BATON ROUGE, La. (AP) — An old political standby — the future of Medicare — is emerging as the go-to issue in Louisiana's bitter Senate race as the candidates woo seniors who typically wield strong influence in midterm elections.
The challenge for voters is to figure out which side, if either, is telling the whole truth about who would cut and who would protect the popular insurance program. Medicare serves more than 50 million people and accounts for about 15 percent of federal spending, with about 10,000 new beneficiaries added daily as baby boomers reach age 65. The issue is so powerful that it's cropping up in North Carolina and Iowa, too, amid a national battle for control of the Senate.
Louisiana Sen. Mary Landrieu got hundreds of seniors grumbling at a recent forum when she told them her top Republican rival, Rep. Bill Cassidy, wants to turn Medicare into a "voucher system" and has voted to raise the retirement age to make Americans wait longer for benefits.
"No wonder Bill Cassidy didn't come today, because he didn't want you to know this," said Landrieu, who finds herself in another tough re-election bid as she seeks a fourth term.
Landrieu has made the issue of entitlement programs for the elderly a centerpiece of her campaign, traveling Tuesday to three senior centers across south Louisiana to announce a new endorsement from the National Committee to Preserve Social Security and Medicare, a Washington-based advocacy group.
The Senate Democrats' campaign arm has aired an ad against Cassidy featuring three older white women — a crucial demographic for Landrieu in a state that President Barack Obama twice lost badly — bemoaning Cassidy's plan that "(requires) seniors to buy private insurance with fewer benefits and higher costs." Democrats have hit Iowa Republican Senate nominee Joni Ernst with similar ads.
Cassidy and his backers answer that it's Landrieu who cut Medicare when she voted in 2010 for Obama's signature health care overhaul, which reduced payments for private policies under the Medicare Advantage program.
Americans for Prosperity, the political action organization backed by the conservative billionaire Koch brothers, Charles and David, cites that Affordable Care Act vote in similar ads opposing Landrieu and her North Carolina colleague, Sen. Kay Hagan.
The three races are among the handful that will decide which party controls the Senate for the final two years of Obama's presidency. Republicans must net six more seats for a majority.
The back-and-forth reprises a major theme of the 2012 presidential election. Obama and Republican nominee Mitt Romney leveled the same attacks, with Romney prevailing among voters older than 55. The issue also helped Republicans in 2010, when the GOP used dissatisfaction and confusion over the new health care law to win a House majority.
While Republican Medicare attacks are based on the health care law, the Democratic attacks are based mostly on House Republicans' budget blueprint, the Paul "Ryan Budget," so-named for the Wisconsin congressman and budget chairman who was Romney's running mate.
The Affordable Care Act changed how Medicare pays doctors and hospitals and included reductions — the $700 billion in cuts the GOP cites — in Medicare Advantage, which allows seniors in certain markets to purchase coverage from private insurers.
Ryan's budgets, meanwhile, propose a long-term shift to a voucher system for seniors' health care, where beneficiaries would get taxpayer money and then choose among traditional Medicare and private policies sold on the open market — similar to the exchanges the health care law set up for working-age Americans. The House has stopped short of passing legislation that would actually implement the overhauls assumed in their budget plans, and the budget votes have been largely symbolic anyway since Republicans have the political cover of a Democratic Senate, which routinely kills legislation passed in the House.
Medicare's latest annual report, issued this summer, projects that the program's hospital trust fund won't be exhausted until 2030, at which time payroll taxes are projected to cover just 85 percent of Medicare's costs. Yet each side persists in attacking the other's proposals as untenable "cuts."
"The $700 billion that Obamacare cut from Medicare spends it on other programs," Cassidy said, referring to the law shifting some health care spending to premium subsidies for working-age policy holders. "The $700 billion in the Ryan budget puts it back into the trust fund."
Landrieu and Democrats argue that the new law covers more Americans and, thus, lowers health care costs across the board by saving on treating the uninsured.
Democrats also note Congressional Budget Office projections that premiums for traditional Medicare could nearly double under the Ryan proposal, leaving seniors to choose the more expensive public insurance or less expensive private plans with lower benefits and more out-of-pocket expenses.
Analyses from the insurance industry and independent groups note that under both parties' models there would be rural areas where private firms may not offer policies at all.
Landrieu's most aggressive criticism of Republican Medicare plans, meanwhile, ignores that the changes would not affect anyone who is old enough now to qualify for Medicare. That means none of those voters Landrieu stirred up at a senior center would be forced off traditional coverage under plans Cassidy has supported.
Nonetheless, Landrieu defends her attacks. "You can only judge what somebody's going to do based on what they've already done," she said.
GENEVA (AP) — Tens of thousands of doses of experimental Ebola vaccines could be available for "real-world" testing in West Africa as soon as January as long as they are deemed safe, a top World Health Organization official said Tuesday.
Dr. Marie Paule Kieny, an assistant director general for WHO, said clinical trials that are either underway or planned in Europe, Africa and the U.S. are expected to produce preliminary safety data on two vaccines by December.
If the vaccines are declared safe, she said they will be used in trials in West Africa beginning in January to test their effectiveness among tens of thousands — but not millions — of people.
"I'm not suggesting at this moment that there would be mass vaccination campaigns at population levels starting in 2015," she said, adding that none of the volunteers who take part in the trials could accidentally contract Ebola from the testing.
The Ebola outbreak in West Africa has already killed over 4,500 people, mostly in Liberia, Guinea and Sierra Leone, since it emerged 10 months ago. Experts have said the world could face 10,000 new cases of Ebola a week in two months if authorities don't take stronger steps to fight the deadly virus.
In other Ebola news Tuesday:
— Sierra Leone said the number of infected people in the country's western region is soaring, with more than 20 Ebola deaths a day. That region is on the opposite side of the country from where the first Ebola cases emerged.
— In the United States, the Homeland Security Department is requiring that anyone coming in from Sierra Leone, Guinea or Liberia must enter through one of the five U.S. airports screening passengers for Ebola: New York's Kennedy, Newark Liberty, Washington's Dulles, Chicago's O'Hare and Hartsfield-Jackson Atlanta.
And in Spain, doctors said tests showed that a Spanish nursing assistant infected with Ebola in Madrid was completely clear of the virus. Teresa Romero, 44, had battled for her life after she tested positive Oct. 6.
Safety isn't the only question before larger studies of the vaccines begin — the shots must also trigger an adequate immune-system response in the first volunteers tested.
One of the two vaccines that Kieny mentioned was developed by the U.S. National Institutes of Health and GlaxoSmithKline from a modified chimpanzee cold virus and an Ebola protein. It is in clinical trials now in the U.K. and in Mali and will be used in trials in Lausanne, Switzerland, by the start of February.
GlaxoSmithKline says the vaccine is being manufactured at a plant in Rome, which Glaxo acquired last year along with the Italian company that developed the Ebola vaccine, Okairos AG.
"We have other vaccine facilities around the world and we are seeing what we can do to ramp up production to commercial scale," said Mary Anne Rhyne, Glaxo's U.S. director of external communications.
The second front-runner, developed by the Public Health Agency of Canada and known as VSV-EBOV, has been sent to the U.S. Walter Reed Army Institute of Research in Maryland for testing on healthy volunteers, with preliminary results about its safety expected by December. The next stage would be to test it more broadly, including among those directly handling Ebola cases in West Africa.
Canada has donated 800 vials of the experimental vaccine to WHO but the shipment was delayed by a Lufthansa pilots' strike. Those are now expected to arrive in Switzerland on Wednesday for testing coordinated by the U.N. health agency among volunteers at the University Hospital of Geneva, and volunteers in Hamburg, Germany, and in Gabon and Kenya, Kieny said.
"These data are absolutely crucial to allow decision-making on what dose level should go in the efficacy testing in Africa," Kieny said. "We expect, we hope, to have a go-ahead by the end of the month."
That would allow the vaccine to be shipped for use in Africa immediately afterward.
Kieny said decisions about "which strategy to use and how and where and who" regarding the vaccines will be made in the next few weeks. Then vaccines will be given to health workers and select segments of the general population "early in 2015, in January."
At a separate news conference, WHO spokeswoman Fadela Chaib promised a thorough public audit of the agency's early missteps — and those by countries and partner organizations — in responding to the Ebola crisis.
"There is certainly a wish and a will to have this review," she said. "We know many elements need to be explained in the future. ... WHO will do that, but in the future; now our focus is on the response."
The U.N.'s emergency committee on Ebola plans to meet later this week in Geneva to study the outbreak further and decide what more should be done.
The East African nation of Rwanda, meanwhile, was singling out travelers from the three West African nations for special treatment, as well as people from Spain and the U.S., where a very limited number of Ebola cases have emerged.
The Rwandan Ministry of Health said Tuesday all passengers from those five nations will have their temperatures taken upon arrival. If a passenger has a fever, they will be denied entry. If there is no fever, the visitors still must report their health condition daily to authorities.
The U.S. Embassy in Rwanda urged Americans who may have a fever or who have traveled to Ebola countries "to weigh carefully whether travel to Rwanda at this time is prudent."
No Ebola cases have emerged in Rwanda.
AP reporters Maria Cheng in London, Edmund Kagire in Kigali, Rwanda, Lauran Neergaard and Matthew Perrone in Washington, D.C., contributed to this report.
PRETORIA, South Africa (AP) — Oscar Pistorius was taken away in a police van with barred windows Tuesday to start serving a five-year prison sentence for killing girlfriend Reeva Steenkamp.
Delivering her sentence, Judge Thokozile Masipa cited the "gross negligence" the double-amputee Olympic runner showed when he shot Steenkamp multiple times through a toilet cubicle door in his home.
Pistorius, who cried and retched during his murder trial, was unemotional as he stood to hear his sentence. His prison term begins immediately and he was led by police down a flight of stairs to holding cells before leaving the courthouse in the armored vehicle.
The world-famous runner later arrived at the nearby Kgosi Mampuru II prison in the South African capital, a facility that has had problems with violence and overcrowding and where during the years of apartheid death row inmates were executed before capital punishment was outlawed with the advent of democracy. Despite the prison's reported problems, authorities have said Pistorius would be held away from the general prison population because of his disability and high profile — possibly in a hospital wing or a high-security section.
Pistorius could be released after 10 months to serve the remainder under house arrest, according to legal experts. Masipa last month convicted Pistorius of culpable homicide, or negligent killing, but acquitted him of murder after he testified he mistook Steenkamp for a nighttime intruder.
Steenkamp's parents were in court to hear the sentence and the dead model's mother, June, said justice had been done. A close friend of Steenkamp, Gina Myers, said: "I really don't think any of us will heal anytime soon ... there will always be questions."
Pistorius' uncle, Arnold Pistorius, appealed to reporters to give the family privacy after what he called "20 months of relentless public trial." He criticized prosecutors for pursuing a premeditated murder charge against Pistorius, and said "they decided to inflict as much collateral damage as they could." He said Pistorius' family accepted the sentence.
"Oscar will embrace this opportunity to pay back to society," Arnold Pistorius said.
Judge Masipa earlier described the sentencing as a balancing act between retribution and clemency.
"I am of the view that a non-custodial sentence would send a wrong message to the community," Masipa said, taking just over an hour to summarize parts of the case and explain why she reached her decision. "On the other hand, a long sentence would not be appropriate either as it would lack the element of mercy."
Masipa asked Pistorius to stand as she delivered the sentence, and he faced her with his hands clasped in front of him. Pistorius was then led away, stopping briefly to grip the hands of his uncle and other family members as he headed to prison.
Prosecutors said they are considering whether to appeal the sentence, where Pistorius, 27, could serve less than a year in jail for killing his 29-year-old girlfriend. They have 14 days to apply for permission to appeal.
Nathi Mncube, the prosecution spokesman, said his office was disappointed in the culpable homicide conviction and had not yet decided whether to appeal. He said that there was an "appetite" to appeal but prosecutors would review their options.
"We are satisfied with the fact that he will be serving some time in prison," Mncube said.
Masipa had a wide range of options available to her because South Africa does not have a minimum sentence for culpable homicide, which is comparable to manslaughter. Pistorius, a once-inspiring athlete, known as the Blade Runner because he competed on carbon-fiber blades, was the first amputee to run at the Olympics in 2012. He had faced up to 15 years in jail. He also could have received a completely suspended sentence or house arrest.
The sentence raised questions over if Pistorius, a multiple Paralympic champion, would ever return to the career that made him famous. The International Paralympic Committee said he would not be eligible to run during his five-year sentence, ruling him out of the 2016 Rio de Janeiro Paralympics.
Pistorius must serve one-sixth of his sentence in prison — 10 months — before he is eligible to be moved to house arrest, said Marius du Toit, a legal analyst and criminal defense lawyer.
"It's an appropriate sentence," du Toit said.
As Pistorius left in the police van, a crowd gathered around the vehicle, with some whistling, shouting and banging on the caged windows.
Imray reported from Stellenbosch, South Africa. AP writer Lynsey Chutel contributed to this report from Johannesburg.
BEIRUT (AP) — Islamic State group fighters seized at least one cache of weapons airdropped by U.S.-led coalition forces that were meant to supply Kurdish militiamen battling the extremist group in a border town, activists said Tuesday.
The cache of weapons included hand grenades, ammunition and rocket-propelled grenade launchers, according to a video uploaded by a media group loyal to the Islamic State group.
The video appeared authentic and corresponded to The Associated Press' reporting of the event. The Britain-based Syrian Observatory for Human Rights, which bases its information on a network of activists on the ground, said the militants had seized at least one cache.
The caches were airdropped early Monday to Kurds in the embattled Syrian town of Kobani that lies near the Turkish border. The militant group has been trying to seize the town for over a month now, causing the exodus of some 200,000 people from the area into Turkey. While Kurds are battling on the ground, a U.S.-led coalition is also targeting the militants from the air.
On Tuesday, IS loyalists on social media posted sarcastic thank you notes to the United States, including one image that said "Team USA."
But the lost weapons drop was more an embarrassment than a great strategic loss. The Islamic State militants already possess millions of dollars-worth of U.S. weaponry that they captured from fleeing Iraqi soldiers when the group seized swaths of Iraq in a sudden sweep in June.
On Tuesday, the U.S. Central Command said U.S. military forces conducted four airstrikes near Kobani that destroyed IS fighting positions, an IS building and a large IS unit.
Also Tuesday, Syrian government airstrikes hit a rebel-held town along the country's southern border with Jordan, killing at least eight people.
Activists with the Local Coordination Committees and the Observatory said the number of those killed was likely to rise as there are more victims under the rubble.
The LCC said Syrian government planes dropped crude explosives-laden canisters on the town of Nasib on the Syria-Jordan border.
The airstrikes are part of battles between Syrian government forces and Islamic rebel groups for control of the area.
Syrian government forces have been heavily bombing rebel areas in recent weeks, while the U.S-led coalition has been conducting airstrikes against Islamic State militants elsewhere in Syria.
WASHINGTON (AP) — Everyone coming to the United States from the three West African countries at the center of the Ebola outbreak will now be screened for the deadly disease at one of five airports, the Homeland Security Department said Tuesday.
Earlier this month, Customs and Border Protection officers at New York's Kennedy, Newark Liberty, Washington's Dulles, Chicago's O'Hare and Hartsfield-Jackson Atlanta airports started screening people arriving from West Africa. The screening includes using no-touch thermometers to determine if travelers have a temperature, one symptom of a possible Ebola infection. The Centers for Disease Control and Prevention is also working with DHS on the screening.
There are no direct flights to the United States from West Africa. About 94 percent of the roughly 150 people traveling daily from West Africa to the U.S. arrive at the one of the five airports. Homeland Security Secretary Jeh Johnson said Tuesday that now everyone traveling from Liberia, Sierra Leone or Guinea will have to land in the U.S. at one of the five airports and then fly on to their destination.
The new requirement means that people traveling from the region who were not originally passing through one of those five airports will have to rebook their flights.
Johnson said DHS now has "measures to identify and screen anyone at all land, sea and air ports of entry into the United States who we have reason to believe has been present in Liberia, Sierra Leone or Guinea in the preceding 21 days."
Concerns about travelers infected with Ebola have risen since a Liberian man traveled from the region to Dallas last month. Thomas Eric Duncan became the first person in the United States diagnosed with Ebola, a few days after arriving from West Africa. He died on Oct. 8.
Since then, two nurses who helped care for him have also been diagnosed with Ebola.
Some members of Congress have urged President Barack Obama to ban all travel from West Africa. Tuesday, House Judiciary Committee Chairman Bob Goodlatte, R-Va., praised the expansion of airport screening but again urged Obama to halt all travel from the region.
"President Obama has a real solution at his disposal under current law and can use it at any time to temporarily ban foreign nationals from entering the United States from Ebola-ravaged countries," Goodlatte said.
Sen. Chuck Schumer, D-N.Y., described the move as an "added layer of protection against Ebola entering our country."
BOSTON (AP) — A friend of Boston Marathon bombing suspect Dzhokhar Tsarnaev told a string of lies to investigators, a prosecutor told a jury Tuesday, but a defense lawyer said the defendant was a frightened 19-year-old who couldn't remember certain details because he had smoked marijuana for at least 12 hours straight.
Robel Phillipos, of Cambridge, is charged with lying to the FBI about being in Tsarnaev's dorm room at the University of Massachusetts-Dartmouth while two other friends removed a backpack containing fireworks and other potential evidence several days after the April 15, 2013, attack. Two bombs placed near the marathon finish line killed three people and injured more than 260.
During closing arguments in Phillips' trial Tuesday, Assistant U.S. Attorney Stephanie Siegmann said Phillipos repeatedly lied to FBI agents about what he did on the night of April 18, 2013, and dismissed the defense claim that Phillipos couldn't clearly remember what he did.
"First, ladies and gentlemen, there are some events that are so profound, so significant, that you cannot possibly forget them," Siegmann said. "Would you ever conceivably forget that you went to the dorm room of someone that you believe murdered three people and maimed hundreds of others?"
But Phillipos' attorney, Derege Demissie, told the jury that Phillipos had smoked marijuana at least a half dozen times that day and was unable to recall many of his activities when he was questioned by the FBI days later. Demissie said Phillipos sat in Tsarnaev's dorm room passively watching TV that night, never saw the backpack or the fireworks and did not see his friends remove the items.
Demissie repeatedly referred to Phillipos, now 21, as "this kid" and sarcastically dismissed what he said was an attempt by prosecutors to depict him as a "criminal mastermind." He emphasized that Phillipos voluntarily agreed to talk to the FBI multiple times.
"This criminal mastermind brought his cellphone and did not delete anything related to going to Dzhokhar's room and handed the phone to the agent," Demissie said. "It's consistent with a kid who has nothing to hide."
The jury was expected to begin deliberating Tuesday after after receiving instructions on the law from U.S. District Judge Douglas Woodlock.
Phillipos attended high school in Cambridge with Tsarnaev and later attended UMass-Dartmouth with him.
Prosecutors say Tsarnaev and his older brother, Tamerlan, planted two pressure-cooker bombs near the marathon finish line. Tamerlan Tsarnaev died following a shootout with police several days after the bombing.
Dzhokhar Tsarnaev has pleaded not guilty to 30 federal charges and is scheduled to go on trial in January. He could face the death penalty if convicted.