoena meant he could face criminal charges if he didn’t comply.

When Trump ultimately did not turn over the records and the criminal investigation intensified, Little’s involvement in that pivotal meeting got her called before a grand jury by federal prosecutors.

Some of her testimony before that grand jury, which determines whether someone will be indicted, may have been favorable for Trump. In one reported instance, Little’s recollections undermined contemporaneous documentary evidence that was damaging to Trump. Investigators had obtained notes from another lawyer at the May 2022 meeting indicating Trump suggested they not “play ball” with federal authorities: “Wouldn’t it be better if we just told them we don’t have anything here?”

Little told the grand jury she remembered the question more benignly, according to an ABC News story that cited anonymous sources, and said she couldn’t recall Trump recommending they not “play ball.”

Trump has since been indicted over his handling of the classified documents. If the case goes to trial, Little’s testimony could prove crucial as the two sides try to make their case about Trump's consciousness of guilt and whether he purposely withheld documents. (Trump has pleaded not guilty in that case and has said he did nothing wrong.)

Just after Little was forced to testify before the grand jury in March 2023, a Trump political action committee paid her $218,000, by far the largest payment she’d received while working for Trump. In the year after she became a witness, she has made at least $1.3 million from the Trump political committee, more than twice as much as she had during the year prior.

Little told ProPublica the large payment she received soon after she was compelled to testify was due to a lengthy motion she filed around then to block the release of the Georgia grand jury’s findings and prevent Trump from being indicted. Her hourly rate did not change, she said, the workload increased. The elevated payments in the year after she became a witness did coincide with the Georgia case heating up and Trump getting indicted.

The Trump campaign official said the spike in payments to Little after she became a witness was the result of her billing for multiple time periods at once.

A similar pattern played out for the other Trump lawyer present at the Mar-a-Lago meeting about the subpoena.

Evan Corcoran, a former federal prosecutor who specializes in white-collar criminal defense, was new to the team at the time. And it was his notes, obtained by investigators, that memorialized Trump suggesting they not “play ball.” His notes also included a description of Trump seeming to instruct him to withhold some sensitive documents from authorities when the former president made a “plucking motion.”

“He made a funny motion as though — well okay why don’t you take them with you to your hotel room and if there’s anything really bad in there, like, you know, pluck it out,” Corcoran’s notes read, according to the indictment.

Like Little, Corcoran tried to fight being forced to testify before a grand jury, asserting that as Trump’s lawyer, their communications were protected. But prosecutors were able to convince a judge that the protection didn’t apply because their legal advice was used to commit crimes.

Corcoran’s notes from his conversations with Trump formed the backbone of the eventual indictment, and his descriptions of those meetings are expected to be a critical component at trial. The lawyer made an initial appearance before the grand jury in January 2023 and appeared again in another session in March.

Around the time he was forced to be a witness, Corcoran recused himself from the classified documents case, but he continued to represent Trump on other matters. Nevertheless his firm’s compensation shot up for a few months.

Just days after his March grand jury testimony, the Trump campaign sent two payments to his firm totaling $786,000, the largest amount paid in a single day in his almost two years working for Trump. The firm brought in a total of $1.4 million in that four-week span, more than double its payments from any other comparable period during Corcoran’s time working for Trump.

Corcoran did not respond to questions from ProPublica. The Trump campaign official said the spike in payments came because the firm was billing for more hours of work as Trump’s cases ramped up. The official added that the number of lawyers from the firm working on the case may have increased but could not provide specifics.

The issue of witnesses who have received financial rewards from Trump has already come up at both of the former president’s New York trials.

In the civil fraud case last year, prosecutors questioned the Trump Organization’s former controller about the $500,000 in severance he had been promised after retiring earlier in the year. During his testimony, the former controller broke down in tears as he complained about allegations against an employer he loved and defended the valuations at the center of the case as “justified.” At the time of the testimony, he was still receiving his severance in installments.

Former chief financial officer Allen Weisselberg got a $2 million severance agreement in January 2023, four months after the New York attorney general sued Trump for financial fraud in his real estate business. The agreement contains a nondisparagement clause and language barring Weisselberg from voluntarily cooperating with investigators.

It came up in Trump’s hush money trial last month when prosecutors told the judge that the severance agreement was one of the reasons they would not call Weisselberg . He was still due several payments.

“The agreement seems to preclude us from talking to him or him talking to us at the risk of losing $750,000 of outstanding severance pay,” one prosecutor said.

In last year’s fraud trial, the judge wrote of the severance agreement, “The Trump Organization keeps Weisselberg on a short leash, and it shows.”

A Trump Organization spokesperson said in a statement that after Weisselberg and the controller announced their retirement plans, “the company agreed to pay them severance based on the number of years they worked at the company. President Trump played no role in that decision.” Weisselberg’s severance agreement was signed by Trump’s son Eric.

Another witness from the civil trial last year, longtime Trump friend and real estate executive Steve Witkoff, was called as an expert witness by Trump’s defense team, and he defended the Trump Organization real estate valuations at the heart of the case.

Two months after Witkoff’s testimony, Trump’s campaign for the first time started paying his company, the Witkoff Group, for air travel. The payments continued over several weeks, ultimately totalling more than $370,000.

The Trump campaign official confirmed the campaign used Witkoff’s private jet for multiple trips, including Trump’s visit to a stretch of the Texas border in February, saying it “appropriately reimbursed” him for the flights. The official said it sometimes used commercial charter jet services but opted for Witkoff’s plane because of “availability, space, and convenience.”

Witkoff and The Witkoff Group did not respond to requests for comment.

Do you have any information about Trump’s campaign or his businesses that we should know? Robert Faturechi can be reached by email at robert.faturechi@propublica.org and by Signal or WhatsApp at 213-271-7217. Justin Elliott can be reached by email at justin@propublica.org or by Signal or WhatsApp at 774-826-6240.

The bug killer — also used on tomatoes, cranberries, Brussels sprouts and other fruits and vegetables — belongs to a class of compounds linked to autism, hyperactivity and reduced scores on intelligence tests in children.

But rather than banning the pesticide, as the European Union did more than 20 years ago, the U.S. Environmental Protection Agency recently proposed easing restrictions on acephate.

The federal agency’s assessment lays out a plan that would allow 10 times more acephate on food than is acceptable under the current limits. The proposal was based in large part on the results of a new battery of tests that are performed on disembodied cells rather than whole lab animals. After exposing groups of cells to the pesticide, the agency found “little to no evidence” that acephate and a chemical created when it breaks down in the body harm the developing brain, according to an August 2023 EPA document.

The EPA is moving ahead with the proposal despite multiple studies linking acephate to developmental problems in children and lab rats, and despite warnings from several scientific groups against using the new tests on cells to relax regulations, interviews and records reviewed by ProPublica show.

To create the new tests designed to measure the impact of chemicals on the growing brain, the EPA worked with the Organization for Economic Cooperation and Development, which comprises some of the world’s wealthiest democratic countries and conducts research on economic, social and scientific issues. The OECD has warned against using the tests to conclude a chemical does not interfere with the brain’s development.

A scientific advisory panel the EPA consulted found that, because of major limitations, the tests “may not be representative of many processes and mechanisms that could” harm the developing nervous system. California pesticide regulators have argued that the new tests are not yet reliable enough to discount results of the older animal tests. And the Children’s Health Protection Advisory Committee, a second group of advisers handpicked by the EPA, also warned against using results of the nonanimal tests to dismiss concerns.

“It’s exactly what we recommended against,” Veena Singla, a member of the children’s committee who also teaches at Columbia University, said of the EPA’s acephate proposal. “Children’s development is exquisitely sensitive to toxicants. … It’s disappointing they’re not following the science.”

The EPA’s proposal, which could be finalized later this year, marks one of the first times the agency has recommended changing its legal safety threshold largely based on nonanimal tests designed to measure a chemical’s impact on the developing brain. And in March, the EPA released a draft assessment of another pesticide in the same class, malathion, that also proposes loosening restrictions based on similar tests.

The proposed relaxing of restrictions on both chemicals comes even as the Biden administration has been strengthening limits on several other environmental contaminants, including some closely related pesticides.

In response to questions from ProPublica, the EPA acknowledged that it “will need to continually build scientific confidence” in these new methods but said that the introduction of the nonanimal tests to predict the danger chemicals pose to the developing brain “has not been done in haste. Rather, a methodical, step-wise approach has been implemented over the course of more than a decade.”

The agency said its recent review of acephate included a thorough examination of a variety of scientific studies and that, even with its proposed changes, children and infants would still be protected.

The EPA expects to start accepting public comments on the acephate proposal in the coming months before it makes a final decision. The agency anticipates soliciting comments on malathion this summer.

Some environmental scientists strongly oppose loosening the restrictions on both acephate and malathion, arguing that the new tests are not reliable enough to capture all the hazards a chemical poses to the developing brain.

“It will put children at an increased risk of neurodevelopmental disorders like autism and ADHD that we already know are linked to this class of chemicals,” said Rashmi Joglekar, a toxicologist at the Program on Reproductive Health and the Environment at the University of California, San Francisco.

Health and environmental scientists are concerned about more than the direct impact of having potentially greater amounts of acephate and malathion on celery and other produce. They also worry that using the new tests as a basis for allowing more pesticides on crops will set a dangerous precedent for other brain-harming chemicals.

“I think the companies see this as a new way over a 10- or 20-year period to gradually lobby” the EPA “to allow higher levels of pesticides in food,” said Charles Benbrook, an agricultural economist who has monitored pesticide regulation for decades. “If they can convince regulators to not pay attention to animal studies, they have a very good chance of raising the allowable exposure levels.”

Industry Helped Fashion EPA’s Testing Strategy

Since its founding in 1970, the EPA has relied on studies of mice, rats, guinea pigs and other species to set exposure limits for chemicals. The lab animals serve as a proxy for humans. Scientists expose them to different doses of substances and watch to see what levels cause cancer, reproductive problems, irritation to the skin and eyes, or other conditions. Some tests look specifically at chemicals’ effects on the offspring of rats exposed during pregnancy, and some of those tests focus on the development of their brains and nervous systems.

But over the past decade, chemical manufacturers and animal rights advocates have argued for phasing out the tests on the grounds they are impractical and inhumane. The animal experiments are also expensive, and the pesticide industry, which by law shoulders the cost of testing its products, is among the biggest proponents of the change.

The EPA has allowed the chemical industry and animal rights groups to help fashion its testing strategy. Agency officials have co-authored articles and held workshops on the use of the cell-based tests to regulate chemicals alongside representatives of People for the Ethical Treatment of Animals as well as Corteva Agriscience, BASF and Syngenta Crop Protection, companies that make pesticides regulated by the EPA.

The EPA said its scientists have been working to develop the nonanimal tests for decades with other government and scientific organizations, both nationally and internationally.

“It is absurd to describe those scientific efforts as an apparent conflict of interest,” the agency said in a statement.

The EPA’s Office of Pesticide Programs has previously come under fire for its willingness to allow pesticides onto the market without required toxicity testing. In 2018, as The Intercept reported, staff members held a party to celebrate a milestone: The number of legally required tests the office had waived for pesticide companies had reached 1,000. A science adviser to the office at the time said the move spared companies more than $6 million in expenses.

While phasing out animal experiments would save money and animal lives, experiments involving collections of cells do not always accurately predict how entire organisms will respond to exposure to a toxic chemical. The new cell-based tests and computer techniques that are sometimes used with them can be reliable predictors of straightforward effects like eye or skin irritation. But they are not yet up to the task of modeling the complex, real-world learning disorders that have been linked to acephate and malathion, according to Jennifer Sass, a senior scientist at the Natural Resources Defense Council, an environmental advocacy organization.

The new tests can show whether a chemical can kill a brain cell. And they can show if a chemical affects how a brain cell connects with other brain cells, said Sass.

“But these tests can’t show that a kid is going to be able to sit through class and not go to the principal’s office,” she said.

While the cell-based tests may point to certain harms, they are likely to miss others, said Sass, who likens their use to fishing with a loose net. “You only know what you caught — the big stuff,” she said. “You don’t know about all the little stuff that got through.”

A 2023 study revealed the failure of the cell-based tests to detect certain problems. In it, scientists exposed brain cells to 28 chemicals known to interfere with the development of the nervous system. Although the tests were specifically designed to assess whether chemicals harm growing brains, they failed to clearly identify harm in one-third of the substances known to cause these very problems. Instead of registering as harmful, the test results on these established developmental neurotoxins were either borderline or negative.

Because of these potential blind spots and other uncertainties associated with the tests, the Organization for Economic Cooperation and Development has advised against interpreting results of the nonanimal tests as evidence that a chemical doesn’t damage the brain. Several scientific groups have recommended that the EPA do the same.

A federal advisory panel of scientists assembled to advise the EPA on pesticide-related issues published a 2020 report that identified numerous limitations and gaps in the nonanimal studies, finding that they “underestimated the complexity of nervous system development.”

In 2021, the Children’s Health Protection Advisory Committee, a group the EPA created to provide advice on how to best protect children from environmental threats, warned the agency that, “due to important limitations,” the test results “cannot be used to rule-out a specific hazard.”

In comments to the EPA, California’s Department of Pesticide Regulation also cautioned the agency against using the tests to conclude that a chemical doesn’t cause specific harms. The California regulators emphasized that the traditional battery of animal tests was still necessary to understand complex outcomes like the effects on children’s developing brains.

“To abandon it at this time would be to abandon a critical support for health-protective decisions,” they wrote.

EPA Accused of Double Standard

As much as 12 million pounds of acephate were used on soybeans, Brussels sprouts and other crops in 2019, according to the most recent estimates from the U.S. Geological Survey. The federal agency estimates that up to 30% of celery, 35% of lettuce and 20% of cauliflower and peppers were grown with acephate. Malathion is used on crops such as strawberries, blueberries and asparagus. (The U.S. Department of Agriculture prohibits the use of most synthetic pesticides, including acephate and malathion, to grow and process products certified by the agency as organic.)

Acephate and malathion belong to a class of chemicals called organophosphates, which U.S. farmers have used for decades because they efficiently kill aphids, fire ants and other pests. But what makes the pesticides good bug killers — their ability to interfere with signals sent between nerve cells — also makes them dangerous to people. For years, there has been a scientific consensus that children are particularly vulnerable to the harms of pesticides, a recognition that led the EPA to strengthen restrictions on them. But with both acephate and malathion, the agency is now proposing to remove that extra layer of protection.

The EPA effectively banned another organophosphate pesticide, chlorpyrifos, in 2021, based in part on evidence linking it to ADHD, autism and reduced IQ in children. (In response to a lawsuit brought by a company that sells the pesticide and several agricultural groups, a court vacated the ban in December, allowing the resumed use of chlorpyrifos on certain crops, including cherries, strawberries and wheat.) While some health and farmworker groups are petitioning the EPA to ban all organophosphate pesticides, the agency is arguing that it can adequately protect children by limiting the amount farmers can use.

Several studies suggest that, even at currently allowable levels, acephate may already be causing learning disabilities in children exposed to it while in the uterus or in their first years of life. In 2017, a team of University of California, Berkeley researchers, partly funded by the EPA, found that children of Californians who, while pregnant, lived within 1 kilometer of where the pesticide was applied had lower IQ scores and worse verbal comprehension on average than children of people who lived further away. Two years later, a group of UCLA scientists reported that mothers who lived near areas where acephate was used during their pregnancies had children who were at an increased risk of autism with an intellectual disability.

The EPA considered this research when deciding to relax the limits on acephate use but stated that flaws and inconsistencies made these epidemiological studies “not compelling.” The agency also dismissed a rat study submitted to the EPA in 2005 in which the pups of mother rats exposed to higher levels of acephate were, on average, less likely to move than the pups of mothers exposed to lower levels. The EPA told ProPublica that “no conclusions could be drawn” from the experiment, citing the “high variability of the data” it produced. But some scientists outside the agency find that study a particularly worrisome indication of the pesticide’s potential to harm children.

In its proposals to increase the allowable amount of both acephate and malathion on food, the EPA also had to look past other potentially concerning test results. Some of the cell-based tests of acephate showed borderline results for interference with brain functions, while some of the tests of malathion clearly indicated specific problems, including interference with the connections between nerve cells and the growth of certain parts of nerve cells. Several scientists interviewed by ProPublica said that such results demand further investigation.

Some scientists see a double standard in the agency accepting the imperfect nonanimal tests while citing flaws in other research as reasons to dismiss it.

“They’re acknowledging limitations in epidemiology while at the same time not acknowledging the even greater limitations of using a clump of cells in a petri dish to try to model what’s happening in a really complex organism,” said Nathan Donley, a scientist at the Center for Biological Diversity, an environmental advocacy organization.

Asked about the criticism, an EPA spokesperson wrote in an email to ProPublica that the agency “does not believe there was a double standard applied.”

Universities are required by law to support victims of violence. The Education Department found that the Christian evangelical Liberty University had fundamentally failed to do so. Sexual assault victims were “punished for violating the student code of conduct,” the report concluded, “while their assailants were left unpunished.”

The government found that Liberty’s actions had created a “culture of silence.”

The findings, which the department announced Tuesday, echo a ProPublica investigation that detailed how officials had discouraged and dismissed women who tried to come forward with accounts of sexual assault. Women who went to school officials to report being raped recalled being threatened with punishment for breaking the university’s strict moral code, known as “The Liberty Way.”

The coverage prompted widespread outrage, including demands from senators for a Department of Education investigation.

That investigation culminated in Tuesday’s announcement. The fines against Liberty are more than double the amount of the next-largest fines in Department of Education history — against Michigan State University for its failures to protect hundreds of women and girls from sexual abuser Larry Nassar.

Liberty will also face two years of federal oversight.

Elizabeth Axley, a former Liberty University student who was threatened with punishment when she reported her rape to campus officials, said the government’s findings against Liberty feel “so validating and sort of surreal.”

“For an official report to say, ‘Yes, everything you said happened, everything you described was real,’ is more powerful than I can describe,” said Axley, who recalled that when she first wanted to report her rape, a resident adviser told her to pray instead. “After I first fought to stand up for myself at Liberty, I was silenced. I didn’t feel hopeful. It took everything for me to stand up to tell my story again and hope it turned out right. This reminds me it was completely worth it.”

In response to the government’s report, Liberty University said in a statement that it faced “unfair treatment.” But the school also admitted to mistakes and committed to spending $2 million to improve campus safety.

“We acknowledge and sincerely regret these errors and have since corrected them in a manner that allows us to maintain compliance in each of these areas,” the school said. “Today is a new day at Liberty University. We remain committed to prioritizing the safety and security of our students and staff without exception.”

Liberty University was co-founded in 1971 by the televangelist Jerry Falwell. His son, Jerry Falwell Jr., took over the university’s helm in 2007 but resigned in 2020 after a series of scandals. With more than 90,000 students enrolled on its Virginia campus and online, Liberty remains one of the most influential Christian universities in the county.

S. Daniel Carter, who helped craft the Clery Act, the federal law that requires schools to report sexual assault and other crimes, said the significance of the Department of Education’s actions go beyond the record fines. “It’s not about a bottom line number,” Carter said. “It’s about the fact that they are proactively investigating and leading efforts to bring schools into compliance.”

Sitting at her computer one day in late December, Dr. Sarah Osmundson mustered her best argument to approve an abortion for a suffering patient.

The woman was 14 weeks pregnant when she learned her fetus was developing without a skull. This increased the likelihood of a severe buildup of amniotic fluid, which could cause her uterus to rupture and possibly kill her. Osmundson, a maternal-fetal specialist at Vanderbilt University Medical Center who helps patients navigate high-risk pregnancies, knew that outcome was uncommon, but she had seen it happen.

She drafted an email to her colleagues on the Nashville hospital’s abortion committee, arguing that the risk was significant enough to meet the slim exception to Tennessee’s strict abortion ban, which allows termination only when “necessary to prevent the death of the pregnant woman or to prevent serious risk of substantial and irreversible impairment of a major bodily function.” She pleaded with her fellow doctors to spare this woman the gamble when her baby wasn’t even viable.

Then came the replies.

One doctor wasn’t “brave enough.”

Another urged her to consider the optics — approving an abortion in this case could be seen as “cavalier” and trying to circumvent the law. “I’m saying this because I care about you and your personal liberties,” the doctor said.

To Osmundson, the responses reflected just how much abortion bans had warped doctors’ decision-making and forced them to violate the ethics of their profession, which require acting in the best interests of their patients.

Most medical exceptions in abortion bans only allow the procedure to “save the life of the mother.” But there is a wide spectrum of health risks patients can face during pregnancy, and even those that are potentially fatal could fall outside of the exceptions, depending on how the law is interpreted and enforced. Without clarification from legislators and prosecutors on how to handle the real-life nuances that have emerged in hospitals across America, doctors in abortion ban states say they are unable to provide care to high-risk pregnant patients that meets medical standards.

Under threat of prison time and professional ruin, they are finding their personal interests pitted against their patients’ and are overriding their expert training for factors that have nothing to do with medicine, like political perceptions and laws they aren’t qualified to interpret. As a result, some patients are forced to endure significant risks or must travel out of state if they want to end a pregnancy. Sometimes, their doctors aren’t even giving them adequate information about the dangers they face.

Osmundson and 30 other doctors across nine states in which abortion is banned or restricted described to ProPublica the impossible landscape they must navigate in the nearly two years since the Supreme Court struck down Roe v. Wade.

It is one in which fetuses — some with no chance of survival — are being prioritized over their at-risk mothers and oncologists are hesitating to give chemotherapy to cancer patients for fear of legal consequences if it disrupts the pregnancies.

Doctors described the position they’ve been put in — denying abortions to high-risk patients who are begging for them — as “distressing,” “untenable” and “insane.” Speaking out about the broken system felt like the only way to not be complicit, Osmundson said. “It’s going to take physicians coming together and saying: ‘We’re not going to participate in this. We’re going to do what we think is right for patients.’”

Osmundson, who has worked at Vanderbilt for the past eight years, decided to share with ProPublica the inner workings of the hospital’s abortion committee to give the public a rare glimpse into the tortured decisions she and her colleagues are being forced to make. It shows how maternal health care could be dramatically altered across America if Republicans gain control of Congress this fall and succeed in passing the nationwide ban that influential anti-abortion activists have long sought.

In a series of interviews, Osmundson detailed the deliberations in a wide variety of cases and described conversations and emails among doctors. She did not disclose the identities of patients or their individual files. ProPublica was able to confirm details with one patient and three colleagues familiar with the committee, some of whom were not willing to speak publicly for fear of professional repercussions. Vanderbilt declined to comment.

What she shared shows how the strictly written bans fail to account for a broad range of dangerous maternal health risks, leaving doctors to deny abortion requests for medical reasons like warning signs of preeclampsia, a potentially fatal blood pressure condition; complications related to Type 1 diabetes, which can cause vision loss, kidney disease and death; and conditions requiring patients to have their uteruses “cracked open” in order to give birth.

She’s come to believe it’s time to take abortion decisions out of doctors’ hands and shift the final say to hospital lawyers and administrators. In her view, that’s the only way to protect the independent judgment of the medical experts, who could make strong arguments in their patients’ interests using research and data.

“I understand pragmatism,” Osmundson told ProPublica. “I also don’t want to have a patient die and be responsible for it.”

She also thinks hospitals should require doctors to obtain informed consent from patients facing dangerous pregnancy complications, so that providers can’t make decisions on their behalf without counseling them about their risk and getting their response. “In this climate, we’ve really diminished women’s autonomy,” she said. “If a patient says, ‘I don’t want to take on that risk,’ we need to honor that.”

A few months ago, she was on call caring for a patient who had developed severe high blood pressure near 24 weeks, a warning sign for preeclampsia, which can rapidly deteriorate and lead to organ damage or death. With her pregnancy at the edge of viability, the patient requested to have a cesarean section, Osmundson said, even though there was a significant chance the baby might not survive.

Osmundson said she scheduled the surgery. This was not considered an abortion, because the intent was still to deliver a live baby. But after her shift ended, Osmundson recalled, a colleague overrode her and kept the patient pregnant.

Osmundson and her colleagues launched the committee in fall 2022 to address a crisis they were seeing unfold in abortion ban states across the country and at Vanderbilt: Patients facing severe and urgent pregnancy complications were being denied care by hospitals where doctors were terrified about the new legal personal and professional risks.

With strength in numbers, the committee members would back one another up and aim to serve the most patients possible while staying within the law.

Since then, the committee has helped Vanderbilt doctors respond to the most severe emergencies. Abortion requests can hit the committee’s inbox at any hour — at least two a month, but sometimes four in a week. When complications are urgently life-threatening — cardiac failure, Stage 3 kidney disease — doctors often coordinate through a few text messages and sign off that an abortion is medically indicated.

The committee has also developed critical protocols. If a patient’s water breaks before a fetus is viable, the administration considers it a medical emergency because the patient has a high chance of developing sepsis, which can lead to death. In those cases, it’s a blanket policy that doctors can offer abortion care, Osmundson said.

Other cases fall outside of the committee’s power. Osmundson said she has seen some doctors avoid the issue entirely, never informing their patients about the option to terminate their risky pregnancies; those cases never make it to the committee’s attention. The law also makes no exception for sexual assault or fetal anomaly cases, even when the pregnancy is not viable. Doctors direct these and other patients who want abortions to leave the state, if they can. In 2023, Osmundson counted 27 cases of nonviable pregnancies that were referred out of state.

It is those cases in the middle — potentially perilous, but not urgently deadly — that can feel like bombs hitting their inboxes, blasting shrapnel into the rest of their days as they turn over the particulars and try to come to a consensus.

The six doctors, five of whom are women, sometimes call one another up to hash it out. Other times, the discussion unfolds over email and can involve specialists from other departments. They respect one another and know they share the same goals, but the conversations can be heated and emotionally draining.

Last October, a challenging case came before the abortion committee, showcasing the murky limits of Tennessee’s exception.

The patient was seven weeks pregnant and stable, but with a medical history that would make delivery very high risk. Surgeons would need to make a vertical incision on her abdomen — a procedure Osmundson described as “fileting” the uterus — that could lead to permanent bladder or bowel damage due to the patient’s existing complications.

When Osmundson read the file, her mind ticked through worst-case scenarios if things didn’t go well: The patient might need to use an ostomy bag attached to her abdomen to dispel waste. She could suffer severe blood loss or develop sepsis. She could die. The patient already had children and, in a letter to her doctors, requested an abortion.

The challenge for the doctors: The patient had no immediate complications; the potential emergency would not occur until the baby was at full term and doctors were performing surgery. Was it enough to predict that a patient might suffer “substantial and irreversible impairment” or death, based on past case studies? Or did the emergency need to have actually begun?

The law doesn’t say. Nor does it give guidance on how doctors should interpret the spectrum of risk. Was a 50% chance of death or “substantial and irreversible impairment” enough to meet the standard of the law? Twenty percent? Ten? The law says only that an abortion must be “necessary” in a doctor’s “reasonable” medical judgment.

Committee members could see how a zealous prosecutor might challenge that judgment. Doctors like Osmundson often help manage risk for patients who choose to go forward with dangerous pregnancies; some make it through with few long-term issues. It wasn’t hard to imagine a scenario in which a prosecutor held up cases of women who had survived similar complications and pointed to one patient’s abortion as a crime. The penalties for violating the ban include up to 10 years in prison and a $15,000 fine. Doctors can also lose their medical licenses if they are criminally charged. Many have expressed that they would not trust jurors without medical training to evaluate their cases and decide their fate.

In that October case, one doctor argued that the patient’s condition did not fit the definition of a medical emergency because continuing the pregnancy itself would not cause direct harm to an organ — all of the risk would emerge at the time of delivery.

“Who are we to say what is too much or not enough risk?” another wrote. “Where is the line and why do we have to decide that?” But the doctor pointed out that if they offered the abortion, “nurses and other staff will be upset.”

A third wrote: “I unfortunately don't think this meets the criteria for the law and my interpretation even though it is the ethical right thing to do.”

A fourth: “If one of our purposes is to protect the physicians involved in the care of these patients, I think this case is too risky.”

Osmundson bit her lips as she read the responses. After work, as she cooked dinner for her family and played with her kids, she couldn’t stop thinking about the patient. It was one thing to choose to continue a high-risk pregnancy — another to be forced to. As a doctor who spent her career working with the most difficult cases, she knew better than anyone that even healthy pregnancies could suddenly turn life-threatening.

“I just watched a woman die from liver failure this weekend after a normal uncomplicated pregnancy,” Osmundson told them. “I’m finding it morally repugnant to force anyone to continue a pregnancy for a potential life when the pregnancy poses a real threat to her life.”

If the patient the committee was considering died, Osmundson felt they would all have blood on their hands.

“I cannot deny abortion care to a patient concerned about their medical safety,” she wrote.

The group punted the decision until the university’s ethics committee could weigh in.

The patient was left waiting on a faceless abortion committee to deliver its verdict as the clock ticked.

Soon after, Osmundson learned, the woman was no longer pregnant. Perhaps it was a miscarriage. Or perhaps, Osmundson thought, she had gotten fed up and taken measures into her own hands.

It saved the committee from making a difficult decision. This time.

The predicament is far worse at many other hospitals.

Plenty of doctors ProPublica interviewed don’t work at a well-resourced institution or have an administration that has promised criminal defense if they are prosecuted. And some hospitals rely on state funding, leaving them subject to the demands of lawmakers who could request their emails and protocols, which are public record. Many doctors requested anonymity to speak about sensitive internal matters, fearful they could land on the radar of state officials looking to target abortion providers.

There were wide variations in how their hospitals have navigated the post-Roe reality. Some had abortion committees, but many relied on informal networks among colleagues to make decisions. A few had developed protocols like Vanderbilt’s, but others still require signs of infection or bleeding in order to act, even in cases when a patient’s water breaks before viability. “We are trying to push the idea that the harm does not have to be immediate,” said Dr. Nisha Verma, an OB-GYN and abortion provider in Georgia. “But institutions want to protect themselves.”

Doctors recounted nurses saying they weren’t allowed to treat patients who needed urgent abortions to survive. One was bleeding out. Another was septic. “That’s part of our risk,” one doctor said. “You don’t know who you are working with, who will decide you need to run this by the district attorney.”

Doctors felt similar hesitation from their specialist colleagues, some of whom have balked at having to sign off on any abortion-related paperwork. One OB-GYN described trying to get a cardiologist to evaluate a pregnant patient with heart failure. “We got a ‘Look, we know what you guys are doing and we don’t agree with abortion, so we aren’t going to say she can have an abortion,’” the doctor said.

In other cases, specialists have been afraid to treat patients for fear of accidentally causing harm to a fetus. One OB-GYN said an oncologist at their hospital was reluctant to provide cancer treatment for a patient who wanted to continue their pregnancy, in case chemotherapy were to be misconstrued as an abortion.

Some doctors feel that instead of offering backup, their hospitals have siloed all responsibility to a few providers who would take the fall if an abortion case were challenged. “Care was dependent on each case and who saw the patient and what their risk tolerance was and their views about abortion,” said Dr. Jessica Tarleton, an OB-GYN and abortion provider in South Carolina who left her institution due to its handling of the ban. “It was like chaos all the time.”

Doctors have no clarity on whether they could face repercussions for offering abortions for life-threatening health risks that aren’t active emergencies.

Lawmakers and prosecutors don’t want to offer it.

In Tennessee, legislators sided with an anti-abortion group last year to defeat an effort to include clear exceptions for fatal fetal anomalies and broader health risks. A lobbyist for the group opposed language that would allow doctors to provide abortions to “prevent” emergencies because, he said, “that would mean that the emergency hasn’t even occurred yet.” And Attorney General Jonathan Skrmetti is fighting a legal effort aimed at getting a judge to clarify the ban’s exception; he argues that the state can’t be held liable for doctors “overcomplying” for fear of violating the law. The case is ongoing.

Anti-abortion groups that support the bans have advocated for the narrowest possible interpretation of exceptions. “We would want a stricter standard,” Blaine Conzatti, the president of Idaho Family Policy Center, told ProPublica in November. “The only appropriate reason for abortion would be treating the mother and the unintended consequence is the death of the preborn child.”

Meanwhile, officials have doubled down on their warnings about the consequences if doctors go too far.

Texas Attorney General Ken Paxton fought back against the Biden administration’s federal guidance to offer abortion care for patients with medical complications and threatened doctors with prosecution if they complied with a court’s order to offer emergency abortion care. And in Indiana, the Attorney General Todd Rokita investigated a doctor for sharing with the media that a 10-year-old rape victim had to go out of state to get an abortion.

“There aren’t many people who want to risk or just rely on the goodwill of the legislature and the attorney general or any politician in our state,” one doctor said. Penalties vary by state — in Texas a doctor could face 99 years behind bars.

No doctor has been prosecuted under their state’s abortion ban. But the few public glimpses into judges’ thinking hasn’t provided reassurance. Recently, a Texas court denied a doctor’s request to serve a woman who wanted an abortion because her fetus had a fatal anomaly. The doctor argued the woman shouldn’t be subject to the risks of carrying to term a baby that would not survive. The court said the doctor hadn’t proved her life was in danger.

Will a judge decide the same if a doctor is charged with a felony? Would a jury, or an appellate court, or ultimately the Supreme Court? “The bottom line,” said Dr. Emily Patel, a maternal-fetal medicine specialist in Nebraska, “we don’t know what [the exception] means and won’t know until it’s tested in a court of law.”

No doctor wants to be the first to stand trial. “I don’t know how you can overinterpret the law when you are looking at jail time,” said Dr. Dawn Bingham, an OB-GYN in South Carolina. “A prudent person would hear that and go, ‘Well I guess I will interpret that to be as safe as possible.’”

A year ago, Osmundson said, she could never have imagined arguing to strip her committee of its decision-making power and turning it into an advisory board. But now she believes it’s the only way to shield doctors from the ethical conflict of denying patients evidence-based care. “I feel like these committees are kind of making physicians become complicit in an unethical and unjust system,” she said.

Dr. Mack Goldberg, her committee colleague, knows the position perhaps better than anyone else. Unlike most of his colleagues, including Osmundson, he actually performs abortions; since clinics shuttered in the wake of the ban, he’s one of the only people in the state with the expertise and institutional support to do so for medical complications.

He knows the hospital submits paperwork to the state after each one. And while he recognizes that his colleagues are putting their names on the decisions, he feels more exposed. He often can’t shake the feeling of being constantly on call, his livelihood perpetually on the line, a burning question in the back of his mind: “When push comes to shove, if I ever got trudged through a court case, how many people will truly have my back?”

Despite all of the anguish it causes him to turn away some patients, Goldberg disagrees with Osmundson. He believes it’s important for doctors to continue walking the tightrope: Do as much as possible with the support of colleagues and their institution, while being honest with patients about their risks and options. He feels the committee has made it possible for him to save some lives by acting quickly, and he doesn’t want to leave the call to hospital administrators and lawyers, who may be even more risk averse.

”We are on the front lines,” he said. “At the end of the day, the patients are staring right in our faces.”

Late last year, he sighed heavily as he counseled the woman whose baby was developing without a skull and gently told her what he tells all of his patients in her position: that he had the training to help her, but because of Tennessee’s laws, he might face prosecution and jail time if he did. He had a baby at home and couldn’t take that risk, he explained. Instead he would refer her to options outside the state.

The patient, Charlotte Miller, told ProPublica she understood and appreciated his thorough counseling. But she was stricken to realize it would have been different had they been in her home state of Colorado.

When the 22-year-old sat across from Goldberg in his office, all she knew was that she didn’t want to spend the next six months putting her body through the hardships of pregnancy to give birth to a baby that would never survive.

Her first pregnancy had been challenging. She struggled with worsened asthma and endometriosis, a painful condition in which tissue grows outside of the uterus. The toll on her mental health alone would be enormous, she believed, and she didn’t want to risk any unexpected complications that could make getting pregnant again more difficult. She desperately desired another child, but in this case, the best option, she was certain, would be to deliver her baby as soon as possible — to have the chance to hold him and say goodbye.

Instead, her family would have to scrape together more than $1,200, a week of her partner’s paycheck as a waiter, so she could travel to a clinic in Illinois. There, her only choice would be a dilation and evacuation procedure while unconscious, not a delivery in which her baby could emerge intact and she could hold him in his last moments. Before it came to that, she lost the pregnancy naturally.

She’d been unaware of the committee’s debate about her health risks. When she learned of it, it only affirmed what she’d come to believe: “It’s just so disheartening to me that doctors can want to provide me care and not be able to because of what a law says, for fear that they would have repercussions.”

The curiously drawn district and other oddities associated with the state’s extreme gerrymandering would be erased in new voting maps passed this week by the Wisconsin Legislature.

A state Supreme Court decision finally forced Wisconsin Republicans to cede an advantage they enjoyed for more than a decade with maps that made the state one of the nation’s foremost examples of gerrymandering.

The Senate and Assembly voted to adopt voting maps drawn by the office of Gov. Tony Evers, a Democrat. Evers said a week ago that he would sign his redistricting plan into law if passed unchanged by the Legislature, and proponents of fairer maps have encouraged him to do so.

The surprising legislative development promises to end a six-month battle in front of the state’s now left-leaning high court, which ruled the GOP maps unconstitutional shortly before Christmas.

The new design resolves many of the irregularities in the current electoral maps, chief among them the “Swiss cheese” appearance that stranded some constituents in segments detached from the rest of their districts.

One of the more obvious examples of partisan artifice was in the northwest corner of the state, in the 73rd Assembly District, where the GOP had strategically added Republican areas and subtracted Democratic ones in a plan enacted in 2022. Residents joked the contours came to resemble a Tyrannosaurus rex.

The maneuver was successful. That year, a Republican won the seat, which had been held by Democrats for 50 years. The new map completely redraws that district and others.

“The legislature will be up for grabs,” Republican Assembly Speaker Robin Vos said from the floor on Tuesday, the day the vote was taken.

In an unusually magnanimous gesture, Vos said, “Pains me to say it, but Gov. Evers gets a huge win today.”

Even under the governor’s maps, the GOP is still expected to retain majorities in both chambers, though the party’s advantage would likely be slimmer than the absolute authority it now commands, particularly in the Senate. Currently, the GOP has a supermajority in the Senate and a near supermajority in the Assembly.

Vos acknowledged in a news conference that running under Evers’ map is “going to be more challenging, there’s no doubt about that.” But, he said, “I still think we can win because we have a better message.”

Prior to the legislative action, justices had been set to select new district maps from a group of proposals, including the one from Evers. Indications were the decision would not be favorable to the GOP.

Rather than take their chances, Republicans decided to approve the governor’s maps, which are considered to be “friendlier” to the GOP than the others when measuring partisan bias and incumbent matchups.

A Marquette University analysis determined that if the 2022 election had taken place under Evers’ maps, it’s likely that Democrats would have won an additional 11 seats in the Assembly and five in the Senate, neither enough to flip control.

Nine Senate Democrats voted against Evers’ plan, signaling concerns that the GOP’s approval was a strategic ploy to be followed by a challenge in federal court from a Republican ally. “I am voting no because I do not trust what you guys are up to,” said Sen. Chris Larson, a Milwaukee Democrat.

But Vos downplayed the likelihood of more court action, telling reporters Tuesday that he preferred to get on with the business of campaigning and talking about ideas with voters. “I think that is a better answer than drawn-out court battles and going through millions of dollars of taxpayer expense when there’s really no need to do so,” he said.

The Assembly passed the governor’s maps without debate. Only one Democrat voted yes.

Democrats were unhappy with a provision in the bill that would stall the implementation of the new maps until November — a move seen to benefit Vos, who is facing a recall effort from constituents on the far right. Democrats also indicated a desire to let the state Supreme Court case play out.

It was only six months ago that a new justice, Janet Protasiewicz, took office, tilting the court decidedly to the left. During her campaign, which she won in a landslide, she made it clear she would welcome the chance to review the constitutionality of the maps, flatly describing them as “rigged.”

A day after her swearing-in ceremony, a maps case landed on the court’s doorstep, brought by 19 Democratic voters. For months after Protasiewicz’s election, Vos threatened to impeach her if she did not recuse herself from the case, claiming her remarks on the campaign trail made her biased. He later abandoned that tactic.

On Dec. 22, the high court overturned the current maps and ordered the parties to propose new ones. The vote on the decision was 4-3, with Protasiewicz siding with the majority.

The court hired two academic consultants to analyze the proposals and issue a report evaluating the plans for their conformity to standard districting requirements, including compactness and equal population distribution.

The consultants found that plans offered by GOP lawmakers and by a conservative policy group constituted “partisan gerrymanders” and should not be considered.

The four remaining proposals greenlit by the consultants were submitted by the plaintiffs, Evers’ office, a group of Democratic senators, and a team of mathematicians and data scientists. The consultants — from Carnegie Mellon University in Pittsburgh and the University of California, Irvine — determined that those four plans were “similar on most criteria.”

Good-government groups applauded the possibility of a legislative agreement, largely because it brings about stability and a measure of political certainty until the next redistricting process, after the 2030 census. Besides, said Jay Heck, executive director of Common Cause Wisconsin, “The governor’s maps are pretty darn good.”

One of the key problems with the current maps, the court concluded, was that the districts had noncontiguous shapes.

The state’s constitution stipulates that Assembly members must be elected from districts consisting of “contiguous territory.” Likewise, Senate districts, which are each made up of three Assembly districts, must consist of “convenient contiguous territory.”

Fifty-five of the state’s 99 Assembly districts and 21 of 33 Senate districts contained “disconnected pieces of territory,” according to the petition presented to the Supreme Court.

“A map can’t be fair if it doesn’t meet the requirements of the constitution,” said Debbie Patel, founder of North Shore Fair Maps, a group of suburban Milwaukee residents who have been fighting for statewide maps that are not skewed in favor of either party.

The random islands or irregular blobs in the current maps are largely due to the annexation of land over time by cities and villages, resulting in disjointed municipal boundaries.

The Evers maps and the others under consideration fix that problem.

The 88th Assembly District, for example, which currently includes eastern portions of Green Bay, has a couple of islands and a hole that would be eliminated under Evers’ plan.

The district’s current occupant, Republican Rep. John Macco, voted yes Tuesday, even though his home would no longer be within the district’s boundaries. “They literally carved me out by 581 feet. Intentionally,” he said.

He expects to have to sell his house and move to compete again there. “I’ll do whatever I have to do to represent the people of the 88th District,” he said in an interview.

In northwest Wisconsin, Democrats hope they can reclaim the 73rd District under a new map. All four maps under court consideration relegate the “T. rex” to fossil status.

Under Evers’ iteration, the district would no longer stretch more than 100 miles south from the Minnesota border city of Superior. Instead, it would be more homogeneous, encompassing much of Douglas County, and reach farther east, embracing more of the coastal communities along Lake Superior.

“Historically, you’ll see from voting records, it’s always been blue up here right along the lake,” said Laura Gapske, a Democrat who narrowly lost in 2022 to the district’s current representative, Republican Angie Sapik. Gapske handily carried Douglas County, with 58% of the vote. She’s now running for the Superior School Board.

Sapik, who wrote social media posts cheering on the Jan. 6 insurrectionists, has announced her reelection bid. She declined to speak to ProPublica but complained on Facebook in early February that the proposed maps “would make this district upwards of 65% Dem to 35% Republican. Does that sound like a ‘Fair Map’ to you?”

One area where the four maps differed was in how they handled redistricting for territories aligned with Wisconsin’s federally recognized Native American tribes.

The current GOP map divides four of 10 reservations into multiple Assembly districts, “disrespecting Tribal communities of interest,” according to a brief filed by the Midwest Alliance of Sovereign Tribes and the Lac du Flambeau tribe in Wisconsin. Lawyers for the tribes have argued that dividing tribal members among different districts dilutes their voting power.

The Lac du Flambeau tribe and the Midwest Alliance did not favor the governor’s plan, supporting instead a proposal put forward by the group of mathematicians, in which each tribe would have had its own Assembly voting district.

In its brief, the alliance called the mathematicians’ proposal “hands down, the best map for all of Wisconsin, including Wisconsin’s Indian people and communities.”

A spokesperson for Evers told ProPublica in an email that “the governor’s maps do unite tribal communities in several respects while still complying with constitutionally required criteria to minimize splitting community and county lines.”

The Wisconsin Fair Maps Coalition, while celebrating the prospect of new maps, is vowing to continue to push for a nonpartisan body, rather than politicians, to handle future redistricting plans.

“The coalition isn’t done,” said Debra Cronmiller, executive director of the League of Women Voters of Wisconsin, which is part of the coalition. “We still need a legislative fix. We need an independent commission. We need, likely, a constitutional amendment that would codify that. So our work is not done.”

A key congressional committee is pressuring billionaire Harlan Crow for answers after investigators turned up additional evidence that he misrepresented his yacht as a business to score a tax break.

The inquiry is part of the ongoing congressional investigations of Justice Clarence Thomas’ gifts from billionaires. Crow was perhaps Thomas’ greatest patron, often hosting the justice on his private jet and his 162-foot yacht, the Michaela Rose.

ProPublica reported last July that Crow had taken millions in questionable tax deductions related to his yacht. In a letter Monday, Senate Finance Committee Chair Ron Wyden, D-Ore. asked Crow to justify those deductions, especially in light of new information turned up by his committee.

“Any effort to mischaracterize a yacht used as a pleasure craft as a business is a run of the mill tax scam, plain and simple,” Wyden wrote.

Drawing on the trove of leaked tax data that was the basis of our “Secret IRS Files” series, ProPublica reported that, from 2003 to 2015, Crow and his father reported nearly $8 million in net losses from operating the ship, with about half flowing to Harlan Crow.

In response to an inquiry about the letter, Crow’s office said in a statement: “Mr. Crow engages professional accounting firms to prepare his tax returns and complies with tax law in good faith. Any suggestion to the contrary is baseless and defamatory.” Crow will respond to the committee to “correct the record,” it said.

Yacht owners who regularly lease out their ships can write off losses related to chartering, but ProPublica could find no evidence of the Michaela Rose being chartered. In fact, former crew members said the ship was used solely by Crow’s family, friends and executives of his company, along with their guests.

Congressional investigators found the same thing when they spoke to former crew members, Wyden wrote. One crew member noted that the ship didn’t even have “the appropriate registrations” to operate commercially. The letter says the committee’s inquiry “casts fresh doubt on the validity of reported deductions from purported yacht charter losses” and “raises serious concerns regarding the tax treatment of Mr. Crow’s luxury assets.”

The committee’s investigators were able to confirm that the ship lacked the proper registrations. “Michaela Rose is not legally licensed to be chartered out for the transportation of passengers for hire in the United States and is only registered as a pleasure boat for Mr. Crow’s personal use,” Wyden wrote. The ship is flagged in the United Kingdom, but there, too, the registration has long been for a “pleasure yacht.” In both countries, a commercial registration is required for chartering and comes with additional costs and regulations.

Meanwhile, not only has Crow represented to the IRS that the boat is used commercially, but, in a bid to obtain a trademark for the Michaela Rose name and icon, his company argued the same to the U.S. Patent and Trademark Office. In his letter, Wyden noted that it is a crime to deliberately mislead either agency.

Wyden’s investigation into Crow’s gifts to Thomas first launched after ProPublica’s story last April detailing that relationship. Since then, the Senate Finance Committee and Crow have exchanged multiple letters, with Crow generally refusing to provide more detail about the gifts and travel. Similar exchanges between Crow and the Senate Judiciary Committee resulted in that committee authorizing a subpoena to Crow last November.

Wyden’s latest letter asks Crow to reply to a list of questions about Crow’s use of the yacht by the end of February.

The candidate she wanted to vote for, Vivek Ramaswamy, wasn’t included. Neither were Florida Gov. Ron DeSantis and, most notably, former President Donald Trump. The only name she recognized was former South Carolina Gov. Nikki Haley.

“What the heck? This is weird,” she remembered thinking. “Are they trying to convince people Nikki is the only option?”

A quick internet search turned up the answer: The Nevada Republican Party opted to eschew the state-run presidential primary on Feb. 6, in favor of running its own caucus two days later, which will decide who wins Nevada’s delegates to the national GOP convention. Presidential contenders who participate in the primary are prohibited by the party from also being candidates in the caucus.

While legal, the party’s decision to host a competing nominating contest in the state has confused and angered GOP voters.

Hooper had no idea there would also be a caucus or that Ramaswamy opted to participate in it instead of the primary before dropping out of the race.

“If you don’t want me to be a conspiracy theorist, then be transparent,” Hooper said. “Send me all of the information at once.”

Since Trump’s loss in the 2020 presidential election, supporters have cultivated an ecosystem of confusion around election processes through unfounded claims of voter fraud, demands for paper ballots and hand counts, and state-by-state efforts to subvert the 2020 results.

Leaders of the caucus effort are among those who tried to keep Trump in power. Three caucus overseers face felony charges for their roles in trying to overturn the 2020 election. Others running the caucus have been on the vanguard of those pushing unfounded election fraud allegations in the state.

These Republicans claim the caucus will serve as a model for how to run a more secure election — a claim disputed by election experts who note the drastic differences between a caucus, which attracts a fraction of the electorate to decide a single race, and elections, where many more voters cast ballots for local, state and federal offices.

The primary election is run by state election officials and adheres to Nevada’s voting laws — which allow for mail-in ballots, early voting and same-day registration. The Nevada Republican Party’s rules for its caucus reflect some GOP leaders’ efforts to limit voting. Participation requires registering as a Republican 30 days in advance, arriving at a set location and time, and presenting identification.

The confusion created about how elections work, including fraud allegations and now around how Nevada will choose who it backs in the Republican primary, has provided fertile ground for conspiracy theories and misinformation to take hold, experts say, causing a greater share of voters to distrust election results and democratic institutions.

“It does make the misinformation environment more dangerous,” said Gowri Ramachandran, deputy director of elections and government for the Brennan Center for Justice’s Democracy Program. “These information gaps about voting, how it works, that sort of thing, can get filled in by incorrect information.”

“It’s clear from Jan. 6 that when that kind of misinformation spreads, it has a negative impact on people’s trust in elections and willingness to abide by the results,” she added. “It’s had a negative effect on democracy over the years.”

Confusion Over Competing Contests

When primary ballots absent Trump’s name began hitting mailboxes, Republicans across the state reacted with angry bewilderment.

Some thought he had been kicked off the ballot by a court because of his role in the Jan. 6, 2021, insurrection, as happened in a Colorado case that is now pending before the U.S. Supreme Court. (A judge in Nevada rejected a similar challenge.) Others latched on to a false rumor that an inept campaign staffer forgot to file paperwork to get Trump on the ballot. Voters also wondered whether they could participate in both contests, or if casting a primary ballot and caucusing would constitute an illegal attempt to vote twice. (Nevada’s attorney general and secretary of state have assured voters they are free to participate in both.)

“I haven’t heard anybody who is happy with this unless they are with the state party and the county parties,” said Assemblywoman Danielle Gallant, R-Las Vegas, who has spent recent weeks explaining the situation to her constituency of mostly older voters.

The Nevada Republican Party’s decision to force candidates to forgo the primary if they wanted to be included in the caucus will likely hand the state’s 26 convention delegates to the former president. (At this point only one other obscure candidate remains in the caucuses.) It also foreclosed on any of Trump’s opponents building momentum from a strong showing in the state’s primary even as the field has shrunk since Iowa and New Hampshire, leaving Haley and a handful of lesser-known contenders.

Trump’s allies in the state, including Nevada’s popular Republican governor, Joe Lombardo, have urged GOP voters who participate in the primary to mark “none of these candidates” on the ballot rather than vote for a candidate. They hope to avoid Haley emerging with a larger vote total in the primary than Trump receives in the caucus, a possibility because more voters are expected to cast a ballot in the primary than attend the caucus.

In a Jan. 27 campaign visit to Las Vegas, Trump urged supporters to skip the primary entirely, describing it as a “con job” and a “meaningless event.” The caucus, he said, “is the right way and the legitimate way.”

“Don’t go on Tuesday, Feb. 6,” he told the crowd. “Don’t do it. Don’t use the mail-in ballot.”

“We Will Deliver You 100% of the Delegates”

Because of the primary-caucus confusion, candidates and the national political press have largely ignored Nevada’s “First in the West” contests despite the state’s early spot on the presidential nominating calendar. Trump is the only candidate to visit the state more than once since August.

Democrats have worked since 2007 to establish Nevada as an important early primary state. The effort was spearheaded by the late U.S. Sen. Harry Reid, D-Nev., who used caucuses as a party-building exercise. Since then, both parties have held early caucuses with varying success at making them relevant and competitive.

A couple of years back, that looked to be changing. With the caucus process coming under fire for hindering participation, the Nevada Legislature passed a law in 2021 to create this year’s presidential preference election. Although that effort was led by Democratic lawmakers, Republicans had tried years earlier without success to swap the caucus for a primary.

The Nevada GOP rejects the notion that by holding a caucus it has rigged this year’s contest for the former president. But Trump has been actively preparing to secure the nomination for the past year, including courting party insiders across the country. Those efforts extended to Nevada. Early last year he wooed GOP leaders — including Nevada Republican Chairman Michael McDonald, National Committeeman Jim DeGraffenreid and Bruce Parks, chairperson of the second-largest county party — at his Mar-a-Lago estate in Florida.

McDonald, DeGraffenreid and Jim Hindle are under indictment for acting as fraudulent electors for Trump in his effort to overturn the 2020 election — charges to which they’ve pleaded not guilty and are arguing to have dropped. Hindle, as Storey County clerk, is responsible for administering elections, putting him in the novel position of overseeing parts of both the primary and the caucus.

“I’m just doing the job I was elected to do,” Hindle said.

Despite claims of neutrality, McDonald has referred to Trump as the “next president of the United States.” At Trump’s January rally, McDonald stated his intentions more explicitly, referring to Trump simply as “the president.”

“When I talked to the president, I said, ‘I guarantee you Nevada will show up and we will deliver you 100% of the delegates for the state of Nevada to Donald J. Trump,’” he said.

While the caucus favors Trump, the party was transparent with Republican voters and GOP presidential candidates in creating it, McDonald argued.

McDonald blamed the state’s lack of a voter identification requirement for the party’s decision to run a caucus, saying Republican voters don’t trust the system without it.

Parks, chairperson of the party in Washoe County, home to Reno, has also been a leading voice in promoting unfounded election fraud allegations. Under his leadership, the county party adopted a resolution in 2022 declaring Joe Biden’s presidency to be illegitimate. Trump endorsed Parks in his reelection bid for county party chair last year, which Parks described as “one of the proudest moments of my life.”

In an interview with ProPublica, Parks said the party’s central committee decided not to participate in Nevada’s new presidential preference primary election because it wants to demonstrate what he contends is the proper way to run an election: required identification, paper ballots and hand-counting with results reported on the same day.

“There was much discussion — the pros and cons were weighed and measured — and in the end, the people decided we are going to do a caucus because it is more secure and more transparent than a universal mail-in system that does not require ID,” he said.

“Anybody who wants to observe is welcome to,” he said before catching himself. “Let me rephrase that: Anybody who is a Republican and can participate in the process is welcome to observe.”

Until ProPublica raised the issue with the state party, Parks said he wouldn’t allow the news media into Washoe County sites. Now, he said he will allow a few reporters into a single caucus site. McDonald said each county’s chairperson decides whether reporters can observe the proceedings. In the past, reporters have not been barred from observing caucuses held by either party in Nevada.

When asked why the GOP was changing its policy, Parks said, “For obvious reasons. There seems to be a shortage of honest reporters. We’re not going to open the doors and allow a particular narrative to be put out there that is not truthful. That is just not going to happen.”

Anyone who disagrees with the way the caucuses are being run can register with the party and keep an eye on things themselves, he said. “You want to make sure everything is above board? Get involved. Most importantly, change your registration and become a Republican,” he said.

Counting caucus results is not the same as counting election results, Ramachandran said. Hand-counting an election with hundreds of thousands of voters and dozens of races is neither efficient nor accurate.

“It’s really important when people are looking at those issues not to make the mistake of comparing apples to oranges,” she said.

Unknown Impact on the General Election

How the confusion and resulting disinformation from the presidential nominating process will influence general-election voter behavior is difficult to forecast. Ramachandran said it’s challenging to study how disinformation affects turnout.

“It’s hard to know who’s been subjected to that confusion or has become susceptible to misinformation, and it’s really hard to tie that to impact on turnout or specific candidates,” she said.

Gallant, who is running for reelection to the Assembly this year, isn’t so sure. Beliefs about unfounded voter-fraud accusations kept Republican voters home in 2020, she said, describing it as “oops, we screwed up.” Polling has backed that up, with surveys showing claims of fraud have made Republicans less likely to vote.

“We’ve done a lot of reeducation around that,” Gallant said, referencing the national party’s “Bank Your Vote” campaign that now encourages Republicans to vote early and by mail.

Jeremy Hughes, a Republican political consultant who is not involved in any of the presidential campaigns this year, said too much is being made over the caucus confusion.

“Donald Trump would have won the primary and he will win the caucus, so the mode of voting isn’t going to matter,” he said. “I have zero concern with it affecting voting behaviors.”

Two years earlier, the body of 25-year-old Jennifer Kirk lay curled at the foot of a bed, a rifle on the floor, strangulation marks on her neck and a bullet hole beneath her chin. City police swiftly closed the case, declaring it a suicide.

Now police were back at the property, where the lifeless body of Susanna “Sue Sue” Norton, 30, was discovered in an adjacent house, beaten and strangled. An autopsy determined the cause of death to be homicide.

Kirk and Norton, both Inupiaq, had each dated sons of the former borough mayor, and the sons had previously been convicted of beating each of them. One of the sons had admitted to strangling Kirk twice before. Another pleaded guilty to kicking Norton in the stomach when she was six months pregnant.

No one has ever been charged with a crime in connection to the deaths.

In a state where women are 2.5 times more likely than the national average to be killed by a man and Alaska Native women are especially at risk, elected leaders here have repeatedly pledged action. The Department of Justice declared a rural law enforcement emergency in Alaska following a 2019 report by the Anchorage Daily News and ProPublica on glaring lapses in local policing. Two years later, the governor created a state council on Missing and Murdered Indigenous Persons, and in 2022, new investigators were hired to solve cases like Norton’s.

Unexplained holes in the investigations into the deaths of Kirk and Norton call into question this commitment, a review by the Anchorage Daily News and ProPublica found. More than that, the events leading up to the women’s deaths illustrate how police, prosecutors and judges here have regularly given pass after pass to people accused of domestic violence and strangulation.

Police records obtained by the newsrooms show that Kirk’s body revealed signs of strangulation. Her boyfriend, Anthony Richards, son of then-Mayor Clement Richards Sr., admitted to police that he had caused the marks on the day she died. After reviewing the records, former Kotzebue Police Chief Ed Ward said the 10 red flags that the Training Institute on Strangulation Prevention instructs police to look for in cases of domestic violence killings all appeared to apply to the scene of Kirk’s death. (Ward did not work at the police department at the time of her death.)

Yet the Kotzebue Police Department closed the case after a single day of investigation, labeling it a suicide before receiving the final autopsy report.

In Norton’s case, police never told her family she had been strangled, family members said. Police didn’t ask the public to help catch the suspect, as they had the prior year when a fire department dog was killed in the same neighborhood. They never interviewed key witnesses and failed to obtain a search warrant, leaving evidence uncollected.

State troopers, who took over the investigation into Norton’s death in 2022, told her family they planned to travel to Kotzebue over the summer to investigate further. Norton’s family says that didn’t happen either. (A department spokesperson said on Oct. 27 that investigators had not yet visited Kotzebue for the case but planned to do so before the end of the year. He said the agency’s Missing and Murdered Indigenous Persons unit is “taking investigative steps with the goal of finding the person responsible for Sue Sue’s tragic death and holding that person responsible for their actions through the criminal justice system.”)

Both Kirk and Norton had been victims of domestic violence at the hands of two of the Richards brothers. The Daily News and ProPublica found that state prosecutors repeatedly allowed the men to avoid felony domestic violence convictions for strangling or beating women, including Kirk and Norton. In those cases, the state offered the sons deals, allowing them to plead guilty to reduced misdemeanor charges such as “harassment” and receive slaps on the wrist, not prison sentences.

In one sexual assault case involving a different woman, state Superior Court Judge Paul Roetman granted Anthony Richards, the mayor’s youngest son, uncommonly low bail. Roetman explained his decision by saying he had worked with Anthony’s mother and knew his father held elected office.

Roetman and two prosecutors, now magistrates, declined to comment through a court system spokesperson. “Judicial officers cannot and do not comment on their cases, in order to maintain the integrity of their decisions and to ensure that, for fairness reasons, their thinking is reflected solely in the official court record without extraneous commentary,” the spokesperson wrote.

In the center of Kotzebue, Norton’s adoptive mother, Susanna “Mama Sue” Norton, is waiting for answers from Alaska’s criminal justice system. She lives three doors down from the house where her daughter was found strangled to death.

“My family is not going to have peace until they know that they found someone that did this to her,” she said in an interview in 2020. Three years later, as another winter begins, the case grows colder by the day.

A History of Criminal Charges

Kotzebue lies just above the Arctic Circle on a frying-pan-shaped peninsula, nearer to Russia than to Anchorage. Clement Richards Sr. was born here in 1961, two years after Alaska became a state. The city sold itself back then as the Polar Bear Capital of the World, where small planes carrying trophy hunters from across the globe parked on the sea ice. (One of the largest polar bears ever recorded was hunted here in 1963.)

In the 1970s, geologists confirmed what a local bush pilot long suspected: The red-stained creeks that veined the tundra hinted at a massive mineral deposit. In the ’80s, Kotzebue and surrounding villages voted to create a new Northwest Arctic Borough government, with the second-largest zinc mine in the world funding public services such as search and rescue.

Meantime, Clement Richards Sr. and Annette Richards were busy growing their family. The couple had two sons, Amos and Clement Jr., and another on the way in May 1989 when Clement Sr. kicked Annette in the stomach, according to charges filed in Kotzebue state Superior Court. Clement Sr. had previously struck her, Annette wrote in an earlier restraining order request. This time she was eight months pregnant.

The charges say Annette was “bleeding profusely from her genital area.” The couple’s third son, Anthony, was born the next day.

Clement Sr. pleaded no contest to felony domestic violence assault and received a six-month jail sentence. The conviction wasn’t mentioned by his opponents or the media a decade later when he won a seat on the city council in 1999 or still later when he became the city’s vice mayor, then mayor. Annette began working in a local office for the Alaska State Troopers where her duties involved assisting state prosecutors, including one who later served as the judge in domestic violence cases against her sons.

The sons wrestled in high school, competed in fishing derbies and sometimes worked at the nearby zinc mine. Now 34, 37 and 39, all three have listed the former mayor’s property as their home address for most of their adult lives.

All three sons have been charged with assaulting women at the mayor’s property but dodged serious punishment.

The Daily News and ProPublica reviewed 31 criminal court cases involving the three sons, including more than 800 pages of charging documents, testimony, sentencing orders and protective order requests. In 12 of those cases, one of the sons was charged with committing domestic violence. The victims — six different women — included the sons’ relatives and current and ex-girlfriends, including Kirk and Norton. (The other criminal cases involved driving while intoxicated, indecent exposure and trespassing.)

Seven of these domestic violence cases were filed while Clement Sr. held political office, from 1999 to 2018. All told, the three sons have been charged with a combined 16 counts of domestic violence, including five felonies. Yet none of the charges against them resulted in a felony domestic violence conviction.

While the details in each case differ, seven of the domestic violence cases unfolded in familiar ways:

First, one of the girlfriends or a worried neighbor called the Kotzebue police. Officers arrived to find the victim with visible wounds such as bruises, markings on her neck or a bloody nose. The girlfriend told police one of the sons punched, kicked or strangled her.

She told police the attacks began when she tried to stop the son from drinking, attempted to leave the house or refused sex. In two cases, police noted the mayor or his wife refused to cooperate with the active investigation. The Kotzebue Police Department then arrested the son but usually labeled the attack as a low-level misdemeanor rather than felony assault.

Next, the son appeared before a local judge or magistrate who was sometimes a former state prosecutor who had worked alongside the ex-mayor’s wife. The judge or magistrate agreed to set bail for the son — once even acknowledging on the record that the bail was unusually low and telling the victim that the mayor and his wife would help keep the son out of trouble until the trial.

But the cases never made it to trial. They were settled at a change-of-plea hearing where prosecutors dropped any felony charges and the son promised to do better. Within a few months, maybe a year, the cycle would begin again.

In one 2013 case, a woman said Clement Richards Jr. punched her in the face and police filed a charge of domestic violence assault. Clement Jr. eventually pleaded guilty to harassment and received a suspended sentence, scrubbing his conviction from the public record. In a sexual assault case filed the following year against Anthony Richards, Roetman reduced Anthony’s bail from $7,500 to $2,500 over the protests of the victim, who said in a quaking voice that she feared running into Anthony in the town of 2,900.

“I know Mrs. Richards from when she used to work for the troopers,” Roetman said at Anthony’s bail hearing. “She has a lot of experience with these types of cases and knows what these are like.”

The Alaska Judicial Code of Conduct states that a judge “shall not allow family, social, political, or other relationships to influence the judge’s judicial conduct or judgment.” Roetman did not respond to questions about his remarks in court, his work relationship with Annette Richards or the cases he presided over involving her sons. A court system spokesperson provided the newsrooms with a statement saying “judicial officers cannot and do not comment on their cases.”

Although a Kotzebue grand jury indicted him on felony charges of sexual assault and attempted sexual assault, Anthony Richards eventually pleaded guilty to a single misdemeanor count of indecent exposure in the 2014 case. The deal allowed him to avoid registering as a sex offender. (The prosecutor, Rachel Ahrens, is now a state magistrate and declined to comment through a court system spokesperson.)

“To say that you dodged a bullet is probably an understatement on this one,” Roetman told him at the change-of-plea hearing.

Increasingly Dangerous Attacks

Clement Richards Sr. won election as Northwest Arctic Borough mayor in November 2015, campaigning on his experience leading the city and his bona fides as a born-and-raised son of Kotzebue. He became chief executive of a region the size of Indiana with a population of about 7,500. As climate change threatened the nearby village of Kivalina, the Northwest Arctic moved into the national spotlight.

“What’s happening here is America’s wake-up call,” then-President Barack Obama said after flying over the village and touring Kotzebue just before Richards was elected in 2015.

Clement Sr. had been in office just a month when Kirk showed up at the local hospital. She told police that Anthony had punched her five times.

Kirk grew up in the village of Buckland, 75 miles outside of Kotzebue. She and Anthony sometimes lived in one of two teal homes that Clement Sr. and Annette Richards own on a grassy lot, one block from the police department and City Hall. Officer Nate Lecours came to the property to investigate the beating.

“Upon arrival the Borough Mayor, Clement Richards, who appeared extremely intoxicated, answered the door and stated how can I help you a total of three times speaking over me then slammed the door in my face,” Lecours wrote in a Dec. 6, 2015, affidavit. (In a brief phone interview, Lecours said he remembered that encounter but no longer works for Kotzebue police and referred all questions to the department.)

A few days later, Magistrate Judge Stephan Brady reduced Anthony’s bail in this new assault case to just $100. (Brady no longer works for the state. He did not respond to phone messages or emails.)

As the years passed, the attacks grew more dangerous. On March 14, 2017, Kirk told police Anthony strangled her until her field of vision began to shrink and she nearly passed out.

That would have been enough, under a 2005 Alaska law, to charge him with a felony for nonfatal strangulation. Alaska was one of the first states to recognize that strangulation is often a precursor to homicide and increases suicide risk, according to the Training Institute on Strangulation Prevention.

The prosecutor, Ahrens, allowed Anthony to plead guilty to a single count of misdemeanor assault.

Despite the light punishment, Magistrate Judge Aaron Michels warned Anthony he could have killed Kirk that day.

“Strangulation is a very serious thing and it’s recognized that way by the Legislature, that’s why these types of cases can be charged as felonies,” Michels said at an October 2017 change-of-plea hearing. (He declined to comment through a court system spokesperson.)

“The result of strangulation — if it’s not stopped, if a person can’t breathe — is death,” the magistrate told Anthony Richards.

On May 23, 2018, Kirk and Anthony’s final argument began on the mayor’s property.

Alerted by a neighbor, two officers came to the house around 6 p.m. They found Anthony in the bedroom holding Jennifer Kirk’s body, according to police records, his hands and clothes coated in blood.

Anthony told police he had been watching TV with two children in the living room when he heard the pop of a gunshot and discovered Kirk dying on the floor. A .22-caliber rifle lay across her feet and a gunshot wound pierced the underside of her chin.

The police department’s investigator at the time, Thomas Milliette, measured the weapon.

“I noted the length of the rifle from the tip of the barrel to the tip of the trigger as being 27 1/8 inches long,” Milliette wrote in his report. Next he measured the length of Kirk’s arm: 26 3/18 inches. In interviews, members of Kirk’s family wondered how Kirk, who was 5 feet, 5 inches tall, could have shot herself with a long gun.

Robert Shem, a retired firearm expert for the state crime laboratory, said in an interview that such measurements can be useful in determining whether a death is indeed a suicide, but in this case, more information would be needed. (Shem was the forensic scientist who first established a link among the shooting victims of Alaska serial killer James Dale Ritchie in 2016.)

“Before I would write it off as a suicide myself,” he said, “I would probably try to locate somebody of the same size and build and use that rifle, or one similar to it, with the same length barrel and configuration, demonstrate that it’s completely unloaded and see if the person can lean over and potentially get their thumb in position to pull the trigger.”

Kirk’s father, Timothy Gavin, said Kirk gave no hints she might kill herself.

“We never seen that in her. No signs, nothing,” Gavin said. “So it’s hard to believe she did that to herself.”

Gavin knows something about policing and public service. A Buckland city councilmember and the former mayor, he served 11 years as a village police officer. He’s also no stranger to gunshot deaths. His stepfather shot and killed his mother, Kirk’s grandmother. (The stepfather was convicted of manslaughter and sentenced to prison.)

Kirk’s mother, Dora Stalker, chatted with her daughter hours before the shooting and recalls that nothing seemed amiss. They even made plans. “She was trying to ask me to send diapers for her daughter,” Stalker said.

“We kind of had a plan to send each other some Native foods,” Stalker said. Kirk would trade her mother beluga muktuk in exchange for springtime smelt from Buckland.

Two days after Kirk’s death, the state medical examiner’s office phoned Kotzebue police and said her body “showed signs of strangulation,” according to the death investigation report compiled by police and obtained through a public records request.

In his first interviews with police, Anthony had not revealed that he and Kirk violently fought before she died. Once Milliette knew about the strangulation marks, Anthony admitted to causing the injuries to her neck. He said he acted in self-defense.

Anthony said Kirk slapped him and he “held her away by the neck and didn’t know how hard he was squeezing,” according to the police report. Anthony said Kirk continued to slap him so he pushed her to the ground, twice. He said he didn’t know if he knocked her unconscious.

Milliette closed the case after one day of investigation. He concluded his report with a note that the medical examiner’s office had called again and said Kirk’s death would be ruled a suicide, with the final autopsy findings to be sent to Kotzebue police when finished. Kirk’s mother, Stalker, said police never interviewed her or asked her what her daughter had said to her the day she died.

“They should have investigated a lot better, a lot more thorough before they said it was a suicide,” Stalker said. “It’s like they just rush and do whatever to get it over with.”

The Kotzebue Police Department did not answer certain questions about the death investigation, including any about what conclusions Milliette drew from the rifle measurements, referring questions to the former police chief. Milliette did not respond to interview requests. The Alaska Department of Law, which oversees state prosecutors, did not answer questions about why no charges were filed in the case.

“I would have prosecuted him for the strangulation before she died,” said Casey Gwinn, a former prosecutor and president of the Training Institute on Strangulation Prevention.

A Missing 10-Year-Old Girl

Kirk’s death never made the news. Three months passed and the city of Kotzebue, along with the rest of Alaska, became absorbed with the case of a missing child. In this time of crisis, everyone turned to Mayor Clement Richards Sr.

Hundreds of volunteers hunted for 10-year-old Ashley Johnson-Barr, who disappeared in September 2018 from a playground at the center of town. The Northwest Arctic Borough Assembly chambers, adorned with antlers and a scrimshaw walrus tusk, served as the nerve center for the search with Clement Sr. acting as spokesperson.

“We’re a small community where everyone knows everyone, so we’re trying as hard as we can to find her,” Clement Sr. told the Daily News at the time.

“I’m deeply concerned she hasn’t been found yet,” he said, explaining that as many as 50 people were looking for the child at any one time. Norton joined in, her family said, cooking her best-loved food, caribou stew with pilot bread crackers, to feed fellow searchers.

After eight days, a volunteer spotted Johnson-Barr’s body in a brushy hollow outside the city. Federal investigators and state troopers raced to Kotzebue to aid local police and soon arrested a 41-year-old man for her death by strangulation. To solve the case, law enforcement used cellphone location data, DNA evidence, search warrants, surveillance video and the advantage of the FBI, who first arrested the suspect on grounds of lying to a federal officer. The killer, Peter Wilson, pleaded guilty to first-degree murder and first-degree sexual abuse of a minor and is serving life in prison.

The response shows how cases involving missing and murdered Indigenous people can be solved when they are immediately prioritized by local authorities and when state and federal agencies give assistance. The state declared an annual Ashley Johnson-Barr Day and hired a retired Kotzebue-area trooper, Alaska Native Anne Sears, as Alaska’s first full-time Missing and Murdered Indigenous People investigator.

The message: Alaska would no longer tolerate the rape and killing of Indigenous women and girls.

But as the mayor prepared to leave office, nothing appeared to change for his sons. On Nov. 17, 2018, two months after Johnson-Barr was found dead, Kotzebue police received yet another report of domestic violence.

This time the victim was Norton, who by then was six months pregnant. Police found her crying, her right eye swollen shut. She said she had tried to stop her boyfriend, Amos Richards, from drinking by pouring out his beer.

City police Sgt. Norman Hughes described the attack in a report: “Susanna said the defendant became angry and grabbed her by the hair and drug her around the house. Susanna said the defendant kicked her repeatedly in the head, face, stomach and back. Susanna showed me her forearms which were swollen and told me she was holding her arms up to protect her head when the defendant was kicking her.”

Hughes categorized the beating in a criminal complaint filed in state court as misdemeanor, fourth-degree assault, the least serious form of assault spelled out by state law. (Hughes did not respond to interview requests or written questions.)

According to medical records, Norton flew to Anchorage, where her baby was born two weeks later at the Providence Alaska Medical Center. Doctors noted she had suffered “premature rupture of membranes.” Her family said the trip to Anchorage was medically necessary and believe the premature birth was brought on by the attack.

The baby weighed 3.1 pounds. Norton named her Eden.

“She is a tough baby girl,” Norton posted that day to friends and family. “Please remember us in your prayers.”

Doctors recommended the baby stay in Anchorage, even after leaving the hospital, because Eden had health problems unrelated to the premature birth and needed surgery to survive. Mama Sue Norton said the Office of Children’s Services became involved and planned to temporarily place Eden with a foster family so she could be closer to medical care.

Sue Sue sang to the baby in Inupiaq over FaceTime, said Lesley and Joel Sundberg, a foster family who housed Eden after she left the hospital and have since adopted her. Amos, for a time, frequently texted the foster parents to ask how Eden was feeling and discuss the upcoming adoption.

Up in Kotzebue, a new strangulation case captured the attention of City Hall and local police. Authorities did not hesitate to seek the public’s help.

“The Kotzebue Police Department suspects foul play and is pursuing all investigative leads,” said Milliette, the investigator who had closed Kirk’s case without an arrest the year before. By this time, he had become chief of police. Volunteers raised thousands of dollars in reward money and the story made statewide news for days. After police released a surveillance photo of the suspect, a tipster came forward and identified the killer, who pleaded guilty to a felony in Roetman’s courtroom.

The victim was a dog: the city fire department’s pet husky.

A Second Death

On Jan. 19, 2020, Norton changed her Facebook profile photo to display a red handprint across her closed mouth, the symbol of the Missing and Murdered Indigenous Women movement.

A few days later, Amos Richards appeared in court to face charges for kicking Norton while she was six months pregnant. Once again the magistrate was Michels, who approved a deal that allowed Amos to plead guilty to a single count of “reckless endangerment.”

Despite the plea, Norton and Amos made plans to fly to Anchorage to finalize adoption paperwork.

“I cant tell if she has me or Amos’s eyes,” Norton wrote on Jan. 30, 2020, after seeing the latest picture of Eden at the hospital. She sent the Sundbergs a selfie of her and Amos, heads together, to show the baby.

Like Kirk, Norton was a Leo. (Although born years apart, Kirk and Norton shared the same Aug. 21 birthday.) Norton had a habit of cracking her knuckles and dreamed of one day taking a Caribbean cruise. Her biggest fear, she once wrote, was losing her children.

Her mother remembers her, most of all, as a helper. The last time the whole Norton family gathered with Sue Sue, she sat on a square of cardboard on the tiled floor, separating the hide from the marbled meat of a freshly killed caribou.

Five days before Norton and Amos were to sign adoption papers, Amos stopped responding to texts from the adopting family.

The timeline of Norton’s last week alive is muddled by conflicting evidence. In a 2020 email to the Daily News and ProPublica, Kotzebue police estimated her date of death as March 5 or 6. But Norton’s sister, Vera Norton, said Sue Sue helped family prepare a caribou on March 7 or 8.

At 8:32 a.m. on March 9, police were called to the former mayor’s house, where they found Norton’s body, her head covered by a jacket.

Outside, the temperature fell to 13 below. Here above the Arctic Circle, graves must be carved into the icy soil and permafrost, and as Vera Norton was leaving home to look for a burial site, she saw police placing Amos into a patrol car.

Hughes later told Sundberg that police were unable to collect certain evidence. Asked to clarify by ProPublica and the Daily News, Kotzebue Police Chief Roger Rouse said in an email that Hughes had been referring to “the rejection of a search warrant from the judge in regard to some evidence.” The police chief would not say which judge he was referring to.

Amos skipped the funeral.

Mama Sue Norton said police never spoke to her about the case. She first learned the official cause of her daughter’s death was homicide when a death certificate arrived in the mail.

The certificate listed the cause of death as “asphyxiation due to obstruction of airways and compression of neck.” The autopsy also found that Norton had suffered “multiple blunt force injuries of head, neck and extremities.”

She’d been beaten. But it was the strangling that killed her.

“We’re Not Interested”

The homes on the Richards’ property are 440 feet from the Kotzebue Police Department lobby. City Hall is even closer. A dozen domed surveillance cameras circle the various government buildings, several within view of the former mayor’s house.

One day in June 2021, I knocked on the door of the main house, the first of three visits to the property where police found Kirk and Norton’s bodies. “What’s this about?” Clement Sr. asked.

Richards was no longer borough mayor at the time, having lost reelection in 2018. Norton’s family says the deaths on his property were common knowledge and gave voters pause. Other Kotzebue residents said the election was simply more competitive, with a new crop of respected candidates. When asked about the death of Norton, he said, “I have no comment,” and shut the door.

Clement Jr., the middle son, stood outside by a four-wheeler watching the exchange. He said he knew nothing about the case because he was in Anchorage with his father when Norton died. Asked how he thinks she died, Clement Jr. said he didn’t know, hasn’t thought about it and never asked.

Maybe she killed herself, he volunteered. “It’s a common thing in Alaska.”

In 2022, Sears, the state’s Murdered and Missing Indigenous People investigator, began looking into the case and met with Eden’s foster family to learn more. But Sears soon resigned, just five months into the new job. She declined an interview request.

The Daily News and ProPublica on June 14 of this year again attempted to interview Clement Sr. and his sons about the deaths. A man who answered the door at the back house refused to comment and closed the door.

“We’re not interested,” he said.

Last month, the newsrooms sent certified letters detailing the findings of this story to members of the Richards family; we didn’t hear back. The family also didn’t respond to letters, phone calls, texts and Facebook messages.

It’s all made for a long three years for Mama Sue, a devout Christian and a retired tribal doctor who practiced traditional medicine in Inupiaq villages. She suffered a stroke months after her daughter’s death and temporarily lost her ability to speak. On a recent weekday she sat in a formation of half-filled produce boxes, silently packing everything she owns as she prepared for her house to be demolished.

Her family built the home by hand decades earlier. Now a new house is arriving on a barge, and soon Mama Sue will have indoor plumbing and running water for the first time. Builders will place the new home on the same lot, 230 feet from the house where her daughter was found strangled.

As of September, Kotzebue police had never interviewed Mama Sue about the homicide. Nor had they talked to Norton’s other relatives and potential witnesses. Nor did they ever talk to neighbors who live between Mama Sue and the former mayor’s house, who regularly visit with Amos and Anthony Richards.

The new Kotzebue police chief, Rouse, said he could not comment on Norton’s death because it remains an open investigation, although the case is now in the hands of Alaska State Troopers.

In 2021, Lesley Sundberg, who adopted Amos and Sue Sue’s child, filed a formal complaint with the state regulators against the Kotzebue Police Department, accusing the department of “dishonesty and untruthfulness.”

“One must wonder,” Sundberg wrote to the Alaska Police Standards Council in November 2021. “If there are unethical reasons why a Native Alaskan woman, mother of 3, daughter, niece, sister, aunt, and well-known community member’s murder, has been swept under the rug.” (The executive director for the council said in an email to the newsrooms that the agency “does not investigate complaints of this nature until the involved criminal investigation is completed by the law enforcement agency working on it, so that we do not interfere with the criminal investigation.”)

She never received an answer.

Two years into his 25-year sentence for attempted aggravated rape, Nathan Brown could tell the man sitting across from him — a jailhouse lawyer improbably named Lawyer Winfield — was not going to help him get out of prison. It was astounding to Brown that he was pinning his hopes on a fellow inmate who had an eighth grade education and whose formal legal training amounted to a prison paralegal course. “But he knew more than I did,” Brown said.

Brown laid out for Winfield the details of his case. In the summer of 1997, a woman was assaulted in the courtyard of the apartment complex in Jefferson Parish, Louisiana, where Brown was living with his mother. The woman, who was white, fended off the attacker with her high-heeled shoe until he fled on a bicycle. When sheriff’s deputies arrived, a security guard suggested they question Brown — one of the few Black tenants in the complex.

Brown, 23 at the time, was in his pajamas, rocking his baby daughter to sleep. The deputies put him in handcuffs and brought him to the victim. When she couldn’t identify him, the officers allowed her to get close enough to smell him. She had told them her attacker had a foul body odor. Brown, she would later testify, smelled like soap; he must have showered immediately after, she speculated. In a trial that lasted one day, the jury found him guilty. After his appeal was rejected, he no longer had a right to an attorney provided by the state.

Winfield began translating Brown’s grievances into a legal petition. He argued that Brown’s lawyer had provided ineffective counsel: He had overlooked the most basic defense strategies, failing to challenge the discrepancies in the victim’s story and to insist on DNA testing. The two of them worked on the petition for months, so Brown was surprised when the Louisiana 5th Circuit Court of Appeal delivered a rejection just a week later. The denial — a single sentence that didn’t address any of Brown’s claims — bore the names of three judges. But something didn’t feel right. How could they return the ruling so quickly? Why was it so vague?

The answer to those questions would come years later, in the suicide note of a high-level court employee who disclosed that the judges of the 5th Circuit had decided, in secret, to ignore the petitions of prisoners who could not afford an attorney. It was a shocking revelation. In a state where police and prosecutorial misconduct frequently make national headlines and a stream of exonerations has revealed a criminal justice system still functioning in the shadow of slavery and Jim Crow, a group of white judges had decided that the claims of hundreds, perhaps thousands, of inmates — most of them Black — were not worth taking the time to read.

Among those petitions was Brown’s claim that a DNA test would have proven his innocence.

A Death at the Courthouse

On a warm Monday morning in May 2007, as the secretaries and clerks began filing through the glass doors of the Louisiana 5th Circuit Court of Appeal, staff director Jerrold Peterson was inside his office with a 9 mm Beretta pistol. A letter he had written to the court’s eight judges was making its way to the chambers of Chief Judge Edward Dufresne Jr. Versions of that letter were en route to the Judiciary Commission, the panel responsible for investigating allegations of judicial misconduct, and to the Times-Picayune, the state’s most influential paper.

Peterson hoped the letter would unleash a massive scandal — one that he had helped perpetuate for more than a decade. Fifty-five years old, Peterson had long been a fixture at the courthouse, and he reminded the judges that he had kept their secrets, clearing contempt charges against their friends and fixing traffic tickets whenever they asked. But he focused his rage on one secret in particular: their handling of appeals sent to the court by prisoners who claimed they’d been unjustly convicted.

Louisiana requires that a panel of three judges review all such petitions — known as pro se petitions, a Latin phrase that means “for oneself.” But Peterson wrote that the judges had instructed him to ignore the law and dispose of the appeals on his own. Defresne, he explained, signed off on the documents “without so much as a glance.”

The implications were staggering. Over 12 years, the 5th Circuit, which is responsible for reviewing challenges from trial courts in four parishes, had disregarded at least 5,000 pro se petitions from Louisiana prisoners, according to the court’s records. The inmates ranged from people convicted of murder to nonviolent offenders sent away for life. Many had limited education and struggled to present their arguments in the language of the courts. If Peterson’s accusations were true, none of the judges had ever laid eyes on their claims.

Peterson, who was known to keep his door open, didn’t answer the business services manager when she came by to tell him that Dufresne wanted to see him. The chief judge instructed her to have the head of security unlock the door. As he slid in his passkey, the sound of a gunshot echoed through the building.

A police detective arrived at the courthouse and found Peterson at his desk, slumped to one side, the Beretta still clutched in his right hand. The rest of the office, the detective wrote in his incident report, “seemed to be void of any further evidence.” When the officer searched the room a second time “for a final attempt to locate a possible suicide note,” Dufresne joined him. The chief judge didn’t mention that he had already read Peterson’s suicide letter. The detective, though, sensed something was amiss. In his report, he noted that Dufresne “appeared to be evasive.”

The 5th Circuit courthouse sits on the edge of downtown Gretna, a sleepy New Orleans suburb of 17,000 that serves as the government seat for Jefferson Parish. A tight bend in the Mississippi River separates Gretna from New Orleans, but politically and socially, the two are much further apart. Connecting the cities are twin bridges that became notorious after Hurricane Katrina when thousands of New Orleans residents tried to evacuate over the span but were forced back by a line of Gretna police officers. For many Black people in Louisiana, the moment encapsulated the hostility of the suburb, an area shaped by white families who had fled school desegregation half a century earlier.

On the Gretna side of the bridge, the road becomes the Harry Lee Expressway, named for a sheriff of the parish who was elected in 1979 and returned to office six times on a platform of aggressive policing. Lee once proudly announced that he had ordered his deputies to stop any “young blacks” they might find driving at night in a white neighborhood. “There’s a pretty good chance they’re up to no good,” he explained. During Lee’s tenure, the voters of Jefferson Parish sent David Duke, the former grand wizard of the Ku Klux Klan, to the Louisiana House of Representatives for a term.

Dufresne’s ancestors were among the area’s early settlers. His father, a plantation owner known as Big Eddie, built a white-columned brick home at the edge of his sugarcane fields in the neighboring parish of St. Charles. Dufresne, known as “Little Eddie,” launched his first campaign — a successful run for clerk of court — while he was still in law school. After he won a seat on the court, a local publication called him “the Thomas Jefferson of St. Charles government” and asked, “Can Eddie Dufresne, Jr. go cold turkey on politics now that he’s a judge?” The answer was no. By the time he was elected to the newly formed 5th Circuit Court in 1982, he had become a power broker like his father, weighing in on disputes and promoting politicians he favored. Each spring, he hosted a lavish crawfish boil on the riverfront that drew sheriffs, businesspeople, judges and public officials.

Long before he became chief judge in 2001, Dufresne dominated the 5th Circuit. On most weekdays, he would arrive at the courthouse in the passenger seat of one of his Cadillacs, driven by his longtime secretary, who would pick him up at the plantation house. Yet he was perceived by many as a “real salt-of-the-earth kind of guy,” as one lawyer put it. He earned the loyalty of staff by keeping work hours short — he would often leave at 2 p.m. — and wages high. “Dufresne ran a court for the benefit of the judges,” another lawyer told me.

During a monthly meeting of the 5th Circuit’s judges in 1994, he proposed changing how the court handled criminal pro se petitions, also known as writs. The minutes note the proposal but only in passing; it’s sandwiched between a lengthy debate over plans to upgrade the court’s computer system and a discussion about renting a new office copier. Dufresne’s plan is described in two sentences: A three-judge panel would no longer rule on the petitions unless they were “special or unusual”; instead, Dufresne would oversee them himself.

“Administratively, it got somewhat cumbersome to have to select three-judge panels for every writ, because you’d get hundreds of them,” said Bryan Pedeaux, who was Dufresne’s longtime law clerk. “So Dufresne said, ‘Let’s see if we can somehow streamline the situation.’”

At the time, the 5th Circuit had the lowest caseload — and the lowest number of pro se petitions — of the state’s five appellate courts. In the year preceding the meeting, it reported 235 criminal pro se petitions, fewer than one-tenth of the statewide total. The 4th Circuit, which includes New Orleans, reported 1,031.

Dufresne’s proposal was in keeping with his judicial views, former staff members told me. He believed that people convicted of crimes were almost certainly guilty and that any issue they raised on appeal was an attempt to avoid paying for their actions. He almost never reversed a decision of the lower criminal courts. “There was a total prejudice against all people charged and convicted of crimes,” said a former law clerk. “They never planned to give any of these people any relief anyway, so what difference does it make?”

The minutes give no hint of why the judges believed they could circumvent the state’s law. Although Peterson attended the meeting, his future role in drafting rulings on the court’s behalf is not mentioned. Still, it was clear Dufresne was offering to substantially reduce the judges’ caseloads: At the time of that meeting, more than 75% of the court’s post-conviction petitions came from prisoners without an attorney. The change went into effect immediately.

ProPublica made multiple attempts to contact each of the three 5th Circuit judges who presided during the relevant years and are still alive. ProPublica also asked for comment from the 5th Circuit courthouse. None responded.

Entrusted with overseeing the new protocol, Peterson developed a system to dispense with the prisoners’ applications speedily. He drew up 15 rulings for his assistant to cut and paste; they were typically no longer than one or two sentences and ambiguous enough to fit a wide range of claims. A couple of the rulings were labeled “grants” but did little more than allow prisoners access to their trial transcripts.

Sixty years ago, the U.S. Supreme Court ruled in Gideon v. Wainwright that the Sixth Amendment guarantees all criminal defendants the right to an attorney. But in most states, including Louisiana, that right ends after an appeal of the initial conviction. Every subsequent appeal is part of the post-conviction process, an area of law that even experienced lawyers find challenging.

Judges often view pro se appeals skeptically because they are filed by people who are not only untrained in the law but sometimes barely literate. Even liberal courts struggle with the high volume of petitions that lack merit. They are frequently assigned to clerks, who tend to recommend that judges dismiss them on technical grounds to avoid having to unravel what they see as frivolous or poorly made arguments. Still, the post-conviction process is essentially the only avenue prisoners have to introduce new evidence of their innocence or to persuade the court a defense attorney didn’t do their job.

There is overwhelming evidence that state courts routinely send innocent men and women to prison. Researchers estimate that at least 1% of those serving time for violent offenses have been wrongfully convicted — roughly 7,000 inmates in state prisons alone — though they believe that number is much higher. Louisiana law says that people sentenced to death are entitled to court-appointed lawyers for all of their appeals. Subjected to such scrutiny, an astounding number of the state’s prosecutions have fallen apart. Since 1976, 82% of Louisiana’s death sentences have been overturned by appeals judges after defense attorneys exposed serious violations that occurred at trial. Most sentences were reduced to life; some prisoners were exonerated.

That statistic underscores a fundamental inequity. The people sentenced to lengthy or life sentences were arrested by the same police forces, prosecuted by the same district attorneys, represented by the same public defenders and convicted in the same courts as those on death row, but they are on their own. When they file a pro se petition asking Louisiana’s appellate courts to reconsider their cases, they are at a significant disadvantage. Those petitioning the 5th Circuit after that meeting in 1994 had no chance at all.

To create the appearance of a proper review, former staffers said Dufresne formed a “pro se committee,” which included three judges who agreed to lend their names to Peterson’s rulings. Whenever a judge on the committee retired, Dufresne appointed someone new. The nature of the pro se committee was an open secret at the courthouse. “I knew what they were doing, and I knew it was unconstitutional,” said one former clerk. “Everyone knew about it.”

In Louisiana, courts charge prisoners a fee for petitions — generally $50. Those costs are usually paid by parishes in which the defendants are convicted. By 1999, the 5th Circuit was charging $300. The money, paid by taxpayers, flowed into the 5th Circuit’s discretionary fund. In a period when the state’s criminal justice system was close to financial collapse, with some public defenders representing as many as 400 people at a time, records show that the 5th Circuit collected at least $1.7 million for the pro se petitions its judges did not read. Former 5th Circuit employees told me the judges spent the money on office furnishings, travel allowances — even for retired judges — and other perks the state didn’t cover. When asked about the fund’s expenditures, the 5th Circuit said it keeps financial records for only three years and could not provide an accounting.

The pro se petitions made up only a small part of Peterson’s responsibilities. His primary task was to oversee the court’s central staff, a group of lawyers who reviewed criminal petitions filed by attorneys and wrote recommendations for the judges. He also spearheaded the court’s lobbying of the state legislature and oversaw the construction of the new court building. “He loved that job more than anything in the world,” a former colleague told me.

Although Peterson often put in long days, he advised his staff to spend more time with their families. Those who knew him well said his devotion to his work seemed to rise and fall in proportion to what was occurring in his personal life, which was in a perpetual state of flux. Former colleagues said he was unhappy in his marriage and had several affairs with staff members. At times his home mail was delivered to the office, and some of his co-workers suspected he might sleep there on occasion. Putting his children through parochial school was a financial strain. One of his daughters had died in her teens, and a brother had killed himself. A devout Catholic, Peterson had a hard time reconciling his faith with his troubled marriage and bouts of depression.

Peterson was born into a family of river pilots responsible for guiding ships through the lower Mississippi. It’s one of the most lucrative jobs in the state, with pay frequently exceeding $700,000 a year. Peterson’s grandfather, father and brother all held the job, and two of his sons now do. Peterson took a different path. After he graduated from the U.S. Naval Academy, he attended law school at Tulane University and took a job at a firm in New Orleans. He joined the 5th Circuit at age 37; his time with the court was interrupted only by his military service — as a reserve Marine colonel, he served in both the Afghanistan and Iraq wars.

After years of overseeing the scheme, Peterson sought out Karla Baker, who had worked at the court years earlier and with whom he had been romantically involved. Baker was much younger than Peterson, and their relationship had continued after she left the 5th Circuit and took a job as a defense attorney at a prominent New Orleans firm. Peterson told her he wanted someone else to know what the judges had asked him to do, and he gave her a copy of his list of denials and the minutes from the 1994 meeting. He asked her not to do anything unless she heard from him.

On Saturday, May 19, 2007, two days before his suicide, Peterson received a call from Dufresne, summoning him to the courthouse. When he arrived, Dufresne and two judges were waiting in the conference room, and it quickly became clear they were there to fire him. They had evidence that Peterson had tried to improperly sway a case — that he had directed his staff to write a memo advising the judges to rule in favor of a defendant. Peterson rarely, if ever, recommended relief, even in cases filed by attorneys. But this happened to be a case Baker was defending, and Peterson had intervened.

Some law clerks had reported what they viewed as Peterson’s misconduct to the judges. Dufresne wanted to let it go, but a new judge on the court insisted they launch an investigation, which also revealed that Peterson was having a relationship with one of his subordinates. It had become too much to ignore. After more than a decade of denying the appeals of defendants, he was being fired for trying to aid one.

Peterson was blindsided. He had assumed he had a level of job security commensurate with the amount of dirty work he had done for the court. “Jerry thought he was one of them,” a former colleague told me. “He thought he was unfireable because he knew all the court’s secrets.” Now, some of the same judges who had asked him to break the law were dismissing him for what struck him as comparatively small-scale misconduct.

After the meeting, he sat down and began to write a letter to the judges. “Not one criminal writ application filed by an inmate pro se has been reviewed by a judge on the court,” he wrote. “Who’s integrity is really in question when you have conveniently ignored your duty to review pro se criminal writ applications so you can reduce your workload, present a false picture of the court’s work, and charge large sums for work you haven’t done?”

On the morning of his suicide, Baker said, she received an email from Peterson.” He said by the time he was finished it will be Gretnagate.” But he underestimated the determination of the state’s legal establishment to protect its own.

The Times-Picayune ran a short piece on the suicide a few days later. It described Peterson as a well-liked, reliable employee. A staff member told the paper that Peterson’s problems were personal ones: “As far as anyone knows it has nothing to do with anything here at the court.” The article made no mention of the letter Peterson had sent to the paper.

The Judiciary Commission initiated an investigation into the 5th Circuit. A person familiar with the inquiry told me it focused on Dufresne, but it never became public and never had any consequences. Its findings were sealed and sent to a storage facility that was already filled with the records of other misconduct investigations that are not subject to the state’s public records law.

None of the judges involved in the episode was disciplined. A few months after Peterson’s suicide, the 5th Circuit quietly adopted a new policy for handling pro se petitions: A panel of three randomly selected judges would now review them, as Louisiana law required. No one, however, alerted the men and women whose petitions the court had improperly rejected and who were in prisons across the state.

Hundreds of Petitions

Karla Baker wanted no part of the mess Peterson had left behind. But she had loved him, despite their complicated relationship, and felt partly responsible for his unraveling. She knew that Peterson had gotten into trouble because he had tried to influence the judges in her case. Although she never asked for him to intervene, she said, she worried her own legal career could be in jeopardy.

More than 16 years after Peterson’s suicide, Baker is still hesitant to talk about what happened, and unsure of how to cast herself in the story. Raised in Louisiana, she graduated from Loyola University New Orleans College of Law and began her career as a staff attorney for the state Supreme Court. When she joined the 5th Circuit as a law clerk in 2002, she was taken with Peterson’s intelligence and kindness. He never spoke down to her, she said, despite her lack of experience. He seemed to know everything about the courthouse, and he was always willing to help. As they became closer, she came to see a dark side. He was deeply unhappy, haunted. “He lived on the edge,” Baker said, but felt powerless to change his own circumstances.

Peterson could have taken his documents to the Innocence Project or another nonprofit dedicated to fighting the injustices of the Louisiana criminal justice system, but those were not his people. So, he had left it to Baker, who had never seen herself as an activist, to bring the scandal to light.

Baker anguished about the matter for months. She was engaged to someone by then and was embarrassed about having had a relationship with a married man. She wanted to put the episode behind her. She said she decided to send an anonymous complaint to the Judiciary Commission, laying out some details of the 5th Circuit’s pro se arrangement. She didn’t know about Peterson’s suicide letter or that he had sent the commission a copy. She waited for something to happen, but nothing did, even after she sent the commission a second letter, this time identifying herself as the one who sent the initial complaint.

Finally, Baker took the documents that Peterson had given her and drove to the Louisiana State Penitentiary at Angola. Roughly 130 miles north of New Orleans, the maximum-security prison sits on a former plantation that covered 18,000 acres and is named for the African country from which many of its enslaved people were taken. That year it housed some 5,200 inmates, most of whom were expected to die at the prison hospice.

Angola was once considered the most violent prison in the United States. Brutal assaults and murders among the inmates were common, and the guards were known for sanctioning a system of inmate rape and sexual slavery. After decades of federal intervention and grudging reforms, the prison has largely shed that reputation. Vocational programs, recreational clubs and a Southern Baptist Bible college that has ordained hundreds of inmates have been credited with reducing the violence. Angola also established one of the best prison law libraries in the United States, a sanctuary of sorts where jailhouse lawyers help other prisoners challenge their convictions and sentences.

After passing through security, Baker asked to see Ted Addison, a former client who could no longer afford her services but with whom she had kept in touch. Addison was halfway through a 20-year sentence for armed robbery. For years he had been petitioning the courts on his own, insisting he had been unfairly convicted.

Baker handed Addison a sheaf of documents, which included the list of canned denials Peterson had developed and the minutes to the 1994 meeting. Addison was stunned. Like many other prisoners, he had spent years trying to get the 5th Circuit to grant him a new hearing. He had filed six pro se petitions, and each had come back almost immediately with a brief rejection.

Addison took the documents to the prison law library. Here, amid the rows of concrete cubicles, they were both a revelation and a confirmation of what the jailhouse lawyers had long suspected. For years inmates had noticed an unusual pattern in denials coming from the 5th Circuit: They would arrive just days after the petitions were filed, a process that usually took months at the state’s other appellate courts, and the perfunctory language never varied, with only the names and dates changing from case to case. Now it all made sense.

The jailhouse lawyers set about alerting the prisoners who had petitioned the 5th Circuit during the relevant years. They believed Peterson’s accusations could revive their cases. Addison felt they were organizing “a movement.” He sent copies of Peterson’s documents to inmate lawyers at the state’s other prisons and introduced Baker to Kerry Myers, editor of Angola’s award-winning prison magazine, The Angolite. Myers had been convicted of killing his wife in 1984 and was serving a life sentence for second-degree murder. He had filed five unsuccessful pro se petitions with the 5th Circuit. “I actually had a lot of hope,” Myers told me. “I said, ‘This thing is going to blow up.’”

With Baker representing them, Addison and Myers filed a joint petition to the Louisiana Supreme Court, demanding an investigation into Peterson’s allegations and new hearings for all of the prisoners whose appeals had been ignored. Within three months, the court received 299 petitions from men and women across the Louisiana prison system, most of them drafted from a form that Baker had provided.

Baker also prodded the Times-Picayune to cover the story. The newspaper’s first article, which focused on the prisoners petitioning the state Supreme Court, quoted the suicide note Peterson had sent the paper more than a year earlier. Baker, who hadn’t known about the letter, filed a public records request to obtain a copy from the Gretna police. The Angolite ran a story as well, calling the 5th Circuit’s pro se system a “simple and lucrative process for disposing of the dispossessed.”

The independent review the inmates were asking for presented a threat to the 5th Circuit. If it showed that judgments were unjust, the appeals court could be exposed to civil lawsuits. If the reviews revealed a wrongful conviction, Dufresne and the other judges could face serious discipline, especially since the state’s laws against judicial misconduct take into account the harm the injustice has caused.

The probability that at least some of the 299 petitions had merit was high. More than 90% of the prisoners came from Jefferson Parish, where prosecutors were known for striking Black men and women from jury pools in felony trials at a rate more than three times as often as their white counterparts. Because the state had long allowed “split jury” convictions requiring only 10 of the 12 jurors to agree, many of the Black defendants whose petitions Peterson rejected were convicted by what amounted to an all-white jury.

The Jefferson Parish district attorney had also made aggressive use of the state’s “Habitual Offender” law, which can turn a two-year sentence into life without parole; almost all of the cases involved Black defendants. Many of the prisoners asking for a review had been sentenced under the law and were serving life sentences for nonviolent offenses like drug possession and “purse snatching.”

Some of the judges who had sent these men and women to prison had gained notoriety a few years before Peterson’s suicide, when an FBI corruption sting revealed they had accepted cash bribes and campaign contributions in exchange for allowing a bail bonds company to dictate the amounts defendants were required to post. The scandal sent two judges to prison and unseated a third.

More than 85% of defendants in the state are considered indigent, meaning they qualify for a public defender when they are prosecuted. Louisiana’s public defender system is widely considered one of the worst in the country. It relies primarily on traffic fines and court fees — an unpredictable source of revenue that has never come close to meeting the need. Offices across the state struggle with caseloads so large that they have no choice but to put defendants on long waitlists, leaving them in jail until an attorney becomes available. Some attorneys have so little time to prepare, they meet their clients for the first time on the day of trial.

The Louisiana Supreme Court did not grant the 299 petitioners an independent review of Peterson’s rulings. Instead, it adopted a plan proposed by Dufresne and the other 5th Circuit judges: Rather than saddle another court, the 5th Circuit offered to reconsider the cases itself. “We are guided in this request by a desire to avoid imposing financial or other burdens on other judges in this state,” the 5th Circuit judges wrote. In October 2008, the Louisiana Supreme Court remanded the 299 petitions to the 5th Circuit. (It did the same with another 155 that came later.) As part of the agreement, the 5th Circuit judges whose names had appeared on the Peterson rulings would not be involved in the “reconsideration” of the cases. New three-judge panels would decide whether the rulings, which their colleagues had never read, were nonetheless fair.

With new documents Baker had obtained through public records requests, including Peterson’s suicide letter and the Gretna police report raising questions about Dufresne’s behavior, Addison and Myers challenged the Supreme Court’s decision. The documents, they wrote, “show that all of the judges of the Fifth Circuit … have an apparent or actual conflict of interest in this matter.”

The Louisiana Supreme Court saw it otherwise, stating that it would not be appropriate to task the other appellate courts with the additional work or to spend $200,000 of the public’s money to pay for retired judges to review the cases. Justice Catherine “Kitty” Kimball wrote that the court could not base its decision on the allegations of a depressed court clerk and an “unsubstantiated” police report about his suicide. “While this may be the fodder of news reports and movies,” she wrote, “it is not, in my view, proper evidence for judicial action.”

While the Judiciary Commission inquiry was going nowhere, the state bar launched its own misconduct investigation — into Baker. The 5th Circuit judges had alerted the Louisiana Attorney Disciplinary Board that Peterson had intervened on her behalf. The following year, she left the defense firm and went into practice for herself, representing drug offenders and pursuing damages in personal injury cases. The bar association kept the case against Baker open for almost a decade before sending her a letter saying it found no evidence of wrongdoing and was dropping the investigation.

It took the 5th Circuit three years to review the pro se petitions of 454 prisoners. The Times-Picayune and other local news outlets had by then dropped the story, so no one was paying attention when the judges found that, aside from a dozen procedural mistakes, Peterson’s cut-and-paste denials had been correct. In one case after another, they wrote, “there was no error in the prior rulings of this court.” The court had investigated itself and found it had done nothing wrong.

Myers’ life sentence was commuted in 2013. Addison served out the remainder of his sentence and was released in 2016.

As for the 5th Circuit judges, they prospered in the years after Peterson’s suicide. Some were picked to serve on the state Supreme Court; others enjoyed successful political careers. Dufresne remained the court’s chief judge until he collapsed in the office of one of his businesses on December 7, 2010. His obituary in the Times-Picayune didn’t mention the pro se scheme. In St. Charles Parish, there’s a Judge Edward Dufresne Parkway, a Dufresne Loop and an Edward Dufresne Community Center, where a life-size bronze statue stands. He is wearing a suit with a lobster pin on his lapel and one of Lady Justice on his tie.

The Last Case

That might have been the end of the story but for an unusual confluence of events that landed a former federal law clerk with an extraordinary resumé in a prison bunk bed next to the last inmate still fighting the 5th Circuit’s sham denials.

On January 2, 2019, Haller Jackson IV walked into Angola to serve out the remainder of a sentence for soliciting sex from a minor. He was 37 years old, 6-foot-4 and weighed 200 pounds, but he carried himself like a man who was doing his best to appear smaller. His right eye was blood red, a reminder of a beating he’d received a few weeks earlier at another prison.

Jackson had begun his sentence in Angola four years earlier. When his legal advocacy on behalf of fellow inmates called attention to, among other things, the prison’s inadequate health care, he was transferred to Dixon Correctional Institute, some 35 miles away. After he was assaulted, Jackson said, his lawyer secured his return to Angola, as long as he promised to refrain from embarrassing the authorities.

Jackson was relieved to be able to resume his work as an inmate lawyer. He had a year and a half left on his sentence, and he wanted to make the most of it. As a registered sex offender, he likely would never be allowed to practice law. While he settled in that first day, a man in the adjacent bunk bed introduced himself. His name was Louie M. Schexnayder Jr., but in Angola everybody called him Schex.

Schexnayder was convicted of murder in 1995. He’d petitioned the 5th Circuit 11 times during the period of Peterson’s blanket denials, raising questions about the competency of his defense attorney and the testimony of a witness who later recanted. After the judges at the 5th Circuit affirmed Peterson’s rulings, Schexnayder hired a lawyer to help him petition the federal courts.

Standing in Schexnayder’s way — and in the way of all the 5th Circuit petitioners who tried to take their cases to federal court — was the Antiterrorism and Effective Death Penalty Act, a federal law signed by President Bill Clinton in 1996, at the height of his efforts to portray himself as a tough-on-crime Democrat. The law, known by its unwieldy initials as AEDPA, has made it all but impossible for federal judges to overturn criminal rulings by state courts.

AEDPA was supposed to help deter domestic terrorism and expedite delays in carrying out capital punishment, but it did neither. The time between sentencing and execution is almost twice as long today as it was 27 years ago, and by most measures domestic terrorism has increased. But the law has significantly undermined habeas corpus, the constitutional safeguard that gives prisoners the right to challenge their incarceration.

One of the act’s toughest restrictions, and the one keeping the Louisiana prisoners from taking their cases to federal court, requires federal judges to defer to state court rulings in all but the narrowest of circumstances. Federal judges can’t step in just because a state court proceeding or ruling violated a prisoner’s rights. They can reverse the state ruling only if it was so wrong that not a single “reasonable jurist” would agree with it. Before AEDPA, federal judges provided a critical safeguard. Unlike state judges, most of whom face reelection and can be loath to reverse convictions for fear of appearing “soft on crime,” they are appointed for life and are theoretically free from political pressure.

Since AEDPA was enacted, state convictions based on the fabricated testimony of jailhouse informants or obtained by prosecutors suppressing or falsifying evidence are routinely upheld. Even in cases in which trial judges adopted the prosecution’s brief as their ruling, typos and all, federal judges have declined to step in. Those who do have been repeatedly slapped down by the Supreme Court in opinions that further narrowed the grounds for federal review. If the better-known 1994 crime bill was intended to lock more people up, AEDPA effectively threw away the key.

While some federal judges have tried to push back against AEDPA’s restrictions, those in Louisiana have applied them with zeal. In case after case, Louisiana’s federal courts have signaled to state court judges that virtually no violation of a prisoner’s constitutional rights is so egregious as to warrant review. Dufresne’s pro se scheme was no exception. When Schexnayder asked a federal district court for a new hearing in light of Peterson’s revelations, the judge cited AEDPA in denying his request, and the federal appellate court affirmed. But on that day in January 2019, when Jackson climbed into the top bunk in the prison dormitory he shared with 85 other men, Schexnayder thought finally he might get the help he needed.

Angola has produced some formidable jailhouse lawyers, but Jackson was unlike any of them. The son of a prominent family in Shreveport, he had studied law at Tulane, graduating first in his class with the highest grade-point average in the school’s history. While also pursuing a doctorate in epidemiology, he served as editor-in-chief of the law review and shattered the school’s record for the number of awards and honors earned by an individual student. The lives of most Angola prisoners were marked by extreme poverty; Jackson had grown up in extraordinary privilege. If he hadn’t been gay, he believes he might have been a frat boy, practicing at the family law firm and going to the Shreveport Club for dinner, just as generations of Haller Jacksons before him had done. Instead, he distanced himself from that lineage. After graduating from law school, he landed several prestigious federal clerkships and focused his efforts on prisoner rights and habeas cases.

But it all came crashing down in 2014, when he was arrested in New Orleans after arranging online with an undercover agent to pay for sex with a 10-year-old boy. By his own account, he had become addicted to alcohol and dependent on methamphetamines. It was a spectacular downfall, and it made headlines in legal publications. Jackson pleaded guilty and asked to be sent to Angola. This was an unusual request. The prison still evokes fear and is generally reserved for people sentenced to more than 40 years. His lawyers were against it, but he insisted. “It’s my drag queen approach to life,” he said. “If you’re going to send me to prison, well, send me to Angola.”

It was also a way for Jackson to derive meaning from the wreckage. Angola is where Louisiana’s injustices intersect most dramatically, and Jackson knew his rare expertise in post-conviction law would be valuable. He had always understood that pro se petitioners got short shrift, but in Angola he was shocked to see how many of the prisoners’ claims had merit and how few managed to receive any attention from the courts.

Shortly after he arrived, Jackson met an inmate convicted of stealing a carpenter’s level. He had been sentenced to life without the possibility of parole under the state’s repeat offender law; his previous crimes included stealing a pack of cigarettes and a lighter and writing two bad checks to Home Depot. The man, Jackson wrote in a petition arguing the sentence was illegal, will die in prison over a “tool with a little bubble in it, worth less than $10.” It was denied. Jackson petitioned the court on behalf of a man who had found evidence of his innocence in a police report the prosecutor had withheld at trial. His request for a new hearing was rejected. As was a filing on behalf of a severely disabled man who was still in prison months after he should have been released, and another for a man who claimed he had lost his vision because of the prison’s neglect.

Almost all of Jackson’s filings speak not just to the particulars of a specific case but to the devastation wrought by the entire Louisiana criminal justice apparatus. The state has more people serving life without parole than Texas, Tennessee, Arkansas, Alabama and Mississippi combined. In a petition to the U.S. Supreme Court for a man serving a life sentence for possession of cocaine, Jackson protested “this destruction of another black family — perhaps a tiny tragedy in the civil rights Chernobyl that has been Louisiana’s war on drugs.” There was no evidence linking the man to the ounce of cocaine found at a relative’s home, he wrote. “And yet here he sits still, sentenced to life without parole on the banks of the Mississippi,” he continued. “As seen from the heavens, the scene on these banks has changed little since 1820.” The petition was denied.

By the time Jackson met Schexnayder, his writing had progressed “from disappointed but fundamentally-confident-in-justice liberal to just this side of burn-the-house-down nutter,” he told me. The indignation he felt over the 5th Circuit’s pro se cases was not because of the court’s obvious indifference to the inmates; this he had come to expect. “It’s that the judges got caught saying they don’t care,” he said. “The poor already knew this and have known it viscerally all their lives — from the way every arm of the state has ever treated them.” But here was a case in which they had irrefutable proof, and still there was no outrage on their behalf. “It was crickets,” he said. “They got caught so, so red-handed, and the response of all the other courts has been a collective shrug.”

Schexnayder, who had a criminal record so long that he would almost certainly have landed in prison for life much sooner had he been Black, could hardly be seen as the face of Louisiana’s criminal justice failures. But of all the 5th Circuit petitioners, Schexnayder was the one who had somehow managed to keep his case alive. Jackson knew that a victory for him could open the door for the others. He began working on a petition to the U.S. Supreme Court, arguing the 5th Circuit’s reconsideration of Peterson’s denials did little more than allow the judges to “whitewash the scandal.”

“Why would the Louisiana 5th Circuit think it could get away with such appalling misconduct?” Jackson wrote. “To this there is an easy, if disturbing, answer: Because it has. And now, the lower federal courts are deferring to that court’s decisions in the affected cases, many involving a sentence to life without parole.”

Jackson realized the case was unlikely to get any attention unless he could line up some outside help. AEDPA had been a particular target of one of his mentors, Alex Kozinski, a federal judge on the 9th U.S. Circuit Court of Appeals for whom Jackson had clerked. Frequently mentioned as a candidate for the U.S. Supreme Court, Kozinski had been one of the country’s most prominent judges, a Reagan appointee known for his cutting and iconoclastic opinions. In a 2015 law review article, he wrote that AEDPA was “a cruel, unjust and unnecessary law that effectively removes federal judges as safeguards against miscarriages of justice.” He called for its repeal.

But like Jackson’s, Kozinski’s career had come to an abrupt end. In 2017, amid multiple accusations of sexual harassment, he left the bench. Within the legal world, especially around issues of criminal justice, however, his opinion still commanded respect, even among some of his accusers. Jackson knew that his involvement could draw attention to Schexnayder’s petition. He called the former judge at his home in California. Kozinski thought the 5th Circuit’s conduct — and the federal courts’ unwillingness to wade into it — might provide a valuable test for AEDPA. The law requires deference to the work of state court judges, but what if those judges hadn’t done the work? Kozinski asked the National Association of Criminal Defense Lawyers to submit a brief in support of Schexnayder’s petition and recruited another former clerk to write it.

In April 2019, the U.S. Supreme Court asked the state of Louisiana to submit a response to Schexnayder’s claims, signaling that someone on the court was interested in considering the case. The justices were initially scheduled to vote in April on whether to grant a full hearing, but they postponed that decision nine times over the next eight months. The delays gave Jackson hope. Maybe one of the justices was working to drum up enough votes to give the case a chance or preparing a powerful dissent from the court’s refusal to hear it.

Instead, on Dec. 9, 2019, the court unanimously rejected the case. Justice Sonia Sotomayor wrote a short opinion, citing technical issues with Schexnayder’s original petition to the Louisiana federal court as her reason for agreeing with her colleagues’ decision. She ended with what seemed like an encouraging note to the prisoners, saying the 5th Circuit’s reconsideration of Peterson’s rulings brings up “serious due process concerns.”

“I expect that lower federal courts will examine the issue of what deference is due to these decisions when it is properly raised,” she wrote.

But the federal courts will not get that chance. The 454 prisoners whose denials the 5th Circuit “reconsidered” have exhausted their appeals and can no longer ask federal judges to weigh in on the 5th Circuit’s conduct. In refusing to hear Schexnayder’s case, the Supreme Court has prevented the episode from being raised in federal court again.

When Jackson found out that Schexnayder’s petition had been rejected, he struggled to articulate his reaction. After a long silence, he said, “Well, they got away with it.”

Since they petitioned the Louisiana Supreme Court, some of the 454 inmates have died in prison. Others have been released after serving their time or have had their sentences reduced as a result of recent criminal justice reforms. But at least 170, including Schexnayder, are still incarcerated. They continue to petition the appellate courts, trying to show new evidence of their innocence or to argue that their sentences should be reduced.

After the Schexnayder episode, Jackson set his sights on the modest goal of filing as many petitions as he could before his release. “I’m going to make them tell me they’re OK with all these crazy cases,” he said. When he walked out the prison gates in June 2020, he smuggled several office boxes containing case files he had secretly copied — documents he would use to help the men he was leaving behind. In the months that followed, Jackson found lawyers to represent dozens of prisoners and worked with legal nonprofits to reduce the sentences of more than 100 people. Among them are several men whose pro se petitions the 5th Circuit had ignored.

Epilogue

In the years that Peterson was rejecting pro se petitions, the 5th Circuit denied claims that ended in at least five exonerations. Four of these men were freed only after the New Orleans Innocence Project agreed to represent them. Nathan Brown was one of them. He had appealed to the organization early in his incarceration, and lawyers there had discovered that the victim’s dress had been preserved as evidence and could be tested for DNA.

Hurricane Katrina put a stop to everything, though, and for a long time Brown heard nothing. While he waited, the 5th Circuit reviewed Peterson’s denial and concluded that the failure of Brown’s attorney to introduce DNA evidence was “within the scope of trial strategy” and did not constitute inadequate counsel.

Then, on his 39th birthday, Brown received a letter from the national Innocence Project, saying it would take his case. Brown’s new lawyers compelled the Jefferson Parish district attorney to send the dress for DNA testing, and the analysis identified another man — a convicted felon — as the attacker. In 2014, after 16 years, 10 months and 18 days, Brown was exonerated.

It’s been nine years since Brown was released, and he’s still trying to find stable ground. He has struggled with addiction and depression. He cycles through phones. He has lost his Social Security card so many times the federal government will no longer replace it. The dreams he had for himself when he was in prison — that he would go to college, that he would help his daughter to rise above the poverty that had plagued his own childhood — have slipped so far out of his reach he can hardly allow himself to believe in them. Still, he knows how exceptional his case is.

“They have a lot of guys in prison that are filing claims,” he told me. “They’re not all saying, ‘I didn’t do this.’ They’re just saying, ‘The way you sentenced me is wrong. The crime doesn’t warrant all this time you gave me.’ But they can’t come home, because once they get you, they got you, and the courts — they’re not listening. They don’t see you.”

So, when Martinson joined a call in April 2018, he was anxious for the verdict about a tuberculosis vaccine he’d helped test on hundreds of people.

The results blew him away: The shot prevented over half of those infected from getting sick; it was the biggest TB vaccine breakthrough in a century. He hung up, excited, and waited for the next step, a trial that would determine whether the shot was safe and effective enough to sell.

Weeks passed. Then months.

More than five years after the call, he’s still waiting, because the company that owns the vaccine decided to prioritize far more lucrative business.

Pharmaceutical giant GSK pulled back on its global public health work and leaned into serving the world’s most-profitable market, the United States, which CEO Emma Walmsley recently called its “top priority.” As the London-based company turned away from its vaccine for TB, a disease that kills 1.6 million mostly poor people each year, it went all in on a vaccine against shingles, a viral infection that comes with a painful rash. It afflicts mostly older people who, in the U.S., are largely covered by government insurance.

Importantly, the shingles vaccine shared a key ingredient with the TB shot, a component that enhanced the effectiveness of both but was in limited supply.

From a business standpoint, GSK’s decision made sense. Shingrix would become what the company calls a “crown jewel,” raking in more than $14 billion since 2018.

But the ability of a corporation to allow a potentially lifesaving vaccine to languish lays bare the distressing reality of public health vaccine creation. With limited resources, governments have long seen no other option but to team with Big Pharma to develop vaccines for global scourges. But after the governments pump taxpayer money and resources into the efforts, the companies get control of the products, locking up ownership and prioritizing their own gain.

That’s what GSK did with the TB vaccine. Decades ago, the U.S. Army brought in GSK to work on a malaria vaccine and helped develop the ingredient that would prove game-changing for the company. It was an adjuvant, a substance that primed the body’s immune system to successfully respond to a vaccine for malaria — and, the company would come to learn, a variety of other ailments.

GSK patented the adjuvant and took control of the supply of the ingredients in it. It accepted government and nonprofit funding to develop a TB vaccine using the adjuvant. But even though it isn’t carrying the vaccine to the finish line, it isn’t letting go of it entirely either, keeping a tight grip on that valuable ingredient.

As TB continued to rage around the globe, it took nearly two years for GSK to finalize an agreement with the nonprofit Bill & Melinda Gates Medical Research Institute, or Gates MRI, to continue to develop the vaccine. While the Gates organization agreed to pay to keep up the research, GSK reserved the right to sell the shot in wealthy countries.

The trial that will determine whether the vaccine is approved won’t begin until 2024, and isn’t expected to end until at least 2028. “We just can’t operate like that for a disease that is this urgent,” said Thomas Scriba, a South African scientist and TB expert who also worked on the study.

GSK pushes back against the premise that the company delayed the development of the TB vaccine and says it remains dedicated to researching diseases that plague underserved communities. “Any suggestion that our commitment to continued investment in global health has reduced, is fundamentally untrue,” Dr. Thomas Breuer, the company’s chief global health officer, wrote in a statement.

The company told ProPublica that it cannot do everything, and it now sees its role in global health as doing early development of products and then handing off the final clinical trials and manufacturing to others. It also said that a vaccine for TB is radically different from the company’s other vaccines because it can’t be sold at scale in wealthy countries.

Though a good TB vaccine would be used by tens of millions of people, it has, in the parlance of industry, “no market,” because those who buy it are mostly nonprofits and countries that can’t afford to spend much. It’s not that a TB vaccine couldn’t be profitable. It’s that it would never be as profitable as a product like the shingles vaccine that can be sold in the U.S. or Western Europe.

Experts say the story of GSK’s TB vaccine, and its roller coaster of hope and disappointment, highlights a broken system, which has for too long prioritized the needs of corporations over those of the sick and poor.

“We don’t ask for a fair deal from our pharma partners,” said Mike Frick, a director of the tuberculosis program at Treatment Action Group and a global expert on the TB vaccine pipeline. “We let them set the terms, but we don’t ask them to pick up the check. And I just find it frankly a little humiliating.”

Steven Reed, a co-inventor of the TB vaccine, brought his idea to GSK decades ago, believing that working with a pharmaceutical giant was essential to getting the shots to people who desperately needed them. He’s disillusioned that this hasn’t happened and now says that Big Pharma is not the path to saving lives with vaccines in much of the world. “You get a big company to take it forward? Bullshit,” he said. “That model is gone. It’s failed. It’s dead. We have to create a new one.”

Gaining Control

In the early 1980s, the U.S. Army was desperate for a way to keep troops safe from the parasite that causes malaria. Military scientists had some promising ideas but wanted to find a company that could help them develop and manufacture the antigen, the piece of a vaccine that triggers an immune response. They called on SmithKline Beckman, now part of GSK, which had a plant outside of Philadelphia committed to the exact type of antigen technology they were researching.

For the company’s part, working with the Army gave it access to new science and, importantly, the ability to conduct specialized research. The Army had laboratories for animal testing and ran clinical trial sites around the world. It’s also generally easier to get experimental products through regulatory approval when working with the government, and Army scientists were willing to be infected with malaria and run the first tests of the vaccine on themselves.

Col. Carl Alving, then an investigator at the Walter Reed Army Institute of Research, said he was the first person known to be injected with an ingredient called MPL, an adjuvant added to the vaccine. Today, we know that adjuvants are key to many modern vaccines. But at the time, only one adjuvant, alum, had ever been approved for use. Alving published promising results, showing that MPL boosted the shot’s success in the body.

Company scientists took note and began adding MPL to other ingredients. If one adjuvant was good, maybe two adjuvants together, stimulating different parts of the immune system, might be even better.

It was an exciting development, bringing the multiple adjuvants together, Alving said in an interview. But then he learned that the company scientists had filed a patent for the combinations in Europe, which put limits on what he and his colleagues could do with MPL. “The Army felt perhaps a little frustrated by that because we had introduced Glaxo to the field.”

Still, the Army wanted the malaria vaccine. Military personnel started comparing the adjuvant combinations on rhesus monkeys at an Army facility in Thailand and ran clinical trials that tested the most promising pairs in humans and devised dosing strategies.

The Army found that one of the combinations came out on top: MPL and an extract from the bark of a tree that grows in Chile. The bark extract was already used in veterinary vaccines, but a scientist at one of the world’s first biotech companies had recently discovered you could purify it into a material that makes it safe enough for use in humans.

Alving said that at the time, he didn’t patent the work he and his colleagues were doing or demand an exclusive license for MPL. “It’s a question of the Army being the Army, which is not a company,” Alving said. (This was actually the second time the government failed to secure its rights over MPL. Decades earlier, the ingredient was discovered and formulated by scientists working for the Department of Veterans Affairs and a National Institutes of Health lab in Montana. One of the scientists, frustrated that his bosses in Bethesda, Maryland, wouldn’t let him test the product in humans, quit and formed a company, taking the research with him. Though his company initially said it thought MPL was in the public domain and couldn’t be patented, he did manage to patent it.)

Experts say drug development in the U.S. is littered with such missed opportunities, which allow private companies to seize control of and profit off work done by publicly funded researchers. Governments, they say, need to be more aggressive about keeping such work in the public domain. Alving has since done just that, recently receiving his 30th patent owned by the military.

It’s an open secret in the pharmaceutical world that companies participate in global health research because it’s where they get to try out new technologies that can be applied to other, more lucrative diseases.

At an investor presentation in 2016, a GSK executive used the malaria vaccine example to explain the benefit of such work. “Of those of you who think this is just philanthropy, it is not,” Luc Debruyne, then president of vaccines at GSK, told the group. He explained that it was through the malaria work that the company invented the adjuvant that is now in its blockbuster shingles vaccine. And, he explained, vaccines are high-volume products that make a steady stream of money over time. “So doing good business, innovating and doing well for the world absolutely can get married.”

As the Army’s research on the combination of MPL and the bark extract evolved — and its market potential became clear — GSK moved to vacuum up the companies that owned the building blocks to the adjuvant.

In 2005, it bought the company that owned the rights to MPL for $300 million. In 2012, it struck a deal for the rights to a lion’s share of the supply of the Chilean tree bark extract.

The company was now in full control of the adjuvant.

Picking a Winner

GSK eagerly began to test its new adjuvant on a number of diseases — hepatitis, Lyme, HIV, influenza.

Steven Reed, a microbiologist and immunologist, had come to the company in 1994 with an idea for a tuberculosis vaccine. An estimated 2 billion people are infected with TB globally, but it’s mainly those with weakened immune systems who fall ill. A century-old vaccine called BCG protects young children, but immunity wanes over time, and that vaccine does little to shield people from the most common type of infection in the lungs.

Reed had just the background and resources to attempt a breakthrough: An adjunct professor at Cornell University’s medical school, he also ran a nonprofit research organization that worked on infectious diseases and had co-founded a biotech company to create and market products.

He and his colleagues were building a library of the proteins that make up the mycobacterium that causes TB. He also had access to a blood bank in Brazil, where TB was more prevalent, that he could screen the proteins against to determine which generated an immune response that prevented people from getting sick.

At the time Reed pitched the vaccine, the company’s decision over whether to take him up was made by researchers, said Michel De Wilde, a former vice president of research and development at the company that partnered with Reed and later became part of GSK. Today, across the industry, finance units play a much stronger role in deciding what a company works on, he said.

GSK signed on, asking Reed to add the company’s promising new adjuvant to his idea for a TB vaccine.

Reed and his colleagues used more than $2 million in federal money to conduct trials from 1995 to 2005. GSK also invested, but NIH money and resources were the key, Reed said. As the vaccine progressed into testing, the Bill & Melinda Gates Foundation pitched in, as did the governments of the United Kingdom, the Netherlands and Australia, among others.

Amid all that, in 2003, GSK started testing the adjuvant in its shingles vaccine, according to annual reports, but at a much faster speed. With TB, it performed a small proof-of-concept study to justify moving to a larger one. There’s no evidence it did so with shingles. By 2010, GSK’s shingles vaccine was in final trials; in 2017, the FDA approved it for use.

To employees and industry insiders, GSK was making its priorities clear. The company built a vaccine research facility in Rockville, Maryland, to be closer to the NIH and the Food and Drug Administration; at the same time, it was retreating from TB and other global public health projects, according to former employees of the vaccine division.

All the while, the adjuvant was limited. GSK struggled to ramp up production of MPL, according to former employees there; it relies on a cumbersome manufacturing process. And it wasn’t clear whether there was sufficient supply of the Chilean tree that is essential to both vaccines.

After researchers learned of the TB vaccine’s successful proof-of-concept results in 2018, GSK said nothing about what was next.

“You would have thought people would have said: ‘Oh shit, this is doable. Let’s double down, let’s quadruple down,’” said Dr. Tom Evans, former president and CEO of Aeras, a nonprofit that led and paid for half of the proof-of-concept study. “But that didn’t happen.”

Scriba, who was involved in the study in South Africa, said he never imagined that GSK wouldn’t continue the research. “To be honest it never occurred to us that they wouldn’t. The people we worked with at GSK were the TB team. They were passionate about TB,” Scriba said. “It’s extremely frustrating.”

But Reed said that when the shingles vaccine was approved, he had a gut feeling that GSK would abandon the tuberculosis work.

“The company that dropped it used similar technology to make billions of dollars on shingles, which doesn’t kill anyone,” Reed said.

Those in the field grew so concerned about the fate of the TB vaccine that the World Health Organization convened a series of meetings in 2019.

Breuer, then chief medical officer for GSK’s vaccine division, explained that the pharmaceutical giant was willing to hand off the vaccine to an organization or company that would cover the cost of future development, licensing, manufacturing and liability. If the next trial went well, they could sell the vaccine in the “developing world,” with GSK retaining the sales rights in wealthier countries.

GSK would, however, retain control of the adjuvant, Breuer said. And the company only had enough for its other vaccines, so whoever took over the TB vaccine’s development would need to pay GSK to ramp up production, which Breuer estimated would cost around $200 million.

Dr. Julio Croda was director of communicable diseases for Brazil at the time and attended the meeting. He said he was authorized to spend significant government funds on a tuberculosis vaccine trial but needed assurances that GSK would transfer technology and intellectual property if governments paid for its development. “But in the end of the meeting, we didn’t have an agreement,” he said.

Dr. Glenda Gray, a leading HIV vaccine expert who attended the meeting on behalf of South Africa, said she wasn’t able to get a straight answer about the availability of the adjuvant.

The year after the WHO meeting, after what a Gates representative described as “a lot of negotiation,” GSK licensed the vaccine to Gates MRI, a nonprofit created by the Gates Foundation to develop drugs and vaccines for global health issues that for-profit companies won’t tackle.

GSK told ProPublica that it did not receive upfront fees or royalties as part of the arrangement, but that Gates MRI paid it a small incentive to invest in the company’s global health endeavors. GSK and Gates MRI declined to comment on the amount.

Gates MRI tax documents show a payment designated as “royalties, license fees, and similar amounts that allow the organization to use intellectual property such as patents and copyrights” the year the agreement was finalized. Among available tax documents, that is the only year the organization has made a payment in that category.

The amount: $10 million.

An Uncertain Future

In June of this year, the Gates Foundation and the Wellcome Trust announced they were pledging $550 million to fund the phase 3 trial that will finally show whether the vaccine works. They’ve selected trial locations and are currently testing it on a smaller subset of patients, those with HIV.

Jeremy Farrar, chief scientist at the WHO, said he’s more optimistic than he’s ever been in his career that we’ll have a new TB vaccine this decade.

Gates MRI and GSK declined to say who had the rights to sell the vaccine in which countries, but Gates MRI said it will “work with partners to ensure the vaccine is accessible for people living in high TB-burden lower- and middle-income countries,” and GSK acknowledged that its rights extend to South America and Eastern Europe, two regions with significant pockets of TB.

As expected, Gates MRI will be reliant on GSK to supply the adjuvant, which concerns vaccine hopefuls because of the lack of transparency surrounding its availability. One of the key ingredients, the bark extract, comes from a tree whose harvest and export has been controlled by the Chilean government since the 1970s because of overexploitation. A megadrought and forest fires continue to threaten native forests today. The main exporter of the bark says it has resolved previous bottlenecks, and GSK said it is working on a synthetic version as part of its long-term plan.

In response to questions about why it retained control of the adjuvant, GSK said it was complicated to make, would not be economical to produce in more than one place, and was a very important component in many of the company’s vaccines, so it wasn’t willing to share the know-how.

The adjuvant is only growing in value to the company, as it adds yet another lucrative vaccine to its portfolio that requires it. In May, the FDA approved a GSK vaccine for the respiratory virus known as RSV. Analysts project that the shot will bring in $4 billion annually at its peak. GSK continues to study the adjuvant in additional vaccines.

GSK strongly insists that it has enough of the adjuvant to fulfill its forecasted needs for the RSV, shingles, malaria and TB vaccines through 2035.

The company and Gates MRI said their agreement includes enough adjuvant for research and the initial supply of the TB vaccine, if it is approved. The organizations declined, however, to specify how many people could be vaccinated. GSK also said it was willing to supply more adjuvant after that, but further negotiations would be necessary and Gates MRI would likely need to pay to increase adjuvant manufacturing capacity. For its part, Gates MRI said it is evaluating several strategies to ensure longer term supply.

Several experts said that Gates MRI should test other adjuvants with the vaccine’s antigen. That includes Farrar, who said it would be “very wise” to start looking for a new adjuvant. He is one of the few people who has seen the agreement between Gates MRI and GSK as a result of his previous role as director of the Wellcome Trust. Farrar is now helping to lead a new TB Vaccine Accelerator Council at the WHO and said he believes one of the group’s roles would be to find solutions to any future problems with the adjuvant.

Gates MRI declined to answer when asked if it was considering testing other adjuvants with the vaccine’s antigen. GSK, along with several other scientists and regulators that ProPublica spoke with, expressed that using a new adjuvant would require redoing all of the long and expensive clinical trials.

U.S. government officials, meanwhile, are working to identify adjuvants that aren’t already tied up by major pharmaceutical companies.

For a corporation, the primary concern is “what is this adjuvant doing for my bottom line,” said Wolfgang Leitner, who began his career working at Walter Reed Army Institute of Research on the malaria vaccine as a consultant for GSK. Now the chief of the innate immunity section at the National Institute of Allergy and Infectious Diseases, his job is to encourage the development of new adjuvants and to make sure that researchers have access to ones that aren’t tightly controlled by individual companies.

The WHO has also been helping to build a global network of vaccine manufacturers who can develop and supply vaccines to less wealthy countries outside of the shadow of Big Pharma; it is using a technology debuted during the COVID-19 pandemic called mRNA, which deploys snippets of genetic code to trigger an immune response. Reed, an inventor of GSK’s TB vaccine, co-founded the company at the center of that effort, Afrigen, after growing concerned about the fate of the vaccine he made for GSK.

Reed helped create a second TB vaccine, which Afrigen has the rights to manufacture for sale in Africa. But that vaccine has yet to start a proof-of-concept trial.

Over the past five years, an average of just $120 million a year has been spent on all TB vaccine research globally, including money from governments, pharmaceutical companies and philanthropic organizations, according to annual surveys conducted by the Treatment Action Group. For perspective, the U.S. alone spent more than $2 billion developing COVID-19 vaccines from 2020 to 2022. At a special UN meeting on tuberculosis in 2018, the nations of the world pledged to ensure $3 billion was spent on TB vaccine research and development over the next five years. Just 20% of that was handed out.

While that mRNA hub holds promise, it will be years before an mRNA TB vaccine enters a proof-of-concept trial, according to people involved. The pharmaceutical companies that made successful COVID-19 vaccines have refused to share the technology and manufacturing techniques that make mRNA vaccines work. One company, Moderna, has said it won’t enforce its patents on mRNA vaccines Afrigen creates for COVID-19, but it’s not clear what it’ll do if Afrigen applies those techniques to a disease like TB. (Paul Sagan, board chairman of ProPublica, is a member of Moderna’s board.)

To date, the GSK tuberculosis vaccine — which does not use mRNA technology — is the only one that meets a set of characteristics the WHO believes are necessary for a viable TB vaccine.

The phase 3 trial is set to begin early next year. In the time between the two trials, approximately 9 million people will have died from TB.

Kim Gardner emerged as a voice for change. A lifelong resident of St. Louis, she had diverse professional experiences, having worked as a funeral director, a nurse, a lawyer and a state legislator. When campaigning for circuit attorney, the city’s top prosecutor, she focused on the disproportionate frequency of arrests and police officers using force against St. Louis’ Black community.

“We need to change decades of old practices that left many in our community distrustful of the criminal justice system as a whole,” she told The St. Louis American, the city’s Black newspaper, just days before her decisive primary victory in August 2016 that all but sealed her general election win.

In the last decade, prosecutors in other major American cities also campaigned on promises of systemic reform: Kim Foxx in Chicago, Larry Krasner in Philadelphia, Chesa Boudin in San Francisco.

Yet, much like Gardner, these prosecutors have faced resistance from the police and the unions that represent rank-and-file officers. They’ve been accused of being soft on crime and have even been met with political maneuvers aimed at derailing their initiatives. Several have been targeted by efforts to remove them from office or pare away their powers.

Boudin lost a recall vote and was removed in June 2022. And Krasner, criticized for his reduced emphasis on prosecuting minor crimes, was impeached by the state legislature in November, although a state court threw out the result.

In Florida, Gov. Ron DeSantis has removed elected prosecutors in Tampa and Orlando. He suspended Hillsborough County State Attorney Andrew Warren over Warren’s refusal to prosecute offenses related to abortion and gender-related health care. He suspended the state attorney for Orange and Osceola counties, Monique Worrell, because he said she wasn’t tough enough on some serious offenses.

Georgia recently became the first state to establish a commission with the authority to discipline and even remove local elected prosecutors. Republican Gov. Brian Kemp framed the law as a way to check “far-left prosecutors.”

Gardner, who was reelected in 2020, stepped down in May of 2023 while facing both a lawsuit from the state attorney general that sought her removal and a separate attempt by the Republican-led legislature to curtail her authority. Gardner’s mismanagement of her office played a significant role in her downfall. Reform-minded lawyers who she personally hired had departed. And while judges fumed about prosecutors failing to show up for court, Gardner was moonlighting as a nursing student.

Though other prosecutors faced various challenges, there are no widely known instances like that of retired detective Roger Murphey in St. Louis, who has refused to testify in at least nine murder cases and hasn’t received any departmental discipline.

“For every progressive prosecutor who’s managed to stick it out, there’s one who’s either been recalled or driven out,” said Lara Bazelon, a University of San Francisco law school professor who volunteered on Boudin’s campaign and serves as chair of the commission he created to review inmates’ claims of innocence. “So it’s a real mix of success and cautionary tales.”

She added: “If the police are against you, or literally out to get you, you’re probably not going to be able to last in that job.”

Foxx, elected in 2016 and reelected in 2020, announced in April that she will not seek a third term next year, though she said it was not because of resistance from the police. In an interview, Foxx said that even before she took office, the Chicago police union felt threatened by her assertion that Black lives matter and that the criminal justice system could be more fair, particularly to communities of color.

It was a signal, she said, “that I was not one of them.”

“The reality is we were offering something very different to what was traditionally viewed as the law-and-order approach to prosecution,” Foxx said. “I think it was surprising to folks that prosecutors could be elected addressing these issues.”

R. Michael Cassidy, a law professor at Boston College and an expert in prosecutorial ethics, said the Ferguson unrest emphasized the need for change in how police and prosecutors work. He said some prosecutors have failed to manage their relationships with police; prosecutors depend on the officers to bring them cases and to testify in court, but they must conduct oversight of the police as well.

Foxx pushed back against any assertion that she didn’t manage her relationship with police. She pointed to a popular Chicago police blog that often refers to her as “Crimesha” — “a play on the word ‘crime’ and what I believe to be a racist insinuation about me being Black with the name ‘-esha.’” The blog has also sexualized her last name by adding a third X and has insinuated that members of her family are connected to gangs.

“From the moment we came into office, we reached out to our partners in law enforcement, and what we saw was there was a segment of them who were never going to be satisfied with me in this role because I said ‘Black lives matter,’ because I said ‘We need police accountability,’ because I said that we had a criminal justice system that overly relied on incarceration that targeted Black and brown communities,” she said.

She said that she, Gardner and other prosecutors “have been faced with an unprecedented level of hate and vitriol” from the police.

“That,” she said, “is the story.”

Chicago Fraternal Order of Police President John Catanzara and other union officials did not respond to requests for comment. But Catanzara told the Chicago Sun-Times in 2020 that the union’s complaints about Foxx were based on her job performance. He said she was a “social activist in an elected law enforcement position” who was unwilling to “faithfully do her job.”

Boudin was elected in 2019 on a reform platform. Soon after taking office, he eliminated cash bail for most misdemeanors and nonviolent felonies. He also brought criminal charges against nine city officers for misconduct and announced a plan to compensate victims of police violence.

But as property crime rates climbed in San Francisco, Boudin came under increased scrutiny. Then, in 2021, his office declined to bring charges in a rape case in Golden Gate Park in spite of DNA evidence that appeared to implicate a suspect. Boudin cited concerns about the victim's identification of the suspect and the absence of other physical evidence, and said he was concerned about the risks of a wrongful conviction.

Critics seized on the case to argue that he was soft on crime and made it a central point in the push for his recall.

Cassidy said Boudin and other like-minded prosecutors have been scapegoated for isolated incidents or temporary spikes in crime statistics, as if they alone are responsible. In some cities, that has swung public opinion against them.

Boudin said the claims were unfair and largely the product of police resistance to his reforms.

“We’ve seen, on body-worn camera footage, police officers telling victims there’s nothing they can do and, ‘Don’t forget to vote in the upcoming recall election,’” Boudin said in an interview.

Boudin said he and other local prosecutors have found “there is absolutely zero accountability for these officers who engage in explicitly political acts of sabotage or dereliction of duty.”

A spokesperson for the San Francisco police union declined to comment.

Some prosecutors have held onto their positions despite challenges to their power. In November, veteran public defender Mary Moriarty was elected county attorney for the jurisdiction that includes Minneapolis in the first election since the death there of George Floyd. The same night, Dallas District Attorney John Creuzot was reelected by a nearly 20-point margin in spite of calls by a police union for his ouster over his plan not to prosecute certain low-level offenses.

In August 2022, Sarah George, the incumbent state’s attorney in Vermont’s Chittenden County, which includes Burlington, secured her seat with a 20-point victory in the Democratic primary over Ted Kenney, a challenger backed by the police.

George had introduced a variety of reforms, including eliminating cash bail and declining to prosecute cases where evidence was obtained during noncriminal traffic stops, like those for broken taillights. The Burlington police union called her actions “disastrous” and Kenney argued that the approach made streets less safe.

George, too, has seen police body camera video of officers blaming her for crime. In one video, which she provided to ProPublica, the Riverfront Times and NPR, an officer from a suburban police department tells a couple that officers can’t do anything about a crack house in their neighborhood. He then implores them to vote for Kenney because of George’s “super-progressive, soft-on-crime approach where we arrest the same people daily and they get out the same day.”

George said that, with some crime investigations, the police are “not really doing the work that we need to do on the case, and then blaming us for the case not being filed.”

The Burlington police union declined to comment. The chiefs of police in Burlington and Winooski, the suburb where the video was taken, did not respond to messages seeking comment.

Gardner, too, often faced criticism from police for her reluctance to prosecute cases based on arrests alone. In one notable instance in 2019, she dropped child-endangerment charges against two day care workers who were captured on video as they appeared to encourage toddlers to box using toy Incredible Hulk fists.

The police union called for her ouster, writing on Facebook: “The first rule of toddler fight club is … that you prosecute the sadistic promoters of toddler fight club.”

In comments made before her resignation, Gardner noted that she had been careful not to file criminal charges in cases where she did not feel there was enough evidence. “What they want me to do is make it look like this job is easy,” she said. “We can’t make things fit and people don’t like that. That’s not what justice is about.”

Richard Rosenfeld, a professor emeritus of criminology at the University of Missouri, St. Louis, was one of several researchers who pooled data from 65 major cities and found “no evidence to support the claim that progressive prosecutors were responsible for the increase in homicide during the pandemic or before it.”

Indeed, Chicago’s murder rate fell during Foxx’s first years in office, rose during the first years of the pandemic and has been falling this year, city crime statistics show. Philadelphia’s murder rate was in steep decline this year after a precipitous rise that started in 2020. And most categories of crime were in retreat in St. Louis at the time Gardner resigned, while violent crime was up in San Francisco a year after Boudin’s exit, according to statistics.

Acknowledging that the St. Louis police commonly blamed Gardner for crime trends, Rosenfeld, a veteran observer of policing in St. Louis, said, “Case not proved, is what I would argue there.”