“If you don’t have between $600,000 and $800,000, you’re not buying a house out there,” Reese said. “Las Vegas has a lot of opportunity, and it was affordable in 2006, but it’s become unaffordable. We quit our jobs and moved across the country. We’re hoping this is the right decision for us.”

Reese and her family are unpacking at her parents’ Youngstown home, a temporary stop until she and her husband, who was a casino worker in Las Vegas, can find jobs and a house of their own with their young daughter. Youngstown is one of the last two metro areas in the country where a household with nearly any income should be able to find a single-family home they can afford to buy, according to an analysis of April data by the National Association of Realtors.

Before the pandemic, there were 20 states that were considered affordable as a whole under the group’s definition, including the presidential election swing states of Michigan, Pennsylvania and Wisconsin. As of this year, there is none. Even the states with the closest match between income and home prices — Iowa, West Virginia, Ohio, Indiana and Michigan — didn’t make the cut.

Since the pandemic, two states, Montana and Idaho, have surpassed California as the most unaffordable states for local homebuyers, according to the analysis. Hawaii and Oregon round out the list of the five least affordable states.

The Realtors’ analysis assigns affordability scores to states and large metro areas on a scale of 0 to 2. A score of 0 means that no household can afford any home on the market.

A score of 1 means that homes on the market are affordable to households in proportion to their position on the income ladder — in other words, 100% of families can afford at least some homes on the market. And a score of 2 would mean that all households can afford all homes on the market, but no state or metropolitan area even reached a 1.

The least affordable metro area was Los Angeles, which scored only 0.3, while the metro areas of Youngstown (0.97) and Akron (0.95) in Ohio were rated most affordable.

According to the latest estimates from July by real estate company Redfin, median single-family home sale prices were $175,000 in Youngstown and $239,500 in Akron. That compared with $487,000 in Las Vegas, $490,000 in Boise and $1 million in the Los Angeles area.

The Las Vegas area, where the Reese family had lived for 18 years, had a score of 0.5 on the Realtors’ scale. No state earned an overall score of 1, though Iowa, West Virginia and Ohio came close, at nearly 0.9. The least affordable states, Montana, Idaho, California, Hawaii and Oregon, all had scores around 0.4.

Nationwide, home affordability has evaporated over the past three years as interest rates have gone up, according to a monitoring index maintained by the Federal Reserve Bank of Atlanta. It measures affordability more simply than the Realtors’ analysis, focusing solely on the ability of a homebuyer with the median household income to buy the median-priced house.

By that measure, the national affordability percentage was above 100% between January 2019 and April 2021. But it fell as low as 67% last year and remained below 70% in June, meaning a homebuyer with the median income had only two-thirds of the earnings needed to buy the median-priced house.

Home prices have increased by 47% nationwide just since 2020, according to a June report by the Harvard Joint Center for Housing Studies. A major factor is that there aren’t many homes for sale: Many current homeowners are reluctant to sell because they’re locked into historically low interest rates. Meanwhile, investors have gobbled up single-family starter homes, reducing the supply.

Lawrence Yun, chief economist for the National Association of Realtors, said there are signs of more houses coming up for sale. For example, there was a 20% increase in houses and condos for sale in July compared with July 2023, according to the association.

“We are still short on inventory, but I think the worst is over,” Yun said. “We have seen mortgage rates begin to decline, so it’s less of a big financial penalty to move and give up a low interest rate. And the second factor is just the passage of time — life-changing events always occur, a death, a divorce, a new child or just job relocation, and that means changing residence.”

Along with high prices and interest rates, home buyers are getting slammed by higher property taxes and insurance costs, according to the Harvard Joint Center for Housing Studies.

Home prices in northeast Ohio might be lower because the area has a stable population, curbing competition and bidding wars, said Alison Goebel, executive director of the Greater Ohio Policy Center, a Columbus nonprofit aimed at revitalizing Ohio cities.

“Our population numbers have remained fairly steady in the last several decades, so we don’t have egregious demand and supply issues like you see on the West Coast and other rapidly growing areas,” Goebel said.

Montana and Idaho are the least affordable states: Housing prices are exploding in both, as deep-pocketed newcomers — many of them white-collar employees working in high-wage jobs based out of state — have driven up prices beyond what longtime residents can afford.

The city of Boise scored 0.4 on the Realtors’ affordability scale, on par with the New York City area. Like Montana, Idaho has natural beauty that is attracting people who are cashing out of more expensive areas, said Nicki Hellenkamp, Boise’s director of housing and homelessness policy.

“It’s one of the Zoom boom towns, where it’s beautiful but the wages are low, and the cost of living is low. If you sell your house in Los Angeles and buy two houses here, as my uncle did, then you can have a very different standard of living,” Hellenkamp said.

It’s not just home prices — rents are up 40% in Boise since the pandemic began, she added.

“Obviously wages didn’t go up 40%, so some people have been displaced,” Hellenkamp said.

The city is working on modest proposals to help with down payments and to create more affordable apartments, she said, but building more affordable housing will mean state and federal cooperation to help solve labor shortages and soaring material costs.

“We can’t do this alone as a city. This issue is a big one,” Hellenkamp said.

A state housing task force in Montana made recommendations in June to streamline construction of houses and apartments statewide and create incentives for cities to loosen zoning and allow denser housing.

A member of the task force, Kendall Cotton, said he personally found it impossible to buy a house in Montana, but was happy to recently purchase half a duplex for his growing family.

“We were thrilled to have that as an option, just to get our foot in the door and start on our journey to homeownership,” Cotton said. “Montana is an in-demand place. We’ve been kind of discovered in the last couple of years.”

Republicans and Democrats have come together to support fighting restrictive zoning, said Cotton, director of the Frontier Institute, a nonprofit policy and educational organization.

“We’re a free-market organization that tends to lead from right of center, but when I was at the governor’s press conference to support these issues, I was standing shoulder to shoulder with a Democratic socialist city council member and we were all united on this,” Cotton said.

Shallon Lester, a YouTube influencer who moved from New York to Montana and paid $1 million for a five-bedroom house in Bozeman in 2022, said she likes both the lower cost of living and the lifestyle there. Locals tend to think she’s an outsider “invading” the area, she said, but “people like me take nothing from this economy — we only give. We spend and spend.”

“People who are remote workers are sick of the cost of living in cities,” Lester added. “There’s a mass return to the concept of the simple life.”

Even in the Youngstown metro area, which includes a slice of Pennsylvania, housing can be a challenge for residents with low incomes. A forthcoming regional housing study has found a 4,000-unit shortage for households making less than $25,000 a year; 7,500 people are on a waiting list for subsidized housing. Black and Hispanic residents are more likely to struggle with housing costs, as are older people, young singles and families with young children, according to preliminary conclusions discussed in April.

But for many, Youngstown is a rare island of affordability. Jim Johnston, 40, a digital account executive at media company Nexstar in Youngstown, said many of his high school classmates from the area, who now live in places such as Montana, Illinois and Maryland, envy his decision to stay there and buy a $250,000 house in 2022 when interest rates were lower.

“One of them has a mortgage payment three times mine for the same size house, and a child care bill that’s bigger than my mortgage,” said Johnston. “They could put an extra $50,000 or $60,000 a year in their pockets. Remote work has opened up new possibilities for them, and they’re considering this very seriously.”

Such messages are shown intermittently on thousands of highway signs, known as variable messaging signs, when the billboards aren’t lit up with alerts about accidents, construction or other real-time traffic issues.

As the summer vacation season gets going, millions of America’s interstate drivers can expect to find more puns, silly turns of phrase or cultural references on those massive missives.

But federal safety officials aren’t amused by states’ cheek. In recent years, they’ve begun to discourage what they view as overly creative messages, fearing that in trying to entertain drivers, highway officials are confusing rather than enlightening them. Some states, most recently Arizona and New Jersey, have pushed back. As a result, officials at the Federal Highway Administration clarified this year that they’re not banning road-sign humor outright.

Mississippi, the state with the highest motor vehicle fatality rate in the country last year, has been particularly creative. Recent messages have included “FOUR I’S IN MISSISSIPPI TWO EYES ON THE ROAD,” and a reference to the Taylor Swift song “Anti-Hero”: “TEXTING AND DRIVING? SAY IT: I’M THE PROBLEM IT’S ME.”

“It’s been an effective program for us. We haven’t been contacted by [the] federal highway department and told to cease and desist. We want to be in compliance, but we haven’t stopped our message program,” said Paul Katool, a spokesperson for the Mississippi Department of Transportation.

A new rulebook issued last year “does not prohibit messages from including humor or cultural references,” Federal Highway Administration chief Shailen Bhatt wrote in a recent letter to U.S. Reps. Greg Stanton, an Arizona Democrat, and Thomas Kean Jr., a New Jersey Republican.

The representatives had complained earlier this year that the agency was stifling state creativity, calling the new rules “a blanket discouragement of humorous signs that leaves no room for state-by-state discretion.”

“Both of these states have signs that use slang or popular language, but the messages are clear,” the representatives wrote in their letter to Bhatt.

They cited messages such as two Arizona contest winners, “SEATBELTS ALWAYS PASS THE VIBE CHECK” and “I’M JUST A SIGN ASKING DRIVERS TO USE TURN SIGNALS,” as well as New Jersey’s recent holiday messages: “ DON’T BE A GRINCH, LET THEM MERGE” and “ SANTA’S WATCHING, PUT DOWN THE PHONE.”

Bhatt’s response is an apparent softening of the FHWA’s opposition to the signs, after the agency asked New Jersey to pull down some messages in 2022. Some became so popular on social media that the state Department of Transportation asked drivers not to take photos of the signs while driving, posting a cat meme on its own social media accounts: “IF YOU KEEP TAKING PHOTOS OF THE VMS BOARDS WHILE DRIVING WE WILL TURN THIS CAR AROUND AND GO BACK TO THE OLD MESSAGES.”

Messages shown in 2022 included “GET YOUR HEAD OUT OF YOUR APPS” and “SLOW DOWN. THIS AIN’T THUNDER ROAD,” a reference to a song by favorite son Bruce Springsteen, The Philadelphia Inquirer reported.

The Federal Highway Administration isn’t telling states what to do — states retain control of their message boards — but it doesn’t think humor and cultural references are helpful. Vehicles pass under the signs in the blink of an eye, and the missives could puzzle people who don’t “get it” right away.

“FHWA appreciates the States’ efforts to creatively convey important safety messaging to motorists. Those messages need to be balanced with maintaining driver attention,” Bhatt wrote in his letter to the lawmakers.

An agency spokesperson, Nancy Singer, said in a statement that “states may develop their own traffic safety campaign messages” but they should avoid “messages with obscure meaning, references to popular culture, that are intended to be humorous, or otherwise use non-standard syntax.”

There’s some serious research behind the new guidance: One of the studies cited in Bhatt’s letter shows that overly creative language can have the wrong effect when used on a highway message sign. Driving behavior can get more dangerous, not less so, if you’re trying to process a confusing message.

“Messages involving humor, wit or pop culture references could have adverse consequences on driving behavior for motorists who are unable to correctly interpret those messages,” according to the 2022 study published by the National Academies of Sciences, Engineering and Medicine.

Lead author Gerald Ullman, who was senior research engineer at the Texas A&M Transportation Institute at the time the study was published, said it simulated highway-sign messages seen while driving.

Highway wit can work well but only “for drivers who get the humor used and the traffic safety point of the message,” Ullman said in an email exchange. “However, it does appear to have adverse effects on those drivers who don’t get it.

“Pop culture references that younger drivers get might very easily be confusing for older drivers,” he said. “Conversely, puns or references to older funny movies that older drivers find witty can fly completely over the heads of younger drivers.”

Still in states such as Mississippi, state officials have heard from residents who say creative messages changed their habits, which might not have happened with more direct language, Katool said.

“It’s all good fun, but the point is to save lives,” Katool said. “There’s really only so many times you can just tell somebody to stop texting and driving or tell them to slow down. Eventually they just kind of tune you out. So we feel this is a way to leverage holidays, popular culture, music, that kind of thing.”

New Jersey is still using humor in its messages: A batch that ran in May included “SLOW DOWN BAD DRIVERS AHEAD” AND “CAMP IN THE WOODS NOT THE LEFT LANE.”

But the state is “mindful of the kinds of messages we put up, keeping them safety oriented” and does follow federal guidance, said New Jersey Department of Transportation spokesperson Stephen Schapiro.

The latest messages in June include “THERE’S NO DEBATE DON’T TAILGATE” and “LET THE WAVES DO THE CRASHING STAY ALERT!”

New Jersey has one of the lowest rates of traffic fatalities as of 2023, about 0.78 deaths per 100 million vehicle miles driven. Minnesota is the only state lower, at 0.71, with the highest being Mississippi (1.76) and Arizona (1.69), according to preliminary National Highway Traffic Safety Administration statistics.

In Arizona, messages “sometimes include humor and cultural references, and we work hard to make sure key messages about safety will be easily understood by drivers,” said Doug Pacey, a transportation spokesperson. Over the Memorial Day weekend, the department used a relatively straightforward message: “COOKOUT ESSENTIALS BBQ, MUSIC, WATER, DESIGNATED DRIVERS.”

Like New Jersey and Mississippi, Arizona sometimes gets the public involved in picking safety messages with contests. A contest last fall led to two winning messages: “I’M JUST A SIGN ASKING DRIVERS TO USE TURN SIGNALS” — a reference to a line in the 1990 film “Notting Hill” with actor Julia Roberts, whose character in the film says, “I’m also just a girl, standing in front of a boy, asking him to love her.”

Another contest winner, Elise Riker, won for “SEATBELTS ALWAYS PASS THE VIBE CHECK” which was also displayed last fall. A marketing professor at Arizona State University, Riker told Stateline she crafted it to appeal to Gen Z drivers.

“A vibe check is Gen Z slang for good vibrations, from the 70’s,” Riker said. “Levity definitely helps a safety message get through. ‘You can die in a car accident without your seatbelt’ is more likely to be ignored.

“Nobody likes to think about dying,” she said. “Friendly and funny safety messages are a reminder that there are humans at the heart of it.”

Stateline is part of States Newsroom, a national nonprofit news organization focused on state policy.

©2024 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

Deaths from vehicle crashes, homicides, suicides and overdoses spiked in many states during the national health emergency that began in January 2020. Deaths of despair, which include people who died by suicide or from an accidental overdose, reached their highest numbers during the first year of the pandemic. And even as fewer cars were on the roads during shutdowns, vehicle fatalities jumped.

Yet after historic increases during the pandemic, deaths in most of the country are nearing a return to pre-pandemic levels, according to a Stateline analysis of preliminary federal statistics.

Still, in the first half of this year, the death count in some states and the District of Columbia was much higher than it was during the first half of 2019. The District’s death count was 35% higher than before the pandemic, and in six states the count was at least 15% higher: Arizona, Delaware, Nevada, Tennessee, Texas and Utah.

Nationally, death counts for the first six months of 2023 are about 7.7% higher than they were for the same period in 2019, before the pandemic, the analysis found. That’s just a bit above the 6.7% increase to be expected anyway; counts routinely inch up annually with the United States’ aging population.

Before the pandemic, the historical trend since 1900 was for the number of deaths to rise a little every year as the population got larger and older, and for age-adjusted death rates to go down and life expectancy to rise every year due to advances in health and medicine.

COVID-19 played havoc with that pattern, bringing historic spikes in both death counts and death rates. Between 2019 and 2020, the number of U.S. deaths from all causes jumped 19%, a 100-year record. The current U.S. death toll from the virus is more than 1.1 million people, according to the World Health Organization.

The year-over-year spike in death rates between 2019 and 2020 surpassed that of the 1918 flu epidemic. In 2020, the death rate rose 17% to 835.4 per 100,000 people, compared with a 12% jump between 1917 and 1918. The death rate peaked at 879.7 in 2022.

Life expectancy in the United States dropped 2.7 years by 2021, the biggest dip in almost 100 years.

States where COVID-19 hit first, such as New Jersey and New York, are the closest to complete recovery.

Public health experts debate why deaths might be stubbornly high in some areas of the country — as in Arizona, where death rates rose the most between 2019 and 2022, and where increases in deaths continue to be high in preliminary 2023 data.

There’s some evidence that COVID-19 deaths have gone unrecognized, and that the chaos from the pandemic caused still more deaths by shutting sick people out of hospitals packed with COVID-19 patients.

“There’s a lot of things going on that might cause [continued high death rates]. It’s not just one thing,” said Robert Anderson, chief of the mortality statistics branch at the federal National Center for Health Statistics in Maryland.

Nationally, only about 62% of the increase in death rates between 2019 and 2022 is directly attributed to COVID-19, according to the Stateline analysis. But that might be an undercount because COVID-19 was not always detected as a cause, according to Boston University School of Public Health research published in January.

In the pandemic, unexplained or “excess deaths” tended to peak earlier than COVID-19 deaths did, suggesting that many deaths really were undetected COVID-19 deaths.

COVID-19 cases were more likely to be misclassified in Arizona, the Rocky Mountain states, the South and rural areas, than in New England and in mid-Atlantic states such as New Jersey and New York, the article said.

As deaths peaked in New Jersey in 2020, a report from the New Jersey Hospital Association said two trends suggested people were dying from lack of hospital care as well as COVID-19: an increase in deaths at home from conditions usually treated in hospitals, and a decrease in hospital admission for life-threatening emergencies like heart attacks and strokes.

New Jersey, despite being the first state hit hard by COVID-19 in 2020, is now the only state with fewer deaths in early 2023 compared with the first six months of 2019. Eight other states saw increases of about 2% or less, including New York, another of the states slammed early in the pandemic.

The other seven states with death rates falling back to normal are Connecticut, Illinois, Maryland, Mississippi, South Dakota, West Virginia and Wyoming.

COVID-19 is listed as a contributing cause of only 1,143 deaths in New Jersey so far this year, down from more than 14,000 in the same time frame in 2020. Similarly in New York, COVID-19 deaths were down to 2,685 from more than 32,000 early on.

New Jersey, like many other states, has worked hard to get the virus under control, reaching its goal to vaccinate 4.7 million people who live or work in the state by mid-2021, and zeroing in on hot spots as they popped up with concentrated publicity campaigns to boost testing and vaccination, said Nancy Kearney, a spokesperson for the state Department of Health, in a statement.

As an early epicenter of the virus, New Jersey became a laboratory for techniques that became standard practices in the rest of the country, said Cathy Bennett, president of the New Jersey Hospital Association.

“New Jersey health care providers were writing their own playbook for responding to this novel virus,” Bennett said. “Our hospital teams were among the first to use new medication and tactics like proning [turning patients face down] to ease the burden on COVID-19 patients’ lungs.”

But even Arizona is slowly returning to normal death patterns, despite spikes in February, April and May, according to an analysis by Allan Williams, an Arizona epidemiologist who collaborates on state reports. COVID-19 deaths in the state are down to fewer than a thousand so far this year, compared with about 7,000 at the peak during the same time period in 2021.

“Deaths are returning to normal,” Williams said.

The state faces unique challenges in that COVID-19 deaths spiked late compared with the East Coast, with peaks coming in late 2020 and early 2021 at much higher rates than nationally, according to Williams’ analysis.

Williams said Arizona also saw increases in deaths from a multitude of other factors, including traffic accidents, overdoses, firearms, heart disease and strokes.

The state-by-state difference in COVID-19 deaths has been studied and discussed by experts for years. COVID-19 had the biggest cumulative impact on Arizona from 2020 to mid-2022, according to a study published this March in The Lancet, which concluded some states did better than others in extending health care access equitably and in convincing residents to get vaccinated.

Hawaii, which took an early hit economically when tourism from Asia stopped even before the pandemic hit the United States, has been one of the least-affected states in terms of deaths.

A White House Council of Economic Advisers analysis last year calculated that if deaths in the whole country followed Hawaii’s pattern, another 780,000 people would have survived the pandemic. Hawaii and New England states got high marks for health care during the pandemic, though Hawaii is facing new challenges from COVID-19 as well as wildfire deaths on Maui.

The Council of Economic Advisers study also suggested that lower rates of health insurance were associated with more deaths. Health insurance rates have been rising and reached an all-time high last year, the latest figures available. Among those states with death counts that are at least 15% higher this year than they were during the first six months of 2019, Arizona, Texas and Nevada were also in the top 10 for uninsurance rates as of 2021, and Tennessee was 11th.

Changes in population could explain some of the differences among states. Many of the states with large death count increases also grew rapidly in 2022, and many of those with small increases are losing population.

But in some states, such as Arizona, the increase in deaths outpaced population gains. Between 2019 and 2021, the height of pandemic death rates nationally, Arizona’s age-adjusted death rate rose 38%, the biggest increase among states. Arizona also had the highest change in death totals between 2019 and 2022 at 21%.

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Stateline is part of States Newsroom, a national nonprofit news organization focused on state policy.

©2023 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

Such laws would help people such as Miraya and Andy Gran of Bloomington, Minnesota, who ended up spending $102,000 to have their now 2-year-old daughter, Isla, through in vitro fertilization after trying other expensive options. Miraya Gran has since become an advocate for state laws requiring insurance coverage for fertility treatments.

“I had a lot of resentment and a lot of anger on top of the financial sacrifice. I just thought it was wrong. I don’t want other parents to go through this,” Gran said.

Twenty-one states require such coverage, but a proposed mandate failed to pass the Minnesota legislature this year. With the exception of New York, Medicaid programs do not cover fertility treatments.

Minnesota was one of at least 16 states where legislators introduced bills this year to create or expand fertility insurance mandates. The District of Columbia recently approved legislation and California, New Jersey and Pennsylvania are still considering bills. Last year, Illinois enacted a new law that requires insurers to cover the treatments and mandates that employers offer paid leave for people recovering from unsuccessful procedures.

Some states are expanding mandates to cover more residents, including single people or same-sex couples. They’re also expanding mandates to include coverage of fertility preservation procedures for cancer patients or others who would like to preserve sperm or eggs before undergoing treatments that could make them infertile.

Mayor Muriel Bowser, a Democrat, signed the District of Columbia insurance coverage mandate in July, but Congress still must approve it, said the bill’s sponsor, Councilmember Christina Henderson.

Henderson has said she heard from people who took on extra part-time jobs just because those employers’ health insurance covered fertility treatments. The bill would take effect in 2025.

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Decades of history

Fertility coverage mandates have a long history, beginning with the first one passed in West Virginia in 1977 that required HMOs to cover unspecified “infertility services.”

Maryland’s mandate in 1985 was the first to specifically cover in vitro fertilization, widely considered the most effective fertility treatment. It has a roughly 50% success rate in producing babies in women under 35 years of age. But the cost of in vitro fertilization, in which fertilized eggs are transplanted to the womb, can be prohibitive without insurance.

“The cost of IVF remains the greatest barrier to infertility care in the U.S.,” concluded a Duke University study published last year in the journal Reproductive Biology and Endocrinology, which notes that the cost for each successful birth can be $60,000. “State infertility insurance mandates are a crucial mechanism for expanding access to fertility care in the US in the absence of federal legislation.”

West Virginia’s mandate came before the first IVF birth, and recent bills to add the procedure to the state mandate — including proposed legislation this year — have failed to pass. Fourteen states include IVF in their mandates, according to RESOLVE: The National Infertility Association, which tracks state and federal legislation.

Limited mandates like those in Texas and California only require insurers to offer fertility coverage when employers request it. A California bill that would expand the mandate to require that all large insurance plans provide coverage passed the state Senate and has progressed in the state Assembly.

The proposed expansion of the California mandate would cover unlimited embryo transfers, though other states have set limits. Maryland limits its coverage requirement to three IVF attempts per live birth and sets a $100,000 lifetime cap. Connecticut has a lifetime limit of four embryo implantations.

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Religious objections

Jessica Tincopa of Orange, California, and her husband, Rob Tran, have endured six miscarriages since 2015. They had saved $20,000 for an IVF procedure before the pandemic hit, but were forced to spend their savings to stay afloat when their wedding photography business dried up. They’ve tried to find jobs with IVF insurance but have not succeeded.

“Our insurance company was billed $100,000 for the miscarriages — they would have been better off covering one trial round of IVF for us at $30,000,” Tincopa said.

Last year, 61% of large employers had health plans that covered fertility treatment, and 47% covered IVF, according to an annual survey by Mercer, a consulting firm.

Even California’s new law wouldn’t cover the small group policy Tincopa has now, since it only applies to large group policies, but at least it would create more opportunities to find a job with insurance she can use, she said.

But in California and other states, insurers have raised objections to basic or expanded fertility insurance mandates.

One insurer in Oregon, for example, objected to a fertility insurance mandate bill that would cover IVF, saying that the procedure runs afoul of a Catholic doctrine that declares the method immoral.

The insurer, Providence Health Plan, asked in written testimony to the legislature for an exemption from covering IVF. Oregon’s bill did not pass, though there was an amendment stripping the IVF requirement.

An insurer in North Dakota said the procedure could create legal issues and uncertainty when people stop paying for embryo storage because of job changes or other reasons.

The Sanford Health Plan, which provides coverage throughout the upper Midwest, also argued there would be higher costs, citing a state study that showed a plan with a $50,000 maximum benefit could increase premiums by anywhere from $1.98 to $24.85 monthly for each person insured. By a quirk of North Dakota law, the mandate must apply first to retiree insurance before the legislature can pass a general fertility insurance mandate.

The bills in Oregon and North Dakota failed to pass this year, as did others in Connecticut, Illinois, New Hampshire, New York, Vermont, Virginia, Washington, West Virginia and Wisconsin.

In North Dakota, Republican state Rep. Mike Brandenburg said it was his third attempt to get the bill through the legislature.

“I’ll keep trying,” Brandenburg said. “We’re making headway. I can see more younger people coming in (to the legislature), and it’s gaining votes all the time. If we can assist people who want to have families, why not?”

Like the Grans in Minnesota, parents in North Dakota testified about the financial burden and emotional stress of fertility treatments.

Elizabeth Carter of West Fargo, in a January letter to the legislature, said she and her husband both have advanced degrees and full-time jobs but have started moonlighting to try to pay for treatments.

“I wish I had greater access to affordable medical care for infertility through my insurance benefits so that my husband and I could also have the chance to have even a single child, who could be born into a stable household to two parents who fought and worked very hard to bring them into the world,” Carter wrote.

In Wisconsin, Democratic Gov. Tony Evers added a fertility coverage mandate to the state budget this year, but the provision didn’t make it through the Republican-dominated legislature. Democratic state Sen. Kelda Roys told Stateline she plans a stand-alone bill later this year.

“Infertility is a common disease and should be covered by insurance like any other health need,” Roys said.

A New Hampshire bill to study the cost of extending a fertility insurance requirement to single people and same-sex couples stalled in committee, but state Sen. Rebecca Perkins Kwoka said she’s still hoping to convince the state Department of Insurance may do the study without legislation.

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Postponing childbirth

Some bill sponsors have pointed out that residents may postpone childbirth because of the high cost of housing and child care, as well as the reality of younger women increasingly working to establish careers before parenthood. But it’s unlikely such laws will have an effect on fertility rates that have been below the replacement rate of two children per woman since 2010.

One study from the University of California, Irvine found a connection between low fertility and states’ willingness to pass mandates, though author Katherine Bogaard said in a video presentation last year that “states are following each other’s leads” as the issue gains more attention. Bogaard told Stateline she’s preparing to publish a more detailed study.

Alison Gemmill, a demographer and fertility expert at Johns Hopkins University, said lower fertility rates are linked to postponed childbirth. That’s likely what’s driving new state legislation, along with increased concerns with equality for groups like single parents and same-sex couples, she said.

“It’s about states being receptive to messaging and advocacy from infertility treatment advocates, including many from the LBGTQ+ community,” Gemmill said. Even with more insurance, however, birth rates overall are likely to keep falling, she said.

“The increasing use of fertility treatment won’t have a large impact on U.S. birth rates just yet,” she said. “Births involving assisted reproductive technologies make up a small share, 2% of all births. It would take quite an uptick to move the needle on overall births.”

Much of the gain reflects a boom in jobs traditionally held by women, including nursing and teaching. Many good-paying jobs in fields such as construction and tech management are still dominated by men, a continuing challenge for states trying to even the playing field for women workers.

In June, the national share of employed women ages 25-54, considered prime working age, hit 75.3%, the highest recorded since the U.S. Census Bureau’s Current Population Survey started reporting the numbers in 1948. The share of women 25-54 working or looking for work also hit a new high of 77.8% in June, the third straight month it beat the previous record of 77.3% from 2000.

“It’s good news that women are finding jobs in this economy at a greater rate than they were previously,” said Elise Gould, a senior economist at the left-leaning think tank Economic Policy Institute. She noted that brisk hiring in health care and government has helped more women find jobs.

But there is still a gap between rates of men and women in the workforce overall in every state except Vermont. As of March 2022, the latest figures available, the largest gap is 18 percentage points in Arizona, where 89.6% of prime-age men have jobs compared with 71.4% of women. The smallest is in Maine, where 77.8% of men in that age range have jobs compared with 77.3% of women.

Mothers of small children lost work at three times the rate of fathers early in the pandemic as they struggled to supervise remote learning sessions. Even when schools and day cares reopened in person, they often closed down unexpectedly during outbreaks, drawing out employment woes for many working women with children. Combined with early pandemic job losses in tourism and hospitality, fields where many women hold jobs, women’s employment dipped as low as 63.4% in April 2020, the lowest since 1984.

For some women, getting back to the workforce after the pandemic slump in women’s employment is a relief, and in some cases hybrid work has created the flexibility they need to return to jobs.

“It really means a lot because apart from the feeling that you’re contributing to your family, which is so important in today’s world, there’s just more fulfillment as a person,” said Deepika Gosain of Fremont, California. She started work in April as a learning and development specialist at a surgical company, finding that hybrid work helped her return to the workforce after taking several years off to care for two small children.

Health care and education represented the biggest gains for women in the past year, between June 2022 and June 2023, comprising about 778,000 of the 2 million jobs added for women, according to a Stateline analysis. Government and hospitality jobs added another 727,000 jobs for women.

Jobs in construction and tech management remain stubbornly male dominated, however. Men are 96.5% of carpenters and nearly 74% of computer system managers, for example.

Karen Arrigo-Hill is looking for work in financial tech again after taking a break to raise small children. Like Gosain, she’s used the networking group Women Back to Work for tips on California jobs for women who have taken breaks from work. She also participates in an incubator program for underrepresented genders in tech, called In the Lab Product Management.

“The biggest thing I notice is all the support there is for the women who took a career break for caregiving and want to return to work in technology,” Arrigo-Hill said. “This process of returning is a long process, and it really helps.”

States such as California, Massachusetts and New York are working to get more women into male-dominated fields.

A Democratic-sponsored bill in the New York State Assembly calls for $500,000 in funding to get more women into high-wage jobs, including construction and some tech fields, where they make up less than 25% of workers.

Elsewhere in the region, the state-funded Massachusetts Commission on the Status of Women in June recommended passage of a legislative resolution saying that COVID-19 had an outsized effect on women, including on their jobs, and that “prejudices against gender and race have served to make it difficult for women to fill roles demanded by society and their professions.” In its annual report, the commission urged passage of bills that would provide more day care and improve pay transparency, which can lead to women earning higher salaries.

California has budgeted $30 million over the last two years to helping more women get jobs in construction, including grants for apprenticeships and child care.

“When we spoke with women in construction, they told us childcare costs were one of the biggest barriers to working in the trade,” said Katie Hagen, director of the state Department of Industrial Relations, in a statement.

In Wisconsin, using state, local and private funding, the Operation Fresh Start Build Academy is helping 21-year-old Naomi Campbell train for a career in construction. On a recent day she hung drywall in a home under construction in Deerfield.

“Being the only girl on a crew of all men, it feels like a lot of pressure,” Campbell said. “They expect you to be less than them. But I’ve proven them wrong. I love the people and I love the results — seeing this house go from studs to walls in here and siding. It’s amazing.”

Construction is an important field for women to get into because the pay can be good, there’s a labor shortage, and a college degree isn’t necessary, according to a forthcoming report by the Institute for Women’s Policy Research in Washington, D.C. Since the pandemic started, there are 126,000 more women working in construction for a total of 1.1 million, though women still make up only 14% of workers in the industry.

“The percentage is so low for women that it can easily send the message that this is clearly a sector just for men,” said Ariane Hegewisch, the group’s program director for employment and earnings. The U.S. Commerce Department is also pushing to double the number of women in construction as federally funded infrastructure projects ramp up.

Vermont is the only state where prime-age women work at a greater rate than men: 83% compared with 81% for men. Vermont may be unique because of its mix of jobs, said Mathew Barewicz, the state’s labor market information director. “Vermont has a diverse industry composition without an overreliance on typically male-dominated industries (like) mining, transportation, finance.”

Progress in bringing more women to the workplace is likely to continue, said Beth Almeida, a senior fellow at the progressive Center for American Progress think tank specializing in women’s economic security.

“This generation of women ages 25-54 have more college degrees than any other generation of women, and having college degrees is a very strong predictor of labor force attachment,” Almeida said.

“They’ve made a substantial financial investment in their future. But their employment is very impacted by caregiving, because women have a greater responsibility when it comes to family.”

©2023 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

Mass shootings get more attention, but the smaller-scale tragedy of gun suicide represents a majority of firearm deaths in most states. In the United States, suicides make up 57% of all gun deaths, or about 117,000 out of 206,000 firearm deaths in the past five years, according to federal Centers for Disease Control and Prevention preliminary data analyzed by Stateline.

Many states are grappling with new ways to prevent gun suicide. It’s a goal of many state laws focused on gun violence in general, including storage, waiting periods and red flag laws aimed at removing guns from those who might be a danger either to themselves or others.

Since 2018, Utah, Virginia and Washington state have passed Donna’s Law, registries for those who think they could become suicidal and don’t want the ability to buy a gun on a whim. Maryland lawmakers are considering such legislation this spring.

U.S. Reps. Pramila Jayapal, a Washington state Democrat, and John Curtis, a Utah Republican, sponsored federal legislation last year, but it did not advance beyond the House Judiciary Committee. Jayapal plans to reintroduce the bill during this congressional session, said Rachel Madley, a health policy adviser in her office.

Named for Donna Nathan, who took her own life in 2018 in New Orleans with a handgun she had just purchased, Donna’s Law is promoted by Nathan’s daughter, Katrina Brees.

Nathan had a long history of depression and mental illness and had attempted suicide in Massachusetts by other methods before the family moved to New Orleans in 2010, Brees recalled in an interview.

“Massachusetts doesn’t have a gun store on every corner,” said Brees, adding that she has joined the registries in Virginia and Washington state as a show of support and because she doesn’t want other families to go through the same pain as hers.

Nationally, the lowest rates of gun suicide over the past five years are in Massachusetts (1.4 per 100,000 people), New Jersey (1.5) and New York (1.7), while the highest rates are in Wyoming (15.5), Montana (13.1) and Alaska (13.0). The national rate is 5.6, according to the Stateline analysis of CDC data.

In all but nine states, most gun deaths are self-inflicted. The highest proportion is in Maine, where 89% of gun deaths are suicides, and the lowest is Maryland, where 34% of gun deaths are suicide.

Suicides are a majority of gun deaths nationally and in most states, according to a Stateline analysis of deaths reported between 2018 and early 2023.

In that time, the rate of gun suicides was 5.6 per 100,000 population, on an age-adjusted basis, and varied from 1.1 in the District of Columbia and 1.4 in Massachusetts to 15.5 in Wyoming and 13.1 in Montana.

In Maryland, bill sponsor Del. David Moon, a Democrat, during floor debate called the measure “similar to what we in Maryland do for gambling, where a problem gambler can put themselves on a list.”

“A person who is having a moment of clarity and wishes to place themselves on a list to prevent themselves from being able to purchase a regulated firearm, handgun, may do so,” he added.

Although House of Delegates Minority Leader Jason Buckel, a Republican, during the debate said, “I like the word ‘voluntary,'” he ultimately voted against the bill during its 96-36 passage. He did not respond to a request for comment. The measure now goes to the state Senate for consideration.

As in other states, Maryland’s registry allows people to take themselves off the no-sell list without leaving a trace in the public record. In Utah, the minimum time on the list is 30 days; in Maryland, it would be three weeks.

“You’re basically creating a mandatory waiting period for yourself,” Moon said in the debate.

The self-registry is meant to draw bipartisan support by respecting the Second Amendment right to own a gun, said Frederick Vars, a University of Alabama School of Law professor who also has helped draft model legislation for Donna’s Law.

“I’m hoping bills get introduced all over,” said Vars, adding that he’s working with legislative staffers to prepare bills in Alabama and Michigan. He helped draft model legislation that Brees then helped promote.

About 100 people have signed the existing registries, he said, a drop in the bucket compared with studies he’s helped conduct showing 30% of adults and 46% of psychiatric patients want to enroll in such a registry, he said. Similar laws have been proposed in California and Louisiana, but so far, they haven’t advanced.

In Texas, state Sen. Nathan Johnson, a Democrat from the Dallas area, proposed a bill based on Donna’s Law in 2021, and again this year after reading about the idea in The Wall Street Journal. He’s optimistic that because the registry would be voluntary, it eventually will get attention from the Republican-dominated legislature.

“In Texas, there’s a tremendous political and cultural climate in support of gun owner rights,” Johnson said. “This doesn’t even create the appearance of infringing on those rights. We can prevent suicide and promote personal autonomy at the same time — everybody has the right to say, ‘I don’t want to own a gun.'”

States also are trying other options with the stated intent of cutting rising rates of gun suicide.

A Colorado bill that passed the state House this month would require a three-day waiting period for delivery of a firearm, noting that “establishing a waiting period for receipt of firearms can help prevent impulsive acts of firearm violence, including homicides and suicides.”

In Hawaii, a bill passed by the state House and under consideration by the state Senate mentions suicide prevention as a goal of required firearms safety training. And a North Carolina bill with Democratic sponsors, introduced early this month in the state House, cites suicide as the primary reason for a red flag, or extreme risk protection order, to restrict a person’s access to firearms after a court finding that they’re a danger to themselves or others.

The most effective methods of preventing gun suicide have been strict licensing requirements, said Joshua Horwitz, a public health professor at Johns Hopkins University focused on gun violence prevention, because the rules usually include waiting periods and the ability to screen for mental health issues. Gun safety legislation also plays an important role, he said.

“Suicide is under-appreciated. It’s the biggest chunk of the gun violence problem,” said Horwitz. “We can’t stop all suicide, but if we make the means less lethal, we can save lives.”

It’s too soon to say how effective Donna’s Law can be, he added.

“It’s interesting. For some individuals, it could be the solution, but we need to know more,” Horwitz said.

More mental health services also could help alleviate gun suicide rates, especially in the rural states most affected. But the return on investment would be much lower, said Thomas Wickizer, an emeritus professor of public health at the Ohio State University who has studied state firearm suicides and how the availability of mental health services can reduce them.

He has concluded that restricting firearm access would be far more effective than mental health services alone.

“For every firearm suicide death avoided, states would have to expend roughly $15 million to increase their mental health workforce,” Wickizer said. “Obviously, this is not practical.”

Mental health services are more effective in preventing other types of suicide, he added.

“Firearm suicide is impulsive and almost always lethal,” Wickizer said. “Other suicide methods are less lethal and afford the persons who do not die an opportunity to obtain help through the mental health services system.”

If you or a loved one is in distress, you can call the National Suicide Prevention Lifeline at 988.

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(c)2023 The Pew Charitable Trusts. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

Among urban areas with populations of at least half a million, the Texas capital city of Austin grew the fastest as more people arrived, and development intensified and spread. The Austin area’s population grew by 33%. The area also added almost 100 square miles of formerly rural land that the census now classifies as urban because of new development and population growth. As a result, Austin’s total urban area increased by 18%.

Other urban areas also experienced rapid population growth: The urban population grew by 25% in Raleigh, North Carolina, and Charleston, South Carolina; 23% in Orlando, Florida; 22% in Provo-Orem, Utah; 21% in Des Moines, Iowa; 19% in Nashville-Davidson, Tennessee; 18% in Houston and in Riverside-San Bernardino, California; and 17% in Jacksonville, Florida.

“Urban growth is booming here,” said Nathan Dollar, director of Carolina Demography at the University of North Carolina at Chapel Hill. “Metro populations like those in the Research Triangle Area (Raleigh, Durham and Chapel Hill) were and are growing quickly as well as migration to coastal and mountain communities driven by retirees.”

Understanding the growth patterns of metro areas helps state and local planners develop infrastructure, from roads to schools to hospitals, to serve those ballooning regions.

Booming Southern cities and suburbs have attracted newcomers for a long time, creating some new tensions between urban progressives and rural conservatives in states such as Texas and Florida, and helping to turn Georgia into a swing state as Atlanta suburbs have grown and become more racially diverse.

But the Midwest also saw increased percentages in urban share. Growth in the Des Moines suburbs gave that urban area the sixth-fastest population growth and the third-fastest growth in land area nationally, behind only Austin and Charleston.

The U.S. Census Bureau adjusted its metrics in December and began defining urban areas as those with at least 5,000 residents (up from 2,500 in 2010) or 2,000 housing units. The bureau looks for areas with dense housing, at least 425 units per square mile, and adds surrounding suburbs and commercial areas.

As a result of the new metrics, 4.2 million people in 1,140 small communities once considered urban by the Census Bureau are now officially rural residents. But other federal agencies already had a broader definition of rural that included those communities for health and transportation funding purposes.

At the same time, dozens of places made the switch from rural to urban because they are vacation spots with small year-round populations that spike during certain seasons.

To measure growth in urban population and area, Stateline applied the 2020 standard to 2010 for comparison.

California, Nevada and New Jersey are the most urban states under the new census definitions, with about 94% of their residents living in such areas. Vermont (35%), Maine (39%) and West Virginia (45%) are the least urban.

The New York-Jersey City-Newark urban area remains the nation’s most populous, with a count of 19.4 million. The Los Angeles-Long Beach-Anaheim area has a population of 12.2 million, and the Chicago urban area, which includes parts of Indiana, is home to 8.7 million people.

These three urban areas have been the most populous since the 1950 census, though the Los Angeles area overtook Chicago in 1960.

In addition to changing the population threshold for urban status, the census added housing units to the calculation as a nod to tourism-oriented places, such as Snowmass Village, Colorado, and Fire Island, New York, that don’t have large year-round populations but need infrastructure to support seasonal crowds.

“Our little village of 3,000 or so residents can swell to urban levels pretty quickly,” said Clint Kinney, town manager for the Town of Snowmass Village. “During ski season we can have 10,000 people skiing on the hill, which is in the town, in addition to several thousand employees and our own population.”

Some demographers questioned the change that took urban status from the 1,140 communities.

“I am not quite sure what prompted this,” said William Frey of the Brookings Institution, noting that the changes will make areas defined as “rural” larger. “Making rural areas more dense, and perhaps faster growing because of the definition change, will shift the demographic makeup of these areas.”

However, the changes bring Census Bureau definitions more into line with other federal programs that already define areas of 2,500 to 4,999 as rural, said Michael Ratcliffe, a senior adviser in the Census Bureau’s Geography Division who has written about the new definitions.

Ratcliffe said he hopes the changes will “spark further thought and discussion” about the definition of rural and urban areas and how they’re used by policy makers.

For health care funding purposes, areas of fewer than 5,000 and even larger ones up to 49,999 are considered rural by the federal Health Resources & Services Administration, said Harold Miller, president of the Center for Healthcare Quality and Payment Reform, an advocacy group.

There also are federal transportation grants for rural areas to help with public transit, but they apply to any areas with fewer than 50,000 residents.

“There are other federal programs that use their own definitions, and states have their own definitions,” Miller said, noting that, for example, Pennsylvania has its own “rural health model” with different standards.

“There are a variety of programs which only apply to areas designated as ‘rural,'” Miller said. “But there are multiple definitions of ‘rural,’ and they don’t depend solely on Census Bureau designations.”

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(c)2023 The Pew Charitable Trusts. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

El suministro de billetes de autobús y avión es un método usado desde hace mucho tiempo por los funcionarios locales y los defensores de los derechos humanos que intentan acelerar el camino de los inmigrantes hacia sus familiares y amigos mientras solicitan legalmente el asilo, al igual que para despejar el espacio de los refugios para los recién llegados, pero los defensores subrayan que el transporte debe ser bien recibido por los migrantes y coordinado con las personas que los van a recibir.

“La idea de llevar a la gente desde la frontera hasta su destino final, si van a presentar un caso de asilo, no es una idea descabellada, especialmente si se hace bien: es una solución provisional mientras trabajamos en soluciones políticas”, dijo Andrew Selee, presidente del Instituto de Política Migratoria (MPI), con sede en Washington DC, un grupo de expertos que está a favor de una mayor inmigración legal para desalentar el cruce individual de la frontera en busca de asilo. “Hay tanta gente que quiere llegar aquí ahora mismo y tanta demanda de su mano de obra”.

Los miles de migrantes a los que los gobernadores de Texas y Arizona ofrecieron viajes en autobús a Chicago, New York y Washington DC, son una fracción del movimiento récord de migrantes a través de la frontera mexicana, impulsado por la demanda de su mano de obra y las condiciones represivas y las crisis económicas en países como Cuba, Nicaragua y Venezuela.

En la frontera de Arizona, cerca de Yuma, la mayoría de los solicitantes de asilo liberados tras el control federal, unos 350 a la semana, suben a los aviones en Phoenix con billetes comprados por amigos y familiares, dijo Amanda Aguirre, exsenadora estatal demócrata que es presidenta de Regional Center for Border Health, sin ánimo de lucro, en Somerton. Solo unas 60 personas a la semana usan los autobuses proporcionados por Arizona para llegar a las zonas cercanas a Washington DC, dijo.

“La gente protesta por los autobuses, pero la mayoría [de los migrantes] llegan a los aeropuertos”, dijo Aguirre, cuya organización ayuda a los migrantes a llegar a donde necesitan ir una vez que son liberados después de la revisión federal en la frontera. Lo mismo ocurre en la frontera de Texas, dijeron los defensores.

“Los migrantes estaban comprando billetes de Greyhound y de avión mucho antes de que los autobuses estatales entraran en escena”, dijo Tiffany Burrow, directora de operaciones de Val Verde Border Humanitarian Coalition (VVBHC), en Del Río, Texas.

La ciudad de El Paso, Texas, dirigida por los demócratas, ha empezado a proporcionar autobuses cuando la oleada de migrantes venezolanos ha desbordado el espacio de los refugios de la ciudad. La ciudad ha rentado al menos 60 autobuses desde agosto para llevar a 3,000 personas a New York y Chicago.

“No enviamos a nadie a donde no quiere ir. Nos aseguramos de ayudarlos”, dijo el alcalde de El Paso, el demócrata Oscar Leeser, en una entrevista reciente con ABC News.

La ciudad de Albuquerque, New Mexico, ha estado ayudando a los solicitantes de asilo a organizar el viaje bajo la administración demócrata del alcalde Tim Keller. La mayoría de los emigrantes tienen que marcharse, ya que el estado no cuenta con un tribunal de inmigración en el que puedan solicitar asilo. Aun así, la mayoría organiza sus propios vuelos o autobuses y otros reciben ayuda a través de donaciones privadas organizadas por voluntarios, dijo Michelle Meléndez, directora de la Oficina de Equidad e Inclusión (OEI) de la ciudad.

Michael Hopkins, director general de Jewish Family Service of San Diego (JFSSD), calificó de “deshumanizante” el transporte de los gobernantes de los estados rojos [republicanos] y dijo que su servicio traslada a los solicitantes de asilo de forma “más compasiva”.

En un periodo de cuatro semanas, entre finales de agosto y septiembre, el grupo ayudó a más de 5,700 personas a salir de San Diego, de las cuales alrededor del 85 por ciento se dirigieron fuera del estado, de acuerdo con las estadísticas publicadas en su página web. El grupo compra boletos de autobús y avión con la ayuda de dinero local y estatal, así como de donantes privados, pero, a diferencia de Arizona y Texas, no proporciona autobuses rentados programados a un único destino.

“Nuestro objetivo es asegurarnos de que los huéspedes lleguen a sus destinos cómodamente. Han pasado por experiencias traumáticas”, dijo Kate Clark, directora sénior de servicios de inmigración de JFSSD.

Florida y Texas son los países que reciben más solicitantes de asilo, de acuerdo con las estadísticas federales. Los gobernadores republicanos de allí y de Arizona se han manifestado a favor de enviar a los inmigrantes en autobuses a ciudades demócratas, aunque muchos de ellos desembarcan en estados republicanos de todos modos.

Las oficinas federales de asilo en Florida, en donde los migrantes se registran mientras esperan las audiencias de asilo, recibieron la mayor parte de los solicitantes de asilo, alrededor del 45 por ciento del total nacional de 43.289 solicitudes entre enero y marzo de este año, las últimas cifras disponibles. En Houston se tramita alrededor del 10 por ciento de los casos, que pueden incluir a inmigrantes que viven en estados cercanos, y alrededor del nueve por ciento se tramitan en la zona de Washington, D. C., en una oficina de Arlington, Virginia.

Los solicitantes de asilo puestos en libertad condicional en la frontera no tienen permiso legal de trabajo hasta que un tribunal de inmigración acepte su caso, lo que puede llevar años.

El máximo responsable de la frontera del país, el comisario de Aduanas y Protección Fronteriza (CBP), Chris Magnus, acusó a los gobernadores republicanos de “atraer” a más inmigrantes con transporte a la costa este y falsas promesas de trabajo en ciudades demócratas.

Un grupo de inmigrantes venezolanos presentó una demanda el 20 de septiembre contra el gobernador republicano de Florida, Ron DeSantis, diciendo que fueron engañados para abordar un avión que luego aterrizó sin previo aviso en Martha’s Vineyard, Massachusetts.

Los defensores de la inmigración en la ciudad de New York y Washington DC, también se quejaron de que los autobuses patrocinados por el estado de Texas llegan sin previo aviso ni coordinación y que los migrantes a menudo están hambrientos o enfermos. Los autobuses de Arizona, por el contrario, sirven comida y llevan profesionales médicos para ayudar a los migrantes en el camino.

“Arizona es definitivamente el mejor ejemplo de hacer esto de la manera correcta”, dijo Selee.

En el período de 11 meses que va de octubre de 2021 a agosto de 2022, la Patrulla Fronteriza de Estados Unidos dijo que encontró 2.15 millones de personas cruzando la frontera desde México, un récord para cualquier año y más de cuatro veces el nivel de 2020.

Algunos de esos cruces fronterizos son segundos o terceros intentos, ya que los migrantes a los que se les prohíbe pedir asilo siguen intentándolo, dijo Sara Ramey, directora de Migrant Center for Human Rights, un grupo de servicios legales en San Antonio, Texas.

Eso no incluye a los miles de personas que llegan a Estados Unidos con visados de turista cada mes desde Haití, Nicaragua y Venezuela, quienes a menudo también solicitan asilo, dijo Ava Benach, una abogada de inmigración de Washington, D. C., que ha ayudado a cientos de migrantes con casos de asilo.

“Hay una tonelada de venezolanos y cubanos que se dirigen a Florida”, dijo Benach. Junto con los nicaragüenses, dijo, esos migrantes suelen quejarse de las represivas “brigadas comunitarias” semigubernamentales, que imponen la ideología izquierdista en sus países de origen y amenazan o acosan a cualquiera que se considere disidente.

El gobernador republicano de Texas, Greg Abbott, citó el anunciado fin de una política fronteriza de la era Trump que expulsaba inmediatamente a los migrantes para detener la propagación del COVID-19 cuando Abbott comenzó a ofrecer viajes en autobús a los migrantes en abril. Sin embargo, las llamadas restricciones federales del Título 42 siguen vigentes, lo que provoca expulsiones en la frontera para muchos de El Salvador, Guatemala, Honduras y México.

Pero los cubanos, nicaragüenses y venezolanos no pueden ser expulsados de Estados Unidos porque México no los acepta, dijo Selee.

El gobierno de Biden, en vista de la afluencia, está negociando con México para permitir que más de esos migrantes sean devueltos por la frontera, dijeron funcionarios estadounidenses y mexicanos a Reuters.

El gobernador de Texas, Greg Abbott, y el de Arizona, Doug Ducey, han gastado millones de dólares en transportar a los migrantes a las ciudades liberales, para protestar por la intención del presidente Joe Biden de eliminar algunas restricciones fronterizas de la época de la pandemia y por las políticas de inmigración demócratas en general.

Pero cada vez más, los migrantes se bajan de los autobuses antes de llegar a Washington y New York, que son demasiado caras para instalarse para muchos migrantes que no tienen amigos ni familia en esas ciudades. En su lugar, desembarcan en estados republicanos a lo largo de la ruta, donde el costo de la vida es mucho menor, pero en donde su presencia ha generado la oposición de algunos funcionarios estatales y locales.

“Si Texas va a poner a la gente en los autobuses, tienen que asegurarse de que estas personas van a sus destinos”, dijo el representante estatal de Georgia, Mike Cameron, un republicano que protestó en las paradas de autobús en el Condado Dade, Georgia. “Entiendo el problema de Texas, pero no hay que poner a la gente en un autobús y dejar que se baje en cualquier sitio. Esa no es una solución”.

Tanto Arizona como Texas le ofrecen a los solicitantes de asilo viajes voluntarios en autobús, ya que son liberados con permiso para viajar y proseguir con sus solicitudes de asilo después de las revisiones realizadas por los agentes de la Oficina de Aduanas y Protección Fronteriza de Estados Unidos (CBP), que determinan que no son una amenaza para la seguridad y no cumplen los requisitos para los programas que obligan a algunos solicitantes de asilo a esperar al sur de la frontera. En Texas, un grupo humanitario ofrece los asientos de los autobuses financiados por el Estado a quienes necesitan transporte.

Texas no puede impedir que la gente baje en las paradas intermedias, pero los autobuses ya no se detienen en el Condado Dade o en la cercana Chattanooga, Tennessee, luego de las protestas de Cameron y otros funcionarios republicanos.

Los migrantes han desembarcado en Georgia, North Carolina y Tennessee en las últimas semanas y algunos de los autobuses que llegan a New York y Washington están casi vacíos, de acuerdo con los medios de comunicación, aunque las organizaciones benéficas locales dijeron que siguen ayudando a decenas de migrantes que llegan casi a diario. El gobernador de Florida, el republicano Ron DeSantis, le advirtió a los migrantes en abril que no usaran los autobuses para llegar a su estado, diciendo que “Florida no es un estado santuario”.

Sin embargo, alrededor del 20 por ciento de los migrantes transportados en autobús por Arizona tienen como destino final Florida, de acuerdo con un informe estatal. Texas no ha publicado un desglose de los destinos de sus migrantes.

Los que se quedan en los autobuses y llegan a Washington, DC, a menudo solo necesitan un poco de asesoramiento y ayuda para reunirse con amigos y familiares dispuestos a ayudarles, dijo Abel Núñez, director de la organización sin ánimo de lucro CARECEN DC, o Central American Resource Center, que ha estado reuniendo de ocho a 10 autobuses a la semana en el Distrito de Columbia. Un hombre manejó desde Nueva Jersey para conocer a su hijo cubano perdido hace tiempo cuando llegó en un autobús recientemente, dijo.

Pero los que no tienen dinero o conexiones, tal vez el 15 por ciento de los que llegan, tienen un camino difícil sin permiso para trabajar legalmente y sin manera de pagar los costos de vivienda que se disparan, dijo.

“A veces tienen la idea de que todo está pavimentado con oro si logran llegar aquí. Tenemos que decirles: ‘No, básicamente si te quedas aquí vas a ser un sin techo, [estarás] trabajando con albergues’. Esa es la realidad”, dijo Núñez.

Los pasajeros de autobús que se bajaron en el Condado Dade, Georgia, generaron quejas de los habitantes y del jefe de policía local en agosto, y algunos habitantes de Chattanooga se alarmaron cuando los migrantes sin recursos empezaron a pedir comida en un McDonald’s local. Algunos intentaban llegar al cercano aeropuerto de Chattanooga para alcanzar otros destinos. Los políticos republicanos protestaron y los autobuses ya no se detienen en esa zona.

El gobernador republicano de Georgia, Brian Kemp, “comparte la preocupación del jefe de policía por esta práctica” de que los autobuses se detengan en el Condado Dade, le dijo el portavoz Andrew Isenhour en un correo electrónico a Stateline.

Hubo quejas similares en la cercana Chattanooga, que colinda con el Condado Dade, aunque las autoridades de la ciudad no se molestaron en ayudar a los migrantes.

“Esta administración responderá con compasión a las personas vulnerables que huyen de circunstancias extremadamente difíciles”, publicó el jefe de gabinete del alcalde Tim Kelly en un comunicado a mediados de agosto, señalando que los migrantes habían sido examinados por CBP y estaban legalmente en libertad condicional mientras buscaban asilo.

Sin embargo, la senadora estadounidense Marsha Blackburn, republicana de Tennessee, también se quejó públicamente de las paradas el 15 de agosto, acusando a los migrantes de “querer llegar a donde están sus amigos” y de esperar “un viaje gratis en autobús a donde quieran ir”.

Al día siguiente, 16 de agosto, la empresa de autobuses contratada por Texas, Wynne Transportation, le comunicó a las autoridades de Chattanooga que no habría más paradas en la ciudad.

Sería ilegal que la empresa de autobuses impidiera que la gente se bajara del autobús cuando este se detuviera, dijo Muzaffar Chishti, experto en política de inmigración y miembro principal de la oficina de New York del Instituto de Política Migratoria (MPI), una organización no partidista.

“Estos inmigrantes pobres tienen la capacidad de decidir a dónde quieren ir. No se les puede decir: ‘Tienes que ir a New York’ cuando tienen parientes en Georgia, Miami o North Carolina”, dijo Chishti. “Eso sería detenerlos en el autobús y Texas no tiene ninguna base para hacer eso”.

La oficina de Abbott no respondió a una pregunta respecto a si ha reducido las paradas en Georgia, Tennessee o en cualquier otro lugar del trayecto, pero la secretaria de prensa del gobernador de Texas, Renae Eze, enfatizó en un correo electrónico que los migrantes son libres de bajarse en cualquier lugar en donde el autobús se detenga.

“Los migrantes pueden comprar cualquier provisión necesaria o desembarcar en cualquiera de estas paradas”, escribió Eze, aunque añadió que “los migrantes eligieron voluntariamente ir a la ciudad de New York o a la capital de nuestra nación” y aceptaron el destino cuando firmaron una renuncia de liberación.

Cuando cruzan la frontera mexicana, los solicitantes de asilo son examinados por agentes de CBP. Tienen libertad condicional de 60 días mientras solicitan asilo en los tribunales, dijo Chishti.

A los que son liberados en Del Río, Texas, una organización de servicios, la Coalición Humanitaria de la Frontera de Val Verde, puede ofrecerles un asiento en el autobús si eso los acerca a su destino final, dijo Tiffany Burrow, directora de operaciones de la coalición. Depende de cuántos asientos estén disponibles y de cuántos migrantes sean liberados.

“Cada día es diferente”, dijo Burrow.

Por lo general, los asientos se destinan a personas que planean ir al noreste, pero, si hay extras, las personas que se dirigen al sureste podrían obtener un asiento y desembarcar en una de las seis paradas para que el autobús recargue gasolina o para cambiar de conductor, dijo.

CBP dijo que los migrantes que pueden acceder a los autobuses deben tener una dirección en Estados Unidos y registrarse regularmente para mantener su estatus legal de libertad condicional.

Sin embargo, hay cierta confusión en torno a los migrantes con direcciones de destino, rellenadas por CBP, que resultan ser centros de servicio de Catholic Charities o las propias oficinas de CARECEN DC en el Distrito de Columbia. Catholic Charities se quejó de esta práctica en New York, diciendo que nunca había oído hablar de los migrantes antes de que empezaran a recibir correo para ellos.

“Es difícil calibrar su intención”, dijo Chishti. “Si la intención es decir ‘Esto les dará una lección por apoyar a los inmigrantes’, eso es una cosa. Pero podría ser que estén poniendo esa dirección pensando ‘Al menos este lugar les ofrecerá algo de ayuda'”.

La portavoz de CBP, Cecilia Barreda, no dijo cómo se acaban usando las direcciones de lugares como Catholic Charities, pero dijo que a los inmigrantes se les da un formulario para que puedan cambiar la dirección cuando lleguen a su destino.

Nuñez dijo que interpreta las direcciones falsas, que a veces son de su propia oficina de CARECEN DC, como un intento de los funcionarios federales de inmigración de ayudar a los migrantes que no tienen amigos o familiares en Estados Unidos.

“No pueden presentar una solicitud de asilo si no tienen una dirección”, dijo.

De acuerdo con lo que le explicaron trabajadores de organizaciones sin ánimo de lucro a Stateline, la mayoría de los migrantes de Texas proceden de Venezuela, Cuba, Colombia y Nicaragua. Los autobuses de Arizona a Washington, DC, se han llenado en su mayoría con personas de Colombia, Perú y Venezuela, de acuerdo con los informes del estado.

Otros solicitantes de asilo procedentes de Guatemala, Honduras y El Salvador siguen estando vetados en virtud de los programas pandémicos para limitar la inmigración. El gobierno de Biden pretendía detener las llamadas expulsiones del Título 42, pero el asunto está detenido en los tribunales.

El representante estadounidense Adriano Espaillat, un demócrata que representa a partes de Manhattan y el Bronx, dijo que los inmigrantes deberían recibir más información acerca de los servicios que la ciudad de New York puede proporcionarles cuando lleguen.

“Se les deja abandonados y sin saber los recursos que necesitan”, dijo, diciendo que él personalmente rescató a una familia venezolana con niños pequeños cuando intentaban caminar desde un centro de servicios en Manhattan hasta un refugio para personas sin hogar cerca del estadio de los Yankees en el Bronx.

“Fue una larga caminata y estaban a punto de perder el plazo para entrar en el refugio. Todo lo que saben es caminar, así que eso es lo que estaban haciendo”, dijo Espaillat. “Habían caminado todo el camino hasta la frontera, incluyendo el Tapón del Darién [entre Panamá y Colombia], a través de la selva con animales salvajes, sosteniendo a un pequeño bebé”.

Arizona ha gastado alrededor de 3 millones de dólares desde mayo para transportar a los migrantes en autobús a Washington, DC, y Ducey destinó hasta 15 millones de dólares para continuar con el programa en el presupuesto del próximo año. Texas empezó a aceptar donaciones públicas para sufragar parte de los 7 millones de dólares que ha gastado en autobuses desde abril.

“Se está usando a los migrantes como peones en unas elecciones cargadas de política, sembrando intencionalmente el caos para que los gobernadores puedan decir: ‘Están probando su propia medicina’. Eso no puede ser bueno”, dijo Chishti.

Texas Gov. Greg Abbott and Arizona Gov. Doug Ducey have spent millions of dollars transporting the migrants to the liberal cities to protest President Joe Biden’s intention to roll back some pandemic-era border restrictions and Democratic immigration policies more generally.

But increasingly the migrants are hopping off the buses before reaching Washington and New York, which are too expensive to settle in for many migrants who don’t have friends or family in those cities. Instead, they are disembarking in red states along the route, where the cost of living is much lower — but where their presence has generated opposition from some state and local officials.

“If Texas is going to put people on buses, they need to make sure that these individuals are going to their destinations,” said Georgia state Rep. Mike Cameron, a Republican who protested bus stops in Dade County, Georgia. “I understand Texas’ problem, but don’t just put people on a bus and let them get off anywhere. That’s not a solution.”

Both Arizona and Texas offer asylum-seekers voluntary bus rides as they are released with permission to travel and pursue their asylum claims after screenings by U.S. Customs and Border Protection agents, who determine they’re not a security threat and don’t qualify for programs that force some asylum-seekers to wait south of the border. In Texas, a humanitarian group offers the seats on state-funded buses to those who need transportation.

Texas can’t stop people from getting off at intermediate stops, but the buses no longer stop in Dade County or nearby Chattanooga, Tennessee, after protests from Cameron and other Republican officials.

Migrants have disembarked in Georgia, North Carolina and Tennessee in recent weeks, and some of the buses arriving in New York and Washington have been nearly empty, according to media reports, though local charities say they’re still helping dozens of arriving migrants almost daily. Florida Gov. Ron DeSantis, a Republican, warned migrants back in April not to use the buses to get to his state, saying “Florida is not a sanctuary state.”

Nevertheless, about 20% of migrants bused by Arizona have final destinations in Florida, according to a state report. Texas has not released a breakdown of destinations for its migrants.

Those who do stay on the buses and arrive in Washington, D.C., often just need a little advice and help to join friends and family ready to help them, said Abel Nuñez, director of the nonprofit CARECEN DC, or Central American Resource Center, which has been meeting eight to 10 buses a week in the District of Columbia. One man drove from New Jersey to meet his long-lost Cuban son as he arrived on a bus recently, he said.

But those with no money or connections, maybe 15% of those arriving, have a tough road with no permission to work legally and no way to pay for soaring housing costs, he said.

“Sometimes they get the idea that it’s paved with gold, if they can just get here. We have to tell them ‘No, basically if you stay here, you’re going to be homeless, working with shelters.’ That’s the reality,” Nuñez said.

Bus riders who got off in Dade County, Georgia, generated complaints from residents and the local sheriff in August, and some Chattanooga residents were alarmed when penniless migrants started asking for food at a local McDonald’s. Some were trying to get to the nearby Chattanooga Airport to reach other destinations. Republican politicians protested, and buses no longer stop in the area.

Georgia Republican Gov. Brian Kemp “shares the Sheriff’s concern about this practice” of buses stopping in Dade County, spokesperson Andrew Isenhour said in an email to Stateline.

There were similar complaints in nearby Chattanooga, which adjoins Dade County, though city officials didn’t mind helping the migrants.

“This administration will respond with compassion to vulnerable people fleeing extremely difficult circumstances,” Mayor Tim Kelly’s chief of staff posted in a statement in mid-August, noting that the migrants had been screened by the Customs and Border Protection and were legally paroled while seeking asylum.

However, U.S. Sen. Marsha Blackburn, a Tennessee Republican, also complained about the stops publicly Aug. 15, accusing migrants of “wanting to get to where their friends are” and expecting “a free bus ride to wherever they want to go.”

The next day, Aug. 16, the bus company hired by Texas, Wynne Transportation, told Chattanooga officials there would be no more stops in the city.

It would be illegal for the bus company to prevent people from leaving the bus when it stops, noted Muzaffar Chishti, an immigration policy expert and senior fellow at the nonpartisan Migration Policy Institute’s New York City office.

“These poor immigrants have the ability to decide where they want to go. You can’t tell them, ‘You have to go to New York,’ when they have relatives in Georgia or Miami or North Carolina,” Chishti said. “That would be detaining them on the bus, and Texas has no basis to do that.”

Abbott’s office did not respond to a question about whether it has curtailed stops in Georgia and Tennessee — or anywhere else along the way. But the Texas governor’s press secretary, Renae Eze, emphasized in an email that migrants are free to get off anywhere the bus happens to stop.

“Migrants are allowed to purchase any needed provisions or disembark at any of these stops,” Eze wrote, though she added that “the migrants willingly chose to go to New York City or our nation’s capital” and agreed to the destination when they signed a release waiver.

When they cross the Mexican border, asylum-seekers are screened by officers from Customs and Border Protection. They are on a 60-day parole while they seek asylum in court, Chishti said.

Those who are released in Del Rio, Texas, may be offered a bus seat by a service organization, the Val Verde Border Humanitarian Coalition, if it gets them closer to their final destination, said Tiffany Burrow, operations director for the coalition. It depends on how many seats are available and how many migrants are released.

“Every day is different,” Burrow said.

Generally, the seats go to people who plan to go to the Northeast. But if there are extras, people headed for the Southeast could get a seat and disembark at one of six stops for gas and driver changes, she said.

Customs and Border Protection said migrants eligible for buses must have an address in the United States and check in regularly to maintain legal parole status.

But some confusion swirls around migrants with destination addresses, filled in by the Customs and Border Protection, that turn out to be Catholic Charities service centers or CARECEN DC’s own offices in the District of Columbia. Catholic Charities complained of the practice in New York, saying it had never heard of the migrants before they started getting mail for them.

“It’s hard to gauge the intent of his,” Chishti said. “If the intent is to say, ‘This will teach them a lesson for supporting immigrants’ that’s one thing. But it could be that they’re putting down that address thinking, ‘At least this place will offer them some help.'”

Customs and Border Protection spokesperson Cecilia Barreda did not say how addresses for places such as Catholic Charities end up getting used, but said migrants are given a form so they can change the address when they reach their destination.

Nuñez said he interprets the bogus addresses, which are sometimes his own CARECEN DC office, as an attempt by federal immigration officers to help migrants with no friends or family in the United States.

“They cannot make an asylum claim if they don’t have an address,” he said.

Most of the migrants from Texas are from Venezuela, Cuba, Colombia and Nicaragua, nonprofit workers told Stateline. Arizona’s buses to Washington, D.C., mostly have been filled with people from Colombia, Peru and Venezuela, according to state reports.

Other asylum-seekers from Guatemala, Honduras and El Salvador are still barred under pandemic programs to limit immigration. The Biden administration intended to stop so-called Title 42 expulsions but the issue is held up in court.

U.S. Rep. Adriano Espaillat, a Democrat representing parts of Manhattan and the Bronx, said the migrants should get more information on the services New York City can provide when they arrive.

“They are left stranded and unaware of the resources they need,” he said, saying he personally rescued a Venezuelan family with small children as they tried to walk from a service center in Manhattan to a homeless shelter near Yankee Stadium in the Bronx.

“That was one long walk, and they were about to miss the deadline to get in the shelter. That’s all they know is walking so that’s what they were doing,” Espaillat said. “They had walked all the way to the border including the Darien Gap (between Panama and Colombia) through the jungle with wild animals, holding a little baby.”

Arizona has spent about $3 million since May to bus migrants to Washington, D.C., and Ducey earmarked as much as $15 million to continue the program in next year’s budget. Texas has started taking public donations to defray some of the $7 million it has spent on buses since April.

“The migrants are being used as pawns in a politically charged election, intentionally sowing chaos so the governors can say, ‘You’re getting a taste of your own medicine.’ That can’t be good,” Chishti said.

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