Contractor to pay soldiers $85M over Iraq chemicals

By NBC News wire services PORTLAND, Ore. -- A jury on Friday ordered an American military contractor to pay $85 million after finding it guilty of negligence for illnesses suffered by a dozen Oregon soldiers who guarded an oilfield water plant during the Iraq War. After a three-week trial, the jury deliberated for just two days before reaching a decision against the contractor, Kellogg Brown and Root. Each Guard soldier was awarded $850,000 in non-economic damages and another $6.25 million in punitive damages for "reckless and outrageous indifference" to their health in the trial in U.S. District Court in Portland.  Guardsman Rocky Bixby, the soldier whose name appeared on the suit, said the verdict should reflect a punishment for the company's neglect of U.S. soldiers. "Justice was definitely served for the 12 of us," Bixby said, adding that two of his children were about to enter the military. "It wasn't about the money, it was about them never doing this again to another soldier."   The suit was the first concerning soldiers' exposure to a toxin at a water plant in southern Iraq. The soldiers said they suffer from respiratory ailments after their exposure to sodium dichromate, and they fear that a carcinogen the toxin contains, hexavalent chromium, could cause cancer later in life. Another suit from Oregon Guardsmen is on hold while the Portland trial plays out. There are also suits pending in Texas involving soldiers from Texas, Indiana and West Virginia. Pre-existing conditions? KBR was found guilty of negligence but not a secondary claim of fraud. U.S. District Court Judge Paul Papak acknowledged before the trial began that, whatever the verdict, the losing side was likely to appeal it. Any appeal must first wait for Papak to formally enter the judgment. The company will appeal the verdict, said KBR attorney Geoffrey Harrison in a statement issued late Friday afternoon. Harrison said the verdict "bears no rational relationship to the evidence." "KBR did safe, professional, and exceptional work in Iraq under difficult circumstances," Harrison said in the statement," and multiple U.S. Army officers testified under oath that KBR communicated openly and honestly about the potential health risks. "We believe the facts and law ultimately will provide vindication." KBR witnesses testified that the soldiers' maladies were a result of the desert air and pre-existing conditions. Even if they were exposed to sodium dichromate, KBR witnesses argued, the soldiers weren't around enough of it, for long enough, to cause serious health problems. The contractor's defense ultimately rested on the fact that they informed the U.S. Army of the risks of exposure to sodium dichromate. KBR was tasked with reconstructing the decrepit, scavenged plant just after the March 2003 invasion while National Guardsmen defended the area. Bags of unguarded sodium dichromate — a corrosive substance used to keep pipes at the water plant free of rust — were ripped open, allowing the substance to spread across the plant an into the air. Read more US news on NBCNews.com Attorneys for the 12 Oregon National Guardsmen focused on the months of April, May and June 2003, alleging KBR knew about the presence of sodium dichromate and took no action. One of the soldiers' key witnesses, a doctor, testified that hexavalent chromium caused a change to soldiers' genes, leaving them more susceptible to cancer. KBR's attorneys challenged that diagnosis, saying the soldiers' witness was the only physician in the U.S. prepared to make such a diagnosis. Concern over role of contractors Plaintiff Jason Arnold said he understands that contractors are a necessity for often-specialized tasks, but he hopes the verdict forces the U.S. military to reexamine its relationship with the private defense industry. "For a corporation to come in and have this much disregard for the health and well-being of men that are shedding blood, sweat and tears for this country," Arnold said, "for them to come in and to say that we mean less than their profit, is wrong." During the Iraq war, KBR was the engineering and construction arm of Halliburton, the biggest U.S. contractor during the conflict. KBR split from Halliburton in April 2007. Read more World news on NBCNews.com KBR has faced lawsuits before related to its work in Iraq. One of the more prominent cases, involving a soldier who was electrocuted in his barracks shower at an Army base, was dismissed. A second case is still in Maryland federal court, in which former KBR employees and others who worked on Army bases in Iraq and Afghanistan allege KBR allowed them to be exposed to toxic smoke from garbage disposal "burn pits." The Associated Press and Reuters contributed to this report. More content from NBCNews.com: Woman sues Texas police department over ruptured breast implant Lawsuit: Cop stuns 10-year-old with Taser for refusing to clean his patrol car Sandy death toll in US rises to nearly 100; 'could be more,' NYC mayor says Texas teacher reportedly duct taped student's mouth shut ATF: Bombing suspect hurls pipe bombs at police during chase Follow US news from NBCNews.com on Twitter and Facebook

KBR told to pay $85M to Guard soldiers

Iraqi workers fix a water pump at the Qarmat Ali water treatment facility in Basra, Iraq on Wednesday March 10, 2004. Defense contractor KBR is found to be negligent in toxic exposure 12 soldiers suffering from various ailments filed the suit Each was awarded more than $7 million (CNN) -- Defense contractor KBR was negligent in exposing National Guard soldiers to toxic chemicals at a water plant in Iraq, a federal jury in Portland, Oregon, found Friday. The lawsuit was filed by a dozen National Guard soldiers, who accused the defense contractor of "knowingly" exposing them to the carcinogen hexavalent chromium while providing security to civilian workers at the Qarmat Ali water facility in 2003. While the jury found KBR negligent in the case, it did not find that the contractor committed fraud. The total judgment was more than $85 million. Each soldier was awarded $850,000 in noneconomic damages and $6.25 million in punitive damages. "The Oregon Qarmat Ali veterans are very pleased with the verdict," said David Sugarman, one of the attorneys representing the 12 soldiers. KBR attorney Geoffrey Harrison said the company, which was involved in the Iraqi facility's restoration, would appeal. "KBR did safe, professional and exceptional work in Iraq under difficult circumstances -- and multiple U.S. Army officers testified under oath that KBR communicated openly and honestly about potential health risks." In their complaint, the soldiers said they suffer from respiratory and skin ailments as a result of the exposure and "now require ongoing, expensive follow-up health care." U.S. Rep. Earl Blumenauer called the jury's decision "an important milestone." "I've met with these brave soldiers and hearing their ordeal made me heartsick. They have clearly been damaged as a result of their service and negligence on the part of the contractor." CNN's Carma Hassan and Greg Morrison contributed to this report.

NYC sees no homicides for days after Sandy

By NBC News staff Superstorm Sandy has brought its share of calamity and devastation to New York City, since it made landfall in the Northeast on Monday evening. But there's at least one ray of light: There were no homicides over an almost five-day period. New York Police Department Detective Cheryl Crispin confirmed that as of 5 p.m. ET Friday, there had been no homicides in New York City since a reported death at 3:40 a.m. Monday in the 62nd Precinct in Brooklyn. That's unusual in the United States' largest city: In the week of Oct. 15 to Oct. 21 this year, for example, there were five murders, according to the NYPD CompStat Unit. That same week in 2011 saw 13 murders. The homicide rate in New York has been declining in recent decades. In 2011, 515 deaths were classified as homicides, according to city figures. In the Monday incident, a man who had reportedly been beaten by a group of men died at Lutheran Medical Center in New York, WNBC's Jonathan Dienst reported. Four people were arrested. But despite the lull in homicides, Superstorm Sandy was deadly: The U.S. toll has risen to nearly 100. More content from NBCNews.com: Near-freezing cold, potential nor'easter add to misery Some angry over decision to hold New York Marathon Death toll nears 100; 'could be more,' NYC mayor says New York Harbor reopens to offer fuel supply Cops: NYC man pulls pistol after cutting in line for gas Deadliest zone: Staten Island reels from devastation Wind, flames, Our Fathers: The inside story of Breezy Point's terrible night 'We'll figure out a way': Breezy Point looks ahead War veterans hit Sandy's front lines for rescues, cleanup How to avoid post-storm insurance and repair scams New Jersey investigating reports of price gouging Your Sandy photos: Show us the heroes in your life Sandy's aftermath: How you can help Full NBC News coverage of Sandy aftermath Follow US news from NBCNews.com on Twitter and Facebook

US death toll from Sandy surpasses 100

The National Guard, FEMA and the Red Cross, among other agencies, set up camp to help the hard-hit working class community of Staten Island. NBC's Andrea Canning reports. By Miguel Llanos, NBC News Updated 11:20 p.m. ET: The death toll in the United States from Superstorm Sandy rosed to 109 victims on Friday, as Pennsylvania reported four additional deaths and New York City reported two more fatalities. Mayor Michael Bloomberg warned: "There could be more fatalities." Two bodies were recovered Friday on Staten Island. The toll in the nation's largest city is now 41 deaths, according to the governor's office. However, the New York Police Department had reported 40 deaths in the city. Half of the city's deaths were on Staten Island and Bloomberg noted the deaths there of two brothers swept from their mother's arms in the storm surge.  "It just breaks your heart to think about it," Bloomberg said. Besides New York City, the deaths NBC News has confirmed are: New Jersey: 22 Pennsylvania: 12 Maryland: 11 Rest of New York state: 8 West Virginia: 6 Connecticut: 4 Virginia: 2 North Carolina: 2 Puerto Rico: 1 The storm also killed at least 69 people in the Caribbean, including 54 in Haiti and 11 in Cuba.  Tempers flared as people camped out all night, waiting for their turn at the pump in the wake of Superstorm Sandy. NBC's Tom Costello reports. Four days after Sandy struck the U.S., New York and the wider region were in full recovery mode Friday: NYC Marathon: Bloomberg said it was being canceled even though he had earlier defended the decision to hold it Sunday. Gasoline shortages: New York Harbor reopened Friday, providing a critical refueling supply line for the region. But motorists still waited in long lines for gasoline. Manhattan traffic: New York City said it had lifted, as of 5 p.m. ET, the order that vehicles entering Manhattan must have at least three occupants. Shelter, food aid: 5,500 people are still in 15 New York City shelters and some could be out of their homes long term. The city on Thursday gave out 290,000 meals and 500,000 bottles of water at 13 stations. Those deliveries will continue indefinitely. But residents of outlying areas like Staten Island and Coney Island complained aid was little and late. "People are defecating in the hallways," one Coney Island resident without power or water told NBC 4 New York. Damage cost: In New York state alone, the cost could exceed $18 billion, a state official said Friday. Private estimates for the entire region range up to $50 billion in economic losses. N.J. beach homes: Thousands of people were still not allowed to return to their Jersey coast properties due to safety concerns. Gov. Chris Christie said Friday he had his first meeting with the Army Corps of Engineers to work on how and where to rebuild along the shore. Casinos reopen: Atlantic City, N.J., was given the green light to reopen casinos on Friday. Military help: Nearly 7,400 National Guard members have provided support, giving out 144,000 meals in New York City and Long Island, rescuing more than 2,000 people and 200 pets, and clearing debris, the Department of Defense said. Equipment and supplies are being delivered, including: ships to New York City to give first responders a place to rest; millions of meals from West Virginia to New York; and trucks that will deliver about 200,000 gallons of fuel. New Yorkers also got a bit of a scare Friday when police ammo and explosives ruined during the storm were detonated in several controlled explosions on Ellis Island. / Superstorm Sandy made landfall Monday evening on a destructive and deadly path across the Northeast. More content from NBCNews.com: Near-freezing cold, potential nor'easter add to misery New York Harbor reopens to offer fuel supply Cops: NYC man pulls pistol after cutting in line for gas Deadliest zone: Staten Island reels from devastation Wind, flames, Our Fathers: The inside story of Breezy Point's terrible night 'We'll figure out a way': Breezy Point looks ahead War veterans hit Sandy's front lines for rescues, cleanup How to avoid post-storm insurance and repair scams Your Sandy photos: Show us the heroes in your life Sandy's aftermath: How you can help Full NBC News coverage of Sandy aftermath Follow US news from NBCNews.com on Twitter and Facebook

'I'm independent, not undecided'

38% of Americans identify themselves as independents, according to a 2012 study CNN iReport asked independents why they refuse to align with a party Not wanting to be labeled and disgust with political rancor were popular reasons (CNN) -- As he watched the presidential debates, Bretton Holmes was irritated. But it wasn't the candidates who were getting to him, it was hearing independent voters and undecided voters lumped into the same group. The 35-year-old from Phoenix has registered as an independent since he was 18. He has voted for Democrats and Republicans over the years. The biggest misconception he hears is this: "If you're registered as an independent, that must mean you're undecided," he said. "That's just an opinion that happens to be very incorrect," he said. "Being independent has nothing to do with being undecided." Living in a two-party country can be tough for this group of voters, but there are more independents these days than ever. Thirty-eight percent of Americans identify themselves as independents, according to a 2012 study on party identification by the Pew Research Center for the People & the Press. "The proportion of independents now equals its highest level in 70 years," said a different Pew study from 2009. "Owing to defections from the Republican Party, independents are more conservative on several key issues than in the past." Being called an undecided voter irks "independent thinker" Holmes, as he already has made his decision. "In my case, it was already clear who I wanted to vote for," he said. He cast an early ballot for President Barack Obama. CNN asked independents why they refuse to align with a party and heard from more than 100 people. A variety of themes arose, from not wanting to be labeled to disgust with political rancor to feeling that being independent is the "spirit of America." 'I don't like being labeled' Omekongo Dibinga of Washington has consistently voted Democrat but explains that he's always identified himself as an independent. He's never voted for a Republican because "I haven't agreed with any of the candidates' values, but I reserve the right to vote for a Republican if their values match mine," he said. Growing up in an impoverished neighborhood in Boston where "violence was a problem," Dibinga faced stereotypes that he has worked to overcome as a diversity consultant and motivational speaker. "I don't like being labeled. I've been labeled a lot of things in my life," he said. Jennifer Cummins, a moderate independent, has a similar problem with siding with just one party. "It's mostly the label," she said. "If you say you're a Democrat, that must mean you are a left-wing liberal with no personal responsibility. If you say you are a Republican, you must be a right-wing millionaire who doesn't care about others." The Frankfort, Kentucky, voter feels a "lack of respect" toward independents like her and wishes there was more air time given to independent candidates. "I think it's a travesty that the only 'limelight' that exists is with either Republican or Democratic when there are other options on the ballot with better opinions, much better track records, and a real solution," she said. Voting for the 'lesser of two evils' Roger Cantillo, 37, identified more with the Democratic Party when he was younger, but he started considering himself an independent in 2008. "The 2008 presidential race is when I really started getting involved in politics and trying to understand what's going on in Washington. It's just unfortunate that there's a lot of gridlock, and people are playing both sides," he said. In the last few elections, he voted for Republican George W. Bush, Democrat John Kerry and, most recently, Obama. While Cantillo's "progressive values" indicate he leans more to the left, Cantillo said he finds faults with both parties. He will be voting for Obama on Election Day, but he's not enthusiastic about it. "I'm picking the lesser of two evils come this election." It's the 'spirit of America' Raised as a Southern Democrat who switched to voting Republican in 1999, Mary Helen Yarborough has voted for presidential candidates from both parties equally. She has identified as a "confused" independent for 10 years, she said. GOP presidential candidates Rick Perry and Newt Gingrich excited the right-leaning independent in the primaries, and she "flirted" with the idea of voting for Obama back in July. Ultimately, she says, her vote will go to Mitt Romney next week. But the opinionated South Carolinian doesn't want to be tied down to a party. "I don't want to be controlled," she said. "I feel better as an independent. I feel like it's a more honest position." Voting independent just feels "more American," she said. "America was born on the theme of independence, and I find that being a committed independent is therefore truer to our national pride." Betty Faller-Pearson, 66, voted for Obama in 2008 and Bush in 2004. She agrees with Yarborough's line of thinking. "I don't vote party lines because I don't always agree with either party, Democrats or Republicans," she said. "I'm not liberal, I'm not conservative. I'm independent and can make my own decisions." For the Las Vegas resident, being an independent goes back to America's roots. "I am an independent voter because I believe in the spirit of America and how and why it was founded," she said. Raised Republican in Texas and now married to a Democrat from New Jersey, Jim Mitchem's flavor of independence stems from a similar tree. "I've never been one for dogma and don't feel like any 'side' could represent my free will well enough to go straight ticket," he said. The 44-year-old has voted for Ronald Reagan, Bush, Ross Perot (twice), Al Gore and Obama. He said it's "too restricting" to affiliate with one party. "In the spirit of independence by Americans who broke away from political dogma in the 1700s, I'm proud to be unaffiliated." Lost between parties Brian Pigg confesses he feels "lost" politically. Growing up in the Reagan era, the 44-year-old holds the Republican beliefs of smaller government and fiscal responsibility, he said. As a veteran, he supports having a strong military. But his concerns with the increasing U.S. debt and George W. Bush's presidency made him reconsider the way he voted, he said. "Years ago, I began to feel disowned by my party, as this debt didn't start in '08 (not that it isn't getting worse)," he wrote on CNN iReport. The "rise of the religious right" was the final straw. What's a man without a party to do? At first he thought about abstaining from voting. "I haven't heard a single candidate worth voting for, not in local, state, or federal elections," he said. "They all seem to say whatever they think will get them votes without actually being nailed to anything." The Grandview, Missouri, resident admits he wasn't going to vote at all this year until controversy arose around U.S. Senate candidate Todd Akin's comments on rape. "Now I'm going just to vote against him. How sad is that," he asked. Be 'free thinkers' But Holmes, the voter who emphasized the difference between independents and undecideds, asserts that voting as "free thinkers" is the answer. "Everyone has the ability to think for themselves and question what other people are saying if they don't think it's right," he said. "Speak up!"

Hawaii's magic Election Day number

Based on 2008 numbers, Hawaii needs 11,466 new voters to jump out of last place The state had the lowest voter turnout in 2008, making it the subject of a CNN series CNN's Change the List hopes to try to increase voter turnout in the islands John Sutter: New get-out-the-vote efforts could lead to increased participation (CNN) -- 11,466. That's Hawaii's magic number on Election Day. If voter turnout stayed exactly as it did in 2008 (impossible, I know, but hear me out) then 11,000-some new voters would push the Aloha State out of last place for voter participation. Watch out West Virginia, Hawaii is coming for you. If 11,466 more people voted in the presidential election in Hawaii, then the state's turnout rate would hit 50% of the eligible population, based on numbers compiled by George Mason University's Michael McDonald on a site called the United States Election Project. That would push Hawaii past West Virginia, which had a 49.9% turnout. That's a lot of numbers, I know. And there are plenty of caveats, since turnout obviously won't be the same as it was, thanks to Superstorm Sandy and a host of other factors. But my takeaway is this: Hawaii is really close. That's an attainable goal. For the past few weeks, I've been working on a new CNN project called Change the List that's focused, at the moment, on boosting Hawaii's lowest-of-the-low voter turnout rate. It's not that I don't love West Virginia and the other 49 states, too, but I'm also a sucker for an underdog story. When it comes to voting, Hawaii's story is just that. Shortly after statehood in 1959, more than 90% of the state's eligible voters cast ballots. In 2008, with Hawaii's own Barack Obama on the ticket, fewer than half of eligible people voted. When I traveled to the Aloha State to talk to nonvoters, I met people who didn't know the election was coming up in November, those who feel like their votes don't matter because they're so far (in distance and psychology) from "the mainland," and those who don't want to participate in a political system that values conflict over compromise. I can't help but think that our national politics -- bogged down in money and aggression -- could use a healthy dose of the Aloha Vote. Hawaii's voice should finally be heard. Here are a few reasons for optimism on this front: 1. Kanu Hawaii: This volunteer group, whose name means "to plant" in Hawaiian, has been working this year to register new voters and engage communities that typically have been left out of the political conversation. As of last month, the group had registered 2,397 new voters and knocked on 789 doors asking people to vote. If all of those new registered voters actually go to the polls (if that's you, do it!) then the contest is already 20% taken care of, thanks to the work of 40 Kanu volunteers. 2. Close races and big issues: It's a generally held belief in the world of voter-turnout-ology that competitive elections tend to drive up turnout. Nationally, the presidential election could hardly be closer -- and the candidates are as different as Gaga and Taylor. But it's the local and state races that will really push people to the polls in Hawaii. Ask just about anyone on Oahu what his or her top political issue is and they'll likely say one word: "rail." A commuter-rail project has become the divisive topic of the Honolulu mayor's race, and both sides are quite polarize d. A Civil Beat poll shows the race is very much up for grabs, with Ben Cayetano, the anti-rail candidate, leading Kirk Caldwell 50% to 45%. "A lot of it is going to come down to turnout," a pollster told the news site. 3. The surf: Before I left for Hawaii, a state representative, Angus McKelvey, gave one very Hawaii-specific reason for the state's low turnout: surf. When the surf's up, he said, people won't go to the polls. The theory is a little wacky, of course, but even if it's true, there will be better surf in Hawaii on Monday than Tuesday, Election Day, said Gary Kewley, "chief surfing officer" of the Surf News Network. "Most people only surf on average for an hour and a half to 2 1/2 hours," he told me by phone. "That leaves plenty of time to go to the voting booth. " Waves on Monday are expected to crest at 15 feet. Tuesday, they'll still be big, but more in the 8-foot range. By the way, Kewley votes. 4. The conversation: Take this with a grain of salt, but it seems from where I'm sitting (far-far away, in Atlanta) that lots of people in Hawaii are talking about voting this year. Maybe it's the people I chat with, like Nani Teruya, in Maui, who told me that her phone has been ringing off the hook (she described this phenomenon as the phone having "diarrhea") since she was featured on CNN.com as one of six nonvoters in Hawaii. And then there's the news coverage. TV stations and newspapers in Hawaii have been talking about Hawaii's low level of voter participation in recent weeks. All of this chatter has to help raise awareness about an important election. On my trip, I learned that one reason people don't vote is that they've never been asked to participate. I hope the state of Hawaii feels a collective plea from those of us on the mainland to vote this year. Of course, none of this is up to me. It's up to people in Hawaii to go to the polls -- even if they never have before. If everyone in the state encouraged a few of their friends to vote, the list certainly would be changed. Just look at what Kanu has done with only 40 volunteers. If you want to help keep the conversation going, here are two small things you can do: Share this "Mahalo for Voting" image on Facebook or Tumblr and do the same with this "11,466" image. It's a small thing, sure, bu t a reminder that this goal is in reach. The opinions expressed in this commentary are solely those of John D. Sutter.

Why health reform key for minorities

Debra Houry and Sheryl Heron say minorities have less access to health care and will be helped by the Affordable Care Act. Houry, Heron: If Romney wins, ends health reform, minorities especially affected They say people of color are a third of U.S. population, account for nearly half of uninsured They say more in low-paying jobs that don't offer insurance; tend to delay care due to cost Writers: If reform repealed, there will be more illness, expense. A healthy nation prospers Editor's note: Dr. Debra Houry is vice chair in emergency medicine at Emory University Hospital and immediate past president for the Society for Academic Emergency Medicine. Dr. Sheryl Heron is an associate professor in emergency medicine at Emory and founding chair for the Academy of Diversity and Inclusion in Emergency Medicine. (CNN) -- When the Affordable Care Act, signed into law in 2010, is fully implemented, many of the disparities that have plagued the nation's health care system will significantly lessen. Even so, ensuring that all Americans have adequate access to health care remains a major issue in the election campaign, and may prove to be far from a settled matter. This is because both President Obama and Mitt Romney agree that insurance is unaffordable for many families and small businesses, but they differ on solutions. If Mitt Romney is elected, he has said he would repeal the act. Become a fan of CNNOpinion Stay up to date on the latest opinion, analysis and conversations through social media. Join us at Facebook/CNNOpinion and follow us @CNNOpinion on Twitter. We welcome your ideas and comments. This would likely mean that adequate health care would remain unavailable to many, particularly minorities. Nearly half of Americans are insured through their jobs. This includes members of Congress, who enjoy great health plans with low premium payments. For everyone else without such coverage, whether to purchase health insurance is not a black and white decision. Rather, it's a black and white difference. Broken down by race, the disparity is even more startling. About half of whites are covered through an employer-sponsored health plan, in contrast to the rate for African-Americans (38%) and Hispanics (28%). Why? Many minorities have lower-paying jobs that do not offer health insurance, and because of the high cost of self-insuring, they choose not to purchase coverage. This leaves one out of every three Hispanics and one out of every five African-Americans without insurance. Of course, the uninsured can access the emergency room for care, as Romney has argued. We know that people without insurance use emergency departments much more frequently, and for less urgent issues, than those with health insurance. Yet the reality is that low-income communities and those with higher minority populations have more hospital closures in their area compared with higher-income communities. As a result, access to emergency rooms for many minorities can be problematic, because they have to commute longer distances to reach the hospital. As emergency physicians at one of the largest public hospitals in the country, we see firsthand how the lack of insurance and then access to a regular health care provider affects our patients, from the middle-aged black man with a stroke from uncontrolled and undiagnosed high blood pressure to the young black woman with breast cancer who chose to use her money to feed her children rather than seek health care. Uninsured patients with diabetes and high blood pressure generally have more complications from these chronic illnesses than insured patients, resulting in prolonged hospital stays. Without an overhaul of our health care system, we will continue to see disproportionately more preventable deaths and disabilities among the uninsured minority population. How your vote affects your health care Doctor: U.S. health care not working Waiting for Obamacare Replacing Obamacare A national survey found that African-Americans and Hispanics were more likely than whites to lack a regular provider, regardless of insurance status, and that the disparity was even worse without insurance. A specific example of how this disparity plays out is with breast cancer. Black women are more likely to be diagnosed with larger, more aggressive tumors. Moreover, uninsured women are four times more likely to have widespread cancer compared with those with private insurance. To be sure, if everyone had some sort of health insurance, many of these disparities would be reduced. A recent study in the New England Journal of Medicine reported that Medicaid expansions were associated with a reduction in mortality in older adults, nonwhites and residents of poorer counties. However, half of physicians in a national poll said they had stopped accepting or were limiting the number of Medicaid beneficiaries they will see because of low reimbursement payments. Currently, 27% of blacks and Hispanics are Medicaid recipients, compared with approximately 11% of whites. A concerted and drastic improvement is needed in both access to care and adequate insurance coverage for all. We must ensure that everyone in the United States has the same opportunity to receive the health care they need. As the Affordable Care Act is implemented, greater health care coverage and access to health care will be cost effective over the long term. If it is repealed, we will see increased rates of illnesses and added expenses, particularly in underserved populations. A healthy nation is a productive nation. The opinions expressed in this country are solely those of the authors.