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by Tim Golden ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. More than two decades after victims of the 9/11 attacks began trying to hold the government of Saudi Arabia responsible for helping the Qaida terrorists who carried out the plot, a federal judge has ruled that a civil lawsuit against the kingdom can go to trial. The decision on Thursday, by Judge George B. Daniels of the Southern District of New York in Manhattan, represents a crucial victory for survivors of the attacks and relatives of the 2,977 people who were killed. “This is a historic win for the families,” said a spokesperson for the families, Brett Eagleson, whose father was killed in the World Trade Center. “The Kingdom of Saudi Arabia is going to be held accountable.” A spokesperson for the Saudi Embassy in Washington, Fahad Nazer, did not respond to requests for comment on the judge’s ruling. The Saudi kingdom, which has long rejected the plaintiffs’ claims, could still appeal Daniels’ decision under special protections that are afforded to foreign governments in federal law, legal experts said. However, they added that the Saudi government might be willing to consider a settlement with the plaintiffs to avoid the scrutiny of a major trial and the expansive discovery of information that it would bring. Already, information uncovered by plaintiffs has rewritten the history of the Sept. 11 plot as it was presented in the years after the attacks by the George W. Bush administration and the bipartisan 9/11 Commission. Most significantly, the plaintiffs’ evidence has undermined the FBI’s conclusion that two Saudi officials in Southern California — one a part-time spy, the other a religious official with diplomatic status — acted “unwittingly” when they helped the first Qaida hijackers who arrived in the United States. In an email, the FBI also declined to comment on the judge’s ruling. It has long been established that in the years before 9/11, some members of the Saudi royal family and some powerful Saudi officials had supported militant Islamist movements and gave money to Islamic charities that in turn helped finance al-Qaida and other extremist groups. However, both the FBI and the CIA emphasized in the aftermath of the attacks that the Saudi royal family was an enemy of al-Qaida and its banished leader, Osama bin Laden, and that senior officials of the government had not assisted the group. The litigation in New York focused on the roles of two lower-level Saudi officials living in the United States. One, Omar al-Bayoumi, was a middle-aged graduate student in San Diego who had long worked for the Saudi civil aviation agency. The other, Fahad al-Thumairy, was a religious official serving in Los Angeles as an imam at a new Saudi-funded mosque and as a diplomat at the Saudi Consulate. The FBI quickly determined that Bayoumi met the first two hijackers near the mosque soon after they flew into Los Angeles in January 2000 and that he helped them rent an apartment in San Diego, open a bank account and buy a car. Bayoumi also introduced the two jihadists — who knew no one in the United States, spoke virtually no English and had no experience of living in the West — to a group of Muslim men who provided them with crucial support over the months that they lived in the city. Bayoumi moved his family to Birmingham, England, in the summer of 2001. Within days of the attacks, he was detained and questioned by the British police at the FBI’s request before being allowed to return to Saudi Arabia. In a search of Bayoumi’s home, the British authorities turned up documents, notebooks, videotapes and computer files that they shared with the FBI, officials said. But only in the last two years did lawyers for the 9/11 families obtain much of that cache — and then only from the British government. From the start, U.S. investigators were skeptical of Bayoumi’s account. In the end, though, the FBI largely accepted his claims that he met the two Qaida operatives by chance, helped them as he would any compatriots and had no idea of their terrorist plans. Both Bayoumi and the Saudi government insisted repeatedly that he had no ties to Saudi intelligence. Despite the efforts of a small group of FBI agents to pursue the case, it was eventually closed by the bureau. The civil lawsuit nearly died in 2016, when President Barack Obama vetoed legislation to carve out an exception to the sovereign immunity of foreign governments and permit the families to sue the Saudi kingdom. Congress overrode that veto, however, allowing the suit to go forward. President Donald Trump later blocked the families from obtaining classified government documents on the 9/11 investigations, claiming they were state secrets. President Joe Biden later reversed that stance and declassified documents that included reporting confirming that Bayoumi was a part-time agent of the Saudi intelligence service. The evidence that plaintiffs’ lawyers obtained from the British government has proved even more powerful. It included videotapes in which Bayoumi was filmed touring Washington before the 9/11 attacks with two visiting Saudi religious officials who had extensive ties to militants. In one of the tapes, he filmed the U.S. Capitol, describing its layout and security to an unidentified audience. Lawyers for the plaintiffs suggested that Bayoumi and his companions were “casing” the target for Qaida plotters; the Saudi government insisted in court that it was a tourist video. In his ruling, Daniels noted that the two sides had different interpretations of almost every piece of evidence. But he endorsed the plaintiffs’ views of several key exhibits, including a diagram of an airplane found in one of Bayoumi’s notebooks. Citing aviation experts, the plaintiffs’ lawyers said the drawing and the calculations beside it showed how a plane might hit an object on the ground. The Saudis’ lawyers suggested that Bayoumi had drawn it while helping his son

by Lauren McGaughy, The Texas Newsroom, and Yilun Cheng, Houston Chronicle ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. This article is co-published with The Texas Newsroom, the Houston Chronicle and The Texas Tribune as part of an initiative to report on how power is wielded in Texas. The devastating flooding in Houston caused by Hurricane Harvey in 2017 killed dozens of people, inundated hundreds of thousands of homes and left the community desperate for a solution. Since then, local flood experts have extensively studied the possibility of a multibillion-dollar tunnel system across Harris County, where Houston is located. Studies have focused on the construction of pipelines, 30 to 40 feet in diameter, that could ferry massive amounts of water out to the Gulf in the event of a storm. Now, after years of research and discussion, Elon Musk wants a piece of the project. An investigation by The Texas Newsroom and the Houston Chronicle has found that the billionaire, in partnership with Houston-area Rep. Wesley Hunt, has spent months aggressively pushing state and local officials to hire Musk’s Boring Co. to build two narrower, 12-foot tunnels around one major watershed. That could be a potentially cheaper, but, at least one expert said, less effective solution to the region’s historic flooding woes. Hunt’s team has said the Boring project would cost $760 million and involve the company getting 15% of the cost up front from state and local coffers. Within two months of this push, the Harris County Commissioners Court unanimously voted to study a pilot program that included a look at smaller tunnels, with specifications similar to what Boring had pitched. The commissioners court, made up of five elected members including a county judge, oversees the county’s budget. Both Musk and Hunt stand to benefit should Boring be selected to build any part of the project. Hunt is reportedly considering a challenge to U.S. Sen. John Cornyn in next year’s Republican Senate primary. And landing a job like this would also be a significant win for Boring, which has not completed a major public project in Texas and faces criticisms for its ventures elsewhere. The discussions about the Boring pitch have happened mostly out of the public eye. Hunt mentioned the project in passing at a town hall in Houston in February. Since then, he has refused to answer the newsrooms’ questions about when Musk sold him on the idea and why he became its pitchman. Efforts to reach Musk and representatives with Boring were unsuccessful. Experts and some local officials question whether Musk and his company are the right pick for the job. The Boring Co. has focused on transportation tunnels, not flood mitigation. “If you build a smaller tunnel, OK, it’ll be cheaper, but it can carry less water,” said Larry Dunbar, a veteran water resources engineer who has advised Houston-area governmental agencies on drainage issues. “So what have you saved? Have you reduced the flooding upstream by an inch? And are you going to spend multimillions of dollars to do that? Well, maybe that’s not worth it.” In response to the newsrooms’ questions, state and local officials said no public money has been allocated to Boring. County officials added that they have not chosen a tunnel contractor and any process to do so would follow normal procurement rules. Lt. Gov. Dan Patrick, whose staff met with Hunt’s team during the legislative session to discuss the proposal, remains open to the idea. As president of the Texas Senate with close ties to President Donald Trump, he is a powerful ally. “If Elon Musk and the Boring Company, or any other company, can build two massive tunnels under the Houston bayous in a few years to save the city from flooding, I am always going to be interested to listen,” Patrick, a Republican, told the newsrooms. “The truth is, Elon Musk is one of the only people in the world who could accomplish this.” Then-candidate Wesley Hunt, now a Republican representative, speaks with volunteers before they campaign on his behalf in 2020. (Mark Mulligan/Houston Chronicle) The Pitch Process Begins In 2022, the Harris County Flood Control District released findings from its yearslong tunnel study, which has so far cost nearly $3 million in local and federal funds. The idea was to build eight tunnels, totalling around 130 miles in length, according to the report. The tunnels would be huge, wide enough for a container ship, and buried 40 to 140 feet underground, depending on the location. Austin and San Antonio have similar systems, although on a smaller scale. The Buffalo Bayou segment of the Houston project — which Boring has proposed to build — is a centerpiece of the design and would run through the city’s core and some of its most developed neighborhoods. The county estimated it would cost $4.6 billion. The total cost for the system was projected to be $30 billion, funded by a potential mix of federal, state and local dollars, and the timeline was 10 to 15 years to complete construction. Given the scope and complexity of the project, the Army Corps of Engineers has been involved in discussions about the tunnels since the beginning. The corps also has jurisdiction over the two federal reservoirs in the area. Eight years after Harvey, however, the tunnel project has not broken ground. Hunt has accused the Army Corps of “​​dragging their feet a little bit” because its study of the tunnel system has been delayed. In December, Congress ordered the Corps to finish the analysis. Hunt hailed the decision, but to date the Army Corps has not completed the study. Just two months later, however, his staffers and Musk’s team started shopping Boring’s proposal to politicians across the state. Emails, text messages and policy memos the newsrooms obtained through public records requests show Hunt’s chief of staff, James Kyrkanides, repeatedly attempted to obtain public money on behalf of Boring. The

by Kyle Hopkins, Anchorage Daily News This article was produced for ProPublica’s Local Reporting Network in partnership with the Anchorage Daily News. Sign up for Dispatches to get our stories in your inbox every week. Leaders in Alaska and elsewhere have repeatedly promised action in recent years to address the nation’s chronic failure to solve the murder or disappearance of Indigenous people. Federal legislation backed by Alaska Sen. Lisa Murkowski called for improving data collection and information sharing among law enforcement and tribes. Gov. Mike Dunleavy said again and again and as recently as May 5 that the state government would work with Alaska Natives to address the crisis. “My administration will continue to support law enforcement, victim advocacy groups, Alaska Native Tribes and other entities working together to solve these cases and bring closure to victims’ families,” Dunleavy said in a news release last year. Yet when an Alaska Native group asked state law enforcement officials in June for one of the most fundamental pieces of data needed to understand the issue — a list of murders investigated by state police — the state said no. Charlene Aqpik Apok launched Data for Indigenous Justice in 2020 after trying to collect the names of missing and murdered Indigenous people to read at a rally, only to discover no government agency had been keeping track. Over time, the nonprofit built its own homegrown database with the help of villagers, friends and family across the state. In 2023, the state started publishing a list quarterly with names of Indigenous people reported missing. But the state still does not issue a list for the other key piece of the group’s efforts: Indigenous people who have been killed. So on June 4, the nonprofit filed two public records requests with the Alaska Department of Public Safety concerning homicide cases the agency had investigated since 2022. The group asked first for victims of all races and then for those identified as Alaska Native. Apok said she didn’t think the request was controversial or complicated. But the state rejected the requests a week later. The agency said fulfilling the request would take “several hours” and cited a state regulation allowing a denial if providing information to a requester would require employees to “compile or summarize” existing public records. “We do not keep lists of victims of any type of crime, including homicide victims, and to fulfil this request DPS would have to manually review incident reports from multiple years to create a record that matched what you are looking for,” Austin McDaniel, communications director for the department, wrote to the nonprofit. McDaniel offered no direct response when the Anchorage Daily News and ProPublica asked why the agency could not retrieve homicide records with a simple database query or why, even if the work required manual review and wasn’t required under state law, the agency didn’t simply create a list of homicide victims. (Alaska’s public records law says any records that take state employees fewer than five hours to produce shall be provided for free, and the state can choose to waive research fees if providing records would serve the public interest. Even if an agency needs to create a new record, as McDaniel asserted in his denial, it’s allowed to “if the public agency can do so without impairing its functioning.”) Data for Indigenous Justice appealed the denial to the head of the department, Public Safety Commissioner James Cockrell, who decided in favor of the agency. The nonprofit’s records request and the state’s denial revealed that Alaska, four years after creating a council on murdered and missing Indigenous people, cannot readily identify murder cases involving Indigenous victims. The state now employs four investigators who focus on such cases. “How do they know which cases are Alaska Native or Indigenous people for their MMIP investigators if they cannot do a simple pull of the demographics that we are talking about?” Apok said. Apok said tracking complete and accurate data on Indigenous people who have disappeared or been killed matters because otherwise, law enforcement can shrug off individual cases and deny the scale of the problem. “That’s the power of data. That’s the power of collective information,” she said. Grace Norton holds a photo of her niece, Ashley Johnson-Barr, who was murdered in Kotzebue, Alaska, in 2018. Kotzebue residents walked along Shore Avenue and scattered rose petals in remembrance of missing and murdered Indigenous people in 2023. (Marc Lester/ADN) In lieu of answering detailed questions for this story, McDaniel provided a one-page response saying that the department receives thousands of records requests each year. He said the agency is a “leader in data transparency” for missing and murdered Indigenous people, adding that “to imply that we are not invested in this work due to the denial of one records request from an advocacy group is absurd.” He cited as examples of transparency the department’s publication of information about missing Indigenous people and its provision of law enforcement data to tribal governments in support of their requests for federal grants. Anchorage, which runs the state’s largest municipal police department, recently reversed a policy that withheld the identities of certain homicide victims. The police chief released the records after Daily News reporting revealed the policy had no basis in law and was opposed by some victims’ rights advocates. State troopers, meanwhile, handle about 38% of all murders in Alaska, according to statistics that law enforcement reports each year. From 2019 to 2023, the most recent data available, troopers investigated an average of 22 murders each year. That means the agency would likely need to review just a few dozen reports to provide the requested names. Watershed reports published in Canada in 2017 and by the Seattle-based Urban Indian Health Institute in 2018 revealed the scope of the crisis of missing and murdered people from Indigenous communities. Those reports, Apok said, “named exactly what a lot of us were seeing and feeling, where we didn’t know our experiences were part

Photography and text by Adriana Loureiro Fernández for ProPublica Leer en español. ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. Mireya Sandia was lying on the bed with her eyes wide open. Her skin was pale, her white hair nearly gone. She had been diagnosed with breast cancer years earlier, and more recently it had spread to her brain and affected her speech. When we first met, in May, she waved me closer, grabbed my hand with a surprisingly strong grip and said, as best she could: “I want to see my son again.” Then she began to cry. With a knot in my throat, I held her hand, fearing that there would not be enough time for her to see her only son, Wilmer Vega Sandia. Her health was what led her son to migrate to the United States. His detention and later deportation to a maximum-security prison in El Salvador, known as CECOT, had, in turn, led me to her bedroom in a small village in the Andes. Over the past four months, as part of a ProPublica-led investigation in collaboration with The Texas Tribune, Alianza Rebelde Investiga (Rebel Alliance Investigates) and Cazadores de Fake News (Fake News Hunters), I have documented in photographs the lives of five families whose sons had been imprisoned in El Salvador, as well as their return to Venezuela, where I am from. I had visited with mothers like Mireya Sandia and other relatives to see how the absence of their loved ones had affected them. I walked beside them when they protested on the streets of Caracas, Venezuela’s capital. I saw them as their hopes grew when there was word that the negotiations for the men’s return were ongoing, and I saw them again when those hopes were deflated after the first negotiations failed. I documented the homecomings, when the men were abruptly flown back. Lina Ramos Hidalgo sits in the bedroom that used to belong to her son Juan José Ramos Ramos while he was detained in CECOT. First image: Mireya Sandia cries after eating lunch at her home while her son, Wilmer, was held in CECOT. Sandia has breast cancer, which has spread to her brain. Second image: Doris Sandia, Wilmer’s aunt, in her home. Crisálida Bastidas plays with her grandson Jared at her home in El Tocuyo, Venezuela, while her son José Manuel Ramos Bastidas was detained in CECOT. Lina Ramos lived in a humble neighborhood on the outskirts of Caracas and attended several marches that I photographed. I knew how tight money was for the family and the incredible effort it took for her to advocate for her son, Juan José Ramos Ramos. Lina told me that she had to crowdfund and get donations from her church, family and neighbors to afford a $2 round-trip bus ticket to the capital. The anguish of his imprisonment, she told me, didn’t let her sit still. Crisálida Bastidas’ home was also modest. Imagine a tiny kitchen in the left corner and, on the opposite wall, two big beds beside one another for several people to sleep on. Her son José Manuel Ramos Bastidas had been in CECOT for more than three months by the time we met, and I could see her hope vanishing as his imprisonment stretched on. Her sadness was visible, and she looked exhausted. She told me that she couldn’t sleep unless her 1-year-old grandson Jared was with her, the two of them nestled together, with a picture of José Manuel as a child hanging above the bed. The two were identical as children, and she clung to her grandson to feel near to her own son. As more time passed, they sometimes slipped into speaking about their sons in the past tense. Then they’d quickly correct themselves and say, “He’s alive.” I remember one mother on her knees, crying and asking, “Please make this stop.” Carmen Bonilla waits for her son to arrive near their house in Valencia, Venezuela. Zoe Martínez plays with balloons used to decorate the house to celebrate the return of her uncle Juan Ramos. Lina Ramos, center, hugs family members during a march in Caracas to celebrate the release of her son and other Venezuelan men held in CECOT. One morning, I got a call telling me that the men were coming home. It was one of the many mothers I had met in the past few months. I was wary, because this was not the first time I had gotten a call like that, and I always worried what disappointment would do to them. Doris Sandia, Wilmer’s aunt, called me and asked several times if I was sure the men were coming home. She was wary of getting her heart broken again. But this time it was true. By the time I got out of the house, families that could afford to come to Caracas were already marching downtown. This time they were celebrating. I ran into Lina Ramos and almost didn’t recognize her. She had a wide smile that I had never seen before. She hugged me tight, relieved to see a familiar face behind dozens of cameras. I walked next to her for miles. The next day I was at Lina’s house at sunrise, waiting to finally photograph her son. Lina had gotten $20 in donations from family members and neighbors, and she used that money to decorate her house. She made stewed chicken with rice and plantains, her son’s favorite. Lina didn’t want to take any phone calls, to keep the line clear in case Juan called. She wouldn’t leave the house because rumors had gone around that if nobody was home, the police officers escorting the men wouldn’t drop them off. Lina was forced to stand still for the first time in four months. Lina’s granddaughters grabbed me by the hand and took me to help them pick flowers to welcome their uncle.

by Cassandra Jaramillo ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. Seven years ago, when President Donald Trump signed the Preventing Maternal Deaths Act into law, it was hailed as a crucial step toward addressing the nation’s maternal mortality crisis. The law pumped tens of millions of dollars a year into a program to help fund state committees that review maternal deaths and identify their causes. The committees’ findings have led to new protocols to prevent hemorrhage, sepsis and suicide. Federal money has allowed some states to establish panels for the first time. The committees’ work only became more urgent after the Supreme Court overturned the constitutional right to abortion. Last year, Georgia’s committee determined the state’s abortion ban contributed to the preventable death of 41-year-old Candi Miller. But now the program that enabled this progress — known as Enhancing Reviews and Surveillance to Eliminate Maternal Mortality, or ERASE MM — is in danger, maternal health advocates say. The program’s funding expires on Sept. 30, and efforts to renew it have thus far not succeeded. Congress included money to extend ERASE MM in a broader stopgap funding measure that almost passed in December 2024 before being scuttled by Republican opposition. The program isn’t paid for in the Trump administration’s budget proposal for 2026. Late last week, the Senate Appropriations Committee introduced a bill to fund the Department of Health and Human Services for the next fiscal year that includes money for ERASE MM, but the measure hasn’t moved forward yet. Adrienne Griffen, executive director of the Maternal Mental Health Leadership Alliance, said she fears how little attention the program’s fraught future has drawn amid waves of layoffs at federal health agencies and ferocious debate over impending Medicaid cuts. “We were concerned when the president’s budget did not include these programs,” Griffen said. “While we are happy with the progress, there is still a lot that needs to happen.” The Centers for Disease Control and Prevention, which is responsible for awarding ERASE MM grants and guiding the work of state maternal mortality committees, didn’t answer specific questions from ProPublica about the future of the program. Andrew Nixon, communications director for HHS, the CDC’s parent agency, said in a statement that HHS “is committed to improving maternal and infant health outcomes.” “We are currently reviewing the maternal and infant health portfolio to identify the most effective ways to collect and analyze data and improve the health and safety of mothers and infants,” the statement said. HHS Secretary Robert F. Kennedy Jr. didn’t respond to requests for comment on whether advocates’ concerns are warranted. The Trump administration’s budget proposal jettisons not only ERASE MM but a slate of programs known as the Safe Motherhood initiative, which aims to reduce risks such as premature births and infections that affect mothers and infants. All previously had bipartisan support. That’s left some members of Congress mystified about why their funding is in jeopardy. At a June budget hearing, Rep. Greg Landsman, D-Ohio, pressed Kennedy on why the administration had proposed eliminating the programs, including ERASE MM. “I genuinely believed this was zeroed out either accidentally or by some sort of oversight,” Landsman said, asking Kennedy to work with members of the House Committee on Energy and Commerce to restore funding. After their exchange at the hearing, Landsman told ProPublica that Kennedy had agreed to meet to discuss restoring the funding. “We want to save this investment,” he said. “It’s critical for expecting moms.” ERASE MM came about in 2019 after reporting by ProPublica and others showed that hundreds of American women were dying each year from preventable causes related to pregnancy. U.S. maternal mortality rates had risen sharply over two decades as rates in other affluent nations had dropped. Other countries, particularly the United Kingdom, had reliable national data on maternal mortality, as well as robust case-review systems designed to turn information into improvements in care. In the U.S., by contrast, only two-thirds of states had review processes at all and even those sometimes went years between reports or operated inconsistently. ERASE MM was designed to plug these holes, ensuring that lessons from maternal deaths didn’t go unlearned. Over the last five years, the CDC has distributed nearly $90 million to fund the work of state review committees. At least by federal standards, the program is relatively inexpensive; it divvied up a total of about $40 million last year between 46 states, an average of $870,000 apiece. The members of maternal mortality review committees — usually a mix of physicians, nurses, mental health professionals and advocates — volunteer their time. ERASE MM grants typically pay to hire the staffers who gather records from hospitals, medical examiners, police and other agencies and abstractors who redact private information from case summaries. Committees are advisory in nature, but their findings have made a difference, advocates say. In recent years, many states have developed mental health initiatives for pregnant people and new mothers based on maternal mortality reviews. Recommendations by New Hampshire’s committee, for example, led to a program in which OB-GYNs collaborate with psychiatrists on treatments for post-partum depression or substance use disorder. In Indiana, which used ERASE MM funds to establish a maternal mortality review committee in 2018, the panel’s work spurred state officials to expand an initiative to have nurses make post-partum home visits to new mothers. Indiana is one of at least five states that rely entirely on federal dollars to pay for their maternal mortality reviews (the others are South Carolina, Iowa, Missouri and Utah). Committee members in several states expressed alarm that this money may evaporate. Before ERASE MM, Utah had a joint committee that reviewed both infant and maternal deaths, said Dr. Marcela Smid, a maternal-fetal health specialist. Utah set up a maternal mortality review committee for the first time in 2019 using funds from ERASE MM, which Smid chairs. It found increasing numbers of maternal deaths by

by David Armstrong, Eric Umansky and Vernal Coleman ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. Veterans hospitals are struggling to replace hundreds of doctors and nurses who have left the health care system this year as the Trump administration pursues its pledge to simultaneously slash Department of Veterans Affairs staff and improve care. Many job applicants are turning down offers, worried that the positions are not stable and uneasy with the overall direction of the agency, according to internal documents examined by ProPublica. The records show nearly 4 in 10 of the roughly 2,000 doctors offered jobs from January through March of this year turned them down. That is quadruple the rate of doctors rejecting offers during the same time period last year. The VA in March said it intended to cut its workforce by at least 70,000 people. The news sparked alarm that the cuts would hurt patient care, prompting public reassurances from VA Secretary Doug Collins that front-line health care staff would be immune from the proposed layoffs. Last month, department officials updated their plans and said they would reduce the workforce by 30,000 by the end of the fiscal year, which is Sept. 30. So many staffers had left voluntarily, the agency said in a press release, that mass layoffs would not be necessary. “VA is headed in the right direction,” Collins said in a statement. But a review of hundreds of internal staffing records, along with interviews with veterans and employees, reveal a far less rosy picture of how staffing is affecting veterans’ care. After six years of adding medical staff, the VA this year is down more than 600 doctors and about 1,900 nurses. The number of doctors on staff has declined each month since President Donald Trump took office. The agency also lost twice as many nurses as it hired between January and June, records viewed by ProPublica show. In response to questions, a VA spokesperson did not dispute numbers about staff losses at centers across the country but accused ProPublica of bias and of “cherry-picking issues that are mostly routine.” Agency spokesperson Peter Kasperowicz said that the department is “working to address” the number of doctors declining job offers by speeding up the hiring process and that the agency “has several strategies to navigate shortages,” including referring veterans to private providers and telehealth appointments. A nationwide shortage of health care workers has made hiring and retention difficult, he said. Kasperowicz said that the recent changes at the agency have not compromised care and that wait times are getting better after worsening under President Joe Biden. While wait times for primary, mental health and specialty care for existing patients did increase during Biden’s presidency, the VA’s statistics show only slight reductions since Trump took office in January. However, appointment wait times for new patients seeking primary and specialty care have slightly increased, according to a report obtained by ProPublica. As of early July, the average wait time nationally to schedule outpatient surgery appointments for new patients was 41 days, which is 13 days higher than the goal set by the VA and nearly two days longer than a year ago. In some locations, the waits for appointments are even longer. At the Togus VA Medical Center in Augusta, Maine, internal records show that there is a two-month wait for primary care appointments, which is triple the VA’s goal and 38 days longer than it was at this time last year. The wife of a disabled Marine veteran who receives care at the facility told ProPublica that it has become harder in recent months to schedule appointments and to get timely care. Her husband, she said, served in Somalia and is completely disabled. He has not had a primary care doctor assigned to him for months after his previous doctor left over the winter, she said. “He has no person who is in charge of his health care,” said the woman, who did not want to be named because of fears her comments might affect benefits for her husband. “It was never like this before. There’s a lack of staff, empty rooms, locked doors. It feels like something that’s not healthy.” Kasperowicz said the VA is taking “aggressive action” to recruit primary care doctors in Maine and anticipates hiring two new doctors by the end of the year. Nationwide, records reviewed by ProPublica show, the vacancy rate for doctors at the VA was 13.7% in May, up from 12% in May of 2024. Kasperowicz said those rates are in line with historical averages for the agency. But while the vacancy rate decreased over the first five months of 2024, it has risen in 2025. Sen. Richard Blumenthal, D-Conn., who has been critical of Collins’ stewardship, has argued that the VA is heading in a dangerous new direction. He said that ProPublica’s findings reinforce his concerns about “damaging and dangerous impacts” from cuts and staffing reductions. “Dedicated professionals are fleeing — and recruitment is flagging — because of toxic work conditions and draconian funding cuts and firings,” he told ProPublica. “We’ve warned repeatedly about these results — shocking, but not surprising.” In the VA’s Texas region, which covers most of the state, officials reported in an internal presentation in June that approximately 90 people had turned down job offers “due to the uncertainty of reorganization” and noted that low morale was causing existing employees to not recommend working at the medical centers. Anthony Martinez, a retired Army captain who did tours of duty in Iraq and Afghanistan, said he has witnessed a downgrade in care at the Temple, Texas, VA facility. He said that the hospital has lost records of his recent allergy shots, which he now has to repeat, and he has to wait longer for appointments. “Problems have always existed but not to this degree,” Martinez said. Martinez, who runs a local nonprofit for veterans, said he’s heard

by Jacob Orledge, North Dakota Monitor, photography by Sarahbeth Maney, ProPublica This article was produced for ProPublica’s Local Reporting Network in partnership with the North Dakota Monitor. Sign up for Dispatches to get our stories in your inbox every week. One morning in February 2023, a small group of mineral owners arrived at the North Dakota Capitol on a mission. They had traveled from across the state and other parts of the country to explain to lawmakers how the powerful oil and gas companies had been chipping away at their income. It’s not easy to recruit people to testify during the winter months of the legislative session. Ranchers are busy with the calving season. Snowbirds have relocated to warmer climates. It’s a more than three-hour drive for those living in the Bakken oil field. But those who made it to Bismarck lined up at a podium to share details of their own experiences and the broader concerns affecting the estimated 300,000 people who receive money from the industry in exchange for the right to their underground minerals. For nearly a decade, they had grappled with companies withholding significant portions of their royalty payments without explaining how they determined how much to deduct, as the North Dakota Monitor and ProPublica reported last week. Now they were at the Capitol for a specific reason: They wanted legislators to require companies to provide more information so owners could discern if they were being paid correctly, and to impose penalties if companies failed to comply. Shane Leverenz, who manages income his extended family receives from numerous oil wells, read aloud email responses from companies to illustrate the lack of cooperation mineral owners face when they request information. “We are not obligated to mail each owner a calculation as to how their interest was calculated,” one company wrote. “There is no transparency,” Leverenz told the legislators. Leverenz, whose great-grandfather homesteaded in North Dakota and had his property deed signed by President Theodore Roosevelt, has helped organize royalty owners on this issue in recent years. Leverenz grew up in Epping, a town of fewer than 100 people in the northwest part of the state, and traveled to North Dakota from Texas, where he now lives, to testify. Shane Leverenz testifies at a bill hearing in the North Dakota Capitol in 2023. (Jeremy Turley/Forum News Service) After input from Leverenz and others, lawmakers decided to create a new state program that they hoped would address conflicts between royalty owners and companies. In particular, mineral owners had mounting concerns over postproduction deductions, the money companies withhold to cover the costs of processing and transporting minerals after they are extracted and before they are sold. Companies say they are allowed to pass on a share of those costs, while royalty owners say they shouldn’t bear that responsibility because in most cases lease agreements don’t mention those expenses. The state’s “postproduction royalty oversight program” had the support of the industry, but it was far less than what Leverenz and other owners wanted. In the two years since its creation, the program has not lived up to its name and has not alleviated owners’ concerns over deductions or transparency, an investigation by the North Dakota Monitor and ProPublica found. The program has resolved 69 cases so far, and none have involved postproduction deductions, according to documents obtained under a public records request. A case can represent a complaint or question from a royalty owner. “The legislative intent was supposed to be addressing the issue of the postproduction costs that they were hitting people with,” said Rep. Don Longmuir, a Republican from Stanley, in the northwest corner of the state. The newsrooms’ investigation found that the program has focused on other issues. It has instead helped owners resolve complaints about companies withholding payments entirely and failing to pay interest on late royalty payments, records show. Some mineral owners said in interviews that they do not trust state officials to help them get information about the deductions and therefore have not tried to use the program. Leverenz said the program, also referred to as the ombudsman program, has not accomplished what he and other royalty owners were told it would. He has taken six complaints to the ombudsman; three were resolved but three remain open, including two for more than a year. The unresolved complaints do not involve deductions, he said, and focus on other issues with his family’s royalty payments. “The ombudsman is running into the same thing that I have, where there’s just no response from the oil companies or they stalled,” Leverenz said. “There’s been no forward momentum.” Ron Webb, who coordinates the program within the state’s Department of Agriculture, said it has helped facilitate communication between mineral owners and companies. He said the program is voluntary and does not have authority to compel companies to change how they calculate payments or even to provide information. “Oil companies are not required to work with us,” Webb said. The program no longer promotes itself as being able to oversee concerns about royalty deductions even though that was part of the legislative intent. On the department’s website and in a brochure, the word “postproduction” has been dropped from the program’s name even though it is in the title of the law that created it. The department’s legal counsel, Dutch Bialke, said the name of the law is irrelevant to how the program operates. “The title is entirely legally non-binding and has no legal effect,” he wrote in an email, citing North Dakota law. A bill introduced in 2023 established what it called the postproduction royalty oversight program. The program has since dropped the word “postproduction” from its name. (Obtained by North Dakota Monitor and ProPublica. Highlighted by ProPublica.) “Nothing Is Clear” Ever since Neil Christensen and his sisters noticed in 2016 that Hess Corp. was withholding nearly 25% of their royalty income — up from less than 1% just two years earlier — his family has tried to get answers from

by Megan Rose and Debbie Cenziper ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. The dispatches from one of India’s most troubled generic drug makers were contrite, filled with far-reaching promises to clean up its factory, stop contamination and send safe medication to Americans counting on the company’s drugs. “We have started addressing FDA concerns very aggressively and comprehensively,” an executive from Sun Pharma wrote to the U.S. Food and Drug Administration in 2015. “Sun is ensuring the presence of a strong, independent quality unit,” the company repeatedly pledged. An FDA inspection in 2014 had turned up dangerous violations at Sun’s factory in the Indian city of Halol, and the details were grim: Managers weren’t following basic rules to prevent the contamination of injectable drugs. They had failed to determine whether “unknown impurities” found in medication were toxic. The factory itself was in disrepair. The ceiling leaked and investigators observed dripping water, another dangerous contamination risk, collecting in buckets in a sterile manufacturing area. Sun vowed bold reform at the factory, its flagship for the U.S. market. In a series of letters to the FDA after the inspection, executives described a long list of “enhancements” in facilities, in staffing, in quality standards, in training. But for eight years, as inspectors returned and discovered again and again that Sun’s efforts were grossly inadequate, the FDA did little to warn the public or stop the drugs from coming to the United States. The trove of Sun correspondence obtained by ProPublica provides a rare glimpse into private discussions between the global drugmaker and the U.S. regulator singularly responsible for protecting consumers from unsafe medication. The documents show how often the FDA tolerated Sun’s broken promises and substandard manufacturing, allowing an uninterrupted flow of generics to an American public clamoring for cheaper medication. As Sun’s fixes fell short, the agency in 2015 even declared the factory’s products “adulterated” which, according to federal law, means they were produced in a way that could have compromised their strength, quality and purity. A 2015 warning letter from the Food and Drug Administration to Sun Pharma stated that the agency “identified significant violations of current good manufacturing practice” and that “these violations cause your drugs products to be adulterated.” (Obtained and highlighted by ProPublica) Not until the final weeks of 2022 would the agency bar the factory from shipping its drugs to the U.S. Even then, regulators immediately excluded more than a dozen medications from the ban. The exemptions allowed Sun to continue sending those drugs — with few restrictions and no regular testing by the FDA. In June, 11 years after that first alarming inspection, the agency went back to the factory and chronicled practically identical deficiencies. Equipment was still dirty. Injectable medications still had impurities. One worker wasn’t wearing clean gloves. The failings convinced the FDA to keep the import ban in place, but the agency continued to allow Sun to send exempted drugs to the United States. “Would you trust somebody who repeatedly lies to you?” said Dinesh Thakur, an industry whistleblower and drug-safety advocate. “I don’t know how you can justify your decision to try to give them a pass every time. … You are basically putting people at risk.” More than 20 foreign factories banned from the U.S. market have received similar exemptions from the FDA since 2013 through a little-known practice used by the agency to prevent drug shortages. ProPublica reported in June that antibiotics, anti-seizure drugs and chemotherapy treatments were shipped from those plants even after inspectors identified critical violations in the way drugs were made. In all, more than 150 drugs or their ingredients received exemptions. And, just like with Sun, the FDA never shared the details with the doctors prescribing the medications or the patients taking them. (ProPublica compiled a list of exempted drugs and ingredients since 2013.) The agency did not respond to questions about the Sun factory, the decision to wait eight years to impose the ban or the exemptions that followed, saying only it could not discuss potential or ongoing compliance matters. The FDA referred further inquiries to Sun. The FDA also did not answer directly whether it believed that drugs exempted from Sun’s Halol plant and the other factories were safe. To “help assure consumer safety,” the agency said, companies are required to subject exempted drugs to extra testing with third-party oversight before the medications are sent to the United States. ProPublica’s review of the FDA’s own records, however, shows the potential weakness of such a system. Some of the companies were caught providing unreliable testing records to the FDA before they received exemptions. FDA inspectors have found managers at Sun’s Halol factory repeatedly disregarded the results of tests showing drugs were tainted with impurities. In 2019, inspectors also discovered that Sun employees could access computer systems without oversight and edit microbiological test results to potentially minimize troubling findings. “All of the inspectors I know who do inspections in India were aware of the problems” at Sun, said one veteran FDA investigator who did not want to be identified because they were not authorized to speak publicly. “You just worry about the patients.” A 2022 FDA inspection report on the Sun factory observed “increased unknown impurities” identified as “extraneous matter” in batches of medication. (Obtained and highlighted by ProPublica) Since the 2014 inspection, FDA records show, the agency has received thousands of reports from doctors and others noting concerns about the drugs that Sun makes at the Halol factory and at other plants. The complaints described potential contamination and other quality issues, or patients who had experienced sudden or unexplained health problems. The FDA cautions that the outcomes in the reports may have no connection to the drugs or could be unexpected side effects. Drug safety experts say there is no way to know for sure without further study. Sun did not respond to detailed questions about its regulatory history.

by Debbie Cenziper and Megan Rose, ProPublica, and Katherine Dailey, Medill Investigative Lab ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. For more than a dozen years, the Food and Drug Administration quietly allowed substandard foreign factories to continue shipping medications to the United States even after the agency officially banned them from doing so because of dangerous manufacturing failures. ProPublica exposed the little-known practice in June. The FDA said the decisions to exempt certain medications from import bans were made to fend off drug shortages and that guardrails were in place to ensure the products were safe, such as requiring the banned factories to do extra testing on the drugs before they were sent to Americans. But the agency itself didn’t regularly test the drugs or proactively monitor reports filed by doctors and others that described drugs with a foul odor, abnormal taste or residue, or consumers who had experienced sudden or unexplained health problems. The FDA cautions the outcomes described in the complaints may have no connection to the drugs or could be unexpected side effects. But drug safety experts say that without further study, it’s impossible to know whether people were harmed or how many. The FDA kept the exemptions largely hidden from the public and has never released a comprehensive list of the drugs allowed into the United States from banned factories. ProPublica is publishing that list today. The list provides the names of the drugs or ingredients that ProPublica has identified as having been exempted from an import ban since 2013 and the names of the manufacturers that made them. The product names are written as they appeared on the FDA’s import alert list. Most of the factories on this list are no longer banned, so their drugs are coming into the country through normal channels. The FDA lifts bans after facilities make all the necessary fixes. Some of the factories are still banned — and are still allowed to send exempted drugs to the U.S. Those are highlighted in yellow. Exempted Drugs Since 2013 See the full list and search for a drug here. All told, ProPublica identified more than 150 exempted products, mostly from factories in India. One factory in China and one factory in Hungary also received exemptions. Several of the factories make ingredients for drugs, which are then sent to the manufacturers that produce pills, capsules, tablets or injectables. To compile the list of exempted drugs and ingredients, reporters pulled historical records from the internet and used Redica Systems, a quality and regulatory intelligence company with a vast collection of agency documents. In finalizing its analysis, ProPublica counted all the drugs and ingredients that were exempted from each banned factory. Sometimes, the same product was exempted from multiple factories and was added to each factory’s total. In a handful of cases, the FDA exempted several formulations — such as a tablet, capsule or injectable — of the same drug. ProPublica counted those different forms as distinct drugs. For this list, ProPublica only included each drug once for each manufacturer. Generic drugs can have many manufacturers, and it can be difficult to know based on information provided on medicine bottles where drugs were made or by whom. Sometimes bottles list the names of repackagers or distributors rather than the drugmaker itself. Pharmacists and possibly health care providers can provide additional information about the source of prescribed medications. This list is current as of Aug. 4. The FDA can add or remove exempted drugs at any time. Company Responses ProPublica reached out to all the drugmakers listed here. Most did not respond. Apotex did not respond to requests for comment. After the inspections that led to the import bans, the company told the FDA that it would launch corrective actions and bring on a third-party consultant, among other things. The factories are no longer banned. Divi’s Laboratories did not respond to requests for comment. In its response to the FDA at the time, the company said it hired third-party consultants and other experts to resolve the FDA’s concerns. The company also said it had taken corrective actions at the facility. The factory is no longer banned. Emcure Pharmaceuticals did not respond to requests for comment. In its response to the FDA at the time, the company said it would revise procedures, provide training and engage consultants, among other things. The factory is still banned but no longer has exemptions. Glenmark Pharmaceuticals did not respond to requests for comment. At the time of the ban, the company said it would engage with the FDA to resolve the concerns. The factory is still banned but is no longer receiving any exemptions. GPT Pharmaceuticals did not respond to requests for comment. In its response to the FDA, the company defended the quality of its products and said it had brought on a consultant to audit the operation. The factory is no longer banned. In a statement to ProPublica, Pfizer, which owns Hospira, said it submitted a comprehensive response to the FDA, paused production at the site and then sold the facility to another company in 2019. “We are committed to operating our manufacturing sites at the highest quality standards,” Pfizer said. The factory is no longer banned. Intas Pharmaceuticals, whose U.S. subsidiary is Accord Healthcare, said in a statement that the company has invested millions of dollars in upgrades and new hires and launched a companywide program focused on quality. Exempted drugs were sent to the United States in a “phased manner,” the company said, with third-party oversight and safety testing. Intas also said that some exempted drugs were never shipped to the United States because the FDA found other suppliers. The company would not provide details. “Intas is well on its way towards full remediation of all manufacturing sites,” the company said. The two Intas factories are still banned and still receiving exemptions. Ipca Laboratories did not respond to requests for

by Heather Vogell ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. What Happened: Greystar, the nation’s largest landlord, has agreed to stop using algorithmic rent-setting software that federal prosecutors say could violate laws against price-fixing. The agreement is part of a proposed settlement with the Justice Department to resolve claims by federal authorities that the company had colluded with other landlords to raise rents in cities across the country. The deal was announced by the DOJ on Friday but still must be approved by a judge. If it is, it will bar Greystar, which is based in South Carolina and manages nearly 950,000 apartments nationwide, from using any “anti-competitive” algorithm that relies on rivals’ sensitive data to suggest rents, the department said in a statement. Greystar was using rent-setting algorithms from RealPage, a Texas-based software-maker who was the subject of a ProPublica investigation in 2022 that showed the firm was helping landlords decide prices in a way that legal experts said could result in cartel-like behavior. The DOJ has also sued RealPage. What They Said: The settlement drew praise from both Republicans and Democrats. The lawsuit began under the Biden administration, but Trump-appointed Attorney General Pam Bondi touted the agreement with Greystar last week, saying “nowhere is competition more important than in making housing affordable again.” Assistant Attorney General Abigail Slater, head of DOJ’s Antitrust Division, said that “whether in a smoke-filled room or through an algorithm, competitors cannot share competitively sensitive information or align prices to the detriment of American consumers.” The settlement was praised by Sen. Amy Klobuchar, a Minnesota Democrat who urged the DOJ to investigate anticompetitive practices in the apartment market after ProPublica’s story in 2022. “This settlement is good news for renters across the country,” Klobuchar said in a statement. “It’s critical the Justice Department continues to prosecute the case against RealPage and other major landlords to provide relief for all renters.” Response: Greystar did not admit wrongdoing as part of the settlement and said in a statement that it “firmly believes that its use of RealPage’s revenue management software complies with all applicable laws.” The company said it will continue to defend itself against claims brought by regulators and cited what it called “unclear regulatory guidance around the use of revenue management tools.” “We entered into these settlements to make clear the government’s interpretation of the law and to ensure we continue to do things the right way,” Greystar said. Greystar also announced it had reached “an agreement in principle” to settle litigation brought by a nationwide group of renters making similar allegations. A Greystar spokesperson declined to comment further. RealPage declined to comment. In January, a RealPage executive called the federal case “flawed” and said the company was committed to “vigorously defending ourselves.” RealPage had already changed its software to remove nonpublic data, she said, despite its view that its technology was legal and “pro-competitive,” adding the company was being made a scapegoat for housing affordability problems stemming from an undersupply of housing stock. Background: The proposed settlement is the latest development to follow ProPublica’s 2022 investigation, which also mentioned Greystar. Dozens of tenants sued RealPage after the initial story. The Justice Department filed an antitrust complaint against RealPage in August 2024, and in January, it sued six of the nation’s landlords, including Greystar, accusing them of improperly working together to raise rents. In their complaint, prosecutors said one landlord told RealPage that it started increasing rents within a week of adopting the software and, within 11 months, had raised them more than 25%. The suit was joined by at least 10 attorneys general, including the one for California, the country’s most populous state — home to roughly 17 million renters. One other landlord, Atlanta-based Cortland, has agreed to a settlement, as well. Senators have also held hearings and introduced legislation seeking to ban the use of rent algorithms similar to RealPage’s. Cities around the country, including San Francisco, Philadelphia and Minneapolis, moved to bar landlords from using similar algorithms to set rents. Under the terms of the proposed settlement, Greystar has agreed to stop sharing its own “competitively sensitive” information with rival companies. And it won’t attend meetings of competitors hosted by RealPage. Why It Matters: The DOJ’s moves against RealPage — and its landlord customers — for using shared data and technology were seen as an indication that authorities were willing to wade into a fraught corner of federal antitrust law. In the past, collusion happened with “a formal handshake in a clandestine meeting,” federal prosecutors wrote in one filing. “Algorithms are the new frontier.” The proposed settlement is also significant as businesses watch to see how aggressively the Trump administration will pursue antitrust cases. Bondi said the agreement aligned with the president’s “pro-consumer agenda.” Now, as part of the deal, Greystar has agreed to cooperate with the DOJ’s monopolization claims against RealPage. The case is ongoing. RealPage has sought to dismiss the suit, saying “it fails to plead anticompetitive effects in a relevant market,” among other things. Mariam Elba contributed research.